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Sample records for acute physiology scores

  1. Validation of the Simplified Acute Physiology Score 3 Scoring System in a Korean Intensive Care Unit

    Lim, So Yeon; Ham, Cho Rom; Park, So Young; Kim, Suhyun; Park, Maeng Real; Jeon, Kyeongman; Um, Sang-Won; Chung, Man Pyo; Kim, Hojoong; Kwon, O Jung; Suh, Gee Young

    2010-01-01

    Purpose The Simplified Acute Physiology Score (SAPS) 3 was recently proposed to reflect contemporary changes in intensive care practices. SAPS 3 features customized equations for the prediction of mortality in different geographic regions. However, the usefulness of SAPS 3 and its customized equation (Australasia SAPS 3) have never been externally validated in Korea. This study was designed to validate SAPS 3 and Australasia SAPS 3 for mortality prediction in Korea. Materials and Methods A re...

  2. A simplified acute physiology score in the prediction of acute aluminum phosphide poisoning outcome

    Shahin Shadnia

    2010-01-01

    Full Text Available Background : Aluminum phosphide (AlP is used as a fumigant. It produces phosphine gas, which is a mitochondrial poison. Unfortunately, there is no known antidote for AlP intoxication, and also, there are few data about its prognostic factors. AIMS: The aim of this study was to determine the impact of the Simplified Acute Physiology Score II (SAPS II in the prediction of outcome in patients with acute AlP poisoning requiring admission to the Intensive Care Unit (ICU. Materials and Methods : This was a prospective study in patients with acute AlP poisoning, admitted to the ICU over a period of 12 months. The demographic data were collected and SAPSII was recorded. The patients were divided into survival and non-survival groups due to outcome. Statistical Analysis : The data were expressed as mean ± SD for continuous or discrete variables and as frequency and percentage for categorical variables. The results were compared between the two groups using SPSS software. Results : During the study period, 39 subjects were admitted to the ICU with acute AlP poisoning. All 39 patients required endotracheal intubation and mechanical ventilation in addition to gastric decontamination with sodium bicarbonate, permanganate potassium, and activated charcoal, therapy with MgSO 4 and calcium gluconate and adequate hydration. Among these patients, 26 (66.7% died. SAPSII was significantly higher in the non-survival group than in the survival group (11.88 ± 4.22 vs. 4.31 ± 2.06, respectively (P < 0.001. Conclusion : SAPSII calculated within the first 24 hours was recognized as a good prognostic indicator among patients with acute AlP poisoning requiring ICU admission.

  3. Magnetic resonance imaging versus Acute Physiology And Chronic Healthy Evaluation II score in predicting the severity of acute pancreatitis

    Objective: To study the correlation between established magnetic resonance (MR) imaging criteria of disease severity in acute pancreatitis and the Acute Physiology And Chronic Healthy Evaluation II (APACHE II) score, and to assess the utility of each prognostic indicators in acute pancreatitis. Materials and methods: In this study there were 94 patients with acute pancreatitis (AP), all had abdominal MR imaging. MR findings were categorized into edematous and necrotizing AP and graded according to the MR severity index (MRSI). The APACHE II score was calculated within 24 h of admission, and local complications, death, duration of hospitalization and ICU were recorded. Statistical analysis was performed to determine their correlation. Results: In patients with pancreatitis, no significant correlation can be found between the APACHE II score and the MRSI score (P = 0.196). The MRSI score correlated well with morbidity (P = 0.006) but not with mortality (P = 0.137). The APACHE II score correlated well with mortality (P = 0.002) but not with the morbidity (P = 0.112). The MRSI score was superior to the APACHE II score as a predictor of the length of hospitalization (r = 0.52 vs. r = 0.35). A high MRSI and APACHE II score correlated with the need for being in the intensive care unit (ICU) (P = 0.000 and P = 0.000, respectively). Conclusion: In patients with pancreatitis, MRSI is superior to APACHE II in assessing local complications from pancreatitis but has a limited role in determining systemic complications in which the APACHE II score excels.

  4. MRI versus acute physiology and chronic healthy evaluation Ⅲ score for the assessment of the severity of acute pancreatitis

    Objective: To study the severity of acute pancreatitis (AP) by using MRI and the acute physiology and chronic healthy evaluation Ⅲ (APACHE Ⅲ) score, and the correlation between corresponding MRI findings and APACHE Ⅲ scores. Methods: One hundred patients with AP undergoing abdominal MRI were recruited in the study. The MRI features of acute pancreatitis were recorded. The severity of AP on MRI was graded by MR severity index (MRSI) as mild (0 to 2 points), moderate (3 to 6 points) and severe (7 to 10 points). APACHE Ⅲ score was denoted for AP was as mild (< 35 points) and severe (≥ 35 points). The local and systematic complications,mortality, need to intense care unit (ICU), and hospitalization time were recorded and compared with MRSI and APACHE Ⅲ score. Nonparametric Spearman correlation was calculated for testing the correlation between the MRSI, the APACHE Ⅲ and hospitalization time. The correlation of clinical results with MRSI and APACHE Ⅲ was calculated by χ2 test. Results: In the 100 patients with AP,there were respectively 80 and 20 patients with edematous and necrotic pancreatitis on MRI. According to MRSI, 34, 59 and 7 patients had mild, moderate, and severe acute pancreatitis,respectively. The APACHE Ⅲ score was (24.9 ± 12.2) points. Seventy-seven patients had less than 35 points and 23 patients had more than 35 point of APACHE Ⅲ score. There were significant differences in the local complication, systematic complication, need to ICU among the three groups in MRSI score, respectively (χ2=9.161, 19.118, 54.767; P<0.01). There was difference in the systematic complication between mild and severe AP in APACHE Ⅲ score (χ2=13.120, P=0.000), but there were no differences (χ2=0.245, χ2=2.568; P>0.05) in the local complication,need to ICU between mild and severe AP in APACHE Ⅲ score. There was weak correlation (r=0.235, P=0.019) between MRSI score and hospitalization time,and no difference (r=0.168, 0.105; P>0.05) between APACHE

  5. Mapping physicians' admission diagnoses to structured concepts towards fully automatic calculation of acute physiology and chronic health evaluation score

    Chandra, Subhash; Kashyap, Rahul; Trillo-Alvarez, Cesar A; Tsapenko, Mykola; Yilmaz, Murat; Hanson, Andrew C.; Pickering, Brian W.; Gajic, Ognjen; Vitaly HERASEVICH

    2011-01-01

    Objective Acute Physiology and Chronic Health Evaluation (APACHE) is most widely used as a mortality prediction score in US intensive care units (ICUs), but its calculation is onerous. The authors aimed to develop and validate automatic mapping of physicians' admission diagnoses to structured concepts for automated APACHE IV calculation. Methods This retrospective study was conducted in medical ICUs of a tertiary healthcare and academic centre. Boolean-logic text searches were used to map adm...

  6. Initial Sequential Organ Failure Assessment score versus Simplified Acute Physiology score to analyze multiple organ dysfunction in infectious diseases in Intensive Care Unit

    Remyasri Nair

    2016-01-01

    Full Text Available Aims: To investigate initial Sequential Organ Failure Assessment (SOFA score of patients in Intensive Care Unit (ICU, who were diagnosed with infectious disease, as an indicator of multiple organ dysfunction and to examine if initial SOFA score is a better mortality predictor compared to Simplified Acute Physiology Score (SAPS. Materials and Methods: Hospital-based study done in medical ICU, from June to September 2014 with a sample size of 48. Patients aged 18 years and above, diagnosed with infectious disease were included. Patients with history of chronic illness (renal/hepatic/pulmonary/  cardiovascular, diabetes, hypertension, chronic obstructive pulmonary disease, heart disease, those on immunosuppressive therapy/chemoradiotherapy for malignancy and patients in immunocompromised state were excluded. Blood investigations were obtained. Six organ dysfunctions were assessed using initial SOFA score and graded from 0 to 4. SAPS was calculated as the sum of points assigned to each of the 17 variables (12 physiological, age, type of admission, and three underlying diseases. The outcome measure was survival status at ICU discharge. Results: We categorized infectious diseases into dengue fever, leptospirosis, malaria, respiratory tract infections, and others which included undiagnosed febrile illness, meningitis, urinary tract infection and gastroenteritis. Initial SOFA score was both sensitive and specific; SAPS lacked sensitivity. We found no significant association between age and survival status. Both SAPS and initial SOFA score were found to be statistically significant as mortality predictors. There is significant association of initial SOFA score in analyzing organ dysfunction in infectious diseases (P < 0.001. SAPS showed no statistical significance. There was statistically significant (P = 0.015 percentage of nonsurvivors with moderate and severe dysfunction, based on SOFA score. Nonsurvivors had higher SAPS but was not statistically

  7. Initial Sequential Organ Failure Assessment score versus Simplified Acute Physiology score to analyze multiple organ dysfunction in infectious diseases in Intensive Care Unit

    Nair, Remyasri; Bhandary, Nithish M.; D’Souza, Ashton D.

    2016-01-01

    Aims: To investigate initial Sequential Organ Failure Assessment (SOFA) score of patients in Intensive Care Unit (ICU), who were diagnosed with infectious disease, as an indicator of multiple organ dysfunction and to examine if initial SOFA score is a better mortality predictor compared to Simplified Acute Physiology Score (SAPS). Materials and Methods: Hospital-based study done in medical ICU, from June to September 2014 with a sample size of 48. Patients aged 18 years and above, diagnosed with infectious disease were included. Patients with history of chronic illness (renal/hepatic/pulmonary/  cardiovascular), diabetes, hypertension, chronic obstructive pulmonary disease, heart disease, those on immunosuppressive therapy/chemoradiotherapy for malignancy and patients in immunocompromised state were excluded. Blood investigations were obtained. Six organ dysfunctions were assessed using initial SOFA score and graded from 0 to 4. SAPS was calculated as the sum of points assigned to each of the 17 variables (12 physiological, age, type of admission, and three underlying diseases). The outcome measure was survival status at ICU discharge. Results: We categorized infectious diseases into dengue fever, leptospirosis, malaria, respiratory tract infections, and others which included undiagnosed febrile illness, meningitis, urinary tract infection and gastroenteritis. Initial SOFA score was both sensitive and specific; SAPS lacked sensitivity. We found no significant association between age and survival status. Both SAPS and initial SOFA score were found to be statistically significant as mortality predictors. There is significant association of initial SOFA score in analyzing organ dysfunction in infectious diseases (P < 0.001). SAPS showed no statistical significance. There was statistically significant (P = 0.015) percentage of nonsurvivors with moderate and severe dysfunction, based on SOFA score. Nonsurvivors had higher SAPS but was not statistically significant (P

  8. The Modified Early Warning Score (MEWS: An Instant Physiological Prognostic Indicator of Poor Outcome in Acute Pancreatitis

    Aravind Suppiah

    2014-11-01

    Full Text Available Context The Modified Early Warning Score (MEWS is a bedside scoring system that is non-invasive, simple and repeatable to reflect dynamic changes in physiological state. Objective This study aims to assess accuracy of MEWS and determine an optimal MEWS value in predicting severity in acute pancreatitis (AP. Methods A prospective database of consecutive admissions with AP to a single institution was analysed to determine value of MEWS in identifying severe acute pancreatitis (SAP and predicting poor outcome. Receiver operator curves (ROC were used to determine optimal accuracy. Sensitivity, specificity, negative predictive value (NPV, and positive predictive values (PPV were calculated for the optimal MEWS values obtained. Results One-hundred and 42 patients with AP were included. The optimal highest MEWS per 24 hours period (hMEWS and mean MEWS per 24 hour period (mMEWS in predicting SAP as determined by ROC were 2.5 and 1.625 respectively; with hMEWS ≥3 and mMEWS > 1 utilised in this cohort as MEWS scores are whole numbers. Onadmission, sensitivity, specificity, NPV, PPV, and accuracy of hMEWS ≥3 was 95.5%, 90.8%, 99%, 65.6% & 92%; and for mMWES > 1 was 95.5%, 87.5%, 99%, 58.3% & 88.7%, both superior than the Imrie score: 31.5%, 92.1%, 88.9%, 40% and 83.5%. The accuracy of hMEWS ≥3 and mMEWS > 1 increased over the subsequent 72 hours (days 0-2 from 92 to 96%, and 89% to 94% respectively. Conclusions MEWS provides a novel, easy, instant, repeatable, reliable prognostic score that may be superior to existing scoring systems. A larger cohort is required to validate these findings.

  9. Stroke mortality: predictive value of simple laboratory tests and acute physiology, age, chronic health evaluation III scoring system: a hospital based study

    Ajeet K. Chaurasia; Manoj K. Mathur; N C Dwivedi; Manjul Mishra

    2016-01-01

    Background: Acute stroke is a heterogeneous condition with respect to prognosis. This study was undertaken with the aim to evaluate the significance of routine simple blood parameters and APACHE (acute physiology, age, chronic health evaluation) III scoring system as methods of prediction of 1-month mortality in stroke patients and to assess the sensitivity and specificity of APACHE III scoring system in predicting short term outcome in critically ill patients having stroke. Methods: Patie...

  10. Increased Resistin Levels in Intra-abdominal Sepsis: Correlation with proinflammatory cytokines & Acute Physiology & Chronic Health Evaluation II scores

    Tonguç U. Yilmaz

    2014-10-01

    Full Text Available Objectives: Resistin, a hormone secreted from adipocytes and considered to be a likely cause of insulin resistance, has recently been accepted as a proinflammatory cytokine. This study aimed to determine the correlation between resistin levels in patients with intra-abdominal sepsis and mortality. Methods: Of 45 patients with intraabdominal sepsis, a total of 35 adult patients were included in the study. This study was undertaken from December 2011 to December 2012 and included patients who had no history of diabetes mellitus and who were admitted to the general surgery intensive care units of Gazi University and Bülent Ecevit University School of Medicine, Turkey. Evaluations were performed on 12 patients with sepsis, 10 patients with severe sepsis, 13 patients with septic shock and 15 healthy controls. The patients’ plasma resistin, interleukin-6 (IL-6, tumour necrosis factor alpha (TNF-α, interleukin-1 beta (IL-1β, procalcitonin, lactate and glucose levels and Acute Physiology and Chronic Health Evaluation (APACHE II scores were studied daily for the first five days after admission. A correlation analysis of serum resistin levels with cytokine levels and APACHE II scores was performed. Results: Serum resistin levels in patients with sepsis were significantly higher than in the healthy controls (P <0.001. A significant correlation was found between serum resistin levels and APACHE II scores, serum IL-6, IL-1β, TNF-α, procalcitonin, lactate and glucose levels. Furthermore, a significant correlation was found between serum resistin levels and all-cause mortality (P = 0.02. Conclusion: The levels of resistin were significantly positively correlated with the severity of disease and were a possible mediator of a prolonged inflammatory state in patients with intra-abdominal sepsis.

  11. Comparison of acute physiology and chronic health evaluation II and Glasgow Coma Score in predicting the outcomes of Post Anesthesia Care Unit′s patients

    Mohammad Hosseini

    2015-01-01

    Full Text Available Context: Acute physiology and chronic health evaluation II (APACHE II is one of the most general classification systems of disease severity in Intensive Care Units and Glasgow Coma Score (GCS is one of the most specific ones. Aims: The aim of the current study was to assess APACHE II and GCS ability in predicting the outcomes (survivors, non-survivors in the Post Anesthesia Care Unit′s (PACU. Settings and Design: This was an observational and prospective study of 150 consecutive patients admitted in the PACU during 6-month period. Materials and Methods: Demographic information recorded on a checklist, also information about severity of disease calculated based on APACHE II scoring system in the first admission 24 h and GCS scale. Statistical Analysis Used: Logistic regression, Hosmer-Lemeshow test and receiver operator characteristic (ROC curves were used in statistical analysis (95% confidence interval. Results: Data analysis showed a significant statistical difference between outcomes and both APACHE II and Glasgow Coma Score (GCS (P < 0.0001. The ROC-curve analysis suggested that the predictive ability of GCS is slightly better than APACHE II in this study. For GCS the area under the ROC curve was 86.1% (standard error [SE]: 3.8%, and for APACHE II it was 85.7% (SE: 3.5%, also the Hosmer-Lemeshow statistic revealed better calibration for GCS (χ2 = 5.177, P = 0.521, than APACHE II (χ2 = 10.203, P = 0.251. Conclusions: The survivors had significantly lower APACHE II and higher GCS compared with non-survivors, also GCS showed more predictive accuracy than APACHE II in prognosticating the outcomes in PACU.

  12. Retrospective study on prognostic importance of serum procalcitonin and amino - terminal pro - brain natriuretic peptide levels as compared to Acute Physiology and Chronic Health Evaluation IV Score on Intensive Care Unit admission, in a mixed Intensive Care Unit population

    Chitra Mehta; Babita Dara; Yatin Mehta; Tariq, Ali M.; George V Joby; Singh, Manish K

    2016-01-01

    Background: Timely decision making in Intensive Care Unit (ICU) is very essential to improve the outcome of critically sick patients. Conventional scores like Acute Physiology and Chronic Health Evaluation (APACHE IV) are quite cumbersome with calculations and take minimum 24 hours. Procalcitonin has shown to have prognostic value in ICU/Emergency department (ED) in disease states like pneumonia, sepsis etc. NTproBNP has demonstrated excellent diagnostic and prognostic importance in cardiac d...

  13. USEFULNESS OF SEQUENTIAL ORGAN FAILURE ASSESSMENT (SOFA AND ACUTE PHYSIOLOGY AND CHRONIC HEALTH EVALUATION II (APACHE II SCORE IN ANALYSING PATIENTS WITH MULTIPLE ORGAN DYSFUNCTION SYNDROME IN SEPSIS

    Abhinandan

    2013-12-01

    Full Text Available Sepsis with multiple organ dysfunction syndrome (MODS is a common cause of Intensive Care Unit (ICU mortality and morbidity. Early initiation of appro priate effective antimicrobial therapy is essential for a favorable outcome in the patient with sepsis. Cultures and serology are available only after 24 to 48 hours. In the crucial hours which determine the prognosis of the patient the physician has to de pend on clinical symptoms and demographic data to aid in diagnosis and management. Using scores like APACHE II at the admission and SOFA on admission and also in their due course may help in predicting outcome. Though there are some studies on sepsis in In dia but use of APACHE II and SOFA scores in India have been rare. OBJECTIVES: To assess morbidity and mortality of patients with multi - organ dysfunction syndrome in sepsis. To prognosticate the patients by using defined scores like SOFA and APACHE II score s. MATERIALS AND METHODS: The study was carried out in the period of November 2010 to September 2012 and 50 patients were included in the study. The detailed history, clinical examination and all the relevant laboratory investigations were done including b lood culture. In the present study the conditions were defined according to standard practice and based on relevant literature. All the patients of sepsis admitted to ICU/ emergency ward were prognosticated on the basis of APACHE II score and SOFA score. W e have analysed various profiles between two groups; survivor group which include the patients who are successfully discharged after recovery and non - survivor group which include the patients who died. RESULTS: The clinical profile of 50 patients with seps is with MODS was studied. There were 28 males and 22 females in this cohort. In this study, 18 patients died and 32 patients survived with mortality rate of 36%. In this study, though APACHE II score was high among non survivors than survivors (23.28 v/s 1 8.75, it was of just

  14. Retrospective study on prognostic importance of serum procalcitonin and amino - terminal pro - brain natriuretic peptide levels as compared to Acute Physiology and Chronic Health Evaluation IV Score on Intensive Care Unit admission, in a mixed Intensive Care Unit population

    Chitra Mehta

    2016-01-01

    Full Text Available Background: Timely decision making in Intensive Care Unit (ICU is very essential to improve the outcome of critically sick patients. Conventional scores like Acute Physiology and Chronic Health Evaluation (APACHE IV are quite cumbersome with calculations and take minimum 24 hours. Procalcitonin has shown to have prognostic value in ICU/Emergency department (ED in disease states like pneumonia, sepsis etc. NTproBNP has demonstrated excellent diagnostic and prognostic importance in cardiac diseases. It has also been found elevated in non-cardiac diseases. We chose to study the prognostic utility of these markers on ICU admission. Settings and Design: Retrospective observational study. Materials and Methods: A Retrospective analysis of 100 eligible patients was done who had undergone PCT and NTproBNP measurements on ICU admission. Their correlations with all cause mortality, length of hospital stay, need for ventilator support, need for vasopressors were performed. Results: Among 100 randomly selected ICU patients, 28 were non-survivors. NTproBNP values on admission significantly correlated with all cause mortality (P = 0.036, AUC = 0.643 and morbidity (P = 0.000, AUC = 0.763, comparable to that of APACHE-IV score. PCT values on admission did not show significant association with mortality, but correlated well with morbidity and prolonged hospital length of stay (AUC = 0.616, P = 0.045. Conclusion: The current study demonstrated a good predictive value of NTproBNP, in terms of mortality and morbidity comparable to that of APACHE-IV score. Procalcitonin, however, was found to have doubtful prognostic importance. These findings need to be confirmed in a prospective larger study.

  15. 简化急性生理学评分Ⅲ与其他评分方法对急诊严重脓毒症患者28 d死亡的预测能力比较%Comparison of simplified acute physiology score Ⅲ and other scoring systems in prediction of 28-day ;prognosis in patients with severe sepsis

    李岩; 李春盛

    2015-01-01

    SAPSⅡ评分预测能力相当,可用于对急诊ICU严重脓毒症患者的预后进行预测,但SAPSⅢ评分有不适合预测急诊ICU脓毒症患者预后的选项,导致SAPSⅢ评分在预测急诊ICU脓毒症患者的预后方面并未优于其他评分。%Objective To investigate the power of the simplified acute physiology score Ⅲ ( SAPSⅢ) for prediction of outcome for patients with severe sepsis admitted to the intensive care unit ( ICU ). Methods A retrospective study was conducted. 677 severe sepsis patients with age ≥ 18 years old and the survival time in emergency ICU≥24 hours admitted to the emergency ICU of Beijing Chaoyang Hospital Affiliated to Capital Medical University from January 2008 to December 2011 were enrolled. The acute physiology and chronic health evaluationⅡ ( APACHEⅡ), sequential organ failure assessment ( SOFA ), SAPSⅡ, SAPSⅢ, and mortality in emergency department sepsis ( MEDS ) scores were recorded based on the poorest value within 24 hours of ICU admission. The 28-day result as denoted as survival or death was considered as the end point of the study. The ability to predict mortality by the score systems was assessed by using receiver operating characteristic ( ROC ) curve analysis and binary logistic regression models. Results Among the 677 patients with severe sepsis, 284 cases died within 28 days after admission, and the mortality rate was 41.9%. Compared with survivors, the patients in non-survival group was older with higher APACHEⅡ, SOFA, SAPSⅡ, SAPSⅢ, and MEDS scores and higher ratio of underlying diseases, such as primary hypertension and renal dysfunction, and they had more organ injury, higher ratio of lung infection and bacterial infection ( P 0.05 ). The MEDS score in predicting the prognosis was obviously better than that of APACHEⅡ, SOFA, SAPSⅡ, and SAPSⅢscores ( all P<0.05 ). The MEDS score showed the best sensitivity ( 91.5%), and specificity ( 89.1%). The 28-day mortality in cases

  16. ACUTE NORMOVOLEMIC ANEMIA: PHYSIOLOGICAL AND PRACTICAL CONCERNS

    P. Van der Linden

    2007-07-01

    Full Text Available The adequacy of a hemoglobin concentration in a given clinical situation depends on whether a sufficient amount of oxygen is carried to the tissues to meet metabolic requirements. Therefore, the decision to transfuse a given patient cannot be based only on the hemoglobin level. Rather, rigid adherence to an arbitrarily predefined transfusion threshold will result in the over-transfusion of some patients, but also in the under-transfusion of others. A better knowledge of the physiologic responses developed during acute isovolemic anemia and the clinical factors that can limit the ability of the organism to maintain adequate tissue oxygenation in these situations, will allow the clinician to better define the transfusion trigger for each patient. This paper reviews the physiological and clinical factors of acute isovolemic anemia and presents the therapeutic options available.

  17. Comparison of BISAP Score with Ranson Score in Determining the Severity of Acute Pancreatitis

    Objective:To determine the accuracy of BISAPscore in finding out the frequency of severity and mortality in patients with acute pancreatitis by comparing it with Ranson score. Study Design: Crosse-sectional study. Place and Duration of Study: Department of Surgery, Pakistan Institute of Medical Sciences, Islamabad, from April to December 2010. Methodology: A total of 80 patients who presented in emergency with acute pancreatitis were included by consecutive non probability sampling technique. Cases of acute pancreatitis were classified as mild or severe based on the organ failure criteria and/or local complications according to the Atlanta Symposium. All patients were scored according to both Ranson score and BISAP score. Results: Out of 80 patients, 35 (44 percentage) were males and 45 (56 percentage) were females. The mean age was 46.89 ± 15.75 years. Twenty five patients (31.25 percentage) were classified as severe acute pancreatitis and 3 patients (3.75 percentage) had evidence of pancreatic necrosis on CT scan. The duration of hospital stay was 1 - 54 days with a mean of 13.12 ± 12.83 days and mortality rate was 5 percentage. The number of patients with a BISAP score of =3 was 15 and Ranson score =3 was 25. The observed incidence of severe disease stratified by the BISAP score has (p greater than 0.001) and by Ranson score has (p greater than 0.001). In regards to mortality, patients having BISAP score =3 has p=0.003, while patients having Ranson score =3 has p=0.002, both are statistically significant. Conclusion:The newly proposed BISAPscore is a simple and accurate tool for severity stratification and is equally effective in finding out frequency of severity and in turns mortality in patients with acute pancreatitis as Ranson score. (author)

  18. MR imaging of acute pancreatitis: Correlation of abdominal wall edema with severity scores

    Yang, Ru, E-mail: yangru0904@163.com [Sichuan Key laboratory of Medical Imaging, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000 (China); Jing, Zong Lin, E-mail: jzl325@163.com [Sichuan Key laboratory of Medical Imaging, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000 (China); Zhang, Xiao Ming, E-mail: zhangxm@nsmc.edu.cn [Sichuan Key laboratory of Medical Imaging, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000 (China); Tang, Wei, E-mail: tw-n-g-up@163.com [Sichuan Key laboratory of Medical Imaging, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000 (China); Xiao, Bo, E-mail: xiaoboimaging@163.com [Sichuan Key laboratory of Medical Imaging, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000 (China); Huang, Xiao Hua, E-mail: nc_hxh1966@yahoo.com.cn [Sichuan Key laboratory of Medical Imaging, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000 (China); Yang, Lin, E-mail: llinyangmd@163.com [Sichuan Key laboratory of Medical Imaging, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000 (China); Feng, Zhi Song, E-mail: fengzhisong@medmail.com.cn [Department of Gastroenterology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000 (China)

    2012-11-15

    Objective: To study MRI findings of abdominal wall edema (AWE) in acute pancreatitis as well as correlations between AWE and the severity of acute pancreatitis according to the MR severity index (MRSI) and the Acute Physiology And Chronic Healthy Evaluation III (APACHE III) scoring system. Materials and methods: A total of 160 patients with AP admitted to our institution between December 2009 and March 2011 were included in this study. MRI was performed within 48 h after admission. MRI findings of acute pancreatitis were noted, including AWE on the MRI. The abdominal wall area was divided into quarters, and each area involved was recorded as 1 point to score the severity of AWE. The severity of acute pancreatitis was studied using both the MRSI and the APACHE III scoring system. Spearman correlation of AWE with the MRSI and the APACHE III scoring system was analyzed. Results: In 160 patients with acute pancreatitis, 53.8% had AWE on MRI. The average AWE score was 1.2 {+-} 1.4 points. The prevalence of AWE was 30.5%, 64.5% and 100% in mild, moderate and severe AP, respectively, according to MRSI. AWE on MRI was correlated with MRSI scores (r = 0.441, p = 0.000). According to APACHE III scores, the averages were 2.0 {+-} 1.1 and 2.6 {+-} 1.1 points in mild AP and severe AP, respectively (P = 0.016). AWE was slightly correlated with the APACHE III scores (r = 0.222, p = 0.005). Conclusion: AWE on MRI in acute pancreatitis is common, which may be a supplementary indicator in determining the severity of AP.

  19. MR imaging of acute pancreatitis: Correlation of abdominal wall edema with severity scores

    Objective: To study MRI findings of abdominal wall edema (AWE) in acute pancreatitis as well as correlations between AWE and the severity of acute pancreatitis according to the MR severity index (MRSI) and the Acute Physiology And Chronic Healthy Evaluation III (APACHE III) scoring system. Materials and methods: A total of 160 patients with AP admitted to our institution between December 2009 and March 2011 were included in this study. MRI was performed within 48 h after admission. MRI findings of acute pancreatitis were noted, including AWE on the MRI. The abdominal wall area was divided into quarters, and each area involved was recorded as 1 point to score the severity of AWE. The severity of acute pancreatitis was studied using both the MRSI and the APACHE III scoring system. Spearman correlation of AWE with the MRSI and the APACHE III scoring system was analyzed. Results: In 160 patients with acute pancreatitis, 53.8% had AWE on MRI. The average AWE score was 1.2 ± 1.4 points. The prevalence of AWE was 30.5%, 64.5% and 100% in mild, moderate and severe AP, respectively, according to MRSI. AWE on MRI was correlated with MRSI scores (r = 0.441, p = 0.000). According to APACHE III scores, the averages were 2.0 ± 1.1 and 2.6 ± 1.1 points in mild AP and severe AP, respectively (P = 0.016). AWE was slightly correlated with the APACHE III scores (r = 0.222, p = 0.005). Conclusion: AWE on MRI in acute pancreatitis is common, which may be a supplementary indicator in determining the severity of AP.

  20. Acute Kidney Injury Enhances Outcome Prediction Ability of Sequential Organ Failure Assessment Score in Critically Ill Patients

    Chang, Chih-Hsiang; Fan, Pei-Chun; Chang, Ming-Yang; Tian, Ya-Chung; Hung, Cheng-Chieh; Fang, Ji-Tseng; Yang, Chih-Wei; Chen, Yung-Chang

    2014-01-01

    Introduction Acute kidney injury (AKI) is a common and serious complication in intensive care unit (ICU) patients and also often part of a multiple organ failure syndrome. The sequential organ failure assessment (SOFA) score is an excellent tool for assessing the extent of organ dysfunction in critically ill patients. This study aimed to evaluate the outcome prediction ability of SOFA and Acute Physiology and Chronic Health Evaluation (APACHE) III score in ICU patients with AKI. Methods A tot...

  1. Assessment of acute physiological demand for soccer

    Daniel Barbosa Coelho

    2013-09-01

    Full Text Available Soccer is a sport practiced worldwide, on all continents. It is considered an intermittent activity of high intensity and long duration, in which movements that require great strength and speed, such as jumps and sprints, result in high levels of muscle microtrauma, hampering athletes’ training and recovery. The present study aimed to evaluate the magnitude of changes in different markers of physiological demand resulting from a soccer match in healthy individuals. Ten healthy male physical education students participated in the study and were evaluated in two matches: the semi-final and final games of the college tournament at the federal university where they studied. Blood samples were collected from each volunteer pre- and post-match. Cortisol, IL-6 and CK concentrations were increased after the match (p < 0.05. Testosterone and alpha-actin concentrations did not change. Our results indicate that changes in some of the acute response markers evaluated in players before and after competitive soccer matches provide important information for planning training or recovery, as well as nutritional strategies for improving performance.

  2. Procalcitonin and BISAP score versus c-reactive protein and APACHE II score in early assessment of severity and outcome of acute pancreatitis

    Bezmarević Mihailo

    2012-01-01

    Full Text Available Background/Aim. Early assessment of severity and continuous monitoring of patients are the key factors for adequate treatment of acute pancreatitis (AP. The aim of this study was to determine the value of procalcitonin (PCT and Bedside Index for Severity in Acute Pancreatitis (BISAP scoring system as prognostic markers in early stages of AP with comparison to other established indicators such as Creactive protein (CRP and Acute Physiology and Chronic Health Evaluation (APACHE II score. Methods. This prospective study included 51 patients (29 with severe AP. In the first 24 h of admission in all patients the APACHE II score and BISAP score, CRP and PCT serum concentrations were determined. The values of PCT serum concentrations and BISAP score were compared with values of CRP serum concentrations and APACHE II score, in relation to the severity and outcome of the disease. Results. Values of PCT, CRP, BISAP score and APACHE II score, measured at 24 h of admission, were significantly elevated in patients with severe form of the disease. In predicting severity of AP at 24 h of admission, sensitivity and specificity of the BISAP score were 74% and 59%, respectively, APACHE II score 89% and 69%, respectively, CRP 75% and 86%, respectively, and PCT 86% and 63%, respectively. It was found that PCT is highly significant predictor of the disease outcome (p < 0,001. Conclusion. In early assessment of AP severity, PCT has better predictive value than CRP, and similar to the APACHE II score. APACHE II score is a stronger predictor of the disease severity than BISAP score. PCT is a good predictor of AP outcome.

  3. Ripasa score: a new diagnostic score for diagnosis of acute appendicitis

    Objective: To determine the usefulness of RIPASA score for the diagnosis of acute appendicitis using histopathology as a gold standard. Study Design: Cross-sectional study. Place and Duration of Study: Department of General Surgery, Combined Military Hospital, Kohat, from September 2011 to March 2012. Methodology: A total of 267 patients were included in this study. RIPASA score was assessed. The diagnosis of appendicitis was made clinically aided by routine sonography of abdomen. After appendicectomies, resected appendices were sent for histopathological examination. The 15 parameters and the scores generated were age (less than 40 years = 1 point; greater than 40 years = 0.5 point), gender (male = 1 point; female = 0.5 point), Right Iliac Fossa (RIF) pain (0.5 point), migration of pain to RIF (0.5 point), nausea and vomiting (1 point), anorexia (1 point), duration of symptoms (less than 48 hours = 1 point; more than 48 hours = 0.5 point), RIF tenderness (1 point), guarding (2 points), rebound tenderness (1 point), Rovsing's sign (2 points), fever (1 point), raised white cell count (1 point), negative urinalysis (1 point) and foreign national registration identity card (1 point). The optimal cut-off threshold score from the ROC was 7.5. Sensitivity analysis was done. Results: Out of 267 patients, 156 (58.4%) were male while remaining 111 patients (41.6%) were female with mean age of 23.5 +- 9.1 years. Sensitivity of RIPASA score was 96.7%, specificity 93.0%, diagnostic accuracy was 95.1%, positive predictive value was 94.8% and negative predictive value was 95.54%. Conclusion: RIPASA score at a cut-off total score of 7.5 was a useful tool to diagnose appendicitis, in equivocal cases of pain. (author)

  4. 30-Day Mortality in Acute Pulmonary Embolism: Prognostic Value of Clinical Scores and Anamnestic Features

    Bach, Andreas Gunter; Taute, Bettina-Maria; Baasai, Nansalmaa; Wienke, Andreas; Meyer, Hans Jonas; Schramm, Dominik; Surov, Alexey

    2016-01-01

    Purpose Identification of high-risk patients with pulmonary embolism is vital. The aim of the present study was to examine clinical scores, their single items, and anamnestic features in their ability to predict 30-day mortality. Materials and Methods A retrospective, single-center study from 06/2005 to 01/2010 was performed. Inclusion criteria were presence of pulmonary embolism, availability of patient records and 30-day follow-up. The following clinical scores were calculated: Acute Physiology and Chronic Health Evaluation II, original and simplified pulmonary embolism severity index, Glasgow Coma Scale, and euroSCORE II. Results In the study group of 365 patients 39 patients (10.7%) died within 30 days due to pulmonary embolism. From all examined scores and parameters the best predictor of 30-day mortality were the Glasgow Coma scale (≤ 10) and parameters of the circulatory system including presence of mechanical ventilation, arterial pH (< 7.335), and systolic blood pressure (< 99 mm Hg). Conclusions Easy to ascertain circulatory parameters have the same or higher prognostic value than the clinical scores that were applied in this study. From all clinical scores studied the Glasgow Coma Scale was the most time- and cost-efficient one. PMID:26866472

  5. Physiological-Social Scores in Predicting Outcomes of Prehospital Internal Patients

    Abbasali Ebrahimian

    2014-01-01

    Full Text Available The physiological-social modified early warning score system is a newly developed instrument for the identification of patients at risk. The aim of this study was to investigate the feasibility of using the physiological-social modified early warning score system for the identification of patients that needed prehospital emergency care. This prospective cohort study was conducted with 2157 patients. This instrument was used as a measure to detect critical illness in patients hospitalised in internal wards. Judgment by an emergency medicine specialist was used as a measure of standard. Data were analyzed by using receiver operating characteristics curves and the area under the curve with 95% confidence interval. The mean score of the physiological-social modified early warning score system was 2.71 ± 3.55. Moreover, 97.6% patients with the score ≥ 4 needed prehospital emergency services. The area under receiver operating characteristic curve was 0.738 (95% CI = 0.708–0.767. Emergency medical staffs can use PMEWS ≥ 4 to identify those patients hospitalised in the internal ward as at risk patients. The physiological-social modified early warning score system is suggested to be used for decision-making of emergency staff about internal patients’ wards in EMS situations.

  6. Neurointerventional Treatment in Acute Stroke. Whom to Treat? (Endovascular Treatment for Acute Stroke: Utility of THRIVE Score and HIAT Score for Patient Selection)

    Fjetland, Lars, E-mail: lars.fjetland@lyse.net; Roy, Sumit, E-mail: sumit.roy@sus.no; Kurz, Kathinka D., E-mail: kathinka.dehli.kurz@sus.no [Stavanger University Hospital, Department of Radiology (Norway); Solbakken, Tore, E-mail: tore.solbakken@sus.no [Stavanger University Hospital, Department of Neurology (Norway); Larsen, Jan Petter, E-mail: jan.petter.larsen@sus.no; Kurz, Martin W., E-mail: martin.kurz@sus.no [The Norwegian Center for Movement Disorders, Stavanger University Hospital (Norway)

    2013-10-15

    Purpose: Intra-arterial therapy (IAT) is used increasingly as a treatment option for acute stroke caused by central large vessel occlusions. Despite high rates of recanalization, the clinical outcome is highly variable. The authors evaluated the Houston IAT (HIAT) and the totaled health risks in vascular events (THRIVE) score, two predicting scores designed to identify patients likely to benefit from IAT. Methods: Fifty-two patients treated at the Stavanger University Hospital with IAT from May 2009 to June 2012 were included in this study. We combined the scores in an additional analysis. We also performed an additional analysis according to high age and evaluated the scores in respect of technical efficacy. Results: Fifty-two patients were evaluated by the THRIVE score and 51 by the HIAT score. We found a strong correlation between the level of predicted risk and the actual clinical outcome (THRIVE p = 0.002, HIAT p = 0.003). The correlations were limited to patients successfully recanalized and to patients <80 years. By combining the scores additional 14.3 % of the patients could be identified as poor candidates for IAT. Both scores were insufficient to identify patients with a good clinical outcome. Conclusions: Both scores showed a strong correlation to poor clinical outcome in patients <80 years. The specificity of the scores could be enhanced by combining them. Both scores were insufficient to identify patients with a good clinical outcome and showed no association to clinical outcome in patients aged {>=}80 years.

  7. Neurointerventional Treatment in Acute Stroke. Whom to Treat? (Endovascular Treatment for Acute Stroke: Utility of THRIVE Score and HIAT Score for Patient Selection)

    Purpose: Intra-arterial therapy (IAT) is used increasingly as a treatment option for acute stroke caused by central large vessel occlusions. Despite high rates of recanalization, the clinical outcome is highly variable. The authors evaluated the Houston IAT (HIAT) and the totaled health risks in vascular events (THRIVE) score, two predicting scores designed to identify patients likely to benefit from IAT. Methods: Fifty-two patients treated at the Stavanger University Hospital with IAT from May 2009 to June 2012 were included in this study. We combined the scores in an additional analysis. We also performed an additional analysis according to high age and evaluated the scores in respect of technical efficacy. Results: Fifty-two patients were evaluated by the THRIVE score and 51 by the HIAT score. We found a strong correlation between the level of predicted risk and the actual clinical outcome (THRIVE p = 0.002, HIAT p = 0.003). The correlations were limited to patients successfully recanalized and to patients <80 years. By combining the scores additional 14.3 % of the patients could be identified as poor candidates for IAT. Both scores were insufficient to identify patients with a good clinical outcome. Conclusions: Both scores showed a strong correlation to poor clinical outcome in patients <80 years. The specificity of the scores could be enhanced by combining them. Both scores were insufficient to identify patients with a good clinical outcome and showed no association to clinical outcome in patients aged ≥80 years

  8. Acute hyperhydration reduces athlete biological passport OFF-hr score

    Bejder Rasmussen, Jacob; Hoffmann, M F; Ashenden, M;

    2016-01-01

    Anecdotal evidence suggests that athletes hyperhydrate to mask prohibited substances in urine and potentially counteract suspicious fluctuations in blood parameters in the athlete biological passport (ABP). It is examined if acute hyperhydration changes parameters included in the ABP. Twenty...

  9. EVALUATION OF MODIFIED ALVARADO SCORE IN PREOPERATIVE DIAGNOSIS OF ACUTE APPENDICITIS

    Ramachandra

    2013-11-01

    Full Text Available ABSTRACT: BACKGROUND AND OBJECTIVES: Decision making in case of acute appendicitis may be difficult, especiall y for junior surgeon. Radiological investigations do not appear to be helpful sometime. A decision to operate based on clinical suspicion alone can lead to removal of normal appendix in 15 - 30% cases. In some studies Modified Alvarado Scoring System (MASS was helpful in minimizing unnecessary appendectomies. The present study aims to evaluate the efficiency of Modified Alvarado scoring in preoperative diagnosis of acute appendicitis.

  10. Modified physiological and operative severity score for risk assessment in patient of perforation peritonitis

    Gopal Tak

    2014-05-01

    Full Text Available Aim: To establish a scoring system for predicting the incidence of postoperative complications and mortality in patients with perforation peritonitis based on the modified physiological and operative severity score for the enumeration of mortality and morbidity (M-POSSUM, and to evaluate its efficacy. Methods: Patients under study, were grouped as those with postoperative complications (n = 35 and those without postoperative complications (n = 35. The period of study was 12 months and the data was analysed retrospectively and prospectively for logistical regression. Patients with age less than 12 years were excluded. Modified POSSUM (M-POSSUM was used and its efficacy evaluated. Fifteen indices were assessed as part of the scoring system such as age, cardiovascular function, respiratory function, blood test results, endocrine function, central nervous system function, hepatic function, renal function, nutritional status, extent of operative trauma, and course of anaesthesia. Results: Logistic regression analysis yielded statistically significant equations for both morbidity and mortality for comparison of both groups. The predictive accuracy of morbidity equation and mortality equation was 83.6% and 94.1%, respectively. Significant risk factors were found to be age, cardiovascular function, respiratory function, hepatic function, renal function, blood test results, endocrine function, nutritional status, duration of operation, intra-operative blood loss, and course of anaesthesia. These factors were all included in the scoring system. There was significant difference in the scores between the patients with and without postoperative complications, between the patients who died and those who survived with complications, and between the patients who died and those who survived without complications. Conclusion: Our study validates the main perioperative complications of surgery for perforation peritonitis and influencing and non-influencing risk

  11. Comparison of acute physiology and chronic health evaluation II and acute physiology and chronic health evaluation IV to predict intensive care unit mortality

    Bashu Dev Parajuli

    2015-01-01

    Full Text Available Context: Clinical assessment of severity of illness is an essential component of medical practice to predict the outcome of critically ill-patient. Acute Physiology and Chronic Health Evaluation (APACHE model is one of the widely used scoring systems. Aims: This study was designed to evaluate the Performance of APACHE II and IV scoring systems in our Intensive Care Unit (ICU. Settings and Design: A prospective study in 6 bedded ICU, including 76 patients all above 15 years. Subjects and Methods: APACHE II and APACHE IV scores were calculated based on the worst values in the first 24 h of admission. All enrolled patients were followed, and outcome was recorded as survivors or nonsurvivors. Statistical Analysis Used: SPSS version 17. Results: The mean APACHE score was significantly higher among nonsurvivors than survivors (P < 0.005. Discrimination for APACHE II and APACHE IV was fair with area under receiver operating characteristic curve of 0.73 and 0.79 respectively. The cut-off point with best Youden index for APACHE II was 17 and for APACHE IV was 85. Above cut-off point, mortality was higher for both models (P < 0.005. Hosmer-Lemeshow Chi-square coefficient test showed better calibration for APACHE II than APACHE IV. A positive correlation was seen between the models with Spearman′s correlation coefficient of 0.748 (P < 0.01. Conclusions: Discrimination was better for APACHE IV than APACHE II model however Calibration was better for APACHE II than APACHE IV model in our study. There was good correlation between the two models observed in our study.

  12. Waterlow score as a surrogate marker for predicting adverse outcome in acute pancreatitis.

    Gillick, K; Elbeltagi, H; Bhattacharya, S

    2016-01-01

    Introduction Introduced originally to stratify risk for developing decubitus ulcers, the Waterlow scoring system is recorded routinely for surgical admissions. It is a composite score, reflecting patients' general condition and co-morbidities. The aim of this study was to investigate whether the Waterlow score can be used as an independent surrogate marker to predict severity and adverse outcome in acute pancreatitis. Methods In this retrospective analysis, a consecutive cohort was studied of 250 patients presenting with acute pancreatitis, all of whom had their Waterlow score calculated on admission. Primary outcome measures were length of hospital stay and mortality. Secondary outcome measures included rate of intensive care unit (ICU) admission and development of complications such as peripancreatic free fluid, pancreatic necrosis and pseudocyst formation. Correlation of the Waterlow score with some known markers of disease severity and outcomes was also analysed. Results The Waterlow score correlated strongly with the most commonly used marker of disease severity, the Glasgow score (analysis of variance, p=0.0012). Inpatient mortality, rate of ICU admission and length of hospital stay increased with a higher Waterlow score (Mann-Whitney U test, p=0.0007, p=0.049 and p=0.0002 respectively). There was, however, no significant association between the Waterlow score and the incidence of three known complications of pancreatitis: presence of peripancreatic fluid, pancreatic pseudocyst formation and pancreatic necrosis. Receiver operating characteristic curve analysis demonstrated good predictive power of the Waterlow score for mortality (area under the curve [AUC]: 0.73), ICU admission (AUC: 0.65) and length of stay >7 days (AUC: 0.64). This is comparable with the predictive power of the Glasgow score and C-reactive protein. Conclusions The Waterlow score for patients admitted with acute pancreatitis could provide a useful tool in prospective assessment of disease

  13. Acute hyperhydration reduces athlete biological passport OFF-hr score.

    Bejder, J; Hoffmann, M F; Ashenden, M; Nordsborg, N B; Karstoft, K; Mørkeberg, J

    2016-03-01

    Anecdotal evidence suggests that athletes hyperhydrate to mask prohibited substances in urine and potentially counteract suspicious fluctuations in blood parameters in the athlete biological passport (ABP). It is examined if acute hyperhydration changes parameters included in the ABP. Twenty subjects received recombinant human erythropoietin (rhEPO) for 3 weeks. After 10 days of rhEPO washout, 10 subjects ingested normal amount of water (∼ 270 mL), whereas the remaining 10 ingested a 1000 mL bolus of water. Blood variables were measured 20, 40, 60, and 80 min after ingestion. Three days later, the subjects were crossed-over with regard to water ingestion and the procedure was repeated. OFF-hr was reduced by ∼ 4%, ∼ 3%, and ∼ 2% at 40, 60, and 80 min, respectively, after drinking 1000 mL of water, compared with normal water ingestion (P < 0.05). Forty percent of the subjects were identified with atypical blood profiles (99% specificity level) before drinking 1000 mL of water, whereas 11% (n = 18), 10% and 11% (n = 18) were identified 40, 60, and 80 min, respectively, after ingestion. This was different (P < 0.05) compared with normal water intake, where 45% of the subjects were identified before ingestion, and 54% (n = 19), 45%, and 47% (n = 19) were identified 40, 60, and 80 min, respectively, after ingestion. In conclusion, acute hyperhydration reduces ABP OFF-hr and reduces ABP sensitivity. PMID:25773052

  14. Quantification of clinical scores through physiological recordings in low-responsive patients: a feasibility study

    Wieser Martin

    2012-05-01

    Full Text Available Abstract Clinical scores represent the gold standard in characterizing the clinical condition of patients in vegetative or minimally conscious state. However, they suffer from problems of sensitivity, specificity, subjectivity and inter-rater reliability. In this feasibility study, objective measures including physiological and neurophysiological signals are used to quantify the clinical state of 13 low-responsive patients. A linear regression method was applied in nine patients to obtain fixed regression coefficients for the description of the clinical state. The statistical model was extended and evaluated with four patients of another hospital. A linear mixed models approach was introduced to handle the challenges of data sets obtained from different locations. Using linear backward regression 12 variables were sufficient to explain 74.4% of the variability in the change of the clinical scores. Variables based on event-related potentials and electrocardiogram account for most of the variability. These preliminary results are promising considering that this is the first attempt to describe the clinical state of low-responsive patients in such a global and quantitative way. This new model could complement the clinical scores based on objective measurements in order to increase diagnostic reliability. Nevertheless, more patients are necessary to prove the conclusions of a statistical model with 12 variables.

  15. Evaluation of initial diffusion-weighted image findings in acute stroke patients using a semiquantitative score

    We evaluated the usefulness of rating diffusion-weighted images (DWI) using a semiquantitative score modified from the Alberta Stroke Programme Early CT Score (ASPECTS) to predict deterioration of neurological symptoms in patients with hyperacute ischemic stroke who had undergone thrombolytic therapy with recombinant tissue plasminogen activator (rt-PA). We examined 22 patients with acute stroke (14 men, 8 women, mean age 72.5 years) treated with intravenous rt-PA. All were assessed using the National Institutes of Health Stroke Scale (NIHSS) and underwent emergent magnetic resonance (MR) imaging within 3 hours and 24 hours of stroke onset. Patients were divided into a deteriorated group (16 patients), in which NIHSS scores were increased after thrombolysis, and a non-deteriorated group (6 patients). We compared the DWI score, ASPECTS, and volume of hyperintense ischemic lesion on DWI (DWI volume) of the 2 groups and examined correlations between these scores and initial NIHSS score or DWI volume. The DWI score and ASPECTS tended to be lower in the deteriorated group than the non-deteriorated group. In addition, with a cutoff value ≤7, the DWI score could discriminate the deteriorated group from the non-deteriorated group with a sensitivity of 50% and specificity of 87.5%, whereas for ASPECTS, sensitivity was 50% and specificity, 81.2%. The DWI score, ASPECTS, and DWI volume had no correlation with NIHSS score but weak negative correlations with the DWI volume (P<0.01; Spearman's test). Comparing initial NIHSS score with each DWI score and DWI volume, the non-deteriorated group tended to have higher DWI scores and smaller DWI volumes than the deteriorated group, but there was no statistical difference between initial NIHSS and DWI scores. Though the DWI score was not statistically different, the threshold would be set to 6 points or above. Comparing initial DWI score with volume, patients with low DWI scores tended to show large variation in DWI volume and

  16. The Algoplus Score to Assess Acute Postoperative pain in Elderly patients-A Pilot Observational Study.

    Dualé, Christian; Pereira, Bruno; Abbal, Bertrand; Julien, Hugues; Rat, Patrice; Schoeffler, Pierre; Pickering, Gisèle

    2015-12-01

    Standard verbal or analogue scales may not be accurate to assess acute postoperative pain in elderly patients. This study was designed to field test the Algoplus tool, developed specifically for this population and based on observation of patient behavior. Prospective, observational cohort. Single center, French University hospital. Forty-eight patients, aged over 65, scheduled for surgery under general anesthesia, and observed on admission to the postanesthesia care unit, immediately after extubation, during the different steps of analgesic intervention (demand, relief with intravenous opioid titration, plus intermediate measures when relevant), and either at discharge or 3 hours after admission. A numerical rating scale (NRS) was used to guide analgesia. The Algoplus score and the state of alertness or sedation were noted. NRS scores and Algoplus scores were significantly related, and both scores significantly decreased under the effect of analgesia, but the correlation was low. In early observations, the Algoplus score was higher than that predicted by the NRS score, in relation to residual sedation. Female gender tended to lower the Algoplus score compared to the NRS score. When the NRS score exceeded 3/10, indicating the need for analgesic intervention, the Algoplus score was generally lower than the recommended trigger for analgesia (2/5). These results are promising, but further evidence of a clinical benefit to the use of Algoplus for acute postoperative pain is needed. In future studies, scoring should be adjusted to take into account the time from extubation, the state of sedation, and the patient's gender in order to interpret results. PMID:26697817

  17. Prediction of Patients with Acute Cholecystitis Requiring Emergent Cholecystectomy: A Simple Score

    Wael N. Yacoub

    2010-01-01

    Full Text Available The objective was to develop a score, to stratify patients with acute cholecystitis into high, intermediate, or low probability of gangrenous cholecystitis. The probability of gangrenous cholecystitis (score was derived from a logistic regression of a clinical and pathological review of 245 patients undergoing urgent cholecystectomy. Sixty-eight patients had gangrenous inflammation, 132 acute, and 45 no inflammation. The score comprised of: age > 45 years (1 point, heart rate > 90 beats/min (1 point, male (2 points, Leucocytosis > 13,000/mm3 (1.5 points, and ultrasound gallbladder wall thickness > 4.5 mm (1 point. The prevalence of gangrenous cholecystitis was 13% in the low-probability (0–2 points, 33% in the intermediate-probability (2–4.5 points, and 87% in the high probability category (>4.5 points. A cutoff score of 2 identified 31 (69% patients with no acute inflammation (PPV 90%. This scoring system can prioritize patients for emergent cholecystectomy based on their expected pathology.

  18. Acute exacerbation of idiopathic pulmonary fibrosis: high-resolution CT scores predict mortality

    Fujimoto, Kiminori [Kurume University School of Medicine, and Center for Diagnostic Imaging, Kurume University Hospital, Department of Radiology, Kurume, Fukuoka (Japan); Taniguchi, Hiroyuki; Kondoh, Yasuhiro; Kataoka, Kensuke [Tosei General Hospital, Department of Respiratory Medicine and Allergy, Seto, Aichi (Japan); Johkoh, Takeshi [Kinki Central Hospital of Mutual Aid Association of Public School Teachers, Department of Radiology, Itami (Japan); Ichikado, Kazuya [Saiseikai Kumamoto Hospital, Division of Respiratory Medicine, Kumamoto (Japan); Sumikawa, Hiromitsu [Osaka University Graduate School of Medicine, Department of Radiology, Suita, Osaka (Japan); Ogura, Takashi; Endo, Takahiro [Kanagawa Cardiovascular and Respiratory Center, Department of Respiratory Medicine, Yokohama, Kanagawa (Japan); Kawaguchi, Atsushi [Kurume University School of Medicine, Biostatistics Center, Kurume (Japan); Mueller, Nestor L. [University of British Columbia and Vancouver General Hospital, Department of Radiology, Vancouver, B.C. (Canada)

    2012-01-15

    To determine high-resolution computed tomography (HRCT) findings helpful in predicting mortality in patients with acute exacerbation of idiopathic pulmonary fibrosis (AEx-IPF). Sixty patients with diagnosis of AEx-IPF were reviewed retrospectively. Two groups (two observers each) independently evaluated pattern, distribution, and extent of HRCT findings at presentation and calculated an HRCT score at AEx based on normal attenuation areas and extent of abnormalities, such as areas of ground-glass attenuation and/or consolidation with or without traction bronchiectasis or bronchiolectasis and areas of honeycombing. The correlation between the clinical data including the HRCT score and mortality (cause-specific survival) was evaluated using the univariate and multivariate Cox-regression analyses. Serum KL-6 level, PaCO{sub 2}, and the HRCT score were statistically significant predictors on univariate analysis. Multivariate analysis revealed that the HRCT score was an independently significant predictor of outcome (hazard ratio, 1.13; 95% confidence interval, 1.06-1.19, P = 0.0002). The area under receiver operating characteristics curve for the HRCT score was statistically significant in the classification of survivors or nonsurvivors (0.944; P < 0.0001). Survival in patients with HRCT score {>=}245 was worse than those with lower score (log-rank test, P < 0.0001). The HRCT score at AEx is independently related to prognosis in patients with AEx-IPF. (orig.)

  19. Acute exacerbation of idiopathic pulmonary fibrosis: high-resolution CT scores predict mortality

    To determine high-resolution computed tomography (HRCT) findings helpful in predicting mortality in patients with acute exacerbation of idiopathic pulmonary fibrosis (AEx-IPF). Sixty patients with diagnosis of AEx-IPF were reviewed retrospectively. Two groups (two observers each) independently evaluated pattern, distribution, and extent of HRCT findings at presentation and calculated an HRCT score at AEx based on normal attenuation areas and extent of abnormalities, such as areas of ground-glass attenuation and/or consolidation with or without traction bronchiectasis or bronchiolectasis and areas of honeycombing. The correlation between the clinical data including the HRCT score and mortality (cause-specific survival) was evaluated using the univariate and multivariate Cox-regression analyses. Serum KL-6 level, PaCO2, and the HRCT score were statistically significant predictors on univariate analysis. Multivariate analysis revealed that the HRCT score was an independently significant predictor of outcome (hazard ratio, 1.13; 95% confidence interval, 1.06-1.19, P = 0.0002). The area under receiver operating characteristics curve for the HRCT score was statistically significant in the classification of survivors or nonsurvivors (0.944; P < 0.0001). Survival in patients with HRCT score ≥245 was worse than those with lower score (log-rank test, P < 0.0001). The HRCT score at AEx is independently related to prognosis in patients with AEx-IPF. (orig.)

  20. Evaluation of modified Alvarado score in the diagnosis of acute appendicitis

    Abhinandan B. Vandakudri

    2016-01-01

    Results: The result of the study showed that high scores in men and children (7-9 had a sensitivity of 92.3% and 83.3% respectively, whereas in females it had a sensitivity of 72.7%. The score (5-6 in males and females had a sensitivity of 57% and 50% respectively. Conclusions: The high scores in modified Alvarado score is dependable aid in the early diagnosis of acute appendicitis in men and children but it's not true as far as women are considered. Ultrasonography of abdomen is a useful tool in avoiding negative appendicectomy rates particularly in females. [Int J Res Med Sci 2016; 4(1.000: 84-88

  1. Comparison of Existing Clinical Scoring Systems in Predicting Severity and Prognoses of Hyperlipidemic Acute Pancreatitis in Chinese Patients

    Qiu, Lei; Sun, Rui Qing; Jia, Rong Rong; Ma, Xiu Ying; Cheng, Li; Tang, Mao Chun; Zhao, Yan

    2015-01-01

    Abstract It is important to identify the severity of acute pancreatitis (AP) in the early course of the disease. Clinical scoring systems may be helpful to predict the prognosis of patients with early AP; however, few analysts have forecast the accuracy of scoring systems for the prognosis in hyperlipidemic acute pancreatitis (HLAP). The purpose of this study was to summarize the clinical characteristics of HLAP and compare the accuracy of conventional scoring systems in predicting the progno...

  2. CT findings and CT score in acute pancreatitis compared with severity

    CT findings in 28 patients with acute pancreatitis were compared with severity of the disease. The pancreatic image, which demonstrates the pancreatic lesion, was studied with respect to 9 items, and fluid collection showing the peripancreatic status with respect to 13 items. 1) According to Forell's classification, the lesion was minor in 8 patients, moderate in 11, and severe in 9. 2) The detection rates of abnormal pancreatic images and fluid collection increased with the advance in the severity of the disease. 3) The mean CT score by severity was 0.88 ± 0.64 for minor pancreatitis, 7.18 ± 4.51 for moderate pancreatitis, and 13.44 ± 4.22 for severe pancreatitis. Significant differences were observed among the groups, suggesting the usefulness of the CT score in evaluating the severity of acute pancreatitis. (author)

  3. Predictive value of POSSUM score in surgery of acute abdomen in cirrhotic patients

    Banu, P; Popa, F; Constantin, VD; Balalau, C

    2013-01-01

    Abstract Introduction: As liver cirrhosis has an increasing incidence in the general population and the life expectancy for these patients has increased, surgery procedures practiced for acute abdomen in such category of patients are more frequent. Aim: To evaluate the predictive value of POSSUM score in cirrhotic patients undergoing abdominal surgery in emergency cases. Material and method: A prospective study based on 115 consecutive patients with liver cirrhosis hospitalized and operated i...

  4. ASTRAL-R score predicts non-recanalisation after intravenous thrombolysis in acute ischaemic stroke.

    Vanacker, Peter; Heldner, Mirjam R; Seiffge, David; Mueller, Hubertus; Eskandari, Ashraf; Traenka, Christopher; Ntaios, George; Mosimann, Pascal J; Sztajzel, Roman; Mendes Pereira, Vitor; Cras, Patrick; Engelter, Stefan; Lyrer, Philippe; Fischer, Urs; Lambrou, Dimitris; Arnold, Marcel; Michel, Patrik

    2015-05-01

    Intravenous thrombolysis (IVT) as treatment in acute ischaemic strokes may be insufficient to achieve recanalisation in certain patients. Predicting probability of non-recanalisation after IVT may have the potential to influence patient selection to more aggressive management strategies. We aimed at deriving and internally validating a predictive score for post-thrombolytic non-recanalisation, using clinical and radiological variables. In thrombolysis registries from four Swiss academic stroke centres (Lausanne, Bern, Basel and Geneva), patients were selected with large arterial occlusion on acute imaging and with repeated arterial assessment at 24 hours. Based on a logistic regression analysis, an integer-based score for each covariate of the fitted multivariate model was generated. Performance of integer-based predictive model was assessed by bootstrapping available data and cross validation (delete-d method). In 599 thrombolysed strokes, five variables were identified as independent predictors of absence of recanalisation: Acute glucose > 7 mmol/l (A), significant extracranial vessel STenosis (ST), decreased Range of visual fields (R), large Arterial occlusion (A) and decreased Level of consciousness (L). All variables were weighted 1, except for (L) which obtained 2 points based on β-coefficients on the logistic scale. ASTRAL-R scores 0, 3 and 6 corresponded to non-recanalisation probabilities of 18, 44 and 74 % respectively. Predictive ability showed AUC of 0.66 (95 %CI, 0.61-0.70) when using bootstrap and 0.66 (0.63-0.68) when using delete-d cross validation. In conclusion, the 5-item ASTRAL-R score moderately predicts non-recanalisation at 24 hours in thrombolysed ischaemic strokes. If its performance can be confirmed by external validation and its clinical usefulness can be proven, the score may influence patient selection for more aggressive revascularisation strategies in routine clinical practice. PMID:25589216

  5. Red cell distribution width and neurological scoring systems in acute stroke patients

    Kara H

    2015-03-01

    Full Text Available Hasan Kara,1 Selim Degirmenci,1 Aysegul Bayir,1 Ahmet Ak,1 Murat Akinci,1 Ali Dogru,1 Fikret Akyurek,2 Seyit Ali Kayis3 1Department of Emergency Medicine, Faculty of Medicine, Selcuk University, Konya, Turkey; 2Department of Biochemistry, Faculty of Medicine, Selcuk University, Konya, Turkey; 3Department of Biostatistics, Faculty of Medicine, Karabuk University, Karabuk, Turkey Objectives: The purpose of the present study was to evaluate the association between the red blood cell distribution width (RDW and the Glasgow Coma Scale (GCS, Canadian Neurological Scale (CNS, and National Institutes of Health Stroke Scale (NIHSS scores in patients who had acute ischemic stroke. Methods: This prospective observational cohort study included 88 patients who have had acute ischemic stroke and a control group of 40 patients who were evaluated in the Emergency Department for disorders other than acute ischemic stroke. All subjects had RDW determined, and stroke patients had scoring with the GCS, CNS, and NIHSS scores. The GCS, CNS, and NIHSS scores of the patients were rated as mild, moderate, or severe and compared with RDW. Results: Stroke patients had significantly higher median RDW than control subjects. The median RDW values were significantly elevated in patients who had more severe rather than milder strokes rated with all three scoring systems (GCS, CNS, and NIHSS. The median RDW values were significantly elevated for patients who had moderate rather than mild strokes rated by GCS and CNS and for patients who had severe rather than mild strokes rated by NIHSS. The area under the receiver operating characteristic curve was 0.760 (95% confidence interval, 0.676–0.844. Separation of stroke patients and control groups was optimal with RDW 14% (sensitivity, 71.6%; specificity, 67.5%; accuracy, 70.3%. Conclusion: In stroke patients who have symptoms <24 hours, the RDW may be useful in predicting the severity and functional outcomes of the stroke

  6. Predictive score for early diagnosis of acute encephalopathy with biphasic seizures and late reduced diffusion (AESD).

    Tada, Hiroko; Takanashi, Jun-ichi; Okuno, Hideo; Kubota, Masaya; Yamagata, Takanori; Kawano, Gou; Shiihara, Takashi; Hamano, Shin-ichiro; Hirose, Shinichi; Hayashi, Takuya; Osaka, Hitoshi; Mizuguchi, Masashi

    2015-11-15

    Acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) at onset manifests an early seizure (ES) usually lasting more than 30 min. Following ES, some patients exhibit almost clear consciousness with no neurological symptoms, and no MRI abnormality for a few days, which may lead to an initial misdiagnosis of prolonged febrile seizures (PFS). To allow an early diagnosis of AESD, we retrospectively analyzed clinical manifestations, laboratory data, and radiologic and EEG findings in patients with AESD (n=62) having ES of over 30 min, and ones with PFS (n=54), using logistic regression analyses. Multivariate logistic regression analysis revealed that an age below 1.5 years and a Glasgow Coma Scale score of 14 or less than 14 (Japan Coma Scale score of 1 or higher) were high risk factors of developing AESD. We proposed an AESD prediction score system consisting of consciousness level, age, duration of convulsions, enforcement of mechanical intubation, and aspartate aminotransferase, blood glucose and creatinine levels (full score: 9), the mean scores in AESD and PFS being 5.9 and 1.8, which were significantly different (psystem for differentiating patients with AESD and PFS around the time of ES (score of 4 or more than 4 suggesting AESD), which may contribute to early therapeutic intervention and an improved neurologic outcome. PMID:26333951

  7. Yellow flag scores in a compensable New Zealand cohort suffering acute low back pain

    Karen Grimmer-Somers

    2008-12-01

    Full Text Available Karen Grimmer-Somers1, Mathew Prior1, Jim Robertson21Centre for Allied Health Evidence, University of South Australia, City East Campus, North Tce, Adelaide, South Australia, Australia; 2New Zealand Accident Compensation Corporation, Auckland, New ZealandBackground: Despite its high prevalence, most acute low back pain (ALBP is nonspecific, self-limiting with no definable pathology. Recurrence is prevalent, as is resultant chronicity. Psychosocial factors (yellow flags comprising depression and anxiety, negative pain beliefs, job dissatisfaction are associated with the development of chronic LBP.Methods: A national insurer (Accident Compensation Corporation, New Zealand [NZ], in conjunction with a NZ primary health organization, piloted a strategy for more effective management of patients with ALBP, by following the NZ ALBP Guideline. The guidelines recommend the use of a psychosocial screening instrument (Yellow Flags Screening Instrument, a derivative of Örebro Musculoskeletal Pain Questionnaire. This instrument was recommended for administration on the second visit to a general medical practitioner (GP. This paper tests whether published cut-points of yellow flag scores to predict LBP claims length and costs were valid in this cohort.Results: Data was available for 902 claimants appropriately enrolled into the pilot. 25% claimants consulted the GP once only, and thus were not requested to provide a yellow flag score. Yellow flag scores were provided by 48% claimants who consumed two or more GP services. Approximately 60% LBP presentations resolved within five GP visits. Yellow flag scores were significantly and positively associated with treatment costs and service use, although the association was nonlinear. Claimants with moderate yellow flag scores were similarly likely to incur lengthy claims as claimants with at-risk scores.Discussion: Capturing data on psychosocial factors for compensable patients with ALBP has merit in predicting

  8. Association between nih stroke scale score and functional outcome in acute ischemic stroke

    To evaluate the association between baseline national institutes of health stroke scale score and functional outcome after acute ischemic stroke. Study Design: Descriptive study. Place and Duration of Study: Medical unit-IV, Jinnah Hospital, Lahore, from May 2009 to October 2009. Patients and Methods: Patients who presented with stroke within 24 hours of onset of symptom and had a developing infarct on the CT- scan were further evaluated for neurological impairment using NIH stroke scale. The baseline NIHSS score was calculated using a proforma. Age of the patient, gender and time of presentation to the hospital was recorded. Follow-up was done on the 7th day of admission using Glasgow outcome scale (GOS). Results: Total number of subjects was 150. Good outcome (GOS=1-2) was noticed in those subjects who had a low baseline NIHSS score (0-6) while poor outcome (GOS=3-5) was noticed in those subjects who had a higher baseline NIHSS score (>16)( p value< 0.05). In cases who had a moderate score (7-15); the ratio of good outcome to bad outcome was almost 70:30. Likewise good outcome (GOS=1-2) was noticed in those subjects who were younger (less than 45 years) while poor outcome (GOS=3-5) was noticed in the elderly (more than 45 years)( p value< 0.05). Similarly patients who presented within 12 hrs of symptom onset had a good outcome compared to those who presented after 12 hrs( p value< 0.05). Conclusion: Baseline NIH Stroke Scale score is strongly associated with functional outcome after 1 week of acute ischemic stroke. (author)

  9. The SYNTAX score predicts early mortality risk in the elderly with acute coronary syndrome having primary PCI.

    Scherff F.; Vassalli G.; Sürder D.; Mantovani A; Corbacelli C.; Pasotti E.; Klersy C.; Auricchio A.; Moccetti T.; Pedrazzini G.B.

    2011-01-01

    BACKGROUND: The SYNTAX score (SXscore), an angiographic score reflecting coronary lesion complexity, predicts clinical outcomes in patients with left main or multivessel disease, and in patients with ST-segment elevation myocardial infarction undergoing primary PCI. The clinical SXscore (CSS) integrates the SXscore and clinical variables (age, ejection fraction, serum creatinine) into a single score. We analyzed these scores in elderly patients with acute coronary syndrome (ACS) undergoing pr...

  10. The role of THRIVE score in prediction of outcomes of acute ischemic stroke patients with atrial fibrillation

    尤寿江

    2014-01-01

    Objective To study whether the total health risks in vascular events(THRIVE)score could predict the prognosis in the acute ischemic stroke patients with atrial fibrillation.Methods A total of 169 patients were enrolled in the study,with NIH Stroke Scale(NIHSS)score,THRIVE score and CHADS2score given to each patients at admission and modified Rankin Scale(mRS)given at3 months follow up.All patients were divided into the

  11. New scoring system identifies kidney outcome with radiation therapy in acute renal allograft rejection

    concomitant immunosuppressive therapy. Independent factors examined by Cox regression modeling were: gender (p 0.005), creatinine levels (p = 0.000), HLA-DR (p = 0.05), PRA-Maximum >70% (p = 0.014). Each factor was scored using integral coefficients to generate four different groups. The Kaplan-Meier survival analyzed by group produces an interpretable separation of the risk factors for graft loss. Conclusions: The outcome in patients treated with radiation therapy for acute renal graft rejection can be predicted by a novel scoring system. Patients with scores of three or less are able to achieve 100% renal graft salvage, while patients who have scores of 12 or higher are not able to be salvaged with the current radiation therapy regimen. Future studies should be directed toward identifying more effective treatment for patients who have a high score based on our criteria. The scoring system should be utilized to identify patients at risk who could benefit from radiation therapy. Further study with a randomized trial utilizing this scoring system is needed to confirm the validity of the scoring system in predicting graft survival and the efficacy of radiation in patients who receive radiation therapy for acute graft rejection

  12. Acute Radiation Syndrome Severity Score System in Mouse Total-Body Irradiation Model.

    Ossetrova, Natalia I; Ney, Patrick H; Condliffe, Donald P; Krasnopolsky, Katya; Hieber, Kevin P

    2016-08-01

    Radiation accidents or terrorist attacks can result in serious consequences for the civilian population and for military personnel responding to such emergencies. The early medical management situation requires quantitative indications for early initiation of cytokine therapy in individuals exposed to life-threatening radiation doses and effective triage tools for first responders in mass-casualty radiological incidents. Previously established animal (Mus musculus, Macaca mulatta) total-body irradiation (γ-exposure) models have evaluated a panel of radiation-responsive proteins that, together with peripheral blood cell counts, create a multiparametic dose-predictive algorithm with a threshold for detection of ~1 Gy from 1 to 7 d after exposure as well as demonstrate the acute radiation syndrome severity score systems created similar to the Medical Treatment Protocols for Radiation Accident Victims developed by Fliedner and colleagues. The authors present a further demonstration of the acute radiation sickness severity score system in a mouse (CD2F1, males) TBI model (1-14 Gy, Co γ-rays at 0.6 Gy min) based on multiple biodosimetric endpoints. This includes the acute radiation sickness severity Observational Grading System, survival rate, weight changes, temperature, peripheral blood cell counts and radiation-responsive protein expression profile: Flt-3 ligand, interleukin 6, granulocyte-colony stimulating factor, thrombopoietin, erythropoietin, and serum amyloid A. Results show that use of the multiple-parameter severity score system facilitates identification of animals requiring enhanced monitoring after irradiation and that proteomics are a complementary approach to conventional biodosimetry for early assessment of radiation exposure, enhancing accuracy and discrimination index for acute radiation sickness response categories and early prediction of outcome. PMID:27356057

  13. Human physiological responses to cold exposure: Acute responses and acclimatization to prolonged exposure.

    Castellani, John W; Young, Andrew J

    2016-04-01

    Cold exposure in humans causes specific acute and chronic physiological responses. This paper will review both the acute and long-term physiological responses and external factors that impact these physiological responses. Acute physiological responses to cold exposure include cutaneous vasoconstriction and shivering thermogenesis which, respectively, decrease heat loss and increase metabolic heat production. Vasoconstriction is elicited through reflex and local cooling. In combination, vasoconstriction and shivering operate to maintain thermal balance when the body is losing heat. Factors (anthropometry, sex, race, fitness, thermoregulatory fatigue) that influence the acute physiological responses to cold exposure are also reviewed. The physiological responses to chronic cold exposure, also known as cold acclimation/acclimatization, are also presented. Three primary patterns of cold acclimatization have been observed, a) habituation, b) metabolic adjustment, and c) insulative adjustment. Habituation is characterized by physiological adjustments in which the response is attenuated compared to an unacclimatized state. Metabolic acclimatization is characterized by an increased thermogenesis, whereas insulative acclimatization is characterized by enhancing the mechanisms that conserve body heat. The pattern of acclimatization is dependent on changes in skin and core temperature and the exposure duration. PMID:26924539

  14. Is it possible to make a useful scoring system for the diagnosis of acute appendicitis?

    We conducted a prospective study of 561 patients hospitalized with abdominal pain suggestive of acute appendicitis. History, signs, symptoms, leukocytosis and CT findings were analyzed for sensitivity and specificity. The result of a multivariate analysis of these factors revealed five factors which were found to be useful in making the diagnosis of acute appendicitis, as follows: age; CT findings (distended appendix, appendicolith, periappendiceal inflammatory changes); and the inflammatory changes around the ascending colon (negative finding). Based on this weighting, we devised a practical diagnostic score that may help in excluding catarrhal appendicitis and diagnosing only phlegmonous and gangrenous appendicitis for operation. As a result, the sensitivity and specificity were only 77.2% and 75.6%, respectively. The actual comprehensive diagnostic sensitivity and specificity of 88% and 88.7%, respectively, were 10% greater than the sensitivity and specificity by the scoring system. This difference was equivalent to the overall judgment based on the experience of the surgeons, and appeared impossible to fill by the diagnostic score with statistical analysis. (author)

  15. Computational Issues Associated with Automatic Calculation of Acute Myocardial Infarction Scores

    Destro-Filho, J. B.; Machado, S. J. S.; Fonseca, G. T.

    2008-12-01

    This paper presents a comparison among the three principal acute myocardial infarction (AMI) scores (Selvester, Aldrich, Anderson-Wilkins) as they are automatically estimated from digital electrocardiographic (ECG) files, in terms of memory occupation and processing time. Theoretical algorithm complexity is also provided. Our simulation study supposes that the ECG signal is already digitized and available within a computer platform. We perform 1000 000 Monte Carlo experiments using the same input files, leading to average results that point out drawbacks and advantages of each score. Since all these calculations do not require either large memory occupation or long processing, automatic estimation is compatible with real-time requirements associated with AMI urgency and with telemedicine systems, being faster than manual calculation, even in the case of simple costless personal microcomputers.

  16. Comparison of ACUITY and CRUSADE Scores in Predicting Major Bleeding during Acute Coronary Syndrome

    Luis C. L. Correia

    2015-07-01

    Full Text Available Background:The ACUITY and CRUSADE scores are validated models for prediction of major bleeding events in acute coronary syndrome (ACS. However, the comparative performances of these scores are not known.Objective:To compare the accuracy of ACUITY and CRUSADE in predicting major bleeding events during ACS.Methods:This study included 519 patients consecutively admitted for unstable angina, non-ST-elevation or ST-elevation myocardial infarction. The scores were calculated based on admission data. We considered major bleeding events during hospitalization and not related to cardiac surgery, according to the Bleeding Academic Research Consortium (BARC criteria (type 3 or 5: hemodynamic instability, need for transfusion, drop in hemoglobin ≥ 3 g, and intracranial, intraocular or fatal bleeding.Results:Major bleeding was observed in 31 patients (23 caused by femoral puncture, 5 digestive, 3 in other sites, an incidence of 6%. While both scores were associated with bleeding, ACUITY demonstrated better C-statistics (0.73, 95% CI = 0.63 - 0.82 as compared with CRUSADE (0.62, 95% CI = 0.53 - 0.71; p = 0.04. The best performance of ACUITY was also reflected by a net reclassification improvement of + 0.19 (p = 0.02 over CRUSADE’s definition of low or high risk. Exploratory analysis suggested that the presence of the variables ‘age’ and ‘type of ACS’ in ACUITY was the main reason for its superiority.Conclusion:The ACUITY Score is a better predictor of major bleeding when compared with the CRUSADE Score in patients hospitalized for ACS.

  17. Factors associated with IQ scores in long-term survivors of childhood acute lymphoblastic leukemia

    To identify factors which might be associated with intellectual function following treatment for childhood acute lymphoblastic leukemia, 50 long-term survivors were studied using the Wechsler Intelligence Scale for Children-Revised. All patients were diagnosed between 1972 and 1974 and were treated on a single clinical trial protocol with identical induction and maintenance chemotherapy plus central nervous system prophylaxis that included cranial radiation. The mean full scale IQ score for the group was 95 (SEM 2.0), with mean verbal IQ of 94.4 and mean performance IQ of 96.9. Factors which were found to be closely associated with a lower IQ score included female sex (in both verbal IQ and full-scale IQ), longer duration of chemotherapy (in performance IQ), and younger age at the time of radiation (in both verbal IQ and full-scale IQ). The age at the time of radiation was found to be significantly correlated with discrepancy between verbal and performance IQ, with younger age being associated with verbal IQ scores higher than performance IQ scores. When analyses were performed within specific subgroups of patients defined by sex and age at the time of radiation, dose of cranial radiation, concomitant intrathecal methotrexate therapy, and duration of therapy were all found to be correlated with a lower level of intellectual function. These preliminary findings provide direction for future studies to help identify high-risk patients

  18. Risk stratification in non-ST elevation acute coronary syndromes: Risk scores, biomarkers and clinical judgment

    David Corcoran

    2015-09-01

    Clinical guidelines recommend an early invasive strategy in higher risk NSTE-ACS. The Global Registry of Acute Coronary Events (GRACE risk score is a validated risk stratification tool which has incremental prognostic value for risk stratification compared with clinical assessment or troponin testing alone. In emergency medicine, there has been a limited adoption of the GRACE score in some countries (e.g. United Kingdom, in part related to a delay in obtaining timely blood biochemistry results. Age makes an exponential contribution to the GRACE score, and on an individual patient basis, the risk of younger patients with a flow-limiting culprit coronary artery lesion may be underestimated. The future incorporation of novel cardiac biomarkers into this diagnostic pathway may allow for earlier treatment stratification. The cost-effectiveness of the new diagnostic pathways based on high-sensitivity troponin and copeptin must also be established. Finally, diagnostic tests and risk scores may optimize patient care but they cannot replace patient-focused good clinical judgment.

  19. Factors associated with IQ scores in long-term survivors of childhood acute lymphoblastic leukemia

    Robison, L.L.; Nesbit, M.E. Jr.; Sather, H.N.; Meadows, A.T.; Ortega, J.A.; Hammond, G.D.

    To identify factors which might be associated with intellectual function following treatment for childhood acute lymphoblastic leukemia, 50 long-term survivors were studied using the Wechsler Intelligence Scale for Children-Revised. All patients were diagnosed between 1972 and 1974 and were treated on a single clinical trial protocol with identical induction and maintenance chemotherapy plus central nervous system prophylaxis that included cranial radiation. The mean full scale IQ score for the group was 95 (SEM 2.0), with mean verbal IQ of 94.4 and mean performance IQ of 96.9. Factors which were found to be closely associated with a lower IQ score included female sex (in both verbal IQ and full-scale IQ), longer duration of chemotherapy (in performance IQ), and younger age at the time of radiation (in both verbal IQ and full-scale IQ). The age at the time of radiation was found to be significantly correlated with discrepancy between verbal and performance IQ, with younger age being associated with verbal IQ scores higher than performance IQ scores. When analyses were performed within specific subgroups of patients defined by sex and age at the time of radiation, dose of cranial radiation, concomitant intrathecal methotrexate therapy, and duration of therapy were all found to be correlated with a lower level of intellectual function. These preliminary findings provide direction for future studies to help identify high-risk patients.

  20. The relationship between serum procalcitonin (PCT) level and acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ ) score in septic patients%脓毒症患者降钙素原与APACHEⅡ评分的相关性探讨

    刘慧琳; 刘桂花

    2012-01-01

    Objective To investigate the relationships between serum procalcitonin (PCT) level and APACHE Ⅱ score as well the prognosis of septic patients.Methods Ninety patients with sepsis were collected from emergency and critical care department of Third Hospital,Peking University,Beijing.Within 24 hours after admission,the serum PCT,hypersensitive C-reactive protein (hs-CRP),leucocyte count (WBC) and lactic acid were examined,and APACHE Ⅱ score were calculated.According to APACHE Ⅱscore,the septic patients were divided into three groups of high,median and low scores.Based on the 28 -day outcomes of patients,the patients were divided into survival group and death group.The differences in PCT,APACHE score,WBC and lactic acid between the survival group and the death group were detected.Results The serum levels of PCT were significantly higher ( P < 0.01 ) in patients with high APACHE Ⅱ score ( > 20) than that in patients with median score (10-20) and low score ( < 10 ).There was significant correlation between PCT level and APACHE Ⅱscore ( r =0.58,P <0.01 ).Conclusions There is a good correlation between serum PCT level and APACHE Ⅱ score.The serum PCT and APACHE Ⅱ can be used for predicting the outcomes of septic patients.%目的 探讨脓毒症患者血清降钙素原(PCT)与急性生理学与慢性健康状况Ⅱ(APACHEⅡ)评分及预后的关系,进而了解PCT对脓毒症早期诊断和预后的影响.方法 采用前瞻性方法进行研究,将北京大学第三医院急诊重症监护病房(EICU)脓毒症90例患者按照APACHEⅡ评分分组,测定患者入院后24h内PCT、超敏C反应蛋白(hs-CRP)及乳酸的水平,比较PCT、白细胞和乳酸的差异.后再根据患者28 d结局不同(分为生存组和死亡组两组),比较PCT、APACHEⅡ评分、白细胞及乳酸的差异.结果 低危组患者PCT为(0.15±0.14) ng/ml,低于中危组(0.62±0.61) ng/ml和高危组(5.32±5.20) ng/ml,中危组PCT低于高危组,其差

  1. Alvarado score: A valuable clinical tool for diagnosis of acute appendicitis –a retros-pective study

    Swagata Brahmachari1 and Ashwini B. Jajee2

    2013-08-01

    Full Text Available Appendicitis is a common surgical emergency and diagnosis is still a great challenge. Accurate diagnosis and timely intervention re-duces morbidity and mortality. The present study was conducted to evaluate Alvarado scoring system for diagnosis of acute appen-dicitis in Indian set up. The study was carried out on 200 patients admitted in Surgery ward between January 2009 and December 2010 with right lower quadrant abdominal pain. Alvarado score was calculated and all patients were divided in three groups. Mean age of presentation was 29.12 years and male to female ratio was 1.27:1. Higher the Alvarado score, more is the sensitivity. So pa-tients having score 7 or above had sensitivity of 66%. We con-clude that Alvarado score is unique since it incorporates signs, symptoms and laboratory findings of suspicious patients. Alvarado score can be utilized safely for diagnosis of acute appendicitis.

  2. Evaluation of physiological parameters before and after respiratory physiotherapy in newborns with acute viral bronchiolitis

    S Gonçalves, Rodrigo A; Feitosa, Sérgio; de Castro Selestrin, Cláudia; Vitor E. Valenti; de Sousa, Fernando H; F Siqueira, Arnaldo A; Petenusso, Márcio; de Abreu, Luiz Carlos

    2014-01-01

    Background Acute viral bronchiolitis is a respiratory disease with high morbidity that affects newborn in the first two years of life. Its treatment with physiotherapy has been highlighted as an important tool, however, there is no consensus regarding its effects on patients improvement. We aimed to evaluate the physiological parameters before and after the procedure respiratory therapy in newborn with acute viral bronchiolitis. Method This was a cross sectional observational study in 30 newb...

  3. Sex differences in physiological reactivity to acute psychosocial stress in adolescence

    Ordaz, Sarah; Luna, Beatriz

    2012-01-01

    Females begin to demonstrate greater negative affective responses to stress than males in adolescence. This may reflect the concurrent emergence of underlying differences in physiological response systems, including corticolimbic circuitries, the hypothalamic—pituitary— adrenal axis (HPAA), and the autonomic nervous system (ANS). This review examines when sex differences in physiological reactivity to acute psychosocial stress emerge and the directionality of these differences over developmen...

  4. Validity of samul's paediatric appendicitis score (pas) in the diagnosis of acute appendicitis in children

    Objective: To validate the paediatric appendicitis score for the diagnosis of acute appendicitis in children using histopathology as a gold standard. Study Design: Case control study. Place and Duration of Study: Military Hospital (MH) and Combined Military Hospital (CMH) Rawalpindi, Pakistan from Dec 2009 to Jul 2010. Patients and Methods: Eighty five children 1-7year old who came to our tertiary surgical department with the chief complaint of abdominal pain of less than 7 days duration were included in the study. Paediatric appendicitis score (PAS) components including fever > 380 C, anorexia, nausea/vomiting, cough/percussion/hopping tenderness, right-lower-quadrant tenderness, migration of pain, leukocytosis > 10,000 (109/1) and polymorphonuclear - neutrophilia > 7500 (109/1) were assessed and recorded on admission, but the sum was not calculated until later and the score did not play any role in the management of the patient. The diagnosis of appendicitis was made by the trainees and consultants clinically and with the aid of routine sonography of abdomen. After appendicetomies, resected specimens were sent for histopathological examination. Pre-operative PAS, histopathology report of resected appendix were endorsed on patient's performa. A two by two table was used to determine sensitivity, specificity, positive and negative predictive values and diagnostic efficacy of PAS. Results: Sensitivity of PAS was 92.16%, specificity 88.23%, positive predictive value 92.16%, negative predictive value 88.23% and the diagnostic efficacy 90.59%. Conclusion: PAS is a highly sensitive test with fair degree of specificity in diagnosing acute appendicitis in children and its routine usage may improve the diagnostic accuracy. (author)

  5. Efficiency of unenhanced MRI in the diagnosis of acute appendicitis: Comparison with Alvarado scoring system and histopathological results

    Inci, Ercan, E-mail: ercan_inci@mynet.com [Department of Radiology, Istanbul Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Incirli-Bakirkoy, Istanbul (Turkey); Hocaoglu, Elif; Aydin, Sibel; Palabiyik, Figen; Cimilli, Tan [Department of Radiology, Istanbul Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Incirli-Bakirkoy, Istanbul (Turkey); Turhan, Ahmet Nuray; Ayguen, Ersan [Department of Surgery, Istanbul Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul (Turkey)

    2011-11-15

    Purpose: The purpose of this study was to assess the diagnostic value of unenhanced magnetic resonance imaging (MRI) in the diagnosis of acute appendicitis and compare with Alvarado scores and histopathological results. Materials and methods: The study included 85 consecutive patients (mean age, 26.5 {+-} 11.3 years) who were clinically suspected of having acute appendicitis. Each patients Alvarado scores were recorded and unenhanced MRI was performed, consisting of T1-weighted, T2-weighted and fat-suppressed T2-weighted fast spin-echo sequences. The MR images were prospectively reviewed in consensus for the presence of acute appendicitis by two radiologists who were blinded to the results of the Alvarado scores. The study population were divided into three subgroups based on the MRI findings: Group I: definitely not appendicitis, Group II: probably appendicitis, Group III: definitely appendicitis. All patients were divided into two subgroups according to Alvarado scores as Group A (low: 1-6), and Group B (high: 7-10). MR findings were compared with Alvarado scores and histopathological findings. Results: Sixty-six (77.6%) of the 85 patients with clinically suspected acute appendicitis, had undergone surgery. The diagnosis of appendicitis could be correctly achieved with MRI in 55 (83.3%) of 57 (86.4%) patients with histopathologically proven acute appendicitis. The sensitivity, specificity, positive predictive value and negative predictive value of MRI examination and Alvarado scoring system in the diagnosis of acute appendicitis were 96.49%, 66.67%, 94.83%, 75.0% and 84.21%, 66.67%, 94.12%, 40.0%, respectively. Conclusions: MRI is a valuable technique for detecting acute appendicitis even in the cases with low Alvarado scores. To increase the diagnostic accuracy and preventing unnecessary laparotomies for suspected appendicitis, shorter and cheaper unenhanced basic MRI may be performed.

  6. Efficiency of unenhanced MRI in the diagnosis of acute appendicitis: Comparison with Alvarado scoring system and histopathological results

    Purpose: The purpose of this study was to assess the diagnostic value of unenhanced magnetic resonance imaging (MRI) in the diagnosis of acute appendicitis and compare with Alvarado scores and histopathological results. Materials and methods: The study included 85 consecutive patients (mean age, 26.5 ± 11.3 years) who were clinically suspected of having acute appendicitis. Each patients Alvarado scores were recorded and unenhanced MRI was performed, consisting of T1-weighted, T2-weighted and fat-suppressed T2-weighted fast spin-echo sequences. The MR images were prospectively reviewed in consensus for the presence of acute appendicitis by two radiologists who were blinded to the results of the Alvarado scores. The study population were divided into three subgroups based on the MRI findings: Group I: definitely not appendicitis, Group II: probably appendicitis, Group III: definitely appendicitis. All patients were divided into two subgroups according to Alvarado scores as Group A (low: 1-6), and Group B (high: 7-10). MR findings were compared with Alvarado scores and histopathological findings. Results: Sixty-six (77.6%) of the 85 patients with clinically suspected acute appendicitis, had undergone surgery. The diagnosis of appendicitis could be correctly achieved with MRI in 55 (83.3%) of 57 (86.4%) patients with histopathologically proven acute appendicitis. The sensitivity, specificity, positive predictive value and negative predictive value of MRI examination and Alvarado scoring system in the diagnosis of acute appendicitis were 96.49%, 66.67%, 94.83%, 75.0% and 84.21%, 66.67%, 94.12%, 40.0%, respectively. Conclusions: MRI is a valuable technique for detecting acute appendicitis even in the cases with low Alvarado scores. To increase the diagnostic accuracy and preventing unnecessary laparotomies for suspected appendicitis, shorter and cheaper unenhanced basic MRI may be performed.

  7. Does C-reactive Protein Add Prognostic Value to GRACE Score in Acute Coronary Syndromes?

    Correia, Luis Cláudio Lemos, E-mail: lccorreia@terra.com.br; Vasconcelos, Isis; Garcia, Guilherme; Kalil, Felipe; Ferreira, Felipe; Silva, André; Oliveira, Ruan; Carvalhal, Manuela; Freitas, Caio; Noya-Rabelo, Márcia Maria [Escola Bahiana de Medicina e Saúde Pública, Salvador, BA (Brazil); Hospital São Rafael, Salvador, BA (Brazil)

    2014-05-15

    The incremental prognostic value of plasma levels of C-reactive protein (CRP) in relation to GRACE score has not been established in patients with acute coronary syndrome (ACS) with non-ST segment elevation. To test the hypothesis that CRP measurements at admission increases the prognostic value of GRACE score in patients with ACS. A total of 290 subjects, consecutively admitted for ACS, with plasma material obtained upon admission CRP measurement using a high-sensitivity method (nephelometry) were studied. Cardiovascular outcomes during hospitalization were defined by the combination of death, nonfatal myocardial infarction or nonfatal refractory angina. The incidence of cardiovascular events during hospitalization was 15% (18 deaths, 11 myocardial infarctions, 13 angina episodes) with CRP showing C-statistics of 0.60 (95% CI = 0.51-0.70, p = 0.034) in predicting these outcomes. After adjustment for the GRACE score, elevated CRP (defined as the best cutoff point) tended to be associated with hospital events (OR = 1.89, 95% CI = 0.92 to 3.88, p = 0.08). However, the addition of the variable elevated CRP in the GRACE model did not result in significant increase in C-statistics, which ranged from 0.705 to 0.718 (p = 0.46). Similarly, there was no significant reclassification of risk with the addition of CRP in the predictor model (net reclassification = 5.7 %, p = 0.15). Although CRP is associated with hospital outcomes, this inflammatory marker does not increase the prognostic value of the GRACE score.

  8. Does C-reactive Protein Add Prognostic Value to GRACE Score in Acute Coronary Syndromes?

    The incremental prognostic value of plasma levels of C-reactive protein (CRP) in relation to GRACE score has not been established in patients with acute coronary syndrome (ACS) with non-ST segment elevation. To test the hypothesis that CRP measurements at admission increases the prognostic value of GRACE score in patients with ACS. A total of 290 subjects, consecutively admitted for ACS, with plasma material obtained upon admission CRP measurement using a high-sensitivity method (nephelometry) were studied. Cardiovascular outcomes during hospitalization were defined by the combination of death, nonfatal myocardial infarction or nonfatal refractory angina. The incidence of cardiovascular events during hospitalization was 15% (18 deaths, 11 myocardial infarctions, 13 angina episodes) with CRP showing C-statistics of 0.60 (95% CI = 0.51-0.70, p = 0.034) in predicting these outcomes. After adjustment for the GRACE score, elevated CRP (defined as the best cutoff point) tended to be associated with hospital events (OR = 1.89, 95% CI = 0.92 to 3.88, p = 0.08). However, the addition of the variable elevated CRP in the GRACE model did not result in significant increase in C-statistics, which ranged from 0.705 to 0.718 (p = 0.46). Similarly, there was no significant reclassification of risk with the addition of CRP in the predictor model (net reclassification = 5.7 %, p = 0.15). Although CRP is associated with hospital outcomes, this inflammatory marker does not increase the prognostic value of the GRACE score

  9. Optimizing cutoff scores for the Barthel Index and the modified Rankin Scale for defining outcome in acute stroke trials

    Uyttenboogaart, Maarten; Stewart, Roy E.; Vroomen, Patrick C A J; Keyser, Jacques De; Luijckx, Gert-Jan

    2005-01-01

    Background and Purpose - There is little agreement on how to assess outcome in acute stroke trials. Cutoff scores for the Barthel Index (BI) and modified Rankin Scale (mRS) are frequently arbitrarily chosen to dichotomize favorable and unfavorable outcome. We investigated sensitivity and specificity of BI cutoff scores in relation to the mRS to obtain the optimal corresponding BI and mRS scores. Methods - BI and mRS scores were collected from 1034 ischemic stroke patients. Sensitivity and spe...

  10. Renal response to acute acid loading--an organ physiological approach

    Osther, P J; Engel, K; Kildeberg, P

    2004-01-01

    OBJECTIVE: In previous studies of the renal response to acute NH4Cl acidosis no correlation was found between systemic acid-base status and the traditionally used quantity, renal net acid excretion (NAE). If NAE is to be considered a physiologically meaningful quantity then this is surprising, as......-base metabolism during acid loading than previously described methods....

  11. The risk assessment score in acute whiplash injury predicts outcome and reflects biopsychosocial factors

    Kasch, Helge; Qerama, Erisela; Kongsted, Alice;

    2011-01-01

    One-year prospective study of 141 acute whiplash patients (WLP) and 40 acute ankle-injured controls.......One-year prospective study of 141 acute whiplash patients (WLP) and 40 acute ankle-injured controls....

  12. Impact of the use of contrast-enhancement multidetector CT for acute appendicitis: a prospective comparison with the Alvarado score

    To determine the diagnostic performance of contrast-enhanced multidetector CT (MDCT) and the Alvarado score for acute appendicitis. MDCT and determination of the Alvarado score were prospectively performed in 282 patients with 146 pathologically proven cases of acute appendicitis and 136 pathologically proven or clinically diagnosed cases of non-acute appendicitis. To compare the diagnostic performance of MDCT and the Alvarado score, the patients were subdivided according to age and sex, and receiver operating characteristics (ROC) analysis and Spearman rank correlation were performed. ROC analysis revealed that the optimal cut off value of the CT appendicitis grades was 2 in all patients, resulting in a sensitivity of 96.6% and a specificity of 94.9%. The optimal cut off values of the Alvarado score was different according to age and sex, resulting in a sensitivity of 85.6% and a specificity of 48.5%. There was a significant correlation between the CT appendicitis grades and the surgical-pathological grades (r = 0.496, ρ < .0001). However, no significant correlation was observed between the Alvarado score and the surgical-pathological grades. Contrast-enhanced MDCT has a higher diagnostic accuracy and significant correlation with pathological findings than those of the Alvarado score in patients with acute appendicitis

  13. Evaluation of acute myocardial infarction by 201Tl single-photon emission computed tomography using scoring system

    In 36 patients with acute myocardial infarction (AMI) 201Tl single photon emission computed tomography (SPECT) examinations were performed in a relatively early phase of AMI. The short and long axis views of the left ventricle (LV) were divided into 6 segments. Images of each segment were assigned scores (segmental scores) based on a visual evaluation of the extent of 201Tl accumulations. SPECT scores were compared with max GOT, max LDT, max CPK and max CK-MB, Killip classification and Forrester hemodynamic subset on admission, and LV ejection fraction (LVEF). Segmental scores were compared with LV wall motion evaluated by left ventriculography. The results are as follows: There were significant correlations between SPECT scores and max GOT, max LDH, max CPK and max CK-MB. SPECT scores in patients with Killip group III were significantly higher than in patients with Killip group I+II. However, no significant differences in max GOT, max LDH, max CPK and max CK-MB were observed between patients with Killip group III and those with Killip group I+II. SPECT scores were significantly higher in patients with Forrester group III+IV than in patients with Forrester group I+II. Segmental scores in segments evaluated as akinesis, dyskinesis and aneurysm by left ventriculography were significantly higher than those evaluated as hypokinesis or normal. Segmental scores in segments evaluated as hypokinesis were significantly high in comparison with normal segments. Significant correlations were observed between LVEF and SPECT scores. However, LVEF correlated poorly with max GOT, max LDH and max CPK, and no significant correlation was observed between LVEF and max CK-MB. SPECT examinations were performed in 11 patients in both the acute and chronic phase of AMI. SPECT scores in the chronic phase did not change in 4 patients, decreased in 5, increased in 2. These results suggest that SPECT scores and segmental scores can be useful indices in the evaluation of AMI. (J.P.N.)

  14. Tail docking in pigs: acute physiological and behavioural responses.

    Sutherland, M A; Bryer, P J; Krebs, N; McGlone, J J

    2008-02-01

    Tail docking of piglets is a routine procedure on farms to control tail-biting behaviour; however, docking can cause an acute stress response. The objectives of this research were to determine the stress responses to tail docking in piglets and to compare two methods of tail docking; cautery iron (CAUT) and the more commonly used blunt trauma cutters (BT). At approximately 6 days of age, piglets were tail docked using CAUT (n = 20), BT (n = 20) or sham tail docked with their tails remaining intact (CON; n = 40). Blood samples were taken prior to tail docking and at 30, 60 and 90 min after tail docking to evaluate the effect of tail docking on white blood cell (WBC) measures and cortisol concentrations. The above experiment was repeated to observe behaviour without the periodic blood sampling, so as not to confound the effects of blood sampling on piglet behaviour. Piglet behaviour was recorded in the farrowing crate using 1 min scan-samples via live observations for 60 min prior to and 90 min after tail docking. Total WBC counts were reduced (P > 0.05) among BT and CAUT compared with CON piglets 30 min after tail docking. Cortisol concentrations were higher (P tail docking. Cautery and BT-docked piglets spent more (P tail docking. Piglets tail docked using CAUT and BT tended to spend more (P tail docking. Elevated blood cortisol can be reduced by the use of the CAUT rather than the BT method of tail docking. Although the tail docking-induced rise in cortisol was prevented by using CAUT, the behavioural response to BT and CAUT docking methods was similar. PMID:22445023

  15. BISAP SCORE: A SIMPLE TOOL TO ASSESS THE SEVERITY AND PREDICT THE MORBIDITY AND MORTALITY IN ACUTE PANCREATITIS

    Hariprasad; Haridarshan; Puneetha; Rajagopalan

    2015-01-01

    NEED FOR STUDY The present study is to use a simple bedside tool as a scoring system to assess the severity of acute pancreatitis and to predict its risks for morbidity and mortality. The main criteria of this study is to highlight the ease of using this tool to identify the severity of acute pancreatitis as early as possible in order to reduce the complications, risks and to improve the outcome and overall survival. MATERIALS AND METHODS Our study is a single centre,...

  16. BISAP SCORE: A SIMPLE TOOL TO ASSESS THE SEVERITY AND PREDICT THE MORBIDITY AND MORTALITY IN ACUTE PANCREATITIS

    Hariprasad

    2015-12-01

    Full Text Available NEED FOR STUDY The present study is to use a simple bedside tool as a scoring system to assess the severity of acute pancreatitis and to predict its risks for morbidity and mortality. The main criteria of this study is to highlight the ease of using this tool to identify the severity of acute pancreatitis as early as possible in order to reduce the complications, risks and to improve the outcome and overall survival. MATERIALS AND METHODS Our study is a single centre, prospective observational study conducted at Rajarajeshwari Medical College Hospital, Bangalore, India from September 2014 to September 2015. Forty six patients, both males and females presenting within 24 hours of onset of symptoms diagnosed with acute pancreatitis were included in the study. Informed consents were obtained from all patients. Cases of chronic pancreatitis and acute on chronic pancreatitis were excluded. Pediatric patients of age less than 14 years and geriatric patients more than 70 years were excluded. RESULTS We observed that biliary pancreatitis was the most common with male population more affected than females. Pain abdomen was the most common presentation in the entire study population. Necrotizing pancreatitis was most commonly associated with ICU admission and prolonged hospital stay. Patients with organ failure and BISAP score more than 3 were found to have prolonged hospital stay. SIRS was the most common component of BISAP scoring system seen in 91.3%. Elderly patients with age more than 60 years (6 pts. had high BISAP score (5. All patients with shock had BISAP score of >3. A BISAP score of ≥3 was associated with higher morbidity than scores of <3. CONCLUSION BISAP is a simple and a quick tool over other scoring systems and is similar to other scoring systems to predict the severity and prognosis of acute pancreatitis. In summary we have studied the ease of BISAP scoring system and its advantage in early recognition of acute pancreatitis, thus taking

  17. The thromboelastometric discrepancy between septic and trauma induced disseminated intravascular coagulation diagnosed by the scoring system from the Japanese association for acute medicine.

    Koami, Hiroyuki; Sakamoto, Yuichiro; Sakurai, Ryota; Ohta, Miho; Imahase, Hisashi; Yahata, Mayuko; Umeka, Mitsuru; Miike, Toru; Nagashima, Futoshi; Iwamura, Takashi; Yamada, Kosuke Chris; Inoue, Satoshi

    2016-08-01

    The aim of this study is to evaluate the hematological differences between septic and traumatic disseminated intravascular coagulation (DIC) using the rotational thromboelastometry (ROTEM).This retrospective study includes all sepsis or severe trauma patients transported to our emergency department who underwent ROTEM from 2013 to 2014. All patients were divided into 2 groups based on the presence of DIC diagnosed by the Japanese Association for Acute Medicine (JAAM) DIC score. We statistically analyzed the demographics, clinical characteristics, laboratory data, ROTEM findings (EXTEM and FIBTEM), and outcome.Fifty-seven patients (30 sepsis and 27 severe trauma) were included in primary analysis. Sepsis cases were significantly older and had higher systemic inflammatory response syndrome (SIRS) scores, whereas there were no significant differences in other parameters including Acute Physiology and Chronic Health Evaluation (APACHE) II score, sequential organ failure assessment (SOFA) score. Twenty-six patients (14 sepsis and 12 severe trauma) were diagnosed with DIC. The Septic DIC (S-DIC) group was significantly older and had higher DIC scores than the traumatic DIC (T-DIC) group. Hematologic examination revealed significantly higher CRP, fibrinogen, lower FDP, DD, and higher FDP/DD ratio were found in the S-DIC group in comparison with the T-DIC group. ROTEM findings showed that the A10, A20, and MCF in the FIBTEM test were significantly higher in the S-DIC group. However, no statistical differences were confirmed in the LI30, LI45, and ML in EXTEM test.The plasma fibrinogen level and fibrinogen based clot firmness in whole-blood test revealed statistical significance between septic and traumatic DIC patients. PMID:27495106

  18. External Validation of the Simple Clinical Score and the HOTEL Score, Two Scores for Predicting Short-Term Mortality after Admission to an Acute Medical Unit

    Stræde, Mia; Brabrand, Mikkel

    2014-01-01

    the objective of validating the Simple Clinical Score (SCS) and the HOTEL score, two existing risk stratification systems that predict mortality for medical patients based solely on clinical information, but not only vital signs. METHODS: Pre-planned prospective observational cohort study. SETTING......], 0.932 to 0.988) for 24-hours mortality and 0.826 (95% CI, 0.774-0.879) for 30-day mortality, and goodness-of-fit test, χ2 = 2.68 (10 degrees of freedom), P = 0.998 and χ2 = 4.00, P = 0.947, respectively. We included 1470 patients when calculating the HOTEL score. Discriminatory power (AUROC) was 0.......931 (95% CI, 0.901-0.962) for 24-hours mortality and goodness-of-fit test, χ2 = 5.56 (10 degrees of freedom), P = 0.234. CONCLUSION: We find that both the SCS and HOTEL scores showed an excellent to outstanding ability in identifying patients at high risk of dying with good or acceptable precision....

  19. Physiological Responses to Acute Psychological Stress Are Reduced by the PPARγ Agonist Rosiglitazone

    Ryan, Karen K.; Grayson, Bernadette E.; Jones, Kenneth R.; Schneider, Alexander L.; Woods, Stephen C.; Seeley, Randy J.; Herman, James P.; Ulrich-Lai, Yvonne M.

    2012-01-01

    Physiological reactions to psychological stress are positively associated with several important chronic conditions including cardiovascular and neurodegenerative diseases and are linked to increased mortality. As such, the identification of cellular and molecular pathways that act to reduce stress responding may represent important targets for therapeutic intervention. Here we report that acute treatment with the peroxisome-proliferator activated receptor-γ (PPARγ) agonist rosiglitazone (RSG...

  20. Metal composition of fine particulate air pollution and acute changes in cardiorespiratory physiology

    Background: Studying the physiologic effects of components of fine particulate mass (PM2.5) could contribute to a better understanding of the nature of toxicity of air pollution. Objectives: We examined the relation between acute changes in cardiovascular and respiratory function, and PM2.5-associated-metals. Methods: Using generalized linear mixed models, daily changes in ambient PM2.5-associated metals were compared to daily changes in physiologic measures in 59 healthy subjects who spent 5-days near a steel plant and 5-days on a college campus. Results: Interquartile increases in calcium, cadmium, lead, strontium, tin, vanadium and zinc were associated with statistically significant increases in heart rate of 1–3 beats per minute, increases of 1–3 mmHg in blood pressure and/or lung function decreases of up to 4% for total lung capacity. Conclusion: Metals contained in PM2.5 were found to be associated with acute changes in cardiovascular and respiratory physiology. - Highlights: • We measured daily lung function, heart rate and blood pressure in 61 subjects. • Study sites were adjacent to a steel plant and on a college campus. • PM2.5-associated metal concentrations were measured daily at each site. • On days of higher metal concentrations, physiologic variables slightly deteriorated. • Some metal components may contribute to the toxicity of PM2.5. - Several PM2.5 metals were associated with acute changes in cardiovascular or respiratory physiology. Given the evidence of source specificity, our study provides novel information

  1. Detection of acute deterioration in health status visit among COPD patients by monitoring COPD assessment test score

    Pothirat C

    2015-02-01

    Full Text Available Chaicharn Pothirat, Warawut Chaiwong, Atikun Limsukon, Athavudh Deesomchok, Chalerm Liwsrisakun, Chaiwat Bumroongkit, Theerakorn Theerakittikul, Nittaya PhetsukDivision of Pulmonary, Critical Care and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, ThailandBackground: The Chronic Obstructive Pulmonary Disease Assessment Test (CAT could play a role in detecting acute deterioration in health status during monitoring visits in routine clinical practice.Objective: To evaluate the discriminative property of a change in CAT score from a stable baseline visit for detecting acute deterioration in health status visits of chronic obstructive pulmonary disease (COPD patients.Methods: The CAT questionnaire was administered to stable COPD patients routinely attending the chest clinic of Chiang Mai University Hospital who were monitored using the CAT score every 1–3 months for 15 months. Acute deterioration in health status was defined as worsening or exacerbation. CAT scores at baseline, and subsequent visits with acute deterioration in health status were analyzed using the t-test. The receiver operating characteristic curve was performed to evaluate the discriminative property of change in CAT score for detecting acute deterioration during a health status visit.Results: A total of 354 follow-up visits were made by 140 patients, aged 71.1±8.4 years, with a forced expiratory volume in 1 second of 47.49%±18.2% predicted, who were monitored for 15 months. The mean CAT score change between stable baseline visits, by patients’ and physicians’ global assessments, were 0.05 (95% confidence interval [CI], -0.37–0.46 and 0.18 (95% CI, -0.23–0.60, respectively. At worsening visits, as assessed by patients, there was significant increase in CAT score (6.07; 95% CI, 4.95–7.19. There were also significant increases in CAT scores at visits with mild and moderate exacerbation (5.51 [95% CI, 4.39–6

  2. Some physiological and biochemical methods for acute and chronic stress evaluation in dairy cows

    Giuseppe Bertoni

    2010-01-01

    Full Text Available Stress factors are so numerous and so diverse in their strength and duration that the consequences on animal welfare can be quite varied. The first important distinction concerns the characterization of acute and chronic stress conditions. Acute stress is a short-lived negative situation that allows a quick and quite complete recovery of the physiological balance (adaptation, while chronic stress is a long lasting condition from which the subject cannot fully recover (maladaptation. In the latter case, the direct effects of the stress factors (heat, low energy, anxiety, suffering etc., as well as the indirect ones (changes occurring at endocrinological, immune system or function level can be responsible for pre-pathological or pathological consequences which reduce animal welfare. To evaluate the possible chronic stress conditions in single animals or on a farm (in particular a farm of dairy cows, some parameters of the direct or indirect effects can be utilised. They are physiological (mainly hormone changes: cortisol, β-endorphin, behavioural (depression, biochemical (metabolites, acute phase proteins, glycated proteins etc., as well as performance parameters (growing rate, milk yield, fertility, etc.. Special attention has been paid to the interpretation of cortisol levels and to its changes after an ACTH challenge. Despite fervent efforts, well established and accepted indices of chronic stress (distress are currently lacking; but without this objective evaluation, the assessment of animal welfare and, therefore, the optimization of the livestock production, could prove more difficult.

  3. Physiotherapy Needs Assessment of People with Stroke Following Discharge from Hospital, Stratified by Acute Functional Independence Measure Score

    DePaul, Vincent G; Moreland, Julie D.; deHueck, Amy L.

    2013-01-01

    Purpose: To determine the physiotherapy-related needs of people with stroke at discharge, 6 months after discharge, and 1 year after discharge from hospital, and to examine the results stratified by participants' acute Functional Independence Measure (FIM) scores. Methods: A total of 241 adults with recent stroke were recruited into this longitudinal cohort study. As well as participating in a semi-structured interview that included questions about mobility needs and barriers, participants we...

  4. Physiology

    Kay, Ian

    2008-01-01

    Underlying recent developments in health care and new treatments for disease are advances in basic medical sciences. This edition of "Webwatch" focuses on sites dealing with basic medical sciences, with particular attention given to physiology. There is a vast amount of information on the web related to physiology. The sites that are included here…

  5. Characterization and scoring of skin changes in severe acute malnutrition in children between 6 months and 5 years of age

    Heilskov, S; Vestergaard, C; Iriso, Esther Babirekere;

    2015-01-01

    BACKGROUND: Severe acute malnutrition is a life-threatening condition. It can be associated with severe skin changes, first properly described by Williams in 1933. The aetiology of these skin changes is still unknown and their character has never been systematically described in dermatological...... objective was to identify the skin changes characteristic of children with severe acute malnutrition and to develop a clinical score that describes the morphology and severity in dermatological terms. We also investigated if any of the different skin changes were connected to prognosis. MATERIALS AND...... METHODS: At Mulago Hospital, Mwanamugimu (Department of Paediatrics and Child Health), Uganda, 120 children were included over a period of six months and observed when treated for severe acute malnutrition. Skin changes were registered through clinical examination and photo documentation and associated to...

  6. Pulmonary perfusion imaging combined with Wells score and D-dimer assay for the diagnosis of acute pulmonary embolism

    Objective: To investigate the value of the Wells score and D-dimer assay in assisting pulmonary perfusion imaging (PPI) for the diagnosis of acute pulmonary embolism (APE). Methods: One hundred twenty-one patients with suspected APE were studied from January, 2006 to December, 2008. All patients underwent the Wells score, the quantitative D-dimer assay, chest X-ray photography, and PPI. The diagnostic sensitivity, specificity, positive predictive value and negative predictive value of PPI with the assistance of Wells score and D-dimer assay were calculated. Results: Fifty (41.3%) patients were diagnosed with APE. PPI combined with chest X-ray photography (Q/X scan) showed positive results in 49 patients. The sensitivity, specificity, positive predictive value and negative predictive value of the Q/X scan were 86.0% (43/50), 91.5% (65/71), 87.8% (43/49) and 90.3% (65/72), respectively. With assistance of Wells score >4 and D-dimer ≥0.5 mg/L, Q/X scan had a positive predictive value of 100.0% (29/29), for patients with Wells score ≤4 and D-dimer <0.5 mg/L, the negative predictive value for Q/X scan was 100.0% (41/41). Conclusion: Combined with Wells score and D-dimer assay, PPI can make accurate diagnosis of APE. (authors)

  7. Effect of harmless acute pancreatitis score, red cell distribution width and neutrophil/lymphocyte ratio on the mortality of patients with nontraumatic acute pancreatitis at the emergency department

    Gülen, Bedia; Sonmez, Ertan; Yaylaci, Serpil; Serinken, Mustafa; Eken, Cenker; Dur, Ali; Turkdogan, Figen Tunali; Söğüt, Özgür

    2015-01-01

    BACKGROUND: Harmless acute pancreatitis score (HAPS), neutrophile/lymphocyte ratio and red blood cell distribution width (RDW) are used to determine the early prognosis of patients diagnosed with nontraumatic acute pancreatitis in the emergency department (ED). METHODS: Patients diagnosed with acute pancreatitis (K 85.9) in the ED according to the ICD10 coding during one year were included in the study. Patients with chronic pancreatitis and those who had missing data in their files were excluded from the study. Patients who did not have computed tomography (CT) in the ED were not included in the study. RESULTS: Ultimately, 322 patients were included in the study. The median age of the patients was 53.1 (IQR=36–64). Of the patients, 68.1% (n=226) had etiological causes of the biliary tract. The mortality rate of these patients within the first 48 hours was 4.3% (n=14). In the logistic regression analysis performed by using Balthazar classification, HAPS score, RDW, neutrophile/lymphocyte ratio, age, diabetes mellitus and systolic blood pressure, the only independent variable in determining mortality was assigned as Balthazar classification (OR: 15; 95% CI: 3.5 to 64.4). CONCLUSIONS: HAPS, neutrophile/lymphocyte ratio and RDW were not effective in determining the mortality of nontraumatic acute pancreatitis cases within the first 48 hours. The only independent variable for determining the mortality was Balthazar classification. PMID:25802563

  8. Effects of LI4 Acupressure on length of delivery time, some of physiologic responseEffects of LI4 Acupressure on Length of Delivery Time, Mothers’ Physiologic Physiologic Responses and Newborn’s Apgar Scores s and Apgar scores in women during of labor

    azam hamidzade; Farangis Shahpourian; Roohangiz Jamshidi- Orak; Mahbobe Pourheydar

    2010-01-01

    Introduction: Prolonged labor has been associated with cesarean delivery and low Ph cord blood. Furthermore, hemorrhage and infection, which are strongly associated with long labor, are leading causes of maternal death. Due to the importance of duration of labor, this study investigates the effects of Hego (LI4) acupressure on length of delivery time, mothers’ physiological responses i.e., respiration and pulse rates of mothers, and Apgar scores of newborns. Methods: In this randomized clinic...

  9. Effects of copper on the acute cortisol response and associated physiology in rainbow trout.

    Tellis, Margaret S; Alsop, Derek; Wood, Chris M

    2012-03-01

    The aim of this study was to determine the effects of chronic waterborne copper (Cu) exposure on the acute stress-induced cortisol response and associated physiological consequences in rainbow trout (Oncorhynchus mykiss). Trout were exposed to 30 μg Cu/L in moderately hard water (120 mg/L as CaCO(3)) for 40 days, following which time the acute cortisol response was examined with a series of stressors. At 40 days, a 65% increase in Cu was observed in the gill, but no accumulation was observed in the liver, brain or head kidney. Stressors such as air exposure or confinement did not elicit an increase in circulating cortisol levels for Cu-exposed fish, in contrast to controls. However, this inhibitory effect on the acute cortisol response appeared to have few implications on the ability of Cu-exposed fish to maintain ion and carbohydrate homeostasis. For example, plasma Na(+), Ca(2+) and glucose levels as well as hepatic glycogen levels were the same post-stress in control and Cu-exposed fish. Trout were also challenged with exposure to 50% seawater for 48 h, where Cu-exposed trout maintained plasma Na(+), glucose and hepatic glycogen levels. However, Cu-exposed fish experienced decreased plasma K(+) levels throughout the Cu exposure and stress tests. In conclusion, chronic Cu exposure resulted in the abolition of an acute cortisol response post-stress. There was no Cu accumulation in the hypothalamus-pituitary-interrenal axis (HPI axis) suggesting this was not a direct toxic effect of Cu on the cortisol regulatory pathway. However, the lack of an acute cortisol response in Cu-exposed fish did not impair the ability of the fish to maintain ion and carbohydrate homeostasis. This effect on cortisol may be a strategy to reduce costs during the chronic stress of Cu exposure, and not endocrine disruption as a result of toxic injury. PMID:21964321

  10. A Genomic Score Prognostic of Outcome in Trauma Patients

    Warren, H. Shaw; Elson, Constance M; Hayden, Douglas L.; Schoenfeld, David A.; Cobb, J. Perren; Ronald V Maier; Moldawer, Lyle L; Moore, Ernest E; HARBRECHT, BRIAN G; Pelak, Kimberly; Cuschieri, Joseph; Herndon, David N; Jeschke, Marc G.; Finnerty, Celeste C.; Brownstein, Bernard H

    2009-01-01

    Traumatic injuries frequently lead to infection, organ failure, and death. Health care providers rely on several injury scoring systems to quantify the extent of injury and to help predict clinical outcome. Physiological, anatomical, and clinical laboratory analytic scoring systems (Acute Physiology and Chronic Health Evaluation [APACHE], Injury Severity Score [ISS]) are utilized, with limited success, to predict outcome following injury. The recent development of techniques for measuring the...

  11. Acute Physiological Responses to Strongman Training Compared to Traditional Strength Training.

    Harris, Nigel K; Woulfe, Colm J; Wood, Matthew R; Dulson, Deborah K; Gluchowski, Ashley K; Keogh, Justin B

    2016-05-01

    Harris, NK, Woulfe, CJ, Wood, MR, Dulson, DK, Gluchowski, AK, and Keogh, JB. Acute physiological responses to strongman training compared to traditional strength training. J Strength Cond Res 30(5): 1397-1408, 2016-Strongman training (ST) has become an increasingly popular modality, but data on physiological responses are limited. This study sought to determine physiological responses to an ST session compared to a traditional strength exercise training (RST) session. Ten healthy men (23.6 ± 27.5 years, 85.8 ± 10.3 kg) volunteered in a crossover design, where all participants performed an ST session, an RST session, and a resting session within 7 days apart. The ST consisted of sled drag, farmer's walk, 1 arm dumbbell clean and press, and tire flip at loads eliciting approximately 30 seconds of near maximal effort per set. The RST consisted of squat, deadlift, bench press, and power clean, progressing to 75% of 1 repetition maximum. Sessions were equated for approximate total set duration. Blood lactate and salivary testosterone were recorded immediately before and after training sessions. Heart rate, caloric expenditure, and substrate utilization were measured throughout the resting session, both training protocols and for 80 minutes after training sessions. Analyses were conducted to determine differences in physiological responses within and between protocols. No significant changes in testosterone occurred at any time point for either session. Lactate increased significantly immediately after both sessions. Heart rate, caloric expenditure, and substrate utilization were all elevated significantly during ST and RST. Heart rate and fat expenditure were significantly elevated compared to resting in both sessions' recovery periods; calorie and carbohydrate expenditures were not. Compared to RST, ST represents an equivalent physiological stimulus on key parameters indicative of potential training-induced adaptive responses. Such adaptations could conceivably

  12. Predictive value of daily living score in acute respiratory failure of COPD patients requiring invasive mechanical ventilation pilot study

    Langlet Ketty

    2012-10-01

    Full Text Available Abstract Background Mechanical ventilation (MV is imperative in many forms of acute respiratory failure (ARF in COPD patients. Previous studies have shown the difficulty to identify parameters predicting the outcome of COPD patients treated by invasive MV. Our hypothesis was that a non specialized score as the activities daily living (ADL score may help to predict the outcome of these patients. Methods We studied the outcome of 25 COPD patients admitted to the intensive care unit for ARF requiring invasive MV. The patients were divided into those weaning success (group A n = 17, 68% or failure (group B n = 8, 32%. We investigated the correlation between the ADL score and the outcome and mortality. Results The ADL score was higher in group A (5.1 ±1.1 vs 3.7 ± 0.7 in group B, p  Conclusion Our pilot study demonstrates that the ADL score is predictive of weaning success and mortality at 6 months, suggesting that the assessment of daily activities should be an important component of ARF management in COPD patients.

  13. Serious acute pyelonephritis: a predictive score for evaluation of deterioration of treatment based on clinical and radiologic findings using CT

    Kim, See Hyung; Kim, Young Whan; Lee, Hee Jung (Department of Radiology, Keimyung University, Dongsan Hospital, Daegu (Korea, Republic of)), Email: kseehdr@dsmc.or.kr

    2012-03-15

    Background. Acute pyelonephritis (APN) requires prompt diagnosis and immediate treatment. Purpose To develop a simple score to assist in diagnosing treatment deterioration in patients with serious APN. Material and Methods. Using data from a retrospective cohort of 193 patients with APN, we developed scores based on multivariate logistic regression after the jackknife procedure. We validated the scores in a prospective cohort of 40 patients. Results. Nine criteria were independently associated with our investigation: Abscess (adjusted odds ratio [OR], 19.8; 95% confidence interval [95% CI] 4.5-72.1), pyonephrosis with or without stone (18.3; 4.8-70.9), pelvicalyceal air (15.5; 3.2-26.9), poor global excretion of contrast (12.3; 2.9-68.5), tachycardia or hypotension (10.1; 2.5-28.0), obliteration of the renal sinus (9.6; 2.5-45.2), persistent fever or pyuria (9.8; 1.9-25.8), diabetes (9.4; 2.0-31.8), and global renal enlargement (7.5; 2.1-35.8). The APN score was based on these nine criteria. Low-risk and high-risk groups were derived from the score (probability, 3.5% [95% CI 0-7.5] and 67% [51-83]). Application of these criteria to the prospective cohort confirmed the diagnostic accuracy of the score (probability 0% [0-15] and 71% [25-100] in the low-risk and high-risk groups, respectively). Conclusion. This easy-to-calculate score may prove useful for diagnosing patients with serious APN who deteriorate with treatment

  14. ALVARADO’S ACUTE APPENDICITIS SCORE FOR ALGORITHM, ADMISSION AND APPENDICECTOMY

    Kiran Kumar

    2014-03-01

    Full Text Available Appendicitis is a most common abdominal surgical emergency, clinically mimicked by other pathologies. Even with modern imaging, at times diagnosis is challenging. Several scorings are available to predict pre-operative diagnosis.

  15. Canada acute coronary syndrome score was a stronger baseline predictor than age ≥75 years of in-hospital mortality in acute coronary syndrome patients in western Romania

    Pogorevici, Antoanela; Citu, Ioana Mihaela; Bordejevic, Diana Aurora; Caruntu, Florina; Tomescu, Mirela Cleopatra

    2016-01-01

    Background Several risk scores were developed for acute coronary syndrome (ACS) patients, but their use is limited by their complexity. Purpose The purpose of this study was to identify predictors at admission for in-hospital mortality in ACS patients in western Romania, using a simple risk-assessment tool – the new Canada acute coronary syndrome (C-ACS) risk score. Patients and methods The baseline risk of patients admitted with ACS was retrospectively assessed using the C-ACS risk score. The score ranged from 0 to 4; 1 point was assigned for the presence of each of the following parameters: age ≥75 years, Killip class >1, systolic blood pressure 100 bpm. Results A total of 960 patients with ACS were included, 409 (43%) with ST-segment elevation myocardial infarction (STEMI) and 551 (57%) with non-ST-segment elevation acute coronary syndrome (NSTE-ACS). The C-ACS score predicted in-hospital mortality in all ACS patients with a C-statistic of 0.95 (95% CI: 0.93–0.96), in STEMI patients with a C-statistic of 0.92 (95% confidence interval [CI]: 0.89–0.94), and in NSTE-ACS patients with a C-statistic of 0.97 (95% CI: 0.95–0.98). Of the 960 patients, 218 (22.7%) were aged ≥75 years. The proportion of patients aged ≥75 years was 21.7% in the STEMI subgroup and 23.4% in the NSTE-ACS subgroup (P>0.05). Age ≥75 years was significantly associated with in-hospital mortality in ACS patients (odds ratio [OR]: 3.25, 95% CI: 1.24–8.25) and in the STEMI subgroup (OR >3.99, 95% CI: 1.28–12.44). Female sex was strongly associated with mortality in the NSTE-ACS subgroup (OR: 27.72, 95% CI: 1.83–39.99). Conclusion We conclude that C-ACS score was the strongest predictor of in-hospital mortality in all ACS patients while age ≥75 years predicted the mortality well in the STEMI subgroup.

  16. Baux’s and Abbreviated Burn Severity Score for the Prediction of Mortality in Patients with Acute Burn Injury

    Peeyush Dahal

    2016-01-01

    Full Text Available jdjdBackground & Objectives: Prediction of outcome for patients with major thermal injury is important to inform clinical decision making, alleviate individual suffering and improve hospital resource allocation. Early prediction of outcome (i.e., survival or mortality may help triage effectively, and to implement medical and surgical interventions efficiently as soon as possible. Burn mortality has decreased markedly with the improvement in burn management in the past 100 years, and multiple burn mortality prediction models have been developed over these times in response to that decline. But these services are still not enough to reduce the burn related injuries in low income country like Nepal. So we did a study to observe the effectiveness of two different but very popular models (Baux and ABSI in our context.Materials & Methods: This was a prospective observational study where 92 cases of severe burn injury was selected and the results were compared with Baux and ABSI scoring system.Results: Total admission was 140 and mortality was 33. Out of these admission 92 cases of severe burn injury was selected for the study. Most (85.8 % of were among the young group 16-40 years. It comprises 41.3 % in total. In total 63.7 % were female. Mortality with severe burn injury was 29.3%. No death had occurred below the Baux’s score 30 and there was more than 51% mortality above the score of 60. There was no mortality with ABSI scoring < 3 and mortality was high in ABSI scoring > 6.Conclusion: Baux and ABSI score systems are simple to calculate and ABSI is more accurate for prediction of acute burn injury.Journal of College of Medical Sciences-Nepal, Vol.11(4 2015: 24-27

  17. Application of Portsmouth modification of physiological and operative severity scoring system for enumeration of morbidity and mortality (P-POSSUM in pancreatic surgery

    Tamijmarane Appou

    2008-04-01

    Full Text Available Abstract Background Pancreatoduodenectomy (PD is associated with high incidence of morbidity and mortality. We have applied P-POSSUM in predicting the incidence of outcome after PD to identify those who are at the highest risk of developing complications. Method A prospective database of 241 consecutive patients who had PD from January 2002 to September 2005 was retrospectively updated and analysed. P-POSSUM score was calculated for each patient and correlated with observed morbidity and mortality. Results 30 days mortality was 7.8% and morbidity was 44.8%. Mean physiological score was 16.07 ± 3.30. Mean operative score was 13.67 ± 3.42. Mean operative score rose to 20.28 ± 2.52 for the complex major operation (p 18, the O:P ratio was nearer to 1. Physiological score and white cell count were significant in a multivariate model. Conclusion P-POSSUM underestimated the mortality rate. While P-POSSUM analysis gave a truer prediction of morbidity, underestimation of morbidity and potential for systematic inaccuracy in prediction of complications at lower risk levels is a significant issue for pancreatic surgery

  18. Clinical use of the combined Sclarovsky Birnbaum Severity and Anderson Wilkins Acuteness scores from the pre-hospital ECG in ST-segment elevation myocardial infarction.

    Fakhri, Yama; Schoos, Mikkel M; Clemmensen, Peter; Sejersten, Maria

    2014-01-01

    This review summarizes the electrocardiographic changes during an evolving ST segment elevation myocardial infarction and discusses associated electrocardiographic scores and the potential use of these indices in clinical practice, in particular the ECG scores developed by Anderson and Wilkins estimating the acuteness of myocardial ischemia and Sclarovsky-Birnbaum's grades of ischemia evaluating the severity of ongoing ischemia. PMID:24792905

  19. Time course of lesion development in patients with acute brain stem infarction and correlation with NIHSS score

    Background and purpose: diffusion weighted magnetic resonance imaging (MRI) is highly sensitive in detecting acute supratentorial cerebral ischemia and Diffusion Weighted Imaging (DWI) lesion size has been shown to correlate strongly with the neurologic deficit in middle cerebral artery territory stroke. However, data concerning infratentorial strokes are rare. We examined the size and evolution of acute brain stem ischemic lesions and their relationship to neurological outcome. Methods: brain stem infarctions of 11 patients were analyzed. We performed DWI in all patients and in 7/11 patients within 24 h, T2W sequences within the first 2 weeks (10/11 patients) and follow-up MRI (MR2) within 3-9 months (median 4.8 months) later (12/12 patients). Lesion volumes were compared with early and follow-up neurologic deficit as determined by National Institutes of Health Stroke Scale (NIHSS) score. Results: the relative infarct volumes--with MR2 lesion size set to 100%--decreased over the time (P<0.02) with a mean shrinking factor of 3.3 between DWI (MR0) and the follow-up MRT (P<0.02), and 1.6 between early T2W (MR1) and MR2 (P<0.04). The mean DWI volume size (MR0) was larger than the early T2W (P<0.02). Although neurological outcome was good in all patients (mean NIHSS score of 1.3 at follow-up), early NIHSS and follow-up NIHSS scores were strongly correlated (r=0.9, P<0.00). NIHSS score at follow-up was highly correlated with lesion size of DWI (MR0; r=0.71, P<0.04) and T2W of MR1 (r=0.86, P<0.001). Conclusions: in this study, we saw a shrinking of the brain stem infarct volume according to clinical improvement of patients. Great extension of restricted diffusion in the acute stage does not necessarily implicate a large resulting infarction or a bad clinical outcome

  20. A chest radiograph scoring system in patients with severe acute respiratory infection: a validation study

    Taylor, Emma; Haven, Kathryn; Reed, Peter; Bissielo, Ange; Harvey, Dave; McArthur, Colin; Bringans, Cameron; Freundlich, Simone; Ingram, R. Joan H.; Perry, David; Wilson, Francessa; Milne, David; Modahl, Lucy; Huang, Q. Sue; Gross, Diane

    2015-01-01

    Background The term severe acute respiratory infection (SARI) encompasses a heterogeneous group of respiratory illnesses. Grading the severity of SARI is currently reliant on indirect disease severity measures such as respiratory and heart rate, and the need for oxygen or intensive care. With the lungs being the primary organ system involved in SARI, chest radiographs (CXRs) are potentially useful for describing disease severity. Our objective was to develop and validate a SARI CXR severity s...

  1. Yellow flag scores in a compensable New Zealand cohort suffering acute low back pain

    Grimmer-Somers, Karen

    2008-01-01

    Karen Grimmer-Somers1, Mathew Prior1, Jim Robertson21Centre for Allied Health Evidence, University of South Australia, City East Campus, North Tce, Adelaide, South Australia, Australia; 2New Zealand Accident Compensation Corporation, Auckland, New ZealandBackground: Despite its high prevalence, most acute low back pain (ALBP) is nonspecific, self-limiting with no definable pathology. Recurrence is prevalent, as is resultant chronicity. Psychosocial factors (yellow flags comprising depression ...

  2. Combined Value of Red Blood Cell Distribution Width and Global Registry of Acute Coronary Events Risk Score for Predicting Cardiovascular Events in Patients with Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention

    Zhao, Na; Mi, Lan; Liu, Xiaojun; Pan, Shuo; Xu, Jiaojiao; Xia, Dongyu; Liu, Zhongwei; Zhang, Yong; Xiang, Yu; Yuan, Zuyi; Guan, Gongchang; Wang, Junkui

    2015-01-01

    Global Registry of Acute Coronary Events (GRACE) risk score and red blood cell distribution width (RDW) content can both independently predict major adverse cardiac events (MACEs) in patients with acute coronary syndrome (ACS). We investigated the combined predictive value of RDW and GRACE risk score for cardiovascular events in patients with ACS undergoing percutaneous coronary intervention (PCI) for the first time. We enrolled 480 ACS patients. During a median follow-up time of 37.2 months,...

  3. JPN Guidelines for the management of acute pancreatitis: severity assessment of acute pancreatitis

    Hirota, Masahiko; Takada, Tadahiro; Kawarada, Yoshifumi; Hirata, Koichi; Mayumi, Toshihiko; Yoshida, Masahiro; Sekimoto, Miho; Kimura, Yasutoshi; Takeda, Kazunori; ISAJI, Shuji; Koizumi, Masaru; Otsuki, Makoto; Matsuno, Seiki

    2006-01-01

    This article addresses the criteria for severity assessment and the severity scoring system of the Ministry of Health and Welfare of Japan; now the Japanese Ministry of Health, Labour, and Welfare (the JPN score). It also presents data comparing the JPN score with the Acute Physiology and Chronic Health Evaluation (APACHE) II score and the Ranson score, which are the major measuring scales used in the United States and Europe. The goal of investigating these scoring systems is the achievement...

  4. The Risk Assessment Score in acute whiplash injury predicts outcome and reflects bio-psycho-social factors

    Kasch, Helge; Qerama, Erisela; Kongsted, Alice;

    2011-01-01

    One-year prospective study of 141 acute whiplash patients (WLP) and 40 acute ankle-injured controls.......One-year prospective study of 141 acute whiplash patients (WLP) and 40 acute ankle-injured controls....

  5. Predicting the severity of acute bronchiolitis in infants: should we use a clinical score or a biomarker?

    Amat, Flore; Henquell, Cécile; Verdan, Matthieu; Roszyk, Laurence; Mulliez, Aurélien; Labbé, André

    2014-11-01

    Krebs von den Lungen 6 antigen (KL-6) has been shown to be a useful biomarker of the severity of Respiratory syncytial virus bronchiolitis. To assess the correlation between the clinical severity of acute bronchiolitis, serum KL-6, and the causative viruses, 222 infants with acute bronchiolitis presenting at the Pediatric Emergency Department of Estaing University Hospital, Clermont-Ferrand, France, were prospectively enrolled from October 2011 to May 2012. Disease severity was assessed with a score calculated from oxygen saturation, respiratory rate, and respiratory effort. A nasopharyngeal aspirate was collected to screen for a panel of 20 respiratory viruses. Serum was assessed and compared with a control group of 38 bronchiolitis-free infants. No significant difference in KL-6 levels was found between the children with bronchiolitis (mean 231 IU/mL ± 106) and those without (230 IU/mL ± 102), or between children who were hospitalized or not, or between the types of virus. No correlation was found between serum KL-6 levels and the disease severity score. The absence of Human Rhinovirus was a predictive factor for hospitalization (OR 3.4 [1.4-7.9]; P = 0.006). Older age and a higher oxygen saturation were protective factors (OR 0.65[0.55-0.77]; P < 0.0001 and OR 0.67 [0.54-0.85] P < 0.001, respectively). These results suggest that in infants presenting with bronchiolitis for the first time, clinical outcome depends more on the adaptive capacities of the host than on epithelial dysfunction intensity. Many of the features of bronchiolitis are affected by underlying disease and by treatment. PMID:24374757

  6. PREDICTING OUTCOME AND SEVERITY IN ACUTE ORGANOPHOSPHOROUS POISONING WITH CLINICAL SCORING AND SERUM CHOLINESTERASE LEVELS

    Basavaraj R

    2014-11-01

    Full Text Available BACKGROUND AND OBJECTIVES: Organophosphorus compound poisoning is the most common medico toxic emergency in India the increase in pesticide use in agriculture has paralleled the increase in the use of these products for deliberate self-warm. Respiratory failure is the most common complication of OP poisoning leading to death. Early recognition and prompt ventilator support may improve survival. Owing to limited availability of resources, all OP poisoning patients are not managed in ICUs in Indian setup. It is therefore important that clinical features and criteria to predict the need for ventilator support be identified at initial examination. Hence this study was undertaken to assess the severity of organophosphorus compound poisoning both clinically by using Peradeniya scoring and by estimating serum choline esterase levels. METHODS: Cross sectional study was done at basaveswar teaching and general hospital attached to MR Medical College. Cases with history of exposure to organophosphorus compound within previous 24 hours were chosen after applying inclusion and exclusion criteria. Patients were evaluated for Peradeniya OP poisoning scale and serum cholinesterase levels for assessment of severity of poisoning. Serum cholinesterase levels and Peradeniya OP poisoning scale were studied to predict the need for ventilator support. The results were analyzed using Chi-square test. STATISTICAL ANALYSIS: It was done using pearson’s chi square test. RESULTS: In this study requirement of ventilator support was seen in 36% of patients. Mortality in our study was 18%. Only 15.6% of patients with mild grade of poisoning according to Peradeniya OP poisoning scale required ventilator support, whereas 84.4% did not require ventilator support. Most of patients with moderate (70.6% and severe poisoning (100% according to Peradeniya OP poisoning scale required ventilator support. 93.7% of patients with serum cholinesterase levels more than 50% did not require

  7. Acute effects of heat on neuropsychological changes and physiological responses under noise condition.

    Bhattacharya, S K; Tripathi, S R; Pradhan, C K; Kashyap, S K

    1990-09-01

    To examine the effects of heat and noise individually and jointly on certain physiological responses and cognitive and neuromotor based functions, 12 male participants were tested under 6 experimental conditions which resulted by combining 3 levels of heat (25 degrees, 30 degrees and 35 degrees C) and 2 levels of white noise (70 and 100 dB). The experiment was carried out in a controlled climatic chamber following two 6 x 6 latin square designs. The results indicated elevations in heart rate, oxygen uptake and body temperature due to the independent effect of heat or the combined effects of heat and noise. The independent action of noise was found to be depressive on the first two responses. On the neuropsychological effects, the heat adversely affected the speed in card sorting (by design configuration) and digit symbol tests, and also the accuracy and error rate in the reasoning ability test. The noise caused performance improvements in critical flicker frequency (simultaneous) and in error rates in card sorting (by design configuration). The combined effects of heat and noise indicated higher error rates in card sorting (by face value), decreased accuracy in reasoning ability and improvements in performance in accuracy scores and error rates in digit symbol test. PMID:2279778

  8. Scoring System for the Management of Acute Gallstone Pancreatitis: Cost Analysis of a Prospective Study.

    Prigoff, Jake G; Swain, Gary W; Divino, Celia M

    2016-05-01

    Predicting the presence of a persistent common bile duct (CBD) stone is a difficult and expensive task. The aim of this study is to determine if a previously described protocol-based scoring system is a cost-effective strategy. The protocol includes all patients with gallstone pancreatitis and stratifies them based on laboratory values and imaging to high, medium, and low likelihood of persistent stones. The patient's stratification then dictates the next course of management. A decision analytic model was developed to compare the costs for patients who followed the protocol versus those that did not. Clinical data model inputs were obtained from a prospective study conducted at The Mount Sinai Medical Center to validate the protocol from Oct 2009 to May 2013. The study included all patients presenting with gallstone pancreatitis regardless of disease severity. Seventy-three patients followed the proposed protocol and 32 did not. The protocol group cost an average of $14,962/patient and the non-protocol group cost $17,138/patient for procedural costs. Mean length of stay for protocol and non-protocol patients was 5.6 and 7.7 days, respectively. The proposed protocol is a cost-effective way to determine the course for patients with gallstone pancreatitis, reducing total procedural costs over 12 %. PMID:27000127

  9. Changes of pathological and physiological indicators affecting drug metabolism in rats after acute exposure to high altitude

    Li, Wenbin; Wang, Rong; Xie, Hua; ZHANG, JUANHONG; Jia, Zhengping

    2014-01-01

    High altitude environments cause the human body to undergo a series of pathological, physiological and biochemical changes, which have a certain effect on drug pharmacokinetics. The objective of the present study was to observe changes in factors affecting pharmacokinetics in rats following acute exposure to high altitude and return to low altitude. A total of 21 male Wistar rats were randomly assigned to three groups. The rats in group A were maintained at low altitude in Shanghai, 55 m abov...

  10. Comparison of the TIMI and the GRACE risk scores with the extent of coronary artery disease in patients with non-ST-elevation acute coronary syndrome

    Objective: To compare the accuracy of the Global Registry of Acute Coronary Events risk score and the Thrombolysis In Myocardial Infarction risk score in predicting the extent of coronary artery disease in patients with non-ST segment elevation acute coronary syndrome. Methods: The cross-sectional study comprising 406 consecutive patients was conducted at the National Institute of Cardiovascular Diseases, Karachi, from August 2010 to March 2011. For all patients, the GRACE and TIMI RS's relevant scores on the two indices were calculated on admission using specified variables. The patients underwent coronary angiography to determine the extent of the disease. A significant level was defined as >70% stenosis in any major epicardial artery or >50% stenosis in the left main coronary artery. SPSS 19 was used for statistical analysis. Results: Both the indices showed good predictive value in identifying the extent of the disease. A Thrombolysis In Myocardial Infarction score >4 and Global Registry of Acute Coronary Events score >133 was significantly associated with 3vessel disease and left main disease, while for the former score <4 and latter score <133 was associated with normal or non-obstructive coronary disease (p<0.01). On comparison of the two risk scores, the discriminatory accuracy of the latter was significantly superior to the former in predicting 2vessel, 3vessel and left main diseases (p<0.05). Conclusion: Although both the indices were helpful in predicting the extent of the disease, the Global Registry showed better performance and was more strongly associated with multi-vessel and left main coronary artery disease. (author)

  11. Effects of LI4 Acupressure on length of delivery time, some of physiologic responseEffects of LI4 Acupressure on Length of Delivery Time, Mothers’ Physiologic Physiologic Responses and Newborn’s Apgar Scores s and Apgar scores in women during of labor

    azam hamidzade

    2010-01-01

    Full Text Available Introduction: Prolonged labor has been associated with cesarean delivery and low Ph cord blood. Furthermore, hemorrhage and infection, which are strongly associated with long labor, are leading causes of maternal death. Due to the importance of duration of labor, this study investigates the effects of Hego (LI4 acupressure on length of delivery time, mothers’ physiological responses i.e., respiration and pulse rates of mothers, and Apgar scores of newborns. Methods: In this randomized clinical trial study, 100 pregnant women, who were at the beginning of active phase of labor (dilatation 5-3and had referred to Fatemiye educational and research clinic in Shahroud, were randomly assigned to either the LI4 acupressure (n=50 or LI4 touch control (n=50 group. The experimental group received LI4 acupressure at the onset of the active phase for duration of each uterine contraction over a period of 20 minutes but the control group received only LI4 touch. Length of delivery time was calculated in two stages: from 3-5 cm cervical dilation to full cervical dilation and full cervical dilation to the delivery. Pulse and respiration rates were measured before intervention, immediately after intervention, 20, 60 minutes after intervention and then each hour until delivery. One-minute and five-minute Apgar scores were also registered. Results: There were significant differences between the groups in length of delivery time. The total labor (3-5 dilation to delivery was significantly shorter in the LI4 acupressure intervention group (P=0.038. Maternal pulse and respiration rates weren’t significantly different between the groups (P=0.711, P=0.108. There were no significant differences between two groups for neonatal Apgar scores at one and five minutes. (P= 0.2, P= 0.3. Conclusion: These finding showed that LI4 acupressure was effective for shortening the length of delivery time and had no side effects on mothers’ pulse and respiration rate or no

  12. Influence of acute normobaric hypoxia on physiological variables and lactate turn point determination in trained men.

    Ofner, Michael; Wonisch, Manfred; Frei, Mario; Tschakert, Gerhard; Domej, Wolfgang; Kröpfl, Julia M; Hofmann, Peter

    2014-12-01

    The goal of this study is to evaluate the response of physiological variables to acute normobaric hypoxia compared to normoxia and its influence on the lactate turn point determination according to the three-phase model of energy supply (Phase I: metabolically balanced at muscular level; Phase II: metabolically balanced at systemic level; Phase III: not metabolically balanced) during maximal incremental exercise. Ten physically active (VO2max 3.9 [0.49] l·min(-1)), healthy men (mean age [SD]: 25.3 [4.6] yrs.), participated in the study. All participants performed two maximal cycle ergometric exercise tests under normoxic as well as hypoxic conditions (FiO2 = 14%). Blood lactate concentration, heart rate, gas exchange data, and power output at maximum and the first and the second lactate turn point (LTP1, LTP2), the heart rate turn point (HRTP) and the first and the second ventilatory turn point (VETP1, VETP2) were determined. Since in normobaric hypoxia absolute power output (P) was reduced at all reference points (max: 314 / 274 W; LTP2: 218 / 184 W; LTP1: 110 / 96 W), as well as VO2max (max: 3.90 / 3.23 l·min(-1); LTP2: 2.90 / 2.43 l·min(-1); LTP1: 1.66 / 1.52 l·min(-1)), percentages of Pmax at LTP1, LTP2, HRTP and VETP1, VETP2 were almost identical for hypoxic as well as normoxic conditions. Heart rate was significantly reduced at Pmax in hypoxia (max: 190 / 185 bpm), but no significant differences were found at submaximal control points. Blood lactate concentration was not different at maximum, and all reference points in both conditions. Respiratory exchange ratio (RER) (max: 1.28 / 1.08; LTP2: 1.13 / 0.98) and ventilatory equivalents for O2 (max: 43.4 / 34.0; LTP2: 32.1 / 25.4) and CO2 (max: 34.1 / 31.6; LTP2: 29.1 / 26.1) were significantly higher at some reference points in hypoxia. Significant correlations were found between LTP1 and VETP1 (r = 0.778; p exercise performance in both environments. Key PointsThe lactate turn point concept can be used for

  13. Effects of Treatment Intensification on Acute Local Toxicity During Radiotherapy for Head and Neck Cancer: Prospective Observational Study Validating CTCAE, Version 3.0, Scoring System

    Purpose: To quantify the incidence and severity of acute local toxicity in head and neck cancer patients treated with radiotherapy (RT), with or without chemotherapy (CHT), using the Common Terminology Criteria for Adverse Events, version 3.0 (CTCAE v3.0), scoring system. Methods and Materials: Between 2004 and 2006, 149 patients with head and neck cancer treated with RT at our center were prospectively evaluated for local toxicity during treatment. On a weekly basis, patients were monitored and eight toxicity items were recorded according to the CTCAE v3.0 scoring system. Of the 149 patients, 48 (32%) were treated with RT alone (conventional fractionation), 82 (55%) with concomitant CHT and conventional fractionation RT, and 20 (13%) with accelerated-fractionation RT and CHT. Results: Severe (Grade 3-4) adverse events were recorded in 28% (mucositis), 33% (dysphagia), 40% (pain), and 12% (skin) of patients. Multivariate analysis showed CHT to be the most relevant factor independently predicting for worse toxicity (mucositis, dysphagia, weight loss, salivary changes). In contrast, previous surgery, RT acceleration and older age, female gender, and younger age, respectively, predicted for a worse outcome of mucositis, weight loss, pain, and dermatitis. The T-score method confirmed that conventional RT alone is in the 'low-burden' class (T-score = 0.6) and suggests that concurrent CHT and conventional fractionation RT is in the 'high-burden' class (T-score = 1.15). Combined CHT and accelerated-fractionation RT had the highest T-score at 1.9. Conclusions: The CTCAE v3.0 proved to be a reliable tool to quantify acute toxicity in head and neck cancer patients treated with various treatment intensities. The effect of CHT and RT acceleration on the acute toxicity burden was clinically relevant

  14. A randomized controlled trial comparing the physiological and directed pushing on the duration of the second stage of labor, the mode of delivery and Apgar score

    Freshteh Jahdi

    2011-02-01

    Full Text Available Background: In recent year, there has been an increased trend to the physiological approach to labor. Physiological (spontaneous pushing in upright position is one of the practices promote the normal physiological process.Objective: Effect of physiological pushing versus directed pushing on the duration of the second stage of labor, mode of birth and Apgar.Methods: A randomized controlled trial was completed on 191 women who gave birth at a maternity unit in Iran between August and December 2009. Randomization occurred upon confirmation of full dilatation of the cervix with using block randomization. In the intervention group (n = 100, with full dilatation of the cervix and a fetal head plus 1, the midwives providing care suggested they commenced pushing in upright position only when they felt the urge to do so and gave no specific instructions about the timing and duration of pushing. In the control group (n =91, women were coached by the midwife to use closed-glottis pushing three to four times in supine position during each contraction immediately as the same period. Findings: Mean duration of the second stage of labor in the primiparous women was 47.38±36.75 mins and 57.12±33.10 mins in the intervention and control groups, respectively; the difference was significant (p <.0001. In the multiparous women the second stage of labor lasted for 26.12±23.43 mins and 33.20±22.76 mins in the intervention and control groups, respectively, which was significantly different (p <.0001. One woman in the control group and 2 mother in the intervention group undertook cesarean surgery (p=1. Apgar scores were similar in both groups.Conclusion: Physiological pushing was not associated with demonstrable adverse outcome. It seems that this technique can reduce the duration of the second stage of labor and it can be a safe method during the second stage of labor without any harm for mother and baby.

  15. Comparative studies of hemolymph physiology response and HIF-1 expression in different strains of Litopenaeus vannamei under acute hypoxia.

    Wei, Lin; Li, Yuhu; Qiu, Liguo; Zhou, Hailong; Han, Qian; Diao, Xiaoping

    2016-06-01

    Litopenaeus vannamei has a high commercial value and is the primary cultured shellfish species globally. In this study, we have compared the hemolymph physiological responses between two L. vannamei strains under acute hypoxia. The results showed that hemocyanin concentration (HC) of strain A6410 was significantly higher than strain Zhengda; Total hemocyte counts (THC) decreased significantly in both strains under hypoxic stress (p  0.05), but in the gills and hepatopancreas under hypoxia for 12 h (p selective breeding process of hypoxia tolerance in L. vannamei. PMID:27016815

  16. Influence of Acute Normobaric Hypoxia on Physiological Variables and Lactate Turn Point Determination in Trained Men

    Michael Ofner, Manfred Wonisch, Mario Frei, Gerhard Tschakert, Wolfgang Domej, Julia M. Kröpfl, Hofmann Peter

    2014-12-01

    Full Text Available The goal of this study is to evaluate the response of physiological variables to acute normobaric hypoxia compared to normoxia and its influence on the lactate turn point determination according to the three-phase model of energy supply (Phase I: metabolically balanced at muscular level; Phase II: metabolically balanced at systemic level; Phase III: not metabolically balanced during maximal incremental exercise. Ten physically active (VO2max 3.9 [0.49] l·min-1, healthy men (mean age [SD]: 25.3 [4.6] yrs., participated in the study. All participants performed two maximal cycle ergometric exercise tests under normoxic as well as hypoxic conditions (FiO2 = 14%. Blood lactate concentration, heart rate, gas exchange data, and power output at maximum and the first and the second lactate turn point (LTP1, LTP2, the heart rate turn point (HRTP and the first and the second ventilatory turn point (VETP1, VETP2 were determined. Since in normobaric hypoxia absolute power output (P was reduced at all reference points (max: 314 / 274 W; LTP2: 218 / 184 W; LTP1: 110 / 96 W, as well as VO2max (max: 3.90 / 3.23 l·min-1; LTP2: 2.90 / 2.43 l·min-1; LTP1: 1.66 / 1.52 l·min-1, percentages of Pmax at LTP1, LTP2, HRTP and VETP1, VETP2 were almost identical for hypoxic as well as normoxic conditions. Heart rate was significantly reduced at Pmax in hypoxia (max: 190 / 185 bpm, but no significant differences were found at submaximal control points. Blood lactate concentration was not different at maximum, and all reference points in both conditions. Respiratory exchange ratio (RER (max: 1.28 / 1.08; LTP2: 1.13 / 0.98 and ventilatory equivalents for O2 (max: 43.4 / 34.0; LTP2: 32.1 / 25.4 and CO2 (max: 34.1 / 31.6; LTP2: 29.1 / 26.1 were significantly higher at some reference points in hypoxia. Significant correlations were found between LTP1 and VETP1 (r = 0.778; p < 0.01, LTP2 and HRTP (r = 0.828; p < 0.01 and VETP2 (r = 0.948; p < 0.01 for power output for both

  17. Lumbar Disc Screening Using Back Pain Questionnaires: Oswestry Low Back Pain Score, Aberdeen Low Back Pain Scale, and Acute Low Back Pain Screening Questionnaire

    Kim, Do Yeon; Oh, Chang Hyun; Yoon, Seung Hwan; Park, Hyung Chun; Park, Chong Oon

    2012-01-01

    Objective To evaluate the usefulness of back pain questionnaires for lumbar disc screening among Korean young males. Methods We carried out a survey for lumbar disc screening through back pain questionnaires among the volunteers with or without back pain. Three types of back pain questionnaire (Oswestry Low Back Pain Score, Aberdeen Low Back Pain Scale, and Acute Low Back Pain Screeing Questionnaire) were randomly assigned to the examinees. The authors reviewed lumbar imaging studies (simple ...

  18. Validation of the Model for End-Stage Liver Disease Score Criteria in Urgent Liver Transplantation for Acute Flare Up of Hepatitis B.

    Lee, Wei-Chen; Lee, Ching-Song; Wang, Yu-Chao; Cheng, Chih-Hsien; Wu, Tsung-Han; Lee, Chen-Fang; Soong, Ruey-Shyang; Chang, Ming-Ling; Wu, Ting-Jung; Chou, Hong-Shiue; Chan, Kun-Ming

    2016-05-01

    Acute flare up of hepatitis B in noncirrhotic liver with rapid liver function deterioration is a critical condition. This flare up of hepatitis B may be subsided under medical treatments, otherwise urgent liver transplantation is needed. However, the necessity of urgent liver transplantation is hard to decide. In this institute, the indications of urgent liver transplantation for acute flare up of hepatitis B in noncirrhotic liver were settled according to the model for end-stage liver disease (MELD) scores: once upon MELD scores ≥35 (criterion 1) or MELD score flare up of hepatitis B virus with total bilirubin ≥17.5 mg/dL were included in this study. Among 83 patients, 20 patients met criterion 1. Five patients were transplanted and 15 patients died of liver failure with a median survival of 17 days. Fifty-one patients met criterion 2. Nineteen were transplanted, 30 patients died of liver failure with a median survival of 23.5 days, and 2 patients recovered from this critical condition. The other 12 patients did not meet criteria 1 and 2, and urgent liver transplantation was spared although 5 patients needed liver transplantation in subsequent 2 to 3 months. Therefore, the sensitivity of MELD score criteria for urgent liver transplantation was 100% and specificity was 85.7%. In conclusion, determination of urgent liver transplantation for hepatitis B with acute liver failure is crucial. MELD score criteria are valid to make a decision of urgent liver transplantation for hepatitis B patients with acute flare up and liver failure. PMID:27258492

  19. Abnormal physiological conditions in acute schizophrenic patients on emergency admission: dehydration, hypokalemia, leukocytosis and elevated serum muscle enzymes.

    Hatta, K; Takahashi, T; Nakamura, H; Yamashiro, H; Endo, H; Fujii, S; Fukami, G; Masui, K; Asukai, N; Yonezawa, Y

    1998-01-01

    This study investigated varieties and incidence of abnormal physiological conditions in acute schizophrenic patients on emergency. Laboratory data obtained prior to treatment from patients, admitted on an emergency basis during an 18-month period, were evaluated retrospectively, as well as demographics and clinical characteristics. Of 259 male acute schizophrenic patients (ICD-10: F2), 6.9% revealed dehydration, a third had hypokalemia and leukocytosis, and two thirds showed elevated serum muscle enzymes. These percentages were statistically significant compared with those of outpatients. In addition, the former three of these conditions in the F2 group were as frequent as those in alcohol and/or psychoactive substance abusers (ICD-10: F1) on emergency admission, although elevated serum muscle enzymes in the F2 group was less frequent than that in the F1 group. In order to prevent these abnormal physiological conditions from worsening and becoming life-threatening, one fourth of the F2 group [dehydration, 6.9%, severe hypokalemia ( 1000 IU/l), 16.5%] required medical management such as fluid therapy and various types of monitoring. In cases of a behavioral emergency, laboratory screening and monitoring of urinary output were essential. Due to their lack of cooperation, case history, physical examination, and initial vital signs did not contribute to detection of their medical condition. PMID:9810481

  20. A Puzzle of Vestibular Physiology in a Meniere’s Disease Acute Attack

    Marta Martinez-Lopez; Raquel Manrique-Huarte; Nicolas Perez-Fernandez

    2015-01-01

    The aim of this paper is to present for the first time the functional evaluation of each of the vestibular receptors in the six semicircular canals in a patient diagnosed with Meniere's disease during an acute attack. A 54-year-old lady was diagnosed with left Meniere's disease who during her regular clinic review suffers an acute attack of vertigo, with fullness and an increase of tinnitus in her left ear. Spontaneous nystagmus and the results in the video head-impulse test (vHIT) are shown ...

  1. Preservation of high glycolytic phenotype by establishing new acute lymphoblastic leukemia cell lines at physiologic oxygen concentration

    Cancer cells typically exhibit increased glycolysis and decreased mitochondrial oxidative phosphorylation, and they continue to exhibit some elevation in glycolysis even under aerobic conditions. However, it is unclear whether cancer cell lines employ a high level of glycolysis comparable to that of the original cancers from which they were derived, even if their culture conditions are changed to physiologically relevant oxygen concentrations. From three childhood acute lymphoblastic leukemia (ALL) patients we established three new pairs of cell lines in both atmospheric (20%) and physiologic (bone marrow level, 5%) oxygen concentrations. Cell lines established in 20% oxygen exhibited lower proliferation, survival, expression of glycolysis genes, glucose consumption, and lactate production. Interestingly, the effects of oxygen concentration used during cell line initiation were only partially reversible when established cell cultures were switched from one oxygen concentration to another for eight weeks. These observations indicate that ALL cell lines established at atmospheric oxygen concentration can exhibit relatively low levels of glycolysis and these levels are semi-permanent, suggesting that physiologic oxygen concentrations may be needed from the time of cell line initiation to preserve the high level of glycolysis commonly exhibited by leukemias in vivo. - Highlights: • Establishing new ALL cell lines in 5% oxygen resulted in higher glycolytic expression and function. • Establishing new ALL cell lines in 5% oxygen resulted in higher proliferation and lower cell death. • The divergent metabolic phenotypes selected in 5% and 20% oxygen are semi-permanent

  2. Preservation of high glycolytic phenotype by establishing new acute lymphoblastic leukemia cell lines at physiologic oxygen concentration

    Sheard, Michael A., E-mail: msheard@chla.usc.edu [Developmental Therapeutics Program, USC-CHLA Institute for Pediatric Clinical Research, Division of Hematology-Oncology, Children' s Hospital Los Angeles, 4650 Sunset Blvd., Los Angeles, CA 90027 (United States); Ghent, Matthew V., E-mail: mattghent@gmail.com [Department of Pathology, Keck School of Medicine, University of Southern California, Health Sciences Campus, Los Angeles, CA 90089 (United States); Cabral, Daniel J., E-mail: dcabral14@gmail.com [Cancer Center and Departments of Cell Biology & Biochemistry, Pharmacology & Neuroscience, Internal Medicine and Pediatrics, School of Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430 (United States); Lee, Joanne C., E-mail: joannebarnhart@gmail.com [Cancer Center and Departments of Cell Biology & Biochemistry, Pharmacology & Neuroscience, Internal Medicine and Pediatrics, School of Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430 (United States); Khankaldyyan, Vazgen, E-mail: khangaldian@yahoo.com [Developmental Therapeutics Program, USC-CHLA Institute for Pediatric Clinical Research, Division of Hematology-Oncology, Children' s Hospital Los Angeles, 4650 Sunset Blvd., Los Angeles, CA 90027 (United States); Ji, Lingyun, E-mail: lingyun.ji@med.usc.edu [Developmental Therapeutics Program, USC-CHLA Institute for Pediatric Clinical Research, Division of Hematology-Oncology, Children' s Hospital Los Angeles, 4650 Sunset Blvd., Los Angeles, CA 90027 (United States); Wu, Samuel Q., E-mail: swu@chla.usc.edu [Medical Genetics, Children' s Hospital Los Angeles, 4650 Sunset Blvd., Los Angeles, CA 90027 (United States); Kang, Min H., E-mail: min.kang@ttuhsc.edu [Cancer Center and Departments of Cell Biology & Biochemistry, Pharmacology & Neuroscience, Internal Medicine and Pediatrics, School of Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430 (United States); and others

    2015-05-15

    Cancer cells typically exhibit increased glycolysis and decreased mitochondrial oxidative phosphorylation, and they continue to exhibit some elevation in glycolysis even under aerobic conditions. However, it is unclear whether cancer cell lines employ a high level of glycolysis comparable to that of the original cancers from which they were derived, even if their culture conditions are changed to physiologically relevant oxygen concentrations. From three childhood acute lymphoblastic leukemia (ALL) patients we established three new pairs of cell lines in both atmospheric (20%) and physiologic (bone marrow level, 5%) oxygen concentrations. Cell lines established in 20% oxygen exhibited lower proliferation, survival, expression of glycolysis genes, glucose consumption, and lactate production. Interestingly, the effects of oxygen concentration used during cell line initiation were only partially reversible when established cell cultures were switched from one oxygen concentration to another for eight weeks. These observations indicate that ALL cell lines established at atmospheric oxygen concentration can exhibit relatively low levels of glycolysis and these levels are semi-permanent, suggesting that physiologic oxygen concentrations may be needed from the time of cell line initiation to preserve the high level of glycolysis commonly exhibited by leukemias in vivo. - Highlights: • Establishing new ALL cell lines in 5% oxygen resulted in higher glycolytic expression and function. • Establishing new ALL cell lines in 5% oxygen resulted in higher proliferation and lower cell death. • The divergent metabolic phenotypes selected in 5% and 20% oxygen are semi-permanent.

  3. Cognitive and physiological effects of an acute physical activity intervention in elementary school children

    Katja eJäger

    2014-12-01

    Full Text Available The aim of the present study was to investigate the effects of an acute physical activity intervention including cognitive engagement on executive functions and on cortisol level in young elementary school children. Half of the 104 participating children (6 to 8 years old attended a 20-minute sport sequence, which included cognitively engaging and playful forms of physical activity. The other half was assigned to a resting control condition. Individual differences in children`s updating, inhibition, and shifting performance as well as salivary cortisol were assessed before (pre-test, immediately after (post-test, and 40 minutes after (follow-up the intervention or control condition respectively. Results revealed a significantly stronger improvement in inhibition in the experimental group compared to the control group, while it appeared that acute physical activity had no specific effect on updating and shifting. The intervention effect on inhibition levelled out 40 minutes after physical activity. Salivary cortisol increased significantly more in the experimental compared to the control group between post-test and follow-up and results support partly the assumed inverted U-shaped relationship between cortisol level and cognitive performance. In conclusion, results indicate that acute physical activity including cognitive engagement may have immediate positive effects on inhibition, but not necessarily on updating and shifting in elementary school children. This positive effect may partly be explained trough cortisol elevation after acute physical activity.

  4. Behavioral and physiological effects of a short-term feed restriction in lactating dairy cattle with different body condition scores at calving.

    Schütz, K E; Cox, N R; Macdonald, K A; Roche, J R; Verkerk, G A; Rogers, A R; Tucker, C B; Matthews, L R; Meier, S; Webster, J R

    2013-07-01

    Body condition score (BCS) around calving, and the typical BCS loss for up to 100 d after parturition, is associated with both production and reproductive performance of dairy cattle. In addition, there is public concern that thin cows may have impaired welfare, particularly in early lactation where feed demand exceeds pasture growth, and a lag exists between peak milk energy requirements and intake. The aim of this experiment was to determine how BCS at calving influences behavioral and physiological responses to a short-term feed restriction at 47 DIM. Body condition score (on a 10-point scale) at calving was manipulated by modifying the diets in the previous lactation of healthy dairy cattle to generate 3 treatment groups: low BCS (3.4; n=17), medium BCS (4.6; n=18), or high BCS (5.4; n=20). Cows were tested in 4 groups for 8 consecutive days; testing consisted of different levels of feed allocation (d 1 and 2: 100%; d 3 and 4: 75%; d 5: 50%; d 6 to 8: 125%), where 100% was 15kg of DM/cow per day. All BCS groups had similar and marked behavioral and physiological responses to feed restriction. For example, they increased vocalization, time spent eating silage and grazing, aggressive behavior, and fat metabolism (as measured by concentrations of β-hydroxybutyrate and nonesterified fatty acids), and reduced milk production. Body condition affected some of these responses. Fewer cows with low BCS engaged in aggressive interactions in a feed competition test (trough filled with silage that could be consumed in 15 min) on the first day of feed restriction (low: 32%; medium: 74%; high: 64%; standard error of difference=15.4%). High BCS cows had greater concentrations of β-hydroxybutyrate and nonesterified fatty acids throughout the experimental period, which suggests more fat mobilization; however, plasma leptin and fecal glucocorticosteroid metabolite concentrations were unaffected by BCS. Whereas cows demonstrated marked responses to feed restriction, the results

  5. Acute Kidney Injury Classification in Neuro-ICU Patient Group

    Canan Akıncı; Nahit Çakar

    2012-01-01

    Objective: To investigate the role of acute kidney injury (AKI) classification system for kidney injury outcome in neuro-Intensive care unit (ICU) patients. Material and Method: Total 432 patients who admitted to ICU between 2005 and 2009 evaluated in this study. All patients’ AKI stage, Acute Physiology and Chronic Health Evaluation (APACHE-II), Sequential Organ Failure Assessment Score (SOFA), Glasgow Coma Score (GCS), Glasgow Outcome Score (GOS), mortality rate, length of ICU stay, need...

  6. Acute leptin deficiency, leptin resistance, and the physiologic response to leptin withdrawal

    Montez, Jason M.; Soukas, Alex; Asilmaz, Esra; Fayzikhodjaeva, Gulnorakhon; Fantuzzi, Giamila; Friedman, Jeffrey M.

    2005-01-01

    Food restriction and weight loss result in reduced plasma leptin, which is associated with a pleiotropic biologic response. However, because weight loss itself is also associated with changes in numerous other humoral and metabolic signals, it can be difficult to determine the precise features of the biologic response to acute leptin deficiency. To study this response in the absence of changes in nutritional state, we have developed a protocol that allows such analysis in normal, non-food-res...

  7. Cognitive and physiological effects of an acute physical activity intervention in elementary school children

    Jäger, Katja; Schmidt, Mirko; Conzelmann, Achim; Roebers, Claudia M.

    2014-01-01

    The aim of the present study was to investigate the effects of an acute physical activity intervention that included cognitive engagement on executive functions and on cortisol level in young elementary school children. Half of the 104 participating children (6–8 years old) attended a 20-min sport sequence, which included cognitively engaging and playful forms of physical activity. The other half was assigned to a resting control condition. Individual differences in children's updating, inhib...

  8. Cognitive and physiological effects of an acute physical activity intervention in elementary school children

    Katja eJäger; Mirko eSchmidt; Achim eConzelmann; Claudia Maria Roebers

    2014-01-01

    The aim of the present study was to investigate the effects of an acute physical activity intervention including cognitive engagement on executive functions and on cortisol level in young elementary school children. Half of the 104 participating children (6 to 8 years old) attended a 20-minute sport sequence, which included cognitively engaging and playful forms of physical activity. The other half was assigned to a resting control condition. Individual differences in children`s updating, inh...

  9. Collateral blood vessels in acute ischemic stroke: a physiological window to predict future outcomes

    Heitor Castelo Branco Rodrigues Alves

    2016-01-01

    Full Text Available ABSTRACT Collateral circulation is a physiologic pathway that protects the brain against ischemic injury and can potentially bypass the effect of a blocked artery, thereby influencing ischemic lesion size and growth. Several recent stroke trials have provided information about the role of collaterals in stroke pathophysiology, and collateral perfusion has been recognized to influence arterial recanalization, reperfusion, hemorrhagic transformation, and neurological outcomes after stroke. Our current aim is to summarize the anatomy and physiology of the collateral circulation and to present and discuss a comprehensible review of the related knowledge, particularly the effects of collateral circulation on the time course of ischemic injury and stroke severity, as well as imaging findings and therapeutic implications.

  10. Combined Value of Red Blood Cell Distribution Width and Global Registry of Acute Coronary Events Risk Score for Predicting Cardiovascular Events in Patients with Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention

    Zhao, Na; Mi, Lan; Liu, Xiaojun; Pan, Shuo; Xu, Jiaojiao; Xia, Dongyu; Liu, Zhongwei; Zhang, Yong; Xiang, Yu; Yuan, Zuyi; Guan, Gongchang; Wang, Junkui

    2015-01-01

    Global Registry of Acute Coronary Events (GRACE) risk score and red blood cell distribution width (RDW) content can both independently predict major adverse cardiac events (MACEs) in patients with acute coronary syndrome (ACS). We investigated the combined predictive value of RDW and GRACE risk score for cardiovascular events in patients with ACS undergoing percutaneous coronary intervention (PCI) for the first time. We enrolled 480 ACS patients. During a median follow-up time of 37.2 months, 70 (14.58%) patients experienced MACEs. Patients were divided into tertiles according to the baseline RDW content (11.30–12.90, 13.00–13.50, 13.60–16.40). GRACE score was positively correlated with RDW content. Multivariate Cox analysis showed that both GRACE score and RDW content were independent predictors of MACEs (hazard ratio 1.039; 95% confidence interval [CI] 1.024–1.055; p < 0.001; 1.699; 1.294–2.232; p < 0.001; respectively). Furthermore, Kaplan–Meier analysis demonstrated that the risk of MACEs increased with increasing RDW content (p < 0.001). For GRACE score alone, the area under the receiver operating characteristic (ROC) curve for MACEs was 0.749 (95% CI: 0.707–0.787). The area under the ROC curve for MACEs increased to 0.805 (0.766–0.839, p = 0.034) after adding RDW content. The incremental predictive value of combining RDW content and GRACE risk score was significantly improved, also shown by the net reclassification improvement (NRI = 0.352, p < 0.001) and integrated discrimination improvement (IDI = 0.023, p = 0.002). Combining the predictive value of RDW and GRACE risk score yielded a more accurate predictive value for long-term cardiovascular events in ACS patients who underwent PCI as compared to each measure alone. PMID:26468876

  11. Combined Value of Red Blood Cell Distribution Width and Global Registry of Acute Coronary Events Risk Score for Predicting Cardiovascular Events in Patients with Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention.

    Na Zhao

    Full Text Available Global Registry of Acute Coronary Events (GRACE risk score and red blood cell distribution width (RDW content can both independently predict major adverse cardiac events (MACEs in patients with acute coronary syndrome (ACS. We investigated the combined predictive value of RDW and GRACE risk score for cardiovascular events in patients with ACS undergoing percutaneous coronary intervention (PCI for the first time. We enrolled 480 ACS patients. During a median follow-up time of 37.2 months, 70 (14.58% patients experienced MACEs. Patients were divided into tertiles according to the baseline RDW content (11.30-12.90, 13.00-13.50, 13.60-16.40. GRACE score was positively correlated with RDW content. Multivariate Cox analysis showed that both GRACE score and RDW content were independent predictors of MACEs (hazard ratio 1.039; 95% confidence interval [CI] 1.024-1.055; p < 0.001; 1.699; 1.294-2.232; p < 0.001; respectively. Furthermore, Kaplan-Meier analysis demonstrated that the risk of MACEs increased with increasing RDW content (p < 0.001. For GRACE score alone, the area under the receiver operating characteristic (ROC curve for MACEs was 0.749 (95% CI: 0.707-0.787. The area under the ROC curve for MACEs increased to 0.805 (0.766-0.839, p = 0.034 after adding RDW content. The incremental predictive value of combining RDW content and GRACE risk score was significantly improved, also shown by the net reclassification improvement (NRI = 0.352, p < 0.001 and integrated discrimination improvement (IDI = 0.023, p = 0.002. Combining the predictive value of RDW and GRACE risk score yielded a more accurate predictive value for long-term cardiovascular events in ACS patients who underwent PCI as compared to each measure alone.

  12. The Phrenic Component of Acute Schizophrenia – A Name and Its Physiological Reality

    Bär, Karl-Jürgen; Rachow, Tobias; Schulz, Steffen; Bassarab, Katharina; Haufe, Stefanie; Berger, Sandy; Koch, Kathrin; Voss, Andreas

    2012-01-01

    Decreased heart rate variability (HRV) was shown for unmedicated patients with schizophrenia and their first-degree relatives, implying genetic associations. This is known to be an important risk factor for increased cardiac mortality in other diseases. The interaction of cardio-respiratory function and respiratory physiology has never been investigated in the disease although it might be closely related to the pattern of autonomic dysfunction. We hypothesized that increased breathing rates a...

  13. Conflicting Physiological and Genomic Cardiopulmonary Effects of Recruitment Maneuvers in Murine Acute Lung Injury

    Mekontso Dessap, Armand; Voiriot, Guillaume; Zhou, Tong; Marcos, Elisabeth; Dudek, Steven M.; Jacobson, Jeff R.; Machado, Roberto,; Adnot, Serge; Brochard, Laurent; Maitre, Bernard; Joe G N Garcia

    2012-01-01

    Low tidal volume ventilation, although promoting atelectasis, is a protective strategy against ventilator-induced lung injury. Deep inflation (DI) recruitment maneuvers restore lung volumes, but potentially compromise lung parenchymal and vascular function via repetitive overdistention. Our objective was to examine cardiopulmonary physiological and transcriptional consequences of recruitment maneuvers. C57/BL6 mice challenged with either PBS or LPS via aspiration were placed on mechanical ven...

  14. Derivation of a T2-weighted MRI total colonic inflammation score (TCIS) for assessment of patients with severe acute inflammatory colitis - a preliminary study

    To derive an MRI score for assessing severity, therapeutic response and prognosis in acute severe inflammatory colitis. Twenty-one patients with acute severe colitis underwent colonic MRI after admission and again (n = 16) after median 5 days of treatment. Using T2-weighted images, two radiologists in consensus graded segmental haustral loss, mesenteric and mural oedema, mural thickness, and small bowel and colonic dilatation producing a total colonic inflammatory score (TCIS, range 6-95). Pre- and post-treatment TCIS were compared, and correlated with CRP, stool frequency, and number of inpatient days (therapeutic response marker). Questionnaire assessment of patient worry, satisfaction and discomfort graded 1 (bad) to 7 (good) was administered Admission TCIS correlated significantly with CRP (Kendall's tau=0.45, 95% confidence interval [CI] 0.11-0.79, p = 0.006), and stool frequency (Kendall's tau 0.39, 95% CI 0.14-0.64, p = 0.02). TCIS fell after treatment (median [22 range 15-31]) to median 20 [range 8-25], p = 0.01. Admission TCIS but not CRP or stool frequency was correlated with length of inpatient stay (Kendall's tau 0.40, 95% CI 0.11-0.69, p = 0.02). Patients reported some discomfort (median score 4) during MRI. MRI TCIS falls after therapy, correlates with existing markers of disease severity, and in comparison may better predict therapeutic response. (orig.)

  15. The Achilles tendon total rupture score: a study of responsiveness, internal consistency and convergent validity on patients with acute Achilles tendon ruptures

    Kearney Rebecca S

    2012-02-01

    Full Text Available Abstract Background The Achilles tendon Total Rupture Score was developed by a research group in 2007 in response to the need for a patient reported outcome measure for this patient population. Beyond this original development paper, no further validation studies have been published. Consequently the purpose of this study was to evaluate internal consistency, convergent validity and responsiveness of this newly developed patient reported outcome measure within patients who have sustained an isolated acute Achilles tendon rupture. Methods Sixty-four eligible patients with an acute rupture of their Achilles tendon completed the Achilles tendon Total Rupture Score alongside two further patient reported outcome measures (Disability Rating Index and EQ 5D. These were completed at baseline, six weeks, three months, six months and nine months post injury. The Achilles tendon Total Rupture Score was evaluated for internal consistency, using Cronbach's alpha, convergent validity, through correlation analysis and responsiveness, by analysing floor and ceiling effects and calculating its relative efficiency in comparison to the Disability Rating Index and EQ 5D scores. Results The Achilles tendon Total Rupture Score demonstrated high internal consistency (Cronbachs alpha > 0.8 and correlated significantly (p Conclusions A universally accepted outcome measure is imperative to allow comparisons to be made across practice. This is the first study to evaluate aspects of validity of this newly developed outcome measure, outside of the developing centre. The ATRS demonstrated high internal consistency and responsiveness, with limited convergent validity. This research provides further support for the use of this outcome measure, however further research is required to advocate its universal use in patients with acute Achilles tendon ruptures. Such areas include inter-rater reliability and research to determine the minimally clinically important difference

  16. Acute physiological stress down-regulates mRNA expressions of growth-related genes in coho salmon.

    Toshiki Nakano

    Full Text Available Growth and development in fish are regulated to a major extent by growth-related factors, such as liver-derived insulin-like growth factor (IGF -1 in response to pituitary-secreted growth hormone (GH binding to the GH receptor (GHR. Here, we report on the changes in the expressions of gh, ghr, and igf1 genes and the circulating levels of GH and IGF-1 proteins in juvenile coho salmon (Oncorhynchus kisutch in response to handling as an acute physiological stressor. Plasma GH levels were not significantly different between stressed fish and prestressed control. Plasma IGF-1 concentrations in stressed fish 1.5 h post-stress were the same as in control fish, but levels in stressed fish decreased significantly 16 h post-stress. Real-time quantitative PCR (qPCR analysis showed that ghr mRNA levels in pituitary, liver, and muscle decreased gradually in response to the stressor. After exposure to stress, hepatic igf1 expression transiently increased, whereas levels decreased 16 h post-stress. On the other hand, the pituitary gh mRNA level did not change in response to the stressor. These observations indicate that expression of gh, ghr, and igf1 responded differently to stress. Our results show that acute physiological stress can mainly down-regulate the expressions of growth-related genes in coho salmon in vivo. This study also suggests that a relationship between the neuroendocrine stress response and growth-related factors exists in fish.

  17. Physiological responses to acute experimental hypoxia in the air-breathing Indian catfish, Clarias batrachus (Linnaeus, 1758)

    Ratnesh Kumar Tripathi; Vindhya Mohindra; Akanksha Singh; Rajesh Kumar; Rahasya Mani Mishra; Joy Krushna Jena

    2013-06-01

    With an aim to study the mechanism of adaptation to acute hypoxic periods by hypoxia-tolerant catfish, Clarias batrachus, the mass-specific metabolic rate (VO2) along with its hematological parameters, metabolic response and antioxidant enzyme activities were studied. During progressive hypoxia, C. batrachus was found to be an oxyconformer and showed a steady decline in its aquatic oxygen consumption rate. When C. batrachus was exposed for different periods at experimental hypoxia level (0.98±0.1 mg/L, DO), hemoglobin and hematocrit concentrations were increased, along with decrease in mean cellular hemoglobin concentration, which reflected a physiological adaptation to enhance oxygen transport capacity. Significant increase in serum glucose and lactate concentration as well as lactate dehydrogenase activity was observed. Antioxidant enzymes were found to operate independently of one another, while total glutathione concentration was unaffected in any of the tissues across treatments. These observations suggested that hypoxia resulted in the development of oxidative stress and C. batrachus was able to respond through increase in the oxygen carrying capacity, metabolic depression and efficient antioxidant defense system to survive periods of acute hypoxia.

  18. Acute Physiological Responses to Short- and Long-Stage High-Intensity Interval Exercise in Cardiac Rehabilitation: A Pilot Study

    Gerhard Tschakert, Julia M. Kroepfl, Alexander Mueller, Hanns Harpf, Leonhard Harpf, Heimo Traninger, Sandra Wallner-Liebmann, Tatjana Stojakovic, Hubert Scharnagl, Andreas Meinitzer, Patriz Pichlhoefer, Peter Hofmann

    2016-03-01

    Full Text Available Despite described benefits of aerobic high-intensity interval exercise (HIIE, the acute responses during different HIIE modes and associated health risks have only been sparsely discovered in heart disease patients. Therefore, the aim of this study was to investigate the acute responses for physiological parameters, cardiovascular and inflammatory biomarkers, and catecholamines yielded by two different aerobic HIIE protocols compared to continuous exercise (CE in phase III cardiac rehabilitation. Eight cardiac patients (7 with coronary heart disease, 1 with myocarditis; 7 males, 1 female; age: 63.0 ± 9.4 years; height: 1.74 ± 0.05 m; weight: 83.6 ± 8.7 kg, all but one treated with ß-blocking agents, performed a maximal symptom-limited incremental exercise test (IET and three different exercise tests matched for mean load (Pmean and total duration: 1 short HIIE with a peak workload duration (tpeak of 20 s and a peak workload (Ppeak equal to the maximum power output (Pmax from IET; 2 long HIIE with a tpeak of 4 min, Ppeak was corresponding to the power output at 85 % of maximal heart rate (HRmax from IET; 3 CE with a target workload equal to Pmean of both HIIE modes. Acute metabolic and peak cardiorespiratory responses were significantly higher during long HIIE compared to short HIIE and CE (p 0.05. All health-related variables remained in a normal range in any test except NT-proBNP, which was already elevated at baseline. Despite a high Ppeak particularly in short HIIE, both HIIE modes were as safe and as well tolerated as moderate CE in cardiac patients by using our methodological approach.

  19. Relations Between Dispositional Expressivity and Physiological Changes During Acute Positive and Negative Affect

    Asmir Gračanin

    2007-12-01

    Full Text Available The aim of the present study is to examine the relations between emotional expressivity measured by Berkeley Expressivity Questionnaire and physiological response in situations where positive and negative affects were induced. On 65 participants four physiological parameters, including finger pulse amplitude, heart rate, skin conductance level and amplitude of skin conductance response were measured. In situations in which negative affect was induced, individuals higher in negative expressivity showed higher skin conductance level, higher amplitude of skin conductance response and higher heart rate compared to individuals low on negative expressivity, whereas finger pulse amplitude did not differ between these two groups. The same results were obtained even when controlling for five factor personality traits and recorded participants’ facial expression. In situation where a positive affect was induced, no differences in sympathetic responses between participants high and low in positive expressivity have been found. The results are explained in the context of Coactivation theory and possible consequences of the results on health outcomes are discussed.

  20. Correlation of CT angiographic pulmonary artery obstruction scores with right ventricular dysfunction and clinical outcome in patients with acute pulmonary embolism

    Apfaltrer, P., E-mail: paul.apfaltrer@medma.uni-heidelberg.de [Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, D-68167 Mannheim (Germany); Henzler, T.; Meyer, M. [Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, D-68167 Mannheim (Germany); Roeger, S.; Haghi, D.; Gruettner, J.; Süselbeck, T. [Department of Internal Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, D-68167 Mannheim (Germany); Wilson, R.B.; Schoepf, U.J. [Department of Radiology and Radiological Science, Medical University of South Carolina, 25 Courtenay Drive, MSC 226, Charleston, SC 29401 (United States); Schoenberg, S.O.; Fink, C. [Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, D-68167 Mannheim (Germany)

    2012-10-15

    Objective: To correlate CTA pulmonary artery obstruction scores (OS) with right ventricular dysfunction (RVD) and clinical outcome in patients with acute pulmonary embolism (PE). Materials and methods: In a prospective study of 50 patients (66 ± 12.9 years) with PE pulmonary artery OS (Qanadli, Mastora, and Mastora central) were assessed by two radiologists. To assess RVD all patients underwent echocardiography within 24 h. Furthermore, RVD on CT was assessed by calculating the right ventricular/left ventricular (RV/LV) diameter ratios on transverse (RV/LVtrans) and four-chamber views (RV/LV4ch) as well as the RV/LV volume ratio (RV/LVvol). OS were correlated with RVD and the occurrence of adverse clinical outcomes (defined as death, need for intensive care treatment, or cardiac insufficiency ≥NYHA III). Results: Mean Mastora, Qanadli, and Mastora central OS were 26.4 ± 17.7, 12.6 ± 9.9 and 7.5 ± 9, respectively. Echocardiography demonstrated moderate and severe RVD in 10 and 5 patients, respectively. Patients with moderate and severe RVD showed significantly higher Mastora central scores than patients without RVD (14 ± 10.8 vs. 5.9 ± 7.8 [p = 0.05]; 17.6 ± 13.2 vs. 5.9 ± 7.8 [p = 0.038]). A relevant correlation (i.e. r ≥ 0.6) between OS and CT parameters for RVD were only found for the Mastora score and the Mastora central score (RV/LV4ch: r = 0.61 and 0.68, RV/LVvol: r = 0.61 and 0.6). 18 patients experienced an adverse clinical outcome. None of the OS differed significantly between patients with and without adverse clinical outcome. Conclusion: Pulmonary artery obstruction scores can differentiate between patients with and without RVD. However, in this study, obstruction scores were not correlated to adverse clinical outcome.

  1. Validación del score de riesgo TIMI para pacientes con síndrome coronario agudo sin elevación del ST TIMI risk score validation for patients with acute coronary syndrome without ST elevation

    Rodrigo H. Bagur

    2009-10-01

    Full Text Available Los síndromes coronarios agudos sin elevación del segmento ST (SCA-SST son causa frecuente de hospitalización, siendo responsables del 10 al 15% de infartos de miocardio (IM o muertes al año. El objetivo fue evaluar eventos cardiovasculares a 6 meses de seguimiento y validar el score de riesgo TIMI (Thrombolysis in Myocardial Infarction en nuestra población. Se analizaron retrospectivamente pacientes con diagnóstico de SCA-SST. Se realizó seguimiento telefónico a los 6 meses del ingreso. Los puntos finales evaluados fueron la combinación de muerte, internación por síndrome coronario agudo y necesidad de revascularización. Se incluyeron 204 pacientes. El 70.2% eran hombres, edad promedio de 64.5 ± 11.8 años. Luego de la evaluación inicial, se hizo diagnóstico de angina inestable en el 34.6%, IM en 38.9% y el 26.4% fueron catalogados como "dolor no coronario". Al aplicar el score de TIMI, 52 (25.5% pacientes tenían riesgo bajo, 106 (52% riesgo intermedio, y 46 (22.5% riesgo alto. La mortalidad global fue 12.6%. Se encontró un incremento progresivo y significativo en la tasa de eventos combinados a medida que aumentaba el score de TIMI (p Non-ST elevation acute coronary syndromes (NSTE-ACS are frequent cause of hospitalization, being responsible for 10-15% of infarcts or deaths per year. The study was designed to analyze 6 months follow-up of cardiovascular events as well as to validate the Thrombolysis in Myocardial Infarction (TIMI risk score for patients hospitalized for NSTE-ACS. We retrospectively analyzed patients admitted with NSTE-ACS. Telephone follow-up were performed at 6 month. Combination of death, re-admission for acute coronary syndrome and revascularization were considered as end point. Two hundred and four patients were included for the analysis. There were 70.2% males, with a mean age of 64.5 ± 11.8 years. After the initial evaluation, we diagnosed unstable angina in 34.6% of cases, MI in 38.9% of cases, and 26

  2. A randomized controlled trial comparing the physiological and directed pushing on the duration of the second stage of labor, the mode of delivery and Apgar score

    Fereshteh Jahdi; Maryam Shahnazari; Maryam Kashanian; Mansoureh Ashghali Farahani; Hamid Haghani

    2011-01-01

    Background: In recent year, there has been an increased trend to the physiological approach to labor. Physiological (spontaneous) pushing in upright position is one of the practices promote the normal physiological process.Objective: Effect of physiological pushing versus directed pushing on the duration of the second stage of labor, mode of birth and Apgar.Methods: A randomized controlled trial was completed on 191 women who gave birth at a maternity unit in Iran between August and December ...

  3. Acute physiological impacts of CO2 ocean sequestration on marine animals

    The biological impacts of ocean carbon dioxide (CO2) sequestration must be carefully considered before it is implemented as a mitigation strategy. This paper presented details of a study investigating the effects of high CO2 concentrations on marine fish, lobster, and octopus. The influence of water temperature on the physiological effects of CO2 was also discussed. In the first part of the study, eggs and larvae of red seabream were exposed to both CO2 and HCI-acidified seawater at identical pH levels. Seabream in the CO2 group showed a much higher mortality rate than fish in the HCI group. Other tests showed that Japanese Flounder died after complete recovery of pH in seawater equilibrated with 5 per cent CO2. Cardiac output was rapidly depressed in Yellowtail fish without significant changes in blood oxygen concentrations. Lower temperatures resulted in higher mortality and delayed pH recovery during hypercapnia in all fish. Western rock lobsters were the most tolerant to CO2 among all species tested. The recovery of hemolymph pH was complete at exposure to CO2 concentrations of 1 per cent. Changes in hemolymph bicarbonate concentrations indicated that acid-based regulatory mechanisms differed between fish and lobsters. Mortality rates for octopus were significant at CO2 concentrations of 1 per cent. The results of all tests showed that aquatic animals are more susceptible to increases in ambient CO2 levels than terrestrial animals. It was concluded that even slight elevations in CO2 concentration levels adversely affected physiological functioning in the tested species. It was concluded that CO2 sequestration in deeper, colder waters will have a more pronounced effect on aquatic animals due to the interactions between CO2 and lower temperatures, as well as the fact that most deep-sea fish are less tolerant to environmental perturbations. 3 refs., 1 tab., 3 figs

  4. Study on Alcoholic Withdrawal Score, with Questionnaire Based Session Conducted on Acute and Chronic Alcoholic Liver Disease Patients

    Bandi Navyatha

    2016-07-01

    Full Text Available Alcohol liver disease is damage to the Liver and its function due to alcohol abuse. It occurs after years of heavy drinking and by through which cirrhosis can occur and which leads to the final phase of Alcoholic liver disease. It not only occurs in heavy drinkers but also there is a chance of getting liver disease go up the longer of been drinking and more alcohol consumption. A study was observational, prospective and descriptive; and was carried out one hundred and nine patients [n=109] who were with suffering from an Alcoholic liver disease, to determine the alcohol withdrawal score and there symptoms involved after they were kept on alcohol withdrawal therapy. An observational, prospective and randomized study was conducted in the hospital from March 2014-March 2016. Questionnaire based session with 10 scaled questions were framed according to CIWA (assessment and management of alcohol withdrawal and the score was noted with their symptoms occurrence after the alcohol cessation plan. CIWA score with moderate severity were found to be highest. 7 patients out of 33 patients in severe category of CIWA score were admitted in the hospital with alcohol withdrawal syndrome and psychological disturbances. Clinical Institute Withdrawal Assessment of Alcohol Scale (CIWA helps clinicians assess and treat potential alcohol withdrawal.

  5. Acute physiological impacts of CO{sub 2} ocean sequestration on marine animals

    Ishimatsu, A.; Hayashi, M.; Lee, K.S.; Murata, K.; Kumagai, E. [Nagasaki Univ., Nagasaki (Japan). Marine Research Inst.; Kikkawa, T. [Marine Ecology Research Inst., Chiba (Japan). Central Laboratory; Kita, J. [Research Inst. of Innovative Technology for the Earth, Kyoto (Japan)

    2005-07-01

    The biological impacts of ocean carbon dioxide (CO{sub 2}) sequestration must be carefully considered before it is implemented as a mitigation strategy. This paper presented details of a study investigating the effects of high CO{sub 2} concentrations on marine fish, lobster, and octopus. The influence of water temperature on the physiological effects of CO{sub 2} was also discussed. In the first part of the study, eggs and larvae of red seabream were exposed to both CO{sub 2} and HCI-acidified seawater at identical pH levels. Seabream in the CO{sub 2} group showed a much higher mortality rate than fish in the HCI group. Other tests showed that Japanese Flounder died after complete recovery of pH in seawater equilibrated with 5 per cent CO{sub 2}. Cardiac output was rapidly depressed in Yellowtail fish without significant changes in blood oxygen concentrations. Lower temperatures resulted in higher mortality and delayed pH recovery during hypercapnia in all fish. Western rock lobsters were the most tolerant to CO{sub 2} among all species tested. The recovery of hemolymph pH was complete at exposure to CO{sub 2} concentrations of 1 per cent. Changes in hemolymph bicarbonate concentrations indicated that acid-based regulatory mechanisms differed between fish and lobsters. Mortality rates for octopus were significant at CO{sub 2} concentrations of 1 per cent. The results of all tests showed that aquatic animals are more susceptible to increases in ambient CO{sub 2} levels than terrestrial animals. It was concluded that even slight elevations in CO{sub 2} concentration levels adversely affected physiological functioning in the tested species. It was concluded that CO{sub 2} sequestration in deeper, colder waters will have a more pronounced effect on aquatic animals due to the interactions between CO{sub 2} and lower temperatures, as well as the fact that most deep-sea fish are less tolerant to environmental perturbations. 3 refs., 1 tab., 3 figs.

  6. Exertional rhabdomyolysis in an acutely detrained athlete/exercise physiology professor.

    Pearcey, Gregory E P; Bradbury-Squires, David J; Power, Kevin E; Behm, David G; Button, Duane C

    2013-11-01

    The authors report a case of exercise-induced (exertional) rhabdomyolysis in a male athlete/exercise physiology professor who started a high-intensity resistance training program after a period of detraining. The subject performed 1 high-intensity resistance training session that consisted of 48 total sets of push-ups (24) and chin-ups (24) with no rest between the sets. Two days after the exercise session, the subject reported "Cola colored" urine. On arriving at the hospital, test results indicated elevated myoglobin and creatine kinase (CK) levels (59 159 U/L; normal is 20-200 U/L). Treatment included intravenous hydration with sodium bicarbonate to reduce myoglobin, blood work to monitor CK levels, and acupuncture from the shoulder to hand. Three weeks posttreatment, the subject started to exercise again. This case study illustrates that unaccustomed exercise in the form of high-intensity resistance training may be harmful (ie, severe delayed onset muscle soreness or even worse, as reported in this case, rhabdomyolysis) to detrained athletes. PMID:23727696

  7. A novel Respiratory Health Score (RHS supports a role of acute lung damage and pig breed in the course of an Actinobacillus pleuropneumoniae infection

    Gerlach Gerald F

    2009-04-01

    Full Text Available Abstract Background Bacterial lung infections are a major cause of economic losses in the pig industry; they are responsible for approximately 50% of the antibiotics used in pigs and, therefore, also present an increasing concern to consumer protection agencies. In response to this changing market we investigated the feasibility of an old approach aimed at the breeding selection of more resistant pigs. As a first step in this direction we applied a new respiratory health score system to study the susceptibility of four different pig breeding lines (German Landrace, Piétrain, Hampshire, Large White towards the respiratory tract pathogen Actinobacillus (A. pleuropneumoniae. Results A controlled experimental aerosol infection with an A. pleuropneumoniae serotype 7 isolate was performed using 106 weaning pigs of defined breeding lines from the breeds German Landrace, Piétrain, Hamphire, and Large White. Pigs were clinically assessed on days 4 and 20 post infection following a novel scoring system, the Respiratory Health Score (RHS, which combines clinical, sonographic and radiographic examination results. The ranking on day 4 was significantly correlated with the ranking based on the pathomorphological Lung Lesion Score (LLS; Spearman Rank Correlation Coefficient of 0.86 [p Conclusion These results demonstrate that the RHS obtained from live pigs shows a highly significant correlation to the lung lesion score considered as a "gold standard". The correlation of the ranking at days 4 and 20 post infection implies that the course of disease is highly dependent on the acute lung damage. The different severity of signs among the tested pig breeding lines clearly suggests a genetic difference in the susceptibility of pigs to A. pleuropneumoniae infection.

  8. Alberta Stroke Program Early CT Score applied to CT angiography source images is a strong predictor of futile recanalization in acute ischemic stroke

    Kawiorski, Michal M.; Alonso de Lecinana, Maria [Hospital Universitario La Paz, IdiPAZ, Universidad Autonoma de Madrid, Madrid (Spain); Hospital Universitario Ramon y Cajal, IRYCIS, Universidad de Alcala de Henares, Madrid (Spain); Martinez-Sanchez, Patricia; Fuentes, Blanca; Sanz-Cuesta, Borja E.; Marin, Begona; Ruiz-Ares, Gerardo; Diez-Tejedor, Exuperio [Hospital Universitario La Paz, IdiPAZ, Universidad Autonoma de Madrid, Madrid (Spain); Garcia-Pastor, Andres; Diaz-Otero, Fernando [Hospital Universitario Gregorio Maranon, IiSGM, Universidad Complutense de Madrid, Madrid (Spain); Calleja, Patricia [Hospital Universitario 12 de Octubre, Universidad Autonoma de Madrid, Madrid (Spain); Lourido, Daniel; Vicente, Agustina; Fandino, Eduardo [Hospital Universitario Ramon y Cajal, IRYCIS, Universidad de Alcala de Henares, Madrid (Spain); Sierra-Hidalgo, Fernando [Hospital Universitario 12 de Octubre, Universidad Autonoma de Madrid, Madrid (Spain); Hospital Universitario Infanta Leonor, Universidad Complutense de Madrid, Madrid (Spain)

    2016-05-15

    Reliable predictors of poor clinical outcome despite successful revascularization might help select patients with acute ischemic stroke for thrombectomy. We sought to determine whether baseline Alberta Stroke Program Early CT Score (ASPECTS) applied to CT angiography source images (CTA-SI) is useful in predicting futile recanalization. Data are from the FUN-TPA study registry (ClinicalTrials.gov; NCT02164357) including patients with acute ischemic stroke due to proximal arterial occlusion in anterior circulation, undergoing reperfusion therapies. Baseline non-contrast CT and CTA-SI-ASPECTS, time-lapse to image acquisition, occurrence, and timing of recanalization were recorded. Outcome measures were NIHSS at 24 h, symptomatic intracranial hemorrhage, modified Rankin scale score, and mortality at 90 days. Futile recanalization was defined when successful recanalization was associated with poor functional outcome (death or disability). Included were 110 patients, baseline NIHSS 17 (IQR 12; 20), treated with intravenous thrombolysis (IVT; 45 %), primary mechanical thrombectomy (MT; 16 %), or combined IVT + MT (39 %). Recanalization rate was 71 %, median delay of 287 min (225; 357). Recanalization was futile in 28 % of cases. In an adjusted model, baseline CTA-SI-ASPECTS was inversely related to the odds of futile recanalization (OR 0.5; 95 % CI 0.3-0.7), whereas NCCT-ASPECTS was not (OR 0.8; 95 % CI 0.5-1.2). A score ≤5 in CTA-SI-ASPECTS was the best cut-off to predict futile recanalization (sensitivity 35 %; specificity 97 %; positive predictive value 86 %; negative predictive value 77 %). CTA-SI-ASPECTS strongly predicts futile recanalization and could be a valuable tool for treatment decisions regarding the indication of revascularization therapies. (orig.)

  9. Intracerebral Hemorrhage; towards physiological imaging of hemorrhage risk in acute and chronic bleeding.

    Raphael eJakubovic

    2012-05-01

    Full Text Available Despite improvements in management and prevention of intracerebral hemorrhage (ICH, there has been little improvement in mortality over the last 30 years. Hematoma expansion, primarily during the first few hours is highly predictive of neurological deterioration, poor functional outcome and mortality. For each 10% increase in ICH size, there is a 5% increase in mortality and an additional 16% chance of poorer functional outcome. As such, both the identification and prevention of hematoma expansion are attractive therapeutic targets in ICH. Previous studies suggest that contrast extravasation seen on CT Angiography (CTA, MRI, and digital subtraction angiography correlates with hematoma growth, indicating ongoing bleeding. Contrast extravasation on the arterial phase of a CTA has been coined the CTA Spot Sign. These easily identifiable foci of contrast enhancement have been identified as independent predictors of hematoma growth, mortality and clinical outcome in primary ICH. The Spot Sign score, developed to stratify risk of hematoma expansion, has shown high inter-observer agreement. Post-contrast leakage or delayed CTA Spot Sign, on post contrast CT following CTA or delayed CTA respectively are seen in an additional ~8% of patients and explain apparently false negative observations on early CTA imaging in patients subsequently undergoing hematoma expansion. CT perfusion provides an opportunity to acquire dynamic imaging and has been shown to quantify rates of contrast extravasation. Intravenous recombinant factor VIIa(rFVIIa within 4 hours of ICH onset has been shown to significantly reduce hematoma growth. However, clinical efficacy has yet to be proven. There is compelling evidence that cerebral amyloid angiopathy (CAA may precede the radiographic evidence of vascular disease and as such contribute to microbleeding. The interplay between microbleeding, CAA,CTA Spot Sign and genetic composition (ApoE genotype may be crucial in developing a

  10. Dickkopf-1 as a novel predictor is associated with risk stratification by GRACE risk scores for predictive value in patients with acute coronary syndrome: a retrospective research.

    Lin Wang

    Full Text Available OBJECTIVE: Dickkopf-1 (DKK-1, a major regulator of the Wnt pathway, plays an important role in cardiovascular disease. However, no study has evaluated the association of DKK-1 and acute coronary syndrome (ACS. We investigated this association and whether the Global Registry of Acute Coronary Events (GRACE hospital-discharge risk score predicting major adverse cardiac events (MACE can be improved by adding the DKK-1 value. METHODS: We enrolled 291 patients (46 with ST-segment elevation myocardial infarction [STEMI] and 245 with non-ST elevated ACS [NSTE-ACS] who were divided into groups by tertiles of baseline plasma DKK-1 level measured by ELISA. The GRACE risk score was calculated and predictive value alone and together with DKK-1 and/or high-sensitivity C-reactive protein (hs-CRP level were assessed, respectively. RESULTS: Compared with patients with NSTE-ACS, those with STEMI had higher plasma DKK-1 level at baseline (P = 0.006. Plasma DKK-1 level was correlated with hs-CRP level (r = 0.295, P<0.001 and was greater with high than intermediate or low GRACE scores (P = 0.002 and P<0.001, respectively. We found 44 (15.1% MACEs during a median 2-year follow-up. DKK-1 levels were higher for patients with than without events (P<0.001. The rate of MACE increased with increasing DKK-1 level (P<0.001. The area under the receiver operating characteristic curve for GRACE score with MACE was 0.524 and improved to 0.791 with the addition of hs-CRP level, 0.775 with the addition of DKK-1 level and 0.847 with both values added. CONCLUSIONS: DKK-1 is an independent predictor of long-term MACE of patients with ACS. The long-term predictive ability of post-discharge GRACE score may be enhanced by adding DKK-1 level.

  11. Effects of continuous administration of clopidogrel before off-pump coronary artery bypass grafting in patients with acute coronary syndrome. A propensity score analysis

    Clopidogrel has become standard treatment after urgent percutaneous coronary revascularization. Due to its enhanced and irreversible platelet inhibition, patients undergoing urgent surgical revascularization have a higher risk of bleeding complications and transfusions. Therefore, the effect of preoperative continuous administration of clopidogrel on the incidence of hemorrhagic complications in patients undergoing off-pump coronary artery bypass surgery with acute coronary syndrome was evaluated. From March 2004 to September 2006, 172 patients with acute coronary syndrome underwent isolated off-pump coronary artery bypass surgery; 70 (40.7%) and 102 (59.3%) of these patients did or did not take clopidogrel before surgery respectively. Seventy patients in each group were matched using propensity scores and associations between preoperative continuous administration of clopidogrel and postoperative bleeding, hemostatic reoperation, blood products received, the need for multiple transfusions and early graft patency by coronary computed tomography were assessed. Univariate analysis showed the continuous clopidogrel group had similar levels of postoperative bleeding for 24 h (601.4±312.6 ml vs 637.2±452.4 ml, p=0.616) and rates of reexploration (1.4% vs 1.4%), perioperative blood transfusion (33.3% vs 34.3%, p>0.05) and platelet transfusion (2.9% vs 7.1%, p=0.44) compared with the non-continuous group. Preoperative continuous administration of clopidogrel did not increase the risk of hemorrhagic complications in patients with acute coronary syndrome undergoing isolated off-pump coronary artery bypass surgery. These findings indicate that surgery after clopidogrel treatment in patients with acute coronary syndrome should not be delayed until platelet function returns to normal because they may have a higher risk of recurrent myocardial ischemic events. (author)

  12. ECG scores for a triage of patients with acute myocardial infarction transported by the emergency medical system.

    Zalenski, R J; Grzybowski, M; Ross, M A; Blaustein, N; Bock, B

    2000-01-01

    Prehospital triage of cardiac patients for bypass from community hospitals to cardiac centers may improve survival. This article determines if electrocardiogram (ECG)-based scoring triage methods (Aldrich MI scoring, QRS distortion, and the TIMI classification) and location of infarct (via 12 lead ECG) are associated with mortality before and after adjusting for age, sex, and race. It is a retrospective study of 291 AMI adult patients transported by ambulance to community hospitals or cardiac centers. Patients with an ED chief complaint of chest pain or dyspnea, presence of MI as defined by ECG findings of 0.1 mV of ST segment elevation in two leads or positive CPK-MB were eligible for the study. The primary outcome variable was 2-year mortality as determined with a metropolitan Detroit tri-county death index. Logistic regression was used to calculate the unadjusted and adjusted odds ratios (with 95% CIs) of the predictor variables with mortality. Of the initial population selected for the study (n = 291), 229 patients were eligible for the analysis. The mean age was 66 years (SD of 14.4) with 63.8% being male and 54% being white. The overall mortality point estimate was 21.3% (95% CI of 15.2 to 27.3%). Aldrich scores and QRS distortion (yes/no) were not associated with mortality. Patients classified as a "high risk" for AMI per TIMI status were almost 3 times more likely to die than those at "low risk" and reached borderline statistical significance (P = .06) after adjusting for the covariates. Having an anterior infarct, as opposed to an inferior infarct, was significantly associated with death before and after adjusting for the covariates (Unadjusted OR = 2.6, Adjusted OR = 2.8). Properly training emergency medical system professionals in this area may prove useful for identifying higher risk AMI patients in the prehospital setting. PMID:11265729

  13. Heat acclimation attenuates physiological strain and the HSP72, but not HSP90 alpha, mRNA response to acute normobaric hypoxia

    Gibson, OR; Turner, G.; Tuttle, JA; Taylor, L.; Watt, PW; Maxwell, NS

    2015-01-01

    Heat acclimation (HA) attenuates physiological strain in hot conditions via phenotypic and cellular adaptation. The aim of this study was to determine whether HA reduced physiological strain, and heat shock protein (HSP) 72 and HSP90α mRNA responses in acute normobaric hypoxia. Sixteen male participants completed ten 90-min sessions of isothermic HA (40°C/40% relative humidity) or exercise training [control (CON); 20°C/40% relative humidity]. HA or CON were preceded (HYP1) and proceeded (HYP2...

  14. Evaluation of the visual analog score (VAS to assess acute mountain sickness (AMS in a hypobaric chamber.

    Jialin Wu

    Full Text Available The visual analog score (VAS is widely used in clinical medicine to evaluate the severity of subjective symptoms. There is substantial literature on the application of the VAS in medicine, especially in measuring pain, nausea, fatigue, and sleep quality. Hypobaric chambers are utilized to test and exercise the anaerobic endurance of athletes. To this end, we evaluated the degree of AMS using the visual analog scale (VAS in a hypobaric chamber in which the equivalent altitude was increased from 300 to 3500 m.We observed 32 healthy young men in the hypobaric chamber (Guizhou, China and increased the altitude from 300 to 3500 m. During the five hours of testing, we measured the resting blood oxygen saturation (SaO2 and heart rate (HR. Using the VAS, we recorded the subjects' ratings of their AMS symptom intensity that occurred throughout the phase of increasing altitude at 300 m, 1500 m, 2000 m, 2500 m, 3000 m, and 3500 m.During the phase of increasing altitude in the hypobaric chamber, the patients' SaO2 was 96.8 ± 0.8% at 300 m and 87.5 ± 4.1% at 3500 m (P<0.05 and their HR was 79.0 ± 8.0 beats/minute at 300 m and 79.3 ± 11.3 beats/minute at 3500 m. The incidence of symptoms significantly increased from 21.9% at an altitude of 1000 m to 65.6% at an altitude of 3500 m (P<0.05. The composite VAS score, which rated the occurrence of four symptoms (headache, dizziness, fatigue, and gastrointestinal discomfort, was significantly correlated with elevation (P<0.01.Based on the experimental data, the VAS can be used as an auxiliary diagnostic method of Lake Louise score to evaluate AMS and can show the changing severity of symptoms during the process of increased elevation in a hypobaric chamber; it also reflects a significant correlation with altitude.

  15. Acute Ischemic Stroke and Long-Term Outcome After Thrombolysis: Nationwide Propensity Score-Matched Follow-Up Study

    Schmitz, Marie Louise; Simonsen, Claus Z; Hundborg, Heidi;

    2014-01-01

    to compute adjusted hazard ratios for all outcomes. RESULTS: Among 4292 ischemic strokes (2146 intravenous tPA-treated and 2146 propensity score-matched nonintravenous tPA-treated patients), with a follow-up for a median of 1.4 years, treatment with intravenous tPA was associated with a lower risk of long......-term mortality (adjusted hazard ratio, 0.66; 95% confidence interval, 0.49-0.88). The long-term risk of recurrent ischemic stroke (adjusted hazard ratio, 1.05; 95% confidence interval, 0.68-1.64) and major bleeding (adjusted hazard ratio, 0.59; 95% confidence interval, 0.24-1.47) did not differ significantly...

  16. The Impact of Acute and Chronic Weight Restriction and Weight Regulation practices on Physiological, Osteogenic, Metabolic and Cognitive Function in Elite Jockeys

    Dolan, Eimear

    2010-01-01

    Horse racing is a weight category sport. One of the key challenges facing jockeys is the pressure of “making weight” throughout the protracted racing season. Aim: The aim of this study was to examine the effect of a chronically weight restrictive lifestyle and acute weight loss practices on aspects of physiological, osteogenic, metabolic and cognitive function in jockeys. Methods: The primary aim was achieved through the completion of four related studies. Study One: The effect of a 4% reduct...

  17. Comparison and combination of a hemodynamics/biomarkers-based model with simplified PESI score for prognostic stratification of acute pulmonary embolism: findings from a real world study

    Luca Masotti

    2015-11-01

    Full Text Available Background: Prognostic stratification is of utmost importance for management of acute Pulmonary Embolism (PE in clinical practice. Many prognostic models have been proposed, but which is the best prognosticator in real life remains unclear. The aim of our study was to compare and combine the predictive values of the hemodynamics/biomarkers based prognostic model proposed by European Society of Cardiology (ESC in 2008 and simplified PESI score (sPESI. Methods: Data records of 452 patients discharged for acute PE from Internal Medicine wards of Tuscany (Italy were analysed. The ESC model and sPESI were retrospectively calculated and compared by using Areas under Receiver Operating Characteristics (ROC Curves (AUCs and finally the combination of the two models was tested in hemodinamically stable patients. All cause and PE-related in-hospital mortality and fatal or major bleedings were the analyzed endpoints Results: All cause in-hospital mortality was 25% (16.6% PE related in high risk, 8.7% (4.7% in intermediate risk and 3.8% (1.2% in low risk patients according to ESC model. All cause in-hospital mortality was 10.95% (5.75% PE related in patients with sPESI score and #8805;1 and 0% (0% in sPESI score 0. Predictive performance of sPESI was not significantly different compared with 2008 ESC model both for all cause (AUC sPESI 0.711, 95% CI: 0.661-0.758 versus ESC 0.619, 95% CI: 0.567-0.670, difference between AUCs 0.0916, p=0.084 and for PE-related mortality (AUC sPESI 0.764, 95% CI: 0.717-0.808 versus ESC 0.650, 95% CI: 0.598-0.700, difference between AUCs 0.114, p=0.11. Fatal or major bleedings occurred in 4.30% of high risk, 1.60% of intermediate risk and 2.50% of low risk patients according to 2008 ESC model, whereas these occurred in 1.80% of high risk and 1.45% of low risk patients according to sPESI, respectively. Predictive performance for fatal or major bleeding between two models was not significantly different (AUC sPESI 0.658, 95% CI

  18. Proposal for a New Score-Based Approach To Improve Efficiency of Diagnostic Laboratory Workflow for Acute Bacterial Meningitis in Adults.

    Lagi, Filippo; Bartalesi, Filippo; Pecile, Patrizia; Biagioli, Tiziana; Caldini, Anna Lucia; Fanelli, Alessandra; Giannazzo, Giuseppe; Grifoni, Stefano; Massacesi, Luca; Bartoloni, Alessandro; Rossolini, Gian Maria

    2016-07-01

    Microbiological tests on cerebrospinal fluid (CSF) utilize a common urgent-care procedure that does not take into account the chemical and cytological characteristics of the CSF, resulting sometimes in an unnecessary use of human and diagnostic resources. The aim of this study was to retrospectively validate a simple scoring system (bacterial meningitis-Careggi score [BM-CASCO]) based on blood and CSF sample chemical/cytological parameters for evaluating the probability of acute bacterial meningitis (ABM) in adults. BM-CASCO (range, 0 to 6) was defined by the following parameters: CSF cell count, CSF protein levels, CSF lactate levels, CSF glucose-to-serum glucose ratio, and peripheral neutrophil count. BM-CASCO was retrospectively calculated for 784 cases of suspected ABM in adult subjects observed during a four-and-a-half-year-period (2010 to 2014) at the emergency department (ED) of a large tertiary-care teaching hospital in Italy. Among the 28 confirmed ABM cases (3.5%), Streptococcus pneumoniae was the most frequent cause (16 cases). All ABM cases showed a BM-CASCO value of ≥3. Most negative cases (591/756) exhibited a BM-CASCO value of ≤1, which was adopted in our laboratory as a cutoff to not proceed with urgent microbiological analysis of CSF in cases of suspected ABM in adults. During a subsequent 1-year follow-up, the introduction of the BM-CASCO in the diagnostic workflow of ABM in adults resulted in a significant decrease in unnecessary microbiological analysis, with no false negatives. In conclusion, BM-CASCO appears to be an accurate and simple scoring system for optimization of the microbiological diagnostic workflow of ABM in adults. PMID:27170017

  19. Apgar Scores

    ... are more likely to have low scores than infants with normal births. These scores may reflect difficulties the baby experienced during labor or problems with her heart or respiratory system. What if Your Baby Scores Low? If your ...

  20. Application of Portsmouth modification of physiological and operative severity scoring system for enumeration of morbidity and mortality (P-POSSUM) in pancreatic surgery

    Tamijmarane Appou; Bhati Chandra S; Mirza Darius F; Bramhall Simon R; Mayer David A; Wigmore Stephen J; Buckels John AC

    2008-01-01

    Abstract Background Pancreatoduodenectomy (PD) is associated with high incidence of morbidity and mortality. We have applied P-POSSUM in predicting the incidence of outcome after PD to identify those who are at the highest risk of developing complications. Method A prospective database of 241 consecutive patients who had PD from January 2002 to September 2005 was retrospectively updated and analysed. P-POSSUM score was calculated for each patient and correlated with observed morbidity and mor...

  1. The better of two evils? Evidence that children exhibiting continuous conduct problems high or low on callous-unemotional traits score on opposite directions on physiological and behavioral measures of fear.

    Fanti, Kostas A; Panayiotou, Georgia; Lazarou, Chrysostomos; Michael, Raphaelia; Georgiou, Giorgos

    2016-02-01

    The present study examines whether heterogeneous groups of children identified based on their longitudinal scores on conduct problems (CP) and callous-unemotional (CU) traits differ on physiological and behavioral measures of fear. Specifically, it aims to test the hypothesis that children with high/stable CP differentiated on CU traits score on opposite directions on a fear-fearless continuum. Seventy-three participants (M age = 11.21; 45.2% female) were selected from a sample of 1,200 children. Children and their parents completed a battery of questionnaires assessing fearfulness, sensitivity to punishment, and behavioral inhibition. Children also participated in an experiment assessing their startle reactivity to fearful mental imagery, a well-established index of defensive motivation. The pattern of results verifies the hypothesis that fearlessness, assessed with physiological and behavioral measures, is a core characteristic of children high on both CP and CU traits (i.e., receiving the DSM-5 specifier of limited prosocial emotions). To the contrary, children with high/stable CP and low CU traits demonstrated high responsiveness to fear, high behavioral inhibition, and high sensitivity to punishment. The study is in accord with the principle of equifinality, in that different developmental mechanisms (i.e., extremes of high and low fear) may have the same behavioral outcome manifested as phenotypic antisocial behavior. PMID:25916948

  2. Computer-Aided Quantification of Interstitial Lung Disease from High Resolution Computed Tomography Images in Systemic Sclerosis: Correlation with Visual Reader-Based Score and Physiologic Tests

    Fausto Salaffi

    2015-01-01

    Full Text Available Objective. To evaluate the performance of a computerized-aided method (CaM for quantification of interstitial lung disease (ILD in patients with systemic sclerosis and to determine its correlation with the conventional visual reader-based score (CoVR and the pulmonary function tests (PFTs. Methods. Seventy-nine patients were enrolled. All patients underwent chest high resolution computed tomography (HRCT scored by two radiologists adopting the CoVR. All HRCT images were then analysed by a CaM using a DICOM software. The relationships among the lung segmentation analysis, the readers, and the PFTs results were calculated using linear regression analysis and Pearson’s correlation. Receiver operating curve analysis was performed for determination of CaM extent threshold. Results. A strong correlation between CaM and CoVR was observed (P<0.0001. The CaM showed a significant negative correlation with forced vital capacity (FVC (P<0.0001 and the single breath carbon monoxide diffusing capacity of the lung (DLco (P<0.0001. A CaM optimal extent threshold of 20% represented the best compromise between sensitivity (75.6% and specificity (97.4%. Conclusions. CaM quantification of SSc-ILD can be useful in the assessment of extent of lung disease and may provide reliable tool in daily clinical practice and clinical trials.

  3. Comparison of Acute Kidney Injury After Robot-Assisted Laparoscopic Radical Prostatectomy Versus Retropubic Radical Prostatectomy: A Propensity Score Matching Analysis.

    Joo, Eun-Young; Moon, Yeon-Jin; Yoon, Syn-Hae; Chin, Ji-Hyun; Hwang, Jai-Hyun; Kim, Young-Kug

    2016-02-01

    Acute kidney injury (AKI) is associated with extended hospital stay, a high risk of progressive chronic kidney diseases, and increased mortality. Patients undergoing radical prostatectomy are at increased risk of AKI because of intraoperative bleeding, obstructive uropathy, older age, and preexisting chronic kidney disease. In particular, robot-assisted laparoscopic radical prostatectomy (RALP), which is in increasing demand as an alternative surgical option for retropubic radical prostatectomy (RRP), is associated with postoperative renal dysfunction because pneumoperitoneum during RALP can decrease cardiac output and renal perfusion. The objective of this study was to compare the incidence of postoperative AKI between RRP and RALP.We included 1340 patients who underwent RRP (n = 370) or RALP (n = 970) between 2013 and 2014. Demographics, cancer-related data, and perioperative laboratory data were evaluated. Postoperative AKI was determined according to the Kidney Disease: Improving Global Outcomes criteria. Operation and anesthesia time, estimated blood loss, amounts of administered fluids and transfused packed red blood cells, and the lengths of the postoperative intensive care unit and hospital stays were evaluated. Propensity score matching analysis was performed to reduce the influence of possible confounding variables and adjust for intergroup differences between the RRP and RALP groups.After performing 1:1 propensity score matching, the RRP and RALP groups included 307 patients, respectively. The operation time and anesthesia time in RALP were significantly longer than in the RRP group (both P < 0.001). However, the estimated blood loss and amount of administered fluids in RALP were significantly lower than in RRP (both P < 0.001). Also, RALP demonstrated a significantly lower incidence of transfusion and smaller amount of transfused packed red blood cells than RRP (both P < 0.001). Importantly, the incidence of AKI in RALP was

  4. Comparison of Ranson, Glasgow, MOSS, SIRS, BISAP, APACHE-II, CTSI Scores, IL-6, CRP, and Procalcitonin in Predicting Severity, Organ Failure, Pancreatic Necrosis, and Mortality in Acute Pancreatitis

    Ajay K. Khanna

    2013-01-01

    Full Text Available Background. Multifactorial scorings, radiological scores, and biochemical markers may help in early prediction of severity, pancreatic necrosis, and mortality in patients with acute pancreatitis (AP. Methods. BISAP, APACHE-II, MOSS, and SIRS scores were calculated using data within 24 hrs of admission, whereas Ranson and Glasgow scores after 48 hrs of admission; CTSI was calculated on day 4 whereas IL-6 and CRP values at end of study. Predictive accuracy of scoring systems, sensitivity, specificity, and positive and negative predictive values of various markers in prediction of severe acute pancreatitis, organ failure, pancreatic necrosis, admission to intensive care units and mortality were calculated. Results. Of 72 patients, 31 patients had organ failure and local complication classified as severe acute pancreatitis, 17 had pancreatic necrosis, and 9 died (12.5%. Area under curves for Ranson, Glasgow, MOSS, SIRS, APACHE-II, BISAP, CTSI, IL-6, and CRP in predicting SAP were 0.85, 0.75, 0.73, 0.73, 0.88, 0.80, 0.90, and 0.91, respectively, for pancreatic necrosis 0.70, 0.64, 0.61, 0.61, 0.68, 0.61, 0.75, 0.86, and 0.90, respectively, and for mortality 0.84, 0.83, 0.77, 0.76, 0.86, 0.83, 0.57, 0.80, and 0.75, respectively. Conclusion. CRP and IL-6 have shown a promising result in early detection of severity and pancreatic necrosis whereas APACHE-II and Ranson score in predicting AP related mortality in this study.

  5. The Value of Botox-A in Acute Radiation Proctitis: Results From a Phase I/II Study Using a Three-Dimensional Scoring System

    Purpose: Acute radiation proctitis (ARP) is a common side effect of pelvic radiotherapy, and its management is challenging in daily practice. The present phase I/II study evaluates the safety and efficacy of the botulinum toxin A (BTX-A) in ARP treatment for rectal cancer patients undergoing neoadjuvant high-dose-rate endorectal brachytherapy (HDREBT). Methods and Materials: Fifteen patients, treated with neoadjuvant HDREBT, 26-Gy in 4 fractions, received the study treatment that consisted of a single injection of BTX-A into the rectal wall. The injection was performed post-HDREBT and prior to the development of ARP. The control group, 20 such patients, did not receive the BTX-A injection. Both groups had access to standard treatment with hydrocortisone rectal aerosol foam (Cortifoam) and anti-inflammatory and narcotic medication. The ARP was clinically evaluated by self-administered daily questionnaires using visual analog scores to document frequency and urgency of bowel movements, rectal burning/tenesmus, and pain symptoms before and after HDREBT. Results: At the time of this analysis, there was no observed systemic toxicity. Patient compliance with the self-administered questionnaire was 100% from week 1 to 4, 70% during week 5, and 40% during week 6. The maximum tolerated dose was established at the 100-U dose level, and noticeable mean differences were observed in bowel frequency (p = 0.016), urgency (p = 0.007), and pain (p = 0.078). Conclusions: This study confirms the feasibility and efficacy of BTX-A intervention at 100-U dose level for study patients compared to control patients. A phase III study with this dose level is planned to validate these results.

  6. Evaluation of lung infiltration score to predict postural hypoxemia in ventilated acute respiratory distress syndrome patients and the lateralization of skin pressure sore

    Tripathi Mukesh

    2009-09-01

    Full Text Available Context: Mechanical ventilation with positive end expiratory pressure (PEEP is associated with unequal aeration of lungs in acute respiratory distress syndrome (ARDS patients. Therefore, patients may develop asymmetric atelectasis and postural hypoxemia during lateral positioning. Aims: To validate proposed lung infiltration score (LIS based on chest x-ray to predict postural hypoxemia and lateralization of skin sores in ARDS patients. Settings and Design: University hospital ICU. Prospective, observational study of consecutive patients. Materials and Methods: Sixteen adult patients of both genders on mechanical ventilation with PEEP for 24 to < 48 hours. On chest x-ray, 6 segments were identified on each lung. The proposed LIS points (0- normal; 1- patchy infiltrates; 2- white infiltrates matching heart shadow were assigned to each segment. Without changing ventilation parameters, supine, left and right lateral positions at 45° tilt were randomly changed. At the end of 20 minutes of ventilation in each position, we observed arterial oxygen saturation, hemodynamic and arterial blood gases. Later, position change protocol (4 hourly was practiced in ICU, and skin pressure sore grading was noted within a week of ICU stay. Statistical Analysis Used: Nonparametric Bland and Altman correlation analysis, ANOVA and Student t test. Results: Arterial oxygenation (PaO 2 /FiO 2 = 313± 145.6 was significantly (P< 0.01 higher in better lung (lower LIS-down position than supine (PaO 2 /FiO 2 = 199± 70.2 or a better lung-up position (PaO 2 /FiO 2 = 165± 64.8. The positioning-related arterial oxygenation was significant (P< 0.05 at LIS asymmetry ≥3 between two lungs. Conclusions: The LIS mapping on chest x-ray was useful to differentiate between asymmetric lung disease and postural hypoxemia in ICU patients, which predisposed patients to early skin sore changes on higher LIS side.

  7. Clinical use of the combined Sclarovsky Birnbaum Severity and Anderson Wilkins Acuteness scores from the pre-hospital ECG in ST-segment elevation myocardial infarction

    Fakhri, Yama; Schoos, Mikkel M; Clemmensen, Peter;

    2014-01-01

    This review summarizes the electrocardiographic changes during an evolving ST segment elevation myocardial infarction and discusses associated electrocardiographic scores and the potential use of these indices in clinical practice, in particular the ECG scores developed by Anderson and Wilkins...

  8. How to Evaluate the Severity of Acute Pancreatitis: Back to the Past?

    Raffaele Pezzilli

    2012-01-01

    Selecting patients with severe acute pancreatitis as early as possible after the onset of symptoms is crucial for appropriate treatment [1]. The guidelines indicate that the assessment of severity should be carried out as soon as possible by a scoring system, such as Acute Physiology and Chronic Health Evaluation (APACHE) II which is a grade A recommendation [2, 3]. The comment added by the authors of the Italian guidelines is that an APACHE II score greater than 8 is important for determinin...

  9. Relação entre o escore de comportamento materno e as características fisiológicas de ovelhas Relation between maternal behavior score with physiological characteristics of ewes

    Marta Farias Aita

    2012-04-01

    Full Text Available Neste estudo objetivou-se avaliar a relação do escore de comportamento materno de ovelhas com os parâmetros fisiológicos relacionados ao seu temperamento. Durante a parição, foram avaliadas 258 ovelhas Corriedale e 50 ovelhas Ideal criadas em campo natural em três fazendas na região sudoeste do estado do Rio Grande do Sul, Brasil. Foram analisados os efeitos propriedade, idade, tipo de parto, escore de comportamento materno e escore de condição corporal antes do parto e ao desmame em relação às frequências cardíaca e respiratória e temperatura corporal dos animais ao desmame. Nas primeiras 24 horas de vida do cordeiro, o escore de comportamento materno foi atribuído à distância de fuga da ovelha em relação ao seu cordeiro: 1 >10 m e não retorna ao cordeiro; 2 >10 m do cordeiro e retorna; 3 5 a 10 m; 4 entre 1 e 3. Ovelhas criadas em Bagé apresentaram os maiores valores de frequência cardíaca e respiratória. Ovelhas com escore de condição corporal antes do parto The objective of this study to assess the relationship between ewe maternal behavior score and physiological parameters related to their temperament. During lambing, 258 Corriedale and 50 Polwarth ewes were evaluated. They were raised on native pasture in the southwest region of Rio Grande do Sul State, Brazil. The effects of farm, age, type of lambing, maternal behavior scores and body condition score before lambing and during the weaning were evaluated in relation to heart rate, respiratory rate and body temperature of animals at weaning. In the first 24 hours after lambing, the maternal behavior score was assigned to the ewe as the distance from its lamb: 1 >10 meters and does not return to the lamb; 2 >10 meters from the lamb, but returns; 3 five to 10 meters; 4 between one and five meters; 5 less than one meter; 6 maintains physical contact. Ewes with maternal behavior score of 3. Sheep raised on the farm in Bagé municipality had higher heart and

  10. Coronary artery calcium score using electron beam tomography in the patients with acute obstructive coronary arterial disease : comparative study within asymptomatic high-risk group of atherosclerosis and chronic obstructive coronary arterial disease group

    Ryu, Seok Jong; Choi, Byoung Wook; Choe, Kyu Ok [Yonsei Univ. College of Medicine, Seoul (Korea, Republic of)

    2001-04-01

    To compare, through analysis of the coronary artery calcium (CAC) score and the risk factors for atherosclerosis, the characteristics of acute coronary syndrome between an asymptomatic high-risk group of atherosclerosis patients and a chronic coronary arterial obstructive disease(CAOD) group. The CAC scores of an asymptomatic high-risk group of atherosclerosis patients (group I, n=284), a chronic CAOD croup (group II, n=39) and an acute coronary syndrome group (group III, n=21) were measured by electron beam tomography. Forty-seven patients with CAOD from groups II and III underwent coronary angiography, and we scrutinized age, sex and risk factors including diabetes mellitus, hypertension, obesity, smoking, hypercholesterolemia and low high-density lipoproteinemia. The numbers of stenotic coronary arterial branches and degree of stenosis revealed by coronary angiography were also recorded. We determined the differences between the three groups in terms of CAC score and the risk factors, the relationship between CAC score and risk factors, and the characteristic features of each type of CAOD group. The mean CA score of group III (135.1) was not statistically different from that of group I (135.7) or group II (365.8). Among patients aged below 50, the mean CAC score of group III (127.4) was significantly higher than that of group I (6.2), (p=0.0006). The mean CAC score at the sixth decade was also significantly different between group I(81.5) and group II (266.9). The mean age of group III (54.2 years) was significantly lower than that of group I (58.1 years) (p=0.047) and of group II (60.1) (p=0.022). There was significant correlation between the number of stenotic coronary arterial branches and log(CAC +1) (p<.01). The square root of the CAC score and the maximal degree of stenosis was also well correlated (p<.01). There was no difference in the mean number of risk factors among the three groups, though the incidence of smoking in group III was significantly

  11. Coronary artery calcium score using electron beam tomography in the patients with acute obstructive coronary arterial disease : comparative study within asymptomatic high-risk group of atherosclerosis and chronic obstructive coronary arterial disease group

    To compare, through analysis of the coronary artery calcium (CAC) score and the risk factors for atherosclerosis, the characteristics of acute coronary syndrome between an asymptomatic high-risk group of atherosclerosis patients and a chronic coronary arterial obstructive disease(CAOD) group. The CAC scores of an asymptomatic high-risk group of atherosclerosis patients (group I, n=284), a chronic CAOD croup (group II, n=39) and an acute coronary syndrome group (group III, n=21) were measured by electron beam tomography. Forty-seven patients with CAOD from groups II and III underwent coronary angiography, and we scrutinized age, sex and risk factors including diabetes mellitus, hypertension, obesity, smoking, hypercholesterolemia and low high-density lipoproteinemia. The numbers of stenotic coronary arterial branches and degree of stenosis revealed by coronary angiography were also recorded. We determined the differences between the three groups in terms of CAC score and the risk factors, the relationship between CAC score and risk factors, and the characteristic features of each type of CAOD group. The mean CA score of group III (135.1) was not statistically different from that of group I (135.7) or group II (365.8). Among patients aged below 50, the mean CAC score of group III (127.4) was significantly higher than that of group I (6.2), (p=0.0006). The mean CAC score at the sixth decade was also significantly different between group I(81.5) and group II (266.9). The mean age of group III (54.2 years) was significantly lower than that of group I (58.1 years) (p=0.047) and of group II (60.1) (p=0.022). There was significant correlation between the number of stenotic coronary arterial branches and log(CAC +1) (p<.01). The square root of the CAC score and the maximal degree of stenosis was also well correlated (p<.01). There was no difference in the mean number of risk factors among the three groups, though the incidence of smoking in group III was significantly

  12. A Genomic Score Prognostic of Outcome in Trauma Patients

    Warren, H Shaw; Elson, Constance M; Hayden, Douglas L; Schoenfeld, David A; Cobb, J Perren; Maier, Ronald V; Moldawer, Lyle L; Moore, Ernest E; Harbrecht, Brian G; Pelak, Kimberly; Cuschieri, Joseph; Herndon, David N; Jeschke, Marc G; Finnerty, Celeste C; Brownstein, Bernard H; Hennessy, Laura; Mason, Philip H; Tompkins, Ronald G

    2009-01-01

    Traumatic injuries frequently lead to infection, organ failure, and death. Health care providers rely on several injury scoring systems to quantify the extent of injury and to help predict clinical outcome. Physiological, anatomical, and clinical laboratory analytic scoring systems (Acute Physiology and Chronic Health Evaluation [APACHE], Injury Severity Score [ISS]) are utilized, with limited success, to predict outcome following injury. The recent development of techniques for measuring the expression level of all of a person’s genes simultaneously may make it possible to develop an injury scoring system based on the degree of gene activation. We hypothesized that a peripheral blood leukocyte gene expression score could predict outcome, including multiple organ failure, following severe blunt trauma. To test such a scoring system, we measured gene expression of peripheral blood leukocytes from patients within 12 h of traumatic injury. cRNA derived from whole blood leukocytes obtained within 12 h of injury provided gene expression data for the entire genome that were used to create a composite gene expression score for each patient. Total blood leukocytes were chosen because they are active during inflammation, which is reflective of poor outcome. The gene expression score combines the activation levels of all the genes into a single number which compares the patient’s gene expression to the average gene expression in uninjured volunteers. Expression profiles from healthy volunteers were averaged to create a reference gene expression profile which was used to compute a difference from reference (DFR) score for each patient. This score described the overall genomic response of patients within the first 12 h following severe blunt trauma. Regression models were used to compare the association of the DFR, APACHE, and ISS scores with outcome. We hypothesized that patients with a total gene response more different from uninjured volunteers would tend to have poorer

  13. Physiological study on CT image analysis of acute pulmonary edema by oleic acid and its application to diagnosis of drowning

    Recently, various investigations are carried out about the relationship between the pathophysiological changes and the images of the destructive extent in acute lung injury. In present paper, we examined, in progression time, the pathophysiological and histological changes basing upon pulmonary edema model made by administration of oleic acid to beagle dogs, and simultaneously took images of the lung by employing high-resolution X-ray CT and analyzed them. In pathophysiological and histological investigation, VA/Q heterogeneity and lung water volume increased, and decrease of PO2 in arterial blood was observed, and also filling of the alveoli with exudate, edema of the alveolar interstitium, congestion of the alveoli were observed histologically. In image analysis, the findings, that is enough to reflect the pathophysiological and histological changes, were obtained from mean CT value and the distribution of CT value histogram. Moreover, the same examination as in acute pulmonary edema model was carried out in drowning model with seawater. Consequently, it became evident that presuming of pathophysiological changes in drowning was possible from results of X-ray CT image analysis. The results described above seem to indicate that X-ray CT image analysis in acute lung injury can use as an index of the damage degree, and also is available for elucidation of the pathophysiological changes. (author)

  14. Acute effects of caffeine supplementation on cortical arousal, anxiety, physiological response and marksmanship in close quarter combat

    Clemente Suárez, Vicente Javier; Robles Pérez, José Juan

    2015-01-01

    Previous studies have researched the ergogenic effect of caffeine in different shooting actions, but none of them in a stressful combat action. This study aimed to analyse the effect of a dose of 400 mg of caffeine monohydrate on the psycho-physiological response and marksmanship of soldiers in close quarter combat. We analysed the heart rate, blood lactate concentration, cortical arousal, state anxiety and marksmanship of 19 soldiers in the Spanish Army (38.9 ± 4.1 years; 177.4 ± 5.3 cm; 78....

  15. Serum Iron Concentration, but Not Hemoglobin, Correlates with TIMI Risk Score and 6-Month Left Ventricular Performance after Primary Angioplasty for Acute Myocardial Infarction

    Ching-Hui Huang; Chia-Chu Chang; Chen-Ling Kuo; Ching-Shan Huang; Tzai-Wen Chiu; Chih-Sheng Lin; Chin-San Liu

    2014-01-01

    Objective Anemia is associated with high mortality and poor prognosis after acute coronary syndrome (ACS). Increased red cell distribution width (RDW) is a strong independent predictor for adverse outcomes in ACS. The common underlying mechanism for anemia and increased RDW value is iron deficiency. It is not clear whether serum iron deficiency without anemia affects left ventricular (LV) performance after primary angioplasty for acute myocardial infarction (AMI). We investigated the prognost...

  16. Evaluation of prognostic factors and scoring system in colonic perforation

    Atsushi Horiuchi; Yuji Watanabe; Takashi Doi; Kouichi Sato; Syungo Yukumi; Motohira Yoshida; Yuji Yamamoto; Hiroki Sugishita; Kanji Kawachi

    2007-01-01

    AIM: To study the significance of scoring systems assessing severity and prognostic factors in patients with colonic perforation.METHODS: A total of 26 patients (9 men, 17 women;mean age 72.7±11.6 years) underwent emergency operation for colorectal perforation in our institution between 1993 and 2005. Several clinical factors were measured preoperatively and 24 h postoperatively. Acute physiology and chronic health evaluationⅡ (APACHE Ⅱ),Mannheim peritonitis index (MPI) and peritonitis index of Altona (PIA Ⅱ) scores were calculated preoperatively.RESULTS: Overall postoperative mortality rate was 23.1% (6 patients). Compared with survivors, nonsurvivors displayed low blood pressure, low serum protein and high serum creatinine preoperatively, and low blood pressure, low white blood cell count, low pH,low PaO2/FiO2, and high serum creatinine postoperatively.APACHE Ⅱ score was significantly lower in survivors than in non-survivors (10.4±3.84 vs19.3±2.87, P= 0.00003). Non-survivors tended to display high MPI score and low PIA Ⅱ score, but no significant difference was identified.CONCLUSION: Pre- and postoperative blood pressure and serum creatinine level appear related to prognosis of colonic perforation. APACHE Ⅱ score is most associated with prognosis and scores ≥ 20 are associated with significantly increased mortality rate.

  17. Clinical study on validation systemic inflammatory response syndrome score in predicting prognosis in acute craniocerebral trauma%SIRS评分应用于预测急性颅脑损伤患者预后的临床研究

    朱志军; 黄文; 欧阳毅

    2008-01-01

    目的 探讨全身炎症反应综合征(SIRS)评分预测急性颅脑损伤患者预后的作用和意义.方法 对收治的620例急性颅脑损伤患者在入院24 h内进行SIRS评分及GCS评分,分析不同SIRS分值患者的病死率、相同年龄患者不同GCS分值与SIRS分值及预后的关系.结果 随着SIRS分值的升高,患者病死率增加,当SIRS分值≥2分时患者病死率显著升高,与SIRS分值<2分时比较差异有统计学意义(P<0.05);相同年龄组当SIRS分值≥2分时,GCS分值为8~12分的患者病死率15.38%(4/26),GCS分值<8分的患者病死率50.00%(8/16),二者差异有统计学意义(P<0.05).结论 SIRS评分具有独立预测颅脑损伤患者预后的作用,有一定的临床应用价值.%Objective To explore the effect and significance of systemic inflammatory response syndrome(SIRS )score in predicting prognosis in acute craniocerebral trauma. Methods The clinical data of 620 patients were collected at admission from January 2003 to December 2007, GCS and SIRS score were calculated in 24 hours.The relation of the mortality rates and GCS score were analyzed in different SIRS score patients by controlling age. Results With SIRS score increasing,mortality rates increased as well,and pa-tients with SIRS (score≥2) mortality rates had significantly higher,and also in the same age and GCS score group.Mortality rotes were significant in staifistics (P<0.05). Conclusion SIRS score is significant inde-pendent predicting prognosis in acute craniocerebral trauma and in clinic.

  18. Credit scoring

    Sánchez Bilbao, Pablo

    2015-01-01

    RESUMEN: El credit scoring es un sistema de modelos de decisión a través del cual se calcula la probabilidad de que un sujeto sea capaz de devolver o no un crédito comercial. Este trabajo realiza una simulación de este modelo con la intención de familiarizarse con el funcionamiento del mismo, así como con el marco teórico que este conlleva. El uso del credit scoring da respuesta a un problema generalizado en las entidades financieras como es la correcta estimación y valoración del riesg...

  19. Acute Kidney Injury Classification in Neuro-ICU Patient Group

    Canan Akıncı

    2012-12-01

    Full Text Available Objective: To investigate the role of acute kidney injury (AKI classification system for kidney injury outcome in neuro-Intensive care unit (ICU patients. Material and Method: Total 432 patients who admitted to ICU between 2005 and 2009 evaluated in this study. All patients’ AKI stage, Acute Physiology and Chronic Health Evaluation (APACHE-II, Sequential Organ Failure Assessment Score (SOFA, Glasgow Coma Score (GCS, Glasgow Outcome Score (GOS, mortality rate, length of ICU stay, need for intubation, and mechanical ventilation were recorded. Results: AKI was found in 24 of all 432 patents’ (5.5%. We found that, patients with AKI had higher APHACE-II score, SOFA score and mortality rates; longer ICU stay, duration of mechanical ventilation and intubation and lower GCS and GOS than without AKI group. Conclusion: Length of ICU stay and mortality rate were higher in AKI positive group.

  20. Extraocular light via the ear canal does not acutely affect human circadian physiology, alertness and psychomotor vigilance performance.

    Bromundt, Vivien; Frey, Sylvia; Odermatt, Jonas; Cajochen, Christian

    2014-04-01

    We aimed at testing potential effects of extraocular bright light via the ear canals on human evening melatonin levels, sleepiness and psychomotor vigilance performance. Twenty healthy young men and women (10/10) kept a regular sleep-wake cycle during the 2-week study. The volunteers reported to the laboratory on three evenings, 2 h 15 min before usual bedtime, on average at 21:45 h. They were exposed to three different light conditions, each lasting for 12 min: extraocular bright light via the ear canal, ocular bright light as an active control condition and a control condition (extraocular light therapy device with completely blacked out LEDs). The timing of exposure was on average from 22:48 to 23:00 h. During the 2-h protocol, saliva samples were collected in 15-min intervals for melatonin assays along with subjective sleepiness ratings, and the volunteers performed a 10-min visual psychomotor vigilance task (PVT) prior to and after each light condition. The evening melatonin rise was significantly attenuated after the 12-min ocular bright light exposure while no significant changes were observed after the extraocular bright light and sham light condition. Subjective sleepiness decreased immediately over a short period only after ocular light exposure. No significant differences were observed for mean reaction times and the number of lapses for the PVT between the three light conditions. We conclude that extraocular transcranial light exposure in the late evening does not suppress melatonin, reduce subjective sleepiness or improve performance, and therefore, does not acutely influence the human circadian timing system. PMID:24224577

  1. Eco-physiological response of two marine bivalves to acute exposition to commercial Bt-based pesticide.

    Manachini, B; Arizza, V; Rinaldi, A; Montalto, V; Sarà, G

    2013-02-01

    Microbial products based on the entomopathogenic bacterium Bacillus thuringiensis (Bt) are among the most common biopesticides used worldwide to suppress insect pests in forests, horticulture and agricultural crops. Some of the effects of commercial Bt have been recorded for terrestrial and freshwater non-target organisms but little research is available on marine fauna. Nevertheless, due to the contiguity of agro-ecosystems and coastal habitats, marine fauna may be highly influenced by this control method. We studied the effect of a commercial Bt product on the physiological and ecological responses and the energy budget of two of the most frequent marine intertidal bivalves in the Mediterranean, the native Mytilaster minimus and the invasive Brachidontes pharaonis. To test the effects experimentally, we simulated the worst scenarios possible using the average dose applied to fields and a hypothetical accumulation dose. The results showed the feeding rates of both species were affected detrimentally by the different experimental conditions; higher concentrations led to higher respiration rates, however neither species showed any significant difference in excretion rates. The biopesticide had a significant effect on the energy budget, the values decreasing with doses. In addition, it led to high mortality for the worst treatments and, in both species, induced significantly higher cardiac activity than in the controls. These results indicate a measurable effect of Bt commercial products on marine organisms, and great attention should be paid to biopesticides composed by entomopathogenic bacteria and addictive compounds. In addition, the results highlight the urgent need to study not only the effects of anthropogenic pressures on target organisms but also to extend our view to other ecosystems not expected to be influenced. Gaining data at the organismal level should help increase the sustainability of pest control and reduce the consequences of side-effects. PMID

  2. Score Correlation

    Fabián, Z. (Zdeněk)

    2010-01-01

    In this paper, we study a distribution-dependent correlation coefficient based on the concept of scalar score. This new measure of association of continuous random variables is compared by means of simulation experiments with the Pearson, Kendall and Spearman correlation coefficients.

  3. Score Correlation

    Fabián, Zdeněk

    2010-01-01

    Roč. 20, č. 6 (2010), s. 793-798. ISSN 1210-0552 R&D Projects: GA ČR GA205/09/1079 Institutional research plan: CEZ:AV0Z10300504 Keywords : score function * correlation * rank correlation coefficient * heavy tails Subject RIV: BB - Applied Statistics, Operational Research Impact factor: 0.511, year: 2010

  4. Comparison of Charlson comorbidity index with SAPS and APACHE scores for prediction of mortality following intensive care

    Christensen S

    2011-06-01

    Full Text Available Steffen Christensen1, Martin Berg Johansen1, Christian Fynbo Christiansen1, Reinhold Jensen2, Stanley Lemeshow1,31Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark; 2Department of Intensive Care, Skejby Hospital, Aarhus University Hospital, Aarhus, Denmark; 3Division of Biostatistics, College of Public Health, Ohio State University, Columbus, OH, USABackground: Physiology-based severity of illness scores are often used for risk adjustment in observational studies of intensive care unit (ICU outcome. However, the complexity and time constraints of these scoring systems may limit their use in administrative databases. Comorbidity is a main determinant of ICU outcome, and comorbidity scores can be computed based on data from most administrative databases. However, limited data exist on the performance of comorbidity scores in predicting mortality of ICU patients.Objectives: To examine the performance of the Charlson comorbidity index (CCI alone and in combination with other readily available administrative data and three physiology-based scores (acute physiology and chronic health evaluations [APACHE] II, simplified acute physiology score [SAPS] II, and SAPS III in predicting short- and long-term mortality following intensive care.Methods: For all adult patients (n = 469 admitted to a tertiary university–affiliated ICU in 2007, we computed APACHE II, SAPS II, and SAPS III scores based on data from medical records. Data on CCI score age and gender, surgical/medical status, social factors, mechanical ventilation and renal replacement therapy, primary diagnosis, and complete follow-up for 1-year mortality was obtained from administrative databases. We computed goodness-of-fit statistics and c-statistics (area under ROC [receiver operating characteristic] curve as measures of model calibration (ability to predict mortality proportions over classes of risk and discrimination (ability to discriminate among the patients

  5. Diagnostic Value of the Updated Diamond and Forrester Score to Predict Coronary Artery Disease in Patients with Acute-Onset Chest Pain

    Sørgaard, Mathias; Linde, Jesper James; Kofoed, Klaus Fuglsang;

    2016-01-01

    investigated the validity of the new guidelines in a population of patients with acute-onset chest pain. METHODS: We examined 527 consecutive patients with either an exercise-ECG stress test or single-photon emission computed tomography, and subsequently coronary computed tomography angiography (CCTA). We...

  6. Predictive impact of allele-matching and EBMT risk score for outcome after T-cell depleted unrelated donor transplantation in poor-risk acute leukemia and myelodysplasia

    Lodewyck, T.; Oudshoorn, M.; Holt, B. van der; Petersen, E.; Spierings, E.; Borne, P. von dem; Schattenberg, A.V.M.B.; Allebes, W.A.; Groenendijk-Sijnke, M.; Duinhouwer, L.; Willemze, R.; Lowenberg, B.; Verdonck, L.F.; Meijer, E.; Cornelissen, J.J.

    2011-01-01

    Many parameters predict for outcome after unrelated donor (URD) allogeneic hematopoietic stem cell transplantation (alloSCT). High-resolution HLA-matching significantly impacts outcome and also the European Group of Blood and Marrow Transplantation (EBMT) risk score, based on patient age, disease st

  7. Who will be sicker in the morning? Changes in the Simple Clinical Score the day after admission and the subsequent outcomes of acutely ill unselected medical patients.

    Kellett, John

    2011-08-01

    All doctors are haunted by the possibility that a patient they reassured yesterday will return seriously ill tomorrow. We examined changes in the Simple Clinical Score (SCS) the day after admission, factors that might influence these changes and the relationship of these changes to subsequent clinical outcome.

  8. Physiological benefits of being small in a changing world: responses of Coho salmon (Oncorhynchus kisutch) to an acute thermal challenge and a simulated capture event.

    Clark, Timothy D; Donaldson, Michael R; Pieperhoff, Sebastian; Drenner, S Matthew; Lotto, Andrew; Cooke, Steven J; Hinch, Scott G; Patterson, David A; Farrell, Anthony P

    2012-01-01

    Evidence is building to suggest that both chronic and acute warm temperature exposure, as well as other anthropogenic perturbations, may select for small adult fish within a species. To shed light on this phenomenon, we investigated physiological and anatomical attributes associated with size-specific responses to an acute thermal challenge and a fisheries capture simulation (exercise+air exposure) in maturing male coho salmon (Oncorhynchus kisutch). Full-size females were included for a sex-specific comparison. A size-specific response in haematology to an acute thermal challenge (from 7 to 20 °C at 3 °C h(-1)) was apparent only for plasma potassium, whereby full-size males exhibited a significant increase in comparison with smaller males ('jacks'). Full-size females exhibited an elevated blood stress response in comparison with full-size males. Metabolic recovery following exhaustive exercise at 7 °C was size-specific, with jacks regaining resting levels of metabolism at 9.3 ± 0.5 h post-exercise in comparison with 12.3 ± 0.4 h for full-size fish of both sexes. Excess post-exercise oxygen consumption scaled with body mass in male fish with an exponent of b = 1.20 ± 0.08. Jacks appeared to regain osmoregulatory homeostasis faster than full-size males, and they had higher ventilation rates at 1 h post-exercise. Peak metabolic rate during post-exercise recovery scaled with body mass with an exponent of b~1, suggesting that the slower metabolic recovery in large fish was not due to limitations in diffusive or convective oxygen transport, but that large fish simply accumulated a greater 'oxygen debt' that took longer to pay back at the size-independent peak metabolic rate of ~6 mg min(-1) kg(-1). Post-exercise recovery of plasma testosterone was faster in jacks compared with full-size males, suggesting less impairment of the maturation trajectory of smaller fish. Supporting previous studies, these findings suggest that environmental change and non

  9. Physiological benefits of being small in a changing world: responses of Coho salmon (Oncorhynchus kisutch to an acute thermal challenge and a simulated capture event.

    Timothy D Clark

    Full Text Available Evidence is building to suggest that both chronic and acute warm temperature exposure, as well as other anthropogenic perturbations, may select for small adult fish within a species. To shed light on this phenomenon, we investigated physiological and anatomical attributes associated with size-specific responses to an acute thermal challenge and a fisheries capture simulation (exercise+air exposure in maturing male coho salmon (Oncorhynchus kisutch. Full-size females were included for a sex-specific comparison. A size-specific response in haematology to an acute thermal challenge (from 7 to 20 °C at 3 °C h(-1 was apparent only for plasma potassium, whereby full-size males exhibited a significant increase in comparison with smaller males ('jacks'. Full-size females exhibited an elevated blood stress response in comparison with full-size males. Metabolic recovery following exhaustive exercise at 7 °C was size-specific, with jacks regaining resting levels of metabolism at 9.3 ± 0.5 h post-exercise in comparison with 12.3 ± 0.4 h for full-size fish of both sexes. Excess post-exercise oxygen consumption scaled with body mass in male fish with an exponent of b = 1.20 ± 0.08. Jacks appeared to regain osmoregulatory homeostasis faster than full-size males, and they had higher ventilation rates at 1 h post-exercise. Peak metabolic rate during post-exercise recovery scaled with body mass with an exponent of b~1, suggesting that the slower metabolic recovery in large fish was not due to limitations in diffusive or convective oxygen transport, but that large fish simply accumulated a greater 'oxygen debt' that took longer to pay back at the size-independent peak metabolic rate of ~6 mg min(-1 kg(-1. Post-exercise recovery of plasma testosterone was faster in jacks compared with full-size males, suggesting less impairment of the maturation trajectory of smaller fish. Supporting previous studies, these findings suggest that environmental change and non

  10. The clot burden score, the Boston Acute Stroke Imaging Scale, the cerebral blood volume ASPECTS, and two novel imaging parameters in the prediction of clinical outcome of ischemic stroke patients receiving intravenous thrombolytic therapy

    Recently two classification methods based on the location and the extent of thrombosis detected with CT angiography have been introduced: the Boston Acute Stroke Imaging Scale (BASIS) and the clot burden score (CBS). We studied the performance of BASIS and CBS in predicting good clinical outcome (mRS ≤2 at 90 days) in an acute (<3 h) stroke cohort treated with intravenous thrombolytic therapy. Eighty-three consecutive patients who underwent multimodal CT were analyzed. Binary logistic regression model was used to assess how BASIS, CBS, and cerebral blood volume (CBV) ASPECTS predict favorable clinical outcome. Diagnostic sensitivities and specificities were calculated and compared. Patients with low CBS and CBV ASPECTS scores and major strokes according to BASIS had significantly higher admission NIHSS scores, larger perfusion defects, and more often poor clinical outcome. In logistic regression analysis, CBV ASPECTS, CBS and BASIS were significantly associated with the clinical outcome. The performance of BASIS improved when patients with thrombosis of the M2 segment of the middle cerebral artery were classified as having minor stroke (M1-BASIS). In the anterior circulation, the sum of CBS and CBV ASPECTS (CBSV) proved to be the most robust predictor of favorable outcome. CBV ASPECTS and CBS had high sensitivity but moderate to poor specificity while BASIS was only moderately sensitive and specific. CBS, BASIS, and CBV ASPECTS are statistically robust and sensitive but unspecific predictors of good clinical outcome. Two new derived imaging parameters, CBSV and M1-BASIS, share these properties and may have increased prognostic value. (orig.)

  11. The clot burden score, the Boston Acute Stroke Imaging Scale, the cerebral blood volume ASPECTS, and two novel imaging parameters in the prediction of clinical outcome of ischemic stroke patients receiving intravenous thrombolytic therapy

    Sillanpaa, Niko; Hakomaki, Jari; Lahteela, Arto; Dastidar, Prasun; Soimakallio, Seppo [Tampere University Hospital, Medical Imaging Center, Tampere (Finland); Saarinen, Jukka T.; Numminen, Heikki; Elovaara, Irina [Tampere University Hospital, Department of Neurology, Tampere (Finland); Rusanen, Harri [Oulu University Hospital, Department of Neurology, Oulu (Finland)

    2012-07-15

    Recently two classification methods based on the location and the extent of thrombosis detected with CT angiography have been introduced: the Boston Acute Stroke Imaging Scale (BASIS) and the clot burden score (CBS). We studied the performance of BASIS and CBS in predicting good clinical outcome (mRS {<=}2 at 90 days) in an acute (<3 h) stroke cohort treated with intravenous thrombolytic therapy. Eighty-three consecutive patients who underwent multimodal CT were analyzed. Binary logistic regression model was used to assess how BASIS, CBS, and cerebral blood volume (CBV) ASPECTS predict favorable clinical outcome. Diagnostic sensitivities and specificities were calculated and compared. Patients with low CBS and CBV ASPECTS scores and major strokes according to BASIS had significantly higher admission NIHSS scores, larger perfusion defects, and more often poor clinical outcome. In logistic regression analysis, CBV ASPECTS, CBS and BASIS were significantly associated with the clinical outcome. The performance of BASIS improved when patients with thrombosis of the M2 segment of the middle cerebral artery were classified as having minor stroke (M1-BASIS). In the anterior circulation, the sum of CBS and CBV ASPECTS (CBSV) proved to be the most robust predictor of favorable outcome. CBV ASPECTS and CBS had high sensitivity but moderate to poor specificity while BASIS was only moderately sensitive and specific. CBS, BASIS, and CBV ASPECTS are statistically robust and sensitive but unspecific predictors of good clinical outcome. Two new derived imaging parameters, CBSV and M1-BASIS, share these properties and may have increased prognostic value. (orig.)

  12. 脂肪肝诊断联合APACHE-Ⅱ评分提高预测重症急性胰腺炎的能力%A combination of hepatic steatosis with APACHE-Ⅱ score improves the ability of predicting severe acute pancreatitis

    郝一鸣; 王士琪; 冯全新; 冯向英; 余鹏飞; 白槟; 邱兆岩; 王谦; 赵青川

    2016-01-01

    Objective To identify whether hepatic steatosis is the exposure factor of severe acute pancreatitis (SAP) and to investigate the prognostic efficacy of combining hepatic steatosis with APACHE-Ⅱ score in predicting the severity of SAP.Methods Clinicopathological data of 148 patient diagnosed as acute pancreatitis in Xijing Hospital from April 2011 to September 2013 were retrospectively analyzed.There were 41 severe acute pancreatitis(SAP) patients and 107 mild acute pancreatitis (MAP).The prognosis of patients with and without hepatic steatosis were compared in the subgroups of patients with APACHE-Ⅱ scores < and ≥8.The sensitivity,specificity,ROC curve of combining hepatic steatosis with APACHE-Ⅱ score in predicting SAP were evaluated.Results Hepatic steatosis was independently correlated with SAP (OR =5.33,P =0.003).The incidence of SAP with hepatic steatosis is 5.33 times higher than the incidence of SAP without hepatic steatosis.In patients with an APACHE-Ⅱ score < 8,those with hepatic steatosis had a higher incidence of SAP (34.5% vs.6.9,P < 0.001) and systemic complications (31% vs.5.7%,P<0.001).ln patients with an APACHE-lⅡ score ≥8,those with hepatic steatosis also had a higher incidence of SAP (100% vs.65%,P =0.029) and systemic complications (100% vs.65%,P =0.029).The sensitivity and specificity of APACHE-Ⅱ score was 61.0% and 93.5%,the ROC curve area was 0.772.The sensitivity and specificity of hepatic steatosis was 53.7% and 82.2%,the ROC curve area was 0.680.The sensitivity and specificity of combining hepatic steatosis with APACHE-Ⅱ score was 85.4% and 75.5%,the ROC curve area was 0.861.Conclusions Hepatic steatosis correlates with a worse prognosis of AP.Combining hepatic steatosis with APACHE-Ⅱ score can improve the ability of predicting SAP.%目的 明确脂肪肝是否为重症急性胰腺炎的暴露因素,判断脂肪肝诊断联合急性生理学和慢性健康评估(acute physiology and

  13. Physiological relevance and performance of a minimal lung model – an experimental study in healthy and acute respiratory distress syndrome model piglets

    Chiew Yeong

    2012-09-01

    Full Text Available Abstract Background Mechanical ventilation (MV is the primary form of support for acute respiratory distress syndrome (ARDS patients. However, intra- and inter- patient-variability reduce the efficacy of general protocols. Model-based approaches to guide MV can be patient-specific. A physiological relevant minimal model and its patient-specific performance are tested to see if it meets this objective above. Methods Healthy anesthetized piglets weighing 24.0 kg [IQR: 21.0-29.6] underwent a step-wise PEEP increase manoeuvre from 5cmH2O to 20cmH2O. They were ventilated under volume control using Engström Care Station (Datex, General Electric, Finland, with pressure, flow and volume profiles recorded. ARDS was then induced using oleic acid. The data were analyzed with a Minimal Model that identifies patient-specific mean threshold opening and closing pressure (TOP and TCP, and standard deviation (SD of these TOP and TCP distributions. The trial and use of data were approved by the Ethics Committee of the Medical Faculty of the University of Liege, Belgium. Results and discussions 3 of the 9 healthy piglets developed ARDS, and these data sets were included in this study. Model fitting error during inflation and deflation, in healthy or ARDS state is less than 5.0% across all subjects, indicating that the model captures the fundamental lung mechanics during PEEP increase. Mean TOP was 42.4cmH2O [IQR: 38.2-44.6] at PEEP = 5cmH2O and decreased with PEEP to 25.0cmH2O [IQR: 21.5-27.1] at PEEP = 20cmH2O. In contrast, TCP sees a reverse trend, increasing from 10.2cmH2O [IQR: 9.0-10.4] to 19.5cmH2O [IQR: 19.0-19.7]. Mean TOP increased from average 21.2-37.4cmH2O to 30.4-55.2cmH2O between healthy and ARDS subjects, reflecting the higher pressure required to recruit collapsed alveoli. Mean TCP was effectively unchanged. Conclusion The minimal model is capable of capturing physiologically relevant TOP, TCP and SD of both healthy and ARDS lungs. The

  14. Reduced cortisol and metabolic responses of thin ewes to an acute cold challenge in mid-pregnancy: implications for animal physiology and welfare.

    Else Verbeek

    Full Text Available BACKGROUND: Low food availability leading to reductions in Body Condition Score (BCS; 0 indicates emaciation and 5 obesity in sheep often coincides with low temperatures associated with the onset of winter in New Zealand. The ability to adapt to reductions in environmental temperature may be impaired in animals with low BCS, in particular during pregnancy when metabolic demand is higher. Here we assess whether BCS affects a pregnant animal's ability to cope with cold challenges. METHODS: Eighteen pregnant ewes with a BCS of 2.7±0.1 were fed to attain low (LBC: BCS2.3±0.1, medium (MBC: BCS3.2±0.2 or high BCS (HBC: BCS3.6±0.2. Shorn ewes were exposed to a 6-h acute cold challenge in a climate-controlled room (wet and windy conditions, 4.4±0.1°C in mid-pregnancy. Blood samples were collected during the BCS change phase, acute cold challenge and recovery phase. RESULTS: During the BCS change phase, plasma glucose and leptin concentrations declined while free fatty acids (FFA increased in LBC compared to MBC (P<0.01, P<0.01 and P<0.05, respectively and HBC ewes (P<0.05, P<0.01 and P<0.01, respectively. During the cold challenge, plasma cortisol concentrations were lower in LBC than MBC (P<0.05 and HBC ewes (P<0.05, and FFA and insulin concentrations were lower in LBC than HBC ewes (P<0.05 and P<0.001, respectively. Leptin concentrations declined in MBC and HBC ewes while remaining unchanged in LBC ewes (P<0.01. Glucose concentrations and internal body temperature (T(core increased in all treatments, although peak T(core tended to be higher in HBC ewes (P<0.1. During the recovery phase, T4 concentrations were lower in LBC ewes (P<0.05. CONCLUSION: Even though all ewes were able to increase T(core and mobilize glucose, low BCS animals had considerably reduced cortisol and metabolic responses to a cold challenge in mid-pregnancy, suggesting that their ability to adapt to cold challenges through some of the expected pathways was reduced.

  15. Comparison of severity of illness scoring systems for patients with nosocomial bloodstream infection due to Pseudomonas aeruginosa

    Wenzel Richard P

    2006-08-01

    Full Text Available Abstract Background Several acute illness severity scores have been proposed for evaluating patients on admission to intensive care units but these have not been compared for patients with nosocomial bloodstream infection (nBSI. We compared three severity of illness scoring systems for predicting mortality in patients with nBSI due to Pseudomonas aeruginosa. Methods We performed a historical cohort study on 63 adults in intensive care units with P. aeruginosa monomicrobial nBSI. Results The Acute Physiology, Age, Chronic Health Evaluation II (APACHE II, Sequential Organ Failure Assessment (SOFA, and Simplified Acute Physiologic Score (SAPS II, were calculated daily from 2 days prior through 2 days after the first positive blood culture. Calculation of the area under the receiver operating characteristic (ROC curve confirmed that APACHE II and SAPS II at day -1 and SOFA at day +1 were better predictors of outcome than days -2, 0 and day 2 of BSI. By stepwise logistic regression analysis of these three scoring systems, SAPS II (OR: 13.03, CI95% 2.51–70.49 and APACHE II (OR: 12.51, CI95% 3.12–50.09 on day -1 were the best predictors for mortality. Conclusion SAPS II and APACHE II are more accurate than the SOFA score for predicting mortality in this group of patients at day -1 of BSI.

  16. Fetal Biophysical Profile Scoring

    H.R. HaghighatKhah

    2009-01-01

    Full Text Available   "nFetal biophysical profile scoring is a sonographic-based method of fetal assessment first described by Manning and Platt in 1980. "nThe biophysical profile score was developed as a method to integrate real-time observations of the fetus and his/her intrauterine environment in order to more comprehensively assess the fetal condition. These findings must be evaluated in the context of maternal/fetal history (i.e., chronic hypertension, post-dates, intrauterine growth restriction, etc, fetal structural integrity (presence or absence of congenital anomalies, and the functionality of fetal support structures (placental and umbilical cord. For example, acute asphyxia due to placental abruption may result in an absence of the acute variables of the biophysical profile score (fetal breathing movements, fetal movement, fetal tone, and fetal heart rate reactivity with a normal amniotic fluid volume. With post maturity the asphyxial event may be intermittent and chronic resulting in a decrease in amniotic fluid volume, but with the acute variables remaining normal. "nWhile the 5 components of the biophysical profile score have remained unchanged since 1980 (Manning, 1980, the definitions of a normal and abnormal parameter have evolved with increasing experience. "nIn 1984 the definition of oligohydramnios was increased from < 1cm pocket of fluid to < 2.0 x 1.0 cm pocket. Oligohydramnios is now defined as a pocket of amniotic fluid < 2.0 x 2.0 cm (Manning, 1995a "nIf the four ultrasound variables are normal, the accuracy of the biophysical profile score was not found to be significantly improved by adding the non-stress test. As a result, in 1987 the profile score was modified to incorporate the non-stress test only when one of the ultrasound variables was abnormal (Manning 1987. Table 1 outlines the current definitions for quantifying a variable as present or absent. "nEach of the 5 components of the biophysical profile score does not have equal

  17. Comparison of Risk Scoring Systems to Predict the Outcome in ASA-PS V Patients Undergoing Surgery: A Retrospective Cohort Study.

    Yurtlu, Derya Arslan; Aksun, Murat; Ayvat, Pnar; Karahan, Nagihan; Koroglu, Lale; Aran, Gülcin Önder

    2016-03-01

    Operative decision in American Society of Anesthesiology Physical Status (ASA-PS) V patient is difficult as this group of patients expected to have high mortality rate. Another risk scoring system in this ASA-PS V subset of patients can aid to ease this decision.Data of ASA-PS V classified patients between 2011 and 2013 years in a single hospital were analyzed in this study. Predicted mortality of these patients was determined with acute physiology and chronic health evaluations (APACHE) II, simplified acute physiology score (SAPS II), Charlson comorbidity index (CCI), Porthsmouth physiological and operative severity score for enumeration of mortality and morbidity (P-POSSUM), Surgical apgar score (SAS), and Goldman cardiac risk index (GCRI) scores. Observed and predicted mortality rates according to the risk indexes in these patients were compared at survivor and nonsurvivor group of patients. Risk stratification was made with receiver operator characteristic (ROC) curve analysis.Data of 89 patients were included in the analyses. Predicted mortality rates generated by APACHE II and SAPS II scoring systems were significantly different between survivor and nonsurvivor group of patients. Risk stratification with ROC analysis revealed that area under curve was 0.784 and 0.681 for SAPS II and APACHE II scoring systems, respectively. Highest sensitivity (77.3) is reached with SAPS II score.APACHE II and SAPS II are better predictive tools of mortality in ASA-PS V classified subset of patients. Discrimination power of SAPS II score is the best among the compared risk stratification scores. SAPS II can be suggested as an additional risk scoring system for ASA-PS V patients. PMID:27043696

  18. Indocyanine green clearance test combined with MELD score in predicting the short-term prognosis of patients with acute liver failure

    Hong-Ling Feng; Qian Li; Lin Wang; Gui-Yu Yuan and Wu-Kui Cao

    2014-01-01

    BACKGROUND: Acute liver failure (ALF) is an acute severe deterioration of liver function with high mortality. Early and accurate prognostic assessment of patients with ALF is critically important. Although the model for end-stage liver disease (MELD) scores and King's College Hospital (KCH) criteria are well-accepted as predictive tools, their accuracy is unsatisfactory. The indocyanine green (ICG) clearance test (ICGR15, ICG retention rate at the 15 minutes) is a sensitive indicator of liver function. In this study, we investigated the efifcacy of the ICGR15 for the short-term prognosis in patients with ALF. We compared the predictive value of ICGR15 with the MELD scores and KCH criteria. METHODS: Sixty-nine patients who had been diagnosed with ALF were recruited retrospectively. ICGR15 had been performed by ICG pulse spectrophotometry and relevant clinical and laboratory indices were analyzed within 24 hours of diagnosis. In addition, the MELD scores and KCH criteria were calculated. RESULTS: The three-month mortality of all patients was 47.83%. Age,  serum  total  bilirubin  and  creatinine  concentrations, international normalized ratio for prothrombin time, ICGR15, MELD scores and KCH criteria differed signiifcantly between surviving and deceased patients. A positive correlation was observed between ICGR15 and MELD scores (r=0.328, P=0.006). The ICGR15-MELD model, Logit(P)=0.096×ICGR15+0.174 × MELD  score-9.346,  was  constructed  by  logistic  regression analysis. The area under the receiver operating characteristic curve was 0.855.

  19. Escore de risco Dante Pazzanese para síndrome coronariana aguda sem supradesnivelamento do segmento ST Score de riesgo dante pazzanese para síndrome coronario agudo sin supradesnivel del segmento ST Dante Pazzanese risk score for non-st-segment elevation acute coronary syndrome

    Elizabete Silva dos Santos

    2009-10-01

    desarrolló para prever el riesgo de muerte o de (reinfarto en 30 días. La exactitud predictiva del modelo fue determinada por el C statistic. RESULTADOS: El evento combinado ocurrió en 54 pacientes (5,3%. El score se creó por la suma aritmética de puntos de los predictores independientes, cuyos puntajes se designaron por las respectivas probabilidades de ocurrencia del evento. Se identificaron las siguientes variables: aumento de la edad (0 a 9 puntos; antecedente de diabetes mellitus (2 puntos o de accidente vascular cerebral (4 puntos; no utilización previa de inhibidor de la enzima conversora de la angiotensina (1 punto; elevación de la creatinina (0 a 10 puntos; y combinación de elevación de la troponina I cardíaca y depresión del segmento ST (0 a 4 puntos. Se definieron cuatro grupos de riesgo: muy bajo (até 5 puntos; bajo (6 a 10 puntos; intermedio (11 a 15 puntos; y alto riesgo (16 a 30 puntos. El C statistic para la probabilidad del evento fue de 0,78 y para el score de riesgo en puntaje de 0,74. CONCLUSIÓN: Se desarrolló un score de riesgo para prever muerte o (reinfarto en 30 días en una población brasileña con SCA sin SST, pudiendo fácilmente se aplicable en el departamento de emergencia.BACKGROUND: The probability of adverse events estimate is crucial in acute coronary syndrome condition. OBJECTIVES: To develop a risk score for the brazilian population presenting non-ST-segment elevation acute coronary syndrome. METHODS: One thousand and twenty seven (1,027 patients were investigated prospectively at a cardiology center in Brazil. A multiple logistic regression model was developed to estimate death or (reinfarction risk within 30 days. Model predictive accuracy was determined by C statistic. RESULTS: Combined event occurred in 54 patients (5.3%. The score was created by the arithmetic sum of independent predictors points. Points were determined by corresponding probabilities of event occurrence. The following variables have been identified: age

  20. Anatomy & Physiology

    ... Surveillance Modules » Anatomy & Physiology Cancer Registration & Surveillance Modules Anatomy & Physiology Intro to the Human Body Body Functions & Life Process Anatomical Terminology Review ...

  1. Greek stroke score, Siriraj score and allen score in clinical diagnosis of intracerebral hemorrhage and infarct: Validation and comparison study

    Soman Aamod

    2004-10-01

    Full Text Available AIM: To compare Greek stroke score with available previous two stroke scores for the diagnosis of cerebral ischemia and hemorrhage in acute stroke patients, and validate the Greek stroke score. SETTING: A tertiary hospital in India. MATERIALS AND METHODS: In a prospective study acute stroke patients were evaluated with Greek stroke score, Allen score and Siriraj stroke score. Comparability (Kappa Statistics and validity (sensitivity, specificity, negative predictive value and positive predictive value of the Greek stroke score and previous scores were tested. RESULT: Out of the 91 patients enrolled in the study, 47 patients had cerebral infarction and 44 patients had hemorrhage by CT scan. Allen score was uncertain / equivocal in 39 patients, Siriraj Stroke score in 22 and Greek stroke score in 47 patients. Sensitivity, Specificity, positive predictive value, negative predictive value for Allen score were 0.5(95% CI:0.34,0.58, 0.94(95% CI:0.86,0.98, 0.81(95% CI:0.56,0.95, 0.78(95% CI: 0.71,0.81 for Siriraj score were 0.75(95% CI: 0.63,0.84, 0.81(95% CI: 0.71,0.89, 0.77(95% CI: 0.65,0.86, 0.78(95% CI 0.69,0.86 and for Greek Score were 0.42(95% CI: 0.23,0.53, 0.93(95% CI: 0.87,0.98, 0.71(95% CI:0.39,0.91, 0.81(95% CI:0.75,0.85 respectively. Greek stroke score was compared with previous scores using kappa statistics which revealed substantial strength of agreement between the Allen Score for certain results. CONCLUSION: The overall comparability of Greek stroke score and Allen score was better as compared to Greek stroke score and Siriraj stroke score. Greek Stroke score was more specific in diagnosing hemorrhage as compared to Siriraj score. However, all these stroke scores lack accuracy hence could not be applied safely to guide the physician in management of stroke.

  2. Escore TIMI no infarto agudo do miocárdio conforme níveis de estratificação de prognóstico Score TIMI en el infarto agudo de miocardio según niveles de estratificación de pronóstico TIMI risk score for acute myocardial infarction according to prognostic stratification

    Jaqueline Locks Pereira

    2009-08-01

    hospitalaria postinfarto fue de un 17,5%. En el grupo de bajo riesgo no hubo óbito. La mortalidad fue del 8,1% en el grupo de medio riesgo y de un 55,6% en el de alto riesgo. El riesgo de muerte para casos de alto riesgo fue 14,1 veces mayor con relación a los casos de medio y bajo riesgo (IC95% = 4,4 a 44,1 y pBACKGROUND: The TIMI (Thrombolysis in Myocardial Infarction risk score is derived from clinical trial involving patients who are eligible for fibrinolysis. As the risk profiles of these cases differ from those found in non-selected populations, it is important to review the applicability of the score in usual clinical conditions. OBJECTIVES: To evaluate the management and clinical evolution of hospital inpatients with acute myocardial infarction, according to risk stratification by the TIMI score. METHODS: We evaluated, retrospectively, 103 cases of acute myocardial infarction with ST-segment elevation admitted to the Hospital Nossa Senhora da Conceição - Tubarão, in 2004 and 2005. The cases were analyzed in three risk groups according to the TIMI score. RESULTS: The hospital mortality after infarction was 17.5%. In the low-risk group there was no death. The mortality was 8.1% in the medium risk group and 55.6% in the high-risk group. The risk of death in cases of high risk was 14.1 times higher than in the cases of medium and low risk (95% CI = 4.4 to 44.1 and p <0.001. The chance of receiving fibrinolytic was 50% lower in the high-risk group in relation to the low risk group (95% CI = 0.27 to 0.85, p = 0.004. CONCLUSION: There was a progressive increase in mortality and incidence of in-hospital complications according to the stratification by the TIMI score. High risk patients received thrombolytic less frequently than the patients at low risk.

  3. Impact of the revised International Prognostic Scoring System, cytogenetics and monosomal karyotype on outcome after allogeneic stem cell transplantation for myelodysplastic syndromes and secondary acute myeloid leukemia evolving from myelodysplastic syndromes: a retrospective multicenter study of the European Society of Blood and Marrow Transplantation

    Koenecke, C.; Gohring, G.; Wreede, L.C. de; Biezen, A. van; Scheid, C.; Volin, L.; Maertens, J.; Finke, J.; Schaap, N.P.; Robin, M.; Passweg, J.; Cornelissen, J.; Beelen, D.; Heuser, M.; Witte, T.J. de; Kroger, N.

    2015-01-01

    The aim of this study was to determine the impact of the revised 5-group International Prognostic Scoring System cytogenetic classification on outcome after allogeneic stem cell transplantation in patients with myelodysplastic syndromes or secondary acute myeloid leukemia who were reported to the Eu

  4. Impact of the revised international prognostic scoring system cytogenetics and monosomal karyotype on outcome after allogeneic stem cell transplantation for myelodysplastic syndromes and secondary acute myeloid leukemia evolving from myelodysplastic syndromes: A retrospective multicenter study of the European society of blood and marrow transplantation

    C. Koenecke (Christian); G. Göhring (Gudrun); L.C. de Wreede (Liesbeth C.); A. van Biezen (Anja); C. Scheid (Christof); L. Volin (Liisa); J. Maertens (Johan); J. Finke (Jürgen); N. Schaap (Nicolaas); M. Robin (Marie); J. Passweg (Jakob Robert); J.J. Cornelissen (Jan); D.W. Beelen (Dietrich); M. Heuser (Michael); T. de Witte; N. Kröger

    2015-01-01

    textabstractThe aim of this study was to determine the impact of the revised 5-group International Prognostic Scoring System cytogenetic classification on outcome after allogeneic stem cell transplantation in patients with myelodysplastic syndromes or secondary acute myeloid leukemia who were report

  5. Effects of different types of painful procedures on neonatal pain scores and physiological changes%不同类型致痛性操作对新生儿疼痛的影响

    陈银花; 钱丽冰; 陈梦莹; 曹兆兰; 徐玉香; 程锐; 卢官明; 李晓南

    2013-01-01

    Objective To assess the effects of different types of painful procedures on neonatal pain scores and physiological changes.Methods A prospective study was conducted in neonatal intensive care unit of Nanjing Children's Hospital from March 1,2009 to May 31,2009.Around-theclock bedside data of all painful procedures performed on 108 neonates (46 premature and 62 termbirth infants) from admission to discharge for diagnosis or treatment were collected through video,along with cardiac monitoring.Neonatal Facial Coding System (NFCS),Neonatal Infant Pain Scale (NIPS),Premature Infant Pain Profile (PIPP) and physiological changes (heart rate and blood oxygen saturation) were used to evaluate the pain that neonates experienced.Data were analyzed by Student-t test,Chi-square test and analysis of variance.Results There were 6966 painful procedures on preterm neonates,among which tracheal aspiration (23.6 %,1645/6966),nasal aspiration (18.3%,1278/6966) and intravenous cannulation (17.2%,1195/6966) were the most frequently used.There were 3667 painful procedures on term neonates,among which,intravenous cannulation (27.0%,989/3667),removal of indwelling needle (20.5%,751/3667) and tape removal (18.4%,675/3667)were the most frequently used painful procedures on term ones.For preterm neonates,both NFCS and PIPP showed that tracheal intubation (7.00± 1.66 and 14.08±3.54),femoral venous puncture (6.52±1.66 and 12.15±3.11) and axillary vein puncture (5.75± 1.89 and 11.75±4.19) caused much more pain than other procedures.For term neonates,both NFCS and NIPS indicated that femoral venous puncture (6.68±1.34 and 5.58±1.32),tape removal (6.00±1.41 and 5.67±0.58)and abdominal wall vein puncture (6.00 ± 0.00 and 5.50 ± 0.71) were the top three painful procedures.No differences were found in heart rate and blood oxygen saturation changes caused by different types of painful procedures in term neonates (F=0.186,P=0.836; F=1.672,P=0.198).Conclusions Better pain

  6. Assessment of the EuroSCORE risk scoring system for patients undergoing coronary artery bypass graft surgery in a group of Iranian patients

    Hamidreza Jamaati

    2015-01-01

    Full Text Available Background and Aims: Previous studies around the world indicated validity and accuracy of European System for Cardiac Operative Risk Evaluation (EuroSCORE risk scoring system we evaluated the EuroSCORE risk scoring system for patients undergoing coronary artery bypass graft (CABG surgery in a group of Iranian patients. Materials and Methods: In this cohort 2220 patients more than 18 years, who were performed CABG surgery in Massih Daneshvari Hospital, from January 2004 to March 2010 were recruited. Predicted mortality risk scores were calculated using logistic EuroSCORE and Acute Physiology and Chronic Health Evaluation II (APACHE II and compared with observed mortality. Calibration was measured by the Hosmer-Lemeshow (HL test and discrimination by using the receiver operating characteristic (ROC curve area. Results: Of the 2220 patients, in hospital deaths occurred in 270 patients (mortality rate of 12.2%. The accuracy of mortality prediction in the logistic EuroSCORE and APACHE II model was 89.1%; in the local EuroSCORE (logistic was 91.89%; and in the local EuroSCORE support vector machines (SVM was 98.6%. The area under curve for ROC curve, was 0.724 (95% confidence interval [CI]: 0.57-0.88 for logistic EuroSCORE; 0.836 (95% CI: 0.731-0.942 for local EuroSCORE (logistic; 0.978 (95% CI: 0.937-1 for Local EuroSCORE (SVM; and 0.832 (95% CI: 0.723-0.941 for APACHE II model. The HL test showed good calibration for the local EuroSCORE (SVM, APACHE II model and local EuroSCORE (logistic (P = 0.823, P = 0.748 and P = 0.06 respectively; but there was a significant difference between expected and observed mortality according to EuroSCORE model (P = 0.033. Conclusion: We detected logistic EuroSCORE risk model is not applicable on Iranian patients undergoing CABG surgery.

  7. 不同评分系统对急性胰腺炎患者预后评估的比较%Comparative study on different clinical scoring systems in the prognosis of acute pancreatitis

    林孙龙

    2014-01-01

    目的:比较急性胰腺炎严重程度的床边指数(BISAP)、Ranson评分和Balthazar CT严重度指数(CTSI)在急性胰腺炎(AP)预后评估中的价值。方法采用回顾性分析的研究方法,选取2011年5月至2013年5月我科收治的62例AP患者为研究对象,分别采用BISAP、Ranson、CTSI评分评估患者的预后,受试者工作曲线(ROC)分析三种评分系统的临床价值。结果62例AP患者中轻型AP 50例,重型AP 12例;26例患者出现并发症,6例多器官衰竭者,死亡10例,死亡率为16.1%,三种评分系统预测轻、重型AP差异无统计学意义(P>0.05)。BISAP评分在并发症、多器官功能障碍综合征(MODS)以及死亡的预判中最佳约登指数最大,显著高于Ranson评分和CTSI评分(P0.05). BISAP had highest Youden index and CTSI. BISAP score had a higher ability in predicting systemic complica-tions, MODS and death rate, compared to Ranson and CTSI scores (P<0.05). Conclusion BISAP, Ranson, and CTSI score systems all have important values in predicting the severity of acute pancreatitis (AP), But BISAP has a higher ability in the prediction of local complications, systemic complications, MODS, and mortality.

  8. Effects of work-related sleep restriction on acute physiological and psychological stress responses and their interactions: A review among emergency service personnel

    Alexander Wolkow; Sally Ferguson; Brad Aisbett; Luana Main

    2015-01-01

    Emergency work can expose personnel to sleep restriction. Inadequate amounts of sleep can negatively affect physiological and psychological stress responses. This review critiqued the emergency service literature (e.g., firefighting, police/law enforcement, defense forces, ambulance/paramedic personnel) that has investigated the effect of sleep restriction on hormonal, inflammatory and psychological responses. Furthermore, it investigated if a psycho-physiological approach can help contextual...

  9. Effects of work-related sleep restriction on acute physiological and psychological stress responses and their interactions: A review among emergency service personnel

    Alexander Wolkow

    2015-04-01

    Full Text Available Emergency work can expose personnel to sleep restriction. Inadequate amounts of sleep can negatively affect physiological and psychological stress responses. This review critiqued the emergency service literature (e.g., firefighting, police/law enforcement, defense forces, ambulance/paramedic personnel that has investigated the effect of sleep restriction on hormonal, inflammatory and psychological responses. Furthermore, it investigated if a psycho-physiological approach can help contextualize the significance of such responses to assist emergency service agencies monitor the health of their personnel. The available literature suggests that sleep restriction across multiple work days can disrupt cytokine and cortisol levels, deteriorate mood and elicit simultaneous physiological and psychological responses. However, research concerning the interaction between such responses is limited and inconclusive. Therefore, it is unknown if a psycho-physiological relationship exists and as a result, it is currently not feasible for agencies to monitor sleep restriction related stress based on psycho- physiological interactions. Sleep restriction does however, appear to be a major stressor contributing to physiological and psychological responses and thus, warrants further investigation.

  10. Correlation between GRACE score and cardiovascular risk factors in patients with acute coronary syndrome%急性冠脉综合征患者 GRACE 评分与心血管危险因素的相关性

    马冰宁; 徐戈

    2015-01-01

    Objective To investigate the correlation between the global registry of acute coronary event ( GRACE) score and cardiovascular risk factors in patients with acute coronary syndrome ( ACS) .Methods A total of 692 patients who met the diagnostic criteria of ACS were selected divided into 3 treatment groups, 220 cases in the low risk group, 240 cases in the intermediate risk group, 232 cases in the high risk group.Correlation between the GRACE score and cardiovascular risk factors was analyzed by both univariate and multivariate binary logistic regression.Results Uni-variate logistic regression demonstrated that higher ACS risk was correlated with higher GRACE score, larger proportion of patients having one of the cardiovascular risk factors, e.g.old age, hypertension, male and smoking, elevated levels of cysC, Fib, Hcy, ApoB and ApoB/ApoA, and lower ApoA level.Multivariate logistic regression showed that Fib, ApoB/ApoA, Hcy, CysC, old age, male and hypertension were independent risk factors which aggravate the risk of ACS.Among them, Fib (B=2.091, P<0.001) and old age (B=2.091, P<0.001) were two most prominent risk factors for ACS. Conclusion ACS risk was related to various risk factors, among which Fib and old age were two most prominent inde-pendent risk factors for ACS.Combined application of these indices in ACS patients may have important clinical value in early risk stratification, evaluation of prognosis and decision of treatment options.%目的:探讨急性冠脉综合征患者GRACE评分与冠心病危险因素的关系。方法符合标准急性冠脉综合征的患者共692例,根据GRACE评分分为3组:低危组(220例)、中危组(240例)、高危组(232例)。对GRACE评分与冠心病危险因素进行单因素及多因素logistic分析。结果单因素分析结果显示,急性冠脉综合征危险程度越高,GRACE评分越高,存在单个危险因素如高龄、高血压史、吸烟史、男性的患者比例越高, CysC

  11. Luminal lactate in acute pancreatitis - validation and relation to disease severity

    Pynnönen, Lauri; Minkkinen, Minna; Räty, Sari;

    2012-01-01

    systemic inflammation. In acute pancreatitis (AP) bacterial translocation is considered as the key event leading to infection of necrotic pancreatic tissue and high severity of illness. METHODS: We used rectal luminal equilibration dialysis for the measurement of gut luminal lactate in 30 consecutive...... patients admitted to hospital due to acute pancreatitis to test the hypothesis that a single measurement of rectal luminal lactate predicts the severity of acute pancreatitis, the length of hospital stay, the need of intensive care and ultimately, mortality. We also tested the physiological validity of...... the physiological validity of the method. Rectal luminal lactate at the hospital admission was not associated with the first day or the highest SOFA score, CRP level, hospital length of stay, length of stay in intensive care or mortality. In this cohort of unselected consecutive patients with acute...

  12. Chronic Psychosocial Factors and Acute Physiological Responses to Laboratory-Induced Stress in Healthy Populations: A Quantitative Review of 30 Years of Investigations

    Chida, Yoichi; Hamer, Mark

    2008-01-01

    This meta-analysis included 729 studies from 161 articles investigating how acute stress responsivity (including stress reactivity and recovery of hypothalamic-pituitary-adrenal [HPA] axis, autonomic, and cardiovascular systems) changes with various chronic psychosocial exposures (job stress; general life stress; depression or hopelessness;…

  13. Soluble CD163 is increased in patients with acute pancreatitis independent of disease severity.

    Karrasch, Thomas; Brünnler, Tanja; Hamer, Okka W; Schmid, Karin; Voelk, Markus; Herfarth, Hans; Buechler, Christa

    2015-10-01

    Macrophages are crucially involved in the pathophysiology of acute pancreatitis. Soluble CD163 (sCD163) is specifically released from macrophages and systemic levels are increased in inflammatory diseases. Here, sCD163 was measured in serum of 50 patients with acute pancreatitis to find out possible associations with disease activity. Admission levels of systemic sCD163 were nearly three-fold higher in patients with acute pancreatitis compared to controls. In patients sCD163 did not correlate with C-reactive protein and leukocyte count as established markers of inflammation. Levels were not associated with disease severity assessed by the Schroeder score, Balthazar score, Acute Physiology, Age, and Chronic Health Evaluation (Apache) II score and peripancreatic necrosis score. Soluble CD163 was not related to complications of acute pancreatitis. These data show that serum sCD163 is increased in acute pancreatitis indicating activation of macrophages but is not associated with disease severity and outcome. PMID:26209500

  14. Decompositions of Proper Scores

    Bröcker, Jochen

    2008-01-01

    Scoring rules are an important tool for evaluating the performance of probabilistic forecasts. A popular example is the Brier score, which allows for a decomposition into terms related to the sharpness (or information content) and to the reliability of the forecast. This feature renders the Brier score a very intuitive measure of forecast quality. In this paper, it is demonstrated that all strictly proper scoring rules allow for a similar decomposition into reliability and sharpness related terms. This finding underpins the importance of proper scores and yields further credence to the practice of measuring forecast quality by proper scores. Furthermore, the effect of averaging multiple probabilistic forecasts on the score is discussed. It is well known that the Brier score of a mixture of several forecasts is never worse that the average score of the individual forecasts. This property hinges on the convexity of the Brier score, a property not universal among proper scores. Arguably, this phenomenon portends...

  15. Effects of vitamin E administration on APACHE II Score in ARDS patients

    M Hajimahmoodi

    2009-03-01

    Full Text Available ABSTRACT Background and purpose of the study: The acute respiratory distress syndrome (ARDS is a common clinical disorder caused by injury to the alveolar epithelial and endothelial barriers of lung. In ARDS patients, oxidative stress is increased and plasma antioxidant levels are reduced. Vitamin E has an important role in antioxidant defense mechanisms. In this study the effect of vitamin E on decrease of APACHE II score in ARDS patients was investigated.  Materials and methods: Twenty patients [mean (SE: age = 51.2 ± 6.41 years] with ARDS were enrolled. After diagnosis based on inclusion and exclusion criteria, ten patients as treatment group received 600 IU vitamin E daily intramuscularly. Control group received normal saline as placebo. Plasma samples and Acute Physiology and Chronic Health Evaluation (APACHE II score were obtained before administration, 4hrs and 12hrs after each intervention and repeated three days for each patient. Results were analyzed by use of an SPSS software package with a repeated-measures analysis of variance (ANOVA. Results: Significant changes were observed in APACHE II score from first to seventh measurement (p=0.0001 in treatment group, but vitamin E concentration altered significantly in only first to seventh measurement (p= 0.019. Conclusion: From the results of this study, it seems that the use of vitamin E as a lipid-soluble antioxidant along with other supportive measures is beneficial in decreasing APACHE II score in ARDS patients.

  16. Differences in acute stress responses between wild-caught and captive-bred birds: A physiological mechanism contributing to current avian invasions?

    Cabezas, Sonia; Carrete, Martina; Tella, José Luis; Marchant, Tracy A.; Bortolotti, Gary R.

    2013-01-01

    Current avian invasions are often the result of exotic birds accidentally escaping from cages. It has been hypothesised that the higher invasiveness of wild-caught cage-birds compared to captive-bred ones could be related to the loss of ability in captive-bred birds to cope with new environments. The acute stress response plays an important role in how animals cope with challenges because elevated corticosterone (CORT) levels can mediate learning and memory consolidation and help to increase ...

  17. Acute exercise and physiological insulin induce distinct phosphorylation signatures on TBC1D1 and TBC1D4 in human skeletal muscle

    Treebak, Jonas Thue; Pehmøller, Christian; Kristensen, Jonas Møller;

    2014-01-01

    We investigated the phosphorylation signatures of two Rab GTPase activating proteins TBC1D1 and TBC1D4 in human skeletal muscle in response to physical exercise and physiological insulin levels induced by a carbohydrate rich meal using a paired experimental design. Eight healthy male volunteers...... TBC1D4 in response to physiological stimuli in human skeletal muscle and support the idea that Akt and AMPK are upstream kinases. TBC1D1 phosphorylation signatures were comparable between in vitro contracted mouse skeletal muscle and exercised human muscle, and we show that AMPK was regulating...... phosphorylation of these sites in mouse muscle. Contraction and exercise elicited a different phosphorylation pattern of TBC1D4 in mouse compared with human muscle, and although different circumstances in our experimental setup may contribute to this difference, the observation exemplifies that transferring...

  18. The Physiologic Effects of an Acute Bout of Supramaximal High-Intensity Interval Training Compared with a Continuous Exercise Bout in Patients with COPD

    2013-01-01

    This study compared physiological responses and work performed during a supramaximal high-intensity interval exercise training session (HIIT) and a constant work rate (CWR) exercise session. Fourteen patients with COPD (mean FEV1   53±13% predicted (±SD)) completed an incremental cardiopulmonary exercise test (CPET) and a steep ramp anaerobic test (SRAT) and then two exercise bouts to symptom limitation on separate days, in random order: (1) a CWR trial at 80% of CPET peak work rate (mean 63±...

  19. Rowing Physiology.

    Spinks, W. L.

    This review of the literature discusses and examines the methods used in physiological assessment of rowers, results of such assessments, and future directions emanating from research in the physiology of rowing. The first section discusses the energy demands of rowing, including the contribution of the energy system, anaerobic metabolism, and the…

  20. CLINICAL STUDY OF ACUTE PANCREATITIS WITH SPECIAL REFERENCE TO RANSONS PROGNOSTIC CRITERIA

    Sudhir

    2016-02-01

    Full Text Available INTRODUCTION The pancreas is perhaps the most unforgiving organ in the human body and with its critical endocrine functions and its exocrine portion is a major source of extremely potent digestive enzymes Pancreatic diseases are very complex and acute pancreatitis is associated with high morbidity and mortality rates. Early diagnosis of pancreatitis, its severity evaluation and adequate intensive care are highly essential for the reduction in morbidity and mortality. There are various criteria to assess the severity of acute pancreatitis like Ranson’s criteria, The Acute Physiology and Chronic Health Evaluation II (APACHE II score, Glasgow score etc. Ranson’s criteria is most frequently and accurate method to assess the severity and mortality associated with acute pancreatitis because of its relative easy tabulation and resulting scores well correlated with morbidity and mortality. OBJECTIVES To study the clinical presentation, complications and prognosis of patients with acute pancreatitis during the study period. To study the correlation of Ranson’s criteria in acute pancreatitis with prognosis of the patient. METHODS Prospective study conducted in period ranging from November 2012 to October 2014 who admitted in JSS Hospital, Mysore in the Department of surgery satisfying inclusion criteria were taken into study. RESULTS Patients with low Ranson’s score had shorter hospital duration and majority recovered by the time of discharge. High Ranson’s score predicts long hospital stay and increased morbidity and mortality. In our study it predicted long hospital study but could not predict significant morbidity or mortality. CONCLUSION Ranson’s criteria is the best prognostic tool in assessing the severity of the acute pancreatitis and also defines the need for early aggressive management in acute severe pancreatitis to reduce morbidity and mortality.

  1. A large volume of visceral adipose tissue leads to severe acute pancreatitis

    Obesity plays an important role in acute pancreatitis. Assuming that the volume of visceral adipose tissue (VAT) directly influences the severity of acute pancreatitis, we investigated the relationship between VAT and acute pancreatitis. Data were collected consecutively from 124 patients who were diagnosed with acute pancreatitis. Body mass index (BMI) was calculated from the database. Computed tomography was performed in all patients, and VAT, subcutaneous adipose tissue (SAT), and waist circumference (WC) were measured at the level of the intervertebral disk between L2 and L3. Atlanta criteria were adopted to define severe acute pancreatitis. Clinical courses were investigated, and the Ranson and acute physiology and chronic health evaluation II (APACHE II) scores were calculated for all patients. Forty-eight patients had severe acute pancreatitis (38.7%), and 76 were mild cases. BMI, VAT, SAT, and WC were correlated with the severity of acute pancreatitis in a univariate analysis, but only VAT had a strong correlation with severe acute pancreatitis in the multivariate analysis. In a trend analysis, not only severity but also the presence of pseudocysts (local complication) and prognostic factors (Ranson and APACHE II scores) were significantly related to VAT volume. In particular, the presence of a pancreatic pseudocyst was strongly related to VAT volume (p<0.001). In acute pancreatitis, peripancreatic VAT has a stronger correlation with severe acute pancreatitis than BMI or WC. VAT volume is strongly correlated with the formation of a pseudocyst and with systemic inflammatory response syndrome in patients with acute pancreatitis and high VAT volume may lead to severe acute pancreatitis. (author)

  2. Several Cytokines and Protein C Levels with the Apache II Scoring System for Evaluation of Patients with Sepsis

    Nurettin Erben

    2012-06-01

    Full Text Available Objective: We investigated whether determination IL-6, IL-8, IL-1beta and TNF-alpha at baseline, total protein C (PC levels at time of admission and 48 hours after initiation could complement the Acute Physiology and Chronic Health Evaluation (APACHE II scoring system to identify patients with sepsis, severe sepsis or septic shock for clinical outcome.Material and Methods: The study was carried out prospectively. 60 consecutive patients with sepsis, severe sepsis or septic shock were included. Blood samples were obtained at baseline and 48 hours after initiation. Cytokines and PC levels in plasma were measured with an enzyme-linked immunoabsorbent assay (ELISA. APACHE II score was calculated on admission.Results: Baseline IL-6 levels and PC levels 48 hours after initiation were predictive of increased mortality (p=0.016, p=0.044 respectively. Baseline IL-6, IL-8 and TNF-alpha baseline levels correlate with the severity of physiologic insult, as determined by the APACHE II score. However, our multiple logistic regression analysis of these did not reveal any predictive value in combination with the APACHE II score.Conclusion: Determination of baseline IL-6 and PC 48 hours after initiation were of predictive value for prognostic evaluation of septic patients, but did not significantly increase predictive power of the APACHE scoring system to identify patients with sepsis for fatal clinical outcome.

  3. A basic study on molecular hydrogen (H2 inhalation in acute cerebral ischemia patients for safety check with physiological parameters and measurement of blood H2 level

    Ono Hirohisa

    2012-08-01

    Full Text Available Abstract Background In animal experiments, use of molecular hydrogen ( H2 has been regarded as quite safe and effective, showing benefits in multiple pathological conditions such as ischemia-reperfusion injury of the brain, heart, kidney and transplanted tissues, traumatic and surgical injury of the brain and spinal cord, inflammation of intestine and lung , degenerative striatonigral tissue and also in many other situations. However, since cerebral ischemia patients are in old age group, the safety information needs to be confirmed. For the feasibility of H2 treatment in these patients, delivery of H2 by inhalation method needs to be checked for consistency. Methods Hydrogen concentration (HC in the arterial and venous blood was measured by gas chromatography on 3 patients, before, during and after 4% (case 1 and 3% (case2,3 H2 gas inhalation with simultaneous monitoring of physiological parameters. For a consistency study, HC in the venous blood of 10 patients were obtained on multiple occasions at the end of 30-min H2 inhalation treatment. Results The HC gradually reached a plateau level in 20 min after H2 inhalation in the blood, which was equivalent to the level reported by animal experiments. The HC rapidly decreased to 10% of the plateau level in about 6 min and 18 min in arterial and venous blood, respectively after H2 inhalation was discontinued. Physiological parameters on these 3 patients were essentially unchanged by use of hydrogen. The consistency study of 10 patients showed the HC at the end of 30-min inhalation treatment was quite variable but the inconsistency improved with more attention and encouragement. Conclusion H2 inhalation of at least 3% concentration for 30 min delivered enough HC, equivalent to the animal experiment levels, in the blood without compromising the safety. However, the consistency of H2 delivery by inhalation needs to be improved.

  4. Clinical value of bedside index for severity in acute pancreatitis scoring system to predicting severity and prognosis of acute pancreatitis%急性胰腺炎床边指数评分对疾病程度及预后的预测价值

    王东旭; 林连捷; 林艳; 郑长青

    2014-01-01

    目的 与急性胰腺炎(acute pancreatotis,AP)传统评分系统进行比较,探讨急性胰腺炎严重程度床边指数(bedside index for severity in acute pancreatitis,BISAP)评分对疾病程度及预后的预测价值.方法 202例AP患者分别行BISAP、急性生理和慢性健康状况评分(Acute Physiology and Chronic Health EvaluationⅡ,APACHEⅡ)及Ranson评分,比较分析3种评分系统预测AP严重程度、局部并发症、器官功能衰竭的价值.结果 202例AP患者,轻症急性胰腺炎(mild acute pancreatitis,MAP) 103例,重症急性胰腺炎(severe acute pancreatitis,SAP) 99例;SAP患者发生局部并发症62例,器官功能衰竭60例,23例二类并发症均存在;BISAP评分预测SAP的AUC为0.881 (95%CI:0.836~0.927),最佳cutoff值为2,其预测SAP敏感性、特异性、阳性预测值及阴性预测值分别为88.89%、71.84%、75.21%和87.06%;预测SAP患者局部并发症的AUC为0.715(95%CI:0.644~0.785),最佳Cutoff值为3,预测SAP局部并发症的敏感性、特异性、阳性预测值及阴性预测值分别为77.42%、75.00%、57.83%和88.24%;预测SAP患者器官功能衰竭的AUC为0.884(95 %CI:0.837~0.931),最佳Cutoff值为3,预测SAP患者器官功能衰竭的敏感性、特异性、阳性预测值及阴性预测值分别为76.67%、85.21%、68.66%和89.63%.BISAP评分预测AP严重程度、局部并发症、器官功能衰竭的能力与APACHEⅡ和Ranson评分比较差异无统计学意义(P>0.05).结论 BISAP评分对AP严重程度及预后预测价值与传统评分相同,但构成简单,主观偏倚小,可动态监测变化.

  5. Percutaneous necrosectomy in patients with acute, necrotizing pancreatitis

    Bruennler, T.; Langgartner, J.; Lang, S.; Salzberger, B.; Schoelmerich, J. [University Hospital of Regensburg, Department of Internal Medicine 1, Regensburg (Germany); Zorger, N.; Herold, T.; Feuerbach, S.; Hamer, O.W. [University Hospital of Regensburg, Department of Radiology, Regensburg (Germany)

    2008-08-15

    The objective of this retrospective study was to evaluate the outcome of patients with acute necrotizing pancreatitis treated by active percutaneous necrosectomy. By searching the radiological, surgical and internal medicine databases, all patients with acute necrotizing pancreatitis treated by active percutaneous necrosectomy between 1992 and 2004 were identified. Demographic, laboratory, and clinical data, and details about invasive procedures were collected by reviewing patient charts, radiological and surgical reports. The computed tomography severity index (CTSI) scores were determined by reviewing CT images. Eighteen patients were identified. Median Ranson score on admission was 2. The Acute Physiology and Chronic Health Evaluation (APACHE) II score was median 22. Median CTSI score was 7. Initially all patients were treated with CT-guided drainage placement. Because passive drainage proved not to be effective, subsequent minimally invasive, percutaneous necrosectomy was performed. Eight out of 18 patients recovered fully without the need for surgery. Ten of 18 patients required additional surgical necrosectomy. For one of ten patients, percutaneous necrosectomy allowed postponing surgery by 39 days. Four of ten surgically treated patients died: three from septic multiorgan failure, one from pulmonary embolism. Percutaneous minimally invasive necrosectomy can be regarded as a safe and effective complementary treatment modality in patients with necrotizing pancreatitis. It is suitable for a subset of patients to avoid or delay surgery. (orig.)

  6. Percutaneous necrosectomy in patients with acute, necrotizing pancreatitis

    The objective of this retrospective study was to evaluate the outcome of patients with acute necrotizing pancreatitis treated by active percutaneous necrosectomy. By searching the radiological, surgical and internal medicine databases, all patients with acute necrotizing pancreatitis treated by active percutaneous necrosectomy between 1992 and 2004 were identified. Demographic, laboratory, and clinical data, and details about invasive procedures were collected by reviewing patient charts, radiological and surgical reports. The computed tomography severity index (CTSI) scores were determined by reviewing CT images. Eighteen patients were identified. Median Ranson score on admission was 2. The Acute Physiology and Chronic Health Evaluation (APACHE) II score was median 22. Median CTSI score was 7. Initially all patients were treated with CT-guided drainage placement. Because passive drainage proved not to be effective, subsequent minimally invasive, percutaneous necrosectomy was performed. Eight out of 18 patients recovered fully without the need for surgery. Ten of 18 patients required additional surgical necrosectomy. For one of ten patients, percutaneous necrosectomy allowed postponing surgery by 39 days. Four of ten surgically treated patients died: three from septic multiorgan failure, one from pulmonary embolism. Percutaneous minimally invasive necrosectomy can be regarded as a safe and effective complementary treatment modality in patients with necrotizing pancreatitis. It is suitable for a subset of patients to avoid or delay surgery. (orig.)

  7. Physiological parameters

    The physiological characteristics of man depend on the intake, metabolism and excretion of stable elements from food, water, and air. The physiological behavior of natural radionuclides and radionuclides from nuclear weapons testing and from the utilization of nuclear energy is believed to follow the pattern of stable elements. Hence information on the normal physiological processes occurring in the human body plays an important role in the assessment of the radiation dose received by man. Two important physiological parameters needed for internal dose determination are the pulmonary function and the water balance. In the Coordinated Research Programme on the characterization of Asian population, five participants submitted data on these physiological characteristics - China, India, Japan, Philippines and Viet Nam. During the CRP, data on other pertinent characteristics such as physical and dietary were simultaneously being collected. Hence, the information on the physiological characteristics alone, coming from the five participants were not complete and are probably not sufficient to establish standard values for the Reference Asian Man. Nonetheless, the data collected is a valuable contribution to this research programme

  8. The prediction of the in-hospital mortality of acutely ill medical patients by electrocardiogram (ECG) dispersion mapping compared with established risk factors and predictive scores--a pilot study.

    Kellett, John

    2011-08-01

    ECG dispersion mapping (ECG-DM) is a novel technique that analyzes low amplitude ECG oscillations and reports them as the myocardial micro-alternation index (MMI). This study compared the ability of ECG-DM to predict in-hospital mortality with traditional risk factors such as age, vital signs and co-morbid diagnoses, as well as three predictive scores: the Simple Clinical Score (SCS)--based on clinical and ECG findings, and two Medical Admission Risk System scores--one based on vital signs and laboratory data (MARS), and one only on laboratory data (LD).

  9. Mathematical physiology

    Sneyd, James

    2009-01-01

    There has been a long history of interaction between mathematics and physiology. This book looks in detail at a wide selection of mathematical models in physiology, showing how physiological problems can be formulated and studied mathematically, and how such models give rise to interesting and challenging mathematical questions. With its coverage of many recent models it gives an overview of the field, while many older models are also discussed, to put the modern work in context. In this second edition the coverage of basic principles has been expanded to include such topics as stochastic differential equations, Markov models and Gibbs free energy, and the selection of models has also been expanded to include some of the basic models of fluid transport, respiration/perfusion, blood diseases, molecular motors, smooth muscle, neuroendrocine cells, the baroreceptor loop, turboglomerular oscillations, blood clotting and the retina. Owing to this extensive coverage, the second edition is published in two volumes. ...

  10. Physiological breeding.

    Reynolds, Matthew; Langridge, Peter

    2016-06-01

    Physiological breeding crosses parents with different complex but complementary traits to achieve cumulative gene action for yield, while selecting progeny using remote sensing, possibly in combination with genomic selection. Physiological approaches have already demonstrated significant genetic gains in Australia and several developing countries of the International Wheat Improvement Network. The techniques involved (see Graphical Abstract) also provide platforms for research and refinement of breeding methodologies. Recent examples of these include screening genetic resources for novel expression of Calvin cycle enzymes, identification of common genetic bases for heat and drought adaptation, and genetic dissection of trade-offs among yield components. Such information, combined with results from physiological crosses designed to test novel trait combinations, lead to more precise breeding strategies, and feed models of genotype-by-environment interaction to help build new plant types and experimental environments for future climates. PMID:27161822

  11. Regulatory Physiology

    Lane, Helen W.; Whitson, Peggy A.; Putcha, Lakshmi; Baker, Ellen; Smith, Scott M.; Stewart, Karen; Gretebeck, Randall; Nimmagudda, R. R.; Schoeller, Dale A.; Davis-Street, Janis

    1999-01-01

    As noted elsewhere in this report, a central goal of the Extended Duration Orbiter Medical Project (EDOMP) was to ensure that cardiovascular and muscle function were adequate to perform an emergency egress after 16 days of spaceflight. The goals of the Regulatory Physiology component of the EDOMP were to identify and subsequently ameliorate those biochemical and nutritional factors that deplete physiological reserves or increase risk for disease, and to facilitate the development of effective muscle, exercise, and cardiovascular countermeasures. The component investigations designed to meet these goals focused on biochemical and physiological aspects of nutrition and metabolism, the risk of renal (kidney) stone formation, gastrointestinal function, and sleep in space. Investigations involved both ground-based protocols to validate proposed methods and flight studies to test those methods. Two hardware tests were also completed.

  12. Plant physiology

    Duca, Maria

    2015-01-01

    This book covers all aspects of plant physiology: plant cell physiology, water regime of plants, photosynthesis, mineral nutrition, plant respiration, plant growth and development, movements in plants, signal perception and transduction etc. It focuses on the fundamental principles of plant physiology and biochemistry from the molecular level to whole plants, on the mechanisms of plant-environment interactions. The book is intended for students (biologists, physiologists, biochemists, biophysicists, ecologists, geneticists), teachers and researchers. Particular emphasis is given to recent research advances made on national and international levels, as well as to personal experimental results of the author that are relevant for a deeper understanding of processes and for practical implementation of gained knowledge. An essential amount of illustrative material (graphics, images, schemes, illustrations) completes the text and supplies additional information in an accessible manner. At the end of each chapter...

  13. 细胞因子联合BISAP评分系统早期预测急性胰腺炎严重程度及预后的前瞻性研究%A prospective study of cytokines joint BISAP score in the early prediction of severity and prognosis for acute pancreatitis

    张爱平

    2016-01-01

    Objective To analyze the cytokine interleukin 6 (IL-6) combined with bedside index for severity in acute pancreatitis (BISAP) at early time (0.05). Conclusion Cytokines IL-6 combined with BISAP score system was more valuable in early prediction of severity and prognosis for acute pancreatitis.%目的:分析细胞因子白介素6(IL-6)联合急性胰腺炎严重程度床边指数(BISAP)早期(病程0.05)。结论细胞因子IL-6联合BISAP评分系统对早期预测急性胰腺炎严重程度及预后更有价值。

  14. 急性胰腺炎严重程度床边指数评分对重症急性胰腺炎预后评估的价值%Value of BISAP scoring system in evaluating the prognosis of severe acute pancreatitis

    黄胡萍; 曾艳凌; 王君玺; 林志辉

    2015-01-01

    目的:探讨急性胰腺炎严重程度床边指数(bedside index for severity in acute pancreatitis,BisaP)评分在重症急性胰腺炎(severe acute pancreatitis,saP)预后评估中的应用价值。方法收集2007年1月至2013年12月我院收治的saP患者143例,记录入院24小时内的血尿素氮、受损的精神状态、全身炎症反应综合征、年龄、胸腔积液5个指标,进行BisaP评分,分析BisaP评分对saP患者多器官功能衰竭及死亡的预测价值。结果143例saP患者中,BisaP评分1分的29例(20.3%),2分的41例(28.7%),3分的46例(32.2%),4分的19例(13.3%),5分的8例(5.6%)。发生多器官功能衰竭者27例(18.9%),用roc曲线评估mof的曲线下面积(auc)为0.840(95%ci:0.745~0.935),最佳阈值为3分。死亡20例,病死率14.0%,用roc曲线评估saP患者死亡的auc值为0.938(95%ci:0.890~0.986),最佳阈值为3分。不同评分之间的多器官功能衰竭发生率、病死率差异均具有统计学意义(P<0.05)。结论BisaP评分是一种简便易行的评分方法,对saP患者的多器官功能衰竭发生及死亡的预测具有较高价值,是评估saP预后的有效指标。%ObjectiveTo evaluate the value of beside index for severity in acute pancreatitis (BisaP) score in predicting the prognosis of severe acute pancreatitis (saP).Method The data from 143 patients with severe acute pancreatitis admitted into our hospital from January,2007 to december,2013 were collected.The BisaP scores were calculated using the data of first 24 hours from admission. BisaP scoring system including five indexes:blood urea nitrogen, impaired mental status, systemic inflammatory response syndrome (sirs), age, and pleural effusion was used to evaluate the predictive value of BisaP scoring system on multiple organ failure (mof) and death in patients with severe acute pancreatitis.Result among those 143 patients, 29 patients were

  15. Reporting Valid and Reliable Overall Scores and Domain Scores

    Yao, Lihua

    2010-01-01

    In educational assessment, overall scores obtained by simply averaging a number of domain scores are sometimes reported. However, simply averaging the domain scores ignores the fact that different domains have different score points, that scores from those domains are related, and that at different score points the relationship between overall…

  16. Environmental physiology

    Summaries of research projects conducted during 1978 and 1979 are presented. Subject areas include: the effects of environmental pollutants on homeostasis of the hematopoietic system; pollutant effects on steroid metabolism; pollutant effects on pulmonary macrophages; effects of toxic gases on lung cells; the development of immunological methods for assessing lung damage at the cellular level; the response of erythropoietin concentration to various physiological changes; and the study of actinide metabolism in monkey skeletons

  17. BOAS与ASTRAL评分预测急性缺血性脑卒中患者3月不良预后的价值%BOAS vs ASTRAL Score in Predicting the 3-month Unfavorable Outcome of Acute Ischemic Stroke

    龙胤希

    2015-01-01

    Objective To study the clinical values of the Bologna Outcome Algorithm for Stroke (BOAS) and the Acute Stroke Registry and Analysis of Lausanne (ASTRAL)Score in evaluating 3-month unfavorable outcome after Acute Ischemic Stroke (AIS). Methods The clinical data and of 305 consecutive patients with AIS admit ed from January 2013 to April 2014 were col ected in this research. Al patients were evaluated according to BOAS Score and ASTRAL Score criteria. Areas under the curve were calculated to quantify the prognostic value and compared with the values between BOAS and ASTRAL Score in predicting. Unfavorable outcome was assessed as a modified Rankin Scale score >2 at 3 months. Calibration was assessed by comparing predicted and observed probability of unfavorable outcome using Pearson correlation coef icient.Results Al patients appeared functional disability (modified Rankin score> 2) or the death of a poor prognosis 115 cases (37.7%) within 3 months.The AUC of BOAS and ASTRAL Score for 3 months were 0.859( =0.000,95%CI:0.804-0.914)and 0.812( =0.000,95%CI:0.750~0.875)respectively.Conclusion BOAS and ASTRAL score assessment of acute ischemic stroke patients with poor prognosis three months have bet er predictive value, is conducive to clinical decision making.%目的比较博洛尼亚卒中结局算法(BOAS)与洛桑卒中评分(ASTRAL)评估急性缺血性脑卒中(AIS)患者3个月不良预后的预测价值。方法收集2013年1月~2014年4月我院305例急性缺血性脑卒中患者的临床资料,比较BOAS与ASTRAL评分预测缺血性脑卒中的3个月的不良预后,并绘制受试工作者特征曲线下面积(AUC),以卒中后3个月的死亡率或功能残障(改良Rankin评分>2分为不良预后),应用Pearson相关分析评估实际与预期结局事件的关联程度。结果全组患者3个月出现功能残障(改良Rankin评分>2)或死亡的不良预后有115例(37.7%);BOAS和ASTRAL评分预测3个

  18. APHASIE HANDICAP SCORE

    Detante, Olivier

    2004-01-01

    Stroke is the leading cause of disability for adults. Handicap assessment is required to improve follow-up and for clinical trials. The modified Rankin scale is a "best-seller" which has contributed to prove efficacy of thrombolysis. This global score of disability is simple and patient-oriented. It seems interesting to developp such global scoring for aphasia. Our aim was to validate a simple and reproductible tool for handicap due to every type of aphasia. Aphasia Handicap Score (AHS) was d...

  19. The Bandim tuberculosis score

    Rudolf, Frauke; Joaquim, Luis Carlos; Vieira, Cesaltina;

    2013-01-01

    Background: This study was carried out in Guinea-Bissau's capital Bissau among inpatients and outpatients attending for tuberculosis (TB) treatment within the study area of the Bandim Health Project, a Health and Demographic Surveillance Site. Our aim was to assess the variability between 2...... physicians in performing the Bandim tuberculosis score (TBscore), a clinical severity score for pulmonary TB (PTB), and to compare it to the Karnofsky performance score (KPS). Method: From December 2008 to July 2009 we assessed the TBscore and the KPS of 100 PTB patients at inclusion in the TB cohort and...

  20. Evaluation of BISAP and HAP scoring system in predicting prognosis of acute pancreatitis%急性胰腺炎床旁严重度指数和无害性胰腺炎评分对急性胰腺炎预后的评估价值

    李新; 晁康; 姚佳燕; 钟碧慧; 陈旻湖

    2013-01-01

    Objective To evaluate the bedside index for severity in acute pancreatitis (BISAP) and harmless acute pancreatitis (HAP) scoring system in predicting prognosis of acute pancreatitis (AP).Methods A total of 442 AP patients,who were admitted to The First Affiliated Hospital of Sun Yat-sen University from January 2003 to December 2010,were retrospectively studied.BISAP and HAP scores were evaluated respectively.The value of BISAP and HAP scores in predicting severity,local complications,organ failure and mortality were measured by the area under the curve (AUC) of receiver operator characteristic curve (ROC),and it was compared with that of traditional Ranson's score.Results Among 442 patients,73 patients (16.5%) were diagnosed to have severe acute pancreatitis (SAP).AUC for BISAP score in predicting SAP,local complications,organ failure and mortality were 0.90 (95% CI:0.86 ~ 0.93),0.82(95% CI:0.76 ~ 0.89),0.93 (95% CI:0.89 ~ 0.96),0.93 (95% CI:0.87 ~ 0.98).There were no statistically significant differences in AUCs of the four prognostic parameters between BISAP and Ranson's score.The specificity,positive predictive value (PPV),and AUC of HAP score in predicting mild AP were 85%,95% and 0.73 (95% CI:0.67 ~ 0.79).The risk of dismal prognosis increased when both BISAP and HAP score were abnormal.Conclusions BISAP and Ranson's score have comparable ability in predicting prognosis of patients with AP.However,BISAP score is simpler.HAP score is a simple and accurate method for predicting prognosis of patients with mild AP.Combination of BISAP score with HAP score can better help predict the prognosis of AP patients.%目的 评价急性胰腺炎床旁严重度指数(BISAP)与无害性胰腺炎评分(HAPS)评估急性胰腺炎(AP)预后的价值.方法 回顾性分析2003年1月至2010年12月中山大学附属第一医院收治的442例AP患者资料,计算BISAP和HAP评分,绘制受试者工作特征(ROC)曲线并计算曲线下面积(AUC),分

  1. Volleyball Scoring Systems.

    Calhoun, William; Dargahi-Noubary, G. R.; Shi, Yixun

    2002-01-01

    The widespread interest in sports in our culture provides an excellent opportunity to catch students' attention in mathematics and statistics classes. One mathematically interesting aspect of volleyball, which can be used to motivate students, is the scoring system. (MM)

  2. Exercise physiology

    Kiens, Bente; Richter, Erik; Wojtaszewski, Jørgen

    2014-01-01

    The passing of Professor Bengt Saltin on September 12, 2014 truly marks the end of an era. As editor of the Journal of Applied Physiology and one of Bengt’s many collaborators and colleagues, I wanted the Journal to celebrate his many seminal contributions by means of an Editorial. Professor Bent...... Kiens, who is both a colleague of Bengt’s and a Consulting Editor for the Journal, was asked to write it. Thanks to Bente and her colleagues for the impossible task of distilling an enormous body of work into about 1,000 words. Peter Wagner, Editor...

  3. Occupational physiology

    Toomingas, Allan; Tornqvist, Ewa Wigaeus

    2011-01-01

    In a clear and accessible presentation, Occupational Physiology focuses on important issues in the modern working world. Exploring major public health problems-such as musculoskeletal disorders and stress-this book explains connections between work, well-being, and health based on up-to-date research in the field. It provides useful methods for risk assessment and guidelines on arranging a good working life from the perspective of the working individual, the company, and society as a whole.The book focuses on common, stressful situations in different professions. Reviewing bodily demands and r

  4. Prognostic Value of TIMI Score versus GRACE Score in ST-segment Elevation Myocardial Infarction

    Luis C. L. Correia

    2014-08-01

    Full Text Available Background: The TIMI Score for ST-segment elevation myocardial infarction (STEMI was created and validated specifically for this clinical scenario, while the GRACE score is generic to any type of acute coronary syndrome. Objective: Between TIMI and GRACE scores, identify the one of better prognostic performance in patients with STEMI. Methods: We included 152 individuals consecutively admitted for STEMI. The TIMI and GRACE scores were tested for their discriminatory ability (C-statistics and calibration (Hosmer-Lemeshow in relation to hospital death. Results: The TIMI score showed equal distribution of patients in the ranges of low, intermediate and high risk (39 %, 27 % and 34 %, respectively, as opposed to the GRACE Score that showed predominant distribution at low risk (80 %, 13 % and 7%, respectively. Case-fatality was 11%. The C-statistics of the TIMI score was 0.87 (95%CI = 0.76 to 0.98, similar to GRACE (0.87, 95%CI = 0.75 to 0.99 - p = 0.71. The TIMI score showed satisfactory calibration represented by χ2 = 1.4 (p = 0.92, well above the calibration of the GRACE score, which showed χ2 = 14 (p = 0.08. This calibration is reflected in the expected incidence ranges for low, intermediate and high risk, according to the TIMI score (0 %, 4.9 % and 25 %, respectively, differently to GRACE (2.4%, 25% and 73%, which featured middle range incidence inappropriately. Conclusion: Although the scores show similar discriminatory capacity for hospital death, the TIMI score had better calibration than GRACE. These findings need to be validated populations of different risk profiles.

  5. 急性ST段抬高型心肌梗死患者心型脂肪酸结合蛋白水平与GRACE危险评分的相关性研究%Relationship between Heart-type Fatty Acid-binding Protein and GRACE Risk Score in Patients with Acute ST-elevation Myocardial Infarction

    魏庆民; 周彬; 王晓纲; 樊延明; 王爱平; 刘翠华

    2013-01-01

    Objective To study the relationship between heart - type fatty acid - binding protein ( H - FABP ) level and Global Registry of Acute Coronary Events ( GRACE ) risk score in patients with acute ST - elevation myocardial infarction ( STEMI ). Methods From April 2010 to December 2011 , 60 STEM patients admitted to our hospital within 2 hours of symptom onset were enrolled in this study. Twelve hours after admission, blood samples were obtained for H - FABP measurement every two hours. Then, H - FABP peak values were found. The baseline data were recorded and the GRACE risk score were calculated. The Pearson's correlation analysis were used to analyze the relationship between the H - FABP peak value and GRACE risk score. Results The peak value of H - FABP was ( 59. 4 ± 23. 1 ) μg/L, which occmed 4~8 hours after admission. It was positively correlated with GRACE risk score in these patients ( r = 0.701 , P<0. 05 ). Conclusion H -FABP peak value is directly relevant with GRACE risk score in STEMI patients. Measurement of H - FABP level can provide additional risk stratification information in these patients.%目的 探讨急性ST段抬高型心肌梗死(STEMI)患者血浆心型脂肪酸结合蛋白(H-FABP)的峰值水平与全球急性冠状动脉事件注册(GRACE)风险评分的相关性.方法 选择2010年4月-2011年12月我科收治的发病2 h内的STEMI患者60例,于患者发病后2、4、6、8、10、12 h采血,检测H-FABP水平,找出其峰值.记录患者的基线资料,计算GRACE风险评分,对GRACE评分和H-FABP的峰值水平进行Pearson直线相关分析.结果 H-FABP的达峰时间为4~8 h,平均峰值为(59.4±23.1)μg/L;STEMI患者H-FABP峰值水平与GRACE危险评分呈正相关(r=0.701,P<0.05).结论 STEMI的H-FABP峰值水平与GRACE评分相关,检测H-FABP峰值水平可以为STEMI患者的危险分层提供参考.

  6. Environmental physiology

    In Section 3 of this annual report the Environmental Physiology Group reports progress in several areas of research: a study of erythropoietin biogenesis and regulation of hematopoesis; the in vitro production of erythropoietin by cloned lines of erythroleukemic cells; endocrine interactions with lung tissue, and hormonal changes in response to ozone exposure; an in vitro cell culture technique for the detection and enumeration of thymic lymphocyte progenitors in the bone marrow of experimental animals; the study of magnetic field bioeffects; the study of actinide element distribution and retention in primates; and a comparison of the efficiencies of various chelating agents in facilitating the removal of Pu-238 from the skeleton, the liver, and the whole body

  7. Physiological Acoustics

    Young, Eric D.

    The analysis of physiological sound in the peripheral auditory system solves three important problems. First, sound energy impinging on the head must be captured and presented to the transduction apparatus in the ear as a suitable mechanical signal; second, this mechanical signal needs to be transduced into a neural representation that can be used by the brain; third, the resulting neural representation needs to be analyzed by central neurons to extract information useful to the animal. This chapter provides an overview of some aspects of the first two of these processes. The description is entirely focused on the mammalian auditory system, primarily on human hearing and on the hearing of a few commonly used laboratory animals (mainly rodents and carnivores). Useful summaries of non-mammalian hearing are available [1]. Because of the large size of the literature, review papers are referenced wherever possible.

  8. APHASIE HANDICAP SCORE

    Detante, Olivier

    2004-01-01

    L'accident vasculaire cérébral (AVC) est la principale cause de handicap de l'adule dont la quantification est indispensable à l'évaluation de la qualité des soins. Le score de Rankin est un " best-seller " qui a contribué à démontrer l'efficacité de la thrombolyse. Ce score global du handicap est simple et le plus " patient-orienté " des scores actuels. Il nous a semblé intéressant d'adapter cette approche globale du handicap post-AVC au problème spécifique des aphasies. L'objectif était de ...

  9. Acute short-term mental stress does not influence salivary flow rate dynamics.

    Ella A Naumova

    Full Text Available BACKGROUND: Results of studies that address the influence of stress on salivary flow rate and composition are controversial. The aim of this study was to reveal the influence of stress vulnerability and different phases of stress reactivity on the unstimulated and stimulated salivary flow rate. We examined that acute mental stress does not change the salivary flow rate. In addition, we also examined the salivary cortisol and protein level in relation to acute mental stress stimuli. METHODS: Saliva of male subjects was collected for five minutes before, immediately, 10, 30 and 120 min after toothbrushing. Before toothbrushing, the subjects were exposed to acute stress in the form of a 2 min public speech. Salivary flow rate and total protein was measured. The physiological stress marker cortisol was analyzed using enzyme-linked immunosorbent assay. To determine the subjects' psychological stress reaction, the State-Trait-Anxiety Inventory State questionnaire (STAI data were obtained. The subjects were divided into stress subgroup (S1 (psychological reactivity, stress subgroup (S2 (psychological and physiological reactivity and a control group. The area under the curve for salivarycortisol concentration and STAI-State scores were calculated. All data underwent statistical analysis using one-way analysis of variance. RESULTS: Immediately after stress exposure, all participants exhibited a psychological stress reaction. Stress exposure did not change the salivary flow rate. Only 69% of the subjects continued to display a physiological stress reaction 20 minutes after the public talk. There was no significant change in the salivary flow rate during the psychological and the physiological stress reaction phases relative to the baseline. CONCLUSIONS: Acute stress has no impact on the salivary flow rate; however, there may be other responses through salivary proteins that are increased with the acute stress stimuli. Future studies are needed to examine

  10. RIFLE criteria for acute kidney injury in the intensive care units

    Farzaneh Sharifipour

    2013-01-01

    Full Text Available Background: Acute kidney injury (AKI is commonly occurred in intensive care unit (ICU patients. The aim of the study was a comparison of RIFLE (Risk of renal injury/Injury to the kidney/Failure of kidney function/Loss of kidney function/End stage disease classification with other scoring systems in the evaluation of AKI in ICUs. Materials and Methods: We performed a retrospective study on 409 ICU patients who were admitted during the 5 years period. Results: At the 1 st day of admission and time of discharge, the total and non-renal Acute Physiology and Chronic Health Evaluation II and sequential organ failure assessment scores were compared to max RIFLE criteria. In this assessment, there was concordance among the results (P < 0.05. Conclusion: The RIFLE classification can be used for detection of AKI in ICU patients.

  11. Instant MuseScore

    Shinn, Maxwell

    2013-01-01

    Get to grips with a new technology, understand what it is and what it can do for you, and then get to work with the most important features and tasks. Instant MuseScore is written in an easy-to follow format, packed with illustrations that will help you get started with this music composition software.This book is for musicians who would like to learn how to notate music digitally with MuseScore. Readers should already have some knowledge about musical terminology; however, no prior experience with music notation software is necessary.

  12. Space Physiology within an Exercise Physiology Curriculum

    Carter, Jason R.; West, John B.

    2013-01-01

    Compare and contrast strategies remain common pedagogical practices within physiological education. With the support of an American Physiological Society Teaching Career Enhancement Award, we have developed a junior- or senior-level undergraduate curriculum for exercise physiology that compares and contrasts the physiological adaptations of…

  13. Nursing activities score

    Miranda, DR; Nap, R; de Rijk, A; Schaufeli, W; Lapichino, G

    2003-01-01

    Objectives. The instruments used for measuring nursing workload in the intensive care unit (e.g., Therapeutic Intervention Scoring System-28) are based on therapeutic interventions related to severity of illness. Many nursing activities are not necessarily related to severity of illness, and cost-ef

  14. Developing Scoring Algorithms

    We developed scoring procedures to convert screener responses to estimates of individual dietary intake for fruits and vegetables, dairy, added sugars, whole grains, fiber, and calcium using the What We Eat in America 24-hour dietary recall data from the 2003-2006 NHANES.

  15. Validação do escore de Alvarado no diagnóstico de apendicite aguda em crianças e adolescentes no Instituto Materno Infantil de Pernambuco, IMIP The Alvarado score validation in diagnosing acute appendicitis in children and teenagers at the Instituto Materno Infantil de Pernambuco, IMIP

    Paulo Sérgio Gomes Nogueira Borges

    2003-12-01

    Full Text Available OBJETIVOS: determinar a acurácia do escore de Alvarado para o diagnóstico de apendicite aguda em crianças e adolescentes admitidos na emergência do Instituto Materno Infantil de Pernambuco (IMIP. MÉTODOS: foi realizado um estudo de validação de método diagnóstico (escore clínico-laboratorial para diagnóstico de apendicite aguda tendo o exame histopatológico como padrão ouro. A amostra estudada consistiu de 81 crianças e adolescentes, admitidas na emergência pediátrica do IMIP com dor abdominal suspeita de apendicite aguda, no período de março a outubro de 2002. Os pacientes foram atendidos na emergência pediátrica e avaliados quanto ao escore de Alvarado. Entretanto a decisão cirúrgica foi tomada pelo cirurgião responsável. RESULTADOS: tomando como ponto de corte o valor >5 pontos, encontramos uma sensibilidade de 92,6%, especificidade 63,6%, valor preditivo positivo de 86,2% e valor preditivo negativo de 77,8%. CONCLUSÕES: o escore de Alvarado é um procedimento pouco invasivo, simples, rápido, reprodutível, que utilizando o ponto de corte >5 pontos apresenta-se como instrumento de alto valor na triagem de crianças e adolescentes com suspeita diagnóstica de apendicite aguda.OBJECTIVES: to determine the accuracy of the Alvarado score in diagnosing acute appendicitis in children and adolescents admitted in the emergency unit of the Instituto Materno Infantil de Pernambuco (IMIP. METHODS: a diagnostic test study was carried out (clinical and laboratory score to diagnose acute appendicitis using histopathology exam as the golden standard. The sample studied consisted of 81 children and adolescents admitted in the pediatrics emergency unit of IMIP with symptoms and signs consistent with clinical suspicion of acute appendicitis from the period of March to October 2002. Patients were examined in the pediatric emergency and assessed by the Alvarado score. Nevertheless, the decision to whether or not perform the surgery was

  16. Anterior Cruciate Ligament OsteoArthritis Score (ACLOAS)

    Roemer, Frank W; Frobell, Richard; Lohmander, Stefan;

    2014-01-01

    longitudinal changes including osteoarthritis (OA) features. Joint features assessed were acute osteochondral injury, traumatic and degenerative bone marrow lesions (BMLs), meniscus morphology and extrusion, osteophytes, collateral and cruciate ligaments including ACL graft, Hoffa-synovitis and effusion......OBJECTIVE: To develop a whole joint scoring system, the Anterior Cruciate Ligament OsteoArthritis Score (ACLOAS), for magnetic resonance imaging (MRI)-based assessment of acute anterior cruciate ligament (ACL) injury and follow-up of structural sequelae, and to assess its reliability. DESIGN......: Baseline and follow-up 1.5 T MRI examinations from 20 patients of the KANON study, a randomized controlled study comparing a surgical and non-surgical treatment strategy, were assessed for up to six longitudinal visits using a novel MRI scoring system incorporating acute structural tissue damage and...

  17. Early changes in physiological variables after stroke

    Wong Andrew; Read Stephen

    2008-01-01

    Several aspects of physiology, notably blood pressure, body temperature, blood glucose, and blood oxygen saturation, may be altered after an ischemic stroke and intracerebral hemorrhage. Generally, blood pressure and temperature rise acutely after a stroke, before returning to normal. Blood glucose and oxygen levels may be abnormal in individuals, but they do not follow a set pattern. Several aspects of these physiological alterations remain unclear, including their principal determinants - w...

  18. Correlação dos escores de risco com a anatomia coronária na síndrome coronária aguda sem supra-ST Correlation of risk scores with coronary anatomy in non-ST-elevation acute coronary syndrome

    Elizabete Silva dos Santos

    2013-01-01

    Full Text Available FUNDAMENTO:Há poucas publicações sobre a correlação entre escores de risco e anatomia coronária na síndrome coronária aguda (SCA. OBJETIVO: Correlacionar os escores de risco com a gravidade da lesão coronária na SCA sem supra-ST. MÉTODOS: Foram analisados 582 pacientes entre julho de 2004 e outubro de 2006. Avaliou-se a correlação entre os escores de risco TIMI, GRACE hospitalar e em seis meses com lesão coronária > 50%, por método não paramétrico de Spearman. Modelo de regressão logística múltipla foi realizado para determinar a habilidade preditiva dos escores em discriminar quem terá ou não lesão coronária > 50%. RESULTADOS: Foram 319 (54,8% homens e a média de idade era 59,9 (± 10,6 anos. Correlação positiva foi observada entre a pontuação dos escores de risco e lesão coronária > 50% (escore de risco TIMI r = 0,363 [p 50% foi: TIMI = 0,704 [IC95% 0,656-0,752; p BACKGROUND: The literature lacks studies regarding the correlation between risk scores and coronary anatomy in acute coronary syndrome (ACS OBJECTIVE: Correlate risk scores with the severity of the coronary lesion in ACS with non-ST elevation. METHODS: A total of 582 patients were analyzed between July 2004 and October 2006. The correlation between TIMI risk scores and GRACE (hospital and six months scores was performed for patients with coronary lesion > 50%, using Spearman´s non-parametric method. Multiple regression logistics was used to determine the predictive ability of the scores to discriminate to discriminate who will have a coronary lesion > 50%. RESULTS: Most subjects were male (319 or 54.8%, mean age of 59.9 (± 10.6 years. A positive correlation was observed between risk scores and >coronary lesion > 50% (TIMI r = 0.363 [p 50% was: TIMI = 0.704 [CI95% 0.656-0.752; p <0.0001]; hospital GRACE = 0.623 [CI95% 0.573-0.673; p < 0.0001]; GRACE at six months= 0.562 [CI95% 0.510-0.613; p ;= 0.0255]. Comparing the areas under the ROC curve, it was

  19. Clinical discriminators between acute brain hemorrhage and infarction: a practical score for early patient identification Características clínicas diferenciais entre hemorragia e infarto cerebral: uma escala prática para identificação precoce do paciente

    Ayrton R. Massaro

    2002-06-01

    Full Text Available New treatments for acute stroke require a rapid triage system, which minimizes treatment delays and maximizes selection of eligible patients. Our aim was to create a score for assessing the probability of brain hemorrhage among patients with acute stroke based upon clinical information. Of 1805 patients in the Stroke Data Bank, 1273 had infarction (INF and 237 had parenchymatous hemorrhage (HEM verified by CT. INF and HEM discriminators were determined by logistic regression and used to create a score. ROC curve was used to choose the cut-point for predicting HEM (score Novas perspectivas no tratamento do acidente vascular cerebral (AVC requerem um método de triagem rápido para seleção dos pacientes. Nosso objetivo foi criar uma escala com informações clínicas simples para diferenciar hematoma intra-parenquimatoso (HEM entre os pacientes com AVC. Estudamos 1.273 pacientes com AVC isquêmico (INF e 237 com HEM do Stroke Data Bank. Variáveis independentes para o diagnóstico de INF e HEM foram determinadas pela análise de regressão logística e utilizadas para criar uma escala. Através da curva ROC foi escolhido o nível de corte para discriminar HEM (<= 2 , com sensibilidade de 76%, especificidade de 83%. Foi realizada validação externa utilizando os pacientes do estudo NOMASS. Embora o uso de uma escala de fácil aplicação pelas equipes de emergência não possa substituir os métodos de imagem na diferenciação entre INF e HEM para a indicação de trombolítico, a escala proposta pode ser útil para selecionar pacientes para estudos clínicos e tratamento pré-hospitalar, alertar técnicos de tomografia e as equipes médicas sobre a chegada de pacientes, contribuindo para reduzir atrasos cruciais no tratamento.

  20. Music Score for Sticky

    Zhao, Enguang

    2015-01-01

    The thesis is a film composition scoring for the animated documentary film Sticky directed and produced by Jilli Rose, 2013. The film is 20 minutes long and talking about an expedition to the Ball's Pyramid Island, Australia, and the discovery of the stick insect-a type of phasmid which has disappeared on the Lord Howe Island, Australia since 1920, and how to rescue it and preserve it. The music is mainly composed based on orchestra and combining some electronic synthesis instruments with e...

  1. Comparison of AIMS65 Score and Other Scoring Systems for Predicting Clinical Outcomes in Koreans with Nonvariceal Upper Gastrointestinal Bleeding

    Park, Sung Min; Yeum, Seok Cheon; Kim, Byung-Wook; Kim, Joon Sung; Kim, Ji Hee; Sim, Eun Hui; Ji, Jeong-Seon; Choi, Hwang

    2016-01-01

    Background/Aims The AIMS65 score has not been sufficiently validated in Korea. The objective of this study was to compare the AIMS65 and other scoring systems for the prediction of various clinical outcomes in Korean patients with acute nonvariceal upper gastrointestinal bleeding (NVUGIB). Methods The AIMS65 score, clinical and full Rockall scores (cRS and fRS) and Glasgow-Blatchford (GBS) score were calculated in patients with NVUGIB in a single center retrospectively. The performance of these scores for predicting mortality, rebleeding, transfusion requirement, and endoscopic intervention was assessed by calculating the area under the receiver-operating characteristic curve. Results Of the 523 patients, 3.4% died within 30 days, 2.5% experienced rebleeding, 40.0% required endoscopic intervention, and 75.7% needed transfusion. The AIMS65 score was useful for predicting the 30-day mortality, the need for endoscopic intervention and for transfusion. The fRS was superior to the AIMS65, GBS, and cRS for predicting endoscopic intervention and the GBS was superior to the AIMS65, fRS, and cRS for predicting the transfusion requirement. Conclusions The AIMS65 score was useful for predicting the 30-day mortality, transfusion requirement, and endoscopic intervention in Korean patients with acute NVUGIB. However, it was inferior to the GBS and fRS for predicting the transfusion requirement and endoscopic intervention, respectively. PMID:27377742

  2. Determining ICH Score: can we go beyond? Determinando o ICH Score: podemos ir além?

    Gustavo Cartaxo Patriota; João Manoel da Silva-Júnior; Alécio Cristino Evangelista Santos Barcellos; Joaquim Barbosa de Sousa Silva Júnior; Diogo Oliveira Toledo; Fernando Campos Gomes Pinto; José Marcus Rotta

    2009-01-01

    Spontaneous intracerebral hemorrhage (SICH) still presents a great heterogeneity in its clinical evaluation, demonstrating differences in the enrollment criteria used for the study of intracerebral hemorrhage (ICH) treatment. The aim of the current study was to assess the ICH Score, a simple and reliable scale, determining the 30-day mortality and the one-year functional outcome. Consecutive patients admitted with acute SICH were prospectively included in the study. ICH Scores ranged from 0 t...

  3. Correlation of Pain Scores, Analgesic Use, and Beck Anxiety Inventory Scores During Hospitalization in Lower Extremity Amputees

    Trame, Cathy D; Greene, Erin; Moddeman, Gail; Booth, Branyan A; Konstantakos, Emmanuel K; Parada, Stephen; Siebuhr, Karl; Laughlin, Richard T.

    2008-01-01

    Post amputation pain can be debilitating for patients and families. Chronic pain is a common phenomenon after lower extremity amputation, occurring in up to 80% of this population. The purpose of this pilot study was to correlate post amputation pain scores to opioid analgesic consumption and Beck Anxiety Inventory (BAI) scores. Twenty-three patients with lower extremity amputation at an 827-bed acute care inner-city hospital were surveyed pre-operatively and post-operatively to determine if ...

  4. Interpreting the Meaning of Pain Severity Scores

    Marilyn J Hodgins

    2002-01-01

    Full Text Available Poor pain management practices are generally discussed in terms of barriers associated with the patient, clinician and/or health care organization. The impact of deficiencies in the tools that are used to measure pain are seldom addressed. Three factors are discussed that complicate the measurement of pain: the nature of pain, the lack of meaning associated with scores generated by pain scales, and treatment goals that lack specificity and are not linked to patients' pain scores. The major premise presented in the present article is that the utility of pain measurement is limited because health care professionals do not have a common understanding of the meaning of scores generated by pain measurement tools, especially within the acute care setting. To address this issue, approaches to establishing instrument validity need to be broadened to include the examination of the meaning and consequences of these measurements within a specific context. Substantive improvements in pain management are unlikely to occur until criteria are identified to link explicitly the scores generated by pain measurement tools to treatment goals.

  5. Acute Kidney Injury in the Elderly

    Abdel-Kader, Khaled; Palevsky, Paul

    2009-01-01

    The aging kidney undergoes a number of important anatomic and physiologic changes that increase the risk of acute kidney injury (formerly acute renal failure) in the elderly. This article reviews these changes and discusses the diagnoses frequently encountered in the elderly patient with acute kidney injury. The incidence, staging, evaluation, management, and prognosis of acute kidney injury are also examined with special focus given to older adults.

  6. Association between value-based purchasing score and hospital characteristics

    Borah Bijan J

    2012-12-01

    Full Text Available Abstract Background Medicare hospital Value-based purchasing (VBP program that links Medicare payments to quality of care will become effective from 2013. It is unclear whether specific hospital characteristics are associated with a hospital’s VBP score, and consequently incentive payments. The objective of the study was to assess the association of hospital characteristics with (i the mean VBP score, and (ii specific percentiles of the VBP score distribution. The secondary objective was to quantify the associations of hospital characteristics with the VBP score components: clinical process of care (CPC score and patient satisfaction score. Methods Observational analysis that used data from three sources: Medicare Hospital Compare Database, American Hospital Association 2010 Annual Survey and Medicare Impact File. The final study sample included 2,491 U.S. acute care hospitals eligible for the VBP program. The association of hospital characteristics with the mean VBP score and specific VBP score percentiles were assessed by ordinary least square (OLS regression and quantile regression (QR, respectively. Results VBP score had substantial variations, with mean score of 30 and 60 in the first and fourth quartiles of the VBP score distribution. For-profit status (vs. non-profit, smaller bed size (vs. 100–199 beds, East South Central region (vs. New England region and the report of specific CPC measures (discharge instructions, timely provision of antibiotics and beta blockers, and serum glucose controls in cardiac surgery patients were positively associated with mean VBP scores (p Conclusions Although hospitals serving the poor and the elderly are more likely to score lower under the VBP program, the correlation appears small. Profit status, geographic regions, number and type of CPC measures reported explain the most variation among scores.

  7. Fingerprinting of music scores

    Irons, Jonathan; Schmucker, Martin

    2004-06-01

    Publishers of sheet music are generally reluctant in distributing their content via the Internet. Although online sheet music distribution's advantages are numerous the potential risk of Intellectual Property Rights (IPR) infringement, e.g. illegal online distributions, disables any innovation propensity. While active protection techniques only deter external risk factors, additional technology is necessary to adequately treat further risk factors. For several media types including music scores watermarking technology has been developed, which ebeds information in data by suitable data modifications. Furthermore, fingerprinting or perceptual hasing methods have been developed and are being applied especially for audio. These methods allow the identification of content without prior modifications. In this article we motivate the development of watermarking and fingerprinting technologies for sheet music. Outgoing from potential limitations of watermarking methods we explain why fingerprinting methods are important for sheet music and address potential applications. Finally we introduce a condept for fingerprinting of sheet music.

  8. Sequential Oxygenation Index and Organ Dysfunction Assessment within the First 3 Days of Mechanical Ventilation Predict the Outcome of Adult Patients with Severe Acute Respiratory Failure

    Hsu-Ching Kao

    2013-01-01

    Full Text Available Objective. To determine early predictors of outcomes of adult patients with severe acute respiratory failure. Method. 100 consecutive adult patients with severe acute respiratory failure were evaluated in this retrospective study. Data including comorbidities, Sequential Organ Failure Assessment (SOFA score, Acute Physiological Assessment and Chronic Health Evaluation II (APACHE II score, PaO2, FiO2, PaO2/FiO2, PEEP, mean airway pressure (mPaw, and oxygenation index (OI on the 1st and the 3rd day of mechanical ventilation, and change in OI within 3 days were recorded. Primary outcome was hospital mortality; secondary outcome measure was ventilator weaning failure. Results. 38 out of 100 (38% patients died within the study period. 48 patients (48% failed to wean from ventilator. Multivariate analysis showed day 3 OI ( and SOFA ( score were independent predictors of hospital mortality. Preexisting cerebrovascular accident (CVA ( was the predictor of weaning failure. Results from Kaplan-Meier method demonstrated that higher day 3 OI was associated with shorter survival time (log-Rank test, . Conclusion. Early OI (within 3 days and SOFA score were predictors of mortality in severe acute respiratory failure. In the future, prospective studies measuring serial OIs in a larger scale of study cohort is required to further consolidate our findings.

  9. The relationships between COPD assessment test score and right heart function in Patients with Acute Chron-ic Obstructive Pulmonary Disease%慢性阻塞性肺疾病急性加重期患者的CAT评分与右心功能相关性研究

    赵欣; 费广鹤

    2015-01-01

    Objective To explore the relationships between COPD assessment test score and right heart function in Patients with Acute exacerbation Chronic Obstructive Pulmonary Disease( AECOPD) . Methods 124 pa-tients with clinician-diagnosed acute exacerbation of COPD have prospectively studied, Finally, 62 matches were re-cruited. Include Twenty-nine mild-to-moderate, thirty-three severe-to-very severe AECOPD patients, twenty subjects as control. Pulmonary artery pressure, cardiac function parameters ( RA-V, RVD, Tei) was measured and recorded by Color Doppler ultrasound,Pulmonary function, arterial blood gas were evaluated in each subject. Meanwhile, they completed the CAT questionnaire independently. Results Positive correlations were found between CAT scores and PAP, RA-V, RVD, Tei, while, there have more significant correlation between CAT and RA-V, RVD in mild-to-moderate group. Conclusion Among patients with acute exacerbation of COPD, CAT score were found significantly correlated with right ventricular function parameters,which may be also as an useful instrument to evaluate severity of right heart function following COPD exacerbations, thus expanding the scope of application of CAT in clinical prac-tice.%目的:探讨慢性阻塞性肺疾病急性加重期患者CAT评分量表与右心功能之间相关性。方法对2014年1月至6月我科124例慢阻肺急性加重期住院患者进行前瞻性研究,符合入组条件患者62例,其中轻-中度组29例、重-极重度组33例,同期20例健康体检者为对照组。采用彩色多普勒超声测定并记录肺动脉压力( PAP)、心功能参数( RA-V、RVD、Tei ),所有受试者完成CAT评分量表、肺功能参数、动脉血气测定。结果轻-中度、重-极重度组的CAT评分与PAP均具有显著正相关性(P<0.01);CAT评分与RA-V、RVD成正相关,且轻-中度组更具有显著相关性(r=0.654,r=0.444);CAT评分与Tei成显著正相关性,P值<0.01。结论慢阻肺急性加重期

  10. Assessment of surgical outcome in general surgery using Portsmouth possum scoring

    Tejaswini Vallabha; Manish Pangi

    2013-01-01

    Objective: The Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity (POSSUM) and its modification, Portsmouth POSSUM, are considered as methods of risk scoring. Application of this scoring system helps in assessing the quality of the health care provided& surgical outcome. Its utilization in our country where the level of healthcare and resources differ is limited. Hence, a prospective study to assess the outcome of surgeries using P Possum scoring system ...

  11. Acute Bronchitis

    ... of bronchitis: acute and chronic. Most cases of acute bronchitis get better within several days. But your cough ... that cause colds and the flu often cause acute bronchitis. These viruses spread through the air when people ...

  12. Comparison of integrated Chinese and Western medicine with and without somatostatin supplement in the treatment of severe acute pancreatitis

    Qing Xia; Lin Yuan; Xiao-Nan Yang; Wen-Fu Tang; Jun-Ming Jiang

    2005-01-01

    AIM: To evaluate the therapeutic effect of the combined use of early short-term somatostatin and conventional integrated Chinese and Western medicine in treating severe acute pancreatitis.METHODS: Sixty patients with severe acute pancreatitis were divided at random into a somatostatin group and a basic treatment group. Both groups received integrated traditional Chinese and Western medicine without surgery.For patients in the somatostatin group, somatostatin was infused intravenously 250 μg/h for 72 h; other medications were the same as in the basic treatment group. In both groups, comparisons of therapeutic effectiveness were made in terms of morbidity of organic dysfunction and mortality rate, and severity of the disease according to serum levels of C-reaction protein, scores of acute physiology and chronic health evaluation (APACHE Ⅱ), and scores of Balthazar-CT.RESULTS: The indexes for C-reaction protein levels on the fourth and seventh days, and APACHE Ⅱ scores on the seventh day after treatment, were significantly improved in the somatostatin group than in the basic treatment group. The morbidity of organic dysfunction was lower in the somatostatin group than in the basic treatment group, although the difference was not statistically significant. There was no significant difference in mortality between the two groups.CONCLUSION: We conclude that combined traditional Chinese and Western medicines with an early short-term use of somatostatin can improve the condition of patients with severe acute pancreatitis.

  13. Olympic Scoring of English Compositions

    Follman, John; Panther, Edward

    1974-01-01

    Examines empirically the efficacy of utilizing Olympic diving and gymnastic scoring systems for grading graduate students' English compositions. Results indicated that such scoring rules do not produce ratings different in reliability or in level from conventional letter grades. (ED)

  14. Customizing Scoring Functions for Docking

    Pham, Tuan A.; Jain, Ajay N.

    2008-01-01

    Empirical scoring functions used in protein-ligand docking calculations are typically trained on a dataset of complexes with known affinities with the aim of generalizing across different docking applications. We report a novel method of scoring-function optimization that supports the use of additional information to constrain scoring function parameters, which can be used to focus a scoring function’s training towards a particular application, such as screening enrichment. The approach combi...

  15. Credit Scoring Modeling

    Siana Halim

    2014-01-01

    Full Text Available It is generally easier to predict defaults accurately if a large data set (including defaults is available for estimating the prediction model. This puts not only small banks, which tend to have smaller data sets, at disadvantage. It can also pose a problem for large banks that began to collect their own historical data only recently, or banks that recently introduced a new rating system. We used a Bayesian methodology that enables banks with small data sets to improve their default probability. Another advantage of the Bayesian method is that it provides a natural way for dealing with structural differences between a bank’s internal data and additional, external data. In practice, the true scoring function may differ across the data sets, the small internal data set may contain information that is missing in the larger external data set, or the variables in the two data sets are not exactly the same but related. Bayesian method can handle such kind of problem.

  16. Prediction of acute stroke progression by the National Institutes of Health Stroke Scale

    Vinh Phuong; Tran Van Huy

    2007-01-01

    Objective To determine the occurrence of neurological changes during the first 48 hours after acute stroke as it relates to the initial stroke severity assessment. Methods The assessment with the National Institutes of Health Stroke Scale (NIHSS) was performed serially for the first 48 hours on 68 consecutive ischemic stroke patients admitted to the Department of Geriatric Cardiology at the Khanh Hoa Hospital, Nha Trang, Vietnam. Incidence of stroke progression (a ≥ 3-point increase on the NIHSS) was recorded and analysis performed to determine its association with initial stroke severity and other demographic and physiological variables. Deficit resolution by 48 hours, defined as an NIHSS score of 0 or 1, measured the frequency of functional recovery predicted by the initial deficit.Results Overall progression was noted in 28% of events (19/68). Applying Bayes' solution to the observed frequency of worsening, the greatest likelihood of predicting future patient progression occurred with NIHSS score of =7 and >7. Patients with an initial NIHSS score of =7 experienced a 13% (6/47) worsening rate versus those of an initial score of>7 with a 62% (13/21) worsening rate (P<0.01). 42.5%(20/47) of those with an initial score of =7 were functionally normal at 48 hours, whereas only 4.7% (1/21) of those with scores of >7 retnrned to a normal examination within this period (x2, P<0.05). Conclusions This study suggests that the early clinical course of neurological deficit after acute stroke be dependent on the initial stroke severity and that a dichotomy in early outcome exist surrounding an initial NIHSS score of 7. These findings may have significant implications for the design and patient stratification in treatment protocols with respect to primary clinical outcome.

  17. Physiological effects in aromatherapy

    Tapanee Hongratanaworakit

    2004-01-01

    The effects of aromas on humans are divided into physiological and psychological effects. The physiological effect acts directly on the physical organism, the psychological effect acts via the sense of smell or olfactory system, which in turn may cause a physiological effect. This paper reviews on the physiological effects which are used for the evaluation of the effects of aromas. Physiological parameters, i.e. heart rate blood pressure, electrodermal activity, electroencephalogram, slow pot...

  18. Conceptual Learning: Enhancing Student Understanding of Physiology

    Waltz, Micah J.

    Students are leaving undergraduate science programs without the knowledge and skills they are expected to have. This is apparent in professional programs, such as medical and veterinary school, where students do not possess the critical thinking skills necessary to be successful. Physiology is a required discipline for these professional programs and often before, as a pre-requisite. Physiology classrooms are an excellent place to teach critical thinking skills because the content consists of integrated processes. Therefore, in one study, it was investigated whether focusing on physiological concepts improved student understanding of physiology in both a non-physiological science course, Invertebrate Zoology, and in an undergraduate physiology course. An educational intervention was used in Invertebrate Zoology, where students were exposed to human physiology concepts that were similar to comparative physiology concepts they had learned during the semester. A pre-/post-test was used to assess learning gains. In a second study, the use of multimedia file usage was correlated to student exam scores in a physiology course. This was done to see if providing additional study materials that focused on specific concepts improved student understanding, as assessed using exam scores. Overall these studies indicate that encouraging assimilation of new concepts that expand upon material from lecture may help students gain a more complete understanding of a concept. The integration of these concepts into pre-existing conceptual frameworks may serve to teach students valuable critical thinking skills such as evaluation of new ideas within their current understanding and synthesizing the new content with the existing information. Focusing on this type of conceptual learning may enable students to apply content knowledge and think through problems. Additionally, focusing on concepts may enable students to improve their understanding of material without being overwhelmed by

  19. Acute abdomen

    The book first presents the anatomy and physiology of the abdomen and continues with chapters discussing clinical and laboratory aspects and a suitable order of diagnostic examinations with reference to the acute processes, explaining the diagnostic tools: ultrasonography, radiography including angiography and CT, tapping techniques and endoscopy together with their basic principles, examination techniques, and diagnosis. One chapter presents a complete survey of the processes involving the entire abdomen - as e.g. peritonitis, ileus, abdominal trauma, intraperitoneal hemorrage. This chapter profoundly discusses the diagnostics and therapies including emergency measures and surgery. Problems requiring consultation among varous specialists, in internal medicine, gynecology, urology, or pediatrics, are discussed in great detail. Information for the anesthetist is given for cases of emergency. More than one third of the book is devoted to organ-specific information, dicussing the pathogenesis, diagnostics, and therapy of the oesophagus, stomach, large and small intestine, bile ducts, pankreas, liver, spleen, and the abdominal vessels and the abdominal wall. (orig.) With 153 figs., 90 tabs

  20. Prognostic Indicators in Acute Pancreatitis

    2003-01-01

    Several approaches have been used in an attempt to predict the severity and prognosis of attacks of acute pancreatitis. The Ranson and Glasgow criteria include a variety of simple laboratory parameters that are measured on admission and again within 48 h. They are the most widely used indices in clinical practice. The Acute Physiological and Chronic Health Evaluation II system is more complicated, but can be applied to a wide variety of conditions, especially in intensive care settings. The u...

  1. Dead space: the physiology of wasted ventilation.

    Robertson, H Thomas

    2015-06-01

    An elevated physiological dead space, calculated from measurements of arterial CO2 and mixed expired CO2, has proven to be a useful clinical marker of prognosis both for patients with acute respiratory distress syndrome and for patients with severe heart failure. Although a frequently cited explanation for an elevated dead space measurement has been the development of alveolar regions receiving no perfusion, evidence for this mechanism is lacking in both of these disease settings. For the range of physiological abnormalities associated with an increased physiological dead space measurement, increased alveolar ventilation/perfusion ratio (V'A/Q') heterogeneity has been the most important pathophysiological mechanism. Depending on the disease condition, additional mechanisms that can contribute to an elevated physiological dead space measurement include shunt, a substantial increase in overall V'A/Q' ratio, diffusion impairment, and ventilation delivered to unperfused alveolar spaces. PMID:25395032

  2. Development and validation of risk score model for acute myocardial infarction in China:prognostic value thereof for in hospital major adverse cardiac events and evaluation of revascularization%急性冠脉综合征住院风险评分及其对血运重建的评价

    吴小凡; 任芳; 骆景光; 吕树铮; 陈韵岱; 潘伟琪; 宋现涛; 李晶; 刘欣; 王羲之; 张丽洁

    2008-01-01

    Objective To develop a simple risk score model of in-hospital major adverse cardiac events(MACE)including all-cause mortality,new or recurrent myocardial infarction(MI).and evaluate the efficacy about revascularization on patients with different risk.Methods The basic characteristics,diagnosis,therapy,and in-hospital outcomes of 1512 ACS patients from G10bal Registry of Acute Coronary Events(GRACE)study of China were collected to develop a risk score model by multivariable stepwise logistic regression.The goodness-of-fit test and discriminafive power of the final model were assessed respectively.The best cut-off value for the risk score was used to assess the impact of revascularization for ST-elevation Ml(STEMI)and non-ST elevation acute coronary artery syndrome(NSTEACS)on in-hospital outcomes.Results (1)The following 6 independent risk factors accounted for about 92.5%of the prognostic information:age≥80 years(4 points),SBP≤90 mm Hg(6 points),DBP≥90 mm Hg(2points),KiHip Ⅱ(3 points),KillipⅢorⅣ(9 points),cardiac arrest during presentation(4 points),ST-segment elevation(3 points)or depression(5 points)or combination of elevation and depression(4points)on electrocardiogram at presentation.(2)CHIEF risk model was excellent with Hosmer-Lemeshow goodness-of-fit test of 0.673 and c statistics of 0.776.(3)1301 ACS patients previously enrolled in GRACE study were divided into 2 groups with the best cut-0frvalue of 5.5 points.The impact of revascularizafion on the in-hospital MACE of the higber risk subsets was stronger than that of the lower risk subsets both in STEMI[OR(95%CI)=0.32(0.11,0.94),x2=5.39,P=0.02]and NSTEACS[OR(95%CI)=0.32(0.06,0.94),×2=4.17,P=0.04]population.However,beth STEMI(61.7%vs 78.3%,P=0.000)and NSTEACS(42.0%vs 62.3%.P=0.000)patients with the risk scores more than 5.5 points had lower revascularization mtes.Condusion The risk score provides excellent abillty to predict in-hospital death or (re)MI quantitatively and accurately.The patients

  3. Credit Scores and College Investment

    Nicole Simpson; Felicia Ionescu

    2010-01-01

    The private market of student loans has become an important source of college financing in the U.S. Unlike government student loans, the terms on private student loans (i.e., credit limits and interest rates) are based on credit scores We quantify the effects of credit scores on college investment in a heterogeneous life-cycle economy that exhibits a government and private market for student loans. We find that students with higher credit scores invest in more college education. Furthermore, ...

  4. Early warning score predicts acute mortality in stroke patients

    Liljehult, J; Christensen, T

    2015-01-01

    the Copenhagen University Hospital, Nordsjaellands Hospital, Denmark, from May to September 2012 were enrolled in a retrospective cohort study (n = 274). Vital signs were measured immediately after admission and consistently during the hospitalization period. Based on the vital signs, a single...

  5. Confidence scores for prediction models

    Gerds, Thomas Alexander; van de Wiel, MA

    2011-01-01

    distinguish rival prediction models with similar prediction performances. Furthermore, on the subject level a confidence score may provide useful supplementary information for new patients who want to base a medical decision on predicted risk. The ideas are illustrated and discussed using data from cancer...... modelling strategy is applied to different training sets. For each modelling strategy we estimate a confidence score based on the same repeated bootstraps. A new decomposition of the expected Brier score is obtained, as well as the estimates of population average confidence scores. The latter can be used to...

  6. Neuropsychological intervention in the acute phase

    Norup, Anne; Siert, Lars; Mortensen, Erik Lykke

    2013-01-01

    and psycho-educational sessions with a neuropsychologist in the acute care setting. The intervention group completed self-report scales in the acute setting and after the intervention at admission to sub-acute rehabilitation. The control group completed the self-report scales only at admission to sub.......0100.30), but also significantly lower Role Emotional scores (= 2.12 = 0.043, = 0.40). In the sub-acute setting, an analysis of covariance model showed a borderline significant difference between the intervention and the control group on the anxiety scale (= 0.066 = 0.59). Any effects of the acute neuropsychological...

  7. The ability of two scoring systems to predict in-hospital mortality of patients with moderate and severe traumatic brain injuries in a Moroccan intensive care unit

    Hicham Nejmi

    2014-01-01

    Full Text Available Aim of Study: We aim to assess and to compare the predicting power for in-hospital mortality (IHM of the Acute Physiology and Chronic Health Evaluation-II (APACHE-II and the Simplified Acute Physiology Score-II (SAPS-II for traumatic brain injury (TBI. Patients and Methods: This retrospective cohort study was conducted during a period of 2 years and 9 months in a Moroccan intensive care unit. Data were collected during the first 24 h of each admission. The clinical and laboratory parameters were analyzed and used as per each scoring system to calculate the scores. Univariate and multivariate analyses through regression logistic models were performed, to predict IHM after moderate and severe TBIs. Areas under the receiver operating characteristic curves (AUROC, specificities and sensitivities were determined and also compared. Results: A total of 225 patients were enrolled. The observed IHM was 51.5%. The univariate analysis showed that the initial Glasgow coma scale (GCS was lower in nonsurviving patients (mean GCS = 6 than the survivors (mean GCS = 9 with a statistically significant difference (P = 0.0024. The APACHE-II and the SAPS-II of the nonsurviving patients were higher than those of the survivors (respectively 20.4 ± 6.8 and 31.2 ± 13.6 for nonsurvivors vs. 15.7 ± 5.4 and 22.7 ± 10.3 for survivors with a statistically significant difference (P = 0.0032 for APACHE-II and P = 0.0045 for SAPS-II. Multivariate analysis: APACHE-II was superior for predicting IHM (AUROC = 0.92. Conclusion: The APACHE-II is an interesting tool to predict IHM of head injury patients. This is particularly relevant in Morocco, where TBI is a greater public health problem than in many other countries.

  8. Acute Pancreatitis and Pregnancy

    ... Acute Pancreatitis > Acute Pancreatitis and Pregnancy test Acute Pancreatitis and Pregnancy Timothy Gardner, MD Acute pancreatitis is ... of acute pancreatitis in pregnancy. Reasons for Acute Pancreatitis and Pregnancy While acute pancreatitis is responsible for ...

  9. The Machine Scoring of Writing

    McCurry, Doug

    2010-01-01

    This article provides an introduction to the kind of computer software that is used to score student writing in some high stakes testing programs, and that is being promoted as a teaching and learning tool to schools. It sketches the state of play with machines for the scoring of writing, and describes how these machines work and what they do.…

  10. Interpreting Linked Psychomotor Performance Scores

    Looney, Marilyn A.

    2013-01-01

    Given that equating/linking applications are now appearing in kinesiology literature, this article provides an overview of the different types of linked test scores: equated, concordant, and predicted. It also addresses the different types of evidence required to determine whether the scores from two different field tests (measuring the same…

  11. A prospective validation of the HEART score for chest pain patients at the emergency department

    Backus, B. E.; Six, A. J.; Kelder, J. C.; Bosschaert, M. A. R.; Mast, E. G.; Mosterd, A.; Veldkamp, R. F.; Wardeh, A. J.; Tio, R.; Braam, R.; Monnink, S. H. J.; van Tooren, R.; Mast, T. P.; van den Akker, F.; Cramer, M. J. M.; Poldervaart, J. M.; Hoes, A. W.; Doevendans, P. A.

    2013-01-01

    Background: The focus of the diagnostic process in chest pain patients at the emergency department is to identify both low and high risk patients for an acute coronary syndrome (ACS). The HEART score was designed to facilitate this process. This study is a prospective validation of the HEART score.

  12. Acute Biliary Pancreatitis: Diagnosis and Treatment

    Hazem Zakaria

    2009-01-01

    Gallstones are the commonest cause of acute pancreatitis (AP), a potentially life-threatening condition, worldwide. The pathogenesis of acute pancreatitis has not been fully understood. Laboratory and radiological investigations are critical for diagnosis as well prognosis prediction. Scoring systems based on radiological findings and serologic inflammatory markers have been proposed as better predictors of disease severity. Early endoscopic retrograde cholangiopancreatography (ERCP) is benef...

  13. Physiological effects in aromatherapy

    Tapanee Hongratanaworakit

    2004-01-01

    Full Text Available The effects of aromas on humans are divided into physiological and psychological effects. The physiological effect acts directly on the physical organism, the psychological effect acts via the sense of smell or olfactory system, which in turn may cause a physiological effect. This paper reviews on the physiological effects which are used for the evaluation of the effects of aromas. Physiological parameters, i.e. heart rate blood pressure, electrodermal activity, electroencephalogram, slow potential brain waves (contingent negativevariation, and eye blink rate or pupil functions, are used as indices for the measurement of the aroma effects

  14. Bronchitis - acute

    ... sharing features on this page, please enable JavaScript. Acute bronchitis is swelling and inflammation in the main passages ... present only for a short time. Causes When acute bronchitis occurs, it almost always comes after having a ...

  15. Bronchitis - acute

    Acute bronchitis is swelling and inflammation in the main passages that carry air to the lungs. The swelling narrows ... makes it harder to breathe. Another symptom of bronchitis is a cough. Acute means the symptoms have ...

  16. Acute Bronchitis

    Bronchitis is an inflammation of the bronchial tubes, the airways that carry air to your lungs. It ... chest tightness. There are two main types of bronchitis: acute and chronic. Most cases of acute bronchitis ...

  17. Weak Prediction Power of the Framingham Risk Score for Coronary Artery Disease in Nonagenarians

    Josef Yayan

    2014-01-01

    Background Coronary artery disease (CAD) is caused by an acute myocardial infarction and is still feared as a life-threatening heart disease worldwide. In order to identify patients at high risk for CAD, previous studies have proposed various risk assessment scores for the prevention of CAD. The most commonly used risk assessment score for CAD worldwide is the Framingham Risk Score (FRS). The FRS is used for middle-aged people; hence, its appropriateness has not been demonstrated to predict t...

  18. Lessons Learnt in Management of Acute Pancreatitis

    Deshpande Aparna; Velhal Rishikesh; Thanky Harsh; Soman Sundeep; Shah Ritesh

    2008-01-01

    Objective Acute Pancreatitis continues to be a confounding clinical problem and can pose a formidable challenge in its management. This invited review discusses the various clinical studies done while managing cases of acute pancreatitis and the possible avenues for further studies. Method Clinical studies done on various aspects of pancreatitis viz. severity prediction using bedside index of severity in acute pancreatitis score and its validation in Indian patients, current status of interve...

  19. Acute Cholecystitis in Patients with Scrub Typhus

    Lee, Hyun; Ji, Misuk; Hwang, Jeong-Hwan; Lee, Ja-Yeon; Lee, Ju-Hyung; Chung, Kyung Min; Lee, Chang-Seop

    2015-01-01

    Acute cholecystitis is a rare complication of scrub typhus. Although a few such cases have been reported in patients with scrub typhus, the clinical course is not well described. Of 12 patients, acute cholecystitis developed in 66.7% (8/12) of patients older than 60 yr. The scrub typhus group with acute cholecystitis had marginal significant longer hospital stay and higher cost than the group without cholecystitis according to propensity score matching. Scrub typhus should be kept in mind as ...

  20. Acute pancreatitis

    Bo-Guang Fan; Åke Andrén-Sandberg

    2010-01-01

    Background : Acute pancreatitis continues to be a serious illness, and the patients with acute pancreatitis are at risk to develop different complications from ongoing pancreatic inflammation. Aims : The present review is to highlight the classification, treatment and prognosis of acute pancreatitis. Material & Methods : We reviewed the English-language literature (Medline) addressing pancreatitis. Results : Acute pancreatitis is frequently caused by gallstone disease or excess alcohol ingest...

  1. Acute pancreatitis

    Bo-Guang Fan; Åke Andrén-Sandberg

    2010-01-01

    Background: Acute pancreatitis continues to be a serious illness, and the patients with acute pancreatitis are at risk to develop different complications from ongoing pancreatic inflammation. Aims: The present review is to highlight the classification, treatment and prognosis of acute pancreatitis. Material & Methods: We reviewed the English-language literature (Medline) addressing pancreatitis. Results: Acute pancreatitis is frequently caused by gallstone disease or excess alcohol ingestion....

  2. Streptococcal acute pharyngitis

    Lais Martins Moreira Anjos

    2014-07-01

    Full Text Available Acute pharyngitis/tonsillitis, which is characterized by inflammation of the posterior pharynx and tonsils, is a common disease. Several viruses and bacteria can cause acute pharyngitis; however, Streptococcus pyogenes (also known as Lancefield group A β-hemolytic streptococci is the only agent that requires an etiologic diagnosis and specific treatment. S. pyogenes is of major clinical importance because it can trigger post-infection systemic complications, acute rheumatic fever, and post-streptococcal glomerulonephritis. Symptom onset in streptococcal infection is usually abrupt and includes intense sore throat, fever, chills, malaise, headache, tender enlarged anterior cervical lymph nodes, and pharyngeal or tonsillar exudate. Cough, coryza, conjunctivitis, and diarrhea are uncommon, and their presence suggests a viral cause. A diagnosis of pharyngitis is supported by the patient's history and by the physical examination. Throat culture is the gold standard for diagnosing streptococcus pharyngitis. However, it has been underused in public health services because of its low availability and because of the 1- to 2-day delay in obtaining results. Rapid antigen detection tests have been used to detect S. pyogenes directly from throat swabs within minutes. Clinical scoring systems have been developed to predict the risk of S. pyogenes infection. The most commonly used scoring system is the modified Centor score. Acute S. pyogenes pharyngitis is often a self-limiting disease. Penicillins are the first-choice treatment. For patients with penicillin allergy, cephalosporins can be an acceptable alternative, although primary hypersensitivity to cephalosporins can occur. Another drug option is the macrolides. Future perspectives to prevent streptococcal pharyngitis and post-infection systemic complications include the development of an anti-Streptococcus pyogenes vaccine.

  3. Systemic Inflammation Response Syndrome Score Predicts the Mortality in Multiple Trauma Patients

    Baek, Jong Hyun; Kim, Myeong Su; Lee, Jung Cheul; Lee, Jang Hoon

    2014-01-01

    Background Numerous statistical models have been developed to accurately predict outcomes in multiple trauma patients. However, such trauma scoring systems reflect the patient’s physiological condition, which can only be determined to a limited extent, and are difficult to use when performing a rapid initial assessment. We studied the predictive ability of the systemic inflammatory response syndrome (SIRS) score compared to other scoring systems. Methods We retrospectively reviewed 229 patien...

  4. Acute kidney injury in intensive care unit: Incidence, risk factors and mortality rate

    Hamid Reza Samimagham

    2011-01-01

    Full Text Available Acute kidney injury (AKI is a risk factor for increased mortality in critically ill patients. To assess the incidence, risk factors and outcome of patients who develop AKI in the intensive care units (ICUs, we retrospectively studied 235 patients admitted to the ICU of Shahid Mohamadi Hospital, Hormozgan, Iran, and compared those who developed AKI and those who did not. There were 31.1% of patients who developed AKI during ICU admission. There was a significant difference in the mean age, serum sodium (Na, potassium (K, urea, blood urea nitrogen (BUN and creatinine (Cr levels and also platelets, on admission, between patients with and without AKI. Acute physiology and chronic health evaluation (APACHE II score on admission was significantly higher in AKI patients and Glasgow coma scale (GCS was significantly lower. The mortality of AKI patients (72.6% was significantly higher than non-AKI patients (25.91%. The number of underlying diseases and GCS and APACHE II score on admission were significantly different between the expired and survived patients. We conclude that age, first serum K level and APACHE II score on admission time were powerful independent predictors of developing AKI in ICU patients. The GCS on admission and the presence of two or more underlying diseases accurately predict the mortality in AKI positive ICU patients.

  5. Acute pancreatitis

    Bo-Guang Fan

    2010-05-01

    Full Text Available Background: Acute pancreatitis continues to be a serious illness, and the patients with acute pancreatitis are at risk to develop different complications from ongoing pancreatic inflammation. Aims: The present review is to highlight the classification, treatment and prognosis of acute pancreatitis. Material & Methods: We reviewed the English-language literature (Medline addressing pancreatitis. Results: Acute pancreatitis is frequently caused by gallstone disease or excess alcohol ingestion. There are a number of important issues regarding clinical highlights in the classification, treatment and prognosis of acute pancreatitis, and treatment options for complications of acute pancreatitis including pancreatic pseudocysts. Conclusions: Multidisciplinary approach should be used for the management of the patient with acute pancreatitis.

  6. Acute pancreatitis

    Bo-Guang Fan

    2010-01-01

    Full Text Available Background : Acute pancreatitis continues to be a serious illness, and the patients with acute pancreatitis are at risk to develop different complications from ongoing pancreatic inflammation. Aims : The present review is to highlight the classification, treatment and prognosis of acute pancreatitis. Material & Methods : We reviewed the English-language literature (Medline addressing pancreatitis. Results : Acute pancreatitis is frequently caused by gallstone disease or excess alcohol ingestion. There are a number of important issues regarding clinical highlights in the classification, treatment and prognosis of acute pancreatitis, and treatment options for complications of acute pancreatitis including pancreatic pseudocysts. Conclusions : Multidisciplinary approach should be used for the management of the patient with acute pancreatitis.

  7. Bishop score and labor induction

    Radeka Gordana; Novakov-Mikić Aleksandra; Ivanović Ljiljana

    2002-01-01

    Introduction Induction of labor represents initiation of uterine contractions before their spontaneous onset. The aim of the study was to establish the role of Bishop score in prediction of labor induction in routine clinical work. Material and methods The study was a prospective blind, observational one. All patients had a vaginal examination prior to induction, during which Bishop score was evaluated. The mode of induction was either intravenous infusion of oxytocin or endovaginal prostagla...

  8. Stability Scores: Measuring Coalitional Stability

    Feldman, Michal; Meir, Reshef; Tennenholtz, Moshe

    2011-01-01

    We introduce a measure for the level of stability against coalitional deviations, called \\emph{stability scores}, which generalizes widely used notions of stability in non-cooperative games. We use the proposed measure to compare various Nash equilibria in congestion games, and to quantify the effect of game parameters on coalitional stability. For our main results, we apply stability scores to analyze and compare the Generalized Second Price (GSP) and Vickrey-Clarke-Groves (VCG) ad auctions....

  9. From Rasch scores to regression

    Christensen, Karl Bang

    2006-01-01

    Rasch models provide a framework for measurement and modelling latent variables. Having measured a latent variable in a population a comparison of groups will often be of interest. For this purpose the use of observed raw scores will often be inadequate because these lack interval scale propertie....... This paper compares two approaches to group comparison: linear regression models using estimated person locations as outcome variables and latent regression models based on the distribution of the score....

  10. Anatomy of Credit Scoring Models

    Matías Alfredo Gutiérrez Girault

    2008-01-01

    Introduced in the 70´s, the use of credit scoring techniques became widespread in the 90´s thanks to the development of better statistical and computational resources. Nowadays almost all the financial intermediaries use these techniques, at least to originate the credits they grant. Credit scoring models are algorithms that in a mechanical way assess the credit risk of a loan applicant or an existing bank client, by means of statistical, mathematic, econometric or artificial intelligence dev...

  11. Predictors of the outcomes of acute-on-chronic hepatitis B liver failure

    Hsiu-Lung Fan; Po-Sheng Yang; Hui-Wei Chen; Teng-Wei Chen; De-Chuan Chan; Chi-Hong Chu; Jyh-Cherng Yu

    2012-01-01

    AIM:TO identify the risk factors in predicting the outcome of acute-on-chronic hepatitis B liver failure patients.METHODS:We retrospectively divided 113 patients with acute-on-chronic liver failure-hepatitis B virus (ACLF-HBV) and without concurrent hepatitis C or D virus infection and hepatocellular carcinoma into two groups according to their outcomes after anti-HBV therapy.Their demographic,clinical,and biochemical data on the day of diagnosis and after the first week of treatment were analyzed using the Mann-Whitney U test,Fisher's exact test,and a multiple logistic regression analysis.RESULTS:The study included 113 patients (87 men and 26 women) with a mean age of 49.84 years.Fiftytwo patients survived,and 61 patients died.Liver failure (85.2%),sepsis (34.4%),and multiple organ failure (39.3%) were the main causes of death.Multivariate analyses showed that Acute Physiology and Chronic Health Evaluation (APACHE) Ⅱ scores ≥ 12[odds ratio (OR) =7.160,95% CI:2.834-18.092,P <0.001] and positive blood culture (OR =13.520,95%CI:2.740-66.721,P =0.001) on the day of diagnosis and model for end-stage liver disease (MELD) scores ≥ 28 (OR =8.182,95% CI:1.884-35.527,P =0.005)after the first week of treatment were independent predictors of mortality.CONCLUSION:APACHE Ⅱ scores on the day of diagnosis and MELD scores after the first week of anti-HBV therapy are feasible predictors of outcome in ACLF-HBV patients.

  12. Early changes in physiological variables after stroke

    Wong Andrew

    2008-01-01

    Full Text Available Several aspects of physiology, notably blood pressure, body temperature, blood glucose, and blood oxygen saturation, may be altered after an ischemic stroke and intracerebral hemorrhage. Generally, blood pressure and temperature rise acutely after a stroke, before returning to normal. Blood glucose and oxygen levels may be abnormal in individuals, but they do not follow a set pattern. Several aspects of these physiological alterations remain unclear, including their principal determinants - whether they genuinely affect prognosis (as opposed to merely representing underlying processes such as inflammation or a stress response, whether these effects are adaptive or maladaptive, whether the effects are specific to certain subgroups (e.g. lacunar stroke and whether modifying physiology also modifies its prognostic effect. Hypertension and hyperglycemia may be helpful or harmful, depending on the perfusion status after an ischemic stroke; the therapeutic response to their lowering may be correspondingly variable. Hypothermia may provide benefits, in addition to preventing harm through protection from hyperthermia. Hypoxia is harmful, but normobaric hyperoxia is unhelpful or even harmful in normoxic patients. Hyperbaric hyperoxia, however, may be beneficial, though this remains unproven. The above-mentioned uncertainties necessitate generally conservative measures for physiology management, although there are notably specific recommendations for thrombolysis-eligible patients. Stroke unit care is associated with better outcome, possibly through better management of poststroke physiology. Stroke units can also facilitate research to clarify the relationship between physiology and prognosis, and to subsequently clarify management guidelines.

  13. Physiology and clinical significance of natriuretic hormones

    Sandeep Chopra

    2013-01-01

    Full Text Available The natriuretic system consists of the atrial natriuretic peptide (ANP and four other similar peptides including the wrongly named brain natriuretic peptide (BNP. Chemically they are small peptide hormones predominantly secreted by the cardiac myocytes in response to stretching forces. The peptide hormones have multiple renal, hemodynamic, and antiproliferative effects through three different kinds of natriuretic receptors. Clinical interest in these peptide hormones was initially stimulated by the use of these peptides as markers to differentiate cardiac versus noncardiac causes of breathlessness. Subsequently work has been done on using these peptides to prognosticate patients with acute and chronic heart failure and those with acute myocardial infraction. Synthetic forms of both atrial- and brain-natriuretic peptides have been studied and approved for use in acute heart failure with mixed results. This review focuses on the biochemistry and physiology of this fascinating hormone system and the clinical application of these hormones.

  14. Chewing over physiology integration.

    Abdulkader, Fernando; Azevedo-Martins, Anna Karenina; Miranda, Manoel de Arcisio; Brunaldi, Kellen

    2005-03-01

    An important challenge for both students and teachers of physiology is to integrate the different areas in which physiological knowledge is didactically divided. In developing countries, such an issue is even more demanding, because budget restrictions often affect the physiology program with laboratory classes being the first on the list when it comes to cuts in expenses. With the aim of addressing this kind of problem, the graduate students of our department organized a physiology summer course offered to undergraduate students. The objective was to present the different physiological systems in an integrated fashion. The strategy pursued was to plan laboratory classes whose experimental results were the basis for the relevant theoretical discussions. The subject we developed to illustrate physiology integration was the study of factors influencing salivary secretion. PMID:15718383

  15. PHYSIOLOGICAL RESPONSES AND MOOD STATES AFTER DAILY REPEATED PROLONGED EXERCISE

    Ilkka Väänänen

    2004-10-01

    sympathoadrenal stress. The acute increasing effect of a single walking session on cortisol was seen only after the first day when there was a 60% increase. Responses after skiing were greater (2.2- and 2.6-fold. The acute reductions in testosterone concentrations were seen after the first two marching sessions, when they were decreased by 18-22%. LH concentration was decreased by 31-44% after the second and third day. For FSH concentrations suppression was consistently seen after the second march, but not after skiing. The total mood disturbance score remained unchanged during the events. The Fatigue-Inertia affective state was higher after exercise than before the events. This study demonstrates that the pituitary-gonadal axis, excluding the secretion of FSH and the adrenal cortex, adapted to four days of repeated moderate 8 h walking, but not to two days of repeated strenuous 3 h skiing. However, when using the sensitive IFMA, which can detect low concentrations of gonadotropins, secretion of FSH was seen to remain reduced and no adaptation was seen in walking. This study indicated that daily repeated long lasting acute but non-competitive walk and skiing of intensity at approximately 60-90% of the maximum heart rate is well within the physiological capabilities of individuals with good aerobic capacity.

  16. Risk score for contrast induced nephropathy following percutaneous coronary intervention

    Contrast-induced nephropathy (CIN) is an important cause of acute renal failure. Identification of risk factors of CIN and creating a simple risk scoring for CIN after percutaneous coronary intervention (PCI) is important. A prospective single center study was conducted in Kuwait chest disease hospital. All patients admitted to chest disease hospital for PCI from March to May 2005 were included in the study. Total of 247 patients were randomly assigned for the development dataset and 100 for the validation set using the simple random method. The overall occurrence of CIN in the development set was 5.52%. Using multivariate analysis; basal Serum creatinine, shock, female gender, multivessel PCI, and diabetes mellitus were identified as risk factors. Scores assigned to different variables yielded basal creatinine > 115 micron mol/L with the highest score(7), followed by shock (3), female gender, multivessel PCI and diabetes mellitus had the same score (2). Patients were further risk stratified into low risk score (12). The developed CIN model demonstrated good discriminative power in the validation population. In conclusion, use of a simple risk score for CIN can predict the probability of CIN after PCI; this however needs further validation in larger multicenter trials. (author)

  17. Ligand Identification Scoring Algorithm (LISA)

    Zheng, Zheng; Merz, Kenneth M.

    2011-01-01

    A central problem in de novo drug design is determining the binding affinity of a ligand with a receptor. A new scoring algorithm is presented that estimates the binding affinity of a protein-ligand complex given a three-dimensional structure. The method, LISA (Ligand Identification Scoring Algorithm), uses an empirical scoring function to describe the binding free energy. Interaction terms have been designed to account for van der Waals (VDW) contacts, hydrogen bonding, desolvation effects and metal chelation to model the dissociation equilibrium constants using a linear model. Atom types have been introduced to differentiate the parameters for VDW, H-bonding interactions and metal chelation between different atom pairs. A training set of 492 protein-ligand complexes was selected for the fitting process. Different test sets have been examined to evaluate its ability to predict experimentally measured binding affinities. By comparing with other well known scoring functions, the results show that LISA has advantages over many existing scoring functions in simulating protein-ligand binding affinity, especially metalloprotein-ligand binding affinity. Artificial Neural Network (ANN) was also used in order to demonstrate that the energy terms in LISA are well designed and do not require extra cross terms. PMID:21561101

  18. Advances in physiological computing

    Fairclough, Stephen H

    2014-01-01

    This edited collection will provide an overview of the field of physiological computing, i.e. the use of physiological signals as input for computer control. It will cover a breadth of current research, from brain-computer interfaces to telemedicine.

  19. Phun Week: Understanding Physiology

    Limson, Mel; Matyas, Marsha Lakes

    2009-01-01

    Topics such as sports, exercise, health, and nutrition can make the science of physiology relevant and engaging for students. In addition, many lessons on these topics, such as those on the cardiovascular, respiratory, and digestive systems, align with national and state life science education standards. Physiology Understanding Week (PhUn…

  20. Reproduction, Physiology and Biochemistry

    This chapter focuses on the reproduction, physiology, and biochemistry of the root-knot nematodes. The extensive amount of information on the reproduction and cytogenetics of species of Meloidogyne contrasts with the limited information on physiology, biochemistry, and biochemical pathways. In commo...

  1. Interpreting Force Concept Inventory Scores: Normalized Gain and SAT Scores

    Coletta, Vincent P.; Phillips, Jeffrey A.; Steinert, Jeffrey J.

    2007-01-01

    Preinstruction SAT scores and normalized gains (G) on the force concept inventory (FCI) were examined for individual students in interactive engagement (IE) courses in introductory mechanics at one high school (N=335) and one university (N=292), and strong, positive correlations were found for both populations (r=0.57 and r=0.46, respectively).…

  2. Evaluation of severity by whole body CT in acute pancreatitis

    Evaluation of severity in acute pancreatitis is still controversial. We studied about thirteen cases of acute pancreatitis and calculated CT score using findings of early whole body CT scanning within forty eight hours after initial symptoms. Simultaneously we calculated clinical score too. CT score was constituted by ten points (changes limitted in pancreas itself, extension of inflammation and extrapancreatic fluid collection etc.). And clinical score was constituted by eight clinical symptoms and fourteen laboratory findings in fatal pancreatitis reported in Japan. From these studies, we conclude that early CT scanning is more useful for objective determination of severity and therapy (surgical or medical) in acute pancreatitis than clinical findings. So we made new classification of severity in acute pancreatitis by CT score as follows: severe (6=: medical therapy). (author)

  3. A Bootstrap Procedure of Propensity Score Estimation

    Bai, Haiyan

    2013-01-01

    Propensity score estimation plays a fundamental role in propensity score matching for reducing group selection bias in observational data. To increase the accuracy of propensity score estimation, the author developed a bootstrap propensity score. The commonly used propensity score matching methods: nearest neighbor matching, caliper matching, and…

  4. Acute Cholecystitis in Patients with Scrub Typhus.

    Lee, Hyun; Ji, Misuk; Hwang, Jeong-Hwan; Lee, Ja-Yeon; Lee, Ju-Hyung; Chung, Kyung Min; Lee, Chang-Seop

    2015-11-01

    Acute cholecystitis is a rare complication of scrub typhus. Although a few such cases have been reported in patients with scrub typhus, the clinical course is not well described. Of 12 patients, acute cholecystitis developed in 66.7% (8/12) of patients older than 60 yr. The scrub typhus group with acute cholecystitis had marginal significant longer hospital stay and higher cost than the group without cholecystitis according to propensity score matching. Scrub typhus should be kept in mind as a rare etiology of acute cholecystitis in endemic areas because the typical signs of scrub typhus such as skin rash and eschar can present after the abdominal pain. PMID:26539017

  5. Neuropsychological intervention in the acute phase

    Norup, Anne; Siert, Lars; Mortensen, Erik Lykke

    2013-01-01

    consisted of supportive and psycho-educational sessions with a neuropsychologist in the acute care setting. The intervention group completed selfreport scales in the acute setting and after the intervention at admission to sub-acute rehabilitation. The control group completed the self-report scales only......-acute setting (t = 2.70, p = 0.010, d = 0.30), but also significantly lower Role Emotional scores (t = 2.12, p = 0.043, d = 0.40). In the subacute setting, an analysis of covariance model showed a borderline significant difference between the intervention and the control group on the anxiety scale (p = 0.066, d...

  6. Skin scoring in systemic sclerosis

    Zachariae, Hugh; Bjerring, Peter; Halkier-Sørensen, Lars; Heickendorff, Lene; Søndergaard, Klaus

    1994-01-01

    Forty-one patients with systemic sclerosis were investigated with a new and simple skin score method measuring the degree of thickening and pliability in seven regions together with area involvement in each region. The highest values were, as expected, found in diffuse cutaneous systemic sclerosis...... (type III SS) and the lowest in limited cutaneous systemic sclerosis (type I SS) with no lesions extending above wrists and ancles. A positive correlation was found to the aminoterminal propeptide of type III procollagen, a serological marker for synthesis of type III collagen. The skin score is...

  7. Sodium balance-an integrated physiological model and novel approach

    Patel Santosh

    2009-01-01

    Various physiological mechanisms regulate sodium and water balance in the human body. These processes achieve acute and chronic sodium regulation and the simultaneous or se-quential changes can be explained using a single physiological model. Steady intracellular water and osmolality is necessary for cell membrane integrity and cellular processes. Body fluids protect circulatory blood volume by altering Na + and water balance. This is the most vital homeostatic function of the body. C...

  8. THE ROLE OF NATIONAL EARLY WARNING SCORE (NEWS IN MEDICAL EMERGENCY - PATIENTS IN INDIAN SCENARIO: A PROSPECTIVE OBSERVATIONAL STUDY

    Vanamali

    2014-03-01

    Full Text Available INTRODUCTION: The national early warning score is a simple physiological scoring system Suitable for evaluating patients in catastrophic deterioration in busy clinical area and to take timely interventions. MATERIALS AND METHODS: A total of 150 medical emergency patients were prospectively studied. NEWS was recorded daily in all patients. Primary end points were ICU admissions and death. RESULTS: In 37% patients score not changed, in 57% score was improved, 28% patients reached primary end points. In them 81% shifted to ICU, 19% died. In 38 patients score was 0. P value was <0.0001. CONCLUSION: National Early Warning Score (NEWS is a useful simple physiological scoring system for assessment and risk management of medical emergency admissions.

  9. Discrepancy Between Clinician and Research Assistant in TIMI Score Calculation (TRIAGED CPU

    Taylor, Brian T.

    2014-11-01

    Full Text Available Introduction: Several studies have attempted to demonstrate that the Thrombolysis in Myocardial Infarction (TIMI risk score has the ability to risk stratify emergency department (ED patients with potential acute coronary syndromes (ACS. Most of the studies we reviewed relied on trained research investigators to determine TIMI risk scores rather than ED providers functioning in their normal work capacity. We assessed whether TIMI risk scores obtained by ED providers in the setting of a busy ED differed from those obtained by trained research investigators. Methods: This was an ED-based prospective observational cohort study comparing TIMI scores obtained by 49 ED providers admitting patients to an ED chest pain unit (CPU to scores generated by a team of trained research investigators. We examined provider type, patient gender, and TIMI elements for their effects on TIMI risk score discrepancy. Results: Of the 501 adult patients enrolled in the study, 29.3% of TIMI risk scores determined by ED providers and trained research investigators were generated using identical TIMI risk score variables. In our low-risk population the majority of TIMI risk score differences were small; however, 12% of TIMI risk scores differed by two or more points. Conclusion: TIMI risk scores determined by ED providers in the setting of a busy ED frequently differ from scores generated by trained research investigators who complete them while not under the same pressure of an ED provider. [West J Emerg Med. 2015;16(1:24–33.

  10. LSAT Scores of Economics Majors.

    Nieswiadomy, Michael

    1998-01-01

    Argues that economics education provides many benefits to students, including preparation for law school. Examines the ranking of economics majors on the Law School Admission Test (LSAT). Finds that among the 14 majors having more than 2,000 students take the LSAT, economics students received the highest average score. (DSK)

  11. The persistence of depression score

    Spijker, J.; de Graaf, R.; Ormel, J.; Nolen, W. A.; Grobbee, D. E.; Burger, H.

    2006-01-01

    Objective: To construct a score that allows prediction of major depressive episode (MDE) persistence in individuals with MDE using determinants of persistence identified in previous research. Method: Data were derived from 250 subjects from the general population with new MDE according to DSM-III-R.

  12. The Relationship of Depression to Work Status during the Acute Period of Low Back Pain.

    Beaudet, Joanne; Rasch, John

    1988-01-01

    Investigated relationship of Beck Depression Inventory (BDI) scores to employment status and time since injury among persons with acute low back pain. Work status was unrelated to BDI scores. Participants 5 to 6 months post-injury scored higher than participants l month post-injury; participants working 5 to 6 months post-injury scored higher than…

  13. Bishop score and labor induction

    Radeka Gordana

    2002-01-01

    Full Text Available Introduction Induction of labor represents initiation of uterine contractions before their spontaneous onset. The aim of the study was to establish the role of Bishop score in prediction of labor induction in routine clinical work. Material and methods The study was a prospective blind, observational one. All patients had a vaginal examination prior to induction, during which Bishop score was evaluated. The mode of induction was either intravenous infusion of oxytocin or endovaginal prostaglandins. The induction was considered successful if vaginal delivery took place within 24 hours from the onset of induction. Results There were 100 patients, and induction was successful in 74% and unsuccessful in 26%. Mean Bishop score in group A was 5.65 (SD 1.40, 95% CI 5.27 - 6.03, and in group B 4.15 (SD 1.04, 95% CI 3.66 - 4.63 (p < 0.01. Statistical analysis of the area under the ROC curve showed that Bishop score is a good and reliable predictor of the outcome of labor induction (0.816, 95% CI od 0.710 - 0.896, with the best statistical performances at the cut-off value of 5 (sensitivity 65.5% specificity 95%, PPV 97.3%, NPV 50%. Conclusion In our study Bishop score proved to be a reliable and good method for prediction of the outcome of pregnancy if a single, experienced operator evaluates it, with best statistical performances at the cut-off value more than 5 (sensitivity 65.5%, specificity 95%, PPV 97.3%, NPV 50%. The next step would be introduction of more operators, of different skills and experience and subsequent further testing of the method in different conditions.

  14. Initial dosing regimen of vancomycin to achieve early therapeutic plasma concentration in critically ill patients with MRSA infection based on APACHE II score.

    Imaura, Masaharu; Yokoyama, Haruko; Kohata, Yuji; Kanai, Riichiro; Kohyama, Tomoki; Idemitsu, Wataru; Maki, Yuichi; Igarashi, Takashi; Takahashi, Hiroyuki; Kanno, Hiroshi; Yamada, Yasuhiko

    2016-06-01

    It is essential to assure the efficacy of antimicrobials at the initial phase of therapy. However, increasing the volume of distribution (Vd) of hydrophilic antimicrobials in critically ill patients leads to reduced antimicrobial concentration in plasma and tissue, which may adversely affect the efficacy of that therapy. The aim of the present study was to establish a theoretical methodology for setting an appropriate level for initial vancomycin therapy in individual patients based on Acute Physiology and Chronic Health Evaluation (APACHE) II score. We obtained data from patients who received intravenous vancomycin for a suspected or definitively diagnosed Gram-positive bacterial infection within 72 h after admission to the intensive care unit. The Vd and elimination half-life (t 1/2) of vancomycin values were calculated using the Bayesian method, and we investigated the relationship between them and APACHE II score. There were significant correlations between APACHE II scores and Vd/actual body weight (ABW), as well as t 1/2 (r = 0.58, p < 0.05 and r = 0.74, p < 0.01, respectively). Our results suggested that the Vd and t 1/2 of vancomycin could be estimated using the following regression equations using APACHE II score.[Formula: see text] [Formula: see text]We found that APACHE II score was a useful index for predicting the Vd and t 1/2 of vancomycin, and used that to establish an initial vancomycin dosing regimen comprised of initial dose and administration interval for individual patients. PMID:25502612

  15. The Physiologically Difficult Airway

    Jarrod M. Mosier

    2015-12-01

    Full Text Available Airway management in critically ill patients involves the identification and management of the potentially difficult airway in order to avoid untoward complications. This focus on difficult airway management has traditionally referred to identifying anatomic characteristics of the patient that make either visualizing the glottic opening or placement of the tracheal tube through the vocal cords difficult. This paper will describe the physiologically difficult airway, in which physiologic derangements of the patient increase the risk of cardiovascular collapse from airway management. The four physiologically difficult airways described include hypoxemia, hypotension, severe metabolic acidosis, and right ventricular failure. The emergency physician should account for these physiologic derangements with airway management in critically ill patients regardless of the predicted anatomic difficulty of the intubation.

  16. Reproduction, physiology and biochemistry

    This chapter summarizes fundamental knowledge and recent discoveries about the reproduction, physiology and biochemistry of plant-parasitic nematodes. Various types of reproduction are reviewed, including sexual reproduction and mitotic and meiotic parthenogenesis. Although much is known about the p...

  17. Renal Physiology of Pregnancy

    Cheung, Katharine L.; Lafayette, Richard A.

    2013-01-01

    Pregnancy involves remarkable orchestration of physiologic changes. The kidneys are central players in the evolving hormonal milieu of pregnancy, responding and contributing to the changes in the environment for the pregnant woman and fetus. The functional impact of pregnancy on kidney physiology is widespread, involving practically all aspects of kidney function. The glomerular filtration rate increases 50% with subsequent decrease in serum creatinine, urea, and uric acid values. The thresho...

  18. Stroke scale score and early prediction of outcome after stroke

    Objective: To evaluate the baseline National Institute of Health Stroke Scale (NIHSS) score as a predictor of functional outcome after ischemic stroke. Subjects and Methods: The study included 50 patients who presented to Civil Hospital, Karachi, during the study period with acute stroke and were evaluated with CT scan of brain. Only those patients were enrolled in the study that had acute ischemic stroke. The enrolled subjects were then evaluated for the neurological impairment using National Institute of Health Stroke Scale (NIHSS). The subjects were followed-up and their functional outcome was assessed using Barthel index (BI) on the 7th day of their admission. Results: Of the fifty patients enrolled in the study, 31 (62%) were males and 19 (38%) were females, with age ranging from 45 years to 95 years and a mean age of 59.9 years. Neurological impairment at presentation was assessed by NIHSS. The score ranged between 2 and 28. The functional outcome was evaluated on the 7th day using Barthel index (BI), which ranged from 0 to 80. NIHSS score was found to be a good predictor of functional outcome in patients with ischemic stroke (p<0.001). Other factors like gender, hypertension and heart disease did not affect the functional recovery in such patients. Various factors were found to be significant for early prediction of stroke recovery. The NIHSS score was the strongest predictor of outcome after ischemic stroke. Age at the time of the event was also found to be an important predictor for stroke recovery. Conclusion: The NIHSS score is a good predictor of patient's recovery after stroke. Assessing the patient's neurological impairment at first presentation of ischemic stroke can guide the physician regarding the prognosis and management plan. (author)

  19. Peer Teaching to Foster Learning in Physiology

    Srivastava, Tripti K; Waghmare, Lalitbhushan S.; Mishra, Ved Prakash; Rawekar, Alka T; Quazi, Nazli; Jagzape, Arunita T

    2015-01-01

    Introduction Peer teaching is an effective tool to promote learning and retention of knowledge. By preparing to teach, students are encouraged to construct their own learning program, so that they can explain effectively to fellow learners. Peer teaching is introduced in present study to foster learning and pedagogical skills amongst first year medical under-graduates in physiology with a Hypothesis that teaching is linked to learning on part of the teacher. Materials and Methods Non-randomized, Interventional study, with mixed methods design. Cases experienced peer teaching whereas controls underwent tutorials for four consecutive classes. Quantitative Evaluation was done through pre/post test score analysis for Class average normalized gain and tests of significance, difference in average score in surprise class test after one month and percentage of responses in closed ended items of feedback questionnaire. Qualitative Evaluation was done through categorization of open ended items and coding of reflective statements. Results The average pre and post test score was statistically significant within cases (p = 0.01) and controls (p = 0.023). The average post test scores was more for cases though not statistically significant. The class average normalized gain (g) for Tutorials was 49% and for peer teaching 53%. Surprise test had average scoring of 36 marks (out of 50) for controls and 41 marks for cases. Analysed section wise, the average score was better for Long answer question (LAQ) in cases. Section wise analysis suggested that through peer teaching, retention was better for descriptive answers as LAQ has better average score in cases. Feedback responses were predominantly positive for efficacy of peer teaching as a learning method. The reflective statements were sorted into reflection in action, reflection on action, claiming evidence, describing experience, and recognizing discrepancies. Conclusion Teaching can stimulate further learning as it involves

  20. Evaluation of the POSSUM, P-POSSUM and E-PASS scores in the surgical treatment of hilar cholangiocarcinoma

    Wang, Hui; Wang, Haolu; Tao CHEN; Liang, Xiaowen; Song, Yanyan; Wang, Jian

    2014-01-01

    Background The Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity (POSSUM) model, its Portsmouth (P-POSSUM) modification and the Estimation of physiologic ability and surgical stress (E-PASS) are three surgical risk scoring systems used extensively to predict postoperative morbidity and mortality in general surgery. The aim was to undertake the first study of the predictive value of these models in patients undergoing surgical treatment of hilar cholangi...

  1. Risk of acute exacerbation of interstitial pneumonia after pulmonary resection for lung cancer in patients with idiopathic pulmonary fibrosis based on preoperative high-resolution computed tomography

    In patients with lung cancer accompanied by idiopathic pulmonary fibrosis (IPF), acute exacerbation of the IPF often occurs after pulmonary resection; however, few studies have been done to identify its preexisting risk factors. We analyzed the high-resolution computed tomography (HRCT) findings of IPF to identify the radiological characteristics of IPF susceptible to acute exacerbation after lung cancer surgery. We reviewed retrospectively 28 lung cancer patients with IPF who underwent pulmonary resection. Clinical data, respiratory function, HRCT findings, and historical features were compared between the acute exacerbation (n=9) and nonexacerbation (n=19) groups. The classification of radiological findings of IPF on HRCT was done using a scoring system of seven factors related to the interstitial shadow, including fibrosis, ground-glass opacity, and low-attenuation area. There were no significant differences in clinical background, respiratory function, composite physiologic index, or pathological features between the groups; however, the degree of fibrosis on preoperative HRCT was significantly higher in the exacerbation group (P<0.003). The fibrosis score was higher on the opposite side to the lung cancer in the exacerbation group (P<0.05). Although it is difficult to predict postoperative acute IPF exacerbation, the degree and laterality of co-existing fibrosis seem to be predictors. (author)

  2. Validating the effectiveness of Clinically Oriented Physiology Teaching (COPT in undergraduate physiology curriculum

    Ramnarayan Komattil

    2008-07-01

    Full Text Available Abstract Background It has been proved that basic science knowledge learned in the context of a clinical case is actually better comprehended and more easily applied by medical students than basic science knowledge learned in isolation. The present study intended to validate the effectiveness of Clinically Oriented Physiology Teaching (COPT in undergraduate medical curriculum at Melaka Manipal Medical College (Manipal Campus, Manipal, India. Methods COPT was a teaching strategy wherein, students were taught physiology using cases and critical thinking questions. Three batches of undergraduate medical students (n = 434 served as the experimental groups to whom COPT was incorporated in the third block (teaching unit of Physiology curriculum and one batch (n = 149 served as the control group to whom COPT was not incorporated. The experimental group of students were trained to answer clinically oriented questions whereas the control group of students were not trained. Both the group of students undertook a block exam which consisted of clinically oriented questions and recall questions, at the end of each block. Results Comparison of pre-COPT and post-COPT essay exam scores of experimental group of students revealed that the post-COPT scores were significantly higher compared to the pre-COPT scores. Comparison of post-COPT essay exam scores of the experimental group and control group of students revealed that the experimental group of students performed better compared to the control group. Feedback from the students indicated that they preferred COPT to didactic lectures. Conclusion The study supports the fact that assessment and teaching patterns should fall in line with each other as proved by the better performance of the experimental group of students compared to the control group. COPT was also found to be a useful adjunct to didactic lectures in teaching physiology.

  3. Glutamine Attenuates Acute Lung Injury Caused by Acid Aspiration

    Chih-Cheng Lai

    2014-08-01

    Full Text Available Inadequate ventilator settings may cause overwhelming inflammatory responses associated with ventilator-induced lung injury (VILI in patients with acute respiratory distress syndrome (ARDS. Here, we examined potential benefits of glutamine (GLN on a two-hit model for VILI after acid aspiration-induced lung injury in rats. Rats were intratracheally challenged with hydrochloric acid as a first hit to induce lung inflammation, then randomly received intravenous GLN or lactated Ringer’s solution (vehicle control thirty min before different ventilator strategies. Rats were then randomized to receive mechanical ventilation as a second hit with a high tidal volume (TV of 15 mL/kg and zero positive end-expiratory pressure (PEEP or a low TV of 6 mL/kg with PEEP of 5 cm H2O. We evaluated lung oxygenation, inflammation, mechanics, and histology. After ventilator use for 4 h, high TV resulted in greater lung injury physiologic and biologic indices. Compared with vehicle treated rats, GLN administration attenuated lung injury, with improved oxygenation and static compliance, and decreased respiratory elastance, lung edema, extended lung destruction (lung injury scores and lung histology, neutrophil recruitment in the lung, and cytokine production. Thus, GLN administration improved the physiologic and biologic profiles of this experimental model of VILI based on the two-hit theory.

  4. Team Performance with Test Scores

    Kleinberg, Jon; Raghu, Maithra

    2015-01-01

    Team performance is a ubiquitous area of inquiry in the social sciences, and it motivates the problem of team selection -- choosing the members of a team for maximum performance. Influential work of Hong and Page has argued that testing individuals in isolation and then assembling the highest-scoring ones into a team is not an effective method for team selection. For a broad class of performance measures, based on the expected maximum of random variables representing individual candidates, we...

  5. Assessing the need for hospital admission by the Cape Triage discriminator presentations and the simple clinical score.

    Emmanuel, Andrew

    2010-11-01

    There is uncertainty about how to assess unselected acutely ill medical patients at the time of their admission to hospital. This study examined the use of the Simple Clinical Score (SCS) and the medically relevant Cape Triage discriminator clinical presentations to determine the need for admission to an acute medical unit.

  6. Interpreting force concept inventory scores: Normalized gain and SAT scores

    Jeffrey J. Steinert

    2007-05-01

    Full Text Available Preinstruction SAT scores and normalized gains (G on the force concept inventory (FCI were examined for individual students in interactive engagement (IE courses in introductory mechanics at one high school (N=335 and one university (N=292 , and strong, positive correlations were found for both populations ( r=0.57 and r=0.46 , respectively. These correlations are likely due to the importance of cognitive skills and abstract reasoning in learning physics. The larger correlation coefficient for the high school population may be a result of the much shorter time interval between taking the SAT and studying mechanics, because the SAT may provide a more current measure of abilities when high school students begin the study of mechanics than it does for college students, who begin mechanics years after the test is taken. In prior research a strong correlation between FCI G and scores on Lawson’s Classroom Test of Scientific Reasoning for students from the same two schools was observed. Our results suggest that, when interpreting class average normalized FCI gains and comparing different classes, it is important to take into account the variation of students’ cognitive skills, as measured either by the SAT or by Lawson’s test. While Lawson’s test is not commonly given to students in most introductory mechanics courses, SAT scores provide a readily available alternative means of taking account of students’ reasoning abilities. Knowing the students’ cognitive level before instruction also allows one to alter instruction or to use an intervention designed to improve students’ cognitive level.

  7. Interpreting force concept inventory scores: Normalized gain and SAT scores

    Coletta, Vincent P.; Phillips, Jeffrey A.; Steinert, Jeffrey J.

    2007-06-01

    Preinstruction SAT scores and normalized gains (G) on the force concept inventory (FCI) were examined for individual students in interactive engagement (IE) courses in introductory mechanics at one high school (N=335) and one university (N=292) , and strong, positive correlations were found for both populations ( r=0.57 and r=0.46 , respectively). These correlations are likely due to the importance of cognitive skills and abstract reasoning in learning physics. The larger correlation coefficient for the high school population may be a result of the much shorter time interval between taking the SAT and studying mechanics, because the SAT may provide a more current measure of abilities when high school students begin the study of mechanics than it does for college students, who begin mechanics years after the test is taken. In prior research a strong correlation between FCI G and scores on Lawson’s Classroom Test of Scientific Reasoning for students from the same two schools was observed. Our results suggest that, when interpreting class average normalized FCI gains and comparing different classes, it is important to take into account the variation of students’ cognitive skills, as measured either by the SAT or by Lawson’s test. While Lawson’s test is not commonly given to students in most introductory mechanics courses, SAT scores provide a readily available alternative means of taking account of students’ reasoning abilities. Knowing the students’ cognitive level before instruction also allows one to alter instruction or to use an intervention designed to improve students’ cognitive level.

  8. Luminal lactate in acute pancreatitis - validation and relation to disease severity

    Pynnönen Lauri

    2012-04-01

    Full Text Available Abstract Background Increased rectal luminal lactate concentration may be associated with the severity of the septic shock and high dose of vasopressors. It suggests hypoperfusion of the gut mucosa. This is potentially associated with bacterial translocation from the gut leading to local and systemic inflammation. In acute pancreatitis (AP bacterial translocation is considered as the key event leading to infection of necrotic pancreatic tissue and high severity of illness. Methods We used rectal luminal equilibration dialysis for the measurement of gut luminal lactate in 30 consecutive patients admitted to hospital due to acute pancreatitis to test the hypothesis that a single measurement of rectal luminal lactate predicts the severity of acute pancreatitis, the length of hospital stay, the need of intensive care and ultimately, mortality. We also tested the physiological validity of luminal lactate concentration by comparing it to luminal partial tension of oxygen. Additionally, a comparison between two different L-lactate analyzers was performed. Results High rectal luminal lactate was associated with low mucosal partial tension of oxygen (R = 0.57, p = 0.005 thereby indicating the physiological validity of the method. Rectal luminal lactate at the hospital admission was not associated with the first day or the highest SOFA score, CRP level, hospital length of stay, length of stay in intensive care or mortality. In this cohort of unselected consecutive patients with acute pancreatitis we observed a tendency of increased rectal lactate in the severe cases. Low precision and high bias was observed between two lactate analyzers. Conclusions The association between rectal luminal lactate and oxygen tension indicates that luminal lactate is a marker mucosal anaerobiosis. Comparison between two different analyzers showed poor, non-constant precision over the range of lactate concentrations. Rectal luminal lactate concentration at the time of

  9. The HEART score for chest pain patients

    Backus, B.E.

    2012-01-01

    The HEART score was developed to improve risk stratification in chest pain patients in the emergency department (ED). This thesis describes series of validation studies of the HEART score and sub studies for individual elements of the score. The predictive value of the HEART score for the occurrence

  10. Acute pancreatitis

    ... page: //medlineplus.gov/ency/article/000287.htm Acute pancreatitis To use the sharing features on this page, ... fatty foods after the attack has improved. Outlook (Prognosis) Most cases go away in a week. However, ...

  11. Acute Pericarditis

    ... Sugar Control Helps Fight Diabetic Eye Disease Are 'Workaholics' Prone to OCD, Anxiety? ALL NEWS > Resources First ... cancer, or heart surgery, the fluid is blood. Causes Acute pericarditis usually results from infection or other ...

  12. Choroidal physiology and primary angle closure disease.

    Zhang, Xiulan; Wang, Wei; Aung, Tin; Jonas, Jost B; Wang, Ningli

    2015-01-01

    Primary angle closure disease (PACD), prevalent in Asian countries, is generally associated with a shallower anterior chamber, a shorter axial length, thicker lens, hyperopia, and female sex. Other physiologic factors, however, may be important, especially with regard to triggering acute primary angle closure. Thickening of the choroid has been demonstrated in untreated and treated, acute and chronic PACD eyes. Recently, there has been growing interest in studying the role of the choroid in the pathophysiology of PACD. The emergence of new imaging technology such as the enhanced depth imaging mode of spectral-domain optical coherence tomography and swept-source optical coherence tomography has contributed to understanding PACD pathologies. We summarize the functions of the choroid and choroidal changes in the pathogenesis of PACD, and discuss potential future developments. PMID:26164737

  13. Acute dyspnea

    Radiodiagnosis is applied to determine the causes of acute dyspnea. Acute dyspnea is shown to aggravate the course of pulmonary diseases (bronchial asthma, obstructive bronchitis, pulmonary edema, throboembolism of pulmonary arteries etc) and cardiovascular diseases (desiseas of myocardium). The main tasks of radiodiagnosis are to determine volume and state of the lungs, localization and type of pulmonary injuries, to verify heart disease and to reveal concomitant complications

  14. Bronchitis (acute)

    Wark, Peter

    2008-01-01

    Acute bronchitis, with transient inflammation of the trachea and major bronchi, affects over 40/1000 adults a year in the UK. The causes are usually considered to be infective, but only around half of people have identifiable pathogens.The role of smoking or environmental tobacco smoke inhalation in predisposing to acute bronchitis is unclear.A third of people may have longer-term symptoms or recurrence.

  15. Significance of CT severity index in acute pancreatitis

    Hwang, Ho; Ahn, In Oak; Kim, Young Mi; Na, Jae Boem; Chung, Sung Hoon; You, Jin Jong [Gyeongsang National Univ. College of Medicine, Chinju (Korea, Republic of); Jun, Se June [Inchon Christian Hospital, Inchon (Korea, Republic of); Song, Ik Hoon [Masan Samsung Hospital, Masan (Korea, Republic of)

    1997-02-01

    To assess the usefulness of a CT severity index(CTSI) for the evaluation of acute pancreatitis and to correlate it with clinical findings. We retrospectively evaluated contrast enhanced CT in 34 patients with acute pancreatitis. They were categorized into low-score(0-2), middle-socre(3-6), and high-score(7-10) groups according to CTSI points, and those groups were correlated with duration of fasting period, days in hospital morbidity and mortality. We attempted to determine the differences in CTSI between pancreatitis caused by alcohol and by biliary tract disease. Of 34 patients, 11 were placed in the low-score group, 19 in the middle-score group, and 4 in the high-score group. The patients in the middle-score group experienced longer fasting period and stayed longer in hospital than those in the low-score group(p < .05 and p= .08, respectively). Morbidity was 0% in the low-score group, 37% in the middle-score group and 50% in the high-score group. Mortality occurred in two patients in high-score group, only. Alcohol-induced pancreatitis generally showed a higher CTSI and more severe clinical course than pancreatitis caused by biliary tract disease. In the evaluation of acute pancreatitis, CTSI can be a useful predictor of its prognosis.

  16. Significance of CT severity index in acute pancreatitis

    To assess the usefulness of a CT severity index(CTSI) for the evaluation of acute pancreatitis and to correlate it with clinical findings. We retrospectively evaluated contrast enhanced CT in 34 patients with acute pancreatitis. They were categorized into low-score(0-2), middle-socre(3-6), and high-score(7-10) groups according to CTSI points, and those groups were correlated with duration of fasting period, days in hospital morbidity and mortality. We attempted to determine the differences in CTSI between pancreatitis caused by alcohol and by biliary tract disease. Of 34 patients, 11 were placed in the low-score group, 19 in the middle-score group, and 4 in the high-score group. The patients in the middle-score group experienced longer fasting period and stayed longer in hospital than those in the low-score group(p < .05 and p= .08, respectively). Morbidity was 0% in the low-score group, 37% in the middle-score group and 50% in the high-score group. Mortality occurred in two patients in high-score group, only. Alcohol-induced pancreatitis generally showed a higher CTSI and more severe clinical course than pancreatitis caused by biliary tract disease. In the evaluation of acute pancreatitis, CTSI can be a useful predictor of its prognosis

  17. Gait and Glasgow Coma Scale scores can predict functional recovery in patients with traumatic brain injury☆

    Bilgin, Sevil; Guclu-Gunduz, Arzu; Oruckaptan, Hakan; Kose, Nezire; Celik, Bülent

    2012-01-01

    Fifty-one patients with mild (n = 14), moderate (n = 10) and severe traumatic brain injury (n = 27) received early rehabilitation. Level of consciousness was evaluated using the Glasgow Coma Score. Functional level was determined using the Glasgow Outcome Score, whilst mobility was evaluated using the Mobility Scale for Acute Stroke. Activities of daily living were assessed using the Barthel Index. Following Bobath neurodevelopmental therapy, the level of consciousness was significantly impro...

  18. Hypertriglyceridemia-Induced Acute Pancreatitis in Pregnancy

    Mindaugas Serpytis; Jurate Dementaviciene; Kestutis Strupas; Audrius Sileikis; Vytautas Karosas; Jurate Sipylaite; Rokas Tamosauskas

    2012-01-01

    Context Hypertriglyceridemia is a well known phenomenon of pregnancy occurring due to physiologic changes in sex hormone levels. Occasionally, it could lead to development of acute pancreatitis. Gestational hypertriglyceridemia-induced acute pancreatitis occurs in pregnant women usually with preexisting abnormalities of the lipid metabolism and is associated with additional diagnostic and therapeutic challenges related to hypertriglyceridemia and pregnancy. Case report We present a case of hy...

  19. Re-Scoring the Game’s Score

    Gasselseder, Hans-Peter

    2014-01-01

    This study explores immersive presence as well as emotional valence and arousal in the context of dynamic and non-dynamic music scores in the 3rd person action-adventure video game genre while also considering relevant personality traits of the player. 60 subjects answered self-report questionnai......This study explores immersive presence as well as emotional valence and arousal in the context of dynamic and non-dynamic music scores in the 3rd person action-adventure video game genre while also considering relevant personality traits of the player. 60 subjects answered self......-report questionnaires of experiential states each time after playing the game 'Batman: Arkham City' in one of three randomized conditions accounting for [1] dynamic music, [2] non-dynamic music/low arousal potential and [3] non-dynamic music/high arousal potential, aiming to manipulate emotional arousal and structural...... between the player, avatar, and game environment is assumed to moderate a continuous regulatory modulation of emotional response achieved by context effects of dynamic music....

  20. Risk assessment after acute upper gastrointestinal haemorrhage.

    Rockall, T A; Logan, R F; Devlin, H. B.; Northfield, T. C.

    1996-01-01

    The aim of this study was to establish the relative importance of risk factors for mortality after acute upper gastrointestinal haemorrhage, and to formulate a simple numerical scoring system that categorizes patients by risk. A prospective, unselected, multicentre, population based study was undertaken using standardised questionnaires in two phases one year apart. A total of 4185 cases of acute upper gastrointestinal haemorrhage over the age of 16 identified over a four month period in 1993...

  1. Plant Physiology and Development

    Taiz, Lincoln; Zeiger, Eduardo; Møller, Ian Max;

    widely used upper-division plant biology textbook. In the Sixth Edition, the Growth and Development section (Unit III) has been reorganized and expanded to present the complete life cycle of seed plants from germination to senescence. In recognition of this enhancement, the text has been renamed Plant......Throughout its twenty-two year history, the authors of Plant Physiology have continually updated the book to incorporate the latest advances in plant biology and implement pedagogical improvements requested by adopters. This has made Plant Physiology the most authoritative, comprehensive, and...... Physiology and Development. As before, Unit III begins with updated chapters on Cell Walls and Signals and Signal Transduction. The latter chapter has been expanded to include a discussion of major signaling molecules, such as calcium ions and plant hormones. A new, unified chapter entitled Signals from...

  2. Human physiology in space

    Vernikos, J.

    1996-01-01

    The universality of gravity (1 g) in our daily lives makes it difficult to appreciate its importance in morphology and physiology. Bone and muscle support systems were created, cellular pumps developed, neurons organised and receptors and transducers of gravitational force to biologically relevant signals evolved under 1g gravity. Spaceflight provides the only microgravity environment where systematic experimentation can expand our basic understanding of gravitational physiology and perhaps provide new insights into normal physiology and disease processes. These include the surprising extent of our body's dependence on perceptual information, and understanding the effect and importance of forces generated within the body's weightbearing structures such as muscle and bones. Beyond this exciting prospect is the importance of this work towards opening the solar system for human exploration. Although both appear promising, we are only just beginning to taste what lies ahead.

  3. Evaluation of a Modified POSSUM Scoring System for Predicting the Morbidity in Patients Undergoing Lumbar Surgery

    Ying, Li; Bo, Bai; Huo-yan, Wu; Hong, Zhuang

    2013-01-01

    For most spine surgeons, operative intervention is common for the treatment of lumbar disc herniation, lumbar stenosis, lumbar fracture or lumbar spondylolisthesis. However, with the increase in lumbar surgery, the complication rate increases accordingly. Whereas the Physiological and Operative Severity Score for the enUmeration of Mortality and Morbidity (POSSUM) scoring system has been widely used to predict morbidity in various surgical fields, the application of this system in lumbar surg...

  4. Pancreatic Enzyme Supplementation in Acute Pancreatitis

    R. V. Patankar; R. Chand; Johnson, C. D.

    1995-01-01

    This study evaluates the effect of oral pancreatic enzyme supplements on pain, analgesic requirement and the incidence of complications in patients with acute pancreatitis. This double blind, prospectively randomised placebo controlled study included 23 patients. Pain was monitored using a visual analogue scale; the analgesic requirement was assessed with a numerical score. No significant differences were noted between the median (range) pain scores of patients who received placebo: 22 (17.1–...

  5. Alberta stroke program early CT score on diffusion -w eighted imaging predicts new cerebral microbleeds in patients w ith acute middle cerebral artery infarction%弥散加权成像阿尔伯塔卒中项目早期CT 评分预测急性期大脑中动脉供血区梗死患者的新发脑微出血

    刘艳; 丁云龙; 刘文鹏; 魏灿; 张艳荣; 刘丽; 陆云峰; 徐俊

    2015-01-01

    Objective To investigate the predictive value of Alberta stroke program early CT score on diffusion-w eighted imaging (DWI-ASPECTS) for predicting new cerebral microbleeds (CMBs) in patients w ith acute middle cerebral artery infarction. Methods The patients w ith acute middle cerebra artery infarction w ere enroled prospectively. MRI examinations w ere completed w ithin 48 h on admission and they w ere examined again at 10 to 14 d after onset. Susceptibility-w eighted imaging (SWI) w as use to detect CMBs. DWI-ASPECTS w as used to assess the infarction extent. Results A total of 82 patients w ith acute middle cerebra artery infarction w ere enroled, including 27 females and 55 females. Their ages w ere 71.7 ± 8.9 years. Eighteen patients (22.0%) had old CMBs, 25 (30.5%) had new CMBs, 57 (69.5%) did not have new CMBs. Compared w ith the non-new CMB group, DWI-SPECTS (3.20 ±1.73 vs.7.11 ±1.69;t = 9.573, P 5), the risk of new CMBs w ould decrease 86 % (odds ratio 0.14, 95%confidence interval 0.17 -0.48; P 5分时,新发 CMBs 风险下降86%(优势比0.14,95%可信区间0.17~0.48;P <0.001)。受试者工作特征曲线分析显示,ASPECTS 评分≤5分预测新发CMBs 的敏感性为87.7%,特异性为88.3%,曲线下面积为0.940。结论DWI-ASPECTS 可有效预测急性大脑中动脉供血区脑梗死患者新发 CMBs 风险。

  6. Score lists in multipartite hypertournaments

    Pirzada, Shariefuddin; Iványi, Antal

    2010-01-01

    Given non-negative integers $n_{i}$ and $\\alpha_{i}$ with $0 \\leq \\alpha_{i} \\leq n_i$ $(i=1,2,...,k)$, an $[\\alpha_{1},\\alpha_{2},...,\\alpha_{k}]$-$k$-partite hypertournament on $\\sum_{1}^{k}n_{i}$ vertices is a $(k+1)$-tuple $(U_{1},U_{2},...,U_{k},E)$, where $U_{i}$ are $k$ vertex sets with $|U_{i}|=n_{i}$, and $E$ is a set of $\\sum_{1}^{k}\\alpha_{i}$-tuples of vertices, called arcs, with exactly $\\alpha_{i}$ vertices from $U_{i}$, such that any $\\sum_{1}^{k}\\alpha_{i}$ subset $\\cup_{1}^{k}U_{i}^{\\prime}$ of $\\cup_{1}^{k}U_{i}$, $E$ contains exactly one of the $(\\sum_{1}^{k} \\alpha_{i})!$ $\\sum_{1}^{k}\\alpha_{i}$-tuples whose entries belong to $\\cup_{1}^{k}U_{i}^{\\prime}$. We obtain necessary and sufficient conditions for $k$ lists of non-negative integers in non-decreasing order to be the losing score lists and to be the score lists of some $k$-partite hypertournament.

  7. Acute myelogenous leukemia (AML) - children

    Acute myelogenous leukemia - children; AML; Acute myeloid leukemia - children; Acute granulocytic leukemia - children; Acute myeloblastic leukemia - children; Acute non-lymphocytic leukemia (ANLL) - children

  8. Understanding behavioral and physiological phenotypes of stress and anxiety in zebrafish

    Egan, Rupert J.; Bergner, Carisa L.; Hart, Peter C.; Cachat, Jonathan M.; Canavello, Peter R.; Elegante, Marco F.; Elkhayat, Salem I.; Bartels, Brett K.; Tien, Anna K.; Tien, David H.; Mohnot, Sopan; Beeson, Esther; Glasgow, Eric; Amri, Hakima; Zukowska, Zofia

    2009-01-01

    The zebrafish (Danio rerio) is emerging as a promising model organism for experimental studies of stress and anxiety. Here we further validate zebrafish models of stress by analyzing how environmental and pharmacological manipulations affect their behavioral and physiological phenotypes. Experimental manipulations included exposure to alarm pheromone, chronic exposure to fluoxetine, acute exposure to caffeine, as well as acute and chronic exposure to ethanol. Acute (but not chronic) alarm phe...

  9. Physiology of Breastfeeding

    This powerpoint presentation summaries physiology of lactation and the impact of a variety of clinical practices on lactation from delivery through weaning. Factors that inhibit lactogenesis stage II are explained, including retained placenta, excess blood loss during delivery, and hypoplastic brea...

  10. Starting Physiology: Bioelectrogenesis

    Baptista, Vander

    2015-01-01

    From a Cartesian perspective of rational analysis, the electric potential difference across the cell membrane is one of the fundamental concepts for the study of physiology. Unfortunately, undergraduate students often struggle to understand the genesis of this energy gradient, which makes the teaching activity a hard task for the instructor. The…

  11. Renal physiology of pregnancy.

    Cheung, Katharine L; Lafayette, Richard A

    2013-05-01

    Pregnancy involves remarkable orchestration of physiologic changes. The kidneys are central players in the evolving hormonal milieu of pregnancy, responding and contributing to the changes in the environment for the pregnant woman and fetus. The functional impact of pregnancy on kidney physiology is widespread, involving practically all aspects of kidney function. The glomerular filtration rate increases 50% with subsequent decrease in serum creatinine, urea, and uric acid values. The threshold for thirst and antidiuretic hormone secretion are depressed, resulting in lower osmolality and serum sodium levels. Blood pressure drops approximately 10 mmHg by the second trimester despite a gain in intravascular volume of 30% to 50%. The drop in systemic vascular resistance is multifactorial, attributed in part to insensitivity to vasoactive hormones, and leads to activation of the renin-aldosterone-angiostensin system. A rise in serum aldosterone results in a net gain of approximately 1000 mg of sodium. A parallel rise in progesterone protects the pregnant woman from hypokalemia. The kidneys increase in length and volume, and physiologic hydronephrosis occurs in up to 80% of women. This review will provide an understanding of these important changes in kidney physiology during pregnancy, which is fundamental in caring for the pregnant patient. PMID:23928384

  12. The Face of Physiology

    Paul White

    2008-10-01

    Full Text Available This article explores the relationship between the physiology of the emotions and the display of character in Victorian Britain. Charles Bell and others had begun to link certain physiological functions, such as respiration, with the expression of feelings such as fear, regarding the heart and other internal organs as instruments by which the emotions were made visible. But a purely functional account of the emotions, which emerged through the development of reflex physiology during the second half of the century, would dramatically alter the nature of feelings and the means of observing them. At the same time, instinctual or acquired sympathy, which had long underpinned the accurate reading of expressions, became a problem to be surmounted by new 'objectively'. Graphic recording instruments measuring a variety of physiological functions and used with increasing frequency in clinical diagnostics became of fundamental importance for tracing the movement of feelings during the period prior to the development of cinematography. They remained, in the form of devices such as the polygraph, a crucial and controversial means of measuring affective states, beneath the potentially deceptive surface of the body.

  13. STUDY OF CORRELATION OF MODIFIED ALAVARADO SCORING WITH HISTOPATHOLOGY AND EARLY POST OPERATIVE COMPLICATIONS

    Rajanna

    2014-11-01

    Full Text Available Appendicitis being the commonest acute abdominal surgical condition, although diagnosis can be made clinically but possess diagnostic difficulty to junior surgeons. The need for appropriate tool/scoring system that can be easily applicable, accurate & reproducible in the diagnosis of appendicitis is essential to have a low negative Appendicectomy rate. This prospective study is designed to assess one such scoring system, i.e., Modified Alvarado Score. MATERIALS AND METHODS: SETTING AND DURATION: Department of Surgery, Hassan Institute of Medical Sciences/Teaching Hospital, Hassan. From August 2013 to September 2014. A total of 227 consecutive male and female patients with age above 14 years presenting with right lower abdominal pain were enrolled in this study, analysed according to eight variables of Modified Alvarado scoring system and were accordingly placed into 3 groups. Group–I patients having score 1–4 were discharged, Group-II patients having score 5–6 were observed, while Group-III patients having score 7–10 were operated and all the operated patients were followed up for 30 days. These groups were compared with intra-operative findings, histopathological results & early post –operative complications. RESULTS: Of the total 227 patients included in this study, 155 underwent Appendicectomy based on the Modified Alvarado scoring system. Out of 155 operated patients 142(91.6% had acute appendicitis, thus yielding a positive predictive value of 91.6% while negative appendicectomy rate 9.3%. Frequency of negative appendicectomy was 5.3% (5/94 among males and 9.4% (08/61 in females. Post-operative complication rate including wound infection, pelvic abscess, chest and urinary tract infection was 10.3% (16/155. CONCLUSION: The present study showed that Alvarado clinical scoring system has a high diagnostic value of 90%. Alvarado scoring system is dynamic one & its proper application improves diagnostic accuracy. There by reduce the

  14. Surgical management of fulminant acute pancreatitis%暴发性急性胰腺炎的诊断与治疗

    雷若庆

    2010-01-01

    @@ 经过国内、外学者近40年的不懈努力,重症急性胰腺炎(severe acute pancreatitis,SAP)患者的生存率大幅度提高,达86%.但SAP中的暴发性急性胰腺炎(fulminant acute pancreatitis,FAP),因其病情发展迅速,即使在起病72 h内经充分的液体复苏,仍可能出现器官功能衰竭[1].%With the unremitting efforts of researchers for the past 40 years, the survival of patients with severe acute pancreatitis (SAP) has been improved to 86%. Patients with SAP, although had been given fluid resuscitation and formal non-operative therapy in 72 hours after the onset, still progress to organ dysfunction can be diagnosed with fulminant acute pancreatitis (FAP). The treatment methods for FAP include sufficient fluid resuscitation, formal non-operative therapy and removing etiological factors. If patients have the tendency toward deterioration of organ function or incidence of abdominal compartment syndrome (ACS), creating conditions for early surgical drainage is essential, and the surgical procedure should be as simple as possible. The survival rate of patients with FAP is still unsatisfactory, and the advanced age, high scores of acute physiology and chronic health enquiry ( APACHE Ⅱ ), sequential organ failure assessment (SOFA) and Balthazar, and the incidence of ACS are the indicators for a poor prognosis of patients with FAP.

  15. Avian reproductive physiology

    Gee, G.F.

    1995-01-01

    Knowledge of the many physiological factors associated with egg production , fertility, incubation, and brooding in nondomestic birds is limited. Science knows even less about reproduction in most of the 238 endangered or threatened birds. This discussion uses studies of nondomestic and, when necessary, domestic birds to describe physiological control of reproduction. Studies of the few nondomestic avian species show large variation in physiological control of reproduction. Aviculturists, in order to successfully propagate an endangered bird, must understand the bird's reproductive peculiarities. First, investigators can do studies with carefully chosen surrogate species, but eventually they need to confirm the results in the target endangered bird. Studies of reproduction in nondomestic birds increased in the last decade. Still, scientists need to do more comparative studies to understand the mechanisms that control reproduction in birds. New technologies are making it possible to study reproductive physiology of nondomestic species in less limiting ways. These technologies include telemetry to collect information without inducing stress on captives (Howey et al., 1987; Klugman, 1987), new tests for most of the humoral factors associated with reproduction, and the skill to collect small samples and manipulate birds without disrupting the physiological mechanisms (Bercovitz et al., 1985). Managers are using knowledge from these studies to improve propagation in zoological parks, private and public propagation facilities, and research institutions. Researchers need to study the control of ovulation, egg formation, and oviposition in the species of nondomestic birds that lay very few eggs in a season, hold eggs in the oviduct for longer intervals, or differ in other ways from the more thoroughly studied domestic birds. Other techniques that would enhance propagation for nondomestlc birds include tissue culture of cloned embryonic cells, cryopreservation of embryos

  16. The Effects of Acute Stress on Rainbow Trout (Oncorhynchus mykiss)

    KUBİLAY, Ayşegül

    2002-01-01

    The physiological effects of acute stressors (transport, handling, netting and confinement) on rainbow trout in an aquaculture system were investigated. Serum cortisol level, serum glucose and lysozyme activity were determined in rainbow trout stressed by acute stressors, and compared with those of unstressed (control) fish. Serum cortisol, glucose levels and lysozyme activity were significantly higher(P

  17. Stroke Survivors Scoring Zero on the NIH Stroke Scale Score Still Exhibit Significant Motor Impairment and Functional Limitation

    Brittany Hand

    2014-01-01

    Full Text Available Objective. To determine the National Institutes of Health Stroke Scale’s (NIHSS’s association with upper extremity (UE impairment and functional outcomes. Design. Secondary, retrospective analysis of randomized controlled trial data. Setting. Not applicable. Participants. 146 subjects with stable, chronic stroke-induced hemiparesis. Intervention. The NIHSS, the UE Fugl-Meyer (FM, and the Arm Motor Ability Test (AMAT were administered prior to their participation in a multicenter randomized controlled trial. Main Outcome Measures. The NIHSS, FM, and AMAT. Results. The association between the NIHSS and UE impairment was statistically significant (P=-0.204;p=0.014 but explained less than 4% of the variance among UE FM scores. The association between NIHSS total score and function as measured by the AMAT was not statistically significant (P=-0.141;p=0.089. Subjects scoring a “zero” on the NIHSS exhibited discernible UE motor deficits and varied scores on the UE FM and AMAT. Conclusion. While being used in stroke trials, the NIHSS may have limited ability to discriminate between treatment responses, even when only a relatively narrow array of impairment levels exists among patients. Given these findings, NIHSS use should be restricted to acute stroke studies and clinical settings with the goal of reporting stroke severity.

  18. Acute biliary pancreatitis: Diagnosis and treatment

    Hazem Zakaria

    2009-01-01

    Full Text Available Gallstones are the commonest cause of acute pancreatitis (AP, a potentially life-threatening condition, worldwide. The pathogenesis of acute pancreatitis has not been fully understood. Laboratory and radiological investigations are critical for diagnosis as well prognosis prediction. Scoring systems based on radiological findings and serologic inflammatory markers have been proposed as better predictors of disease severity. Early endoscopic retrograde cholangiopancreatography (ERCP is beneficial in a group of patients with gallstone pancreatitis. Laparoscopic cholecystectomy with preoperative endoscopic common bile duct clearance is recommended as a treatment of choice for acute biliary pancreatitis. The timing of cholecystectomy, following ERCP, for biliary pancreatitis can vary markedly depending on the severity of pancreatitis

  19. Impact of alanyl-glutamine dipeptide on severe acute pancreatitis in early stage

    Ping Xue; Li-Hui Deng; Qing Xia; Zhao-Da Zhang; Wei-Ming Hu; Xiao-Nan Yang; Bing Song; Zong-Wen Huang

    2008-01-01

    AIM: To evaluate the therapeutic effect of alanyl- glutamine dipeptide (AGD) in the treatment of severe acute pancreatitis (SAP) in early and advanced stage. METHODS: Eighty patients with SAP were randomized and received 100 mL/d of 20% AGD intravenously for 10 d starting either on the day of (early treatment group) or 5 d after (late treatment group) admission. Groups had similar demographics, underlying diseases, Ranson score, Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ) score, and Balthazar's computed tomography (CT) score at the beginning of the study and underwent similar other medical and nutritional management. RESULTS: The duration of acute respiratory distress syndrome (2.7 ± 3.3 d vs 12.7 ± 21.0 d, P < 0.01), renal failure (1.3 ± 0.5 d vs 5.3 ± 7.3 d, P < 0.01), acute hepatitis (3.2 ± 2.3 d vs 7.0 ± 7.1 d, P < 0.01), shock (1.7 ± 0.4 d vs 4.8 ± 3.1 d, P < 0.05), encephalopathy (2.3 ±1.9 d vs 9.5 ± 11.0 d, P < 0.01) and enteroparalysis (2.2 ± 1.4 d vs 3.5 ± 2.2 d, P < 0.01) and hospital stay (28.8±9.4 d vs 45.2 ± 27.1 d, P < 0.01) were shorter in the early treatment group than in the late treatment group. The 15-d APACHE Ⅱ score was lower in the early treatment group than in the late treatment group (5.0 ±2.4 vs 8.6 ± 3.6, P < 0.01). The infection rate (7.9% vs 26.3%, P < 0.05), operation rate (13.2% vs 34.2%, P < 0.05) and mortality (5.3% vs 21.1%, P < 0.05) in the early treatment group were lower than in the late treatment group. CONCLUSION: Early treatment with AGD achieved a better clinical outcome in SAP patients.

  20. [Scoring systems for assessment of 30-day mortality after colorectal cancer surgery].

    Degett, Thea Helene; Iversen, Lene Hjerrild; Gögenur, Ismail

    2015-03-01

    Post-operative mortality from colorectal cancer depends on multiple factors and varies across countries and hospitals. Pre-operative risk prediction can be helpful in surgical decision-making. Several scoring systems have been developed to predict the risk of post-operative mortality. The Portsmouth Physiological and Operative Severity Score for the enUmeration of Mortality (P-POSSUM) model and a revised Association of Colo-proctology of Great Britan and Ireland (ACPGBI) model are the most accurate predictors in colorectal cancer surgery. No scoring systems have been validated in the Danish population. PMID:25786698

  1. Exogenous Carbon Monoxide Decreases Sepsis-Induced Acute Kidney Injury and Inhibits NLRP3 Inflammasome Activation in Rats

    Peng Wang

    2015-08-01

    Full Text Available Carbon monoxide (CO has shown various physiological effects including anti-inflammatory activity in several diseases, whereas the therapeutic efficacy of CO on sepsis-induced acute kidney injury (AKI has not been reported as of yet. The purpose of the present study was to explore the effects of exogenous CO on sepsis-induced AKI and nucleotide-binding domain-like receptor protein 3 (NLRP3 inflammasome activation in rats. Male rats were subjected to cecal ligation and puncture (CLP to induce sepsis and AKI. Exogenous CO delivered from CO-releasing molecule 2 (CORM-2 was used intraperitoneally as intervention after CLP surgery. Therapeutic effects of CORM-2 on sepsis-induced AKI were assessed by measuring serum creatinine (Scr and blood urea nitrogen (BUN, kidney histology scores, apoptotic cell scores, oxidative stress, levels of cytokines TNF-α and IL-1β, and NLRP3 inflammasome expression. CORM-2 treatment protected against the sepsis-induced AKI as evidenced by reducing serum Scr/BUN levels, apoptotic cells scores, increasing survival rates, and decreasing renal histology scores. Furthermore, treatment with CORM-2 significantly reduced TNF-α and IL-1β levels and oxidative stress. Moreover, CORM-2 treatment significantly decreased NLRP3 inflammasome protein expressions. Our study provided evidence that CORM-2 treatment protected against sepsis-induced AKI and inhibited NLRP3 inflammasome activation, and suggested that CORM-2 could be a potential therapeutic candidate for treating sepsis-induced AKI.

  2. Contemporary Management of Acute Biliary Pancreatitis

    Orhan Ozkan

    2014-03-01

    Full Text Available Acute biliary pancreatitis is one of the major causes of acute pancreatitis.Gallstones, biliary sludge and microlithiasis, especially in pancreatitis without detectable reason, can be the cause of acute pancreatitis. Acute biliary pancreatitis has many controversions in the literature, and its classification and guidelines are being updated very frequently. Atlanta classifications which determine the definitions and guidelines about acute pancreatitis were renewed and published in 2013. It has various clinical aspects, ranging from a mild form which is easily treated, to a severe form that causes complications leading to mortality. The pathogenesis of this disease has not been fully elucidated and several theories have been suggested. New scoring systems and laboratory methods such as proteomics have been suggested for both diagnosis and to predict disease severity, and research on these topics is still in progress. Novel therapeutic approaches with technological developments such as ERCP, ES, MRCP, and EUS are also suggested.

  3. Acute phase response before treatment predicts radiation esophagitis in non-small cell lung cancer

    Background and purpose: Radiation esophagitis (RE) represents an inflammatory reaction to radiation therapy (RT). We hypothesized that aspects of the physiologic acute phase response (APR) predicts RE. Material and methods: We retrospectively analyzed 285 patients with non-small cell lung cancer (NSCLC) treated with definitive radiation. The primary analysis was the association of pretreatment lab values reflective of the APR with symptomatic (grade ⩾2) RE. Univariate and multivariate odds ratios (ORs) were calculated to test associations of clinical and pretreatment lab values with RE. Optimal cutpoints and multivariable risk stratification groupings were determined via recursive partitioning analysis. Results: Pretreatment platelet counts were higher and hemoglobin levels lower in patients who developed RE (P < 0.05). Based on these two pre-treatment risk factors, an APR score was defined as 0 (no risk factors), 1 (either risk factor), or 2 (both risk factors). APR score was significantly associated with RE in both univariate (OR = 2.3 for each point, 95% confidence interval [CI] 1.5–3.4, P = 0.001) and multivariate (OR = 2.1, 95% CI 1.3–3.4, P = 0.002) analyses. Conclusions: The APR score may represent a novel metric to predict RE. However, pending validation in an independent dataset, caution is advised when interpreting these results given their retrospective and thus exploratory nature

  4. Disease severity scoring systems in dermatology

    Cemal Bilaç; Mustafa Turhan Şahin; Serap Öztürkcan

    2016-01-01

    Scoring systems have been developed to interpret the disease severity objectively by evaluating the parameters of the disease. Body surface area, visual analogue scale, and physician global assessment are the most frequently used scoring systems for evaluating the clinical severity of the dermatological diseases. Apart from these scoring systems, many specific scoring systems for many dermatological diseases, including acne (acne vulgaris, acne scars), alopecia (androgenetic alopecia, tractio...

  5. Interpretation of Quality-of-Life Scores

    Chren, Mary-Margaret

    2010-01-01

    Patients’ reports of their experience with illness are a key health outcome, but scores that measure these reports can be difficult to interpret. Skindex-29 measures skin-related quality of life reliably and validly. In this issue, Prinsen and colleagues compare patients’ responses to “anchor” questions with their Skindex scores to derive clinically meaningful scores for the subscales of Skindex-29. The cutoff scores identify patients whose skin diseases severely affect their quality of life....

  6. Credit Scores, Race, and Residential Sorting

    Nelson, Ashlyn Aiko

    2010-01-01

    Credit scores have a profound impact on home purchasing power and mortgage pricing, yet little is known about how credit scores influence households' residential location decisions. This study estimates the effects of credit scores on residential sorting behavior using a novel mortgage industry data set combining household demographic, credit, and…

  7. "Score Choice": A Tempest in a Teapot?

    Hoover, Eric

    2009-01-01

    A new option that allows students to choose which of their test scores to send to colleges has generated renewed criticism of the College Board. College Board officials tout the option, called Score Choice, as a way to ease test taker anxiety. Some prominent admissions officials have publicly described Score Choice as a sales tactic that will…

  8. Validation of Automated Scoring of Science Assessments

    Liu, Ou Lydia; Rios, Joseph A.; Heilman, Michael; Gerard, Libby; Linn, Marcia C.

    2016-01-01

    Constructed response items can both measure the coherence of student ideas and serve as reflective experiences to strengthen instruction. We report on new automated scoring technologies that can reduce the cost and complexity of scoring constructed-response items. This study explored the accuracy of c-rater-ML, an automated scoring engine…

  9. Acute childhood leukemia: Nursing care

    Modern therapy for childhood acute leukemia has provided a dramatically improved prognosis over that of just 30 years ago. In the early 1960's survival rates for acute lymphocytic leukemia (ALL) and acute myelogenous leukemia (AML) were 4% and 3%, respectively. By the 1980's survival rates had risen to 72% for all and 25% to 40% for AML. Today, a diagnosis of all carries an 80% survival rate and as high as a 90% survival rate for some low-risk subtypes. Such high cure rates depend on intense and complex, multimodal therapeutic protocols. Therefore, nursing care of the child with acute leukemia must meet the demands of complicated medical therapies and balance those with the needs of a sick child and their concerned family. An understanding of disease process and principles of medical management guide appropriate and effective nursing interventions. Leukemia is a malignant disorder of the blood and blood- forming organs (bone marrow, lymph nodes and spleen). Most believe that acute leukemia results from a malignant transformation of a single early haematopoietic stem cell that is capable of indefinite self-renewal. These immature cells of blasts do not respond to normal physiologic stimuli for differentiation and gradually become the predominant cell in the bone marrow

  10. Documentation of radiation-induced oral mucositis. Scoring Systems

    Background: Radiation therapy of tumors in the head and neck region is frequently associated with severe side effects in the oral mucosa which often necessitate interruption of the prescribed treatment protocol. In order to compare therapeutic strategies and, more important, in order to perform multicenter studies, generally accepted scoring systems have to be applied for uniform documentation of the oral mucosal response. Methods: Different scoring protocols are found in the literature. The scoring protocols most widely accepted are the CTC classification and the RTOG/EORTC classification. These are compared with more detailed systems. Results: In the CTC classification, grading of stomatitis is included in the responses of the gastrointestinal tract and emphasizes dietary effects. For effects of radiation alone or of radiochemotherapy, the RTOG/EORTC system, focusing on therapeutic interventions, has been established. However, there are only minor differences in the grading of mucositis between these 2 protocols. Based on the RTOG/EORTC classification, Maciejewski et al. introduced a classification system with inclusion of the area affected, but also changed the sensitivity of the scores. The latter may be confusing if the source of the system used is not cited in a report. An alternative system was proposed by Dische, which in addition to objective morphologic criteria also includes the symptoms induced by the mucosal response, and hence includes some subjective aspects reported by the patient. Conclusions: For routine documentation of acute radiation side effects in the oral cavity, the German version of the RTOG/EORTC classification can be recommended. In studies with particular interest in oral mucositis, a more sensitive scoring system may be applied. In any publication concerning mucositis, a table or a detailed description of the system used should be included. (orig.)

  11. A new scoring system to stratify risk in unstable angina

    Salzberg Simón

    2003-08-01

    Full Text Available Abstract Background We performed this study to develop a new scoring system to stratify different levels of risk in patients admitted to hospital with a diagnosis of unstable angina (UA, which is a complex syndrome that encompasses different outcomes. Many prognostic variables have been described but few efforts have been made to group them in order to enhance their individual predictive power. Methods In a first phase, 473 patients were prospectively analyzed to determine which factors were significantly associated with the in-hospital occurrence of refractory ischemia, acute myocardial infarction (AMI or death. A risk score ranging from 0 to 10 points was developed using a multivariate analysis. In a second phase, such score was validated in a new sample of 242 patients and it was finally applied to the entire population (n = 715. Results ST-segment deviation on the electrocardiogram, age ≥ 70 years, previous bypass surgery and troponin T ≥ 0.1 ng/mL were found as independent prognostic variables. A clear distinction was shown among categories of low, intermediate and high risk, defined according to the risk score. The incidence of the triple end-point was 6 %, 19.2 % and 44.7 % respectively, and the figures for AMI or death were 2 %, 11.4 % and 27.6 % respectively (p Conclusions This new scoring system is simple and easy to achieve. It allows a very good stratification of risk in patients having a clinical diagnosis of UA. They may be divided in three categories, which could be of help in the decision-making process.

  12. Scoring System Approach for Assessment of Critical Illness using Mobile Phones

    Karupothula Madhavi Latha

    2012-02-01

    Full Text Available This paper demonstrates the use of mobile phones in assessing the illness of patients by developing a Scoring Systemwhere medical practitioners (often nurses collect various physiological signals like ECG, EEG, SpO2, temperature, continuous blood pressure and subjective parameters like level of pain, level of alertness, awareness, behavioral responses etc. After taking the data, a scoring system is utilized for early detection of critical illnesses. The mechanism of scoring is performed either manually, where the medical practitioner ticks on to a scoring board or is automated by relocating the information from scoring board to a PC, where the software performs the scoring calculation. In the proposed system, the medical practitioner inputs the parameters directly on to their mobile phone by collecting the parameters fromthe patient. The score is automatically calculated by miniature java based software running inside themobile phone. Based on the score, level of urgency is determined by the intelligent program. At the end, specialists are contacted automatically by messaging services. Moreover, the results of the scoring are transmitted to the hospital server. Therefore, assistance from civilians with mobile phone based medical intelligence can save precious life.

  13. The Efficiency of Tennis Doubles Scoring Systems

    Geoff Pollard; Graham Pollard

    2010-01-01

    In this paper a family of scoring systems for tennis doubles for testing the hypothesis that pair A is better than pair B versus the alternative hypothesis that pair B is better than A, is established. This family or benchmark of scoring systems can be used as a benchmark against which the efficiency of any doubles scoring system can be assessed. Thus, the formula for the efficiency of any doubles scoring system is derived. As in tennis singles, one scoring system based on the play-the-loser ...

  14. Effect of admission hypertriglyceridemia on the episodes of severe acute pancreatitis

    Li-Hui Deng; Ping Xue; Qing Xia; Xiao-Nan Yang; Mei-Hua Wan

    2008-01-01

    AIM: To investigate the effect of admission hypertriglyceridemia (HTG) on the episodes of severe acute pancreatitis (SAP).METHODS: One hundred and seventy-six patients with SAP were divided into HTG group (n = 45) and control group (n = 131) according to admission triglyceride (TG) ≥ 5.65 mmol/L and < 5.65 mmol/L,respectively. Demographics, etiology, underlying diseases, biochemical parameters, Ranson's score,acute physiology and chronic heath evaluation Ⅱ(APACHE Ⅱ) score, Balthazar's computed tomography (CT) score, complications and mortality were compared. Correlation between admission TG and 24-h APACHE Ⅱ score was analyzed.RESULTS: SAP patients with HTG were younger (40.8±9.3 years vs 52.6 ± 13.4 years, P < 0.05) with higher etiology rate of overeating, high-fat diet (40.0% vs 14.5%, P < 0.05) and alcohol abuse (46.7%vs 23.7%, P < 0.01), incidence rate of hypocalcemia (86.7% vs 63.4%, P < 0.01) and hypoalbuminemia (84.4% vs 60.3%, P < 0.01), 24-h APACHE 1/ score (13.6±5.7 vs 10.7 ± 4.6, P < 0.01) and admission serum glucose (17.7 ± 7.7 vs 13.4 ± 6.1, P < 0.01),complication rate of renal failure (51.1% vs 16.8%, P <0.01), shock (37.9% vs 14.5%, P < 0.01) and infection (37.4% vs 18.3%, P < 0.01) and mortality (13.1% vs9.1%, P < 0.01). Logistic regression analysis showed a positive correlation between admission TG and 24-h APACHE Ⅱ score (r = 0.509, P = 0.004).CONCLUSION: The clinical features of SAP patients with HTG are largely consistent with previous studies.HTG aggravates the episodes of SAR.

  15. Conservation physiology of marine fishes

    Jørgensen, Christian; Peck, Myron A.; Antognarelli, Fabio;

    2012-01-01

    At the end of May, 17 scientists involved in an EU COST Action on Conservation Physiology of Marine Fishes met in Oristano, Sardinia, to discuss how physiology can be better used in modelling tools to aid in management of marine ecosystems. Current modelling approaches incorporate physiology to...

  16. Acute pancreatitis

    Al Mofleh Ibrahim

    1997-01-01

    Full Text Available The past few years have witnessed a tremendous progress in our knowledge regarding the pathogenesis, diagnosis, prognostic evaluation and classification of acute pancreatitis. The role of ischemia, lysosomal enzymes, oxygen free radicals, polymorphnuclear cells-byproducts and inflammatory mediators in the pathogenesis of pancreatic necrosis and multiple organ failure has been emphasized. Furthermore, the recent knowledge about agents infecting pancreatic necrosis, routes of infection, bacteriological examination of fine needle aspirate and appropriate antibiotics have changed the concept of acute pancreatitis. New diagnostic tests such as rapid urinary trypsinogen-2 test and inflammatory mediators including polymorphnuclear elastase, C-reactive protein and interleukin-6 contribute to early diagnosis, prognostic evaluation and initiation of an appropriate therapy.

  17. Ecallantide: in acute hereditary angioedema.

    Garnock-Jones, Karly P

    2010-07-30

    Ecallantide, a recombinant protein that is a selective, highly potent and reversible inhibitor of human plasma kallikrein, is indicated for the treatment of acute attacks of hereditary angioedema (HAE) in patients aged >or=16 years. In the randomized, double-blind, placebo-controlled, multicentre, phase III trial EDEMA3, mean symptom response to treatment at 4 hours (assessed using the Treatment Outcome Score [TOS]; primary endpoint) was significantly greater with a single subcutaneous dose of ecallantide 30 mg than with placebo in patients with acute, moderate to severe attacks of HAE. In addition, the mean change from baseline in symptom severity at 4 hours (assessed using the Mean Symptom Complex Severity [MSCS] scale) was significantly greater with ecallantide than with placebo. At 4 hours in the similarly designed EDEMA4 trial, the mean change from baseline in MSCS score (primary endpoint) and mean TOS were both significantly greater in recipients of a single subcutaneous dose of ecallantide 30 mg than in placebo recipients. Subcutaneous ecallantide 30 mg was generally well tolerated in patients with acute attacks of HAE in the EDEMA3 and EDEMA4 trials. Adverse events were mostly of mild to moderate severity, and no event that was more common in ecallantide than placebo recipients occurred in >10% of patients. PMID:20614949

  18. Combination of scoring schemes for protein docking

    Schomburg Dietmar

    2007-08-01

    Full Text Available Abstract Background Docking algorithms are developed to predict in which orientation two proteins are likely to bind under natural conditions. The currently used methods usually consist of a sampling step followed by a scoring step. We developed a weighted geometric correlation based on optimised atom specific weighting factors and combined them with our previously published amino acid specific scoring and with a comprehensive SVM-based scoring function. Results The scoring with the atom specific weighting factors yields better results than the amino acid specific scoring. In combination with SVM-based scoring functions the percentage of complexes for which a near native structure can be predicted within the top 100 ranks increased from 14% with the geometric scoring to 54% with the combination of all scoring functions. Especially for the enzyme-inhibitor complexes the results of the ranking are excellent. For half of these complexes a near-native structure can be predicted within the first 10 proposed structures and for more than 86% of all enzyme-inhibitor complexes within the first 50 predicted structures. Conclusion We were able to develop a combination of different scoring schemes which considers a series of previously described and some new scoring criteria yielding a remarkable improvement of prediction quality.

  19. The emergence of Applied Physiology within the discipline of Physiology.

    Tipton, Charles M

    2016-08-01

    Despite the availability and utilization of the physiology textbooks authored by Albrecht von Haller during the 18th century that heralded the modern age of physiology, not all physicians or physiologists were satisfied with its presentation, contents, or application to medicine. Initial reasons were fundamental disagreements between the "mechanists," represented by Boerhaave, Robinson, and von Haller, and the "vitalists," represented by the faculty and graduates of the Montpellier School of Medicine in France, notably, Bordeu and Barthez. Subsequently, objections originated from Europe, United Kingdom, and the United States in publications that focused not only on the teaching of physiology to medical and secondary students, but on the specific applications of the content of physiology to medicine, health, hygiene, pathology, and chronic diseases. At the turn of the 20th century, texts began to appear with applied physiology in their titles and in 1926, physician Samson Wright published a textbook entitled Applied Physiology that was intended for both medical students and the medical profession. Eleven years later, physicians Best and Taylor published The Physiological Basis of Medical Practice: A University of Toronto Texbook in Applied Physiology Although both sets of authors defined the connection between applied physiology and physiology, they failed to define the areas of physiology that were included within applied physiology. This was accomplished by the American Physiological Society (APS) Publications Committee in 1948 with the publication of the Journal of Appplied Physiology, that stated the word "applied" would broadly denote human physiology whereas the terms stress and environment would broadly include work, exercise, plus industrial, climatic and social factors. NIH established a study section (SS) devoted to applied physiology in 1964 which remained active until 2001 when it became amalgamated into other SSs. Before the end of the 20th century when

  20. Control for Confounding in Case-Control Studies Using the Stratification Score, a Retrospective Balancing Score

    Allen, Andrew S.; Satten, Glen A.

    2011-01-01

    The stratification score for a case-control study is the probability of disease modeled as a function of potential confounders. The authors show that the stratification score is a retrospective balancing score and thus plays a similar role in case-control studies as the propensity score plays in prospective studies. The authors further show how standardization using the stratification score can be used to compare the distributions of exposures that would be found among case and control partic...

  1. Evaluation of EMLA cream for preventing pain during tattooing of rabbits: changes in physiological, behavioural and facial expression responses.

    Stephanie C J Keating

    Full Text Available BACKGROUND: Ear tattooing is a routine procedure performed on laboratory, commercial and companion rabbits for the purpose of identification. Although this procedure is potentially painful, it is usually performed without the provision of analgesia, so compromising animal welfare. Furthermore, current means to assess pain in rabbits are poor and more reliable methods are required. The objectives of this study were to assess the physiological and behavioural effects of ear tattooing on rabbits, evaluate the analgesic efficacy of topical local anaesthetic cream application prior to this procedure, and to develop a scale to assess pain in rabbits based on changes in facial expression. METHODOLOGY/PRINCIPAL FINDINGS: In a crossover study, eight New Zealand White rabbits each underwent four different treatments of actual or sham ear tattooing, with and without prior application of a topical local anaesthetic (lidocaine/prilocaine. Changes in immediate behaviour, heart rate, arterial blood pressure, serum corticosterone concentrations, facial expression and home pen behaviours were assessed. Changes in facial expression were examined to develop the Rabbit Grimace Scale in order to assess acute pain. Tattooing without EMLA cream resulted in significantly greater struggling behaviour and vocalisation, greater facial expression scores of pain, higher peak heart rate, as well as higher systolic and mean arterial blood pressure compared to all other treatments. Physiological and behavioural changes following tattooing with EMLA cream were similar to those in animals receiving sham tattoos with or without EMLA cream. Behavioural changes 1 hour post-treatment were minimal with no pain behaviours identifiable in any group. Serum corticosterone responses did not differ between sham and tattoo treatments. CONCLUSIONS: Ear tattooing causes transient and potentially severe pain in rabbits, which is almost completely prevented by prior application of local

  2. Gregorc learning styles and achievement in anatomy and physiology.

    Harasym, P H; Leong, E J; Lucier, G E; Lorscheider, F L

    1995-06-01

    Results from the Gregorc Style Delineator (GSD), administered to 260 undergraduate nursing students, were compared with achievement scores in a human anatomy and physiology course. Factor analysis and VARIMAX rotation demonstrate that there is no relationship between any of the four learning styles allegedly identified by the GSD and achievement in anatomy and physiology. Factor analysis also shows that the GSD measures only a single bipolar scale of sequential vs. random ability rather than two bipolar scales comprising four learning styles, as suggested by Gregorc. These findings question the validity of the GSD and recommend discontinuing its use as an indicator of learning styles. PMID:7598174

  3. Vasogenic shock physiology

    Sotiria Gkisioti

    2011-01-01

    Full Text Available Sotiria Gkisioti, Spyros D MentzelopoulosDepartment of Intensive Care Medicine, University of Athens Medical School, Evaggelismos General Hospital, Athens, GreeceAbstract: Shock means inadequate tissue perfusion by oxygen-carrying blood. In vasogenic shock, this circulatory failure results from vasodilation and/or vasoplegia. There is vascular hyporeactivity with reduced vascular smooth muscle contraction in response to α1 adrenergic agonists. Considering vasogenic shock, one can understand its utmost importance, not only because of its association with sepsis but also because it can be the common final pathway for long-lasting, severe shock of any cause, even postresuscitation states. The effective management of any patient in shock requires the understanding of its underlying physiology and pathophysiology. Recent studies have provided new insights into vascular physiology by revealing the interaction of rather complicated and multifactorial mechanisms, which have not been fully elucidated yet. Some of these mechanisms, such as the induction of nitric oxide synthases, the activation of adenosine triphosphate-sensitive potassium channels, and vasopressin deficiency, have gained general acceptance and are considered to play an important role in the pathogenesis of vasodilatory shock. The purpose of this review is to provide an update on the pathogenesis of vasogenic shock.Keywords: nitric oxide synthases, KATP channels, vasopressin, H2S, vasoplegic syndrome

  4. Assessment and comparison of student engagement in a variety of physiology courses.

    Hopper, Mari K

    2016-03-01

    Calls for reform in science education have promoted active learning as a means to improve student engagement (SENG). SENG is generally acknowledged to have a positive effect on student learning, satisfaction, and retention. A validated 14-question survey was used to assess SENG in a variety of upper- and lower-level physiology courses, including 100-level Anatomy and Physiology 1, 300-level Animal Physiology, 400-level Advanced Physiology, and 500-level Medical Physiology courses. The results indicated that SENG did not vary consistently by course level, format, or curriculum. The highest levels of SENG were found in the Advanced Physiology course, which included SENG as a primary objective of the course. Physiology student SENG scores were compared with National Survey of Student Engagement (NSSE) scores. The results demonstrated that physiology students enrolled in the Anatomy and Physiology 1 course reported lower levels of SENG than first-year students that completed the NSSE. Students enrolled in the Advanced Physiology course reported higher levels of SENG than fourth-year students that completed the NSSE. Assessment of SENG offers insights as to how engaged students are, identifies where efforts may best be applied to enhance SENG, and provides a baseline measure for future comparisons after targeted course modifications. PMID:26873893

  5. [The diagnostic scores for deep venous thrombosis].

    Junod, A

    2015-08-26

    Seven diagnostic scores for the deep venous thrombosis (DVT) of lower limbs are analyzed and compared. Two features make this exer- cise difficult: the problem of distal DVT and of their proximal extension and the status of patients, whether out- or in-patients. The most popular score is the Wells score (1997), modi- fied in 2003. It includes one subjective ele- ment based on clinical judgment. The Primary Care score 12005), less known, has similar pro- perties, but uses only objective data. The pre- sent trend is to associate clinical scores with the dosage of D-Dimers to rule out with a good sensitivity the probability of TVP. For the upper limb DVT, the Constans score (2008) is available, which can also be coupled with D-Dimers testing (Kleinjan). PMID:26502582

  6. Random Walk Picture of Basketball Scoring

    Gabel, Alan

    2011-01-01

    We present evidence, based on play-by-play data from all 6087 games from the 2006/07--2009/10 seasons of the National Basketball Association (NBA), that basketball scoring is well described by a weakly-biased continuous-time random walk. The time between successive scoring events follows an exponential distribution, with little memory between different scoring intervals. Using this random-walk picture that is augmented by features idiosyncratic to basketball, we account for a wide variety of statistical properties of scoring, such as the distribution of the score difference between opponents and the fraction of game time that one team is in the lead. By further including the heterogeneity of team strengths, we build a computational model that accounts for essentially all statistical features of game scoring data and season win/loss records of each team.

  7. Adjusting scoring matrices to correct overextended alignments

    Mills, Lauren J.; Pearson, William R.

    2013-01-01

    Motivation: Sequence similarity searches performed with BLAST, SSEARCH and FASTA achieve high sensitivity by using scoring matrices (e.g. BLOSUM62) that target low identity (33% identity). Adjusting the scoring matrix to reflect the identity of the homologous sequence can correct higher identity overextended alignment boundaries. In addition, the scoring matrix that produced a correct alignment could be reliably predicted based on the sequence identity seen in the original BLOSUM62 alignment....

  8. Programming Interactive Music Scores with INScore

    Fober, Dominique; Letz, Stéphane; Orlarey, Yann; Bevilacqua, Frédéric

    2013-01-01

    International audience INScore is an environment for the design of interactive music scores that includes an original event-based interaction system and a scripting language for associating arbitrary messages to these events. We extended the previous version by supporting scripting languages offering a great flexibility in the description of scores and in the interactions with scores. The textual format is directly derived from the OSC message format that was defined in the original INScor...

  9. A Quantitative Theory of Credit Scoring

    Xuan Tam; Eric Young; Kartik Athreya

    2013-01-01

    Starting in the early 1990s credit scoring became widespread and central in credit granting decisions. Credit scores are scalar representations of default risk. They are used, in turn, to price credit, and as a result alter household borrowing and default decisions. We build on recent work on defaultable consumer credit under asymmetric information to develop a quantitative theory of credit scores. We construct and solve a rich and quantitatively-disciplined lifecycle model of consumption in ...

  10. Motivation, test scores and economic success

    Segal, Carmit

    2006-01-01

    This paper argues that low-stakes test scores, available in surveys, may be partially determined by test-taking motivation, which is associated with personality traits but not with cognitive ability. Therefore, such test score distributions may not be informative regarding cognitive ability distributions. Moreover, correlations, found in survey data, between high test scores and economic success may be partially caused by favorable personality traits. To demonstrate these point...

  11. Consumer credit scoring: do situational circumstances matter?

    Avery, Robert B.; Paul S. Calem; Glenn B. Canner

    2004-01-01

    Although credit history scoring offers benefits to lenders and borrowers, failure to consider situational circumstances raises important statistical issues that may affect the ability of scoring systems to accurately quantify an individual's credit risk. Evidence from a national sample of credit reporting agency records suggests that failure to consider measures of local economic circumstances and individual trigger events when developing credit history scores can diminish the potential effec...

  12. Differentiation of human adipocytes at physiological oxygen levels results in increased adiponectin secretion and isoproterenol-stimulated lipolysis

    Famulla, Susanne; Schlich, Raphaela; Sell, Henrike; Eckel, Jürgen

    2012-01-01

    Adipose tissue (AT) hypoxia occurs in obese humans and mice. Acute hypoxia in adipocytes causes dysregulation of adipokine secretion with an increase in inflammatory factors and diminished adiponectin release. O2 levels in humans range between 3 and 11% revealing that conventional in vitro culturing at ambient air and acute hypoxia treatment (1% O2) are performed under non-physiological conditions. In this study, we mimicked physiological conditions by differentiating human primary adipocytes...

  13. Scoring Function Based on Weighted Residue Network

    Shan Chang

    2011-12-01

    Full Text Available Molecular docking is an important method for the research of protein-protein interaction and recognition. A protein can be considered as a network when the residues are treated as its nodes. With the contact energy between residues as link weight, a weighted residue network is constructed in this paper. Two weighted parameters (strength and weighted average nearest neighbors’ degree are introduced into this model at the same time. The stability of a protein is characterized by its strength. The global topological properties of the protein-protein complex are reflected by the weighted average nearest neighbors’ degree. Based on this weighted network model and these two parameters, a new docking scoring function is proposed in this paper. The scoring and ranking for 42 systems’ bound and unbounded docking results are performed with this new scoring function. Comparing the results obtained from this new scoring function with that from the pair potentials scoring function, we found that this new scoring function has a similar performance to the pair potentials on some items, and this new scoring function can get a better success rate. The calculation of this new scoring function is easy, and the result of its scoring and ranking is acceptable. This work can help us better understand the mechanisms of protein-protein interactions and recognition.

  14. On Almost Monge All Scores Matrices

    Carmel, Amir; Tsur, Dekel; Ziv-Ukelson, Michal

    2016-01-01

    The all scores matrix of a grid graph is a matrix containing the optimal scores of paths from every vertex on the first row of the graph to every vertex on the last row. This matrix is commonly used to solve diverse string comparison problems. All scores matrices have the Monge property, and this was exploited by previous works that used all scores matrices for solving various problems. In this paper, we study an extension of grid graphs that contain an additional set of edges, called bridges...

  15. A Scoring Criterion For Learning Chain Graphs

    Zhong Guo ZHENG; Jing XU; Xing Wei TONG

    2006-01-01

    A chain graph allows both directed and undirected edges, and contains the underlying mathematical properties of the two. An important method of learning graphical models is to use scoring criteria to measure how well the graph structures fit the data. In this paper, we present a scoring criterion for learning chain graphs based on the Kullback-Leibler distance. It is score equivalent, that is, equivalent chain graphs obtain the same score, so it can be used to perform model selection and model averaging.

  16. ACUTE PANCREATITIS - THE SEVERE FORM

    Ioana Grigoras

    2005-01-01

    (systemic inflammatory response. The inflammatory response is locally perpetuated by hypovolemia and pancreatic and intestinal hypoperfusion. The systemic inflammatory response is present in severe acute pancreatitis and along with tissue hypoperfusion promotes the development of multiple organ dysfunction/failure syndrome. The infection of the necrotic tissue occurs usually in the third week of evolution and is caused by enteric bacteria. The intestine plays a major role in the pathophysiology of acute pancreatitis. Diagnosis includes positive diagnosis, assessment of etiology and assessment of severity. Severity scoring systems, biological markers and imaging techniques are used to assess severity. The most used severity scoring systems are Ranson score, Imre score and Apache II score. TREATMENT: should be early instituted, aggressive, nonspecific, supportive and adapted to severity. Due to improvement in intensive care of severe forms, mortality decreased and the survival of fatal cases also increased (usual more than 3 weeks. CONCLUSIONS: In 80% of cases acute pancreatitis has a benign, self-limited evolution with favorable results of medical treatment. In 20% of cases systemic and/or local complication ensue – severe pancreatitis. Early recognition of severe forms is the cornerstone of therapeutic success. The patient should be admitted to Intensive Care Unit for clinical, laboratory and imaging monitoring and treatment. Early and aggressive correction of hypovolemia and hemodynamic optimization are crucial for initial survival. Infection prevention and control are crucial for later survival. Supportive therapy is essential for prevention/treatment of multiple organ dysfunction/failure syndrome. The surgical treatment should be performed in well defined circumstances with proper timing. Despite research mortality is still high (30-40% and increases to 80% in case of infected necrosis.

  17. Developmental stress can uncouple relationships between physiology and behaviour

    Careau, Vincent; Buttemer, William A.; Buchanan, Katherine L.

    2014-01-01

    Phenotypic correlations (rP) have frequently been observed between physiological and behavioural traits, and the nature of these associations has been shown to be modulated by a range of environmental stressors. Studies to date have examined the effects of acute stressors on physiology–behaviour interrelations, but the potential for permanent changes induced by exposure to stress during development remains unexplored. We exposed female zebra finches to dietary restriction during the nestling ...

  18. Venovenous extracorporeal membrane oxygenation in adult respiratory failure: Scores for mortality prediction.

    Hsin, Chun-Hsien; Wu, Meng-Yu; Huang, Chung-Chi; Kao, Kuo-Chin; Lin, Pyng-Jing

    2016-06-01

    Despite a potentially effective therapy for adult respiratory failure, a general agreement on venovenous extracorporeal membrane oxygenation (VV-ECMO) has not been reached among institutions due to its invasiveness and high resource usage. To establish consensus on the timing of intervention, large ECMO organizations have published the respiratory extracorporeal membrane oxygenation survival prediction (RESP) score and the ECMOnet score, which allow users to predict hospital mortality for candidates with their pre-ECMO presentations. This study was aimed to test the predictive powers of these published scores in a medium-sized cohort enrolling adults treated with VV-ECMO for acute respiratory failure, and develop an institutional prediction model under the framework of the 3 scores if a superior predictive power could be achieved. This retrospective study included 107 adults who received VV-ECMO for severe acute respiratory failure (a PaO2/FiO2 ratio failure assessment (SOFA) score before VV-ECMO. The predictive power of hospital mortality of each score was presented as the area under receiver-operating characteristic curve (AUROC). The multivariate logistic regression was used to develop an institutional prediction model. The surviving to discharge rate was 55% (n = 59). All of the 3 published scores had a real but poor predictive power of hospital mortality in this study. The AUROCs of RESP score, ECMOnet score, and SOFA score were 0.662 (P = 0.004), 0.616 (P = 0.04), and 0.667 (P = 0.003), respectively. An institutional prediction model was established from these score parameters and presented as follows: hospital mortality (Y) = -3.173 + 0.208 × (pre-ECMO SOFA score) + 0.148 × (pre-ECMO mechanical ventilation day) + 1.021 × (immunocompromised status). Compared with the 3 scores, the institutional model had a significantly higher AUROC (0.779; P failure. PMID:27336901

  19. The Role of Calcium Scoring in Coronary CTA

    N Shirvandehi

    2009-01-01

    Full Text Available "nCoronary artery disease is the single largest cause of mortality, and is implicated in one of every five deaths. Conventional risk factors fail to identify one third of deaths caused by CAD. The currently available screening tools for coronary artery disease include Framingham risk assessment, clinical examination, and stress testing. "nIt is of interest that most coronary events occur in the territory of coronary arteries that do not demonstrate prior high grade stenosis. "nComplications of atherosclerotic plaque such as rupture or erosion with subsequent thrombus formation are important events leading to acute coronary syndrome. "nMany different factors including plaque composition, hemodynamic, endothelial function, and blood thrombogenicity may influence which plaques lead to hemodynamically significant events. "nNonetheless, there is a strong relation between the extent of coronary plaque burden and the risk of coronary event. "nSince atherosclerosis is the only disease process associated with calcification of coronary arteries, the degree of coronary calcification as demonstrated by CT is predictive of the overall burden of atherosclerotic plaque. "nThe role of coronary calcium scoring in assessing the risk for future coronary events has been a subject of considerable controversy. It is most important to understand that an elevated burden of coronary calcium may not indicate the presence of significant coronary stenosis, but is associated with a higher risk of a coronary event. "nCalcium scoring is based on the identification of high density material within the coronary circulation on a noncontrast CTscan. Both the EBCT and MDCT have been used for the evaluation of coronary calcium. "nThe current literature suggests that MDCT is comparable to EBCT for coronary calcium screening. "nCalcium scoring is a simple test that should take no more than 5 minutes. A prospective ECG gated scan with 3 mm slice thickness is obtained from the level of

  20. CLINICAL STUDY ON ACUTE PANCREATITIS

    Suhaib Rehaman

    2015-07-01

    Full Text Available INTRODUCTION : Early diagnosis and severity evaluation on patients with acute pancreatitis are very important due to its potential morbidity and mortality. Given the wide spectrum of disease seen, the care of patients with pancreatitis must be highly individualized. Sev eral clinical, laboratory and radiologic factors and many scoring systems have been proposed for outcome prediction. AIMS AND OBJECTIVES: To study the symptomatology, clinical presentation and management in pancreatitis . To study the severity of acute panc reatitis according to Glasgow Scale . METHODS: Present study includes consecutive 38 patients hospitalized in CSI Holdsworth Memorial Hospital over the period of 2 years. All patients were thoroughly investigated and were stratified according to the Glasgow criteria. Data was collected on complications, investigations and interventions undertaken, outcome, duration of stay in hospital and ICU. STATISTICAL ANALYSIS USED: Descriptive, Chi square tests, Crosstabs (Contingency coefficient analysis . RESULTS : Mean age of presentation in our study was 43.1 years. There was a male predominance accounting for 68.4% compared to 31.6% females. Alcohol was the main etiological factor in about 50% of the patients. Sensitivity to S. amylase was about 100%. Accuracy of USG abdomen in diagnosing pancreatitis was about 88.5%. Ascitis was the commonest complication seen in 13.2%. Mean duration of hospital stay was 6.2 days. The patient were stratified according to Glasgow scoring system into mild (0 - 3 and severe (>3 panc reatitis. In our study 32 people were graded with mild pancreatitis, all improved and in 6 people who were graded with severe pancreatitis, 83.3 % improved and 2.6% expired because of complications. Test statistics showed Contingency coefficient 0.355 and P 0.019 (NS. CONCLUSION : Glasgow scoring system remains a valid predicting system for the outcome in patients with acute pancreatitis. It is simple easy to apply with

  1. Network Physiology reveals relations between network topology and physiological function

    Bashan, Amir; Kantelhardt, Jan W; Havlin, Shlomo; Ivanov, Plamen Ch; 10.1038/ncomms1705

    2012-01-01

    The human organism is an integrated network where complex physiologic systems, each with its own regulatory mechanisms, continuously interact, and where failure of one system can trigger a breakdown of the entire network. Identifying and quantifying dynamical networks of diverse systems with different types of interactions is a challenge. Here, we develop a framework to probe interactions among diverse systems, and we identify a physiologic network. We find that each physiologic state is characterized by a specific network structure, demonstrating a robust interplay between network topology and function. Across physiologic states the network undergoes topological transitions associated with fast reorganization of physiologic interactions on time scales of a few minutes, indicating high network flexibility in response to perturbations. The proposed system-wide integrative approach may facilitate the development of a new field, Network Physiology.

  2. Physiology for engineers applying engineering methods to physiological systems

    Chappell, Michael

    2016-01-01

    This book provides an introduction to qualitative and quantitative aspects of human physiology. It looks at biological and physiological processes and phenomena, including a selection of mathematical models, showing how physiological problems can be mathematically formulated and studied. It also illustrates how a wide range of engineering and physics topics, including electronics, fluid dynamics, solid mechanics and control theory can be used to describe and understand physiological processes and systems. Throughout the text there are introductions to measuring and quantifying physiological processes using both signal and imaging technologies. Physiology for Engineers describes the basic structure and models of cellular systems, the structure and function of the cardiovascular system, the electrical and mechanical activity of the heart and provides an overview of the structure and function of the respiratory and nervous systems. It also includes an introduction to the basic concepts and applications of reacti...

  3. Acute abdomen

    Acute abdomen may be connected with the injury of one of the internal organs, injury of large blood vessels, with the spreading of pains from some other area. It may also be a manifestation of systemic disease or poisoning. The main purposes of radiodiagnosis are: determination of the cause of clinical syndrome; determination of the localization and spreading of pathological changes in abdominal organs; finding out the character of complications. If the data of the ordinary roentgenological investiagtion and isn't complete, the computer tomography of abdominal and pelvic cavities is needed

  4. [Physiological behavior of Cantilever].

    Feeldman, I; Frugone, R; Vládilo, N T

    1990-11-01

    The prosthetic rehabilitation is common of the integral treatment of patients that integral treatment of patients that have lost one or several dental pieces as a consequence of periodontal diseases. It has been demonstrated that plural fixed prothesis to extention, plovide a distribution pattern and magnitude of favourable forces to the periodontal during the different functions of the stomathologic apparatus, that justify rehabilitation based to it patients periodontically affected. The physiological behaviour of cantilever was basically analized on report on different investigation studies performed on patients periodontically diminis hed treated with plural fixed prothesis of crossed are with two unit or bilateral vear cantilever units, dento supported or fixed in place on implants. It is important to emphasize that favourable results previously analized in base to this type of rehabilitation in its different varieties have been obtained through record done on patients in which considerations of indications, design and occlusion stability have been optimized. PMID:2075270

  5. Home geriatric physiological measurements

    In an ageing society, the elderly can be monitored with numerous physiological, physical and passive devices. Sensors can be installed in the home for continuous mobility assistance and unobtrusive disease prevention. This review presents several modern sensors, which improve the quality of life and assist the elderly, disabled people and their caregivers. The main concept of geriatric sensors is that they are capable of providing assistance without limiting or disturbing the subject's daily routine, giving him or her greater comfort, pleasure and well-being. Furthermore, this review includes associated technologies of wearable/implantable monitoring systems and the ‘smart-house’ project. This review concludes by discussing future challenges of the future aged society. (topical review)

  6. [The physiology of erection].

    Hora, M; Vozeh, F

    1997-06-12

    The majority of contemporary knowledge on the physiology of erection was assembled during the past thirty years. Today we consider erection as a multifactorial process. Mechanically it can be compared to an electromechanically controlled hydraulic system. Its function is conditioned by a number of mutually coordinated processes. As to nervous processes they include autonomous (parasympathetic and sympathetic) innervation, as well as somatic innervation (sensory and motor pathways). The control function is exerted by spinal as well as cerebral centres. As to mediators, in particular acetylcholine, nitrous oxide (NO) released from the endothelium are involved, noradrenaline, VIP (vasoactive intestinal polypeptide), CGRP (calcitonin gene-related peptide) and prostaglandins. The most important roles in the phase of erection are played by nitrous oxide and VIP. Erection can be either reflex erection, psychogenic or nocturnal or morning. It usually takes place in six stages (at rest, latent, the tumescence stage, complete erection, rigid erection and subsequently the stage of detumescence). Except for neurohumoral mechanisms an essential prerequisite for the development of erection are the arterial supply of the genital and the so-called venoocclusive mechanism. Erection takes the following course (simplified): erotogenic stimuli lead to the stimulation of the parasympathetic nerve-->vasodilating substances are released-->the s inusoids are filled with blood (tumescence stage)-->the venoocclusive mechanism starts to work: thus complete erection occurs. Then the contractions of the musculature of the perineum compress the proximal portions of the corpora cavernosa: this leads to rigid erection. Detumescence which occurs as a rule after ejaculation) is due to released noradrenaline (active stage) and the reduced tonus of the smooth muscles of the blood vessels (released endothelin and neuropeptide Y). Knowledge of the physiological mechanisms of erection made clinical

  7. Relating tumor score to hematology in green turtles with fibropapillomatosis in Hawaii

    Work, T.M.; Balazs, G.H.

    1999-01-01

    The relationship between hematologic status and severity of tumor affliction in green turtles (Chelonia mydas) with fibropapillomatosis (FP) was examined. During 1 wk periods in July 1997 and July 1998, we bled 108 free-ranging green turtles from Pala'au (Molokai, Hawaii, USA) where FP is endemic. Blood was analyzed for hematocrit, estimated total solids, total white blood cell (WBC) count and differential WBC count. Each turtle was assigned a subjective tumor score ranging from 0 (no visible external tumors) to 3 (heavily tumored) that indicated the severity of FP. There was a progressive increase in monocytes and a decrease in all other hematologic parameters except heterophils and total numbers of white blood cells as tumor score increased. These data indicate that tumor score can relate to physiologic status of green turtles afflicted with FP, and that tumor score is a useful field monitor of severity of FP in this species.

  8. Acute response of pig skin to irradiation with 12C-ions or 200 kV X-rays

    The acute response of pig skin to treatment with high energy carbon ions (plateau region) at the Gesellschaft fuer Schwerionenforschung (GSI, Darmstadt, Germany) was compared to changes after 200 kV X-irradiation. Carbon doses isoeffective to the X-ray doses were computed with a recently established model for calculation of the biological effect of heavy ions (1, 2). Clinical changes and physiological symptoms (blood flow, erythema, transepidermal water loss, skin hydration) were scored. The parameters analyzed were maximum and mean values of each symptom during days 24 to 70 post irradiation, and the quantal endpoints for the establishment of dose-effect curves were the median values of these. With exception of the maximum change in the red blood cell concentration (p12C-ions (plateau region) and may at least for epidermis be applied to treatment planning. (orig.)

  9. [Acute myocarditis].

    Combes, Alain

    2013-05-01

    Myocarditis is defined as inflammation of the myocardium accompanied by myocellular necrosis. Acute myocarditis must be considered in patients who present with recent onset of cardiac failure or arrhythmia. Fulminant myocarditis is a distinct entity characterized by sudden onset of severe congestive heart failure or cardiogenic shock, usually following a flu-like illness, parvovirus B19, human herpesvirus 6, coxsackievirus and adenovirus being the most frequently viruses responsible for the disease. Treatment of myocarditis remains largely supportive, since immunosuppression has not been proven to be beneficial for acute lymphocytic myocarditis. Trials of antiviral therapies, or immunostimulants such as interferons, suggest a potential therapeutic role but require further investigation. Lastly, early recognition of patients rapidly progressing to refractory cardiac failure and their immediate transfer to a medical-surgical center experienced in mechanical circulatory support is warranted. In this setting, ECMO should be the first-line mechanical assistance. For highly unstable patients, a Mobile Cardiac Assistance Unit, that rapidly travels to primary care hospitals with a portable ECMO system and hooks it up before refractory multiorgan failure takes hold, is the preferred option. PMID:23789482

  10. Bayesian Model Averaging for Propensity Score Analysis

    Kaplan, David; Chen, Jianshen

    2013-01-01

    The purpose of this study is to explore Bayesian model averaging in the propensity score context. Previous research on Bayesian propensity score analysis does not take into account model uncertainty. In this regard, an internally consistent Bayesian framework for model building and estimation must also account for model uncertainty. The…

  11. School Enrollment, Selection and Test Scores

    Filmer, Deon; Schady, Norbert

    2009-01-01

    There is a strong association between schooling attained and test scores in many settings. If this association is causal, one might expect that programs that increase school enrollment and attainment would also improve test scores. However, if there is self-selection into school based on expected gains, marginal children brought into school by such programs may be drawn disproportionately from ...

  12. The Scoring of Writing Samples: A Study.

    Cronnell, Bruce

    Although the design of the writing task itself may present assessment problems, the scoring of the piece of writing raises the greatest difficulties for large-scale testing of writing ability. A study investigated whether teachers and staff members of the Southwest Regional Laboratory (SWRL) (1) scored the same way, (2) agreed with each other in…

  13. Comparability of IQ scores over time

    O. Must; J. te Nijenhuis; A. Must; A.E.M. van Vianen

    2009-01-01

    This study investigates the comparability of IQ scores. Three cohorts (1933/36, 1997/98, 2006) of Estonian students (N = 2173) are compared using the Estonian National Intelligence Test. After 72 years the secular rise of the IQ test scores is.79 SD. The mean .16 SD increase in the last 8 years sugg

  14. Clinical scoring scales in thyroidology: A compendium

    Sanjay Kalra

    2011-01-01

    Full Text Available This compendium brings together traditional as well as contemporary scoring and grading systems used for the screening and diagnosis of various thyroid diseases, dysfunctions, and complications. The article discusses scores used to help diagnose hypo-and hyperthyroidism, to grade and manage goiter and ophthalmopathy, and to assess the risk of thyroid malignancy.

  15. Do Student Growth Scores Measure Academic Growth?

    Pomplun, Mark R.

    2009-01-01

    This study investigated convergent validity evidence for student growth scores with high school course grades. The Measures of Academic Progress and Educational Planning and Assessment System growth scores for approximately 1,800 ninth-grade students over 2 years were related to language, arts, and mathematics course grades for developmental,…

  16. On k-hypertournament losing scores

    Pirzada, Shariefuddin

    2010-01-01

    We give a new and short proof of a theorem on k-hypertournament losing scores due to Zhou et al. [G. Zhou, T. Yao, K. Zhang, On score sequences of k-tournaments, European J. Comb., 21, 8 (2000) 993-1000.

  17. 24 CFR 902.63 - PHAS scoring.

    2010-04-01

    ... audit firm that will perform the audit of the PHA and may serve as the audit committee for the audit in... indicators. (b) Adjustments to the PHAS score. (1) Adjustments to the score may be made after a PHA's audit... changed by HUD in accordance with data included in the independent audit report, or obtained through...

  18. Validation of Automated Scoring of Oral Reading

    Balogh, Jennifer; Bernstein, Jared; Cheng, Jian; Van Moere, Alistair; Townshend, Brent; Suzuki, Masanori

    2012-01-01

    A two-part experiment is presented that validates a new measurement tool for scoring oral reading ability. Data collected by the U.S. government in a large-scale literacy assessment of adults were analyzed by a system called VersaReader that uses automatic speech recognition and speech processing technologies to score oral reading fluency. In the…

  19. RECURRENT SEASONAL ACUTE PSYCHOSIS

    Agarwal, Vivek

    1999-01-01

    Acute psychoses have been reported to occur more frequently in summer. This is a report of seasonal recurrence of acute psychosis in a patient. This case report emphasizes towards the biological etiology of acute psychoses.

  20. Acute cerebellar ataxia

    Cerebellar ataxia; Ataxia - acute cerebellar; Cerebellitis; Post-varicella acute cerebellar ataxia; PVACA ... Acute cerebellar ataxia in children, especially younger than age 3, may occur several weeks after an illness caused by a virus. ...

  1. EFFECTS OF ACUTE THERMAL STRESS ON HSP70 MRNA, PHYSIOLOGY AND NONSPECIFIC IMMUNITY IN SIBERIAN STURGEON (ACIPENSER BAERII)%急性热应激对西伯利亚鲟HSP70mRNA表达、血清皮质醇和非特异性免疫的影响

    田照辉; 徐绍刚; 王巍; 胡红霞; 马国庆

    2013-01-01

    The effect of acute thermal stress on HSP1Q mRNA expression, physiology and nonspecific immunity were investigated in Siberian sturgeon. In the experiment, ten fish were transferred froml7.5℃ to 27.5℃ water, then data were measured at lh and 3h. Fish in 17.5℃ water were taken as Oh group. Respiratory rate increased from 80-90 breaths/min to 210 breaths/min, then decreased to 180 breaths/min after 0.5h. Among the three tissues including gill, spleen and brain, the HSP70 mRNA expression in gill rose most quickly after lh stress, and was about 1.63 fold compared with the Oh group (P<0.05), then remained this level to 3h; The HSP10 mRNA expression in spleen and brain had nearly no change in lh thermal stress, then rose quickly from lh to 3h in the two tissues, especially in brain at 3h rose most quickly to about 1.77 fold compared with the lh group (P<0.05). Compared with the Oh group, serum cortisol increased quickly and was 5.14 fold (PO.05) at lh, then decreased quickly to 2.1 fold at 3h. Spleen macrophage respiratory burst achieved the maximum (P<0.05) at lh, then reduced to the Oh group level. Serum complement C3 increased at lh and decreased significantly at 3h (P<0.05). Serum lysozyme activity firstly elevated then decreased but had no significant differences. Serum SOD activity decreased when thermal stress time prolonged, and achieved the minimum at 3h (P<0.05). Serum MDA content decreased when thermal stress time prolonged and had no significant difference. The results showed that lh acute thermal stress promoted the nonspecific immunity and tolerance, but 3h acute thermal stress decreased it.%为研究西伯利亚鲟(Acipenser baerii)对急性热应激的抗逆机理,将体质量为(155.47±19.50) g的鱼从17.5 ℃迅速转至27.5 ℃水中,在1h和3h取样测定HSP70 mRNA表达变化、血清皮质醇和非特异性免疫指标.结果显示:急性热应激时鳃、脾和脑的HSP70 mRNA表达量升高,具有组织特异性,热应激1h时

  2. Evaluation of POSSUM scoring system in the treatment of osteoporotic fracture of the hip in elder patients

    WANG Tie-jun; ZHANG Bo-hao; GU Gui-shan

    2008-01-01

    To evaluate the applicability of the modified physiological and operative severity score for enumeration of mortality and morbidity(POSSUM)scoring system in predicting mortality in the patients undergoing hip joint arthroplasty.Methods:A total of 295 patients with hip fractures were analyzed using the modified POSSUM surgical scoring system. The mean ages of the patients were 66.59 years in the complicative group,62.28 years in noncomplicative group,77.89 years in the death group and 63.25 years in the living group,respectively. The comparisons between the observed and predicted morbidity,between the observed and predicted mortality were made within 30 days after operation.Results:The average physiological scores and operative severity scores was 18.96±4.83 and 13.47±2.01 in compticative group, while 15.65±3.66 and 11.74±2.26 in noncomplicative group(P<0.05).The average physiological scores and operative severity scores was 25.56±3.78 and 14.22±0.67 in death group,while 16.46±4.09 and 12.25 ±2.33 in living group (P<0.05).Though POSSUM scoring system over-predicted the overall risk of death,its estimate was very close in the high risk groups(>10%). There was perfect consistence between the observed and the predicted morbidity as calculated by published predictor equation for morbidity,and consistence for mortality in the high risk band.Conclusions:Modified POSSUM scoring system may be used to predict the morbidity in patients with hip fracture.Furthermore,POSSUM scoring system overpredicts the overall risk of death, but its estimate iS close to the actual data in the high risk band(>10%).

  3. Intermittent Noise Induces Physiological Stress in a Coastal Marine Fish.

    Tye A Nichols

    Full Text Available Anthropogenic noise in the ocean has increased substantially in recent decades, and motorized vessels produce what is likely the most common form of underwater noise pollution. Noise has the potential to induce physiological stress in marine fishes, which may have negative ecological consequences. In this study, physiological effects of increased noise (playback of boat noise recorded in the field on a coastal marine fish (the giant kelpfish, Heterostichus rostratus were investigated by measuring the stress responses (cortisol concentration of fish to increased noise of various temporal dynamics and noise levels. Giant kelpfish exhibited acute stress responses when exposed to intermittent noise, but not to continuous noise or control conditions (playback of recorded natural ambient sound. These results suggest that variability in the acoustic environment may be more important than the period of noise exposure for inducing stress in a marine fish, and provide information regarding noise levels at which physiological responses occur.

  4. Validity and Reliability of the Achilles Tendon Total Rupture Score

    Ganestam, Ann; Barfod, Kristoffer; Klit, Jakob;

    2013-01-01

    The best treatment of acute Achilles tendon rupture remains debated. Patient-reported outcome measures have become cornerstones in treatment evaluations. The Achilles tendon total rupture score (ATRS) has been developed for this purpose but requires additional validation. The purpose of the present...... study was to validate a Danish translation of the ATRS. The ATRS was translated into Danish according to internationally adopted standards. Of 142 patients, 90 with previous rupture of the Achilles tendon participated in the validity study and 52 in the reliability study. The ATRS showed moderately...... strong correlations with the physical subscores of the Medical Outcomes Study 36-item Short-Form Health Survey (r = .70 to .75; p <.0001) and Victorian Institute of Sports Assessment-Achilles questionnaire (r = .71; p <.0001). Test-retest of the ATRS showed no significant difference in the mean (2.41; p...

  5. Functional neural correlates of reduced physiological falls risk

    Hsu Chun

    2011-08-01

    Full Text Available Abstract Background It is currently unclear whether the function of brain regions associated with executive cognitive processing are independently associated with reduced physiological falls risk. If these are related, it would suggest that the development of interventions targeted at improving executive neurocognitive function would be an effective new approach for reducing physiological falls risk in seniors. Methods We performed a secondary analysis of 73 community-dwelling senior women aged 65 to 75 years old who participated in a 12-month randomized controlled trial of resistance training. Functional MRI data were acquired while participants performed a modified Eriksen Flanker Task - a task of selective attention and conflict resolution. Brain volumes were obtained using MRI. Falls risk was assessed using the Physiological Profile Assessment (PPA. Results After accounting for baseline age, experimental group, baseline PPA score, and total baseline white matter brain volume, baseline activation in the left frontal orbital cortex extending towards the insula was negatively associated with reduced physiological falls risk over the 12-month period. In contrast, baseline activation in the paracingulate gyrus extending towards the anterior cingulate gyrus was positively associated with reduced physiological falls risk. Conclusions Baseline activation levels of brain regions underlying response inhibition and selective attention were independently associated with reduced physiological falls risk. This suggests that falls prevention strategies may be facilitated by incorporating intervention components - such as aerobic exercise - that are specifically designed to induce neurocognitive plasticity. Trial Registration ClinicalTrials.gov Identifier: NCT00426881

  6. Influence of scoring parameter settings on Agatston and volume scores for coronary calcification

    van Ooijen, PMA; Vliegenthart, R; Witteman, JCM; Oudkerk, M

    2005-01-01

    Current multi-detector CT and electron beam tomography (EBT) technology enables the evaluation of coronary calcification. Multiple software packages are available to quantify calcification using several scoring algorithms implementing user-definable scoring parameters. We investigated the effect of

  7. Physiological genomics analysis for Alzheimer's disease.

    Wiwanitkit, Viroj

    2013-01-01

    Alzheimer's disease is a common kind of dementia. This disorder can be detected in all countries around the world. This neurological disorder affects millions of population and becomes an important concern in modern neurology. There are many researches on the pathogenesis of Alzheimer's disease. Although it has been determined for a long time, there is no clear-cut that this is a case with genetic disorder or not. A physiological genomics is a new application that is useful for track function to genes within the human genome and can be applied for answering the problem of underlying pathobiology of complex diseases. The physiogenomics can be helpful for study of systemic approach on the pathophysiology, and genomics might provide useful information to better understand the pathogenesis of Alzheimer's disease. The present advent in genomics technique makes it possible to trace for the underlying genomics of disease. In this work, physiological genomics analysis for Alzheimer's disease was performed. The standard published technique is used for assessment. According to this work, there are 20 identified physiogenomics relationship on several chromosomes. Considering the results, the HADH2 gene on chromosome X, APBA1 gene on chromosome 9, AGER gene on chromosome 6, GSK3B gene on chromosome 3, CDKHR1 gene on chromosome 17, APPBP1 gene on chromosome 16, APBA2 gene on chromosome 15, GAL gene on chromosome 11, and APLP2 gene on chromosome 11 have the highest physiogenomics score (9.26) while the CASP3 gene on chromosome 4 and the SNCA gene on chromosome 4 have the lowest physiogenomics score (7.44). The results from this study confirm that Alzheimer's disease has a polygenomic origin. PMID:23661967

  8. Acute pancreatitis in children and adolescents

    Mitsuyoshi; Suzuki; Jin; Kan; Sai; Toshiaki; Shimizu

    2014-01-01

    In this Topic Highlight, the causes, diagnosis, and treat-ment of acute pancreatitis in children are discussed. Acute pancreatitis should be considered during the dif-ferential diagnosis of abdominal pain in children and requires prompt treatment because it may become life-threatening. The etiology, clinical manifestations, and course of acute pancreatitis in children are often differ-ent than in adults. Therefore, the specific features of acute pancreatitis in children must be considered. The etiology of acute pancreatitis in children is often drugs, infections, trauma, or anatomic abnormalities. Diagnosis is based on clinical symptoms(such as abdominal pain and vomiting), serum pancreatic enzyme levels, and im-aging studies. Several scoring systems have been pro-posed for the assessment of severity, which is useful for selecting treatments and predicting prognosis. The basic pathogenesis of acute pancreatitis does not greatly dif-fer between adults and children, and the treatments for adults and children are similar. In large part, our under-standing of the pathology, optimal treatment, assess-ment of severity, and outcome of acute pancreatitis in children is taken from the adult literature. However, we often find that the common management of adult pan-creatitis is difficult to apply to children. With advances in diagnostic techniques and treatment methods, severeacute pancreatitis in children is becoming better under-stood and more controllable.

  9. Physiology of vitreous surgery.

    Stefánsson, Einar

    2009-02-01

    Vitreous surgery has various physiological and clinical consequences, both beneficial and harmful. Vitrectomy reduces the risk of retinal neovascularization, while increasing the risk of iris neovascularization, reduces macular edema and stimulates cataract formation. These clinical consequences may be understood with the help of classical laws of physics and physiology. The laws of Fick, Stokes-Einstein and Hagen-Poiseuille state that molecular transport by diffusion or convection is inversely related to the viscosity of the medium. When the vitreous gel is replaced with less viscous saline, the transport of all molecules, including oxygen and cytokines, is facilitated. Oxygen transport to ischemic retinal areas is improved, as is clearance of VEGF and other cytokines from these areas, thus reducing edema and neovascularization. At the same time, oxygen is transported faster down a concentration gradient from the anterior to the posterior segment, while VEGF moves in the opposite direction, making the anterior segment less oxygenated and with more VEGF, stimulating iris neovascularization. Silicone oil is the exception that proves the rule: it is more viscous than vitreous humour, re-establishes the transport barrier to oxygen and VEGF, and reduces the risk for iris neovascularization in the vitrectomized-lentectomized eye. Modern vitreous surgery involves a variety of treatment options in addition to vitrectomy itself, such as photocoagulation, anti-VEGF drugs, intravitreal steroids and release of vitreoretinal traction. A full understanding of these treatment modalities allows sensible combination of treatment options. Retinal photocoagulation has repeatedly been shown to improve retinal oxygenation, as does vitrectomy. Oxygen naturally reduces VEGF production and improves retinal hemodynamics. The VEGF-lowering effect of photocoagulation and vitrectomy can be augmented with anti-VEGF drugs and the permeability effect of VEGF reduced with corticosteroids

  10. Building a Patient-Specific Risk Score with a Large Database of Discharge Summary Reports.

    Qu, Zhi; Zhao, Lue Ping; Ma, Xiemin; Zhan, Siyan

    2016-01-01

    BACKGROUND There is increasing interest in clinical research with electronic medical data, but it often faces the challenges of heterogeneity between hospitals. Our objective was to develop a single numerical score for characterizing such heterogeneity via computing inpatient mortality in treating acute myocardial infarction (AMI) patients based on diagnostic information recorded in the database of Discharge Summary Reports (DSR). MATERIAL AND METHODS Using 4 216 135 DSRs of 49 tertiary hospitals from 2006 to 2010 in Beijing, more than 200 secondary diagnoses were identified to develop a risk score for AMI (n=50 531). This risk score was independently validated with 21 571 DSRs from 65 tertiary hospitals in 2012. The c-statistics of new risk score was computed as a measure of discrimination and was compared with the Charlson comorbidity index (CCI) and its adaptions for further validation. RESULTS We finally identified and weighted 22 secondary diagnoses using a logistic regression model. In the external validation, the novel risk score performed better than the widely used CCI in predicting in-hospital mortality of AMI patients (c-statistics: 0.829, 0.832, 0.824 vs. 0.775, 0.773, and 0.710 in training, testing, and validating dataset, respectively). CONCLUSIONS The new risk score developed from DSRs outperform the existing administrative data when applied to healthcare data from China. This risk score can be used for adjusting heterogeneity between hospitals when clinical data from multiple hospitals are included. PMID:27318825

  11. Acute Myopericarditis Mimicking Acute Myocardial Infarction

    Seval İzdeş; Neriman Defne Altıntaş; Gülin Karaaslan; Recep Uygun; Abdulkadir But

    2011-01-01

    Acute coronary syndromes among young adults are relatively low when compared with older population in the intensive care unit. Electrocardiographic abnormalities mimicking acute coronary syndromes may be caused by non-coronary syndromes and the differential diagnosis requires a detailed evaluation. We are reporting a case of myopericarditis presenting with acute ST elevation and elevated cardiac enzymes simulating acute coronary syndrome. In this case report, the literature is reviewed to dis...

  12. DOSHIC PHYSIOLOGY OF SKIN

    Shivprasad Chiplunkar

    2013-06-01

    Full Text Available The balance of dosha  represents the healthy state and imbalance will cause various diseases. In normalcy doshas will be performing their own functions and individual doshas will be having their own specific sites. By telling the various sthana of each dosha, different function that is taken up by individual dosha in different sites has been highlighted.By mentioning ‘sparshanendriyam’ as one of the sthana of vata dosha the sensory functions of skin to vata dosha has been emphasised. By mentioning ‘sparshanam’ as one of the sthana of pittadosha, the function of colouring/pigmentation of skin, which is majorly carried out  by melanocytes by secreting melanin pigment has been highlighted. Meda is one among the sthanas of kapha dosha; this can be considered as the adipose tissue of skin/below skin. Since sweda is mala of meda it can be also considered as the secretions from the eccrine glands.With respect to skin, sensory functions, both tactile and thermal is carried out by vata dosha more specifically vyana vata, pigmentation to the skin carried out by meloncytes by secreting melanin, it is nothing but function of pitta dosha more specifically brajaka pitta with the help of udana vata and finally production of sweat in sweat glands is the function of kapha. So there is the need for further study and research regarding the sthanas of all three doshas in different structures/organs in the body and its physiology.

  13. Polyamines in plant physiology

    Galston, A. W.; Sawhney, R. K.

    1990-01-01

    The diamine putrescine, the triamine spermidine, and the tetramine spermine are ubiquitous in plant cells, while other polyamines are of more limited occurrence. Their chemistry and pathways of biosynthesis and metabolism are well characterized. They occur in the free form as cations, but are often conjugated to small molecules like phenolic acids and also to various macromolecules. Their titer varies from approximately micromolar to more than millimolar, and depends greatly on environmental conditions, especially stress. In cereals, the activity of one of the major polyamine biosynthetic enzymes, arginine decarboxylase, is rapidly and dramatically increased by almost every studied external stress, leading to 50-fold or greater increases in putrescine titer within a few hours. The physiological significance of this increase is not yet clear, although most recent work suggests an adaptive, protective role. Polyamines produced through the action of ornithine decarboxylase, by contrast, seem essential for DNA replication and cell division. The application of exogenous polyamines produces effects on patterns of senescence and morphogenesis, suggesting but not proving a regulatory role for polyamines in these processes. The evidence for such a regulatory role is growing.

  14. Physiology in Modelica

    Marek Mateják

    2014-05-01

    Full Text Available Modelica is an object-oriented language, in which models can be created and graphically represented by connecting instances of classes from libraries. These connections are not only assignments of values; they can also represent acausal equality. Even more, they can model Kirchhoff’s laws of circuits. In Modelica it is possible to develop library classes which are an analogy of electrical circuit components. The result of our work in this field is Physiolibrary (www.physiolibrary.org – a free, open-source Modelica library for human physiology. By graphical joining instances of Physiolibrary classes, user can create models of cardiovascular circulation, thermoregulation, metabolic processes, nutrient distribution, gas transport, electrolyte regulation, water distribution, hormonal regulation and pharmacological regulation. After simple setting of the parameters, the models are ready to simulate. After simulation, the user can examine variables as their values change over time. Representing the model as a diagram has also great educational advantages, because students are able to better understand physical principles when they see them modeled graphically.

  15. Lung physiology and anatomy

    This paper discusses the factors influencing respiration and presents the physiological principles that provide the basis for pulmonary function measurements and for the procedures used in pulmonary nuclear medicine. Respiration is defined as the consumption of O/sub 2/ and the production of CO/sub 2/ at the cellular level, and by extension in common usage the term refers to the entire process leading to gas exchange between the body and the environment. Gas exchange in man can be divided into three principal, but interdependent, functional components: (1) that concerned with the volume and and distribution of air flow within the lungs; (2) that concerned with the volume and distribution of blood flow through the pulmonary circulation; and (3) that concerned with the diffusion of O/sub 2/ and CO/sub 2/ across the air-blood barrier. The air-blood barrier in the terminal respiratory units is the site at which inspired fresh air (ventilation) is brought into contact with the film of blood flowing through the pulmonary capillaries (perfusion)

  16. THE EFFICIENCY OF TENNIS DOUBLES SCORING SYSTEMS

    Geoff Pollard

    2010-09-01

    Full Text Available In this paper a family of scoring systems for tennis doubles for testing the hypothesis that pair A is better than pair B versus the alternative hypothesis that pair B is better than A, is established. This family or benchmark of scoring systems can be used as a benchmark against which the efficiency of any doubles scoring system can be assessed. Thus, the formula for the efficiency of any doubles scoring system is derived. As in tennis singles, one scoring system based on the play-the-loser structure is shown to be more efficient than the benchmark systems. An expression for the relative efficiency of two doubles scoring systems is derived. Thus, the relative efficiency of the various scoring systems presently used in doubles can be assessed. The methods of this paper can be extended to a match between two teams of 2, 4, 8, …doubles pairs, so that it is possible to establish a measure for the relative efficiency of the various systems used for tennis contests between teams of players.

  17. Acute MRI changes in progressive ischemic stroke

    Kalowska, E.; Rostrup, E.; Rosenbaum, S.;

    2008-01-01

    aimed to assess if acute MRI findings could be used for the prediction of stroke in progression (SIP). METHODS: Prospectively 41 patients, 13 with lacunar infarcts and 28 with territorial infarcts, were admitted to an acute stroke unit within 24 h of stroke onset (median 11 h, range 3- 22). Diffusion...... the modified Rankin Scale, Barthel Index and SSS score. Patients with and without SIP were compared using both clinical and MRI data obtained on admission, on day 7 and after 3 months. RESULTS: Fifteen patients (37%) developed SIP. Increased DWI lesion volume on day 7 in all strokes was associated...

  18. Acute MRI Changes in Progressive Ischemic Stroke

    Kalowska, Elizabeth; Rostrup, Egill; Rosenbaum, S;

    2008-01-01

    aimed to assess if acute MRI findings could be used for the prediction of stroke in progression (SIP). Methods: Prospectively 41 patients, 13 with lacunar infarcts and 28 with territorial infarcts, were admitted to an acute stroke unit within 24 h of stroke onset (median 11 h, range 3- 22). Diffusion...... the modified Rankin Scale, Barthel Index and SSS score. Patients with and without SIP were compared using both clinical and MRI data obtained on admission, on day 7 and after 3 months. Results: Fifteen patients (37%) developed SIP. Increased DWI lesion volume on day 7 in all strokes was associated...

  19. Metabolic Acidosis and Strong Ion Gap in Critically Ill Patients with Acute Kidney Injury

    Cai-Mei Zheng

    2014-01-01

    Full Text Available Purpose. To determine the influence of physicochemical parameters on survival in metabolic acidosis (MA and acute kidney injury (AKI patients. Materials and Methods. Seventy-eight MA patients were collected and assigned to AKI or non-AKI group. We analyzed the physiochemical parameters on survival at 24 h, 72 h, 1 week, 1 month, and 3 months after AKI. Results. Mortality rate was higher in the AKI group. AKI group had higher anion gap (AG, strong ion gap (SIG, and apparent strong ion difference (SIDa values than non-AKI group. SIG value was higher in the AKI survivors than nonsurvivors and this value was correlated serum creatinine, phosphate, albumin, and chloride levels. SIG and serum albumin are negatively correlated with Acute Physiology and Chronic Health Evaluation IV scores. AG was associated with mortality at 1 and 3 months post-AKI, whereas SIG value was associated with mortality at 24 h, 72 h, 1 week, 1 month, and 3 months post-AKI. Conclusions. Whether high or low SIG values correlate with mortality in MA patients with AKI depends on its correlation with serum creatinine, chloride, albumin, and phosphate (P levels. AG predicts short-term mortality and SIG value predicts both short- and long-term mortality among MA patients with AKI.

  20. Accuracy of Ultrasonography in Diagnosing Acute Appendicitis

    Parisa Javidi Parsijani; Nima Pourhabibi Zarandi; Shahram Paydar; Hamidreza Abbasi; Shahram Bolandparvaz

    2013-01-01

    Objectives: To evaluate the accuracy of sonography in diagnosing acute appendicitis in patients with Alvarado score 4–7.Methods: This is a retrospective cross-sectional study being performed in Namazee hospital affiliated with Shiraz University of Medical sciences during a one year period from 9/2007 to 9/2008. We evaluated all patients with Alvarado score 4-7 and divided them in two groups: those with Ultrasound study prior to surgery and those without any imaging modalities for diagnosis of...

  1. Frailty score on admission predicts outcomes in elderly burn injury.

    Romanowski, Kathleen S; Barsun, Alura; Pamlieri, Tina L; Greenhalgh, David G; Sen, Soman

    2015-01-01

    With longer life expectancy, the number of burn injuries in the elderly continues to increase. Prediction of outcomes for the elderly is complicated by preinjury physical fitness and comorbid illness. The authors hypothesize that admission frailty assessment would be predictive of outcomes in the elderly burn population. Our primary aim was to determine if higher frailty scores were associated with higher risk of mortality for elderly burn patients. The secondary aims were to assess if higher frailty scores were associated with increased length of stay, increased needs for mechanical ventilation and poor discharge disposition. A 2-year retrospective chart review was performed of all admitted acute burn patients 65 years or older. Data collected included: age, gender, %TBSA of burn injury, presence of inhalation injury, in hospital mortality, hospital length of stay, ventilator days, ICU length of stay, surgical procedures, insurance status, and discharge disposition. Frailty scores were assessed from admission data and calculated using the Canadian Study of Health and Aging clinical frailty scale. A total of 89 patients met entry criteria. Mean age was 75.3 ± 8.1 years and consisted of 62 men and 27 women. Mean %TBSA was 9.6 ± 9.1% and mean frailty score (FS) was 4.5 ± 1.2. Eighty patients survived to discharge and nine died. Nonsurvivors had significantly higher FS compared to survivors (5.2 ± 1.2 vs 4.4 ± 1.2). FS were also significantly higher in patients discharged to skilled nursing facilities (SNF) (5.34 ± 0.9) compared to those who were discharged home (4.1 ± 1.2) or to physical rehabilitation facilities (4 ± 1.5). Multivariate linear regression analysis revealed that age (B = 0.04) and discharge to SNF (B = 1.2) are independently associated with higher FS. However, survivors were independently associated with a significantly lower FS (B = -1.3). Multivariate logistic regression analysis revealed high admission FS independently increased the risk of

  2. Pre-operative risk scores for the prediction of outcome in elderly people who require emergency surgery

    Bates Tom

    2007-06-01

    Full Text Available Abstract Background The decision on whether to operate on a sick elderly person with an intra-abdominal emergency is one of the most difficult in general surgery. A predictive risk-score would be of great value in this situation. Methods A Medline search was performed to identify those predictive risk-scores relevant to sick elderly patients in whom emergency surgery might be life-saving. Results Many of the risk scores for surgical patients include the operative findings or require tests which are not available in the acute situation. Most of the relevant studies include younger patients and elective surgery. The Glasgow Aneurysm Score and Hardman Index are specific to ruptured aortic aneurysm while the Boey Score and the Hacetteppe Score are specific to perforated peptic ulcer. The Reiss Index and Fitness Score can be used pre-operatively if the elements of the score can be completed in time. The ASA score, which includes a significant element of subjective clinical judgement, can be augmented with factors such as age and urgency of surgery but no test has a negative predictive value sufficient to recommend against surgical intervention without clinical input. Conclusion Risk scores may be helpful in sick elderly patients needing emergency abdominal surgery but an experienced clinical opinion is still essential.

  3. Deriving stress from peripheral physiology

    De Vries, J.J.G.; Van Dooren, M.; Van Beek, W.H.M.; Dijk, E.O.; Ouwerkerk, M.; Westerink, J.H.D.

    2012-01-01

    Objectives We set up an experiment to explore whether peripheral physiological parameters are capable of reflecting human (short term) stress. Methods For 30 participants, we measured peripheral physiology (SCR, ECG, RSP, TEMP, EMG) during several tasks (3 relaxing, 3 physically stressful, 3 mental

  4. Non-invasive physiological measurements

    This book discusses the diagnostic techniques of nondestructive type for monitoring the physiology of various organ systems. The topics covered are: non-invasive assessment of gastric activity; uterine activity, intestinal activity; monitoring of fetal cardiovascular system and bilirubin physiology of infants. Respiratory system of infants is monitored and ultrasonography of heart is discussed

  5. Endocan Levels in Peripheral Blood Predict Outcomes of Acute Respiratory Distress Syndrome

    Ling Tang

    2014-01-01

    Full Text Available Purpose. To investigate the prognostic significance of endocan, compared with procalcitonin (PCT, C-reactive protein (CRP,white blood cells (WBC, neutrophils (N, and clinical severity scores in patients with ARDS. Methods. A total of 42 patients with ARDS were initially enrolled, and there were 20 nonsurvivors and 22 survivors based on hospital mortality. Plasma levels of biomarkers were measured and the acute physiology and chronic health evaluation II (APACHE II was calculated on day 1 after the patient met the defining criteria of ARDS. Results. Endocan levels significantly correlated with the APACHE II score in the ARDS group (r=0.676, P=0.000, n=42. Of 42 individuals with ARDS, 20 were dead, and endocan was significantly higher in nonsurvivors than in survivors (median (IQR 5.01 (2.98–8.44 versus 3.01 (2.36–4.36 ng/mL, P=0.017. According to the results of the ROC-curve analysis and COX proportional hazards models, endocan can predict mortality of ARDS independently with a hazard ratio of 1.374 (95% CI, 1.150–1.641 and an area of receiver operator characteristic curve (AUROC of 0.715 (P=0.017. Moreover, endocan can predict the multiple-organ dysfunction of ARDS. Conclusion. Endocan is a promising biomarker to predict the disease severity and mortality in patients with ARDS.

  6. Causality in physiological signals.

    Müller, Andreas; Kraemer, Jan F; Penzel, Thomas; Bonnemeier, Hendrik; Kurths, Jürgen; Wessel, Niels

    2016-05-01

    Health is one of the most important non-material assets and thus also has an enormous influence on material values, since treating and preventing diseases is expensive. The number one cause of death worldwide today originates in cardiovascular diseases. For these reasons the aim of understanding the functions and the interactions of the cardiovascular system is and has been a major research topic throughout various disciplines for more than a hundred years. The purpose of most of today's research is to get as much information as possible with the lowest possible effort and the least discomfort for the subject or patient, e.g. via non-invasive measurements. A family of tools whose importance has been growing during the last years is known under the headline of coupling measures. The rationale for this kind of analysis is to identify the structure of interactions in a system of multiple components. Important information lies for example in the coupling direction, the coupling strength, and occurring time lags. In this work, we will, after a brief general introduction covering the development of cardiovascular time series analysis, introduce, explain and review some of the most important coupling measures and classify them according to their origin and capabilities in the light of physiological analyses. We will begin with classical correlation measures, go via Granger-causality-based tools, entropy-based techniques (e.g. momentary information transfer), nonlinear prediction measures (e.g. mutual prediction) to symbolic dynamics (e.g. symbolic coupling traces). All these methods have contributed important insights into physiological interactions like cardiorespiratory coupling, neuro-cardio-coupling and many more. Furthermore, we will cover tools to detect and analyze synchronization and coordination (e.g. synchrogram and coordigram). As a last point we will address time dependent couplings as identified using a recent approach employing ensembles of time series. The

  7. The relationship between patient physiology, the systemic inflammatory response and survival in patients undergoing curative resection of colorectal cancer

    Richards, C H; Leitch, E F; Horgan, P G; Anderson, J.H.; McKee, R.F.; McMillan, D C

    2010-01-01

    Background: It is increasingly recognised that host-related factors may be important in determining cancer outcome. The aim was to examine the relationship between patient physiology, the systemic inflammatory response and survival after colorectal cancer resection. Methods: Patients undergoing potentially curative resection of colorectal cancer were identified from a prospectively maintained database. Patient physiology was assessed using the physiological and operative severity score for th...

  8. Clinical Scoring Value for Diagnosis of Streptococcal Pharyngitis

    N.M. Noori

    2011-07-01

    Full Text Available Introduction & Objective: β- hemolytic group A streptococcus is the most common cause of acute bacterial pharyngitis in children.Due to the high incidence of this disease and it's difficult diagnosis , we decided to compare clinical scoring and throat cultures for diagnosis of streptococcal pharyngitis. Materials & Methods: This cross-sectional analytic study was done on 3-16 year old patients reffered to pediatric clinic with complaint of sore throat. After taking history and physical examination, scoring was done based on clinical findings.The patients with chronic disease or those who received antibiotics or other drugs were eliminated from the study. Analysis was performed using SPSS. Score for each patient was calculated and compared with the result of throat cultures. Sensitivity, specificity, positive and negative predictive values for each clinical finding were determined. Results: 315 patients out of 350 patients with complaint of sore throat referred to the clinic had fever of whom 51.1% had positive throat culture with 51.1% sensitivity and 77% specifity (p<0.01. 127 patients had pharyngeal petechia of whom 67% had positive throat culture with 66.9% sensitivity and 73.5% specifity (p<0.002. 105 children had pharyngeal exudates of whom 65.7% had positive throat culture with 65.7% sensitivity and 58.3% specifity (p<0.001. Anterior cervical lymphadenopathy was detected in 293 patients of whom 53.24% had positive throat culture with 53.2% sensitivity and 73.8% specifity (p<0.002. 182 patients had no signs of upper respiratory infection, among them 65.9% had positive throat culture with 65.9% sensitivity and 70.4% specifity (p<0.001. 130 patients had sore throat, 66.3% of them had positive throat culture with 62.3% sensitivity and 59% specifity (p<0.001. 310 patients had pharyngeal erythema of which 51.6% had positive throat culture with 57.5% sensitivity and 22.7% specifity (p<0.02. 99 children had gastrointestinal signs, 66.14% had

  9. Film scoring today - Theory, practice and analysis

    Flach, Paula Sophie

    2012-01-01

    This thesis considers film scoring by taking a closer look at the theoretical discourse throughout the last decades, examining current production practice of film music and showcasing a musical analysis of the film Inception (2010).

  10. An ultrasound score for knee osteoarthritis

    Riecke, B F; Christensen, R.; Torp-Pedersen, S;

    2014-01-01

    OBJECTIVE: To develop standardized musculoskeletal ultrasound (MUS) procedures and scoring for detecting knee osteoarthritis (OA) and test the MUS score's ability to discern various degrees of knee OA, in comparison with plain radiography and the 'Knee injury and Osteoarthritis Outcome Score' (KOOS......) domains as comparators. METHOD: A cross-sectional study of MUS examinations in 45 patients with knee OA. Validity, reliability, and reproducibility were evaluated. RESULTS: MUS examination for knee OA consists of five separate domains assessing (1) predominantly morphological changes in the medial...... coefficients ranging from 0.75 to 0.97 for the five domains. Construct validity was confirmed with statistically significant correlation coefficients (0.47-0.81, P < 0.01). CONCLUSION: The MUS score suggested in this study was reliable and valid in detecting knee OA. In comparison with standing radiographs of...

  11. GMAT Scores of Undergraduate Economics Majors

    Nelson, Paul A.; Monson, Terry D.

    2008-01-01

    The average score of economics majors on the Graduate Management Admission Test (GMAT) exceeds those of nearly all humanities and arts, social sciences, and business undergraduate majors but not those of most science, engineering, and mathematics majors. (Contains 1 table.)

  12. Score Matrix for HWBI Forecast Model

    U.S. Environmental Protection Agency — 2000-2010 Annual State-Scale Service and Domain scores used to support the approach for forecasting EPA's Human Well-Being Index. A modeling approach was developed...

  13. The FAt Spondyloarthritis Spine Score (FASSS)

    Pedersen, Susanne Juhl; Zhao, Zheng; Lambert, Robert Gw; Wichuk, Stephanie; Østergaard, Mikkel; Weber, Ulrich; Maksymowych, Walter P

    2013-01-01

    Studies have shown that fat lesions follow resolution of inflammation in the spine of patients with axial spondyloarthritis (SpA). Fat lesions at vertebral corners have also been shown to predict development of new syndesmophytes. Therefore, scoring of fat lesions in the spine may constitute both...... an important measure of treatment efficacy as well as a surrogate marker for new bone formation. The aim of this study was to develop and validate a new scoring method for fat lesions in the spine, the Fat SpA Spine Score (FASSS), which in contrast to the existing scoring method addresses the...... localization and phenotypic diversity of fat lesions in patients with axial SpA....

  14. Effects of vitamin E administration on APACHE II Score in ARDS patients

    M. Hajimahmoodi; Mojtahedzadeh, M.; N GhaffarNatanzi; Sadrai, S.; N. Sadeghi; Najafi, A.; MR Khajavi; Hadadi, A; "Oveisi MR; Kanani, M.

    2009-01-01

    ABSTRACT Background and purpose of the study: The acute respiratory distress syndrome (ARDS) is a common clinical disorder caused by injury to the alveolar epithelial and endothelial barriers of lung. In ARDS patients, oxidative stress is increased and plasma antioxidant levels are reduced. Vitamin E has an important role in antioxidant defense mechanisms. In this study the effect of vitamin E on decrease of APACHE II score in ARDS patients was investigated.  Materials and methods: T...

  15. Interpreting the Meaning of Pain Severity Scores

    Hodgins, Marilyn J

    2002-01-01

    Poor pain management practices are generally discussed in terms of barriers associated with the patient, clinician and/or health care organization. The impact of deficiencies in the tools that are used to measure pain are seldom addressed. Three factors are discussed that complicate the measurement of pain: the nature of pain, the lack of meaning associated with scores generated by pain scales, and treatment goals that lack specificity and are not linked to patients' pain scores. The m...

  16. Dynamic TIMI Risk Score for STEMI

    Amin, Sameer T.; Morrow, David A.; Braunwald, Eugene; Sloan, Sarah; Contant, Charles; Murphy, Sabina; Antman, Elliott M.

    2013-01-01

    Background Although there are multiple methods of risk stratification for ST‐elevation myocardial infarction (STEMI), this study presents a prospectively validated method for reclassification of patients based on in‐hospital events. A dynamic risk score provides an initial risk stratification and reassessment at discharge. Methods and Results The dynamic TIMI risk score for STEMI was derived in ExTRACT‐TIMI 25 and validated in TRITON‐TIMI 38. Baseline variables were from the original TIMI ris...

  17. Restaurant Inspection Scores and Foodborne Disease

    Jones, Timothy F.; Pavlin, Boris I; LaFleur, Bonnie J.; Ingram, L. Amanda; Schaffner, William

    2004-01-01

    Restaurants in the United States are regularly inspected by health departments, but few data exist regarding the effect of restaurant inspections on food safety. We examined statewide inspection records from January 1993 through April 2000. Data were available from 167,574 restaurant inspections. From 1993 to 2000, mean scores rose steadily from 80.2 to 83.8. Mean inspection scores of individual inspectors were 69–92. None of the 12 most commonly cited violations were critical food safety haz...

  18. Comparability of IQ Scores over Time

    Must, Olev; te Nijenhuis, Jan; Must, Aasa; van Vianen, Annelies E. M.

    2009-01-01

    This study investigates the comparability of IQ scores. Three cohorts (1933/36, 1997/98, 2006) of Estonian students (N = 2173) are compared using the Estonian National Intelligence Test. After 72 years the secular rise of the IQ test scores is 0.79 SD. The mean 0.16 SD increase in the last 8 years suggests a rapid increase of the Flynn Effect (FE)…

  19. Improved Credit Scoring with Multilevel Statistical Modelling

    Khudnitskaya, Alesia S.

    2011-01-01

    This dissertation introduces a new type of credit scoring model which assesses credit worthiness of applicants for a loan by forecasting their probability of default. The multilevel scorecard is an improved alternative to the conventional scoring techniques which are regularly applied in retail banking such as discriminant analysis, decision trees and logistic regression scorecards. In addition, this thesis proposes a new way of data clustering for a multilevel structure which ...

  20. Test score disclosure and school performance

    Camargo, Bráz Ministério de; Firpo, Sergio Pinheiro; Ponczek, Vladimir Pinheiro

    2012-01-01

    In this paper we test whether the disclosure of test scores has direct impacts on student performance, school composition and school inputs. We take advantage of the discontinuity on the disclosure rules of The National Secondary Education Examination (ENEM) run in Brazil by the Ministry of Education: In 2006 it was established that the 2005 mean score results would be disclosed for schools with ten or more students who took the exam in the previous year. We use a regression discontinuity des...

  1. Test Scores, Educational Opportunities, and Individual Choice

    Steven F. Venti; Wise, David A.

    1981-01-01

    A model combining student preferences for college with university admissions decisions is estimated to provide information on the role of test scores in the determination of post-secondary educational opportunities. In contrast to implications of much of the recent criticism of tests and their use, we find that scholastic aptitude test scores are more strongly related to student application and choice of college "quality" than to college admissions decisions. In addition, although there is a ...

  2. Schooling in adolescence raises IQ scores

    Brinch, Christian N.; Galloway, Taryn Ann

    2011-01-01

    Although some scholars maintain that education has little effect on intelligence quotient (IQ) scores, others claim that IQ scores are indeed malleable, primarily through intervention in early childhood. The causal effect of education on IQ at later ages is often difficult to uncover because analyses based on observational data are plagued by problems of reverse causation and self-selection into further education. We exploit a reform that increased compulsory schooling from 7 to 9 y in Norway...

  3. Genetic evaluation of elbow scores and the relationship with hip scores in UK Labrador retrievers.

    Lewis, T W; Ilska, J J; Blott, S C; Woolliams, J A

    2011-08-01

    A linear mixed model analysis of elbow and hip score data from UK Labrador retrievers was used to estimate the heritability of elbow score (0.16-0.19) and to determine a moderate and beneficial genetic correlation with hip score (0.40). A small improvement in the genetic trend of elbow score was observed during the years 2000-2008, equivalent to avoiding only the worst 3-4% of scored dogs for breeding, but close to what may have been anticipated if the current British Veterinary Association-approved guidelines were followed. Calculations suggested that a correlated response to indirect selection on hip score may elicit a greater response than direct selection on elbow score and that the genetic trend in elbow score may be explained as a consequence of the stronger selection pressure that has been placed on hip score. Increases in the accuracy of estimated breeding values for elbow score of 4-7% for dogs with elbow data only and 7-11% for dogs with both hip and elbow score were observed from bivariate analysis of elbow and hip data. A selection index confirmed the benefits of bivariate analysis of elbow and hip score data by identifying increases in accuracy (directly related to the response to selection) of 14% from the use of optimum coefficients compared to use of hip data only. The quantified genetic correlation means that hip score effectively acts as a 'secondary indicator' of elbow score in this breed and the preponderance of hip data means that it acts as a major source of information that may be used to improve the accuracy of estimates of genetic risk for elbow dysplasia. PMID:21737324

  4. Anemia and performance status as prognostic markers in acute hypercapnic respiratory failure due to chronic obstructive pulmonary disease

    Haja Mydin H

    2013-03-01

    Full Text Available Helmy Haja Mydin, Stephen Murphy, Howell Clague, Kishore Sridharan, Ian K TaylorDepartment of Respiratory Medicine, Sunderland Royal Infirmary, Sunderland, United KingdomBackground: In patients with acute hypercapnic respiratory failure (AHRF during exacerbations of COPD, mortality can be high despite noninvasive ventilation (NIV. For some, AHRF is terminal and NIV is inappropriate. However there is no definitive method of identifying patients who are unlikely to survive. The aim of this study was to identify factors associated with inpatient mortality from AHRF with respiratory acidosis due to COPD.Methods: COPD patients presenting with AHRF and who were treated with NIV were studied prospectively. The forced expiratory volume in 1 second (FEV1, World Health Organization performance status (WHO-PS, clinical observations, a composite physiological score (Early Warning Score, routine hematology and biochemistry, and arterial blood gases prior to commencing NIV, were recorded.Results: In total, 65 patients were included for study, 29 males and 36 females, with a mean age of 71 ± 10.5 years. Inpatient mortality in the group was 33.8%. Mortality at 30 days and 12 months after admission were 38.5% and 58.5%, respectively. On univariate analysis, the variables associated with inpatient death were: WHO-PS ≥ 3, long-term oxygen therapy, anemia, diastolic blood pressure < 70 mmHg, Early Warning Score ≥ 3, severe acidosis (pH < 7.20, and serum albumin < 35 g/L. On multivariate analysis, only anemia and WHO-PS ≥ 3 were significant. The presence of both predicted 68% of inpatient deaths, with a specificity of 98%.Conclusion: WHO-PS ≥ 3 and anemia are prognostic factors in AHRF with respiratory acidosis due to COPD. A combination of the two provides a simple method of identifying patients unlikely to benefit from NIV.Keywords: acute exacerbations of COPD, noninvasive ventilation, emphysema, prognostic markers

  5. Cancer, acute stress disorder, and repressive coping

    Pedersen, Anette Fischer; Zachariae, Robert

    2010-01-01

    The purpose of this study was to investigate the association between repressive coping style and Acute Stress Disorder (ASD) in a sample of cancer patients. A total of 112 cancer patients recently diagnosed with cancer participated in the study. ASD was assessed by the Stanford Acute Stress...... Reaction Questionnaire, and repressive coping was assessed by a combination of scores from the Marlowe-Crowne Social Desirability Scale, and the Bendig version of the Taylor Manifest Anxiety Scale. Significantly fewer patients classified as "repressors" were diagnosed with ASD compared to patients...... classified as "non-repressors". However, further investigations revealed that the lower incidence of ASD in repressors apparently was caused by a low score on anxiety and not by an interaction effect between anxiety and defensiveness. Future studies have to investigate whether different psychological...

  6. The Acute Coronary Syndrome in elderly patients

    Kalliopi Vougiouka; Theodore Kapadohos

    2015-01-01

    The Acute Coronary Syndrome (ACS) is one of the most common and also life-threatening diseases. Elderly patients due to comorbidity and changes in anatomy and physiology of the body, present some differentiation in the clinical presentation of the disease and common symptoms. Aim: The purpose of this study was to review the literature about the specific characteristics that elderly people with ACS present. Method: A review of international and Greek bibliography of the last fifteen years was ...

  7. Cassava biology and physiology.

    El-Sharkawy, Mabrouk A

    2004-11-01

    Cassava or manioc (Manihot esculenta Crantz), a perennial shrub of the New World, currently is the sixth world food crop for more than 500 million people in tropical and sub-tropical Africa, Asia and Latin America. It is cultivated mainly by resource-limited small farmers for its starchy roots, which are used as human food either fresh when low in cyanogens or in many processed forms and products, mostly starch, flour, and for animal feed. Because of its inherent tolerance to stressful environments, where other food crops would fail, it is often considered a food-security source against famine, requiring minimal care. Under optimal environmental conditions, it compares favorably in production of energy with most other major staple food crops due to its high yield potential. Recent research at the Centro Internacional de Agricultura Tropical (CIAT) in Colombia has demonstrated the ability of cassava to assimilate carbon at very high rates under high levels of humidity, temperature and solar radiation,which correlates with productivity across all environments whether dry or humid. When grown on very poor soils under prolonged drought for more than 6 months, the crop reduce both its leaf canopy and transpiration water loss, but its attached leaves remain photosynthetically active, though at greatly reduced rates. The main physiological mechanism underlying such a remarkable tolerance to drought was rapid stomatal closure under both atmospheric and edaphic water stress, protecting the leaf against dehydration while the plant depletes available soil water slowly during long dry periods. This drought tolerance mechanism leads to high crop water use efficiency values. Although the cassava fine root system is sparse, compared to other crops, it can penetrate below 2 m soil,thus enabling the crop to exploit deep water if available. Leaves of cassava and wild Manihot possess elevated activities of the C4 enzyme PEP carboxylase but lack the leaf Kranz anatomy typical of C4

  8. Acute pancreatitis

    A prospective study was performed on the relationship of CT findings to the clinical course of 148 patients with acute pancreatitis. The type of pancreatic inflammation seen on CT was classified into six categories based on an overall assessment of size, contour and density of the gland, and peripancreatic abnormalities. The majority (94%) of patients in whom CT showed mild pancreatic changes (grades A, B and C) had two or less positive clinical indicaters of severe pancreatitis (Ranson's signs). In contrast, 92% of patients in whom CT showed more severe changes of pancreatitis (grades D, E or F) had three or more positive signs. The nine patients who died with pancreatitis-related complications were in grades D, E or F. We wish to draw attention to a CT appearance which we have called 'fat islets' (low density intrapancreatic or peripancreatic areas, the contents of which approach fat in attenuation values); there was a strong correlation between this appearance and subsequent infection. (author). 24 refs.; 7 figs.; 4 tabs

  9. Value of Modified Possum Scoring System on Predicting Operation Risk 
in Elderly NSCLC Patients

    Wang, Rong; Dewei GAO; Gong, Weiqin; Zhiru LIANG

    2014-01-01

    Background and objective For the assessment of elderly patients can tolerate lung cancer operation, there is no clear standard. To evaluate the clinical validity of POSSUM (Physiological and Operative Severity Score for the Umeration of Mortality and Morbidity) in elderly non-small cell lung cancer (NSCLC) surgery patients, we want to provide an important basis for operation treatment decisions. Methods A total of 138 patients, with 88 males and 50 females, with elderly NSCLC surgery between ...

  10. Analysis of POSSUM score and postoperative morbidity in patients with rectal cancer undergoing surgery

    Valenti, V.; Hernandez-Lizoain, J.L. (José Luis); J. Baixauli; Pastor, C.; Martinez-Regueira, F. (Fernando); Beunza, J J; Aristu, J. (Javier); J.A. Cienfuegos

    2009-01-01

    The Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity (POSSUM) and later modifications (P-POSSUM y CR-POSSUM) have been used to predict morbidity and mortality rates among patients with rectal cancer undergoing surgery. These calculations need some adjustment, however. The aim of this study was to assess the applicability of POSSUM to a group of patients with rectal cancer undergoing surgery, analysing surgic...

  11. Evaluation of POSSUM scoring system in patients with gastric cancer undergoing D2-gastrectomy

    Monig Stefan P; Lubke Thomas; Bollschweiler Elfriede; Holscher Arnulf H

    2005-01-01

    Abstract Background Risk adjustment and stratification play an important role in quality assurance and in clinical research. The Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity (POSSUM) is a patient risk prediction model based on 12 patient characteristics and 6 characteristics of the surgery performed. However, because the POSSUM was developed for quality assessment in general surgical units, its performance within specific subgroups still requires e...

  12. Personalized Risk Scoring for Critical Care Patients using Mixtures of Gaussian Process Experts

    Alaa, Ahmed M.; Yoon, Jinsung; Hu, Scott; Van Der Schaar, Mihaela

    2016-01-01

    We develop a personalized real time risk scoring algorithm that provides timely and granular assessments for the clinical acuity of ward patients based on their (temporal) lab tests and vital signs. Heterogeneity of the patients population is captured via a hierarchical latent class model. The proposed algorithm aims to discover the number of latent classes in the patients population, and train a mixture of Gaussian Process (GP) experts, where each expert models the physiological data streams...

  13. Oxidative Stress Adaptation with Acute, Chronic and Repeated Stress

    Pickering, Andrew. M.; Vojtovich, Lesya; Tower, John; Davies, Kelvin J. A.

    2012-01-01

    Oxidative stress adaptation or hormesis is an important mechanism by which cells and organisms respond to, and cope with, environmental and physiological shifts in the level of oxidative stress. Most studies of oxidative stress adaption have been limited to adaptation induced by acute stress. In contrast, many if not most environmental and physiological stresses are either repeated or chronic. In this study we find that both cultured mammalian cells, and the fruit fly Drosophila melanogaster,...

  14. Psychosocial Care and its Association with Severe Acute Malnutrition.

    Singh, Anurag; Agarwal, Sheesham

    2016-05-01

    This cross-sectional study compared 120 children having severe acute malnutrition with 120 healthy children for exposure to 40 behaviors, by measuring psychosocial care based on Home Observation for Measurement of the Environment (HOME) inventory. The mean (SD) psychosocial care score of cases and controls significantly differed [18.2 (2.2) vs 23.5 (2.1); P<0.001]. A score of less than 14 was significantly associated with severe acute malnutrition (OR 23.2; 95% CI 8.2, 50). PMID:27254059

  15. Acute Generalized Exanthematous Pustulosis Due to Insect Bites?

    Bhat, Yasmeen J; Iffat Hassan; Peerzada Sajad; Atiya Yaseen; Rohi Wani

    2015-01-01

    Acute generalized exanthematous pustulosis is a rare severe cutaneous adverse reaction pattern that is mostly caused by the intake of drugs and rarely associated with viral infections, food allergens or toxins. Here we present the report of three patients who got admitted in our hospital for generalized pustulosis and fever after insect bites. The diagnosis of acute generalized exanthematous pustulosis was made by EuroSCAR scoring. The drug etiology was excluded and spider bite was implicated...

  16. Psychological Evaluation of Acute Low Back Pain in Hospital Workers

    Lamontagne, Yves; Bousquet, Pierre; Elie, Robert; Courtois, Monique

    1983-01-01

    Personality, anxiety and depression were assessed in 62 hospital workers divided in three experimental groups: those with acute organic low back pain, those with acute functional low back pain, and asymptomatic control subjects. Results showed no statistical differences between groups in the evaluation of personality. Asymptomatic subjects had significantly lower scores for trait anxiety and depression than did patients suffering from low back pain. Patients with pain of organic origin were a...

  17. Comparison of biohumoral and morphological parameters in acute pancreatitis

    Tasić Tomislav; Grgov Saša; Nagorni Aleksandar; Benedeto-Stojanov Danijela

    2014-01-01

    Introduction. Acute pancreatitis occurs as a result of autodigestive activation of pancreatic proenzymes, within the parenchyma of the glands. Objective. The goal of the work was to establish possible connection of etiology and severity of the acute pancreatitis and biohumoral parameters, ultrasound and CT. Methods. The study included 273 patients with pancreatitis, classified by Ranson’s score, according to degree of severity and etiology, whose biohumoral...

  18. THERAPEUTIC APPROACH IN THE COMPLICATIONS OF ACUTE PANCREATITIS

    G. Veselu; M. Paduraru; C. Baciu; Doina Veselu

    2006-01-01

    Acute pancreatitis is a disease with severe local, regional and general complications. Material and methods: During 1999 – 2004 in our unit were treated 32 cases of acute pancreatitis. The etiology of the pancreatitis was: biliary lithiasis in 25 cases (78.12%). Only 7 cases have a severe evolution. All the cases were evaluated by abdominal ultrasound exam, computed tomography and severity scores (Ranson and Apache). Also, the patients were treated and monitored in the intensive care unit. We...

  19. ACUTE STROKE: FUNCTIONAL OUTCOME PREDICTORS

    Sujatha

    2016-03-01

    Full Text Available BACKGROUND Ischemic strokes account for >80% of total stroke events. Biochemical modalities like serum uric acid, ESR, CRP, Serum Fibrinogen will be a low cost and useful way to predict functional outcome after ischemic stroke. The Barthel ADL index it is an ordinal scale helping us to measure performances in ADL-activities in daily living. The present study aims to study the Biochemical parameters Uric Acid, CRP, ESR and Fibrinogen in Ischemic Stroke patients and to assess functional outcome in these patients using Barthel Index at admission and at discharge. MATERIALS AND METHODS The present study was undertaken under the Department of Internal Medicine, Govt. Stanley Hospital, Chennai, in 75 patients above 18 yrs. of age presenting with symptoms suggestive of acute stroke at medical OPD/wards/ICU, proven by imaging as ischemic stroke after proper consent were subjected to detailed history taking, complete physical examination and the relevant laboratory investigations as per proforma. Subjects were grouped under mild/moderate/severe categories as per Barthel scoring. A prospective observational study design was chosen and descriptive statistics was done for all data and suitable statistical tests of comparison were done. RESULTS The groups contain subjects with the same basic demographic characteristics, age and gender. The duration of stay in hospital increases with Barthel score. There is an increasing trend of diabetes mellitus and hypertension with stroke severity assessed functionally as per Barthel scores. There is an increasing trend of raised CRP, ESR levels, Uric Acid and Fibrinogen levels with stroke severity. By assessing the functional outcome using Barthel index in ischemic stroke patients at admission and discharge, the average Barthel score in patients at the time of admission was 52.27 in comparison to significantly increased Barthel score at discharge (56 with a p-value of 0.0000 according to paired t-test. CONCLUSION CRP

  20. High inter-tester reliability of the new mobility score in patients with hip fracture

    Kristensen, M.T.; Bandholm, T.; Foss, N.B.;

    2008-01-01

    their own home and 8 from nursing homes to an acute orthopaedic hip fracture unit at a university hospital. METHODS: The New Mobility Score, which evaluates the prefracture functional level with a score from 0 (not able to walk at all) to 9 (fully independent), was assessed by 2 independent physiotherapists...... at the orthopaedic ward. Inter-tester reliability was evaluated using the intraclass correlation coefficient (ICC1.1) and the standard error of measurement (SEM). RESULTS: The ICC between the 2 physiotherapists was 0.98, 95% confidence interval (CI) 0.96-0.99 and the SEM was 0.42, 95% CI -0.40-1.24 New Mobility...... Score points. No systematic between-rater bias was observed (p>0.05). Patients who were scored differently by the 2 physiotherapists had significantly lower mental scores (p=0.02). CONCLUSION: The inter-tester reliability of the New Mobility Score is very high and can be recommended to evaluate...