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Sample records for systemic atherosclerosis score

  1. Cardiovascular risk scores for coronary atherosclerosis.

    Science.gov (United States)

    Yalcin, Murat; Kardesoglu, Ejder; Aparci, Mustafa; Isilak, Zafer; Uz, Omer; Yiginer, Omer; Ozmen, Namik; Cingozbay, Bekir Yilmaz; Uzun, Mehmet; Cebeci, Bekir Sitki

    2012-10-01

    The objective of this study was to compare frequently used cardiovascular risk scores in predicting the presence of coronary artery disease (CAD) and 3-vessel disease. In 350 consecutive patients (218 men and 132 women) who underwent coronary angiography, the cardiovascular risk level was determined using the Framingham Risk Score (FRS), the Modified Framingham Risk Score (MFRS), the Prospective Cardiovascular Münster (PROCAM) score, and the Systematic Coronary Risk Evaluation (SCORE). The area under the curve for receiver operating characteristic curves showed that FRS had more predictive value than the other scores for CAD (area under curve, 0.76, P MFRS, PROCAM, and SCORE) may predict the presence and severity of coronary atherosclerosis.The FRS had better predictive value than the other scores.

  2. Activated TLR signaling in atherosclerosis among women with lower Framingham risk score: the multi-ethnic study of atherosclerosis.

    Directory of Open Access Journals (Sweden)

    Chiang-Ching Huang

    Full Text Available Atherosclerosis is the leading cause of cardiovascular disease (CVD. Traditional risk factors can be used to identify individuals at high risk for developing CVD and are generally associated with the extent of atherosclerosis; however, substantial numbers of individuals at low or intermediate risk still develop atherosclerosis.A case-control study was performed using microarray gene expression profiling of peripheral blood from 119 healthy women in the Multi-Ethnic Study of Atherosclerosis cohort aged 50 or above. All participants had low (100 and carotid intima-media thickness (IMT >1.0 mm, whereas controls (N = 71 had CAC<10 and IMT <0.65 mm. We identified two major expression profiles significantly associated with significant atherosclerosis (odds ratio 4.85; P<0.001; among those with Framingham risk score <10%, the odds ratio was 5.30 (P<0.001. Ontology analysis of the gene signature reveals activation of a major innate immune pathway, toll-like receptors and IL-1R signaling, in individuals with significant atherosclerosis.Gene expression profiles of peripheral blood may be a useful tool to identify individuals with significant burden of atherosclerosis, even among those with low predicted risk by clinical factors. Furthermore, our data suggest an intimate connection between atherosclerosis and the innate immune system and inflammation via TLR signaling in lower risk individuals.

  3. Systemic atherosclerosis and voiding symptom.

    Science.gov (United States)

    Yeniel, A Ozgur; Ergenoglu, A Mete; Meseri, Reci; Ari, Anıl; Sancar, Ceren; Itil, Ismail Mete

    2017-03-01

    To evaluate the effect of atherosclerosis on the storage and voiding symptoms of the bladder in women with overactive bladder (OAB). We retrospectively reviewed the charts of women with OAB who were evaluated between 2013 and 2015 in our urogynecology unit. Charts were assessed for history, examination findings, urinary diary, quality of life (QOL) questionnaires, urodynamic studies (UDSs), and four main risk factors for atherosclerosis: hypertension, diabetes mellitus, smoking, and hyperlipidemia. In a previous study, these were defined as vascular risk factors. Cases were excluded for insufficient data, diabetes mellitus with dysregulated blood glucose, or prolapse greater than 1cm to avoid confusing bladder outlet obstruction. We included 167 eligible cases in this study. We evaluated storage and voiding symptoms such as frequency, nocturia, residual urine volume, and voiding difficulties and UDS findings such as maximum bladder capacity, first desire, strong desire, detrusor overactivity, and bladder contractility index. The vascular risk score was categorized as "no risk" if the woman did not have any of the four risk factors and "at risk" if she had any of the factors. Independent sample t-test and chi-square tests were performed for analyses. Among the participants (n=167), 71.9% had at least one vascular risk factor. Those who were at risk were facing significantly more wet-type OAB (p=0.003) and nocturia (p=0.023). Moreover, mean age (p=0.008) and mean gravidity (p=0.020) were significantly higher in the at-risk group, whereas mean total nocturia QOL questionnaire scores (p=0.029) were significantly lower. Our findings suggest that aging and atherosclerosis may be associated with severe OAB and poorer QOL. Nocturia and related parameters of poor quality can be explained by impaired bladder neck perfusion. Future trials need to assess vascular and molecular changes in women with OAB. Copyright © 2017 Elsevier B.V. All rights reserved.

  4. Atherosclerosis

    Science.gov (United States)

    Atherosclerosis is a disease in which plaque builds up inside your arteries. Plaque is a sticky substance ... flow of oxygen-rich blood to your body. Atherosclerosis can lead to serious problems, including Coronary artery ...

  5. Systems biology of human atherosclerosis.

    Science.gov (United States)

    Shalhoub, Joseph; Sikkel, Markus B; Davies, Kerry J; Vorkas, Panagiotis A; Want, Elizabeth J; Davies, Alun H

    2014-01-01

    Systems biology describes a holistic and integrative approach to understand physiology and pathology. The "omic" disciplines include genomics, transcriptomics, proteomics, and metabolic profiling (metabonomics and metabolomics). By adopting a stance, which is opposing (yet complimentary) to conventional research techniques, systems biology offers an overview by assessing the "net" biological effect imposed by a disease or nondisease state. There are a number of different organizational levels to be understood, from DNA to protein, metabolites, cells, organs and organisms, even beyond this to an organism's context. Systems biology relies on the existence of "nodes" and "edges." Nodes are the constituent part of the system being studied (eg, proteins in the proteome), while the edges are the way these constituents interact. In future, it will be increasingly important to collaborate, collating data from multiple studies to improve data sets, making them freely available and undertaking integrative analyses.

  6. South African Scoring System

    African Journals Online (AJOL)

    2014-11-18

    Nov 18, 2014 ... suitability of the rapid macroinvertebrate biomonitoring tool (the South African Scoring System) was investigated by determining the ... for 80% (SASS score) and 75% (NOT) of the variation in the regression model. Consequently ... et al., 2012), while settled sediments can alter habitat (Wood and Armitage ...

  7. Volleyball Scoring Systems.

    Science.gov (United States)

    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)

  8. Walk Score® and Transit Score® and walking in the multi-ethnic study of atherosclerosis.

    Science.gov (United States)

    Hirsch, Jana A; Moore, Kari A; Evenson, Kelly R; Rodriguez, Daniel A; Diez Roux, Ana V

    2013-08-01

    Walk Score® and Transit Score® are open-source measures of the neighborhood built environment to support walking ("walkability") and access to transportation. To investigate associations of Street Smart Walk Score and Transit Score with self-reported transport and leisure walking using data from a large multicity and diverse population-based sample of adults. Data from a sample of 4552 residents of Baltimore MD, Chicago IL, Forsyth County NC, Los Angeles CA, New York NY, and St. Paul MN from the Multi-Ethnic Study of Atherosclerosis (2010-2012) were linked to Walk Score and Transit Score (collected in 2012). Logistic and linear regression models estimated ORs of not walking and mean differences in minutes walked, respectively, associated with continuous and categoric Walk Score and Transit Score. All analyses were conducted in 2012. After adjustment for site, key sociodemographic, and health variables, a higher Walk Score was associated with lower odds of not walking for transport and more minutes/week of transport walking. Compared to those in a "walker's paradise," lower categories of Walk Score were associated with a linear increase in odds of not transport walking and a decline in minutes of leisure walking. An increase in Transit Score was associated with lower odds of not transport walking or leisure walking, and additional minutes/week of leisure walking. Walk Score and Transit Score appear to be useful as measures of walkability in analyses of neighborhood effects. Copyright © 2013 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  9. Relation of ABO blood groups to the severity of coronary atherosclerosis: an Gensini score assessment.

    Science.gov (United States)

    Gong, Ping; Luo, Song-Hui; Li, Xiao-Lin; Guo, Yuan-Lin; Zhu, Cheng-Gang; Xu, Rui-Xia; Li, Sha; Dong, Qian; Liu, Geng; Chen, Juan; Zeng, Rui-Xiang; Li, Jian-Jun

    2014-12-01

    Although the study on the relationship between ABO blood groups and coronary atherosclerosis has a long history, few data is available regarding ABO to severity of coronary atherosclerosis in a large cohort study. Therefore, the present study aimed to investigate the relation of the ABO blood groups to the severity of coronary atherosclerosis assessed by Gensini score (GS) in a large Chinese cohort undergoing coronary angiography. A total of 2919 consecutive patients undergoing coronary angiography were enrolled, and their baseline characteristics and ABO blood groups were collected. The GS was calculated as 1st tertile (0-10), 2nd tertile (11-36), 3rd tertile (>36) according to angiographic results. The relation of the ABO blood groups to GS was investigated. The frequency of blood group A was significantly higher in the upper GS tertiles (24.4% vs. 28.2% vs. 29.5%, p = 0.032). Multivariable linear regression analysis revealed that blood group A was independently associated with GS (β = 0.043, p = 0.017). Likewise, multivariable logistic regression analysis showed that group A remained significantly associated with mid-high GS (OR = 1.44, 95% CI 1.16-1.80, p = 0.001), and the group O was showed as a protective factor (OR = 0.77, 95% CI = 0.65-0.92, p = 0.004). In this large Chinese cohort study, the data indicated that there was an association between ABO blood groups and the severity of coronary atherosclerosis. Moreover, the blood group A was an independent risk factor for serious coronary atherosclerosis. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  10. Inflammation and immune system interactions in atherosclerosis

    NARCIS (Netherlands)

    Legein, Bart; Temmerman, Lieve; Biessen, Erik A. L.; Lutgens, Esther

    2013-01-01

    Cardiovascular disease (CVD) is the leading cause of mortality worldwide, accounting for 16.7 million deaths each year. The underlying cause of the majority of CVD is atherosclerosis. In the past, atherosclerosis was considered to be the result of passive lipid accumulation in the vessel wall.

  11. A score including ADAM17 substrates correlates to recurring cardiovascular event in subjects with atherosclerosis.

    Science.gov (United States)

    Rizza, Stefano; Copetti, Massimiliano; Cardellini, Marina; Menghini, Rossella; Pecchioli, Chiara; Luzi, Alessio; Di Cola, Giovanni; Porzio, Ottavia; Ippoliti, Arnaldo; Romeo, Franco; Pellegrini, Fabio; Federici, Massimo

    2015-04-01

    Atherosclerosis disease is a leading cause for mortality and morbidity. The narrowing/rupture of a vulnerable atherosclerotic plaque is accountable for acute cardiovascular events. However, despite of an intensive research, a reliable clinical method which may disclose a vulnerable patient is still unavailable. We tested the association of ADAM17 (A Disintegrin and Metallo Protease Domain 17) circulating substrates (sICAM-1, sVCAM-1, sIL6R and sTNFR1) with a second major cardiovascular events [MACEs] (cardiovascular death, peripheral artery surgeries, non-fatal myocardial infarction and non-fatal stroke) in 298 patients belonging to the Vascular Diabetes (AVD) study. To evaluate ADAM17 activity we create ADAM17 score through a RECPAM model. Finally we tested the discrimination ability and the reclassification of clinical models. At follow-up (mean 47 months, range 1-118 months), 55 MACEs occurred (14 nonfatal MI, 14 nonfatal strokes, 17 peripheral artery procedures and 10 cardiovascular deaths) (incidence = 7.8% person-years). An increased risk for incident events was observed among the high ADAM17 score individuals both in univariable (HR 19.20, 95% CI 15.82-63.36, p atherosclerosis. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  12. Maxillofacial trauma scoring systems.

    Science.gov (United States)

    Sahni, Vaibhav

    2016-07-01

    The changing complexity of maxillofacial fractures in recent years has created a situation where classical systems of classification of maxillofacial injuries fall short of defining trauma particularly that observed with high-velocity collisions where more than one region of the maxillofacial skeleton is affected. Trauma scoring systems designed specifically for the maxillofacial region are aimed to provide a more accurate assessment of the injury, its prognosis, the possible treatment outcomes, economics, length of hospital stay, and triage. The evolution and logic of such systems along with their merits and demerits are discussed. The author also proposes a new system to aid users in quickly and methodically choosing the system best suited to their needs without having to study a plethora of literature available in order to isolate their choice. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. Mediterranean diet score and left ventricular structure and function: the Multi-Ethnic Study of Atherosclerosis.

    Science.gov (United States)

    Levitan, Emily B; Ahmed, Ali; Arnett, Donna K; Polak, Joseph F; Hundley, W Gregory; Bluemke, David A; Heckbert, Susan R; Jacobs, David R; Nettleton, Jennifer A

    2016-09-01

    Data are limited on the relation between dietary patterns and left ventricular (LV) structure and function. We examined cross-sectional associations of a diet-score assessment of a Mediterranean dietary pattern with LV mass, volume, mass-to-volume ratio, stroke volume, and ejection fraction. We measured LV variables with the use of cardiac MRI in 4497 participants in the Multi-Ethnic Study of Atherosclerosis study who were aged 45-84 y and without clinical cardiovascular disease. We calculated a Mediterranean diet score from intakes of fruit, vegetables, nuts, legumes, whole grains, fish, red meat, the monounsaturated fat:saturated fat ratio, and alcohol that were self-reported with the use of a food-frequency questionnaire. We used linear regression with adjustment for body size, physical activity, and cardiovascular disease risk factors to model associations and assess the shape of these associations (linear or quadratic). The Mediterranean diet score had a slight U-shaped association with LV mass (adjusted means: 146, 145, 146, and 147 g across quartiles of diet score, respectively; P-quadratic trend = 0.04). The score was linearly associated with LV volume, stroke volume, and ejection fraction: for each +1-U difference in score, LV volume was 0.4 mL higher (95% CI: 0.0, 0.8 mL higher), the stroke volume was 0.5 mL higher (95% CI: 0.2, 0.8 mL higher), and the ejection fraction was 0.2 percentage points higher (95% CI: 0.1, 0.3 percentage points higher). The score was not associated with the mass-to-volume ratio. A higher Mediterranean diet score is cross-sectionally associated with a higher LV mass, which is balanced by a higher LV volume as well as a higher ejection fraction and stroke volume. Participants in this healthy, multiethnic sample whose dietary patterns most closely conformed to a Mediterranean-type pattern had a modestly better LV structure and function than did participants with less-Mediterranean-like dietary patterns. This trial was registered at

  14. South African Scoring System

    African Journals Online (AJOL)

    2014-11-18

    Nov 18, 2014 ... for 80% (SASS score) and 75% (NOT) of the variation in the regression model. Consequently, SASS ... further investigation: spatial analyses of macroinvertebrate assemblages; and the use of structural and functional metrics. Keywords: .... conductivity levels was assessed using multiple linear regres- sion.

  15. Premature atherosclerosis in systemic autoimmune diseases

    NARCIS (Netherlands)

    Leeuw, Karina de

    2008-01-01

    Systemic autoimmune diseases such as systemic lupus erythematosus (SLE) and Wegener’s granulomatosis (WG) are associated with a significantly increased prevalence of cardiovascular disease (CVD) compared to age- and sex-matched controls. Many risk factors are involved in the pathogenesis of

  16. Skin scoring in systemic sclerosis

    DEFF Research Database (Denmark)

    Zachariae, Hugh; Bjerring, Peter; Halkier-Sørensen, Lars

    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...

  17. 17-β Estradiol reduces atherosclerosis without exacerbating lupus in ovariectomized systemic lupus erythematosus-susceptible LDLr−/− mice

    Science.gov (United States)

    Shelton, KA; Cline, JM; Cann, JA

    2013-01-01

    Objective To test the hypothesis that estrogen treatment in a radiation chimera mouse model of systemic lupus erythematosus (SLE) and atherosclerosis will increase SLE-associated atherosclerosis by increasing autoantibody production and inflammation. Methods We used a radiation chimera mouse model in which bone marrow from the polygenic B6.Sle1.2.3 model of SLE was transferred to the low density lipoprotein receptor knock out (LDLr−/−) model of atherosclerosis on a C57BL/6 background (Sle/LDLr−/−). Ovariectomized chimeric mice were treated for 10 weeks with either 5.6 ug/day of 17β-estradiol or placebo; outcomes included atherosclerosis plaque size, anti-dsDNA autoantibody production and renal pathology. Results Mean atherosclerosis plaque size was 67.4 ± 7.6% smaller in the estrogen treated group (patherosclerosis lesion size and either the renal histology score or UP:UC ratio in Sle/LDLr−/− mice. Conclusion These results indicate that 17β-estradiol is atheroprotective within the context of murine SLE independent of changes in serum cholesterol concentration, autoantibody concentration, or renal pathology. The SLE phenotype in Sle/LDLr−/− mice is not exacerbated by exogenous 17β-estradiol administration, and the reduced UP:UC ratio suggests a protective effect against lupus nephritis. PMID:23395521

  18. Association of subclinical atherosclerosis using carotid intima-media thickness, carotid plaque, and coronary calcium score with left ventricular dyssynchrony: the multi-ethnic Study of Atherosclerosis.

    Science.gov (United States)

    Sharma, Ravi K; Donekal, Sirisha; Rosen, Boaz D; Tattersall, Matthew C; Volpe, Gustavo J; Ambale-Venkatesh, Bharath; Nasir, Khurram; Wu, Colin O; Polak, Joseph F; Korcarz, Claudia E; Stein, James H; Carr, James; Watson, Karol E; Bluemke, David A; Lima, João A C

    2015-04-01

    The role of atherosclerosis in the progression of global left ventricular dysfunction and cardiovascular events has been well recognized. Left ventricular (LV) dyssynchrony is a measure of regional myocardial dysfunction. Our objective was to investigate the relationship of subclinical atherosclerosis with mechanical LV dyssynchrony in a population-based asymptomatic multi-ethnic cohort. Participants of the Multi-Ethnic Study of Atherosclerosis (MESA) at exam 5 were evaluated using 1.5T cardiac magnetic resonance (CMR) imaging, carotid ultrasound (n = 2062) for common carotid artery (CCA) and internal carotid artery (ICA) intima-media thickness (IMT), and cardiac computed tomography (n = 2039) for coronary artery calcium (CAC) assessment (Agatston method). Dyssynchrony indices were defined as the standard deviation of time to peak systolic circumferential strain (SD-TPS) and the difference between maximum and minimum (max-min) time to peak strain using harmonic phase imaging in 12 segments (3-slices × 4 segments). Multivariable regression analyses were performed to assess associations after adjusting for participant demographics, cardiovascular risk factors, LV mass, and ejection fraction. In multivariable analyses, SD-TPS was significantly related to measures of atherosclerosis, including CCA-IMT (8.7 ms/mm change in IMT, p = 0.020), ICA-IMT (19.2 ms/mm change in IMT, p atherosclerosis are associated with parameters of subclinical LV dyssynchrony in the absence of clinical coronary event and left-bundle-branch block. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  19. Opium consumption and coronary atherosclerosis in diabetic patients: a propensity score-matched study.

    Science.gov (United States)

    Hosseini, Seyed Kianoosh; Masoudkabir, Farzad; Vasheghani-Farahani, Ali; Alipour-Parsa, Saeed; Sheikh Fathollahi, Mahmood; Rahimi-Foroushani, Abbas; Hakki, Elham; Goodarzynejad, Hamidreza; Eftekhar, Hassan

    2011-11-01

    There is a traditional belief among Eastern people that opium may have ameliorating effects on cardiovascular risk factors, especially diabetes; thus, it is widely used among diabetic patients. We attempted to investigate the association of opium consumption with coronary artery disease (CAD) in diabetic patients. A cross-sectional study was conducted on diabetic patients undergoing coronary angiography in our center. Out of 1925 diabetic patients included in the study, 228 were opium users, and the remaining 1697 non-opium users were used as a pool of potential comparators. Propensity scores were used to match the 228 opium consumers with 228 matched comparators for age, sex, and smoking status. The Gensini score and extent score were respectively used to assess the angiographic severity and extent of CAD. The mean Gensini score (86.9 ± 62.7 vs. 59.6 ± 43.4, p opium user diabetic patients than in non-opium users. After adjustment for potential confounders, a dose-response relationship was observed between dose of opium and the Gensini score ( β = 0.27, p = 0.04). There were no significant differences between the routes of opium administration (inhalation vs. oral) regarding the severity and extent of CAD. In conclusion, exposure to opium in diabetic patients may be positively associated with the risk of CAD, and with the angiographically determined severity and extent of the disease. Furthermore, dosage of opium consumption may correlate with severity of CAD. © Georg Thieme Verlag KG Stuttgart · New York.

  20. Mediterranean diet score and left ventricular structure and function: the Multi-Ethnic Study of Atherosclerosis12

    Science.gov (United States)

    Levitan, Emily B; Ahmed, Ali; Arnett, Donna K; Polak, Joseph F; Hundley, W Gregory; Bluemke, David A; Heckbert, Susan R; Jacobs, David R; Nettleton, Jennifer A

    2016-01-01

    Background: Data are limited on the relation between dietary patterns and left ventricular (LV) structure and function. Objective: We examined cross-sectional associations of a diet-score assessment of a Mediterranean dietary pattern with LV mass, volume, mass-to-volume ratio, stroke volume, and ejection fraction. Design: We measured LV variables with the use of cardiac MRI in 4497 participants in the Multi-Ethnic Study of Atherosclerosis study who were aged 45–84 y and without clinical cardiovascular disease. We calculated a Mediterranean diet score from intakes of fruit, vegetables, nuts, legumes, whole grains, fish, red meat, the monounsaturated fat:saturated fat ratio, and alcohol that were self-reported with the use of a food-frequency questionnaire. We used linear regression with adjustment for body size, physical activity, and cardiovascular disease risk factors to model associations and assess the shape of these associations (linear or quadratic). Results: The Mediterranean diet score had a slight U-shaped association with LV mass (adjusted means: 146, 145, 146, and 147 g across quartiles of diet score, respectively; P-quadratic trend = 0.04). The score was linearly associated with LV volume, stroke volume, and ejection fraction: for each +1-U difference in score, LV volume was 0.4 mL higher (95% CI: 0.0, 0.8 mL higher), the stroke volume was 0.5 mL higher (95% CI: 0.2, 0.8 mL higher), and the ejection fraction was 0.2 percentage points higher (95% CI: 0.1, 0.3 percentage points higher). The score was not associated with the mass-to-volume ratio. Conclusions: A higher Mediterranean diet score is cross-sectionally associated with a higher LV mass, which is balanced by a higher LV volume as well as a higher ejection fraction and stroke volume. Participants in this healthy, multiethnic sample whose dietary patterns most closely conformed to a Mediterranean-type pattern had a modestly better LV structure and function than did participants with less

  1. Assessment of coronary atherosclerosis by cardiac image: complementary amount of the calcium score to myocardial perfusion

    Energy Technology Data Exchange (ETDEWEB)

    Vitola, Joao Vicente; Cerci, Rodrigo J.; Zapparoli, Marcello, E-mail: joaovitola@quantamn.com.br [Quanta Diagnostico Nuclear, Curitiba, PR (Brazil)

    2011-04-15

    Over the last decades we have witnessed significant advances on diagnostic tools and management of patients with or suspected cardiovascular disease, and consequently a significant reduction in mortality. Nevertheless, cardiovascular disease remains the leader cause of death in many countries, including Brazil. Identifying the high risk patient is important, so we can intensify prevention strategies. Non invasive diagnostic tools have been developed to identify the high risk patient in need of a myocardial revascularization, notably using myocardial scintigraphy. However, many clinicians still question, what is the best management for a patient with traditional risk factors, who has a positive treadmill test result and a completely normal myocardial scintigraphy? What is the literature showing in relation to the role of coronary calcium score for these patients? In this article we will reflect over these issues which are so frequently encountered in daily cardiology practice. (author)

  2. Interval Coded Scoring: a toolbox for interpretable scoring systems

    Directory of Open Access Journals (Sweden)

    Lieven Billiet

    2018-04-01

    Full Text Available Over the last decades, clinical decision support systems have been gaining importance. They help clinicians to make effective use of the overload of available information to obtain correct diagnoses and appropriate treatments. However, their power often comes at the cost of a black box model which cannot be interpreted easily. This interpretability is of paramount importance in a medical setting with regard to trust and (legal responsibility. In contrast, existing medical scoring systems are easy to understand and use, but they are often a simplified rule-of-thumb summary of previous medical experience rather than a well-founded system based on available data. Interval Coded Scoring (ICS connects these two approaches, exploiting the power of sparse optimization to derive scoring systems from training data. The presented toolbox interface makes this theory easily applicable to both small and large datasets. It contains two possible problem formulations based on linear programming or elastic net. Both allow to construct a model for a binary classification problem and establish risk profiles that can be used for future diagnosis. All of this requires only a few lines of code. ICS differs from standard machine learning through its model consisting of interpretable main effects and interactions. Furthermore, insertion of expert knowledge is possible because the training can be semi-automatic. This allows end users to make a trade-off between complexity and performance based on cross-validation results and expert knowledge. Additionally, the toolbox offers an accessible way to assess classification performance via accuracy and the ROC curve, whereas the calibration of the risk profile can be evaluated via a calibration curve. Finally, the colour-coded model visualization has particular appeal if one wants to apply ICS manually on new observations, as well as for validation by experts in the specific application domains. The validity and applicability

  3. THE EFFICIENCY OF TENNIS DOUBLES SCORING SYSTEMS

    Directory of Open Access Journals (Sweden)

    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.

  4. Birth size and coronary heart disease risk score in young adulthood. The Atherosclerosis Risk in Young Adults (ARYA) study

    NARCIS (Netherlands)

    Vos, LE; Oren, A; Bots, ML; Gorissen, WHM; Grobbee, DE; Uiterwaal, CSPM

    Data of the Atherosclerosis Risk in Young Adults (ARYA) study were used to investigate the association between birth size and the absolute risk for coronary heart disease in healthy young adults. The cohort study comprises 750 (46.9% men) subjects born between 1970 and 1973. Birth characteristics

  5. Regulation of the renin–angiotensin system in coronary atherosclerosis: A review of the literature

    Directory of Open Access Journals (Sweden)

    Ramadan A Hammoud

    2008-01-01

    Full Text Available Ramadan A Hammoud, Christopher S Vaccari, Sameer H Nagamia, Bobby V KhanEmory University School of Medicine, Division of Cardiology, Grady Memorial Hospital Vascular Research Laboratory, Atlanta, Georgia, USAAbstract: Activation of the renin–angiotensin system (RAS is significant in the pathogenesis of cardiovascular disease and specifically coronary atherosclerosis. There is strong evidence that the RAS has effects on the mechanisms of action of atherosclerosis, including fibrinolytic balance, endothelial function, and plaque stability. Pharmacological inhibition of the renin angiotensin system includes angiotensin converting enzyme (ACE inhibitors, angiotensin receptor blockers (ARBs, and renin inhibitors. These agents have clinical benefits in reducing morbidity and mortality in the management of hypertension. In addition, ACE inhibitors and ARBs have shown to be effective in the management of congestive heart failure and acute myocardial infarction. This review article discusses the biochemical and molecular mechanisms involving the RAS in coronary atherosclerosis as well as the effects of RAS inhibition in clinical studies involving coronary atherosclerosis.Keywords: angiotensin II, atherosclerosis, endothelium, inflammation, vasculature

  6. The complement system and toll-like receptors as integrated players in the pathophysiology of atherosclerosis

    DEFF Research Database (Denmark)

    Hovland, Anders; Jonasson, Lena; Garred, Peter

    2015-01-01

    of innate immunity. The complement system and toll-like receptors (TLRs), and the crosstalk between them, may be of particular interest both with respect to pathogenesis and as therapeutic targets in atherosclerosis. Animal studies indicate that inhibition of C3a and C5a reduces atherosclerosis. In humans...... modified LDL-cholesterol activate complement and TLRs leading to downstream inflammation, and histopathological studies indicate that the innate immune system is present in atherosclerotic lesions. Moreover, clinical studies have demonstrated that both complement and TLRs are upregulated in atherosclerotic......Despite recent medical advances, atherosclerosis is a global burden accounting for numerous deaths and hospital admissions. Immune-mediated inflammation is a major component of the atherosclerotic process, but earlier research focus on adaptive immunity has gradually switched towards the role...

  7. Fluorescence multispectral imaging-based diagnostic system for atherosclerosis.

    Science.gov (United States)

    Ho, Cassandra Su Lyn; Horiuchi, Toshikatsu; Taniguchi, Hiroaki; Umetsu, Araya; Hagisawa, Kohsuke; Iwaya, Keiichi; Nakai, Kanji; Azmi, Amalina; Zulaziz, Natasha; Azhim, Azran; Shinomiya, Nariyoshi; Morimoto, Yuji

    2016-08-20

    Composition of atherosclerotic arterial walls is rich in lipids such as cholesterol, unlike normal arterial walls. In this study, we aimed to utilize this difference to diagnose atherosclerosis via multispectral fluorescence imaging, which allows for identification of fluorescence originating from the substance in the arterial wall. The inner surface of extracted arteries (rabbit abdominal aorta, human coronary artery) was illuminated by 405 nm excitation light and multispectral fluorescence images were obtained. Pathological examination of human coronary artery samples were carried out and thickness of arteries were calculated by measuring combined media and intima thickness. The fluorescence spectra in atherosclerotic sites were different from those in normal sites. Multiple regions of interest (ROI) were selected within each sample and a ratio between two fluorescence intensity differences (where each intensity difference is calculated between an identifier wavelength and a base wavelength) from each ROI was determined, allowing for discrimination of atherosclerotic sites. Fluorescence intensity and thickness of artery were found to be significantly correlated. These results indicate that multispectral fluorescence imaging provides qualitative and quantitative evaluations of atherosclerosis and is therefore a viable method of diagnosing the disease.

  8. Comparison of Myelodysplastic Syndrome Prognostic Scoring Systems

    Directory of Open Access Journals (Sweden)

    Özlen Bektaş

    2016-05-01

    Full Text Available Objective: Myelodysplastic syndrome (MDS is a clonal hematopoietic stem cell disease. Patients are at risk of developing cytopenias or progression to acute myeloid leukemia. Different classifications and prognostic scoring systems have been developed. The aim of this study was to compare the different prognostic scoring systems. Materials and Methods: One hundred and one patients who were diagnosed with primary MDS in 2003-2011 in a tertiary care university hospital’s hematology department were included in the study. Results: As the International Prognostic Scoring System (IPSS, World Health Organization Classification-Based Prognostic Scoring System (WPSS, MD Anderson Prognostic Scoring System (MPSS, and revised IPSS (IPSS-R risk categories increased, leukemia-free survival and overall survival decreased (p<0.001. When the IPSS, WPSS, MPSS, and IPSS-R prognostic systems were compared by Cox regression analysis, the WPSS was the best in predicting leukemia-free survival (p<0.001, and the WPSS (p<0.001 and IPSS-R (p=0.037 were better in predicting overall survival. Conclusion: All 4 prognostic systems were successful in predicting overall survival and leukemia-free survival (p<0.001. The WPSS was found to be the best predictor for leukemia-free survival, while the WPSS and IPSS-R were found to be the best predictors for overall survival.

  9. Disease severity scoring systems in dermatology

    Directory of Open Access Journals (Sweden)

    Cemal Bilaç

    2016-06-01

    Full Text Available 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, tractional alopecia, bullous diseases (autoimmune bullous diseases, toxic epidermal necrolysis, dermatitis (atopic dermatitis, contact dermatitis, dyshidrotic eczema, hidradenitis suppurativa, hirsutismus, connective tissue diseases (dermatomyositis, skin involvement of systemic lupus erythematosus (LE, discoid LE, scleroderma, lichen planoplaris, mastocytosis, melanocytic lesions, melasma, onychomycosis, oral lichen planus, pityriasis rosea, psoriasis (psoriasis vulgaris, psoriatic arthritis, nail psoriasis, sarcoidosis, urticaria, and vitiligo, have also been developed. Disease severity scoring methods are ever more extensively used in the field of dermatology for clinical practice to form an opinion about the prognosis by determining the disease severity; to decide on the most suitable treatment modality for the patient; to evaluate the efficacy of the applied medication; and to compare the efficiency of different treatment methods in clinical studies.

  10. The complement system and toll-like receptors as integrated players in the pathophysiology of atherosclerosis.

    Science.gov (United States)

    Hovland, Anders; Jonasson, Lena; Garred, Peter; Yndestad, Arne; Aukrust, Pål; Lappegård, Knut T; Espevik, Terje; Mollnes, Tom E

    2015-08-01

    Despite recent medical advances, atherosclerosis is a global burden accounting for numerous deaths and hospital admissions. Immune-mediated inflammation is a major component of the atherosclerotic process, but earlier research focus on adaptive immunity has gradually switched towards the role of innate immunity. The complement system and toll-like receptors (TLRs), and the crosstalk between them, may be of particular interest both with respect to pathogenesis and as therapeutic targets in atherosclerosis. Animal studies indicate that inhibition of C3a and C5a reduces atherosclerosis. In humans modified LDL-cholesterol activate complement and TLRs leading to downstream inflammation, and histopathological studies indicate that the innate immune system is present in atherosclerotic lesions. Moreover, clinical studies have demonstrated that both complement and TLRs are upregulated in atherosclerotic diseases, although interventional trials have this far been disappointing. However, based on recent research showing an intimate interplay between complement and TLRs we propose a model in which combined inhibition of both complement and TLRs may represent a potent anti-inflammatory therapeutic approach to reduce atherosclerosis. Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  11. A semantically-aided architecture for a web-based monitoring system for carotid atherosclerosis.

    Science.gov (United States)

    Kolias, Vassileios D; Stamou, Giorgos; Golemati, Spyretta; Stoitsis, Giannis; Gkekas, Christos D; Liapis, Christos D; Nikita, Konstantina S

    2015-08-01

    Carotid atherosclerosis is a multifactorial disease and its clinical diagnosis depends on the evaluation of heterogeneous clinical data, such as imaging exams, biochemical tests and the patient's clinical history. The lack of interoperability between Health Information Systems (HIS) does not allow the physicians to acquire all the necessary data for the diagnostic process. In this paper, a semantically-aided architecture is proposed for a web-based monitoring system for carotid atherosclerosis that is able to gather and unify heterogeneous data with the use of an ontology and to create a common interface for data access enhancing the interoperability of HIS. The architecture is based on an application ontology of carotid atherosclerosis that is used to (a) integrate heterogeneous data sources on the basis of semantic representation and ontological reasoning and (b) access the critical information using SPARQL query rewriting and ontology-based data access services. The architecture was tested over a carotid atherosclerosis dataset consisting of the imaging exams and the clinical profile of 233 patients, using a set of complex queries, constructed by the physicians. The proposed architecture was evaluated with respect to the complexity of the queries that the physicians could make and the retrieval speed. The proposed architecture gave promising results in terms of interoperability, data integration of heterogeneous sources with an ontological way and expanded capabilities of query and retrieval in HIS.

  12. Tanzania River Scoring System (TARISS): a macroinvertebrate ...

    African Journals Online (AJOL)

    The biological assessment of rivers using aquatic macroinvertebrates is an internationally recognised approach for the determination of riverine ecological conditions. In this study a Tanzanian macroinvertebrate-based biotic method, Tanzania River Scoring System (TARISS), was developed in 2012, based on the South ...

  13. The activated endocannabinoid system in atherosclerosis: driving force or protective mechanism?

    Science.gov (United States)

    Steffens, Sabine; Pacher, Pal

    2015-01-01

    Atherosclerosis and its major acute complications, myocardial infarction and stroke, are the leading causes of death and morbidity worldwide. Despite major advances in cardiovascular intervention and healthcare, improving preventive care and treatment remains a continuous mission for cardiovascular research. Within the last 10 to 15 years, the endocannabinoid system has emerged as an important lipid signaling system involved in many biological processes. Growing evidence suggests that an overactive endocannabinoid-CB1 receptor signaling promotes the development of cardiovascular risk factors such as obesity, insulin resistance and dyslipidemia. This prompted an increasing interest in studying the role of the endocannabinoid system in atherosclerosis. As opposed to the detrimental actions of CB1 signaling, the endocannabinoid-CB2 receptor axis exhibits an anti-inflammatory and atheroprotective role. We will review recent findings from experimental and clinical studies aimed at understanding the complex actions of endocannabinoid signaling in cardiovascular disease. This is followed by an outlook on emerging targets for possible therapeutic intervention.

  14. [Association between IGF system and PAPP-A in coronary atherosclerosis].

    Science.gov (United States)

    Fierro-Macías, Alfonso Eduardo; Floriano-Sánchez, Esaú; Mena-Burciaga, Victoria Michelle; Gutiérrez-Leonard, Hugo; Lara-Padilla, Eleazar; Abarca-Rojano, Edgar; Fierro-Almanzán, Alfonso Edmundo

    2016-01-01

    Atherosclerosis is a condition that involves multiple pathophysiological mechanisms and whose knowledge has not been fully elucidated. Often, scientific advances on the atherogenic pathophysiology generate that molecules not previously considered in the scene of this disease, were attributed actions on the onset or progression of it. A representative example is the study of a new mechanism involved in the atherogenic process, consisting of the association between the insulin-like growth factor (IGF) system and pregnancy-associated plasma protein-A (PAPP-A). Insulin-like growth factor system is a family of peptides that include 3 peptide hormones, 4 transmembrane receptors and 6 binding proteins. Insulin-like growth factor-1 (IGF-1) is the main ligand of the IGF system involved in coronary atherosclerosis. IGF-1 exerts its effects via activation of the IGF-1R receptor on vascular smooth muscle cells or macrophages. In vascular smooth muscle cells promotes migration and prevents apoptosis which increases plaque stability while in macrophages reduces reverse cholesterol transport leading to the formation of foam cells. Regulation of IGF-1 endothelial bioavailability is carried out by IGFBP proteases, mainly by PAPP-A. In this review, we address the mechanisms between IGF system and PAPP-A in atherosclerosis with emphasis on molecular effects on vascular smooth muscle cells and macrophages. Copyright © 2016 Instituto Nacional de Cardiología Ignacio Chávez. Published by Masson Doyma México S.A. All rights reserved.

  15. Nuclear Magnetic Resonance Lipoprotein Subclasses and the APOE Genotype Influence Carotid Atherosclerosis in Patients with Systemic Lupus Erythematosus

    NARCIS (Netherlands)

    Gonzàlez, Marta; Ribalta, Josep; Vives, Glòria; Iftimie, Simona; Ferré, Raimón; Plana, Núria; Guardiola, Montse; Dallinga-Thie, Geesje; Masana, Lluís; Castro, Antoni

    2010-01-01

    Objective. Patients with systemic lupus erythematosus (SLE) have accelerated atherosclerosis. Since the conventional lipid profile (total plasma cholesterol, triglycerides, low and high density lipoprotein cholesterol) is not consistently altered in SLE, we hypothesized that investigation of

  16. CARDIOVASCULAR EVENTS IN SYSTEMIC LUPUS ERYTHEMATOSUS: MECHANISMS FOR THE ACCELERATED DEVELOPMENT OF ATHEROSCLEROSIS, DIAGNOSIS, CORRECTION CAPABILITIES

    Directory of Open Access Journals (Sweden)

    A. V. Arshinov

    2017-01-01

    Full Text Available Atherosclerosis and its complications are the major cause of late mortality among patients with systemic lupus erythematosus (SLE. SLE and coronary heart disease share common pathophysiological mechanisms associated with systemic and chronic inflammation. At the same time, traditional risk factors, such as hypertension, elderly age, smoking, hypercholesterolemia, obesity, and male sex, cannot fully explain the mechanism for the accelerated development of atherosclerosis in patients with SLE. Specific risk factors, such as its duration, glucocorticoid use, anti-doublestranded (native DNA autoantibodies and antiphospholipid antibodies, create conditions for the accelerated development of atherosclerosis in this group of patients.The available facts indicate that a rheumatologist can reduce the risk of cardiovascular disease (CVD, by controlling the activity of SLE. Traditional CVD risk factors should be also modified with smoking cessation, weight loss, and blood pressure control. It is necessary to keep in mind the role of anti-inflammatory therapy, in particular the positive effect of drugs, such as anti-malarial drugs and mycophenolate mofetil, and the adverse prognostic effect of prolonged glucocorticoid use. Further studies should assist in elaborating effective risk scales and specific therapeutic programs for the prevention and treatment of CVD in patients with SLE. 

  17. Polygenic Risk Score Identifies Subgroup With Higher Burden of Atherosclerosis and Greater Relative Benefit From Statin Therapy in the Primary Prevention Setting.

    Science.gov (United States)

    Natarajan, Pradeep; Young, Robin; Stitziel, Nathan O; Padmanabhan, Sandosh; Baber, Usman; Mehran, Roxana; Sartori, Samantha; Fuster, Valentin; Reilly, Dermot F; Butterworth, Adam; Rader, Daniel J; Ford, Ian; Sattar, Naveed; Kathiresan, Sekar

    2017-05-30

    Relative risk reduction with statin therapy has been consistent across nearly all subgroups studied to date. However, in analyses of 2 randomized controlled primary prevention trials (ASCOT [Anglo-Scandinavian Cardiac Outcomes Trial-Lipid-Lowering Arm] and JUPITER [Justification for the Use of Statins in Prevention: An Intervention Trial Evaluating Rosuvastatin]), statin therapy led to a greater relative risk reduction among a subgroup at high genetic risk. Here, we aimed to confirm this observation in a third primary prevention randomized controlled trial. In addition, we assessed whether those at high genetic risk had a greater burden of subclinical coronary atherosclerosis. We studied participants from a randomized controlled trial of primary prevention with statin therapy (WOSCOPS [West of Scotland Coronary Prevention Study]; n=4910) and 2 observational cohort studies (CARDIA [Coronary Artery Risk Development in Young Adults] and BioImage; n=1154 and 4392, respectively). For each participant, we calculated a polygenic risk score derived from up to 57 common DNA sequence variants previously associated with coronary heart disease. We compared the relative efficacy of statin therapy in those at high genetic risk (top quintile of polygenic risk score) versus all others (WOSCOPS), as well as the association between the polygenic risk score and coronary artery calcification (CARDIA) and carotid artery plaque burden (BioImage). Among WOSCOPS trial participants at high genetic risk, statin therapy was associated with a relative risk reduction of 44% (95% confidence interval [CI], 22-60; P statin therapy was 3.6% (95% CI, 2.0-5.1) among those in the high genetic risk group and 1.3% (95% CI, 0.6-1.9) in all others. Each 1-SD increase in the polygenic risk score was associated with 1.32-fold (95% CI, 1.04-1.68) greater likelihood of having coronary artery calcification and 9.7% higher (95% CI, 2.2-17.8) burden of carotid plaque. Those at high genetic risk have a greater

  18. Comparative study of four maxillofacial trauma scoring systems and expert score.

    Science.gov (United States)

    Chen, Chen; Zhang, Yi; An, Jin-gang; He, Yang; Gong, Xi

    2014-11-01

    To select a scoring system suitable for the scoring of maxillofacial trauma by comparing 4 commonly used scoring systems according to expert scoring. Twenty-eight subjects who had experienced maxillofacial trauma constituted the study cohort. Four commonly used systems were selected: New Injury Severity Score (NISS), Facial Injury Severity Scale (FISS), Maxillofacial Injury Severity Score (MFISS), and Maxillofacial Injury Severity Score (MISS). Each patient was graded using these 4 systems. From the experience of our trauma center, an expert scoring table was created. After the purpose and scheme of the study had been explained, 35 experts in maxillofacial surgery were invited to grade the injury of the 28 patients using the expert scoring table according to their clinical experience. The results of the 4 scoring systems and expert score were compared. The results of the 4 scoring systems and expert score demonstrated a normal distribution. All results demonstrated significant differences (P expert score was the greatest (0.801). The correlation coefficient between the NISS, FISS, and MISS and the expert score was 0.714, 0.699, and 0.729, respectively. Agreement between the standardized scores and the expert score was evaluated using Bland-Altman plots; the agreement between the standardized MFISS and expert score was the best. Compared with the other 3 scoring systems, the correlation and agreement between the MFISS and expert score was greater. This finding suggests that the MFISS is more suitable for scoring maxillofacial injuries. Copyright © 2014 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  19. Importance of Scoring Systems in Prognosticating Meningococcemia

    Directory of Open Access Journals (Sweden)

    AR Emami Naeini

    2005-01-01

    Full Text Available Background: Meningococcal diseases occur with a worldwide distribution as endemic or in epidemics with an overall mortality rate of 8% to 10%, mainly in patients with signs and symptoms of meningococcemia. Several investigators have devised scoring systems using clinical and laboratory parameters available at the time of presentation to prognosticate the outcome of the infection. This study was designed to determine the distribution of demographic, clinical and laboratory parameters among our patients and the relative frequency of individual Stiehm and Damrosch components. Methods: This was a prospective descriptive study, performed on patients with definite diagnosis of meningococcal infection admitted to Al-Zahra University hospital (adult and pediatric wards, Isfahan, Iran, between 1997 and 2002. The cases were 140 patients [99(70.7% males and 41(29.3%females] from 1 to 50 years old (25.5±1.32. Data were collected by filling checklists. SSPS software was applied to analyze the data using chi-square test. Results: In this study, the relative frequency of individual Stiehm and Damrosch components were as follows: hypotension (10.7%, peripheral white blood cell count <10,000/mm3 (39.3%, leukopenia (11.5%, ESR<10 mm/hr (19.3%, coma (6.4%, early widespread petechiae (18%, absence of meningitis (13.6%. Overall mortality rate was (10.7%. Conclusion: Meningococci are still killers, they affect men more than women. Teenagers are at more risk than other age groups. Mortality in our study was a little higher than what is suggested (10.7%. we recommend using scoring systems for early separation of poor prognostic patients to provide them with more special care. Keywords: Meningococcemia, Scoring systems, Meningococcal infection

  20. Atherosclerosis (image)

    Science.gov (United States)

    Atherosclerosis is a disease of the arteries in which fatty material is deposited in the vessel wall, ... muscle leads to symptoms such as chest pain. Atherosclerosis shows no symptoms until a complication occurs.

  1. Cells of the immune system in atherosclerosis – chosen data

    Directory of Open Access Journals (Sweden)

    Paulina Niedźwiedzka-Rystwej

    2010-08-01

    Full Text Available Development of artherosclerosis is associated with participation of various cell types of the immune system such as: granulocytes, B and T lymphocytes, mast cells, dendritic cells and progenitor cells. Cytokines and growth factors have a great impact on activation of the atheromatous plaque. This pathological process results in increase of artery’s tunic intima thickness, leading to coronary heart disease, myocardial infarction or stroke. It is suggested that a closer look at participation of the immune system cells in artherosclerosis may contribute to a change in the profile of therapy of this disease.

  2. Coronary, Carotid, and Lower-extremity Atherosclerosis and Their Interrelationship in Danish Patients with Systemic Lupus Erythematosus

    DEFF Research Database (Denmark)

    Kay, Susan Due; Poulsen, Mikael Kjaer; Diederichsen, Axel Cosmus Pyndt

    2015-01-01

    OBJECTIVE: Atherosclerosis is highly prevalent among patients with systemic lupus erythematosus (SLE), but has been demonstrated predominantly in non-European SLE cohorts and few investigations have included more than 1 imaging modality. We aimed to investigate the prevalence of atherosclerosis......-media thickening and plaque, and abnormal ankle-brachial index by means of cardiac computed tomography, ultrasound of the carotid arteries, and ankle systolic blood pressure. RESULTS: In patients with SLE, the prevalence of atherosclerosis in any vascular territory was 41%. The distribution of the atherosclerotic...... manifestations showed an overlap with 45% of the patients having involvement in more than 1 vascular territory. However, more than one-third of the patients with SLE with coronary, carotid, or lower-extremity atherosclerosis exclusively demonstrated this particular manifestation. Based on a multiple logistic...

  3. Endotoxemia is related to systemic inflammation and atherosclerosis in peritoneal dialysis patients.

    Science.gov (United States)

    Szeto, Cheuk-Chun; Kwan, Bonnie Ching-Ha; Chow, Kai-Ming; Lai, Ka-Bik; Chung, Kwok-Yi; Leung, Chi-Bon; Li, Philip Kam-Tao

    2008-03-01

    Systemic inflammatory state is a hallmark of peritoneal dialysis (PD) patients, but its etiology remains obscure. Because circulating microbial products are an important cause of systemic immune activation in other conditions such as HIV infection, it was hypothesized that endotoxemia is a cause of systemic inflammatory state and atherosclerosis in PD patients. Plasma lipopolysaccharide (LPS) levels in 30 consecutive new PD patients were measured. The result was compared with serum C-reactive protein (CRP) level, peritoneal transport status, history of pre-existing cardiovascular diseases, and carotid intima media thickness (IMT) by Doppler ultrasound. Among the 30 PD patients, there were 17 men. The average age was 53.7 +/- 15.1 yr. The average endotoxin concentration of PD patients was 0.44 +/- 0.18 EU/ml, which was significantly higher than that of patients with chronic kidney disease secondary to Ig-A nephropathy (IgAN) (0.035 +/- 0.009 EU/ml, P LPS concentration had a significant correlation with serum CRP (r = 0.415, P = 0.025) and serum albumin level (r = -0.394, P = 0.034). In contrast, plasma LPS level did not correlate with Charlson's Comorbidity Index, peritoneal transport characteristics, or nutritional indices. Patients with pre-existing cardiovascular disease (CVD) had higher plasma LPS level than those without CVD (0.53 +/- 0.19 versus 0.36 +/- 0.16 EU/ml, P = 0.016). Plasma LPS level correlated with carotid IMT (r = 0.438, P = 0.016). It was found that endotoxemia was probably common in PD patients, and the degree of circulating endotoxemia might be related to the severity of systemic inflammation and features of atherosclerosis. This result suggests that endotoxemia may have a contributory role to the systemic inflammatory state and accelerated atherosclerosis in PD patients.

  4. Independent associations between a metabolic syndrome severity score and future diabetes by sex and race: the Atherosclerosis Risk In Communities Study and Jackson Heart Study.

    Science.gov (United States)

    Gurka, Matthew J; Golden, Sherita H; Musani, Solomon K; Sims, Mario; Vishnu, Abhishek; Guo, Yi; Cardel, Michelle; Pearson, Thomas A; DeBoer, Mark D

    2017-07-01

    The study aimed to assess for an association between the degree of severity of the metabolic syndrome and risk of type 2 diabetes beyond that conferred by the individual components of the metabolic syndrome. We assessed HRs for an Adult Treatment Panel III (ATP-III) metabolic syndrome score (ATP-III MetS) and a sex- and race-specific continuous metabolic syndrome severity z score related to incident diabetes over a median of 7.8 years of follow-up among participants of two observational cohorts, the Atherosclerosis Risk in Communities study (n = 10,957) and the Jackson Heart Study (n = 2137). The ATP-III MetS had an HR for incident diabetes of 4.36 (95% CI 3.83, 4.97), which was attenuated in models that included the individual metabolic syndrome components. By contrast, participants in the fourth quartile of metabolic syndrome severity (compared with the first quartile) had an HR of 17.4 (95% CI 12.6, 24.1) for future diabetes; in models that also included the individual metabolic syndrome components, this remained significant, with an HR of 3.69 (95% CI 2.42, 5.64). There was a race × metabolic syndrome interaction in these models such that HR was greater for black participants (5.30) than white participants (2.24). When the change in metabolic syndrome severity score was included in the hazard models, this conferred a further association, with changes in metabolic syndrome severity score of ≥0.5 having a HR of 2.66 compared with changes in metabolic syndrome severity score of ≤0. Use of a continuous sex- and race-specific metabolic syndrome severity z score provided an additional prediction of risk of diabetes beyond that of the individual metabolic syndrome components, suggesting an added risk conferred by the processes underlying the metabolic syndrome. Increases in this score over time were associated with further risk, supporting the potential clinical utility of following metabolic syndrome severity over time.

  5. Targeting the adaptive immune system: new strategies in the treatment of atherosclerosis

    NARCIS (Netherlands)

    Zarzycka, Barbara; Nicolaes, Gerry A. F.; Lutgens, Esther

    2015-01-01

    Atherosclerosis is a lipid-driven chronic inflammatory disease of the arterial wall. Current treatment of atherosclerosis is focused on limiting its risk factors, such as hyperlipidemia or hypertension. However, treatments that target the inflammatory nature of atherosclerosis are still under

  6. Nighttime Blood Pressure Patterns and Subclinical Atherosclerosis in Women with Systemic Lupus Erythematosus.

    Science.gov (United States)

    Sabio, José Mario; Martinez-Bordonado, Josefina; Sánchez-Berná, Isabel; Vargas-Hitos, José Antonio; Mediavilla, Juan Diego; Navarrete-Navarrete, Nuria; Zamora-Pasadas, Mónica; Ruíz, Manuela Expósito; Jiménez-Alonso, Juan

    2015-12-01

    To compare 24-h ambulatory blood pressure (BP) monitoring (ABPM) values and patterns in women with systemic lupus erythematosus (SLE) with those of a matched control group and their relationship with the presence of subclinical atherosclerosis. ABPM was assessed in 70 women with SLE and in 65 sex- and age-matched controls without a history of clinic cardiovascular disease (CVD). Carotid-femoral pulse wave velocity (PWV), which is a marker of subclinical atherosclerosis and a predictor of future CVD, was measured. Multivariate logistic analysis was used to determine which explanatory variables were independently associated with the non-dipper pattern and the presence of nocturnal hypertension (HTN) in women with SLE. No differences in PWV were found between patients and controls [median 7.3, interquartile range (IQR) 6.5-8.1 m/s vs median 7.1, IQR 6.5-7.8 m/s, p = 0.474]. The frequency of nondipper pattern (p = 0.025) and nocturnal HTN (p = 0.004) was significantly higher in women with SLE than in controls. White-coat and masked HTN were present in 10% and 11% of patients and in 20% and 8% of controls, respectively (p > 0.05 in all cases). The concordance between office and ambulatory HTN in the SLE and control groups was modest (κ = 0.325 and κ = 0.451, respectively). PWV and chronic kidney disease, and PWV and the Systemic Lupus Erythematosus Disease Activity Index were found to be independently associated with nocturnal HTN and nondipper pattern, respectively. Women with SLE were more likely to have an altered nighttime BP pattern than controls. In women with SLE, nondipper pattern and nocturnal HTN were independently associated with increased subclinical atherosclerosis measured by PWV.

  7. Increased systemic and local interleukin 9 levels in patients with carotid and coronary atherosclerosis.

    Directory of Open Access Journals (Sweden)

    Ida Gregersen

    Full Text Available OBJECTIVE: Atherosclerosis is a chronic inflammatory disorder that involves a range of inflammatory mediators. Although interleukin (IL-9 has been related to inflammation, there are at present no data on its role in atherosclerosis. Here we have examined IL-9 and IL-9 receptor (IL-9R systemically and locally in patients with coronary and carotid atherosclerosis. METHODS: Plasma IL-9 was quantified by enzyme immunoassay and multiplex technology. IL-9 and IL-9R mRNA were quantified by real-time RT-PCR, and their localization within the lesion was assessed by immunohistochemistry. RESULTS: THE MAIN FINDINGS WERE: (i Patients with carotid atherosclerosis had significantly raised IL-9 plasma levels compared with healthy controls (n = 28, with no differences between asymptomatic (n = 56 and symptomatic (n = 88 patients. (ii On admission, patients with acute ST-elevation myocardial infarction (STEMI (n = 42 had markedly raised IL-9 plasma levels which gradually declined during the first week post-MI. (iii T cells and monocytes from patients with unstable angina (n = 17 had increased mRNA levels of IL-9 as compared with controls (n = 11. (iv Carotid plaques (n = 68 showed increased mRNA levels of IL-9 and IL-9R compared to non-atherosclerotic vessels (n = 10. Co-localization to T cells (IL-9 and IL-9R and macrophages (IL-9 were shown by immunohistochemistry. (v IL-9 increased IL-17 release in peripheral blood mononuclear cells from patients with unstable angina (n = 5 and healthy controls (n = 5 with a particularly enhancing effect in cells from the patient group. CONCLUSION: Our findings show increased IL-9 levels in different atherosclerotic disorders both systemically and within the lesion, suggesting a role for the IL-9/IL-9R axis in the atherosclerotic process, potentially involving IL-17 mediated mechanisms. However, the functional consequences of these findings should be further investigated.

  8. Subclinical atherosclerosis in Systemic Lupus Erythematosus: Comparable risk with Diabetes Mellitus and Rheumatoid Arthritis.

    Science.gov (United States)

    Tektonidou, Maria G; Kravvariti, Evrydiki; Konstantonis, George; Tentolouris, Nicholas; Sfikakis, Petros P; Protogerou, Athanasios

    2017-03-01

    Although a high risk of subclinical atherosclerosis has been reported in Systemic Lupus Erythematosus (SLE), it is not adequately compared with that observed in other rheumatic and non-rheumatic high-cardiovascular (CVD) risk diseases, such as Rheumatoid Arthritis (RA) and Diabetes Mellitus (DM). Our objective was to evaluate the relative risk (RR) of subclinical atherosclerosis in SLE, RA and DM patients compared to healthy controls, and examine potential associations with traditional and disease-related CVD risk factors in SLE. We examined for atherosclerotic plaques 460 individuals (92% female) without CVD history, using carotid and femoral artery ultrasound: 115 SLE patients and matched 1:1 for age and gender RA, DM, and control subjects. Multivariate models were used to determine relative risk estimates for the number of atherosclerotic plaques in patient groups versus controls, and associations of plaques with traditional CVD and disease-related factors in SLE. A nearly two-fold higher number of atherosclerotic plaques in the carotid and femoral arteries was detected in each of SLE, RA and DM groups compared to controls, after adjusting for the effect of traditional CVD risk factors (RR=1.80, 95% CI 1.05-3.08, p=0.033, RR=1.90 (1.11-3.26), p=0.019, RR=1.93 (1.14-3.28), p=0.015, respectively). In SLE patients, the number of atherosclerotic plaques was associated with age (prisk of subclinical atherosclerosis in SLE was comparable to that found in RA and DM, indicating that SLE patients merit a similar diligence in CVD risk assessment and management measures. Copyright © 2017 Elsevier B.V. All rights reserved.

  9. [Activation of the kallikrein-kinin system of the blood in hypertension and atherosclerosis with transient cerebral circulatory disorders].

    Science.gov (United States)

    Vizir, A D; Kechin, I L

    1984-01-01

    The authors studied the blood kinin system in patients with transient impairments of the cerebral circulation (TICC) both in the presence of hypertonic crises (30 patients) and cerebral vascular atherosclerosis (30 patients) during a vascular episode on the 10th-15th day of treatment. During TICC, the patients showed a marked activation of the blood kinin system which was especially pronounced in hypertonic rises. The underlying disease had a significant impact on the time-course of kinin system activity. In patients with TICC associated with hypertonic crises, hypotensive treatment decreased kinin activity to a considerable degree whereas in cases of cerebral vascular atherosclerosis the treatment exerted no noticeable effect on the activity of kinins. The involvement of kinins in the processes of the compensation and pathogenesis in TICC is discussed. It is recommended that TICC associated with arterial hypertension be treated by sodium salicylate, whereas in TICC associated with atherosclerosis the administration of antikinin drugs is indicated (parmidin, prodectin).

  10. Performance of an Automated Polysomnography Scoring System Versus Computer-Assisted Manual Scoring

    Science.gov (United States)

    Malhotra, Atul; Younes, Magdy; Kuna, Samuel T.; Benca, Ruth; Kushida, Clete A.; Walsh, James; Hanlon, Alexandra; Staley, Bethany; Pack, Allan I.; Pien, Grace W.

    2013-01-01

    Study Objectives: Manual scoring of polysomnograms (PSG) is labor intensive and has considerable variance between scorers. Automation of scoring could reduce cost and improve reproducibility. The purpose of this study was to compare a new automated scoring system (YST-Limited, Winnipeg, Canada) with computer-assisted manual scoring. Design: Technical assessment. Setting: Five academic medical centers. Participants: N/A. Interventions: N/A. Measurements and Results: Seventy PSG files were selected at University of Pennsylvania (Penn) and distributed to five US academic sleep centers. Two blinded technologists from each center scored each file. Automatic scoring was performed at Penn by a YST Limited technician using a laptop containing the software. Variables examined were sleep stages, arousals, and apnea-hypopnea index (AHI) using three methods of identifying hypopneas. Automatic scores were not edited and were compared to the average scores of the 10 technologists. Intraclass correlation coefficient (ICC) was obtained for the 70 pairs and compared to across-sites ICCs for manually scored results. ICCs for automatic versus manual scoring were > 0.8 for total sleep time, stage N2, and nonrapid eye movement arousals and > 0.9 for AHI scored by primary and secondary American Academy of Sleep Medicine criteria. ICCs for other variables were not as high but were comparable to the across-site ICCs for manually scored results. Conclusion: The automatic system yielded results that were similar to those obtained by experienced technologists. Very good ICCs were obtained for many primary PSG outcome measures. This automated scoring software, particularly if supplemented with manual editing, may increase laboratory efficiency and standardize PSG scoring results within and across sleep centers. Citation: Malhotra A; Younes M; Kuna ST; Benca R; Kushida CA; Walsh J; Hanlon A; Staley B; Pack AI; Pien GW. Performance of an automated polysomnography scoring system versus computer

  11. Crosstalk between Red Blood Cells and the Immune System and Its Impact on Atherosclerosis

    Directory of Open Access Journals (Sweden)

    Brigitta Buttari

    2015-01-01

    Full Text Available Atherosclerosis is a chronic multifactorial disease of the arterial wall characterized by inflammation, oxidative stress, and immune system activation. Evidence exists on a pathogenic role of oxidized red blood cells (RBCs accumulated in the lesion after intraplaque hemorrhage. This review reports current knowledge on the impact of oxidative stress in RBC modifications with the surface appearance of senescent signals characterized by reduced expression of CD47 and glycophorin A and higher externalization of phosphatidylserine. The review summarizes findings indicating that oxidized, senescent, or stored RBCs, due to surface antigen modification and release of prooxidant and proinflammatory molecules, exert an impaired modulatory activity on innate and adaptive immune cells and how this activity contributes to atherosclerotic disease. In particular RBCs from patients with atherosclerosis, unlike those from healthy subjects, fail to control lipopolysaccharide-induced DC maturation and T lymphocyte apoptosis. Stored RBCs, accompanied by shedding of extracellular vesicles, stimulate peripheral blood mononuclear cells to release proinflammatory cytokines, augment mitogen-driven T cell proliferation, and polarize macrophages toward the proinflammatory M1 activation pathway. Collectively, literature data suggest that the crosstalk between RBCs with immune cells represents a novel mechanism by which oxidative stress can contribute to atherosclerotic disease progression and may be exploited for therapeutic interventions.

  12. Scoring system to preoperatively predict choledocholithiasis.

    Science.gov (United States)

    Kamath, Sheshang U; Dharap, Satish B; Kumar, Vineet

    2016-05-01

    The incidence of common bile duct (CBD) calculi has been reported to be 8 % to 20 % among the patients with cholelithiasis. Failure to detect CBD stones on the part of the surgeon not only fails to relieve symptoms but also subjects them to potentially life-threatening complications such as cholangitis, pancreatitis or obstructive jaundice. Modalities for detection of CBD stones have evolved over time from CBD exploration based on clinical and operative findings to intraoperative cholangiography (IOC), to endoscopic retrograde cholangiopancreaticography (ERCP) and, recently, to magnetic resonance cholangiopancreaticography (MRCP) and endoscopic ultrasonography (EUS). We felt a need for a scoring system to predict a patient population having a higher risk of choledocholithiasis so that these modern interventions can be selectively utilized. This study was performed in a tertiary care medical college hospital in a metropolitan city. This is a prospective observational study. All patients with symptomatic cholelithiasis admitted to the hospital were included. Patients were diagnosed as having choledocholithiasis either by ultrasonography (USG), computed tomography scan, MRCP, EUS or ERCP and were followed up for at least 6 weeks. The prevalence of choledocholithiasis among the 275 patients with symptomatic biliary colic in our study was 18.9 % (n = 77). On bivariate analysis, dilated bile duct on USG (>6 mm), raised total bilirubin, raised alkaline phosphatase (ALP), raised amylase, raised SGPT and SGOT were significantly associated with choledocholithiasis (p choledocholithiasis (p 6 mm), total bilirubin >2 mg/dL, ALP >190 IU/L and SGOT >40 IU/L. A positive predictive value of 3 or more factors was over 95 %, necessitating an endoscopic intervention. A negative predictive value of the absence of any factor was 100 %, which ruled out CBD calculi. If only one or two factors are positive, then further evaluation is recommended preferably using non

  13. Performance of an automated polysomnography scoring system versus computer-assisted manual scoring.

    Science.gov (United States)

    Malhotra, Atul; Younes, Magdy; Kuna, Samuel T; Benca, Ruth; Kushida, Clete A; Walsh, James; Hanlon, Alexandra; Staley, Bethany; Pack, Allan I; Pien, Grace W

    2013-04-01

    Manual scoring of polysomnograms (PSG) is labor intensive and has considerable variance between scorers. Automation of scoring could reduce cost and improve reproducibility. The purpose of this study was to compare a new automated scoring system (YST-Limited, Winnipeg, Canada) with computer-assisted manual scoring. Technical assessment. Five academic medical centers. N/A. N/A. Seventy PSG files were selected at University of Pennsylvania (Penn) and distributed to five US academic sleep centers. Two blinded technologists from each center scored each file. Automatic scoring was performed at Penn by a YST Limited technician using a laptop containing the software. Variables examined were sleep stages, arousals, and apnea-hypopnea index (AHI) using three methods of identifying hypopneas. Automatic scores were not edited and were compared to the average scores of the 10 technologists. Intraclass correlation coefficient (ICC) was obtained for the 70 pairs and compared to across-sites ICCs for manually scored results. ICCs for automatic versus manual scoring were > 0.8 for total sleep time, stage N2, and nonrapid eye movement arousals and > 0.9 for AHI scored by primary and secondary American Academy of Sleep Medicine criteria. ICCs for other variables were not as high but were comparable to the across-site ICCs for manually scored results. The automatic system yielded results that were similar to those obtained by experienced technologists. Very good ICCs were obtained for many primary PSG outcome measures. This automated scoring software, particularly if supplemented with manual editing, may increase laboratory efficiency and standardize PSG scoring results within and across sleep centers.

  14. Alvarado vs Lintula Scoring Systems in Acute Appendicitis

    African Journals Online (AJOL)

    relocation of pain, location of pain, vomiting, elevated temperature, guarding, bowel sounds and rebound tenderness).The aim of this study was therefore, to compare the accuracy of two commonly applied scoring systems in the diagnosis of acute appendicitis, namely the Alvarado scoring system and the Lintula scoring ...

  15. Automatic Dialogue Scoring for a Second Language Learning System

    Science.gov (United States)

    Huang, Jin-Xia; Lee, Kyung-Soon; Kwon, Oh-Woog; Kim, Young-Kil

    2016-01-01

    This paper presents an automatic dialogue scoring approach for a Dialogue-Based Computer-Assisted Language Learning (DB-CALL) system, which helps users learn language via interactive conversations. The system produces overall feedback according to dialogue scoring to help the learner know which parts should be more focused on. The scoring measures…

  16. Various scoring systems for predicting mortality in Intensive Care Unit

    African Journals Online (AJOL)

    2015-12-07

    Dec 7, 2015 ... require updating these critical scoring systems. Considering the possibility of a superiority of one system to others, the present study aimed to compare the third generation scoring systems (APACHE IV and SAPS III) with the commonly used system; APACHE II in our critically ill patients. ICU mortality rates ...

  17. Modifying scoring system at South African University rugby level ...

    African Journals Online (AJOL)

    Success in rugby is measured by winning the game and in order to do so, teams need to score more points than the opposing team. The primary aim of this study was to investigate and compare the scoring profile of the 2011 and 2012 tournaments and to determine if modifying the scoring system at South African University ...

  18. Systems for scoring severity of illness in intensive care | Turner ...

    African Journals Online (AJOL)

    Severity of illness scoring systems are increasingly being used by many intensive care units to predict mortality and to compare results and different therapies. A study was undertaken to evaluate three of these systems - therapeutic intervention scoring system (TISS), acute physiology and chronic health evaluation ...

  19. Comparing Computer-Derived and Human-Observed Scores for the Balance Error Scoring System.

    Science.gov (United States)

    Caccese, Jaclyn B; Kaminski, Thomas W

    2016-05-01

    The Balance Error Scoring System (BESS) is the current standard for assessing postural stability in concussed athletes on the sideline. However, research has questioned the objectivity and validity of the BESS, suggesting that while certain subcategories of the BESS have sufficient reliability to be used in evaluation of postural stability, the total score is not reliable, demonstrating limited interrater and intrarater reliability. Recently, a computerized BESS test was developed to automate scoring. To compare computer-derived BESS scores with those taken from 3 trained human scorers. Interrater reliability study. Athletic training room. NCAA Division I student athletes (53 male, 58 female; 19 ± 2 y, 168 ± 41 cm, 69 ± 4 kg). Subjects were asked to perform the BESS while standing on the Tekscan (Boston, MA) MobileMat® BESS. The MobileMat BESS software displayed an error score at the end of each trial. Simultaneously, errors were recorded by 3 separate examiners. Errors were counted using the standard BESS scoring criteria. The number of BESS errors was computed for the 6 stances from the software and each of the 3 human scorers. Interclass correlation coefficients (ICCs) were used to compare errors for each stance scored by the MobileMat BESS software with each of 3 raters individually. The ICC values were converted to Fisher Z scores, averaged, and converted back into ICC values. The double-leg, single-leg, and tandem-firm stances resulted in good agreement with human scorers (ICC = .999, .731, and .648). All foam stances resulted in fair agreement. Our results suggest that the MobileMat BESS is suitable for identifying BESS errors involving each of the 6 stances of the BESS protocol. Because the MobileMat BESS scores consistently and reliably, this system can be used with confidence by clinicians as an effective alternative to scoring the BESS.

  20. A Novel Scoring System Approach to Assess Patients with Lyme Disease (Nutech Functional Score)

    OpenAIRE

    Geeta Shroff; Petra Hopf-Seidel

    2018-01-01

    Introduction: A bacterial infection by Borrelia burgdorferi referred to as Lyme disease (LD) or borreliosis is transmitted mostly by a bite of the tick Ixodes scapularis in the USA and Ixodes ricinus in Europe. Various tests are used for the diagnosis of LD, but their results are often unreliable. We compiled a list of clinically visible and patient-reported symptoms that are associated with LD. Based on this list, we developed a novel scoring system. Methodology: Nutech functional Score (NF...

  1. Validation of a new scoring system: Rapid assessment faecal incontinence score.

    Science.gov (United States)

    de la Portilla, Fernando; Calero-Lillo, Arantxa; Jiménez-Rodríguez, Rosa M; Reyes, Maria L; Segovia-González, Manuela; Maestre, María Victoria; García-Cabrera, Ana M

    2015-09-27

    To implement a quick and simple test - rapid assessment faecal incontinence score (RAFIS) and show its reliability and validity. From March 2008 through March 2010, we evaluated a total of 261 consecutive patients, including 53 patients with faecal incontinence. Demographic and comorbidity information was collected. In a single visit, patients were administered the RAFIS. The results obtained with the new score were compared with those of both Wexner score and faecal incontinence quality of life scale (FIQL) questionnaire. The patient without influence of the surgeon completed the test. The role of surgeon was explaining the meaning of each section and how he had to fill. Reliability of the RAFIS score was measured using intra-observer agreement and Cronbach's alpha (internal consistency) coefficient. Multivariate analysis of the main components within the different scores was performed in order to determine whether all the scores measured the same factor and to conclude whether the information could be encompassed in a single factor. A sample size of 50 patients with faecal incontinence was estimated to be enough to detect a correlation of 0.55 or better at 5% level of significance with 80% power. We analysed the results obtained by 53 consecutive patients with faecal incontinence (median age 61.55 ± 12.49 years) in the three scoring systems. A total of 208 healthy volunteers (median age 58.41 ± 18.41 years) without faecal incontinence were included in the study as negative controls. Pearson's correlation coefficient between "state" and "leaks" was excellent (r = 0.92, P < 0.005). Internal consistency in the comparison of "state" and "leaks" yielded also excellent correlation (Cronbach's α = 0.93). Results in each score were compared using regression analysis and a correlation value of r = 0.98 was obtained with Wexner score. As regards FIQL questionnaire, the values of "r" for the different subscales of the questionnaire were: "lifestyle" r = -0.87, "coping

  2. Prognostic factors and scoring system for survival in colonic perforation.

    Science.gov (United States)

    Komatsu, Shuhei; Shimomatsuya, Takumi; Nakajima, Masayuki; Amaya, Hirokazu; Kobuchi, Taketsune; Shiraishi, Susumu; Konishi, Sayuri; Ono, Susumu; Maruhashi, Kazuhiro

    2005-01-01

    No ideal and generally accepted prognostic factors and scoring systems exist to determine the prognosis of peritonitis associated with colonic perforation. This study was designed to investigate prognostic factors and evaluate the various scoring systems to allow identification of high-risk patients. Between 1996 and 2003, excluding iatrogenic and trauma cases, 26 consecutive patients underwent emergency operations for colorectal perforation and were selected for this retrospective study. Several clinical factors were analyzed as possible predictive factors, and APACHE II, SOFA, MPI, and MOF scores were calculated. The overall mortality was 26.9%. Compared with the survivors, non-survivors were found more frequently in Hinchey's stage III-IV, a low preoperative marker of pH, base excess (BE), and a low postoperative marker of white blood cell count, PaO2/FiO2 ratio, and renal output (24h). According to the logistic regression model, BE was a significant independent variable. Concerning the prognostic scoring systems, an APACHE II score of 19, a SOFA score of 8, an MPI score of 30, and an MOF score of 7 or more were significantly related to poor prognosis. Preoperative BE and postoperative white blood cell count were reliable prognostic factors and early classification using prognostic scoring systems at specific points in the disease process are useful to improve our understanding of the problems involved.

  3. 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

    International Nuclear Information System (INIS)

    Ryu, Seok Jong; Choi, Byoung Wook; Choe, Kyu Ok

    2001-01-01

    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

  4. 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

    Energy Technology Data Exchange (ETDEWEB)

    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

  5. Symptom scoring systems to diagnose distal polyneuropathy in diabetes : the Diabetic Neuropathy Symptom score

    NARCIS (Netherlands)

    Meijer, J.W.G.; Smit, A.J.; van Sonderen, E.; Groothoff, J.W.; Eisma, W.H.; Links, T.P.

    2002-01-01

    AIMS: To provide one of the diagnostic categories for distal diabetic polyneuro-pathy,several symptom scoring systems are available, which are often extensive andlack in validation. We validated a new four-item Diabetic Neuropathy Symptom (DNS) scorefor diagnosing distal diabetic polyneuropathy.

  6. [Validation of a diagnostic scoring system (Ohmann score) in acute appendicitis].

    Science.gov (United States)

    Zielke, A; Sitter, H; Rampp, T A; Schäfer, E; Hasse, C; Lorenz, W; Rothmund, M

    1999-07-01

    A diagnostic scoring system, recently published by Ohmann et al. in this journal, was validated by analyzing the clinicopathological data of a consecutive series of 2,359 patients, admitted for suspicion of acute appendicitis. The results of the scoring system were compared to the results of clinical evaluation by junior (provisional) and senior surgeons (final clinical diagnosis). To assess the diagnostic ability of the score, the accuracy and positive predictive value were defined as the major diagnostic performance parameters; the rate of theoretical negative laparotomies and that of diagnostic errors served as the major procedural performance parameters. Of 2,359 patients admitted for suspected acute appendicitis, 662 were proven to have acute appendicitis by histology, for a prevalence of 28%. The overall sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the provisional clinical diagnosis were 0.50, 0.94, 0.77, 0.83, and 0.82; 0.93, for the score 0.63, 0.93, 0.77, 0.86 and 0.84, and for the final clinical diagnosis 0.90, 0.94, 0.85, 0.96, and 0.93, respectively. Of the main diagnostic performance parameter, the accuracy of the score was significantly better than that of provisional clinical diagnosis (P apendicitis, the score demonstrated a superior performance, with only 6 cases missed (0.9%). However, the number of patients with acute appendicitis, including those with perforated disease, who were not identified by the score, was almost four times that of the final clinical diagnosis (245 vs 63). With regard to the main procedural performance parameter, the score resulted in a significantly smaller number of diagnostic errors than the provisional clinical investigator (P < 0.05, chi 2 test). The results of this study indicate that the diagnostic scoring system might be helpful when experienced investigators or additional diagnostic modalities such as ultrasonography are not available. It may therefore be of value

  7. Evaluation of a Lameness Scoring System for Dairy Cows

    DEFF Research Database (Denmark)

    Thomsen, P T; Munksgaard, L; Tøgersen, F A

    2008-01-01

    Lameness is a major problem in dairy production both in terms of reduced production and compromised animal welfare. A 5-point lameness scoring system was developed based on previously published systems, but optimized for use under field conditions. The scoring system included the words "in most...... cases" in the descriptions of the clinical signs evaluated. This was done to avoid a situation in which cows might not fit into any of the categories. Additionally, a number of clinical signs used in other lameness scoring systems, considered of less importance in relation to lameness, were not included....... Only clinical signs were included that could easily be assessed within a few seconds from a distance. The scoring system was evaluated with intra-and interobserver agreement using kappa statistics. The evaluation was done before and after training 5 observers. Weighted kappa values ranged from 0...

  8. A Novel Scoring System Approach to Assess Patients with Lyme Disease (Nutech Functional Score).

    Science.gov (United States)

    Shroff, Geeta; Hopf-Seidel, Petra

    2018-01-01

    A bacterial infection by Borrelia burgdorferi referred to as Lyme disease (LD) or borreliosis is transmitted mostly by a bite of the tick Ixodes scapularis in the USA and Ixodes ricinus in Europe. Various tests are used for the diagnosis of LD, but their results are often unreliable. We compiled a list of clinically visible and patient-reported symptoms that are associated with LD. Based on this list, we developed a novel scoring system. Nutech functional Score (NFS), which is a 43 point positional (every symptom is subgraded and each alternative gets some points according to its position) and directional (moves in direction bad to good) scoring system that assesses the patient's condition. The grades of the scoring system have been converted into numeric values for conducting probability based studies. Each symptom is graded from 1 to 5 that runs in direction BAD → GOOD. NFS is a unique tool that can be used universally to assess the condition of patients with LD.

  9. A Novel Scoring System Approach to Assess Patients with Lyme Disease (Nutech Functional Score

    Directory of Open Access Journals (Sweden)

    Geeta Shroff

    2018-01-01

    Full Text Available Introduction: A bacterial infection by Borrelia burgdorferi referred to as Lyme disease (LD or borreliosis is transmitted mostly by a bite of the tick Ixodes scapularis in the USA and Ixodes ricinus in Europe. Various tests are used for the diagnosis of LD, but their results are often unreliable. We compiled a list of clinically visible and patient-reported symptoms that are associated with LD. Based on this list, we developed a novel scoring system. Methodology: Nutech functional Score (NFS, which is a 43 point positional (every symptom is subgraded and each alternative gets some points according to its position and directional (moves in direction bad to good scoring system that assesses the patient's condition. Results: The grades of the scoring system have been converted into numeric values for conducting probability based studies. Each symptom is graded from 1 to 5 that runs in direction BAD → GOOD. Conclusion: NFS is a unique tool that can be used universally to assess the condition of patients with LD.

  10. Development of a new Knee Society scoring system.

    Science.gov (United States)

    Noble, Philip C; Scuderi, Giles R; Brekke, Adam C; Sikorskii, Alla; Benjamin, James B; Lonner, Jess H; Chadha, Priya; Daylamani, Daniel A; Scott, W Norman; Bourne, Robert B

    2012-01-01

    The Knee Society Clinical Rating System was developed in 1989 and has been widely adopted. However, with the increased demand for TKA, there is a need for a new, validated scoring system to better characterize the expectations, satisfaction, and physical activities of the younger, more diverse population of TKA patients. We developed and validated a new Knee Society Scoring System. We developed the new knee scoring system in two stages. Initially, a comprehensive survey of activities was developed and administered to 101 unilateral TKA patients (53 women, 48 men). A prototype knee scoring instrument was developed from the responses to the survey and administered to 497 patients (204 men, 293 women; 243 postoperatively, 254 preoperatively) at 15 medical institutions within the United States and Canada. Objective and subjective data were analyzed using standard statistical and psychometric procedures and compared to the Knee Injury and Osteoarthritis Score and SF-12 scores for validation. Based on this analysis, minor modifications led to the new Knee Society Scoring System. We found the new Knee Society Scoring System to be broadly applicable and to accurately characterize patient outcomes after TKA. Statistical analysis confirmed the internal consistency, construct and convergent validity, and reliability of the separate subscale measures. The new Knee Society Scoring System is a validated instrument based on surgeon- and patient-generated data, adapted to the diverse lifestyles and activities of contemporary patients with TKA. This assessment tool allows surgeons to appreciate differences in the priorities of individual patients and the interplay among function, expectation, symptoms, and satisfaction after TKA.

  11. The magazine picture collage: development of an objective scoring system.

    Science.gov (United States)

    Lerner, C; Ross, G

    1977-03-01

    A system for objectively scoring the magazine picture collage was developed and applied to the collages of 12 psychiatric inpatients and 12 paired controls. As a group, the patient collages had fewer cuttings, tended to lack an overall balance and central theme, and contained fewer pictures of people and more of animals. The results are consistent with those reported by other researchers as well as with general clinical experience, and as such, lend support to the construct validity of the scoring system.

  12. Supersparse Linear Integer Models for Optimized Medical Scoring Systems

    OpenAIRE

    Ustun, Berk; Rudin, Cynthia

    2015-01-01

    Scoring systems are linear classification models that only require users to add, subtract and multiply a few small numbers in order to make a prediction. These models are in widespread use by the medical community, but are difficult to learn from data because they need to be accurate and sparse, have coprime integer coefficients, and satisfy multiple operational constraints. We present a new method for creating data-driven scoring systems called a Supersparse Linear Integer Model (SLIM). SLIM...

  13. Physical activity reduces systemic blood pressure and improves early markers of atherosclerosis in pre-pubertal obese children.

    Science.gov (United States)

    Farpour-Lambert, Nathalie J; Aggoun, Yacine; Marchand, Laetitia M; Martin, Xavier E; Herrmann, François R; Beghetti, Maurice

    2009-12-15

    The aim of this study was to determine the effects of physical activity on systemic blood pressure (BP) and early markers of atherosclerosis in pre-pubertal obese children. Hypertension and endothelial dysfunction are premature complications of obesity. We performed a 3-month randomized controlled trial with a modified crossover design: 44 pre-pubertal obese children (age 8.9 + or - 1.5 years) were randomly assigned (1:1) to an exercise (n = 22) or a control group (n = 22). We recruited 22 lean children (age 8.5 + or - 1.5 years) for baseline comparison. The exercise group trained 60 min 3 times/week during 3 months, whereas control subjects remained relatively inactive. Then, both groups trained twice/week during 3 months. We assessed changes at 3 and 6 months in office and 24-h BP, arterial intima-media thickness (IMT) and stiffness, endothelial function (flow-mediated dilation), body mass index (BMI), body fat, cardiorespiratory fitness (maximal oxygen consumption [VO(2)max]), physical activity, and biological markers. Obese children had higher BP, arterial stiffness, body weight, BMI, abdominal fat, insulin resistance indexes, and C-reactive protein levels, and lower flow-mediated dilation, VO(2)max, physical activity, and high-density lipoprotein cholesterol levels than lean subjects. At 3 months, we observed significant changes in 24-h systolic BP (exercise -6.9 + or - 13.5 mm Hg vs. control 3.8 + or - 7.9 mm Hg, -0.8 + or - 1.5 standard deviation score [SDS] vs. 0.4 + or - 0.8 SDS), diastolic BP (-0.5 + or - 1.0 SDS vs. 0 + or - 1.4 SDS), hypertension rate (-12% vs. -1%), office BP, BMI z-score, abdominal fat, and VO(2)max. At 6 months, change differences in arterial stiffness and IMT were significant. A regular physical activity program reduces BP, arterial stiffness, and abdominal fat; increases cardiorespiratory fitness; and delays arterial wall remodeling in pre-pubertal obese children. (Effects of Aerobic Exercise Training on Arterial Function and

  14. Chronic oral infection with major periodontal bacteria Tannerella forsythia modulates systemic atherosclerosis risk factors and inflammatory markers.

    Science.gov (United States)

    Chukkapalli, Sasanka S; Rivera-Kweh, Mercedes F; Velsko, Irina M; Chen, Hao; Zheng, Donghang; Bhattacharyya, Indraneel; Gangula, Pandu R; Lucas, Alexandra R; Kesavalu, Lakshmyya

    2015-04-01

    Tannerella forsythia is a Gram-negative anaerobic organism that inhabits the subgingival cavity and initiates connective tissue destruction and alveolar bone resorption in periodontal disease (PD). PD is a chronic immunoinflammatory disease and has been linked to several systemic diseases including atherosclerosis. This study evaluated the effects of a chronic oral infection with T. forsythia ATCC 43037 on the induction of PD, inflammatory markers and atherosclerosis risk factors in hyperlipidemic ApoE(null) mice. Mice were orally infected for 12 and 24 weeks prior to euthanasia. Bacterial colonization of the oral cavity and bacteremia was confirmed via isolation of genomic DNA from oral plaque and tissues. Oral infection elicited significantly elevated levels of serum IgG and IgM antibodies and alveolar bone resorption compared to control mice. Tannerella forsythia-infected mice had increased serum amyloid A, and significantly reduced serum nitric oxide when compared to controls. Tannerella forsythia chronic infection also significantly increased serum lipoproteins suggesting altered cholesterol metabolism and potential for aortic inflammation. Despite enhanced acute phase reactants and altered lipid profiles, T. forsythia infection was associated with decreased aortic plaque. This study investigates the potential of a known periodontal bacterial pathogen found in atherosclerotic plaque in humans to accelerate atherosclerosis in hyperlipdemic mice. © FEMS 2015. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  15. Myelodysplastic syndromes: a scoring system with prognostic significance.

    Science.gov (United States)

    Mufti, G J; Stevens, J R; Oscier, D G; Hamblin, T J; Machin, D

    1985-03-01

    141 patients with MDS were classified according to the FAB criteria and followed up for a period of 4-192 months. It was recognized that patients with RAEBT had a uniformly poor prognosis. However, there was a wide variation in survival among the other subgroups. A score of 1 was assigned to each of the following presenting haematological features: bone marrow blasts greater than or equal to 5%, platelets less than or equal to 100 X 10(9)/l, neutrophils less than or equal to 2.5 X 10(9)/l and Hb less than or equal to 10.0 g/dl. Therefore the score for each patient ranged between 0 and 4. There were no statistically significant differences between those patients who scored 0 or 1, or between those who scored 2 and 3. Therefore patients were put into three groups: Group A (score 0 or 1), Group B (score 2 or 3), Group C (score 4). The differences in survival between each of the three groups are highly significant (P less than 0.00001). This system further separates patients with RA, RAS, RAEB into good and bad prognostic groups. This study also confirms that deaths due to cytopenias are more common than those due to transformation to AML. The use of this scoring system in conjunction with the FAB criteria for MDS should serve as a prognostic tool on which to base treatment.

  16. Assessment of premature atherosclerosis in systemic lupus erythematosus patients with and without nephritis.

    Science.gov (United States)

    Sharma, S K; Rathi, M; Sahoo, S; Prakash, M; Dhir, V; Singh, S

    2016-04-01

    Risk of subclinical atherosclerosis is increased in patients with systemic lupus erythematosus (SLE). We correlated carotid intima media thickness (CIMT) and endothelial dysfunction through flow-mediated dilation (FMD) in SLE patients with the SLE Disease Activity Index (SLEDAI). This single-centre cross-sectional study recruited 100 consenting SLE outpatients (ACR 1997 criteria) out of which 50 had nephritis, with disease duration of ≥2 years for SLE and ≥6 months for lupus nephritis. We measured baseline laboratory levels, CIMT and FMD (after brachial BP cuff inflation up to 200 mmHg for five minutes), and calculated SLEDAI. Mean age was 29.88 ± 6.53 years; 95/100 were female. CIMT showed positive correlation (p = 0.037; rho = 0.209), and FMD showed inverse correlation with patient's age (p = 0.011; rho = -0.252). CIMT and FMD were more deranged in patients aged ≥25 years (p nephritis (p > 0.05), whereas SLEDAI and FMD were more deranged in nephritis patients (p nephritis, FMD showed significant inverse correlation with disease duration (p = 0.043; rho = -0.288) and urine albumin (p = 0.045; rho = -0.285). In nephritis patients, the correlation between age of the patient was significantly positive with CIMT (p = 0.001; rho = 0.441) and significantly inverse with FMD (p = 0.028; rho = -0.312). SLE patients with nephritis are at a higher risk to develop arterial stiffening, leading to early end-organ damage. Early aggressive treatment may prevent endothelial dysfunction. FMD using vascular ultrasonography on the brachial artery represents a non-invasive, repeatable and useful method for the assessment of endothelial dysfunction. © The Author(s) 2015.

  17. Association of systemic inflammatory activity with coronary and carotid atherosclerosis in the very elderly.

    Science.gov (United States)

    Freitas, Wladimir M; Quaglia, Luiz A; Santos, Simone N; Soares, Alexandre A S; Japiassú, André V T; Boaventura, Vinicius; dos Santos Barros, Edilberto; Córdova, Cláudio; Nóbrega, Otávio T; Sposito, Andrei C

    2011-05-01

    To verify the existence of association between plasma levels of pro- or anti-inflammatory mediators and atherosclerotic burden at coronary and carotid arteries in individuals aged of 80 or more years old. Healthy individuals aged between 80 and 102 years old (n = 178) underwent evaluation of plasma cytokines and acute phase proteins, intima-media thickness (IMT) and presence of plaques in carotid arteries by ultrasound and coronary artery calcification (CAC) by cardiac computed tomography. There was no association between CAC and carotid plaques (p = 0.8), maximum (p = 0.06) or mean IMT (p = 0.2). No association was found between the presence of carotid plaques and CRP (p = 0.4), TNF-α (p = 0.8) or IL-10 (p = 0.2). Likewise, individuals in the first three quartiles for CRP, TNF-α or IL-10 had similar values of CAC, mean and maximum IMT. In contrast, individuals above the 75th percentile for CRP or for TNF-α had enhanced maximum IMT (p = 0.017 and p < 0.0001) and CAC (p = 0.026 and p = 0.01) and subjects with IL-10 levels above the 75th percentile had lower maximum IMT (p = 0.027) and CAC (p = 0.006) as compared with those below this percentile. There was no difference in mean IMT for individuals above or below the 75th percentile for CRP, TNF-α or IL-10. In very old individuals, CAC and maximum IMT were positively associated with systemic inflammatory activity only in those above the 75th percentile. The markers of atherosclerotic burden at coronary and carotid arteries were not related to each other and were distinctly associated with pro- and anti-inflammatory mediators, suggesting that atherosclerosis development is different in these vascular beds. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  18. Genetic Architecture of Atherosclerosis in Mice: A Systems Genetics Analysis of Common Inbred Strains

    Science.gov (United States)

    Bennett, Brian J.; Davis, Richard C.; Civelek, Mete; Orozco, Luz; Wu, Judy; Qi, Hannah; Pan, Calvin; Packard, René R. Sevag; Eskin, Eleazar; Yan, Mujing; Kirchgessner, Todd; Wang, Zeneng; Li, Xinmin; Gregory, Jill C.; Hazen, Stanley L.; Gargalovic, Peter S.; Lusis, Aldons J.

    2015-01-01

    Common forms of atherosclerosis involve multiple genetic and environmental factors. While human genome-wide association studies have identified numerous loci contributing to coronary artery disease and its risk factors, these studies are unable to control environmental factors or examine detailed molecular traits in relevant tissues. We now report a study of natural variations contributing to atherosclerosis and related traits in over 100 inbred strains of mice from the Hybrid Mouse Diversity Panel (HMDP). The mice were made hyperlipidemic by transgenic expression of human apolipoprotein E-Leiden (APOE-Leiden) and human cholesteryl ester transfer protein (CETP). The mice were examined for lesion size and morphology as well as plasma lipid, insulin and glucose levels, and blood cell profiles. A subset of mice was studied for plasma levels of metabolites and cytokines. We also measured global transcript levels in aorta and liver. Finally, the uptake of acetylated LDL by macrophages from HMDP mice was quantitatively examined. Loci contributing to the traits were mapped using association analysis, and relationships among traits were examined using correlation and statistical modeling. A number of conclusions emerged. First, relationships among atherosclerosis and the risk factors in mice resemble those found in humans. Second, a number of trait-loci were identified, including some overlapping with previous human and mouse studies. Third, gene expression data enabled enrichment analysis of pathways contributing to atherosclerosis and prioritization of candidate genes at associated loci in both mice and humans. Fourth, the data provided a number of mechanistic inferences; for example, we detected no association between macrophage uptake of acetylated LDL and atherosclerosis. Fifth, broad sense heritability for atherosclerosis was much larger than narrow sense heritability, indicating an important role for gene-by-gene interactions. Sixth, stepwise linear regression

  19. Genetic Architecture of Atherosclerosis in Mice: A Systems Genetics Analysis of Common Inbred Strains.

    Directory of Open Access Journals (Sweden)

    Brian J Bennett

    2015-12-01

    Full Text Available Common forms of atherosclerosis involve multiple genetic and environmental factors. While human genome-wide association studies have identified numerous loci contributing to coronary artery disease and its risk factors, these studies are unable to control environmental factors or examine detailed molecular traits in relevant tissues. We now report a study of natural variations contributing to atherosclerosis and related traits in over 100 inbred strains of mice from the Hybrid Mouse Diversity Panel (HMDP. The mice were made hyperlipidemic by transgenic expression of human apolipoprotein E-Leiden (APOE-Leiden and human cholesteryl ester transfer protein (CETP. The mice were examined for lesion size and morphology as well as plasma lipid, insulin and glucose levels, and blood cell profiles. A subset of mice was studied for plasma levels of metabolites and cytokines. We also measured global transcript levels in aorta and liver. Finally, the uptake of acetylated LDL by macrophages from HMDP mice was quantitatively examined. Loci contributing to the traits were mapped using association analysis, and relationships among traits were examined using correlation and statistical modeling. A number of conclusions emerged. First, relationships among atherosclerosis and the risk factors in mice resemble those found in humans. Second, a number of trait-loci were identified, including some overlapping with previous human and mouse studies. Third, gene expression data enabled enrichment analysis of pathways contributing to atherosclerosis and prioritization of candidate genes at associated loci in both mice and humans. Fourth, the data provided a number of mechanistic inferences; for example, we detected no association between macrophage uptake of acetylated LDL and atherosclerosis. Fifth, broad sense heritability for atherosclerosis was much larger than narrow sense heritability, indicating an important role for gene-by-gene interactions. Sixth, stepwise linear

  20. Pericardial and thoracic peri-aortic adipose tissues contribute to systemic inflammation and calcified coronary atherosclerosis independent of body fat composition, anthropometric measures and traditional cardiovascular risks

    International Nuclear Information System (INIS)

    Yun, Chun-Ho; Lin, Tin-Yu; Wu, Yih-Jer; Liu, Chuan-Chuan; Kuo, Jen-Yuan; Yeh, Hung-I.; Yang, Fei-Shih; Chen, Su-Chiu; Hou, Charles Jia-Yin; Bezerra, Hiram G.; Hung, Chung-Lieh; Cury, Ricardo C.

    2012-01-01

    Background: Coronary atherosclerosis has traditionally been proposed to be associated with several cardiovascular risk factors and anthropometric measures. However, clinical data regarding the independent value of visceral adipose tissue in addition to such traditional predictors remains obscure. Materials and methods: We subsequently studied 719 subjects (age: 48.1 ± 8.3 years, 25% females) who underwent multidetector computed tomography (MDCT) for coronary calcium score (CCS) quantification. Baseline demographic data and anthropometric measures were taken with simultaneous body fat composition estimated. Visceral adipose tissue of pericardial and thoracic peri-aortic fat was quantified by MDCT using TeraRecon Aquarius workstation (San Mateo, CA). Traditional cardiovascular risk stratification was calculated by metabolic (NCEP ATP III) and Framingham (FRS) scores and high-sensitivity CRP (Hs-CRP) was taken to represent systemic inflammation. The independent value of visceral adipose tissue to systemic inflammation and CCS was assessed by utilizing multivariable regression analysis. Results: Of all subjects enrolled in this study, the mean values for pericardial and peri-aortic adipose tissue were 74.23 ± 27.51 and 7.23 ± 3.69 ml, respectively. Higher visceral fat quartile groups were associated with graded increase of risks for cardiovascular diseases. Both adipose burdens strongly correlated with anthropometric measures including waist circumference, body weight and body mass index (all p < 0.001). In addition, both visceral amount correlates well with ATP and FRS scores, all lipid profiles and systemic inflammation marker in terms of Hs-CRP (all p < 0.001). After adjustment for baseline variables, both visceral fat were independently related to Hs-CRP levels (all p < 0.05), but only pericardial fat exerted independent role in coronary calcium deposit. Conclusion: Both visceral adipose tissues strongly correlated with systemic inflammation beyond traditional

  1. Nutech functional score: A novel scoring system to assess spinal cord injury patients.

    Science.gov (United States)

    Shroff, Geeta; Barthakur, Jitendra Kumar

    2017-06-26

    To develop a new scoring system, nutech functional scores (NFS) for assessing the patients with spinal cord injury (SCI). The conventional scale, American Spinal Injury Association's (ASIA) impairment scale is a measure which precisely describes the severity of the SCI. However, it has various limitations which lead to incomplete assessment of SCI patients. We have developed a 63 point scoring system, i . e ., NFS for patients suffering with SCI. A list of symptoms either common or rare that were found to be associated with SCI was recorded for each patient. On the basis of these lists, we have developed NFS. These lists served as a base to prepare NFS, a 63 point positional (each symptom is sub-graded and get points based on position) and directional (moves in direction BAD → GOOD) scoring system. For non-progressive diseases, 1, 2, 3, 4, 5 denote worst, bad, moderate, good and best (normal), respectively. NFS for SCI has been divided into different groups based on the affected part of the body being assessed, i . e ., motor assessment (shoulders, elbow, wrist, fingers-grasp, fingers-release, hip, knee, ankle and toe), sensory assessment, autonomic assessment, bed sore assessment and general assessment. As probability based studies required a range of (-1, 1) or at least the range of (0, 1) to be useful for real world analysis, the grades were converted to respective numeric values. NFS can be considered as a unique tool to assess the improvement in patients with SCI as it overcomes the limitations of ASIA impairment scale.

  2. The Keith Edward scoring system: A case control study

    Directory of Open Access Journals (Sweden)

    Sarkar Supriya

    2009-01-01

    Full Text Available Objective: The World health organization (WHO has accepted Keith Edward scoring system for the diagnosis of childhood tuberculosis (TB. In the present study, we evaluated this scoring system. Methods and Results: We included 53 children with confirmed TB involving different organs, admitted in NB Medical College, during two years period as cases; and 50 randomly selected, age, sex, and organ matched confirmed non-TB cases as controls. We noticed 15.1% false negative and 22% false positive results in our study, and the scoring system had 84.9% sensitivity, 78% specificity, and 80.36% positive predictive value. Likelihood ratio positive (LR+ was 3.86, likelihood ratio negative (LR- was 0.19, and overall agreement was 81.55%. We observed that Keith Edward scoring system was less effective in children suffering from non-TB chronic diseases (false positive rate: 45.5%. We found no significant difference in nutritional status between study and control groups (P = 0.65. We noticed that more than 15-mm indurations for tuberculin test were specific for TB in children. Conclusion: We concluded that Keith Edward scoring system is good for public health purpose, but there is a scope for improvement, and further study is required for this purpose.

  3. Alcohol and atherosclerosis

    Directory of Open Access Journals (Sweden)

    DA LUZ PROTASIO L.

    2001-01-01

    Full Text Available Atherosclerosis is manifested as coronary artery disease (CAD, ischemic stroke and peripheral vascular disease. Moderate alcohol consumption has been associated with reduction of CAD complications. Apparently, red wine offers more benefits than any other kind of drinks, probably due to flavonoids. Alcohol alters lipoproteins and the coagulation system. The flavonoids induce vascular relaxation by mechanisms that are both dependent and independent of nitric oxide, inhibits many of the cellular reactions associated with atherosclerosis and inflammation, such as endothelial expression of vascular adhesion molecules and release of cytokines from polymorphonuclear leukocytes. Hypertension is also influenced by the alcohol intake. Thus, heavy alcohol intake is almost always associated with systemic hypertension, and hence shall be avoided. In individuals that ingest excess alcohol, there is higher risk of coronary occlusion, arrhythmias, hepatic cirrhosis, upper gastrointestinal cancers, fetal alcohol syndrome, murders, sex crimes, traffic and industrial accidents, robberies, and psychosis. Alcohol is no treatment for atherosclerosis; but it doesn't need to be prohibited for everyone. Thus moderate amounts of alcohol (1-2 drinks/day, especially red wine, may be allowed for those at risk for atherosclerosis complications.

  4. Animal Models of Atherosclerosis

    Science.gov (United States)

    Getz, Godfrey S.; Reardon, Catherine A.

    2012-01-01

    Atherosclerosis is a chronic inflammatory disorder that is the underlying cause of most cardiovascular disease. Both cells of the vessel wall and cells of the immune system participate in atherogenesis. This process is heavily influenced by plasma lipoproteins, genetics and the hemodynamics of the blood flow in the artery. A variety of small and large animal models have been used to study the atherogenic process. No model is ideal as each has its own advantages and limitations with respect to manipulation of the atherogenic process and modeling human atherosclerosis or lipoprotein profile. Useful large animal models include pigs, rabbits and non-human primates. Due in large part to the relative ease of genetic manipulation and the relatively short time frame for the development of atherosclerosis, murine models are currently the most extensively used. While not all aspects of murine atherosclerosis are identical to humans, studies using murine models have suggested potential biological processes and interactions that underlie this process. As it becomes clear that different factors may influence different stages of lesion development, the use of mouse models with the ability to turn on or delete proteins or cells in tissue specific and temporal manner will be very valuable. PMID:22383700

  5. [Atherosclerosis and infection?].

    Science.gov (United States)

    Zeman, K

    2006-09-01

    Atherosclerosis is guided by chronicle inflammation process. In the last decades of the 20th century, studies considering infection another possible risk factor of atherosclerosis development were written. Helicobacter pylori, Porphyromas gingivalis, some viruses but most frequently Chlamydia pneumonie are infection agens mentioned in these studies. Some of them emphasize also combined infections caused by more pathogenic factors having influence on vascular inflammation. Serological, epidemiological, histological and imunological studies show the pathogenic influence of acute or chronic infections. Many studies selected makrolid antibiotics as treatment in patients with ischaemic heart disease. However, existing experience with antibiotics did not bring clear results. These studies have mentioned the fact antibiotics have not been indicated as treatment in patients with acute or chronic vascular system infliction by atherosclerosis. Since the experimental and clinical research of influence of inflammations on the development of atherosclerosis moved forward a lot, no exact evidence of this complicated pathogenic mechanism was given. It will obviously take some time to confirm whether the relation between infections and artherosclerosis is causal, i.e. initiating the pathogenic process, accelerating it or keeping it alive.

  6. Gut Microbiota and Atherosclerosis.

    Science.gov (United States)

    Li, Daniel Y; Tang, W H Wilson

    2017-08-25

    Studies in microbiota-mediated health risks have gained traction in recent years since the compilation of the Human Microbiome Project. No longer do we believe that our gut microbiota is an inert set of microorganisms that reside in the body without consequence. In this review, we discuss the recent findings which further our understanding of the connection between the gut microbiota and the atherosclerosis. We evaluate studies which illustrate the current understanding of the relationship between infection, immunity, altered metabolism, and bacterial products such as immune activators or dietary metabolites and their contributions to the development of atherosclerosis. In particular, we critically examine rec ent clinical and mechanistic findings for the novel microbiota-dependent dietary metabolite, trimethylamine N-oxide (TMAO), which has been implicated in atherosclerosis. These discoveries are now becoming integrated with advances in microbiota profiling which enhance our ability to interrogate the functional role of the gut microbiome and develop strategies for targeted therapeutics. The gut microbiota is a multi-faceted system that is unraveling novel contributors to the development and progression of atherosclerosis. In this review, we discuss historic and novel contributors while highlighting the TMAO story mainly as an example of the various paths taken beyond deciphering microbial composition to elucidate downstream mechanisms that promote (or protect from) atherogenesis in the hopes of translating these findings from bench to bedside.

  7. Dioxin-like PCB 126 increases systemic inflammation and accelerates atherosclerosis in lean LDL receptor deficient mice.

    Science.gov (United States)

    Petriello, Michael C; Brandon, J Anthony; Hoffman, Jessie; Wang, Chunyan; Tripathi, Himi; Abdel-Latif, Ahmed; Ye, Xiang; Li, Xiangan; Yang, Liping; Lee, Eun; Soman, Sony; Barney, Jazmyne; Wahlang, Banrida; Hennig, Bernhard; Morris, Andrew J

    2017-12-01

    Exposure to dioxins and related persistent organic pollutants likely contributes to cardiovascular disease (CVD) risk through multiple mechanisms including the induction of chronic inflammation. Epidemiological studies have shown that leaner individuals may be more susceptible to the detrimental effects of lipophilic toxicants because they lack large adipose tissue depots that can accumulate and sequester these pollutants. This phenomenon complicates efforts to study mechanisms of pollutant-accelerated atherosclerosis in experimental animal models where high-fat feeding and adipose expansion limit the bioavailability of lipophilic pollutants. Here, we investigated whether a model dioxin-like pollutant, PCB 126, could increase inflammation and accelerate atherosclerosis in Ldlr -/- mice fed a low-fat atherogenic diet. We fed Ldlr -/- mice the Clinton/Cybulsky diet (10% kcal fat, 0.15% cholesterol) and sacrificed mice at 8, 10, or 12 weeks post PCB (2 doses of 1 μmol/kg) or vehicle gavage. To characterize this novel model, we examined the effects of PCB 126 on markers of systemic inflammation, hematological indices, fatty livers, and atherosclerotic lesion size. Mice exposed to PCB 126 exhibited significantly increased plasma inflammatory cytokine levels, increased circulating biomarkers of CVD, altered platelet and red blood cell counts, increased accumulation of hepatic fatty acids, and accelerated atherosclerotic lesion formation in the aortic root. PCB 126 also increased circulating neutrophils, monocytes, and macrophages as determined by flow cytometry analysis. Exposure to dioxin-like PCB 126 increases inflammation and accelerates atherosclerosis in mice. This low-fat atherogenic diet may provide a useful tool to study the mechanisms linking exposure to lipophilic pollutants to increased risk of CVD. © The Author 2017. Published by Oxford University Press on behalf of the Society of Toxicology. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  8. Disease scoring systems for oral lichen planus; a critical appraisal

    NARCIS (Netherlands)

    Wang, J.; van der Waal, I.

    2015-01-01

    The aim of the present study has been to critically review 22 disease scoring systems (DSSs) on oral lichen planus (OLP) that have been reported in the literature during the past decades. Although the presently available DSSs may all have some merit, particularly for research purposes, the diversity

  9. The value of international prostate symptom scoring system in the ...

    African Journals Online (AJOL)

    2012-04-10

    Apr 10, 2012 ... Abstract. Objective: To determine the value of international prostate symptom scoring (IPSS) system in management of patients with benign prostatic ... negative effects it has on quality of life.[3]. In any disease, measuring ... pelvic ultrasound, cystoscopy to exclude bladder pathology, quantitative PSA, and ...

  10. Rating Pregnancy Wheel Applications Using the APPLICATIONS Scoring System.

    Science.gov (United States)

    Chyjek, Kathy; Farag, Sara; Chen, Katherine T

    2015-06-01

    To identify the top-rated pregnancy wheel applications (apps) using a newly developed APPLICATIONS scoring system. A list of pregnancy wheel apps was identified. Consumer-based and inaccurate apps were excluded. The APPLICATIONS scoring system was developed to rate the remaining apps. Application comprehensiveness was evaluated. Objective rating components included price, paid subscription, literature used, in-app purchases, connectivity to the Internet, advertisements, text search field, interdevice compatibility, and other components such as images or figures, videos, and special features. Subjective rating components were ease of navigation and subjective presentation. A complete list of 55 pregnancy wheel apps was created from three sources. Thirty-nine (71%) were consumer-based, inaccurate, or both, leaving 16 (29%) for analysis using the APPLICATIONS scoring system. More than two thirds of pregnancy wheel apps were excluded from our study secondary to being consumer-based, inaccurate, or both. This highlights the importance of identifying systematically, reviewing critically, and rating the thousands of available apps to health care providers to ensure accuracy and applicability. We propose that our APPLICATIONS scoring system be used to rate apps in all specialties with the goal of improving health care provider performance and thereby patient outcomes. III.

  11. Classifying snakebite in South Africa: Validating a scoring system ...

    African Journals Online (AJOL)

    Objective. To develop and validate a scoring system for managing snakebites in South Africa (SA). Methods. We studied all snakebite admissions to a regional hospital in KwaZulu-Natal, SA. The primary outcome was an active treatment intervention (ATI) defined as antivenom treatment or any surgical procedure.

  12. [Clinical and immunological study of the relationship of the digestive system chronic diseases and atherosclerosis in the basin of the abdominal aorta in elderly patients].

    Science.gov (United States)

    Dolgushina, A I; Shaposhnik, I I; Volchegorskiĭ, I A

    2014-01-01

    Paper describes clinical and immunological study about the relationship between chronic diseases of the digestive system and atherosclerosis in the basin of the abdominal aorta in patients of elderly and senile age. There were revealed the structural and clinical features of the gastrointestinal tract diseases, depending on the extent of atherosclerosis in the basin of the abdominal aorta. Evaluation of the immune status included the determination of lymphocyte subpopulation composition, the functional state of neutrophils and cytokine levels. It is found that the progression of atherosclerosis in the basin of the abdominal aorta in patients of elderly and senile age with chronic diseases of the digestive system was accompanied by the activation of pro-inflammatory mechanisms of the immune system and the accompanying intensification of oxidative stress.

  13. Development of a prognostic scoring system for resectable hepatocellular carcinoma.

    Science.gov (United States)

    Sposito, Carlo; Di Sandro, Stefano; Brunero, Federica; Buscemi, Vincenzo; Battiston, Carlo; Lauterio, Andrea; Bongini, Marco; De Carlis, Luciano; Mazzaferro, Vincenzo

    2016-09-28

    To develop a prognostic scoring system for overall survival (OS) of patients undergoing liver resection (LR) for hepatocellular carcinoma (HCC). Consecutive patients who underwent curative LR for HCC between 2000 and 2013 were identified. The series was randomly divided into a training and a validation set. A multivariable Cox model for OS was fitted to the training set. The beta coefficients derived from the Cox model were used to define a prognostic scoring system for OS. The survival stratification was then tested, and the prognostic scoring system was compared with the European Association for the Study of the Liver (EASL)/American Association for the Study of Liver Diseases (AASLD) surgical criteria by means of Harrell's C statistics. A total of 917 patients were considered. Five variables independently correlated with post-LR survival: Model for End-stage Liver Disease score, hepatitis C virus infection, number of nodules, largest diameter and vascular invasion. Three risk classes were identified, and OS for the three risk classes was significantly different both in the training (P < 0.0001) and the validation set (P = 0.0002). Overall, 69.4% of patients were in the low-risk class, whereas only 37.8% were eligible to surgery according to EASL/AASLD. Survival of patients in the low-risk class was not significantly different compared with surgical indication for EASL/AASLD guidelines (77.2 mo vs 82.5 mo respectively, P = 0.22). Comparison of Harrell's C statistics revealed no significant difference in predictive power between the two systems (-0.00999, P = 0.667). This study established a new prognostic scoring system that may stratify HCC patients suitable for surgery, expanding surgical eligibility with respect to EASL/AASLD criteria with no harm on survival.

  14. Th17/Treg imbalance induced by increased incidence of atherosclerosis in patients with systemic lupus erythematosus (SLE).

    Science.gov (United States)

    Zhu, Mengya; Mo, Hanyou; Li, Dong; Luo, Xiaohong; Zhang, Lihua

    2013-07-01

    The objective of the study was to investigate whether the immunological factors in patients with Systemic Lupus Erythematosus (SLE) and a high incidence of atherosclerosis correlate with a Th17/Treg imbalance. All cases were recruited from the Affiliated Hospital of Guilin Medical University: a random sample of 42 cases with SLE and atherosclerosis, 39 positive control cases with SLE alone with no anomalies detected via coronary artery angiography or carotid color Doppler ultrasound examination, as well as 45 normal controls based on physical examination were included. The serum expression levels of IL-10, IL-17, IL-6, TNF-α, Th17, Th17 cell transcription factor RORγt, and Treg cell transcription factor Foxp3 were measured in each group of patients. Correlations among Th17/Treg, their secreted cell factors, transcription factors, SLE, and SLE with concurrent atherosclerosis (SLE + AS) were analyzed. The results are as follows: (1) total cholesterol and triacylglycerol levels in the SLE and SLE + AS groups were higher than those in the control group (P < 0.05 and P < 0.01); (2) serum IL-10 in the SLE + AS group was lower than the SLE and control groups; however, serum IL-17 and IL-6 levels in the SLE + AS group were elevated compared to the SLE and control groups (average P < 0.01); (3) the percentage of Treg cells in the SLE + AS patients was lower than those found in the SLE and control groups; in contrast, percentages of serum Th17 cells in SLE + AS patients were higher than the SLE and control groups (average P < 0.01); (4) FoxP3 expression in the SLE + AS group was lower than levels observed in the SLE and control groups (average P < 0.05); in contrast, RORγt expression in the SLE + AS group was higher than levels found in the SLE and control groups (average P < 0.05). The abnormal balance between Th17 cells and Treg cells in SLE + AS patients has obvious implications for Th17 migration. The results suggest that Th17 cell proportion and function can be

  15. Dual effects of statins therapy in systemic lupus erythematosus and SLE-related atherosclerosis: the potential role for regulatory T cells.

    Science.gov (United States)

    Tu, Haiyan; Li, Qi; Xiang, Shilong; Jiang, Hong; Mao, Youying; Shou, Zhangfei; Chen, Jianghua

    2012-05-01

    Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease associated with accelerated atherosclerosis independent of traditional risk factors. Statins, the 3-hydroxy-3-methyl-glutaryl coenzyme A (HMG-CoA) reductase inhibitors, have been widely prescribed for hyperlipidemia, which could slow the atherosclerosis progression, and reduce cardiovascular disease events. Nonetheless, accumulated evidences suggested that statins exert immunomodulatory and anti-inflammatory functions independent of their lipid-lowering effects. By the virtue of pleiotropic immunomodulatory property, statins may be applied for the treatment of both autoimmunity and atherosclerosis in patients with SLE. Interestingly, it has been well documented that regulatory T cells (Tregs) are involved in the pathogenesis of SLE as well as atherosclerosis. Meanwhile, studies have shown that statins could induce augmented number of Tregs with increased functional inhibitory properties. Thus, we hypothesized that the effect of statins ameliorating lupus disease manifestations and lupus-mediated atherogenesis might be mediated, at least partly, via the activation of Tregs. To our knowledge, this is the first hypothesis focused on that Tregs might be involved in the immunomodulatory effect of statins on SLE and SLE-related atherosclerosis. Published by Elsevier Ireland Ltd.

  16. Less is more: the design of early-warning scoring systems affects the speed and accuracy of scoring.

    Science.gov (United States)

    Christofidis, Melany J; Hill, Andrew; Horswill, Mark S; Watson, Marcus O

    2015-07-01

    To evaluate the effect of early-warning scoring system design on the speed and accuracy of scoring. Despite the widespread implementation of early-warning scoring systems in hospitals, the speed and accuracy with which chart-users determine patients' early-warning scores has received minimal research attention. Within-subjects, with scoring-system design as the independent variable. Forty-seven novice chart-users were presented with realistic vital sign observations recorded on charts with three different scoring-system designs. The rows for recording individual vital sign scores were either: (1) grouped together beneath all of the vital sign rows; (2) separated, with each row presented immediately below the corresponding vital sign row; or (3) excluded altogether. Participants' response times and error rates for determining the overall scores were measured for 54 time-points per design. Data were collected in December 2012-January 2013. Contrary to predictions, participants responded fastest and made the fewest errors when using the chart design without individual vital sign scoring-rows. For the other two designs, participants were faster when the rows for scoring individual vital signs were separated (vs. grouped), but accuracy did not differ. For both of these designs, significantly more time-points were affected by scoring errors compared with adding errors. Finally, data for patients with more serious derangements yielded greater response times and error rates on all three charts. Early-warning scoring systems may be more effective without individual vital sign scoring-rows. Even when charts are designed by multi-disciplinary teams of human factors specialists and clinicians, empirical evaluations are essential. © 2015 John Wiley & Sons Ltd.

  17. Scoring system for CT scan findings of ovarian cystic lesions

    Energy Technology Data Exchange (ETDEWEB)

    Hattori, Kaoru

    1987-09-01

    It is important to preoperatively establish a diagnosis of a gynecologic pelvic mass. A group of 137 female patients with suspected pelvic cystic lesions were studied by computerized tomography (CT). Histologically, 22 patients were proved to have ovarian cystadenocarcinoma and 115 patients a benign cystic mass, i.e. cystadenoma, lutein cyst, endometrial cyst, retentional cyst and paraovarian cyst. A scoring system was made to obtain higher accuracy in CT evaluation of ovarian cystic lesions. It includes seven factors, (1) volume, (2) solid component protruding from the wall, (3) thickness of the wall, (4) focal thickening of the wall, (5) loculation, (6) attenuation number of the tumor and (7) nonhomogenousess of the tumor. Using this scoring system, a correct differential diagnosis was made in all cases except 7, 4 uterine fibroids with remarkable degenaration, a large endometrial cyst with a high attenuation number, a dermoid cyst with an irregular pattern and a mucinous cystadenoma with benign solid component. The accuracy of diagnosis was 100 % in malignant masses and 93.9 % in benign masses. This scoring system was shown to have clinical significance for the differential diagnosis of a pelvic cystic lesions.

  18. Selecting a pharmacy layout design using a weighted scoring system.

    Science.gov (United States)

    McDowell, Alissa L; Huang, Yu-Li

    2012-05-01

    A weighted scoring system was used to select a pharmacy layout redesign. Facilities layout design techniques were applied at a local hospital pharmacy using a step-by-step design process. The process involved observing and analyzing the current situation, observing the current available space, completing activity flow charts of the pharmacy processes, completing communication and material relationship charts to detail which areas in the pharmacy were related to one another and how they were related, researching applications in other pharmacies or in scholarly works that could be beneficial, numerically defining space requirements for areas within the pharmacy, measuring the available space within the pharmacy, developing a set of preliminary designs, and modifying preliminary designs so they were all acceptable to the pharmacy staff. To select a final layout that could be implemented in the pharmacy, those layouts were compared via a weighted scoring system. The weighted aspect further allowed additional emphasis on categories based on their effect on pharmacy performance. The results produced a beneficial layout design as determined through simulated models of the pharmacy operation that more effectively allocated and strategically located space to improve transportation distances and materials handling, employee utilization, and ergonomics. Facilities layout designs for a hospital pharmacy were evaluated using a weighted scoring system to identify a design that was superior to both the current layout and alternative layouts in terms of feasibility, cost, patient safety, employee safety, flexibility, robustness, transportation distance, employee utilization, objective adherence, maintainability, usability, and environmental impact.

  19. [Toronto clinical scoring system in diabetic peripheral neuropathy].

    Science.gov (United States)

    Liu, Feng; Mao, Ji-Ping; Yan, Xiang

    2008-12-01

    To evaluate the application value of Toronto clinical scoring system (TCSS) and its grading of neuropathy for diabetic peripheral neuropathy (DPN), and to explore the relationship between TCSS grading of neuropathy and the grading of diabetic nephropathy and diabetic retinopathy. A total of 209 patients of Type 2 diabtes (T2DM) underwent TCSS. Taking electrophysiological examination as a gold standard for diagnosing DPN, We compared the results of TCSS score > or = 6 with electrophysiological examination, and tried to select the optimal cut-off points of TCSS. The corresponding accuracy, sensitivity, and specificity of TCSS score > or = 6 were 76.6%, 77.2%, and 75.6%, respectively.The Youden index and Kappa were 0.53 and 0.52, which implied TCSS score > or = 6 had a moderate consistency with electrophysiological examination. There was a linear positive correlation between TCSS grading of neuropathy and the grading of diabetic nephropathy and diabetic retinopathy (P<0.05). The optimal cut-off point was 5 or 6 among these patients. TCSS is reliable in diagnosing DPN and its grading of neuropathy has clinical value.

  20. Scoring systems of severity in patients with multiple trauma.

    Science.gov (United States)

    Rapsang, Amy Grace; Shyam, Devajit Chowlek

    2015-04-01

    Trauma is a major cause of morbidity and mortality; hence severity scales are important adjuncts to trauma care in order to characterize the nature and extent of injury. Trauma scoring models can assist with triage and help in evaluation and prediction of prognosis in order to organise and improve trauma systems. Given the wide variety of scoring instruments available to assess the injured patient, it is imperative that the choice of the severity score accurately match the application. Even though trauma scores are not the key elements of trauma treatment, they are however, an essential part of improvement in triage decisions and in identifying patients with unexpected outcomes. This article provides the reader with a compendium of trauma severity scales along with their predicted death rate calculation, which can be adopted in order to improve decision making, trauma care, research and in comparative analyses in quality assessment. Copyright © 2013 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

  1. Analysis of the relationship between periodontal disease and atherosclerosis within a local clinical system: a cross-sectional observational pilot study.

    Science.gov (United States)

    Kudo, Chieko; Shin, Wee Soo; Minabe, Masato; Harai, Kazuo; Kato, Kai; Seino, Hiroaki; Goke, Eiji; Sasaki, Nobuhiro; Fujino, Takemasa; Kuribayashi, Nobuichi; Pearce, Youko Onuki; Taira, Masato; Maeda, Hiroshi; Takashiba, Shogo

    2015-09-01

    It has been revealed that atherosclerosis and periodontal disease may have a common mechanism of "chronic inflammation". Several reports have indicated that periodontal infection is related to atherosclerosis, but none have yet reported such an investigation through the cooperation of local clinics. This study was performed in local Japanese clinics to examine the relationship between periodontal disease and atherosclerosis under collaborative medical and dental care. A pilot multicenter cross-sectional study was conducted on 37 medical patients with lifestyle-related diseases under consultation in participating medical clinics, and 79 periodontal patients not undergoing medical treatment but who were seen by participating dental clinics. Systemic examination and periodontal examination were performed at baseline, and the relationships between periodontal and atherosclerosis-related clinical markers were analyzed. There was a positive correlation between LDL-C level and plasma IgG antibody titer to Porphyromonas gingivalis. According to the analysis under adjusted age, at a cut-off value of 5.04 for plasma IgG titer to Porphyromonas gingivalis, the IgG titer was significantly correlated with the level of low-density lipoprotein cholesterol (LDL-C). This study suggested that infection with periodontal bacteria (Porphyromonas gingivalis) is associated with the progression of atherosclerosis. Plasma IgG titer to Porphyromonas gingivalis may be useful as the clinical risk marker for atherosclerosis related to periodontal disease. Moreover, the application of the blood examination as a medical check may lead to the development of collaborative medical and dental care within the local medical clinical system for the purpose of preventing the lifestyle-related disease.

  2. A Novel Risk Scoring System Reliably Predicts Readmission Following Pancreatectomy

    Science.gov (United States)

    Valero, Vicente; Grimm, Joshua C.; Kilic, Arman; Lewis, Russell L.; Tosoian, Jeffrey J.; He, Jin; Griffin, James; Cameron, John L.; Weiss, Matthew J.; Vollmer, Charles M.; Wolfgang, Christopher L.

    2015-01-01

    Background Postoperative readmissions have been proposed by Medicare as a quality metric and may impact provider reimbursement. Since readmission following pancreatectomy is common, we sought to identify factors associated with readmission in order to establish a predictive risk scoring system (RSS). Study Design A retrospective analysis of 2,360 pancreatectomies performed at nine, high-volume pancreatic centers between 2005 and 2011 was performed. Forty-five factors strongly associated with readmission were identified. To derive and validate a RSS, the population was randomly divided into two cohorts in a 4:1 fashion. A multivariable logistic regression model was constructed and scores were assigned based on the relative odds ratio of each independent predictor. A composite Readmission After Pancreatectomy (RAP) score was generated and then stratified to create risk groups. Results Overall, 464 (19.7%) patients were readmitted within 90-days. Eight pre- and postoperative factors, including prior myocardial infarction (OR 2.03), ASA Class ≥ 3 (OR 1.34), dementia (OR 6.22), hemorrhage (OR 1.81), delayed gastric emptying (OR 1.78), surgical site infection (OR 3.31), sepsis (OR 3.10) and short length of stay (OR 1.51), were independently predictive of readmission. The 32-point RAP score generated from the derivation cohort was highly predictive of readmission in the validation cohort (AUC 0.72). The low (0-3), intermediate (4-7) and high risk (>7) groups correlated to 11.7%, 17.5% and 45.4% observed readmission rates, respectively (ppancreatectomy. Identification of patients with increased risk of readmission using the RAP score will allow efficient resource allocation aimed to attenuate readmission rates. It also has potential to serve as a new metric for comparative research and quality assessment. PMID:25797757

  3. A scoring system for capnogram biofeedback: preliminary findings.

    Science.gov (United States)

    Landis, B; Romano, P M

    1998-06-01

    Labored breathing and irregularities in the breathing pattern may be assessed by capnography; and, an abnormal capnogram wave form may often be rectified with the help of capnogram biofeedback. Clinical experience suggests this may relieve dyspnea but to what degree, for how long and for what conditions have not been determined; the issue is complex and much remains to be discovered. The more that can be learned about the various capnogram irregularities, the more effectively such information will guide us in therapy and research. To this end a 15-category capnogram disordered breathing scale (Landis CDBS) was developed to provide a measure of disordered breathing. The CDBS score is the ratio of the total number of abnormal capnogram forms to the total number of capnogram configurations in the test sample, expressed as a percentage. The total score as well as an accounting of each abnormal scoring category was tabulated for each subject. In this retrospective and preliminary study, findings of a normal comparison group were compared with capnogram data for 3 clinical groups: asthma, anxiety/panic attacks, and patients with diverse stress-related somatic symptoms. Mean CDBS scores were: a low 14% for the Normal group compared with 64% for the Asthma group; 66% for the Anxiety patients; and 47% for the Somatic group. Each group was characterized by distinctive clusters of capnogram abnormalities. As there are methodological limitations to this small group study, the findings require validation. However, as an introduction to the scoring system and because of its potential clinical value we present this paper now.

  4. Prospective evaluation of the Sunshine Appendicitis Grading System score.

    Science.gov (United States)

    Reid, Fiona; Choi, Julian; Williams, Marli; Chan, Steven

    2017-05-01

    Although there is a wealth of information predicting risk of post-operative intra-abdominal collection and guiding antibiotic therapy following appendicectomy, confusion remains because of lack of consensus on the clinical severity and definition of 'complicated' appendicitis. This study aimed to develop a standardized intra-operative grading system: Sunshine Appendicitis Grading System (SAGS) for acute appendicitis that correlates independently with the risk of intra-abdominal collections. Two-hundred and forty-six patients undergoing emergency laparoscopy for suspected appendicitis were prospectively scored according to the severity of appendicitis and followed up for complications including intra-abdominal collection. After termination of the study, the SAGS score was repeated by an independent surgeon based on operation notes and intra-operative photography to determine inter-rater agreement. The primary outcome measure was incidence of intra-abdominal collection, secondary outcome measures were all complications and length of stay. SAGS score demonstrated good inter-rater agreement (kappa K w 0.869; 95% CI 0.796-0.941; P appendicitis and to independently predict the risk of intra-abdominal collection. It can therefore be used to stratify risk, guide antibiotic therapy, follow-up and standardize the definitions of appendicitis severity for future research. © 2015 Royal Australasian College of Surgeons.

  5. Normative Data for the Balance Error Scoring System in Adults

    Directory of Open Access Journals (Sweden)

    Grant L. Iverson

    2013-01-01

    Full Text Available Background. The balance error scoring system (BESS is a brief, easily administered test of static balance. The purpose of this study is to develop normative data for this test. Study Design. Cross-sectional, descriptive, and cohort design. Methods. The sample was drawn from a population of clients taking part in a comprehensive preventive health screen at a multidisciplinary healthcare center. Community-dwelling adults aged 20–69 (N=1,236 were administered the BESS within the context of a fitness evaluation. They did not have significant medical, neurological, or lower extremity problems that might have an adverse effect on balance. Results. There was a significant positive correlation between BESS scores and age (r=.34. BESS performance was similar for participants between the ages of 20 and 49 and significantly declined between ages 50 and 69. Men performed slightly better than women on the BESS. Women who were overweight performed significantly more poorly on the test compared to women who were not overweight (P<.0001; Cohen's d=.62. The BESS normative data are stratified by age and sex. Conclusions. These normative data provide a frame of reference for interpreting BESS performance in adults who sustain traumatic brain injuries and adults with diverse neurological or vestibular problems.

  6. Validation of the Toronto Clinical Scoring System for diabetic polyneuropathy.

    Science.gov (United States)

    Bril, Vera; Perkins, Bruce A

    2002-11-01

    The aim of the current study was to determine the validity of the Toronto Clinical Scoring System (CSS) in reflecting the presence and severity of diabetic peripheral sensorimotor polyneuropathy (DSP) as determined by myelinated fiber density (FD) on sural nerve biopsy. Eighty-nine patients with both type 1 and type 2 diabetes, ascertained from a large therapeutic randomized controlled trial, were included in this cross-sectional, observational cohort study. Morphological severity of DSP was expressed as the FD in the sural nerve biopsy. The Toronto CSS was applied to all patients to determine a clinical neuropathy score. General linear regression models were used to assess the relationship between the morphological severity of DSP and the Toronto CSS. The Toronto CSS showed a significant negative correlation with sural nerve FD (R(2) = 0.256, P current study underscore the interrelationships between clinical deficits, electrophysiological findings, and morphological changes in DSP. This evidence suggests that the Toronto CSS may prove useful in documenting and monitoring DSP in the clinic and in clinical research trials.

  7. Intensive care unit scoring systems outperform emergency department scoring systems for mortality prediction in critically ill patients: a prospective cohort study.

    Science.gov (United States)

    Moseson, Erika M; Zhuo, Hanjing; Chu, Jeff; Stein, John C; Matthay, Michael A; Kangelaris, Kirsten N; Liu, Kathleen D; Calfee, Carolyn S

    2014-01-01

    Multiple scoring systems have been developed for both the intensive care unit (ICU) and the emergency department (ED) to risk stratify patients and predict mortality. However, it remains unclear whether the additional data needed to compute ICU scores improves mortality prediction for critically ill patients compared to the simpler ED scores. We studied a prospective observational cohort of 227 critically ill patients admitted to the ICU directly from the ED at an academic, tertiary care medical center. We compared Acute Physiology and Chronic Health Evaluation (APACHE) II, APACHE III, Simplified Acute Physiology Score (SAPS) II, Modified Early Warning Score (MEWS), Rapid Emergency Medicine Score (REMS), Prince of Wales Emergency Department Score (PEDS), and a pre-hospital critical illness prediction score developed by Seymour et al. (JAMA 2010, 304(7):747-754). The primary endpoint was 60-day mortality. We compared the receiver operating characteristic (ROC) curves of the different scores and their calibration using the Hosmer-Lemeshow goodness-of-fit test and visual assessment. The ICU scores outperformed the ED scores with higher area under the curve (AUC) values (p = 0.01). There were no differences in discrimination among the ED-based scoring systems (AUC 0.698 to 0.742; p = 0.45) or among the ICU-based scoring systems (AUC 0.779 to 0.799; p = 0.60). With the exception of the Seymour score, the ED-based scoring systems did not discriminate as well as the best-performing ICU-based scoring system, APACHE III (p = 0.005 to 0.01 for comparison of ED scores to APACHE III). The Seymour score had a superior AUC to other ED scores and, despite a lower AUC than all the ICU scores, was not significantly different than APACHE III (p = 0.09). When data from the first 24 h in the ICU was used to calculate the ED scores, the AUC for the ED scores improved numerically, but this improvement was not statistically significant. All scores had acceptable

  8. Description and validation of a scoring system for tomosynthesis in pulmonary cystic fibrosis

    International Nuclear Information System (INIS)

    Vult von Steyern, Kristina; Bjoerkman-Burtscher, Isabella M.; Bozovic, Gracijela; Wiklund, Marie; Geijer, Mats; Hoeglund, Peter

    2012-01-01

    To design and validate a scoring system for tomosynthesis (digital tomography) in pulmonary cystic fibrosis. A scoring system dedicated to tomosynthesis in pulmonary cystic fibrosis was designed. Three radiologists independently scored 88 pairs of radiographs and tomosynthesis examinations of the chest in 60 patients with cystic fibrosis and 7 oncology patients. Radiographs were scored according to the Brasfield scoring system and tomosynthesis examinations were scored using the new scoring system. Observer agreements for the tomosynthesis score were almost perfect for the total score with square-weighted kappa >0.90, and generally substantial to almost perfect for subscores. Correlation between the tomosynthesis score and the Brasfield score was good for the three observers (Kendall's rank correlation tau 0.68, 0.77 and 0.78). Tomosynthesis was generally scored higher as a percentage of the maximum score. Observer agreements for the total score for Brasfield score were almost perfect (square-weighted kappa 0.80, 0.81 and 0.85). The tomosynthesis scoring system seems robust and correlates well with the Brasfield score. Compared with radiography, tomosynthesis is more sensitive to cystic fibrosis changes, especially bronchiectasis and mucus plugging, and the new tomosynthesis scoring system offers the possibility of more detailed and accurate scoring of disease severity. (orig.)

  9. Description and validation of a scoring system for tomosynthesis in pulmonary cystic fibrosis

    Energy Technology Data Exchange (ETDEWEB)

    Vult von Steyern, Kristina; Bjoerkman-Burtscher, Isabella M.; Bozovic, Gracijela; Wiklund, Marie; Geijer, Mats [Skaane University Hospital, Lund University, Centre for Medical Imaging and Physiology, Lund (Sweden); Hoeglund, Peter [Skaane University Hospital, Competence Centre for Clinical Research, Lund (Sweden)

    2012-12-15

    To design and validate a scoring system for tomosynthesis (digital tomography) in pulmonary cystic fibrosis. A scoring system dedicated to tomosynthesis in pulmonary cystic fibrosis was designed. Three radiologists independently scored 88 pairs of radiographs and tomosynthesis examinations of the chest in 60 patients with cystic fibrosis and 7 oncology patients. Radiographs were scored according to the Brasfield scoring system and tomosynthesis examinations were scored using the new scoring system. Observer agreements for the tomosynthesis score were almost perfect for the total score with square-weighted kappa >0.90, and generally substantial to almost perfect for subscores. Correlation between the tomosynthesis score and the Brasfield score was good for the three observers (Kendall's rank correlation tau 0.68, 0.77 and 0.78). Tomosynthesis was generally scored higher as a percentage of the maximum score. Observer agreements for the total score for Brasfield score were almost perfect (square-weighted kappa 0.80, 0.81 and 0.85). The tomosynthesis scoring system seems robust and correlates well with the Brasfield score. Compared with radiography, tomosynthesis is more sensitive to cystic fibrosis changes, especially bronchiectasis and mucus plugging, and the new tomosynthesis scoring system offers the possibility of more detailed and accurate scoring of disease severity. (orig.)

  10. Towards a contemporary, comprehensive scoring system for determining technical outcomes of hybrid percutaneous chronic total occlusion treatment: The RECHARGE score.

    Science.gov (United States)

    Maeremans, Joren; Spratt, James C; Knaapen, Paul; Walsh, Simon; Agostoni, Pierfrancesco; Wilson, William; Avran, Alexandre; Faurie, Benjamin; Bressollette, Erwan; Kayaert, Peter; Bagnall, Alan J; Smith, Dave; McEntegart, Margaret B; Smith, William H T; Kelly, Paul; Irving, John; Smith, Elliot J; Strange, Julian W; Dens, Jo

    2018-02-01

    This study sought to create a contemporary scoring tool to predict technical outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI) from patients treated by hybrid operators with differing experience levels. Current scoring systems need regular updating to cope with the positive evolutions regarding materials, techniques, and outcomes, while at the same time being applicable for a broad range of operators. Clinical and angiographic characteristics from 880 CTO-PCIs included in the REgistry of CrossBoss and Hybrid procedures in FrAnce, the NetheRlands, BelGium and UnitEd Kingdom (RECHARGE) were analyzed by using a derivation and validation set (2:1 ratio). Variables significantly associated with technical failure in the multivariable analysis were incorporated in the score. Subsequently, the discriminatory capacity was assessed and the validation set was used to compare with the J-CTO score and PROGRESS scores. Technical success in the derivation and validation sets was 83% and 85%, respectively. Multivariate analysis identified six parameters associated with technical failure: blunt stump (beta coefficient (b) = 1.014); calcification (b = 0.908); tortuosity ≥45° (b = 0.964); lesion length 20 mm (b = 0.556); diseased distal landing zone (b = 0.794), and previous bypass graft on CTO vessel (b = 0.833). Score variables remained significant after bootstrapping. The RECHARGE score showed better discriminatory capacity in both sets (area-under-the-curve (AUC) = 0.783 and 0.711), compared to the J-CTO (AUC = 0.676) and PROGRESS (AUC = 0.608) scores. The RECHARGE score is a novel, easy-to-use tool for assessing the risk for technical failure in hybrid CTO-PCI and has the potential to perform well for a broad community of operators. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  11. Hemophilic arthropathy. A scoring system for magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Soler, R.; Rodriguez, E.; Marini, M. [Department of Radiology, Hospital Juan Canalejo, Coruna (Spain); Lopez-Fernandez, F. [Department of Hematology, Hospital Juan Canalejo, Coruna (Spain)

    2002-04-01

    The aim of this study was to define a system for scoring hemophilic arthropathy (HA) based on MR findings, providing for objective evaluation of the degree of joint involvement and evolution after on-demand administration of FVIII substitutional therapy or prophylactic treatment. A total of 133 MR examinations (89 basal and 44 during follow-up) were performed in 25 patients. Patients were divided in two groups depending on the therapy received and the length of time that the disease had been evolving at the start of the study. Group I was composed of 10 patients with secondary prophylaxis and group II was composed by 15 treated on demand. T1-weighted and T2*-weighted images performed on a 0.5-T unit were prospectively evaluated. The joint involvement was established on a scale of 0 (no abnormalities), I (minimal amount of hemosiderin), II (large amount of hemosiderin and isolated cartilaginous erosion), III (cartilage destruction, bone erosions, and subchondral cysts) to IV (large internal joint derangement, secondary osteoarthritis and/or ankylosis). At basal MR examination, patients of group I showed no abnormalities (n=28, 75.6%), grade I (n=3), and grade II (n=6) of HA. Patients of group II corresponded to MR grades III (n=21) and IV (n=11) of HA. The MR follow-up showed improvement in three joints of group I and worsening in 5 joints in group I and 2 joints in group II. Early signs of HA were detected in 10 joints with MR imaging but were underestimated on plain radiographs. Advanced degrees of HA were classified as severe under both imaging techniques. Magnetic resonance is the preferred imaging technique to assess HA. The earliest signs of joint damage, detected by MR, are overlooked by plain radiography. The MR scoring system can be used for evaluating HA. Follow-up MR should be performed to evaluate regression or worsening of the abnormalities, primarily in the case of patients with prophylaxis who usually suffer normal or early joint involvement not

  12. Hemophilic arthropathy. A scoring system for magnetic resonance imaging

    International Nuclear Information System (INIS)

    Soler, R.; Rodriguez, E.; Marini, M.; Lopez-Fernandez, F.

    2002-01-01

    The aim of this study was to define a system for scoring hemophilic arthropathy (HA) based on MR findings, providing for objective evaluation of the degree of joint involvement and evolution after on-demand administration of FVIII substitutional therapy or prophylactic treatment. A total of 133 MR examinations (89 basal and 44 during follow-up) were performed in 25 patients. Patients were divided in two groups depending on the therapy received and the length of time that the disease had been evolving at the start of the study. Group I was composed of 10 patients with secondary prophylaxis and group II was composed by 15 treated on demand. T1-weighted and T2*-weighted images performed on a 0.5-T unit were prospectively evaluated. The joint involvement was established on a scale of 0 (no abnormalities), I (minimal amount of hemosiderin), II (large amount of hemosiderin and isolated cartilaginous erosion), III (cartilage destruction, bone erosions, and subchondral cysts) to IV (large internal joint derangement, secondary osteoarthritis and/or ankylosis). At basal MR examination, patients of group I showed no abnormalities (n=28, 75.6%), grade I (n=3), and grade II (n=6) of HA. Patients of group II corresponded to MR grades III (n=21) and IV (n=11) of HA. The MR follow-up showed improvement in three joints of group I and worsening in 5 joints in group I and 2 joints in group II. Early signs of HA were detected in 10 joints with MR imaging but were underestimated on plain radiographs. Advanced degrees of HA were classified as severe under both imaging techniques. Magnetic resonance is the preferred imaging technique to assess HA. The earliest signs of joint damage, detected by MR, are overlooked by plain radiography. The MR scoring system can be used for evaluating HA. Follow-up MR should be performed to evaluate regression or worsening of the abnormalities, primarily in the case of patients with prophylaxis who usually suffer normal or early joint involvement not

  13. Use of hip and knee clinical scoring systems in prosthesis surgery in Norwegian hospitals

    OpenAIRE

    Stavem, Knut; Arnesen, Øyvind

    2005-01-01

    In a postal survey of all orthopaedic surgery departments performing total hip or knee replacements in Norway, we inquired about the use of hip or knee scoring systems and their impact. All 63 eligible hospitals responded to the questionnaire. Thirteen (21%) reported routine use of hip clinical scoring systems, and five (9%) used knee clinical scoring systems. The Harris hip score and The Knee Society clinical rating system were the most prevalent. We received five different versions of the H...

  14. Midlife Systemic Inflammation, Late-Life White Matter Integrity, and Cerebral Small Vessel Disease: The Atherosclerosis Risk in Communities Study.

    Science.gov (United States)

    Walker, Keenan A; Power, Melinda C; Hoogeveen, Ron C; Folsom, Aaron R; Ballantyne, Christie M; Knopman, David S; Windham, B Gwen; Selvin, Elizabeth; Jack, Clifford R; Gottesman, Rebecca F

    2017-12-01

    It is currently unclear whether midlife systemic inflammation promotes the development of white matter (WM) abnormalities and small vessel disease in the elderly. We examined the association of midlife systemic inflammation with late-life WM hyperintensity volume, deep and periventricular WM microstructural integrity (fractional anisotropy and mean diffusivity [MD]), cerebral infarcts, and microbleeds in a biracial prospective cohort study. Linear and logistic regression examined the relation between midlife high-sensitivity C-reactive protein (CRP)-a nonspecific marker of inflammation-and brain magnetic resonance imaging markers assessed 21 years later in the Atherosclerosis Risk in Communities Study. We included 1485 participants (baseline age, 56[5]; 28% black). After adjusting for demographic factors and cardiovascular disease, each SD increase in midlife CRP was associated with lower fractional anisotropy (-0.09 SD; 95% confidence interval, -0.15 to -0.02) and greater MD (0.08 SD; 95% confidence interval, 0.03-0.15) in deep WM and lower fractional anisotropy (-0.07 SD; 95% confidence interval, -0.13 to 0.00) in periventricular WM. We found stronger associations between CRP and periventricular WM microstructural integrity among black participants ( P interaction=0.011). Although an association between higher CRP levels and greater WM hyperintensity volume was found only among APOE ε4-positive participants in our primary analysis (0.14 SD; 95% confidence interval, 0.01-0.26; P interaction=0.028), this relationship extended to the entire sample after accounting for differential attrition. Midlife CRP was not associated with the presence of cerebral infarcts or microbleeds in late life. Our findings support the hypothesis that midlife systemic inflammation may promote the development of chronic microangiopathic structural WM abnormalities in the elderly. © 2017 American Heart Association, Inc.

  15. The OMERACT rheumatoid arthritis magnetic resonance imaging (MRI) scoring system

    DEFF Research Database (Denmark)

    Østergaard, Mikkel; Peterfy, Charles G.; Bird, Paul

    2017-01-01

    with conventional radiography. Technical improvements, including higher field strengths and improved pulse sequences, allow higher image resolution and contrast-to-noise ratio. These have facilitated development and validation of scoring methods of new pathologies: joint space narrowing and tenosynovitis...

  16. Towards Establishing a Standardized Magnetic Resonance Imaging Scoring System for Temporomandibular Joints in Juvenile Idiopathic Arthritis

    DEFF Research Database (Denmark)

    Tolend, Mirkamal A; Twilt, Marinka; Cron, Randy Q

    2017-01-01

    of a MRI scoring system for TMJs has important clinical utility in timely improvement of diagnosis, and serving as an outcome measure. We report on a multi-institutional collaboration towards developing a TMJ MRI scoring system for JIA. METHODS: Seven readers independently assessed MRI scans from 21...... patients (42 TMJs, age range 6-16y) using three existing MRI scoring systems from American, German, and Swiss institutions. Reliability scores, scoring system definitions and items were discussed among 10 JIA experts through two rounds of Delphi surveys, nominal group voting, and subsequent consensus...... meetings to create a novel TMJ MRI scoring system. RESULTS: Average-measure intraclass correlation coefficients (avICC) for the total scores of all three scoring systems were highly reliable at 0.96 each. Osteochondral items showed higher reliability than inflammatory items. An additive system was deemed...

  17. Inflammasomes and Atherosclerosis

    Directory of Open Access Journals (Sweden)

    S. Vallurupalli, MD

    2016-09-01

    Full Text Available Inflammation plays an important role in atherosclerosis. Inflammasomes play a crucial role in innate immunity, which mediates the body’s response to various pathogens. Of the different types of inflammasomes, NLRP3 has been implicated in atherosclerosis through the production of proinflammatory cytokines, IL-1β and IL-18. This review describes the role of the NLRP3 inflammasome in atherosclerosis and discusses potential therapeutic targets in the inflammasome pathway.

  18. Modified Framingham Risk Factor Score for Systemic Lupus Erythematosus.

    Science.gov (United States)

    Urowitz, Murray B; Ibañez, Dominique; Su, Jiandong; Gladman, Dafna D

    2016-05-01

    The traditional Framingham Risk Factor Score (FRS) underestimates the risk for coronary artery disease (CAD) in patients with systemic lupus erythematosus (SLE). We aimed to determine whether an adjustment to the FRS would more accurately reflect the higher prevalence of CAD among patients with SLE. Patients with SLE without a previous history of CAD or diabetes followed regularly at the University of Toronto Lupus Clinic were included. A modified FRS (mFRS) was calculated by multiplying the items by 1.5, 2, 3, or 4. In the first part of the study, using one-third of all eligible patients, we evaluated the sensitivity and specificity of the FRS and the different multipliers for the mFRS. In the second part of the study, using the remaining 2/3 of the eligible patients, we compared the predictive ability of the FRS to the mFRS. In the third part of the study, we assessed the prediction for CAD in a time-dependent analysis of the FRS and mFRS. There were 905 women (89.3%) with a total of 95 CAD events included. In part 1, we determined that a multiplier of 2 provided the best combination of sensitivity and specificity. In part 2, 2.4% of the patients were classified as moderate/high risk based on the classic FRS and 17.3% using the 2FRS (the FRS with a multiplier of 2). In part 3, a time-dependent covariate analysis for the prediction of the first CAD event revealed an HR of 3.22 (p = 0.07) for the classic FRS and 4.37 (p mFRS in which each item is multiplied by 2 more accurately predicts CAD in patients with SLE.

  19. Pathway analysis of coronary atherosclerosis.

    Science.gov (United States)

    King, Jennifer Y; Ferrara, Rossella; Tabibiazar, Raymond; Spin, Joshua M; Chen, Mary M; Kuchinsky, Allan; Vailaya, Aditya; Kincaid, Robert; Tsalenko, Anya; Deng, David Xing-Fei; Connolly, Andrew; Zhang, Peng; Yang, Eugene; Watt, Clifton; Yakhini, Zohar; Ben-Dor, Amir; Adler, Annette; Bruhn, Laurakay; Tsao, Philip; Quertermous, Thomas; Ashley, Euan A

    2005-09-21

    Large-scale gene expression studies provide significant insight into genes differentially regulated in disease processes such as cancer. However, these investigations offer limited understanding of multisystem, multicellular diseases such as atherosclerosis. A systems biology approach that accounts for gene interactions, incorporates nontranscriptionally regulated genes, and integrates prior knowledge offers many advantages. We performed a comprehensive gene level assessment of coronary atherosclerosis using 51 coronary artery segments isolated from the explanted hearts of 22 cardiac transplant patients. After histological grading of vascular segments according to American Heart Association guidelines, isolated RNA was hybridized onto a customized 22-K oligonucleotide microarray, and significance analysis of microarrays and gene ontology analyses were performed to identify significant gene expression profiles. Our studies revealed that loss of differentiated smooth muscle cell gene expression is the primary expression signature of disease progression in atherosclerosis. Furthermore, we provide insight into the severe form of coronary artery disease associated with diabetes, reporting an overabundance of immune and inflammatory signals in diabetics. We present a novel approach to pathway development based on connectivity, determined by language parsing of the published literature, and ranking, determined by the significance of differentially regulated genes in the network. In doing this, we identify highly connected "nexus" genes that are attractive candidates for therapeutic targeting and followup studies. Our use of pathway techniques to study atherosclerosis as an integrated network of gene interactions expands on traditional microarray analysis methods and emphasizes the significant advantages of a systems-based approach to analyzing complex disease.

  20. Automated Quantification of the Landing Error Scoring System With a Markerless Motion-Capture System.

    Science.gov (United States)

    Mauntel, Timothy C; Padua, Darin A; Stanley, Laura E; Frank, Barnett S; DiStefano, Lindsay J; Peck, Karen Y; Cameron, Kenneth L; Marshall, Stephen W

    2017-11-01

      The Landing Error Scoring System (LESS) can be used to identify individuals with an elevated risk of lower extremity injury. The limitation of the LESS is that raters identify movement errors from video replay, which is time-consuming and, therefore, may limit its use by clinicians. A markerless motion-capture system may be capable of automating LESS scoring, thereby removing this obstacle.   To determine the reliability of an automated markerless motion-capture system for scoring the LESS.   Cross-sectional study.   United States Military Academy.   A total of 57 healthy, physically active individuals (47 men, 10 women; age = 18.6 ± 0.6 years, height = 174.5 ± 6.7 cm, mass = 75.9 ± 9.2 kg).   Participants completed 3 jump-landing trials that were recorded by standard video cameras and a depth camera. Their movement quality was evaluated by expert LESS raters (standard video recording) using the LESS rubric and by software that automates LESS scoring (depth-camera data). We recorded an error for a LESS item if it was present on at least 2 of 3 jump-landing trials. We calculated κ statistics, prevalence- and bias-adjusted κ (PABAK) statistics, and percentage agreement for each LESS item. Interrater reliability was evaluated between the 2 expert rater scores and between a consensus expert score and the markerless motion-capture system score.   We observed reliability between the 2 expert LESS raters (average κ = 0.45 ± 0.35, average PABAK = 0.67 ± 0.34; percentage agreement = 0.83 ± 0.17). The markerless motion-capture system had similar reliability with consensus expert scores (average κ = 0.48 ± 0.40, average PABAK = 0.71 ± 0.27; percentage agreement = 0.85 ± 0.14). However, reliability was poor for 5 LESS items in both LESS score comparisons.   A markerless motion-capture system had the same level of reliability as expert LESS raters, suggesting that an automated system can accurately assess movement. Therefore, clinicians can use

  1. Antithrombotic drugs and non-variceal bleeding outcomes and risk scoring systems: comparison of Glasgow Blatchford, Rockall and Charlson scores

    Science.gov (United States)

    Taha, Ali S; McCloskey, Caroline; Craigen, Theresa; Angerson, Wilson J

    2016-01-01

    Objectives Antithrombotic drugs (ATDs) cause non-variceal upper gastrointestinal bleeding (NVUGIB). Risk scoring systems have not been validated in ATD users. We compared Blatchford, Rockall and Charlson scores in predicting outcomes of NVUGIB in ATD users and controls. Methods A total of 2071 patients with NVUGIB were grouped into ATD users (n=851) and controls (n=1220) in a single-centre retrospective analysis. Outcomes included duration of hospital admission, the need for blood transfusion, rebleeding requiring surgery and 30-day mortality. Results Duration of admission correlated with all scores in controls, but correlations were significantly weaker in ATD users. Rank correlation coefficients in control versus ATD: 0.45 vs 0.20 for Blatchford; 0.48 vs 0.32 for Rockall and 0.42 vs 0.26 for Charlson (all p<0.001). The need for transfusion was best predicted by Blatchford (p<0.001 vs Rockall and Charlson in both ATD users and controls), but all scores performed less well in ATD users. Area under the receiver operation characteristic curve (AUC) in control versus ATD: 0.90 vs 0.85 for Blatchford; 0.77 vs 0.61 for Rockall and 0.69 vs 0.56 for Charlson (all p<0.005). In predicting surgery, Rockall performed best; while mortality was best predicted by Charlson with lower AUCs in ATD patients than controls (p<0.05). Stratification showed the scores' performance to be age-dependent. Conclusions Blatchford score was the strongest predictor of transfusion, Rockall's had the strongest correlation with duration of admission and with rebleeding requiring surgery and Charlson was best in predicting 30-day mortality. Modifications of these systems should be explored to improve their efficiency in ATD users. PMID:28839866

  2. Scoring system in cirrhotics due to viral hepatitis

    International Nuclear Information System (INIS)

    Abbasi, A.; Bhutto, A.R.; Butt, N.; Lal, K.; Munir, S.M.

    2012-01-01

    Objective: To determine the association of serum cholesterol levels with Child-Pugh class in patients with decompensated chronic liver disease due to viral hepatitis. Methodology: Consecutive patients attending outpatient department or admitted in medical unit III were eligible if they had a diagnosis of cirrhosis secondary to viral hepatitis. Patients were excluded if alcoholic, diabetic, hypertensive, or with non-alcoholic fatty liver disease, autoimmune, metabolic, cardiovascular, cerebrovascular or kidney diseases and recent use of lipid-regulating drugs. Serum lipid profile was determined after an overnight fast of 12 hours. On the basis of serum total cholesterol, patients were divided into four groups; Group I with serum total cholesterol = 100 mg/dl, Group II with level of 101-150 mg/dl, Group III with level of 151-200 mg/dl and Group IV with serum total cholesterol level of > 200 mg/dl. Hepatic dysfunction was categorized according to Child-Pugh scoring system. Chi-square and Spearman's correlation testing with p < 0.05 was accepted as significant. Results: One hundred and fourteen patients met the inclusion criteria with a mean age of 40.32 +- 13.59 years. Among these 32 were females (28.1%) while 82 were males (71.9%). According to Child-Pugh class; 34 patients (29.8%) presented with Child-Pugh class A, 34 (29.8%) in class B and 46 (40.4%) were in class C. Serum cholesterol (total) and triglycerides had significant association with Child-Pugh class (p = 0.0001 and p = 0.004 respectively) suggesting that as severity of liver dysfunction increases; serum cholesterol and triglycerides levels decrease. Results also revealed that males were significantly more hypocholesterolemic than females (p = 0.006). Conclusion: Hypocholesterolemia is a common finding in decompensated chronic liver disease and has got significant association with Child-Pugh class. It may increase the reliability of Child-Pugh classification in assessment of severity and prognosis in

  3. Sleep Duration and Quality in Relation to Autonomic Nervous System Measures: The Multi-Ethnic Study of Atherosclerosis (MESA).

    Science.gov (United States)

    Castro-Diehl, Cecilia; Diez Roux, Ana V; Redline, Susan; Seeman, Teresa; McKinley, Paula; Sloan, Richard; Shea, Steven

    2016-11-01

    Short sleep duration and poor sleep quality are associated with adverse cardiovascular outcomes. Potential pathophysiological mechanisms include sleep-associated alterations in the autonomic nervous system. The objective of this study was to examine the associations of shorter sleep duration and poorer sleep quality with markers of autonomic tone: heart rate (HR), high-frequency HR variability (HF-HRV) and salivary amylase. Cross-sectional analysis of data from actigraphy-based measures of sleep duration and efficiency and responses to a challenge protocol obtained from 527 adult participants in the Multi-Ethnic Study of Atherosclerosis. Participants who slept fewer than 6 h per night (compared to those who slept 7 h or more per night) had higher baseline HR (fully adjusted model 0.05 log beats/min, 95% confidence interval [CI] 0.01, 0.09) and greater HR orthostatic reactivity (fully adjusted model 0.02 log beats/min, 95% CI 0.002, 0.023). Participants who slept 6 to less than 7 h/night (compared to those who slept 7 h or more per night) had lower baseline HF-HRV (fully adjusted model -0.31 log msec 2 , 95% CI -0.60, -0.14). Participants with low sleep efficiency had lower baseline HF-HRV than those with higher sleep efficiency (fully adjusted model -0.59 log msec 2 , 95% CI -1.03, -0.15). Participants with low sleep efficiency had higher baseline levels of amylase than those with higher sleep efficiency (fully adjusted model 0.45 log U/mL, 95% CI 0.04, 0.86). Short sleep duration, low sleep efficiency, and insomnia combined with short sleep duration were associated with markers of autonomic tone that indicate lower levels of cardiac parasympathetic (vagal) tone and/or higher levels of sympathetic tone. © 2016 Associated Professional Sleep Societies, LLC.

  4. Various scoring systems for predicting mortality in Intensive Care Unit

    African Journals Online (AJOL)

    Age, gender, body weight, initial diagnosis, clinic of referral, intubation, comorbidities, APACHE II, APACHE IV, Glasgow coma scale, SAPS III scores, length of hospitalization before referral to ICU, length of stay in ICU, mechanical ventilation were recorded. Results: Most of the patients (54.6%) were consulted from ...

  5. POSSUM scoring system in patients undergoing laparotomy in ...

    African Journals Online (AJOL)

    Background: Prediction of complications is an essential part of risk management in surgery. Knowing which patient to operate and those at high risk of developing complications contributes significantly to the quality of surgical care and cost reduction in surgery. The physiological and operative severity score for the ...

  6. 76 FR 10050 - Changes to the Public Housing Assessment System (PHAS): Management Operations Scoring Notice

    Science.gov (United States)

    2011-02-23

    ... Housing Assessment System (PHAS): Management Operations Scoring Notice SUMMARY: This notice provides... issuing scores under the management operations indicator of the Public Housing Assessment System (PHAS... notice is to provide additional information about the scoring process for the PHAS management operations...

  7. Intracranial atherosclerosis following radiotherapy

    International Nuclear Information System (INIS)

    Werner, M.H.; Burger, P.C.; Heinz, E.R.; Friedman, A.H.; Halperin, E.C.; Schold, S.C. Jr.

    1988-01-01

    We describe a case of severe intracranial atherosclerosis in a young man who had received therapeutic radiation for a presumed brain neoplasm. Since there was no evidence of vascular disease outside the radiation ports, we speculate that accelerated atherosclerosis was induced by radiation and that hyperlipidemia may have predisposed him to this effect

  8. Diet and Atherosclerosis

    African Journals Online (AJOL)

    1974-08-14

    Aug 14, 1974 ... Among the various factors affecting the development of atherosclerosis and its complications, the diet emerges as an important influence. This article reviews the evi- dence linking diet and atherosclerosis; the relation be- tween serum cholesterol concentration and incidence of coronary heart disease, and ...

  9. Vaccination against atherosclerosis

    NARCIS (Netherlands)

    Es, Thomas van

    2009-01-01

    Atherosclerosis, the predominantly underlying pathology of cardiovascular events, is the consequence of lipid deposition in the arterial wall, mostly as consequence of high levels of serum cholesterol. Treatment of atherosclerosis is mainly focused at the reduction of cholesterol levels by lipid

  10. Roles of antibody against oxygenized low density lipoprotein in atherosclerosis: recent advances

    OpenAIRE

    Zhang, Jing; Wang, Daxin; He, Shenghu

    2015-01-01

    Atherosclerosis is a chronic immune inflammatory disease. Atherosclerosis and relevant disease are threatening human life and health. Oxygenized low density lipoprotein (oxLDL) is a molecular basis in the pathogenesis of atherosclerosis and able to induce inflammation, stimulate immune system and interfere with lipid metabolism in the occurrence and development of atherosclerosis. Antibody against oxLDL has been an important molecule in the immune related pathogenesis of atherosclerosis. In a...

  11. Phytosterols and atherosclerosis

    DEFF Research Database (Denmark)

    Schrøder, Malene

    Cardiovascular disease (CVD) is the major cause of premature deaths worldwide. Coronary heart disease is the most common CVD, caused by atherosclerosis in the coronary arteries. Atherosclerosis is a multifactorial disease influenced by both genetic and environmental factors. WHO has in 2007 listed...... in its “Guidelines for assessment and management of cardiovascular risk” the following risk factors to influence progressive atherosclerosis: hypertension, abnormal blood lipids, diabetes, unhealthy diet, physical inactivity and smoking. Phytosterols (plant sterols and plant stanols) are known...... their blood cholesterol levels. The aim of this Ph.D. project was to investigate the effects of phytosterols on the development of atherosclerosis in the aorta of heterozygous Watanabe Heritable Hyperlipidemic (WHHL) rabbits. The main advantage of animal studies to human studies in atherosclerosis research...

  12. Insights into atherosclerosis from invasive and non-invasive imaging studies: Should we treat subclinical atherosclerosis?

    Science.gov (United States)

    Santos, Raul D; Nasir, Khurram

    2009-08-01

    Although atherosclerosis is associated with the elderly, young adults with hypercholesterolemia and other cardiovascular risk factors may have subclinical atherosclerotic disease. In many cases, when two or more risk factors are present, conventional risk assessment using the Framingham score, that was not designed to detect atherosclerotic plaques, may significantly underestimate the extent of atherosclerosis. Several non-invasive imaging technologies now make it possible to identify subclinical atherosclerosis before symptoms appear or major vascular events occur. These include B-mode ultrasound to measure carotid intima-media thickness, computed tomography to measure coronary artery calcification, and high-resolution magnetic resonance imaging to evaluate plaque size and composition. On the basis of available evidence, assessment of subclinical atherosclerosis should be considered in persons judged to be at intermediate risk by Framingham score, because test results may influence risk stratification and, consequently, the intensity of therapeutic intervention. Patients with significant subclinical atherosclerosis are at high risk and, like other high-risk individuals, should receive treatment designed to achieve aggressive low-density lipoprotein cholesterol targets. Clinical studies show that statin therapy may delay atherosclerosis progression and that intensive therapy with rosuvastatin may actually reverse the atherosclerotic process.

  13. Introducing the HOPE (Hypospadias Objective Penile Evaluation)-score: A validation study of an objective scoring system for evaluating cosmetic appearance in hypospadias patients

    NARCIS (Netherlands)

    van der Toorn, Fred; de Jong, Tom P. V. M.; de Gier, Robert P. E.; Callewaert, Piet R. H.; van der Horst, Eric H. J. R.; Steffens, Martijn G.; Hoebeke, Piet; Nijman, Rien J. M.; Bush, Nicol C.; Wolffenbuttel, Katja P.; van den Heijkant, Marleen M. C.; van Capelle, Jan-Willem; Wildhagen, Mark; Timman, Reinier; van Busschbach, Jan J. V.

    2013-01-01

    To determine the reliability and internal validity of the Hypospadias Objective Penile Evaluation (HOPE)-score, a newly developed scoring system assessing the cosmetic outcome in hypospadias. The HOPE scoring system incorporates all surgically-correctable items: position of meatus, shape of meatus,

  14. Introducing the HOPE (Hypospadias Objective Penile Evaluation)-score : A validation study of an objective scoring system for evaluating cosmetic appearance in hypospadias patients

    NARCIS (Netherlands)

    van der Toorn, Fred; de Jong, Tom P. V. M.; de Gier, Robert P. E.; Callewaert, Piet R. H.; van der Horst, Eric H. J. R.; Steffens, Martijn G.; Hoebeke, Piet; Nijman, Rien J. M.; Bush, Nicol C.; Wolffenbuttel, Katja P.; van den Heijkant, Marleen M. C.; van Capelle, Jan-Willem; Wildhagen, Mark; Timman, Reinier; van Busschbach, Jan J. V.

    2013-01-01

    Objective: To determine the reliability and internal validity of the Hypospadias Objective Penile Evaluation (HOPE)-score, a newly developed scoring system assessing the cosmetic outcome in hypospadias. Patients and methods: The HOPE scoring system incorporates all surgically-correctable items:

  15. Reliability of a Scoring System for Qualitative Evaluation of Lymphoscintigraphy of the Lower Extremities.

    Science.gov (United States)

    Ebrahim, Mojgan; Savitcheva, Irina; Axelsson, Rimma

    2017-09-01

    Lymphoscintigraphy is an imaging technique to diagnose and characterize the severity of edema in the upper and lower extremities. In lymphoscintigraphy, a scoring system can increase the ability to differentiate between diagnoses, but the use of any scoring system requires sufficient reliability. Our aim was to determine the inter- and intraobserver reliability of a proposed scoring system for visual interpretation of lymphoscintigrams of the lower extremities. Methods: The lymphoscintigrams of 81 persons were randomly selected from our database for retrospective evaluation. Two nuclear medicine physicians scored these scans according to the 8 criteria of a proposed scoring system for visual interpretation of lymphoscintigrams of the lower extremities. Each scan was scored twice 3 mo apart. The total score was the sum of the scores for all criteria, with a potential range of 0 (normal lymphatic drainage) to 58 (severe lymphatic impairment). The intra- and interobserver reliability of the scoring system was determined using the Wilcoxon signed-rank test, percentage of agreement, weighted κ, and intraclass correlation coefficient with 95% confidence interval. In addition, for 7 categories, differences in total scores between and within observers were determined. Results: We found some insignificant differences between observers. Percentage agreement was high or very high, at 82.7%-99.4% between observers and 84.6%-99.4% within observers. For each criterion of the scoring system, the κ-correlations showed moderate to very good inter- or intraobserver reliability. The total scores for all criteria had good inter- and intraobserver reliability. Regarding the interobserver comparison, 66% and 64% of the difference in total scores were within ±1 scale point (-1, +1), and regarding the intraobserver comparison, 68% and 72% of the difference in total scores were within ±1 scale point. Conclusion: The proposed scoring system is a reliable tool for visual qualitative

  16. 76 FR 20366 - Changes to the Public Housing Assessment System (PHAS): Management Operations Scoring Notice

    Science.gov (United States)

    2011-04-12

    ... Housing Assessment System (PHAS): Management Operations Scoring Notice AGENCY: Office of the Assistant... Management Operations interim scoring notice. The document inadvertently omitted a word with respect to the... INFORMATION: I. Background The proposed management operations scoring information was published on August 21...

  17. The longitudinal reliability and responsiveness of the OMERACT Hand Osteoarthritis Magnetic Resonance Imaging Scoring System (HOAMRIS)

    DEFF Research Database (Denmark)

    Haugen, Ida K.; Eshed, Iris; Gandjbakhch, Frederique

    2015-01-01

    Objective. To evaluate the interreader reliability of change scores and the responsiveness of the OMERACT Hand Osteoarthritis (OA) Magnetic Resonance Image (MRI) Scoring System (HOAMRIS). Methods. Paired MRI (baseline and 5-yr followup) from 20 patients with hand OA were scored with known time se...

  18. Histone deacetylases and atherosclerosis.

    Science.gov (United States)

    Zheng, Xia-xia; Zhou, Tian; Wang, Xin-An; Tong, Xiao-hong; Ding, Jia-wang

    2015-06-01

    Atherosclerosis is the most common pathological process that leads to cardiovascular diseases, a disease of large- and medium-sized arteries that is characterized by a formation of atherosclerotic plaques consisting of necrotic cores, calcified regions, accumulated modified lipids, smooth muscle cells (SMCs), endothelial cells, leukocytes, and foam cells. Recently, the question about how to suppress the occurrence of atherosclerosis and alleviate the progress of cardiovascular disease becomes the hot topic. Accumulating evidence suggests that histone deacetylases(HDACs) play crucial roles in arteriosclerosis. This review summarizes the effect of HDACs and HDAC inhibitors(HDACi) on the progress of atherosclerosis. Copyright © 2015. Published by Elsevier Ireland Ltd.

  19. Inflammation, thrombosis, and atherosclerosis

    DEFF Research Database (Denmark)

    de Maat, M.P.M.; Bladbjerg, E.M.; Drivsholm, T.

    2003-01-01

    of inflammatory and hemostatic markers and the severity of atherosclerosis is not yet well studied. We have evaluated 325 men and 370 women of 60 years, participating in the Danish Glostrup study. We diagnosed atherosclerosis by ultrasonographic measurement of intima-media thickness (IMT) of the right carotid...... CRP and the other hemostatic variables and the number of plaques. Genetic variation in the t-PA and MTHFR gene was associated with IMT. In conclusion, in the Glostrup population study, thrombosis and inflammation are associated with the severity of atherosclerosis, as reflected by IMT and plaque...

  20. The Weighted Airman Promotion System: Standardizing Test Scores

    Science.gov (United States)

    2008-01-01

    u th o ri ze d Top 3/E6 ratio, inventory 1401206040 100 70 130 5R 2F 2G 3N 2M 2A 4J 4C 4P 4T 4B 1W 2T 3P 1T 4A 2S 5J 1A 1S1C 6F 4N 7S 4R 4E 1N 3A 3V...Costs If the Air Force decided to standardize test scores, there would be three basic types of costs: implementation costs, marketing costs, and...analytical costs for this more deliberate approach could be three to four person-years. It would be appropriate for the Air Force to market any

  1. The Biochemistry of atherosclerosis

    National Research Council Canada - National Science Library

    Scanu, Angelo M; Getz, Godfrey S; Wissler, Robert W

    1979-01-01

    In this first full-length review of the biochemical parameters and their part in the pathogenesis of atherosclerosis, the reader will discover a range of coverage concerning basic etiological factors...

  2. What Is Atherosclerosis?

    Science.gov (United States)

    ... symptoms Widening or bypassing plaque-clogged arteries Heart-Healthy Lifestyle Changes Your doctor may recommend heart-healthy lifestyle changes if you have atherosclerosis. Heart-healthy lifestyle ...

  3. Atherosclerosis: Hypotheses and theories

    Directory of Open Access Journals (Sweden)

    E. A. Yuryeva

    2014-01-01

    Full Text Available The article gives basic theories of the pathogenesis of atherosclerosis, including inflammatory, cholesterol, lipid, lipoprotein, iron ones, as a result of metabolic syndrome, oxidative stress. In spite of carefully and deeply developed and ongoing elaborated pathogenesis theories, the etiological factors of atherosclerosis remain unknown so far. The age-related aspect of the disease is discussed; atherosclerosis is considered to be a childhood-onset disease that manifests itself at a later age. The authors propose an experimental and clinical evidence-based concept of the common etiology of syndromes of atherosclerosis, namely: the body's endogenous intoxication that is permanent or periodically progressive may be a primary cause of altered conformation of different protein molecules with their higher ability to adsorb the trace elements consolidating the structural changes. This change of proteins diminishes their functions and determines their antigenic properties, which is attended by the development of different pathogenic components in relation to the body's individual features.

  4. Atherosclerosis and Stroke

    Science.gov (United States)

    ... of the arteries.” The word comes from the Greek words a thero (meaning gruel or paste) and ... of atherosclerosis . Males and people with a family history of premature cardiovascular disease have an increased risk ...

  5. The value of international prostate symptom scoring system in the ...

    African Journals Online (AJOL)

    IPSS) system in management of patients with benign prostatic hyperplasia (BPH) in Jos, Nigeria. Materials and Methods: This was a prospective study of 104 newly diagnosed patients with BPH from June 2006 to July 2007. Patients' symptoms ...

  6. An Iranian scoring system for diagnosing Buerger's disease.

    Directory of Open Access Journals (Sweden)

    Mohammad Ramin

    2014-01-01

    Full Text Available Buerger's disease or thromboangiitis obliterans (TAO seems to be common in IR Iran, The present study aimed to evaluate an Iranian population with Buerger's disease in order to suggest a diagnostic criterion for Buerger's disease based on the most frequent findings and to compare it with Papa diagnostic criteria. In a cross-sectional study, all patients with resting limb pain, limb ischemic ulcers, intermittent claudication and limb ischemia who referred to the Vascular Clinic of Sina Hospital during 2009-2011 were evaluated. The patients were allocated to Buerger's and non-Buerger's groups; Evaluating 122 patients (61 in each group, according to the model each clinical manifestations and risk factors in the patients with Buerger's disease obtained a score. Absent pulsation, abnormal distal Doppler sonography and ischemic ulcer were respectively present in 58 (95.1%, 58 (95.1% and 49 (80.3% individuals with Buerger's disease. Multivariate linear regression analysis and multivariate logistic regression analysis were used for modeling. Considering the model finding findings, diagnostic criteria including age, sex, smoking, Raynaud's phenomenon, abnormal proximal Doppler, diabetes mellitus and hyperlipidemia were suggested (R2=0.582; the sensitivity and specificity of the criteria was respectively 95.1% and 78.7%. Compared with Papa criteria, Kappa coefficient was measured at 0.66 with a P-value<0.001. It seems that the recommended criteria have an acceptable accuracy in diagnosing Buerger's disease, especially in the Iranian population; however, it is necessary to conduct more studies with larger sample sizes to evaluate the criteria, especially in other populations.

  7. A scoring system for the prediction of choledocholithiasis: a prospective cohort study.

    Science.gov (United States)

    Al-Jiffry, Bilal O; Khayat, Samah; Abdeen, Elfatih; Hussain, Tasadooq; Yassin, Mohammed

    2016-01-01

    Techniques for diagnosing choledocholithiasis pose significant morbidity and mortality risks. We aimed to develop and validate a clinical scoring system for predicting choledocholithiasis. Data from a prospectively maintained database of all patients with gallstones. Patients were admitted to the general surgery department of a military hospital. We enrolled consecutive patients with symptomatic gallstones, biliary pancreatitis, obstructive jaundice, or cholangitis, who subsequently underwent biochemical testing and ultrasonography. A predictive model was developed from a scoring system using their imaging and laboratory data. Endoscopic retrograde cholangiopancreatography (ERCP) or intraoperative cholangiography were used for confirmatory diagnoses. The predictive efficacy of the scoring system was validated using a retrospective cohort of 272 patients. Predictive accuracy of the scoring system. We enrolled 155 patients in the development group. The common bile duct diameter, alkaline phosphatase of >=200 IU, elevated bilirubin levels, alanine transaminase of >=220 IU, and male age of >=50 years were significantly associated with choledocholithiasis and were included in the scoring system. Ninety-six patients (35%) had scores of >=8 (high risk), 86 patients (32%) had scores of 4-7 (intermediate risk), and 27 patients (10%) had scores of 1-3 (low risk). In the validation cohort, the positive predictive value for a score of >=8 was 91.7%, and the scoring system had an area under the curve of 0.896. Scores of >=8 were strongly correlated with choledocholithiasis in the developmental and validation groups, which indicates that our scoring system may be useful for predicting the need for therapeutic ERCP. However, prospective validation in a large multicenter cohort is needed to fully understand the benefits of the system. The retrospective validation cohort might have introduced selection and observational biases. The study may have been underpowered because of the

  8. Validation of a new prognostic staging system for hepatocellular carcinoma: a comparison of the biomarker-combined Japan Integrated Staging Score, the conventional Japan Integrated Staging Score and the BALAD Score.

    Science.gov (United States)

    Kitai, Satoshi; Kudo, Masatoshi; Minami, Yasunori; Haji, Seiji; Osaki, Yukio; Oka, Hiroko; Seki, Toshihito; Kasugai, Hiroshi; Sasaki, Yo; Matsunaga, Takashi

    2008-01-01

    The conventional Japan Integrated Staging (c-JIS) score has been reported to effectively stratify patients with hepatocellular carcinoma (HCC). Recently, two new staging systems, the biomarker-combined JIS (bm-JIS) score and the BALAD score, have been proposed. Both staging systems include three tumor markers: alpha-fetoprotein (AFP), lens culinaris agglutinin-reactive AFP and des-gamma-carboxy prothrombin specific for HCC. The aim of this study is to evaluate the performance of these three staging systems. A total of 1,173 HCC patients were included in this study. The stratification ability and prognostic predictive power were compared between these three staging systems. These three staging systems effectively predicted the patient survival. When accounting for the best prognostic subgroup of each staging systems (i.e. score of 0), there were significant differences between the bm-JIS score and the BALAD score and, likewise, between the c-JIS score and the BALAD score. The likelihood ratio chi(2) test showed the highest value and the Akaike information criterion value was lowest in the bm-JIS score. The bm-JIS score showed good stratification ability and was thus demonstrated to be a better predictor of the prognosis than the c-JIS score and the BALAD score, especially for the patients with a good prognosis. Copyright 2008 S. Karger AG, Basel.

  9. Immune Response to Lipoproteins in Atherosclerosis

    Directory of Open Access Journals (Sweden)

    Sonia Samson

    2012-01-01

    Full Text Available Atherosclerosis, the underlying cause of cardiovascular disease, is characterized by chronic inflammation and altered immune response. Cholesterol is a well-known risk factor associated with the development of cardiovascular diseases. Elevated serum cholesterol is unique because it can lead to development of atherosclerosis in animals and humans even in the absence of other risk factors. Modifications of low-density lipoproteins mediated by oxidation, enzymatic degradation, and aggregation result in changes in their function and activate both innate and adaptive immune system. Oxidized low-density lipoprotein (LDL has been identified as one of the most important autoantigens in atherosclerosis. This escape from self-tolerance is dependent on the formation of oxidized phospholipids. The emerging understanding of the importance of immune responses against oxidized LDL in atherosclerosis has focused attention on the possibility of development of novel therapy for atherosclerosis. This review provides an overview of immune response to lipoproteins and the fascinating possibility of developing an immunomodulatory therapy for atherosclerosis.

  10. Building an Image-Based System to automatically Score psoriasis

    DEFF Research Database (Denmark)

    G{'o}mez, D. Delgado; Carstensen, Jens Michael; Ersbøll, Bjarne Kjær

    2003-01-01

    the images. The system is tested on patients with the dermatological disease psoriasis. Temporal series of images are taken for each patient and the lesions are automatically extracted. Results indicate that to the images obtained are a good source for obtaining derived variables to track the lesion....

  11. External validation of severity scoring systems for acute renal failure using a multinational database

    NARCIS (Netherlands)

    Uchino, Shigehiko; Bellomo, Rinaldo; Morimatsu, Hiroshi; Morgera, Stanislao; Schetz, Miet; Tan, Ian; Bouman, Catherine; Macedo, Ettiene; Gibney, Noel; Tolwani, Ashita; Doig, Gordon S.; Oudemans van Straaten, Heleen; Ronco, Claudio; Kellum, John A.

    2005-01-01

    Several different severity scoring systems specific to acute renal failure have been proposed. However, most validation studies of these scoring systems were conducted in a single center or in a small number of centers, often the same ones used for their development. Therefore, it is not known

  12. Validation of the prognostic value of histologic scoring systems in primary sclerosing cholangitis

    DEFF Research Database (Denmark)

    de Vries, Elisabeth M G; de Krijger, Manon; Färkkilä, Martti

    2017-01-01

    Histologic scoring systems specific for primary sclerosing cholangitis (PSC) are not validated. We recently determined the applicability and prognostic value of three histological scoring systems in a single PSC cohort. The aim of this study was to validate their prognostic use and reproducibility...

  13. Iterative Development and Reliability of the OMERACT Hand Osteoarthritis MRI Scoring System

    DEFF Research Database (Denmark)

    Haugen, Ida K; Østergaard, Mikkel; Eshed, Iris

    2014-01-01

    To develop and test the interreader reliability of the OMERACT Hand Osteoarthritis Magnetic Resonance Scoring System (HOAMRIS) for assessment of structural and inflammatory hand OA features in the interphalangeal joints.......To develop and test the interreader reliability of the OMERACT Hand Osteoarthritis Magnetic Resonance Scoring System (HOAMRIS) for assessment of structural and inflammatory hand OA features in the interphalangeal joints....

  14. Ultrasonographic scoring system: an auxiliary to differential diagnosis of gastric pathologies.

    Science.gov (United States)

    Boyacioğlu, S; Dolar, E; Acar, Y; Dalay, R; Temuçin, G

    1993-02-01

    In a prospective clinical study, 64 patients with gastric pathologies (27 malignant and 37 benign) were examined ultrasonographically. Gastric wall layer changes, gastric wall thickness, lesion length, and protrusion into the lumen were evaluated. A scoring system was defined based on the distribution of these parameters and the score of each patient was calculated retrospectively. Six of the malignant cases had scores in the benign range and 3 of the benign cases had scores in the malignant range. Sensitivity of this scoring system in terms of detecting malignancy was 78% and specificity 92%. The positive predictive value was 88%, the negative predictive value was 85%, and overall diagnostic accuracy was 86%. This scoring system was considered to be a useful aid in the differential diagnosis of gastric pathologies.

  15. Subclinical atherosclerosis and subsequent cognitive function.

    Science.gov (United States)

    Rossetti, Heidi C; Weiner, Myron; Hynan, Linda S; Cullum, C Munro; Khera, Amit; Lacritz, Laura H

    2015-07-01

    To examine the relationship between measures of subclinical atherosclerosis and subsequent cognitive function. Participants from the Dallas Heart Study (DHS), a population-based multiethnic study of cardiovascular disease pathogenesis, were re-examined 8 years later (DHS-2) with the Montreal Cognitive Assessment (MoCA); N = 1904, mean age = 42.9, range 8-65. Associations of baseline measures of subclinical atherosclerosis (coronary artery calcium, abdominal aortic plaque, and abdominal aortic wall thickness) with MoCA scores measured at follow-up were examined in the group as a whole and in relation to age and ApoE4 status. A significant linear trend of successively lower MoCA scores with increasing numbers of atherosclerotic indicators was observed (F(3, 1150) = 5.918, p = .001). CAC was weakly correlated with MoCA scores (p = .047) and MoCA scores were significantly different between participants with and without CAC (M = 22.35 vs 23.69, p = 0.038). With the exception of a small association between abdominal AWT and MoCA in subjects over age 50, abdominal AWT and abdominal aortic plaque did not correlate with MoCA total score (p ≥ .052). Cognitive scores and atherosclerosis measures were not impacted by ApoE4 status (p ≥ .455). In this ethnically diverse population-based sample, subclinical atherosclerosis was minimally associated with later cognitive function in middle-aged adults. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  16. Developing a magnetic resonance imaging scoring system for peripheral psoriatic arthritis

    DEFF Research Database (Denmark)

    McQueen, Fiona; Lassere, Marissa; Bird, Paul

    2007-01-01

    We describe the first steps in developing an OMERACT magnetic resonance imaging (MRI) scoring system for peripheral psoriatic arthritis (PsA). A preexisting MRI dataset (finger joints) from 10 patients with PsA was scored by 4 readers for bone erosion, bone edema, synovitis, tendinopathy, and ext......We describe the first steps in developing an OMERACT magnetic resonance imaging (MRI) scoring system for peripheral psoriatic arthritis (PsA). A preexisting MRI dataset (finger joints) from 10 patients with PsA was scored by 4 readers for bone erosion, bone edema, synovitis, tendinopathy...

  17. A naïve approach for deriving scoring systems to support clinical decision making.

    Science.gov (United States)

    Barbini, Paolo; Cevenini, Gabriele; Furini, Simone; Barbini, Emanuela

    2014-02-01

    Scoring systems are frequently proposed in medicine to summarize a set of qualitative and quantitative items by means of a numeric score. Their design often requires modelling ability and subjective judgments. This can make it difficult to adapt a scoring system to a clinical setting different from that in which the system was developed. The objective of this study was to discuss an approach to derive scoring systems, which can be easily modified and matched to any scenario. A naïve Bayes approach was used to develop a scoring system that is completely defined by descriptive tables obtained by frequency counts from the training set. The approach was implemented to build a locally customized scoring system for planning transfusion requirements after cardiac surgery. The performance of this system was evaluated and compared with that of a logistic regression model designed using the same predictors. The working sample was a set of 3182 consecutive patients undergoing cardiac surgery at the University Hospital of Siena, Italy. The area under the receiver operating characteristic curve was equal to 0.811 and 0.824 for the scoring system and for the logistic regression model, respectively. This result proves that this global index of discrimination capacity was virtually identical and very good for both models. The values of sensitivity, specificity and overall correct-classification percentage obtained by the leave-one-out method were practically the same for the two models (73.9% versus 75.3%). An easy-fitting and trustworthy scoring system can be directly developed using a naïve Bayes approach. The simplicity of its design allows the system to be customized to any specific institution and updated regularly. This aspect has important practical implications because it can encourage the use of scoring systems among clinicians, enabling their performance to be properly assessed in a wider clinical context. © 2013 John Wiley & Sons, Ltd.

  18. The development and evaluation of a new shoulder scoring system based on the view of patients and physicians: the Fudan University shoulder score.

    Science.gov (United States)

    Ge, Yunshen; Chen, Shiyi; Chen, Jiwu; Hua, Yinghui; Li, Yunxia

    2013-04-01

    Existing patient self-reported shoulder scoring systems fail to express physicians' points of view, and understanding the wording can sometimes lead to confusion in Easterners. We sought to develop a valid, reliable, and responsive shoulder scoring system that combines the points of view of physicians and patients and is easily understood for worldwide applicability. Six steps were followed to develop the scale: (1) investigation, identification of a specific population, and patient and physician interviews; (2) item generation, according to existing shoulder scales, a literature review, and patient and physician interviews; (3) item reduction, by combining and adjusting items; (4) formatting of the questionnaire, designed using both subjective and objective scales, with a 100-point score range; (5) pretesting, to eliminate confusion and misunderstanding of items, and (6) preliminary evaluation. Pearson correlation coefficients were calculated to assess validity (compared with American Shoulder and Elbow Surgeons, Constant-Murley, and University of California, Los Angeles scores), intraclass correlation coefficients were calculated to assess reliability (with a 2-week test-retest interval), and the standardized response mean was calculated to assess responsiveness (comparing preoperative and postoperative scores in patients). The final scoring system was designed to have a 100-point score range, with higher scores indicating better function. It consisted of self-report assessment by patients (61 points in total) and objective assessment by physicians (39 points in total). Updated scales, including a night pain subscale, patient-physician satisfaction, and 2-dimensional visual analog scale tool, were incorporated in our system. Compared with the other 3 scoring systems (American Shoulder and Elbow Surgeons, Constant-Murley, and University of California, Los Angeles scores), the new scoring system has shown favorable validity, with a Pearson correlation coefficient

  19. Study of the osteoprotegerin/receptor activator of nuclear factor-kB ligand system association with inflammation and atherosclerosis in systemic sclerosis.

    Science.gov (United States)

    Gamal, Rania M; Gamal, Walid M; Ghandour, Abeer M; Abozaid, Hanan Sayed M; Mohamed, Mona Embarek; Emad, Yasser; Abdel Galeel, Ahmed

    2018-04-01

    we aimed to study systemic sclerosis patients in order to assess osteoprotegerin/Receptor activator of nuclear factor-kB ligand (OPG/RANKL) system and find the relation of these biomarkers with the clinical features of the disease, the carotid intima thickness, markers of inflammation, lipid profile, and other laboratory characteristics. both the level of (RANKL), (OPG) in sera of participants, in 30 (SSc) patients and the atherosclerotic changes affecting the common carotid artery were measured and, were compared to 30 healthy controls matched for age and sex. All participants were assessed clinically and subjected to the Revised Medsger SSc severity scale and underwent carotid Doppler ultrasound examination. OPG, RANKL, and RANKL/OPG were 1.9 ± 0.4 ng/ml, 24.3 ± 17.25 ng/ml, and 13.5 ±9.8 versus 0.77 ± 0.25 ng/ml, 7.13 ± 3.02 ng/ml, and 9.6 ± 3.1 in the SSc patients and the controls with significance (P = 0.001, P = 0.001, P = 0.045) respectively. The OPG- RANKL axis in the SSc patients correlated significantly with carotid intima thickness, arthritis, arthralgia, inflammatory markers, Medsger joint, Medsger vascular, Medsger skin, and dyslipidemia. In cardiovascular risks, OPG serum level might increase as a preventive compensatory mechanism to neutralize the RANKL level increment. The determination of the OPG-RANKL system is a diagnostic indicator for the intensity of vascular calcification and atherosclerosis in SSc patients.

  20. Phytosterols and atherosclerosis

    DEFF Research Database (Denmark)

    Schrøder, Malene

    in its “Guidelines for assessment and management of cardiovascular risk” the following risk factors to influence progressive atherosclerosis: hypertension, abnormal blood lipids, diabetes, unhealthy diet, physical inactivity and smoking. Phytosterols (plant sterols and plant stanols) are known...... for decades for their natural ability to reduce cholesterol levels in the blood. In the last decade numerous food products added phytosterol esters have been placed on the market, e.g. yellow fat spread, yoghurt, dressing. The products are being marketed as a natural means for people who want to lower...... their blood cholesterol levels. The aim of this Ph.D. project was to investigate the effects of phytosterols on the development of atherosclerosis in the aorta of heterozygous Watanabe Heritable Hyperlipidemic (WHHL) rabbits. The main advantage of animal studies to human studies in atherosclerosis research...

  1. Simplified Therapeutic Intervention Scoring System : The TISS-28 items - Results from a multicenter study

    NARCIS (Netherlands)

    Miranda, DR; deRijk, A; Schaufeli, W

    Objectives: To validate a simplified version of the Therapeutic Intervention Scoring System, the TISS-28, and to determine the association of TISS-28 with the time spent on scored and nonscored nursing activities. Design: Prospective, multicenter study. Setting: Twenty-two adult medical, surgical,

  2. External validation of a clinical scoring system for the risk of gestational diabetes mellitus

    NARCIS (Netherlands)

    van Leeuwen, M.; Opmeer, B. C.; Zweers, E. J. K.; van Ballegooie, E.; ter Brugge, H. G.; de Valk, H. W.; Visser, G. H. A.; Mol, B. W. J.

    Aim: A prediction rule for gestational diabetes mellitus (GDM) could be helpful in early detection and increased efficiency of screening. A prediction rule by means of a clinical scoring system is available, but has never been validated externally. The aim of this study was to validate the scoring

  3. Oxyradical Stress, Endocannabinoids, and Atherosclerosis

    Directory of Open Access Journals (Sweden)

    Anberitha T. Matthews

    2015-12-01

    Full Text Available Atherosclerosis is responsible for most cardiovascular disease (CVD and is caused by several factors including hypertension, hypercholesterolemia, and chronic inflammation. Oxidants and electrophiles have roles in the pathophysiology of atherosclerosis and the concentrations of these reactive molecules are an important factor in disease initiation and progression. Overactive NADPH oxidase (Nox produces excess superoxide resulting in oxidized macromolecules, which is an important factor in atherogenesis. Although superoxide and reactive oxygen species (ROS have obvious toxic properties, they also have fundamental roles in signaling pathways that enable cells to adapt to stress. In addition to inflammation and ROS, the endocannabinoid system (eCB is also important in atherogenesis. Linkages have been postulated between the eCB system, Nox, oxidative stress, and atherosclerosis. For instance, CB2 receptor-evoked signaling has been shown to upregulate anti-inflammatory and anti-oxidative pathways, whereas CB1 signaling appears to induce opposite effects. The second messenger lipid molecule diacylglycerol is implicated in the regulation of Nox activity and diacylglycerol lipase β (DAGLβ is a key biosynthetic enzyme in the biosynthesis eCB ligand 2-arachidonylglycerol (2-AG. Furthermore, Nrf2 is a vital transcription factor that protects against the cytotoxic effects of both oxidant and electrophile stress. This review will highlight the role of reactive oxygen species (ROS in intracellular signaling and the impact of deregulated ROS-mediated signaling in atherogenesis. In addition, there is also emerging knowledge that the eCB system has an important role in atherogenesis. We will attempt to integrate oxidative stress and the eCB system into a conceptual framework that provides insights into this pathology.

  4. Therapeutic intervention scoring system-28 (TISS-28: diretrizes para aplicação Therapeutic intervention scoring system-28 (tiss-28: directrices para su aplicación Therapeutic intervention scoring system-28 (tiss-28: directions for application

    Directory of Open Access Journals (Sweden)

    Katia Grillo Padilha

    2005-06-01

    Full Text Available O Therapeutic Intervention Scoring System-28 (TISS-28 é um instrumento que permite dimensionar carga de trabalho de enfermagem em Unidade de Terapia Intensiva e estimar gravidade da doença. Apresenta-se nesta publicação as definições operacionais para sua aplicação, proposta por um grupo de especialistas na área, com vistas a uniformizar o significado de cada um dos itens e evitar vieses de interpretação.El Therapeutic Intervention Scoring System-28 (TISS-28 es un instrumento que permite dimensionar carga de trabajo de enfermería en una Unidad de Terapia Intensiva y estimar la gravedad de la enfermedad. Se presenta en esta publicación las definiciones operacionales para su aplicación, propuesta por un grupo de especialistas en el área, con vistas a uniformizar el significado de cada uno de los items y evitar sesgos de interpretación.Therapeutic Intervention Scoring System-28 (TISS-28 is a tool that enables the measurement of the nursing work load in Intensive Care Units and the estimate of how grave the disease is. In this study are presented the operational definitions for its application, proposed by a group of specialists in the area, with the aim of rendering uniform the meaning of each of the items and preventing interpretation biases.

  5. B Cell Subsets in Atherosclerosis

    OpenAIRE

    Perry, Heather M.; Bender, Timothy P.; McNamara, Coleen A.

    2012-01-01

    Atherosclerosis, the underlying cause of heart attacks and strokes, is a chronic inflammatory disease of the artery wall. Immune cells, including lymphocytes modulate atherosclerotic lesion development through interconnected mechanisms. Elegant studies over the past decades have begun to unravel a role for B cells in atherosclerosis. Recent findings provide evidence that B cell effects on atherosclerosis may be subset-dependent. B-1a B cells have been reported to protect from atherosclerosis ...

  6. A comprehensive scoring system in correlation with perioperative airway management for neonatal Pierre Robin Sequence.

    Directory of Open Access Journals (Sweden)

    Ning Yin

    Full Text Available To evaluate a comprehensive scoring system which combines clinical manifestations of Pierre Robin Sequence (PRS including severity of breathing difficulties, body weight and preoperative Cormack-Lehane grade, for its correlation with perioperative PRS airway management decision.Forty PRS children were retrospectively recruited after surgery. Specialists examined all subjects and scored for clinical manifestations (1´ - 4´, weight gain (1´- 4´, dyspnea scores (1´- 4´, and Cormack-Lehane grade (1´- 4´. The correlation of the integrated scores and the necessity of endotracheal intubation or laryngeal mask application were analyzed. In addition, the score correlation with postoperative dyspnea and/or low pulse oxygen saturation (SPO2 levels after extubation was determined.In our study every individual patient had a score from 0´ to 16´, while the higher in the numbers represented higher risk of breathing difficulty. All patients with comprehensive scores 13 points required a laryngeal mask assisted airway management and were considered to have difficult airways. Dyspnea after extubation and postoperative low SPO2 occurred among patients who scored over 10 points.In PRS patients, preoperative weight gaining status and severity of dyspnea in combination with Cormack-Lehane classification provide a scoring system that could help to optimize airway management decisions such as endotracheal intubation or laryngeal mask airway placement and has the potential to predict postoperative dyspnea or low SPO2 levels.

  7. A novel scoring system for predicting adherent placenta in women with placenta previa.

    Science.gov (United States)

    Tanimura, Kenji; Morizane, Mayumi; Deguchi, Masashi; Ebina, Yasuhiko; Tanaka, Utaru; Ueno, Yoshiko; Kitajima, Kazuhiro; Maeda, Tetsuo; Sugimura, Kazuro; Yamada, Hideto

    2018-04-01

    Placenta previa (PP) is one of the most significant risk factors for adherent placenta (AP). The aim of this study was to evaluate the diagnostic efficacy of a novel scoring system for predicting AP in pregnant women with PP. This prospective cohort study enrolled 175 women with PP. The placenta previa with adherent placenta score (PPAP score) is composed of 2 categories: (1) past history of cesarean section (CS), surgical abortion, and/or uterine surgery; and (2) ultrasonography and magnetic resonance imaging findings. Each category is graded as 0, 1, 2, or 4 points, yielding a total score between 0 and 24. When women with PP had PPAP score ≥8, they were considered to be at a high risk for AP and received placement of preoperative internal iliac artery occlusion balloon catheters. If they were found to have AP during CS, they underwent hysterectomy or placenta removal using advanced bipolar with balloon catheter occlusion. The predictive accuracy of PPAP score was evaluated. In total, 23 of the 175 women with PP were diagnosed as having AP, histopathologically or clinically. Twenty-one of 24 women with PPAP score ≥8 had AP, whereas two of 151 women with PPAP score PPAP scoring system may be useful for predicting AP in women with PP. Copyright © 2018 Elsevier Ltd. All rights reserved.

  8. A comprehensive scoring system in correlation with perioperative airway management for neonatal Pierre Robin Sequence.

    Science.gov (United States)

    Yin, Ning; Fang, Lei; Shi, Xiaohua; Huang, Hongqiang; Zhang, Li

    2017-01-01

    To evaluate a comprehensive scoring system which combines clinical manifestations of Pierre Robin Sequence (PRS) including severity of breathing difficulties, body weight and preoperative Cormack-Lehane grade, for its correlation with perioperative PRS airway management decision. Forty PRS children were retrospectively recruited after surgery. Specialists examined all subjects and scored for clinical manifestations (1´ - 4´), weight gain (1´- 4´), dyspnea scores (1´- 4´), and Cormack-Lehane grade (1´- 4´). The correlation of the integrated scores and the necessity of endotracheal intubation or laryngeal mask application were analyzed. In addition, the score correlation with postoperative dyspnea and/or low pulse oxygen saturation (SPO2) levels after extubation was determined. In our study every individual patient had a score from 0´ to 16´, while the higher in the numbers represented higher risk of breathing difficulty. All patients with comprehensive scores 13 points required a laryngeal mask assisted airway management and were considered to have difficult airways. Dyspnea after extubation and postoperative low SPO2 occurred among patients who scored over 10 points. In PRS patients, preoperative weight gaining status and severity of dyspnea in combination with Cormack-Lehane classification provide a scoring system that could help to optimize airway management decisions such as endotracheal intubation or laryngeal mask airway placement and has the potential to predict postoperative dyspnea or low SPO2 levels.

  9. Concept mapping assessment in medical education: a comparison of two scoring systems.

    Science.gov (United States)

    West, Daniel C; Park, Jeanny K; Pomeroy, J Richard; Sandoval, Jonathan

    2002-09-01

    Concept mapping has the potential to measure important aspects of a student's evolving knowledge framework in a way that conventional examinations cannot. This is important because development of an elaborate and well-structured knowledge framework is a critical step toward becoming an expert in a particular field. Little is known about the best way to score concept maps in the setting of medical education. Therefore, as a preliminary step in addressing this question, we compared two different scoring systems for validity: a structural method based on the organization of a map's hierarchical structure and a relational method based, not on structure, but on the quality of each individual map component. A total of 21 paediatric resident doctors completed concept map training, drew a preinstruction concept map about "seizures", completed a seizure education course, and then drew a postinstruction seizure map. Two raters using both structural and relational methods scored each map. Structural scores increased significantly after instruction and were higher in more experienced residents, but relational scores were not significantly different. Interrater scoring reliability for both methods ranged from moderate to strong, but was greater using the relational scoring method. These data suggest that scoring systems for evaluating concept maps in postgraduate medical education may need to account for structural features of maps, if scores are to reflect changes in the developing knowledge frameworks of resident doctors. More research to further evaluate reliability and validity is critical prior to any future use of concept mapping assessment in medical education.

  10. Scoring Systems for Outcome Prediction in a Cardiac Surgical Intensive Care Unit: A Comparative Study.

    Science.gov (United States)

    Exarchopoulos, Themistocles; Charitidou, Efstratia; Dedeilias, Panagiotis; Charitos, Christos; Routsi, Christina

    2015-07-01

    Most scoring systems used to predict clinical outcome in critical care were not designed for application in cardiac surgery patients. To compare the predictive ability of the most widely used scoring systems (Acute Physiology and Chronic Health Evaluation [APACHE] II, Simplified Acute Physiology Score [SAPS] II, and Sequential Organ Failure Assessment [SOFA]) and of 2 specialized systems (European System for Cardiac Operative Risk Evaluation [EuroSCORE] II and the cardiac surgery score [CASUS]) for clinical outcome in patients after cardiac surgery. Consecutive patients admitted to a cardiac surgical intensive care unit (CSICU) were prospectively studied. Data on the preoperative condition, intraoperative parameters, and postoperative course were collected. EuroSCORE II, CASUS, and scores from 3 general severity-scoring systems (APACHE II, SAPS II, and SOFA) were calculated on the first postoperative day. Clinical outcome was defined as 30-day mortality and in-hospital morbidity. A total of 150 patients were included. Thirty-day mortality was 6%. CASUS was superior in outcome prediction, both in relation to discrimination (area under curve, 0.89) and calibration (Brier score = 0.043, χ(2) = 2.2, P = .89), followed by EuroSCORE II for 30-day mortality (area under curve, 0.87) and SOFA for morbidity (Spearman ρ= 0.37 and 0.35 for the CSICU length of stay and duration of mechanical ventilation, respectively; Wilcoxon W = 367.5, P = .03 for probability of readmission to CSICU). CASUS can be recommended as the most reliable and beneficial option for benchmarking and risk stratification in cardiac surgery patients. ©2015 American Association of Critical-Care Nurses.

  11. A new prognostic scoring system for perforation peritonitis secondary to duodenal ulcers

    International Nuclear Information System (INIS)

    Nomani, A.Z.; Qureshi, M.S.

    2014-01-01

    Objective: To identify prognostic factors for perforated duodenal ulcers and to devise and assess a new scoring system. Methods: The observational prospective study was conducted at the Mayo Hospital, Lahore in two phases: from March 2010 to September 2011; and from October 2011 to July 2012. It included patients with duodenal ulcer perforation who were observed for identifying factors predicting 30-day prognosis. Each of the predictive factor was given a score based on its severity to devise a new scoring system. Chi-square was used for univariate analysis. Multivariate analysis was done using forward stepwise regression. Accuracy of the new scoring system was calculated using receiver operating curve analysis and its validity was evaluated in the second phase of the study. Results: Predictors of poor prognosis included multiple gut perforations, size of largest perforation >0.5cm, amount of peritoneal fluid >1000ml, simple closure, development of complications, post-operative systemic septicaemia and winter/autumn season of presentation. Overall 30-day mortality rate was 32.3% (n=32) and morbidity rate was 21.2% (n=21). The mean score was higher in the ones with poor prognosis (p=0.001). Similarly, the mean score was greater in those with grave prognosis (p=0.001). The scoring system had an overall sensitivity of 85.12% and specificity of 80.67% and was favourably comparable to other scoring systems. Conclusion: The new scoring system is a useful tool in predicting 30-day prognosis for perforated duodenal ulcers in acid peptic disease. (author)

  12. Commercial Building Energy Asset Score System: Program Overview and Technical Protocol (Version 1.0)

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Na; Gorrissen, Willy J.

    2013-01-11

    The U.S. Department of Energy (DOE) is developing a national voluntary energy asset score system that includes an energy asset score tool to help building owners evaluate their buildings with respect to the score system. The goal of the energy asset score system is to facilitate cost-effective investment in energy efficiency improvements of commercial buildings. The system will allow building owners and managers to compare their building infrastructure against peers and track building upgrade progress over time. The system can also help other building stakeholders (e.g., building operators, tenants, financiers, and appraisers) understand the relative efficiency of different buildings in a way that is independent from their operations and occupancy. This report outlines the technical protocol used to generate the energy asset score, explains the scoring methodology, and provides additional details regarding the energy asset score tool. This report also describes alternative methods that were considered prior to developing the current approach. Finally, this report describes a few features of the program where alternative approaches are still under evaluation.

  13. Assessment of Mycoplasma hyopneumoniae-induced Pneumonia using Different Lung Lesion Scoring Systems: a Comparative Review.

    Science.gov (United States)

    Garcia-Morante, B; Segalés, J; Fraile, L; Pérez de Rozas, A; Maiti, H; Coll, T; Sibila, M

    2016-01-01

    Mycoplasma hyopneumoniae is the primary aetiological agent of swine enzootic pneumonia (EP) and one of the major contributors to the porcine respiratory disease complex (PRDC). Gross lung lesions in pigs affected by EP consist of cranioventral pulmonary consolidation (CVPC), usually distributed bilaterally in the apical, intermediate, accessory and cranial parts of the diaphragmatic lobes. Several lung scoring methods are currently in place for the evaluation of CVPC. The aims of this study were (1) to review the lung lesion scoring systems used to assess pneumonia associated with M. hyopneumoniae infection, and (2) to evaluate eight of these scoring systems by applying them to the lungs of 76 pigs with experimentally-induced M. hyopneumoniae pneumonia. A significant correlation between all lung lesion scoring systems was observed and the coefficients of determination in a regression analysis were very high between each pair-wise comparison, except for a unique scoring system based on image analysis. A formula of equivalence between lung scoring methods was developed in order to compare the results obtained with these methods. The present review provides a basis for comparison (even retrospectively) of lesions evaluated using different lung scoring systems. Copyright © 2015. Published by Elsevier Ltd.

  14. Breast contrast-enhanced ultrasound: is a scoring system feasible? A preliminary study in China.

    Directory of Open Access Journals (Sweden)

    Xiaoyun Xiao

    Full Text Available Although many studies about breast contrast-enhanced ultrasound had been conducted, clear diagnostic criteria for evaluating enhancement patterns are still lacking. This study aims to identify significant indicators for breast contrast-enhanced ultrasound and to establish an initial scoring system.Totally 839 patients were included in the study. This study was divided into two parts. 364 patients were included in part 1 while 475 in part 2. Conventional ultrasound and contrast-enhanced ultrasound were used to examine each lesion. Only the cases in part 2 were also examined by elastography. In part 1, Logistic regression analysis was performed to predict significant variables. A 5-point scoring system was developed based on the results. In part 2, the scoring system was used to evaluate all the breast lesions. To evaluate the diagnostic efficacy of the new scoring system, it was compared with the system established for elastography and conventional ultrasound (BI-RADS.Three independent variables, namely, lesion scope, margin, and shape were selected in the final step of the logistic regression analysis in part 1. In part 2, the area under the ROC (receiver operating characteristic curve for the contrast-enhanced scoring system was 0.912. The difference in the diagnostic capabilities of the contrast-enhanced scoring system and elastography was not statistically significant (P = 0.17. The difference in the diagnostic capabilities of the contrast-enhanced scoring system and BI-RADS was statistically significant (P<0.001.The contrast-enhanced patterns of benign and malignant breast tumors are different. The application of a 5-point scoring system for contrast-enhanced ultrasound is clinically promising.

  15. Predictive value of Tokuhashi scoring systems in spinal metastases, focusing on various primary tumor groups

    DEFF Research Database (Denmark)

    Wang, Miao; Bünger, Cody Eric; Li, Haisheng

    2012-01-01

    and accuracy rate of the 2 scoring systems were compared in each cancer group. RESULTS: Both the T12 and T15 scoring systems showed statistically significant predictive value when the 448 patients were analyzed in total (T12, P rate was significantly higher in T15 (P...... predictive value in patients with spinal metastases. T15 has a statistically higher accuracy rate than T12. Among the various cancer groups, the 2 scoring systems are especially reliable in prostate and breast metastases groups. T15 is recommended as superior to T12 because of its higher accuracy rate.......STUDY DESIGN: We conducted a prospective cohort study of 448 patients with spinal metastases from a variety of cancer groups. OBJECTIVE: To determine the specific predictive value of the Tokuhashi scoring system (T12) and its revised version (T15) in spinal metastases of various primary tumors...

  16. Primary graft dysfunction; possible evaluation by high resolution computed tomography, and suggestions for a scoring system

    DEFF Research Database (Denmark)

    Belmaati, Esther; Jensen, Claus; Kofoed, Klaus F

    2009-01-01

    and appears to have many morphological features similar to what is found in PGD, and might, therefore, be usefully extrapolated to PGD. Principles of HRCT, scoring systems based on HRCT and various terms describing PGD were reviewed and summarized. The sensitivity, inter-intra observer variability......, and reproducibility of these systems were discussed. Lastly, the future perspectives for 64-multi-slice computed tomography (MSCT) in relation to PGD were discussed. Few studies on scoring systems of lung tissue by HRCT in ARDS patients and idiopathic pulmonary fibrosis (IPF) patients were found. Most studies were...... of minimal influence. Studies have reported on how lung tissue images, derived by HRCT, can be scored and graded. There does not seem to be a golden standard for evaluating these images, which makes comparison between methods challenging. These scoring systems assess the presence, severity, and extent...

  17. Dynamics of change of lipid and monoamine metabolisms and the blood coagulation system during experimental atherosclerosis caused by restriction of movement

    Science.gov (United States)

    Gvishiani, G. S.; Kobakhidze, N. G.

    1980-01-01

    Shifts in lipid, catecholamine, and blood coagulation systems following various periods (1, 2, 3, and 4 months) of experimentally induced atherosclerosis were studied. The same indices were studied in the tissues of the myocardium, liver, and brain stem-reticular formation after decapitation of the animals at the end of the experiment. Periodic motion restriction caused an increase in blood beta-lipoproteins in the rabbits at the beginning of the experiment. An increase in general cholesterol content and a decrease in the lecithincholesterol index were established at the end of the experiment. Myocardial beta-lipoprotein and brain stem reticular formation general cholesterol contents were elevated; catecholamine content was increased at the end of the experiment. In the initial months, free adrenaline basically increased, while in later months blood adrenaline decreased and blood noradrenaline increased.

  18. Cytokines and Immune Responses in Murine Atherosclerosis

    NARCIS (Netherlands)

    Kusters, Pascal J. H.; Lutgens, Esther

    2015-01-01

    Atherosclerosis is an inflammatory disease of the vessel wall characterized by activation of the innate immune system, with macrophages as the main players, as well as the adaptive immune system, characterized by a Th1-dominant immune response. Cytokines play a major role in the initiation and

  19. A Posterior Circulation Ischemia Risk Score System to Assist the Diagnosis of Dizziness.

    Science.gov (United States)

    Chen, Ru; Su, Rui; Deng, Mingzhu; Liu, Jia; Hu, Qing; Song, Zhi

    2018-02-01

    We aimed to establish a risk score system without radio-image examination, which could help clinicians to differentiate patients with vertigo and posterior circulation ischemia (PCI) rapidly from the other dizzy patients. We analyzed 304 patients with vertigo (50% PCI). The attributes with more significant contributions were selected as the risk factors for the PCI risk score system, and every one of them was assigned a value according to their respective odds ratio values. We also compared the respective receiver operating characteristic curves of the 3 diagnostic methods (PCI score system, ABCD 2 , and Essen score systems) to evaluate their prediction effectiveness. Nine risk factors were ultimately selected for PCI score system, including high blood pressure (1'), diabetes mellitus (1'), ischemic stroke (1'), rotating and rocking (-1'), difficulty in speech (5'), tinnitus (-5'), limb and sensory deficit (5'), gait ataxia (1'), and limb ataxia (5'). According to their respective PCI risk scores, the patients were divided into 3 subgroups: low risk (≤0', risk 95.0%). When 0' was selected as a cutoff point for differentiating the patients with PCI from patients without PCI, the sensitivity was 94.1%, with a specificity of 41.4%. The areas under the receiver operator curve value of PCI score system was .82 (P = .000), much higher than the areas under the receiver operator curve value of ABCD 2 (.69, P = .000) and that of the Essen system (.67, P = .000) CONCLUSION: The PCI score system could help clinicians to differentiate patients with vertigo and PCI rapidly from the other dizzy patients. Copyright © 2018 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  20. The development of a preliminary ultrasonographic scoring system for features of hand osteoarthritis.

    LENUS (Irish Health Repository)

    Keen, H I

    2008-05-01

    Painful osteoarthritis (OA) of the hand is common and a validated ultrasound (US) scoring system would be valuable for epidemiological and therapeutic outcome studies. US is increasingly used to assess peripheral joints, though most of the US focus in rheumatic diseases has been on rheumatoid arthritis. We aimed to develop a preliminary US hand OA scoring system, initially focusing on relevant pathological features with potentially high reliability.

  1. Evaluation of a scoring system for assessing prognosis in pediatric acute liver failure.

    Science.gov (United States)

    Lu, Brandy R; Gralla, Jane; Liu, Edwin; Dobyns, Emily L; Narkewicz, Michael R; Sokol, Ronald J

    2008-10-01

    Pediatric acute liver failure (PALF) results in death or need for liver transplantation (LT) in up to 50% of patients. A scoring system for predicting death or LT (Liver Injury Units [LIU] score) in PALF was previously derived by our group, and used peak values during hospital admission of total bilirubin, prothrombin time/international normalized ratio, and ammonia as significant predictors of outcome. The aims of this study were to test the predictive value of the LIU score in a subsequent validation set of patients and to derive a hospital admission LIU (aLIU) score predictive of outcome. Data were obtained from 53 children admitted with PALF from 2002 to 2006. Outcome was defined at 16 weeks as alive without LT, death, or LT. Survival without LT at 16 weeks for each LIU score quartile was 92%, 44%, 60%, and 12%, respectively (P < .001). The receiver operating characteristic C index for predicting death or LT by 4 weeks was 86.3. An admission LIU score was derived using admission total bilirubin and prothrombin time/international normalized ratio. Survival without LT at 16 weeks for each quartile using the aLIU score was 85%, 77%, 69%, and 31% (P = .001). The receiver operating characteristic C index for predicting death or LT by 4 weeks was 83.7. The original LIU score is a valid predictor of outcome in PALF. The aLIU score is promising and needs to be validated in subsequent patients.

  2. Novel pre-therapeutic scoring system using patient and haematological data to predict facial palsy prognosis.

    Science.gov (United States)

    Wasano, K; Ishikawa, T; Kawasaki, T; Yamamoto, S; Tomisato, S; Shinden, S; Minami, S; Wakabayashi, T; Ogawa, K

    2017-12-01

    We describe a novel scoring system, the facial Palsy Prognosis Prediction score (PPP score), which we test for reliability in predicting pre-therapeutic prognosis of facial palsy. We aimed to use readily available patient data that all clinicians have access to before starting treatment. Multicenter case series with chart review. Three tertiary care hospitals. We obtained haematological and demographic data from 468 facial palsy patients who were treated between 2010 and 2014 in three tertiary care hospitals. Patients were categorised as having Bell's palsy or Ramsey Hunt's palsy. We compared the data of recovered and unrecovered patients. PPP scores consisted of combinatorial threshold values of continuous patient data (eg platelet count) and categorical variables (eg gender) that best predicted recovery. We created separate PPP scores for Bell's palsy patients (PPP-B) and for Ramsey Hunt's palsy patients (PPP-H). The PPP-B score included age (≥65 years), gender (male) and neutrophil-to-lymphocyte ratio (≥2.9). The PPP-H score included age (≥50 years), monocyte rate (≥6.0%), mean corpuscular volume (≥95 fl) and platelet count (≤200 000 /μL). Patient recovery rate significantly decreased with increasing PPP scores (both PPP-B and PPP-H) in a step-wise manner. PPP scores (ie PPP-B score and PPP-H score) ≥2 were associated with worse than average prognosis. Palsy Prognosis Prediction scores are useful for predicting prognosis of facial palsy before beginning treatment. © 2017 John Wiley & Sons Ltd.

  3. Phytosterols and atherosclerosis

    DEFF Research Database (Denmark)

    Schrøder, Malene

    can cause regression of already established experimental atherosclerosis in the cholesterol-fed heterozygous WHHL rabbit model. After a 12-week induction period with cholesterol feeding the presence of atherosclerotic lesions in the aorta was confirmed by autopsy in a group of the animals. After...

  4. Non-coronary atherosclerosis.

    Science.gov (United States)

    Gallino, Augusto; Aboyans, Victor; Diehm, Curt; Cosentino, Francesco; Stricker, Hans; Falk, Erling; Schouten, Olaf; Lekakis, John; Amann-Vesti, Beatrice; Siclari, Francesco; Poredos, Pavel; Novo, Salvatore; Brodmann, Marianne; Schulte, Karl-Ludwig; Vlachopoulos, Charalambos; De Caterina, Raffaele; Libby, Peter; Baumgartner, Iris

    2014-05-01

    During the last decades, the clinical and research interest in atherosclerosis has been mostly focused on coronary arteries. After the publications of the European Society Guidelines and AHA/ACC Guidelines on Peripheral artery diseases, and of the Registry REduction in Atherothrombosis for Continued Health Registry, there has been an increased interest in atherosclerosis of the lower extremity arteries and its presence in multifocal disease. However, awareness in the general population and the medical community of non-coronary artery diseases, and of its major prognostic implications remain relatively low. The aim of this general review stemming out of an ESC Working Group on Peripheral Circulation meeting in 2011 is to enhance awareness of this complex disease highlighting the importance of the involvement of atherosclerosis at different levels with respect to clinical presentation, diagnosis, and co-existence of the disease in the distinct arterial territories. We also emphasize the need of an interdisciplinary approach to face the broad and complex spectrum of multifocal disease, and try to propose a series of tentative recommendations and measures to be implemented in non-coronary atherosclerosis.

  5. French adaptation of the new Knee Society Scoring System for total knee arthroplasty.

    Science.gov (United States)

    Debette, C; Parratte, S; Maucort-Boulch, D; Blanc, G; Pauly, V; Lustig, S; Servien, E; Neyret, P; Argenson, J N

    2014-09-01

    In November 2011, the Knee Society published its new KSS score to evaluate objective clinical data and also patient expectations, satisfaction and knee function during various physical activities before and after total knee arthroplasty (TKA). We undertook the French cross-cultural adaptation of this scoring system according to current recommendations. The French version of the new KSS score is a consistent, feasible, reliable and discriminating score. Eighty patients with knee osteoarthritis were recruited from two centers: one group of 40 patients had a TKA indication, while the other group of 40 patients had an indication for conservative treatment. After the new KSS score was translated and back-translated, it was compared to three other validated instruments (KOOS, AMIQUAL and SF-12) to determine construct validity, discriminating power, feasibility in terms of response rate and existence of floor or ceiling effect, internal consistency with Chronbach's alpha and reliability based on reproducibility and sensitivity to change (responsiveness). Due to missing data, two cases were eliminated. We found that the score could discriminate between groups; it had a nearly 100% response rate, a ceiling effect in the "expectations" domain, satisfactory Chronbach's alpha, excellent reproducibility and good responsiveness. These results confirm that the French version of the new KSS score is reliable, feasible, discriminating, consistent and responsive. The novelty of this scoring system resides in the "expectations" and "satisfaction" domains, its availability as a self-assessment questionnaire and the evaluation of function during various activities. Level III. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  6. Visualization of atherosclerosis as detected by coronary artery calcium and carotid intima-media thickness reveals significant atherosclerosis in a cross-sectional study of psoriasis patients in a tertiary care center.

    Science.gov (United States)

    Santilli, S; Kast, D R; Grozdev, I; Cao, L; Feig, R L; Golden, J B; Debanne, S M; Gilkeson, R C; Orringer, C E; McCormick, T S; Ward, N L; Cooper, K D; Korman, N J

    2016-07-22

    Psoriasis is a chronic inflammatory disease of the skin and joints that may also have systemic inflammatory effects, including the development of cardiovascular disease (CVD). Multiple epidemiologic studies have demonstrated increased rates of CVD in psoriasis patients, although a causal link has not been established. A growing body of evidence suggests that sub-clinical systemic inflammation may develop in psoriasis patients, even from a young age. We aimed to evaluate the prevalence of atherosclerosis and identify specific clinical risk factors associated with early vascular inflammation. We conducted a cross-sectional study of a tertiary care cohort of psoriasis patients using coronary artery calcium (CAC) score and carotid intima-media thickness (CIMT) to detect atherosclerosis, along with high sensitivity C-reactive protein (hsCRP) to measure inflammation. Psoriasis patients and controls were recruited from our tertiary care dermatology clinic. Presence of atherosclerosis was defined using validated numeric values within CAC and CIMT imaging. Descriptive data comparing groups was analyzed using Welch's t test and Pearson Chi square tests. Logistic regression was used to analyze clinical factors associated with atherosclerosis, and linear regression to evaluate the relationship between psoriasis and hsCRP. 296 patients were enrolled, with 283 (207 psoriatic and 76 controls) having all data for the hsCRP and atherosclerosis analysis. Atherosclerosis was found in 67.6 % of psoriasis subjects versus 52.6 % of controls; Psoriasis patients were found to have a 2.67-fold higher odds of having atherosclerosis compared to controls [95 % CI (1.2, 5.92); p = 0.016], after adjusting for age, gender, race, BMI, smoking, HDL and hsCRP. In addition, a non-significant trend was found between HsCRP and psoriasis severity, as measured by PASI, PGA, or BSA, again after adjusting for confounders. A tertiary care cohort of psoriasis patients have a high prevalence of early

  7. Validation of the computed assessment of cleansing score with the Mirocam® system

    Directory of Open Access Journals (Sweden)

    Ana Ponte

    Full Text Available Background and aims: A computed assessment of cleansing (CAC score was developed to objectively evaluate small-bowel cleansing in the PillCam capsule endoscopy (CE system and to overcome the subjectivity and complexity of previous scoring systems. Our study aimed to adapt the CAC score to the Mirocam® system, evaluate its reliability with the Mirocam® CE system and compare it with three validated subjective grading scales. Patients and methods: Thirty CE were prospectively and independently reviewed by two authors who classified the degree of small-bowel cleanliness according to a quantitative index, a qualitative evaluation and an overall adequacy assessment. The authors were blinded for the CAC score of each CE, which was calculated as ([mean intensity of the red channel]/[mean intensity of the green channel] - 1 x 10. The mean intensities of the red and green channels of the small-bowel segment of the "Map View" bar in the Miroview Client® were determined using the histogram option of two photo-editing software. Results: There was a strong agreement between both CE readers for each of the three subjective scales used. The reproducibility of the CAC score was excellent and identical results were obtained with the two photo-editing software. Regarding the comparison between the CAC score and the subjective scales, there was a moderate-to-good agreement with the quantitative index, qualitative evaluation and overall adequacy assessment. Conclusions: CAC score represents an objective and feasible score in the assessment of small-bowel cleansing in the Mirocam® CE system, and could be used per se or as part of a more comprehensive score.

  8. The Use of the OMERACT Ultrasound Tenosynovitis Scoring System in Multicenter Clinical Trials.

    Science.gov (United States)

    Ammitzbøll-Danielsen, Mads; Østergaard, Mikkel; Naredo, Esperanza; Iagnocco, Annamaria; Möller, Ingrid; D'Agostino, Maria-Antonietta; Gandjbakhch, Frédérique; Terslev, Lene

    2018-02-01

    To test the sensitivity to change of the Outcome Measures in Rheumatology Clinical Trials (OMERACT) ultrasound (US) scoring system for tenosynovitis when applied in a multicenter design. RA patients with US-verified tenosynovitis were recruited when scheduled for treatment intensification. Tenosynovitis was assessed at baseline, and 3 and 6 months followup, using the semiquantitative OMERACT scoring system. Expressed in median (25th; 75th percentiles), the overall greyscale and Doppler score decreased significantly from baseline at 4 (2; 7) and 3 (2; 6), to 6 months at 2 (0; 3) and 0 (0; 1, p The OMERACT US scoring system for tenosynovitis showed high responsiveness, supporting its use for diagnosing and monitoring tenosynovitis in multicenter trials.

  9. Are scoring systems sufficient for predicting mortality due to sepsis in the emergency department?

    Directory of Open Access Journals (Sweden)

    Merve Gunes Ozaydin

    2017-03-01

    Full Text Available Objectives: Scoring systems have been used to risk stratify in intensive care units (ICU, but not routinely used in emergency departments. The aim of this study was to determine accuracy for predicting mortality in emergency medicine with Sequential Organ Failure Assessment (SOFA, Mortality in ED Sepsis (MEDS score and Simplified Acute Physiology Score (SAPSII. Methods: This is a prospective observational study. Patients presenting with evidence of sepsis were all included. SAPSII, MEDS, and SOFA scores were calculated. Analysis compared areas under the receiver operator characteristic (ROC curves for 28-day mortality. Results: Two hundred patients were included; consisting of 31 (14.3% septic shock. 138 (69% severe sepsis and 31 (15.5% infection without organ dysfunction. 53 (26.5% patients died within 28 days.Area under the ROC curve for mortality was 0.76 for MEDS (0.69–0.82, 0.70 for SAPSII (0.62–0.78; and 1.68 for SOFA (0.60–0.76 scores. Pair wise comparison of AUC between MEDS, SAPSII, SOFA and Lactate were not significant. Conclusion: According to our results; SOFA, SAPSII and MEDS were not sufficient to predict mortality. Also this result, MEDS was better than other scoring system. Keywords: Sepsis, Septic shock, Scoring systems, SOFA, SAPSII, MEDS, Lactate, Emergency medicine

  10. [Different scoring systems to evaluate the prognosis of Fournier's gangrene: A comparative study].

    Science.gov (United States)

    Zhu, Xiao-dong; Ding, Fei; Wang, Guo-dong; Shao, Qiang

    2015-08-01

    To sum up the experience in diagnosis and treatment of Fournier's gangrene and find an optimal evaluation tool for its prognosis by comparing currently used prognostic scoring systems. We retrospectively analyzed 16 cases of Fournier's gangrene diagnosed and surgically treated in our hospital between 2004 and 2012. Using Fournier's Gangrene Severity Index (FGSI), Uludag Fournier's Gangrene Severity Index (UFGSI), Age-Adjusted Charlson Comorbidity Index (ACCI), and Surgical Apgar Score (sAPGAR) , we obtained the prognostic scores of the patients and made comparisons among different scoring systems. FGSI, UFGSI, ACCI, and sAPGAR were all clinically used scoring systems. Statistically significant differences were found in the scores of ACCI and UFGSI but not in those of FGSI and sAPGAR between the death and survival groups, with the maximum area under the ROC curve and minimum standard error for the ACCI score. Both ACCI and UFGSI are useful for evaluating the prognosis of Fournier's gangrene. However, ACCI is even better for its higher sensitivity and specificity and easier clinical collection.

  11. MRI-based radiologic scoring system for extent of brain injury in children with hemiplegia.

    Science.gov (United States)

    Shiran, S I; Weinstein, M; Sirota-Cohen, C; Myers, V; Ben Bashat, D; Fattal-Valevski, A; Green, D; Schertz, M

    2014-12-01

    Brain MR imaging is recommended in children with cerebral palsy. Descriptions of MR imaging findings lack uniformity, due to the absence of a validated quantitative approach. We developed a quantitative scoring method for brain injury based on anatomic MR imaging and examined the reliability and validity in correlation to motor function in children with hemiplegia. Twenty-seven children with hemiplegia underwent MR imaging (T1, T2-weighted sequences, DTI) and motor assessment (Manual Ability Classification System, Gross Motor Functional Classification System, Assisting Hand Assessment, Jebsen Taylor Test of Hand Function, and Children's Hand Experience Questionnaire). A scoring system devised in our center was applied to all scans. Radiologic score covered 4 domains: number of affected lobes, volume and type of white matter injury, extent of gray matter damage, and major white matter tract injury. Inter- and intrarater reliability was evaluated and the relationship between radiologic score and motor assessments determined. Mean total radiologic score was 11.3 ± 4.5 (range 4-18). Good inter- (ρ = 0.909, P classification systems (ρ = 0.708, P high inter- and intrarater reliability and significant associations with manual ability classification systems and motor evaluations. This score provides a standardized radiologic assessment of brain injury extent in hemiplegic patients with predominantly unilateral injury, allowing comparison between groups, and providing an additional tool for counseling families. © 2014 by American Journal of Neuroradiology.

  12. Oral microbiota in patients with atherosclerosis

    DEFF Research Database (Denmark)

    Fåk, Frida; Tremaroli, Valentina; Bergström, Göran

    2015-01-01

    to increase the systemic inflammatory level of the host, which may in turn influence plaque composition and rupture. We previously showed that bacteria from the oral cavity and the gut could be found in atherosclerotic plaques. METHODS: To elucidate whether the oral microbiota composition differed between...... that Parvimonas associated positively with uCRP and Capnocytophaga, Catonella and Lactobacillus associated with blood lipid markers. In conclusion, abundance of Anaeroglobus in the oral cavity could be associated with symptomatic atherosclerosis....... patients with asymptomatic and symptomatic atherosclerosis we performed pyrosequencing of the oral microbiota of 92 individuals including patients with asymptomatic and symptomatic atherosclerosis and control individuals without carotid plaques or previous stroke or myocardial infarction. RESULTS...

  13. The OMERACT psoriatic arthritis magnetic resonance imaging scoring system (PsAMRIS): definitions of key pathologies, suggested MRI sequences, and preliminary scoring system for PsA Hands

    DEFF Research Database (Denmark)

    Østergaard, Mikkel; McQueen, Fiona; Wiell, Charlotte

    2009-01-01

    This article describes a preliminary OMERACT psoriatic arthritis magnetic resonance image scoring system (PsAMRIS) for evaluation of inflammatory and destructive changes in PsA hands, which was developed by the international OMERACT MRI in inflammatory arthritis group. MRI definitions of important...... pathologies in peripheral PsA and suggestions concerning appropriate MRI sequences for use in PsA hands are also provided....

  14. Can Procalcitonin Add to the Prognostic Power of the Severity Scoring System in Adults with Pneumonia?

    Science.gov (United States)

    Naderi, HamidReza; Sheybani, Fereshte; Sarvghad, MohammadReza; Nooghabi, Mehdi Jabbari

    2015-01-01

    The first decision confronting clinicians in the management of patients with community acquired pneumonia (CAP) is whether the patient is to be hospitalized or not. We sought to validate the pneumonia scoring system and assess the power of procalcitonin (PCT) level to predict in-hospital mortality (IHM) and intensive vasopressor and respiratory support (IVRS) requirements in patients with CAP. A total of 120 patients with CAP were evaluated for severity of illness based on the defined scoring systems including pneumonia severity index (PSI), confusion, urea, respiratory rate, blood pressure, age>65 (CURB-65), confusion, respiratory rate, blood pressure, age>65 (CRB-65), infectious diseases society of America/American thoracic society 2007 criteria (IDSA/ATS 2007) and systolic blood pressure, multilobar infiltrate, albumin, respiratory rate, tachycardia, confusion, low oxygen, low pH (SMART-COP). Demographic, clinical, laboratory and radiographic data were collected prospectively. The accuracy of each scoring system in predicting IVRS requirement and IHM was assessed from the area under the receiver operating characteristic (ROC) curve (AUC). Level of PCT was determined by semi-quantitative PCT-Q method (BRAHMS). The accuracy of the defined scoring systems, PCT levels and each scoring system plus PCT levels in prediction of IHM and IVRS requirement was analyzed. The accuracy of PCT levels in predicting IHM and IVRS requirement based on AUC was 0.542 and 0.658, respectively and the best threshold was ≥ 2ng/mL for both of them. Adding the level of procalcitonin to different scoring systems (based on the defined scoring systems) improved the accuracy of all systems. We do not suggest using the PCT level alone as a predictor for mortality and IVRS requirement. Instead, we suggest PSI plus PCT and IDSA/ATS 2007 plus PCT as accurate predictors for IHM and SMART-COP plus PCT for IVRS requirement in patients who presented with CAP.

  15. Total hip arthroplasty outcomes assessment using functional and radiographic scores to compare canine systems.

    Science.gov (United States)

    Iwata, D; Broun, H C; Black, A P; Preston, C A; Anderson, G I

    2008-01-01

    A retrospective multi-centre study was carried out in order to compare outcomes between cemented and uncemented total hip arthoplasties (THA). A quantitative orthopaedic outcome assessment scoring system was devised in order to relate functional outcome to a numerical score, to allow comparison between treatments and amongst centres. The system combined a radiographic score and a clinical score. Lower scores reflect better outcomes than higher scores. Consecutive cases of THA were included from two specialist practices between July 2002 and December 2005. The study included 46 THA patients (22 uncemented THA followed for 8.3 +/- 4.7M and 24 cemented THA for 26.0 +/- 15.7M) with a mean age of 4.4 +/- 3.3 years at surgery. Multi-variable linear and logistical regression analyses were performed with adjustments for age at surgery, surgeon, follow-up time, uni- versus bilateral disease, gender and body weight. The differences between treatment groups in terms of functional scores or total scores were not significant (p > 0.05). Radiographic scores were different between treatment groups. However, these scores were usually assessed within two months of surgery and proved unreliable predictors of functional outcome (p > 0.05). The findings reflect relatively short-term follow-up, especially for the uncemented group, and do not include clinician-derived measures, such as goniometry and thigh circumference. Longer-term follow-up for the radiographic assessments is essential. A prospective study including the clinician-derived outcomes needs to be performed in order to validate the outcome instrument in its modified form.

  16. Risk scoring systems for adults admitted to the emergency department: a systematic review

    DEFF Research Database (Denmark)

    Brabrand, Mikkel; Folkestad, Lars; Clausen, Nicola Groes

    2010-01-01

    . Even though most scoring systems are not meant to be used on an individual level, they can support the more inexperienced doctors and nurses in assessing the risk of deterioration of their patients. We therefore performed a systematic review on the level of evidence of literature on scoring systems...... developed or validated in the MAU. We hypothesized that existing scoring systems would have a low level of evidence and only few systems would have been externally validated. METHODS: We conducted a systematic search using Medline, EMBASE and the Cochrane Library, according to the PRISMA guidelines...... between observed and predicted outcome (calibration) along with the method of derivation and validation (application on a new cohort) were extracted. RESULTS: We identified 1,655 articles. Thirty were selected for further review and 10 were included in this review. Eight systems used vital signs...

  17. Prediction of 18-month survival in patients with primary myelodysplastic syndrome. A regression model and scoring system based on the combination of chromosome findings and the Bournemouth score.

    Science.gov (United States)

    Parlier, V; van Melle, G; Beris, P; Schmidt, P M; Tobler, A; Haller, E; Bellomo, M J

    1995-06-01

    The predictive potential of six selected factors was assessed in 72 patients with primary myelodysplastic syndrome using univariate and multivariate logistic regression analysis of survival at 18 months. Factors were age (above median of 69 years), dysplastic features in the three myeloid bone marrow cell lineages, presence of chromosome defects, all metaphases abnormal, double or complex chromosome defects (C23), and a Bournemouth score of 2, 3, or 4 (B234). In the multivariate approach, B234 and C23 proved to be significantly associated with a reduction in the survival probability. The similarity of the regression coefficients associated with these two factors means that they have about the same weight. Consequently, the model was simplified by counting the number of factors (0, 1, or 2) present in each patient, thus generating a scoring system called the Lausanne-Bournemouth score (LB score). The LB score combines the well-recognized and easy-to-use Bournemouth score (B score) with the chromosome defect complexity, C23 constituting an additional indicator of patient outcome. The predicted risk of death within 18 months calculated from the model is as follows: 7.1% (confidence interval: 1.7-24.8) for patients with an LB score of 0, 60.1% (44.7-73.8) for an LB score of 1, and 96.8% (84.5-99.4) for an LB score of 2. The scoring system presented here has several interesting features. The LB score may improve the predictive value of the B score, as it is able to recognize two prognostic groups in the intermediate risk category of patients with B scores of 2 or 3. It has also the ability to identify two distinct prognostic subclasses among RAEB and possibly CMML patients. In addition to its above-described usefulness in the prognostic evaluation, the LB score may bring new insights into the understanding of evolution patterns in MDS. We used the combination of the B score and chromosome complexity to define four classes which may be considered four possible states of

  18. Placenta previa, anemia, care in antenatal, employment score: Development of a scoring system to predict low birth weight in underserved area in Indonesia

    OpenAIRE

    Lumbanraja, Sarma Nursani

    2016-01-01

    Background: Early intervention of low birth weight (LBW) should reduce maternal and fetal morbidity. In underserved areas, with inadequacy of health technologies, it was very important to develop a simple scoring system based on the LBW risk factors. Aims and Objective: The aim of this study is to develop a scoring system to predict LBW in underserved area. Materials and Methods: This case–control study enrolled total of women with a singleton LBW in Padang Sidempuan General Hospi...

  19. The performance quality rating scale (PQRS): reliability, convergent validity, and internal responsiveness for two scoring systems.

    Science.gov (United States)

    Martini, Rose; Rios, Jorge; Polatajko, Helene; Wolf, Timothy; McEwen, Sara

    2015-01-01

    The performance quality rating scale (PQRS) is an observational measure of performance quality of client-selected, personally meaningful activities. It has been used inconsistently with different scoring systems, and there have been no formal publications on its psychometric properties. The purpose of this study was to test and compare the psychometric properties of two PQRS scoring systems in two populations. A secondary analysis of video recorded participant-selected activities from previous studies involving either adults living with stroke or children diagnosed with developmental coordination disorder (DCD) was conducted. Three pairs of raters scored the video recorded performances with PQRS operational definitions (PQRS-OD) and a generic rating system (PQRS-G). For inter-rater reliability, PQRS-OD ICCs were substantial, ranging from 0.83 to 0.93; while the PQRS-G ICCs were moderate, ranging from 0.71 to 0.77. Test-retest reliability was substantial, >0.80 (ICC), for both rating systems across all rater pairs. Internal responsiveness was high for both rating systems. Convergent validity with the Canadian Occupational Performance Measure (COPM) was inconsistent, with scores ranging from low to moderate. Both scoring systems have demonstrated they are reliable and have good internal responsiveness. The PQRS-OD demonstrated greater consistency across raters and is more sensitive to clinically important change than the PQRS-G and should be used when greater accuracy is required. Further exploration of validity with actual rather than perceived performance measures is required.

  20. The association of ABO blood groups with extent of coronary atherosclerosis in Croatian patients suffering from chronic coronary artery disease.

    Science.gov (United States)

    Karabuva, Svjetlana; Carević, Vedran; Radić, Mislav; Fabijanić, Damir

    2013-01-01

    The aim of study was to: 1) examine the relationship between ABO blood groups and extent of coronary atherosclerosis in patients with chronic coronary artery disease (CAD), 2) compare ABO blood groups distribution in CAD patients and general population, 3) examine possible differences in traditional risk factors frequency in CAD patients with different ABO blood groups. In the 646 chronic CAD patients (72.4% males) coronary angiograms were scored by quantitative assessment using multiple angiographic scoring system, Traditional risk factors were self reported or measured by standard methods. ABO blood distribution of patients was compared with group of 651 healthy blood donors (74.6% males). Among all ABO blood group patients there was no significant difference between the extent of coronary atherosclerosis with regard to all the three scoring systems: number of affected coronary arteries (P = 0.857), Gensini score (P = 0.818), and number of segments narrowed > 50% (P = 0.781). There was no significant difference in ABO blood group distribution between CAD patients and healthy blood donors. Among CAD patients, men with blood group AB were significantly younger than their pairs with non-AB blood groups (P = 0.008). Among CAD patients with AB blood group, males groups (P = 0.003). No association between ABO blood groups and the extent of coronary atherosclerosis in Croatian CAD patients is observed. Observation that AB blood group might possibly identify Croatian males at risk to develop the premature CAD has to be tested in larger cohort of patients.

  1. Validating severity of illness scoring systems in the prediction of outcomes in Staphylococcus aureus bacteremia.

    Science.gov (United States)

    Sharma, Mamta; Szpunar, Susan; Khatib, Riad

    2013-08-01

    Severity of illness scores are helpful in predicting mortality; however, no standardized scoring system has been validated in patients with Staphylococcus aureus bacteremia (SAB). The modified Rapid Emergency Medicine Score (REMS), the CURB-65 (confusion, urea, respiratory rate, blood pressure and age 65) and the Charlson weighted index of comorbidity (CWIC) were compared in predicting outcomes at the onset of SAB. All adult inpatients with SAB from July 15, 2008, to December 31, 2009, were prospectively assessed. The 3 scoring systems were applied: REMS, CURB-65 and CWIC. The end points were attributable and overall mortality. A total of 241 patients with SAB were reviewed during the study period. The all-cause mortality rate was 22.8% and attributable mortality 14.1%. Patients who died had higher mean CURB-65 score and REMS than those who lived, whereas the difference in the CWIC score was not significant. Two logistic regression models based on CURB-65 score or REMS, after controlling for CWIC, revealed that both scores were independent predictors of mortality, with an odds ratio of 3.38 (P < 0.0001) and 1.45 (P < 0.0001) for CURB-65 and REMS, respectively. Receiver operating characteristic analysis revealed that a cutoff point of 3.0 (CURB-65) and 6.0 (REMS) provided the highest sensitivity and specificity. The area under the curves for all-cause mortality were 0.832 and 0.806, and for attributable mortality 0.845 and 0.819, for CURB-65 and REMS, respectively. REMS and CURB-65 scores outperformed CWIC as predictors of mortality in SAB and may be effective in predicting the severity of illness at the onset of bacteremia.

  2. Elite athletes' sensitivity to context: the case of a change in scoring system in table tennis.

    Science.gov (United States)

    Sève, Carole

    2004-12-01

    3 elite table tennis players' streams of actions during international matches were compared under the old scoring system (3 winning sets of 21 points) and the new (4 winning sets of 11 points). The organization of actions changed under the new system, with the relative duration of exploration activity becoming shorter than that of execution activity. These results indicate that elite performance in table tennis is characterized by the athletes' close attunement to elements of context--in this case, the scoring system--for the organization of their actions.

  3. Validation of a Simple Scoring System to Predict Sorafenib Effectiveness in Patients with Hepatocellular Carcinoma.

    Science.gov (United States)

    Di Costanzo, Giovan Giuseppe; Casadei Gardini, Andrea; Marisi, Giorgia; Foschi, Francesco Giuseppe; Scartozzi, Mario; Granata, Rocco; Faloppi, Luca; Cascinu, Stefano; Silvestris, Nicola; Brunetti, Oronzo; Palmieri, Vincenzo Ostilio; Ercolani, Giorgio; Tortora, Raffaella

    2017-12-01

    Sorafenib is recommended for the treatment of advanced-stage hepatocellular carcinoma (HCC). Nonetheless, it is expensive, effective in few patients, and may cause significant adverse effects. Therefore, accurate selection of patients is needed. In a previous study, we constructed a simple scoring system to predict patients' outcomes based on the occurrence of sorafenib adverse effects. The present study aimed to validate this scoring system in a real-life cohort of HCC patients. Clinical records of 279 outpatients treated with sorafenib in eight Italian centers were retrospectively analyzed. Adverse effects considered to calculate the score were skin toxicity, diarrhea, and arterial hypertension, occurring during the first month of therapy. For each adverse effect, 1 point was assigned if present; and 0 points if absent (resulting in a total score between 0 and 3). Median overall survival (OS) was 10.8 months and median time to progression (TTP) was 5.1 months. At multivariate analysis, performance status, α-fetoprotein (AFP), and Child-Pugh score were independently associated with TTP and OS. A progressive increase of OS and TTP was observed in patients with scores from 0 to 3 (p < 0.001). Six-, 12-, and 24-month survival probabilities were 55.1, 24.5, and 7.9% in score 0 patients, and 100, 80.9, and 46.2% in score 3 patients, respectively. Complete response was observed in one patient (0.4%), partial responses in 41 (15.2%), and stable disease in 117 (43.5%). The disease control rate in patients with scores of 0, 1, 2, and 3 was 34.3, 51.6, 80.9, and 96.3%, respectively (p < 0.001). Complete or partial responses were not observed in score 0 patients. We have validated a useful scoring system to predict outcomes in sorafenib-treated HCC patients. This score is easy to calculate and suitable for implementation in daily clinical practice.

  4. The Use of a Scoring System to Guide Thromboprophylaxis in a High-Risk Pregnant Population

    Directory of Open Access Journals (Sweden)

    D. Schoenbeck

    2011-01-01

    Full Text Available Guidelines for thromboprophylaxis in pregnancy are usually based upon clinical observations and expert opinion. For optimal impact, their use must be attended by consistency in the advice given to women. In this observational study, we evaluated the performance of a scoring system, used as a guide for clinicians administering dalteparin to pregnant women at increased risk of venous thromboembolism. The work included 47 women treated with dalteparin prior to adoption of the scoring system and 58 women treated with dalteparin after its adoption. The indication for thromboprophylaxis was recorded in each case together with details of the regimen employed, obstetric, and haematological outcomes. The main outcome measure was to determine whether consistency improved after adoption of the scoring system. We also recorded the occurrence of any new venous thromboembolism, haemorrhage, the use of regional anaesthesia during labour, evidence of allergy, and thrombocytopenia. We found that use of the scoring system improved the consistency of advice and increased the mean duration of thromboprophylaxis. None of the subjects suffered venous thromboembolism after assessment using the scoring system. There was no increase in obstetric or anaesthetic morbidity when dalteparin was given antenatally period and no evidence of heparin-induced thrombocytopenia.

  5. Validity and Internal Consistency of the New Knee Society Knee Scoring System.

    Science.gov (United States)

    Culliton, Sharon E; Bryant, Dianne M; MacDonald, Steven J; Hibbert, Kathryn M; Chesworth, Bert M

    2018-01-01

    In 2012, a new Knee Society Knee Scoring System (KSS) was developed and validated to address the needs for a scoring system that better encompasses the expectations, satisfaction, and physical involvement of a younger, more active population of patients undergoing TKA. Revalidating this tool in a separate population by individuals other than the developers of the scoring system seems important, because such replication would tend to confirm the generalizability of this tool. The purposes of this study were (1) to validate the KSS using a separate sample of patients undergoing primary TKA; and (2) to evaluate the internal consistency of the KSS. Intervention and control groups from a randomized controlled trial with no between-group differences were pooled. Preoperative and postoperative (6 weeks and 1 year) data were used. Patients with osteoarthritis undergoing primary TKA completed the patient-reported component of the KSS, Knee Injury and Osteoarthritis Outcome Score (KOOS), SF-12, two independent questions about expectations of surgery, and the Patient Acceptable Symptom State (PASS) single-question outcome. This study included 345 patients with 221 (64%) women, an average (SD) age of 64 (8.6) years, a mean (SD) body mass index of 32.9 (7.5) kg/m, and 225 (68%) having their first primary TKA. Loss to followup in the control group was 18% and loss to followup in the intervention group was 13%. We quantified cross-sectional (preoperative scores) and longitudinal validity (pre- to postoperative change scores) by evaluating associations between the KSS and KOOS subscales using Spearman's correlation coefficient. Preoperative known-group validity of the KSS symptoms and functional activity score was evaluated with a one-way analysis of variance across three levels of physical health status using the SF-12 Physical Component Score. Known-group validity of the KSS expectation score was evaluated with an unpaired t-test by comparing means across known expectation

  6. Chronic rhinosinusitis, endothelial dysfunction, and atherosclerosis.

    Science.gov (United States)

    Elcioglu, Omer Celal; Afsar, Baris; Bakan, Ali; Takir, Mumtaz; Ozkok, Abdullah; Oral, Alihan; Kostek, Osman; Basci, Semih; Kanbay, Asiye; Toprak, Aybala Erek; Bahat, Kubra Aydin; Kalcioglu, M Tayyar; Kanbay, Mehmet

    2016-05-01

    Chronic inflammation is associated with accelerated atherosclerosis, endothelial dysfunction (ED), and cardiovascular diseases. Because chronic rhinosinusitis (CRS) is an inflammatory disease, it may be associated with the development of ED and accelerated atherosclerosis. To investigate the relationship between CRS and carotid intima-media thickness (CIMT), flow-mediated dilation (FMD) of the brachial artery, and microalbuminuria. This cross-sectional study included 38 patients with CRS and 29 healthy controls. In addition to measuring spot urine albumin-creatinine ratios, FMD of the brachial artery and CIMT were assessed noninvasively. Patients with CRS had lower FMD scores (p = 0.031), higher CIMT scores (p = 0.005), and a higher urinary albumin-creatinine ratio (p = 0.036) compared with healthy controls. In a multivariate analysis, CIMT and FMD were independently associated with the presence of CRS. However, the relationship between urinary albumin and creatinine, and the presence of CRS was no longer observed. CRS is associated with ED and atherosclerosis, as indicated by decreased FMD and increased CIMT in patients with CRS. Further studies are necessary to identify the exact pathophysiologic mechanisms responsible for our findings.

  7. 76 FR 10047 - Changes to the Public Housing Assessment System (PHAS): Financial Condition Scoring Notice

    Science.gov (United States)

    2011-02-23

    ... accepted accounting principles (GAAP)-based financial information. This notice updates and clarifies the... Housing Assessment System (PHAS): Financial Condition Scoring Notice AGENCY: Office of the Assistant... under the financial condition indicator of the Public Housing Assessment System (PHAS). This notice...

  8. Genetic Susceptibility to Atherosclerosis

    Directory of Open Access Journals (Sweden)

    Sanja Kovacic

    2012-01-01

    Full Text Available Atherosclerosis is a complex multifocal arterial disease involving interactions of multiple genetic and environmental factors. Advances in techniques of molecular genetics have revealed that genetic ground significantly influences susceptibility to atherosclerotic vascular diseases. Besides further investigations of monogenetic diseases, candidate genes, genetic polymorphisms, and susceptibility loci associated with atherosclerotic diseases have been identified in recent years, and their number is rapidly increasing. This paper discusses main genetic investigations fields associated with human atherosclerotic vascular diseases. The paper concludes with a discussion of the directions and implications of future genetic research in arteriosclerosis with an emphasis on prospective prediction from an early age of individuals who are predisposed to develop premature atherosclerosis as well as to facilitate the discovery of novel drug targets.

  9. A simple prognostic scoring system for patients receiving transarterial embolisation for hepatocellular cancer.

    Science.gov (United States)

    Kadalayil, L; Benini, R; Pallan, L; O'Beirne, J; Marelli, L; Yu, D; Hackshaw, A; Fox, R; Johnson, P; Burroughs, A K; Palmer, D H; Meyer, T

    2013-10-01

    The prognosis for patients with hepatocellular cancer (HCC) undergoing transarterial therapy (TACE/TAE) is variable. We carried out Cox regression analysis of prognostic factors using a training dataset of 114 patients treated with TACE/TAE. A simple prognostic score (PS) was developed, validated using an independent dataset of 167 patients and compared with Child-Pugh, CLIP, Okuda, Barcelona Clinic Liver Cancer (BCLC) and MELD. Low albumin, high bilirubin or α-fetoprotein (AFP) and large tumour size were associated with a two- to threefold increase in the risk of death. Patients were assigned one point if albumin 17 μmol/l, AFP >400 ng/ml or size of dominant tumour >7 cm. The Hepatoma arterial-embolisation prognostic (HAP) score was calculated by summing these points. Patients were divided into four risk groups based on their HAP scores; HAP A, B, C and D (scores 0, 1, 2 and >2, respectively). The median survival for the groups A, B, C and D was 27.6, 18.5, 9.0 and 3.6 months, respectively. The HAP score validated well with the independent dataset and performed better than other scoring systems in differentiating high- and low-risk groups. The HAP score predicts outcomes in patients with HCC undergoing TACE/TAE and may help guide treatment selection, allow stratification in clinical trials and facilitate meaningful comparisons across reported series.

  10. Timely diagnosis of dairy calf respiratory disease using a standardized scoring system.

    Science.gov (United States)

    McGuirk, Sheila M; Peek, Simon F

    2014-12-01

    Respiratory disease of young dairy calves is a significant cause of morbidity, mortality, economic loss, and animal welfare concern but there is no gold standard diagnostic test for antemortem diagnosis. Clinical signs typically used to make a diagnosis of respiratory disease of calves are fever, cough, ocular or nasal discharge, abnormal breathing, and auscultation of abnormal lung sounds. Unfortunately, routine screening of calves for respiratory disease on the farm is rarely performed and until more comprehensive, practical and affordable respiratory disease-screening tools such as accelerometers, pedometers, appetite monitors, feed consumption detection systems, remote temperature recording devices, radiant heat detectors, electronic stethoscopes, and thoracic ultrasound are validated, timely diagnosis of respiratory disease can be facilitated using a standardized scoring system. We have developed a scoring system that attributes severity scores to each of four clinical parameters; rectal temperature, cough, nasal discharge, ocular discharge or ear position. A total respiratory score of five points or higher (provided that at least two abnormal parameters are observed) can be used to distinguish affected from unaffected calves. This can be applied as a screening tool twice-weekly to identify pre-weaned calves with respiratory disease thereby facilitating early detection. Coupled with effective treatment protocols, this scoring system will reduce post-weaning pneumonia, chronic pneumonia, and otitis media.

  11. Validation of the Ectasia Risk Score System for Preoperative Laser in Situ Keratomileusis Screening

    Science.gov (United States)

    Randleman, J. Bradley; Trattler, William B.; Stulting, R. Doyle

    2013-01-01

    Purpose To validate the Ectasia Risk Score System for identifying patients at high risk for developing ectasia after laser in situ keratomileusis (LASIK).. Design Retrospective case-control study Methods Fifty eyes that developed ectasia and 50 control eyes with normal postoperative courses after LASIK were analyzed and compared using the previously described Ectasia Risk Score System, which assigns points in a weighted fashion to the following variables: topographic patter, predicted residual stromal bed thickness (RSB), age, preoperative corneal thickness (CT), and manifest refraction spherical equivalent (MRSE). Results In this series 92% of eyes with ectasia were correctly classified as being at high risk for the development of ectasia, while 6% of controls were incorrectly classified as being at high risk for ectasia. (pectasia risk score than by traditional screening parameters relying on abnormal topography or residual stromal bed thickness less than 250 μ (92% vs. 50%, p Ectasia Risk Score System in the population from which it was derived and this independent population of ectasia cases and controls. Conclusion The Ectasia Risk Score System is a valid and effective method for detecting eyes at risk for ectasia after LASIK and represents a significant improvement over previously utilized screening strategies. PMID:18328998

  12. A novel scoring system for evaluation of results of autologous transplantation methods in vitiligo

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    Gupta Somesh

    2002-01-01

    Full Text Available Autologous transplantation of melanocyte/melanocytes bearing epidermis for vitiligo can be done by mini-punch grafting (MPG, suction blister epidermal grafting (SBEG, thin split -thickness skin grafting (TSTG, transplantation of basal cell layer enriched suspension and cultured epithelial/melanocyte transplantation. To date no comparative study of these transplantation procedures has been published. Comparison of different studies carried out at different centers may be difficult in the absence of uniform evaluation criteria. In most of the published studies, the results were evaluated in terms of extent of pigmentation. Complictions and color match were evaluated separately. This approach, however, may not give a fair idea about the results. We have developed a scoring system with holistic approach considering the extent of pigmentation, color match and the complications of both the donor and the recipient areas, all taken together. In the scoring system, the score for individual criteria was multiplied with a factor, the value of which was decided on the basis of relative importance of each criteria. The use of this scoring system is exemplified in twelve patients who underwent TSTG, SBEG and MPG. In the scoring system the results were judged as excellent and fair in 3 patients each, as good in 4 patients and as poor in 2 patients.

  13. Cervical injuries scored according to the Subaxial Injury Classification system: An analysis of the literature

    Directory of Open Access Journals (Sweden)

    Andrei F Joaquim

    2014-01-01

    Full Text Available Introduction: The Subaxial Injury Classification (SLIC system and severity score has been developed to help surgeons in the decision-making process of treatment of subaxial cervical spine injuries. A detailed description of all potential scored injures of the SLIC is lacking. Materials and Methods: We performed a systematic review in the PubMed database from 2007 to 2014 to describe the relationship between the scored injuries in the SLIC and their eventual treatment according to the system score. Results: Patients with an SLIC of 1-3 points (conservative treatment are neurologically intact with the spinous process, laminar or small facet fractures. Patients with compression and burst fractures who are neurologically intact are also treated nonsurgically. Patients with an SLIC of 4 points may have an incomplete spinal cord injury such as a central cord syndrome, compression injuries with incomplete neurologic deficits and burst fractures with complete neurologic deficits. SLIC of 5-10 points includes distraction and rotational injuries, traumatic disc herniation in the setting of a neurological deficit and burst fractures with an incomplete neurologic deficit. Conclusion: The SLIC injury severity score can help surgeons guide fracture treatment. Knowledge of the potential scored injures and their relationships with the SLIC are of paramount importance for spine surgeons who treated subaxial cervical spine injuries.

  14. Evaluation of illness severity scoring systems and risk prediction in vascular intensive care admissions.

    Science.gov (United States)

    Dover, M; Tawfick, Wael; Hynes, Niamh; Sultan, Sherif

    2016-08-01

    This study examines the predictive value of intensive care unit (ICU) scoring systems in a vascular ICU population. From April 2005 to September 2011, we examined 363 consecutive ICU admissions. Simplified Acute Physiology Score II (SAPS II), Acute Physiology and Chronic Health Evaluation II (APACHE II), APACHE IV, Multiple Organ Dysfunction Score (MODS), organ dysfunctions and/or infection (ODIN), mortality prediction model (MPM) and physiologic and operative severity score for the enumeration of mortality and morbidity (POSSUM) were calculated. The Glasgow Aneurysm Score (GAS) was calculated for patients with aneurysm-related admissions. Overall mortality for complex vascular intervention was 11.6%. At admission, the areas under the receiver operating characteristic curve (AUCs) was 0.884 for SAPS II, 0.894 for APACHE II, 0.895 for APACHE IV, 0.902 for MODS, 0.891 for ODIN and 0.903 for MPM. At 24 h, model discrimination was best for POSSUM (AUC = 0.906) and MPM (AUC = 0.912). The good discrimination of these scoring systems indicates their value as an adjunct to clinical assessment but should not be used on an individual basis as a clinical decision-making tool. © The Author(s) 2015.

  15. Determining utility values in patients with anterior cruciate ligament tears using clinical scoring systems

    Directory of Open Access Journals (Sweden)

    Szucs Thomas

    2011-08-01

    Full Text Available Abstract Background Several instruments and clinical scoring systems have been established to evaluate patients with ligamentous knee injuries. A comparison of individual articles in the literature is challenging, not only because of heterogeneity in methodology, but also due to the variety of the scoring systems used to document clinical outcomes. There is limited information about the correlation between used scores and quality of life with no information being available on the impact of each score on the utility values. The aim of this study was to compare the most commonly used scores for evaluating patients with anterior cruciate ligament (ACL injuries, and to establish corresponding utility values. These values will be used for the interpretation and comparison of outcome results in the currently available literature for different treatment options. Methods Four hypothetical vignettes were defined, based on different levels of activities after rupture of the ACL to simulate typical situations seen in daily practice. A questionnaire, including the Health Utility Index (HUI for utility values, the IKDC subjective score, the Lysholm and the Tegner score, was created and 25 orthopedic surgeons were asked to fill the questionnaire for each hypothetical patient as proxies for all patients they had treated and who would fit in that hypothetical vignette. Results The utility value as an indicator for quality of life increased with the level of activity. Having discomforts already during normal activities of daily living was rated with a mean utility value of 0.37 ± 0.19, half of that of a situation where mild sport activity was possible without discomfort (0.78 ± 0.11. All investigated scores were able to distinguish clearly (p Conclusions Here we report the correlation between the most commonly used scores for the assessment of patients with a ruptured ACL and utility values as an indicator of quality of life. Assumptions were based on expert

  16. Developing nursing students' decision making skills: are early warning scoring systems helpful?

    Science.gov (United States)

    McCallum, Jacqueline; Duffy, Kathleen; Hastie, Elizabeth; Ness, Valerie; Price, Lesley

    2013-01-01

    This paper is presented to contribute to the emerging debate on Early Warning Scoring Systems. The Early Warning Scoring System was introduced, and has been implemented internationally, to aid in the identification of the patient whose condition is deteriorating. Early identification of patient deterioration is of vital importance for patient safety. Therefore how we teach this skill to students and how they become competent and confident in its utilisation, interpretation and subsequent clinical decision-making is crucial. The paper initially explores the competence of student nurses in this area. The discussion then focuses on three models of clinical decision making to illustrate why the introduction of Early Warning Scoring Systems has hindered student nurses in the development of the decision-making skills required to identify and manage the patient whose condition is deteriorating. Copyright © 2012 Elsevier Ltd. All rights reserved.

  17. Comparison of risk scoring systems for patients presenting with upper gastrointestinal bleeding

    DEFF Research Database (Denmark)

    Stanley, Adrian J; Laine, Loren; Dalton, Harry R

    2017-01-01

    OBJECTIVE: To compare the predictive accuracy and clinical utility of five risk scoring systems in the assessment of patients with upper gastrointestinal bleeding. DESIGN: International multicentre prospective study. SETTING: Six large hospitals in Europe, North America, Asia, and Oceania....... PARTICIPANTS: 3012 consecutive patients presenting over 12 months with upper gastrointestinal bleeding. MAIN OUTCOME MEASURES: Comparison of pre-endoscopy scores (admission Rockall, AIMS65, and Glasgow Blatchford) and post-endoscopy scores (full Rockall and PNED) for their ability to predict predefined...... clinical endpoints: a composite endpoint (transfusion, endoscopic treatment, interventional radiology, surgery, or 30 day mortality), endoscopic treatment, 30 day mortality, rebleeding, and length of hospital stay. Optimum score thresholds to identify low risk and high risk patients were determined...

  18. [Results of applying a paediatric early warning score system as a healthcare quality improvement plan].

    Science.gov (United States)

    Rivero-Martín, M J; Prieto-Martínez, S; García-Solano, M; Montilla-Pérez, M; Tena-Martín, E; Ballesteros-García, M M

    2016-06-01

    The aims of this study were to introduce a paediatric early warning score (PEWS) into our daily clinical practice, as well as to evaluate its ability to detect clinical deterioration in children admitted, and to train nursing staff to communicate the information and response effectively. An analysis was performed on the implementation of PEWS in the electronic health records of children (0-15 years) in our paediatric ward from February 2014 to September 2014. The maximum score was 6. Nursing staff reviewed scores >2, and if >3 medical and nursing staff reviewed it. Monitoring indicators: % of admissions with scoring; % of complete data capture; % of scores >3; % of scores >3 reviewed by medical staff, % of changes in treatment due to the warning system, and number of patients who needed Paediatric Intensive Care Unit (PICU) admission, or died without an increased warning score. The data were collected from all patients (931) admitted. The scale was measured 7,917 times, with 78.8% of them with complete data capture. Very few (1.9%) showed scores >3, and 14% of them with changes in clinical management (intensifying treatment or new diagnostic tests). One patient (scored 2) required PICU admission. There were no deaths. Parents or nursing staff concern was registered in 80% of cases. PEWS are useful to provide a standardised assessment of clinical status in the inpatient setting, using a unique scale and implementing data capture. Because of the lack of severe complications requiring PICU admission and deaths, we will have to use other data to evaluate these scales. Copyright © 2016 SECA. Published by Elsevier Espana. All rights reserved.

  19. Evaluation of novel computerized tomography scoring systems in human traumatic brain injury: An observational, multicenter study.

    Directory of Open Access Journals (Sweden)

    Eric Peter Thelin

    2017-08-01

    Full Text Available Traumatic brain injury (TBI is a major contributor to morbidity and mortality. Computerized tomography (CT scanning of the brain is essential for diagnostic screening of intracranial injuries in need of neurosurgical intervention, but may also provide information concerning patient prognosis and enable baseline risk stratification in clinical trials. Novel CT scoring systems have been developed to improve current prognostic models, including the Stockholm and Helsinki CT scores, but so far have not been extensively validated. The primary aim of this study was to evaluate the Stockholm and Helsinki CT scores for predicting functional outcome, in comparison with the Rotterdam CT score and Marshall CT classification. The secondary aims were to assess which individual components of the CT scores best predict outcome and what additional prognostic value the CT scoring systems contribute to a clinical prognostic model.TBI patients requiring neuro-intensive care and not included in the initial creation of the Stockholm and Helsinki CT scoring systems were retrospectively included from prospectively collected data at the Karolinska University Hospital (n = 720 from 1 January 2005 to 31 December 2014 and Helsinki University Hospital (n = 395 from 1 January 2013 to 31 December 2014, totaling 1,115 patients. The Marshall CT classification and the Rotterdam, Stockholm, and Helsinki CT scores were assessed using the admission CT scans. Known outcome predictors at admission were acquired (age, pupil responsiveness, admission Glasgow Coma Scale, glucose level, and hemoglobin level and used in univariate, and multivariable, regression models to predict long-term functional outcome (dichotomizations of the Glasgow Outcome Scale [GOS]. In total, 478 patients (43% had an unfavorable outcome (GOS 1-3. In the combined cohort, overall prognostic performance was more accurate for the Stockholm CT score (Nagelkerke's pseudo-R2 range 0.24-0.28 and the Helsinki CT score

  20. Helsinki Computed Tomography Scoring System Can Independently Predict Long-Term Outcome in Traumatic Brain Injury.

    Science.gov (United States)

    Yao, Shun; Song, Jian; Li, Shun; Cao, Chenglong; Fang, Li; Wang, Chaohu; Xu, Guozheng

    2017-05-01

    The Helsinki computed tomography (CT) scoring system was developed to predict long-term outcome in patients with traumatic brain injury (TBI) 2 years ago; however, it has not yet been external validated. This study aimed to determine whether this system could be used as an independent predictor for TBI. This retrospective cohort study was performed on 302 consecutive patients with TBI. Univariate and multivariate logistic regressions and receiver operating characteristic curve analyses were used to determine the relationship between initial Helsinki CT scores and mortality and unfavorable neurologic outcome at 6 months after injury. Outcomes were assessed using the Glasgow Outcome Scale (scores of 1-3 defined as unfavorable outcome). Of all patients, mortality was 17.9% and unfavorable outcome was 41.4%. The Helsinki CT score was significantly associated with the 6-month outcome in univariate analyses (P < 0.05). After adjustment for other factors in the multivariate regression analysis, the Helsinki CT score remained an independent predictor for mortality (odds ratio [OR], 1.22; 95% confidence interval [CI], 1.08-1.39; P = 0.002) and unfavorable outcome (OR, 1.14; 95% CI, 1.04-1.26; P = 0.007). Receiver operating characteristic curve analyses showed that the Helsinki CT score possessed good discrimination ability for mortality (area under the curve, 0.81; 95% CI, 0.75-0.87; P < 0.001) and moderate discrimination ability for unfavorable outcome (area under the curve, 0.74; 95% CI, 0.69-0.80; P < 0.001). Moreover, at 1.9 hours after TBI, the Helsinki CT score was most accurate for predicting mortality (accuracy, 74.5%) and unfavorable outcome (accuracy, 71.5%). The Helsinki CT score showed good prognostic discrimination and can be used as an independent predictor for long-term outcome prediction in patients with TBI. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Magnetic Resonance Imaging Score and Classification System (AMADEUS) for Assessment of Preoperative Cartilage Defect Severity.

    Science.gov (United States)

    Jungmann, Pia M; Welsch, Götz H; Brittberg, Mats; Trattnig, Siegfried; Braun, Sepp; Imhoff, Andreas B; Salzmann, Gian M

    2017-07-01

    Objective To design a simple magnetic resonance (MR)-based assessment system for quantification of osteochondral defect severity prior to cartilage repair surgery at the knee. Design The new scoring tool was supposed to include 3 different parameters: (1) cartilage defect size, (2) depth/morphology of the cartilage defect, and (3) subchondral bone quality, resulting in a specific 3-digit code. A clearly defined numeric score was developed, resulting in a final score of 0 to 100. Defect severity grades I through IV were defined. For intra- and interobserver agreement, defects were assessed by 2 independent readers on preoperative knee MR images of n = 44 subjects who subsequently received cartilage repair surgery. For statistical analyses, mean values ± standard deviation (SD), interclass correlation coefficients (ICC), and linear weighted kappa values were calculated. Results The mean total Area Measurement And DEpth & Underlying Structures (AMADEUS) score was 48 ± 24, (range, 0-85). The mean defect size was 2.8 ± 2.6 cm 2 . There were 36 of 44 full-thickness defects. The subchondral bone showed defects in 21 of 44 cases. Kappa values for intraobserver reliability ranged between 0.82 and 0.94. Kappa values for interobserver reliability ranged between 0.38 and 0.85. Kappa values for AMADEUS grade were 0.75 and 0.67 for intra- and interobserver agreement, respectively. ICC scores for the AMADEUS total score were 0.97 and 0.96 for intra- and interobserver agreement, respectively. Conclusions The AMADEUS score and classification system allows reliable severity encoding, scoring and grading of osteochondral defects on knee MR images, which is easily clinically applicable in daily practice.

  2. Application of the Process Scoring System to waking, dream and therapy reports.

    Science.gov (United States)

    Corriere, R; Hart, J; Karle, W; Switzer, A; Woldenberg, L

    1978-07-01

    Extended the Process Scoring System, originally developed for measuring dream dynamics and content, to waking and therapy experiences and applied it in a study of 5 new and 5 experienced Ss in an intensive outpatient psychotherapy. Two areas were examined: First, differences on process and content variables related to length of time in therapy and, second, the parallel relationship in these variables between waking, dream, and therapy experiences. The Process Scoring System proved useful in measuring these variables in all three types of experiences. The results indicated significant differences between the new and experienced patients and measurable interaction between the waking, dream, and therapy areas.

  3. Metabolic syndrome: the danger signal in atherosclerosis

    Directory of Open Access Journals (Sweden)

    Patrick Mathieu

    2006-09-01

    Full Text Available Patrick Mathieu1, Philippe Pibarot2, Jean-Pierre Després31Department of Surgery, Centre de Recherche de l’Hôpital Laval/Institut de Cardiologie de Québec, Québec, Canada; 2Department of Medicine, Centre de Recherche de l’Hôpital Laval/Institut de Cardiologie de Québec, Québec, Canada; 3Department of Social and Preventive Medicine, Centre de Recherche de l’Hôpital Laval/Institut de Cardiologie de Québec, Québec, CanadaAbstract: Atherosclerosis is a chronic inflammatory disease characterized by infiltration of blood vessels by lipids and leukocytes. There is a growing body of evidence that among risk factors that promote atherosclerosis, the metabolic syndrome is a powerful and prevalent predictor of cardiovascular events. The systemic inflammatory process associated with the metabolic syndrome has numerous deleterious effects that promote plaque activation, which is responsible for clinical events. Interactions between the innate immune system with lipidderived products seem to play a major role in the pathophysiology of atherosclerosis in relation with the metabolic syndrome. The multiple links among adipose tissue, the vascular wall, and the immune system are the topics of this review, which examines the roles of oxidized low density lipoprotein, inflammatory cytokines, and adipokines in triggering and perpetuating a danger signal response that promotes the development of atherosclerosis. Furthermore, therapeutic options that specifically target the metabolic syndrome components are reviewed in light of recent developments. Keywords: atherosclerosis, inflammation, metabolic syndrome, innate immune system, danger signal theory

  4. [The scoring system for the risk-stratification in patients with the antiphospholipid syndrome].

    Science.gov (United States)

    Oku, Kenji

    2017-01-01

      Antiphospholipid syndrome (APS) is a clinical disorder characterized by thrombosis and/or pregnancy morbidity in the persistence of the pathogenic autoantibodies, the antiphospholipid antibodies (aPL). Recurernt thrombosis is often observed in patients with APS which requires persistent prophylaxis. However, an uniform prophylactic treatment for APS patients is inadequate and stratification of the thrombotic risks is important as aPL are prevalently observed in other various diseases or elderly population. It is previously known that the multiple positivity or high titre of aPL correlate to the thrombotic events. To progress the stratification of the thrombotic risks and to quantitatively analyze them, antiphospholipid score (aPL-S) and the Global Anti-Phospholipid Syndrome Score (GAPSS) were defined as the scoring-systems. Both of these scoring-systems were raised from the large patient cohort data and either aPL profile classified in detail (aPL-S) or simplified aPL profile with classical thrombotic risk factors (GAPSS) were put into scoring system. They have shown a degree of accuracy in identifying high-risk APS patients, especially those at a high risk of thrombosis. However, there are several areas requiring improvement, or at least that clinicians should be aware of, before these instruments are applied in clinical practice. One such issue is standardisation of the aPL tests, including general testing of phosphatidylserine dependent antiprothrombin antibodies (aPS/PT).

  5. Identification and Rating of Gynecologic Oncology Applications Using the APPLICATIONS Scoring System.

    Science.gov (United States)

    Farag, Sara; Fields, Jessica; Pereira, Elena; Chyjek, Kathy; Chen, Katherine T

    2016-12-01

    Currently, there are thousands of medical applications (apps) on the market potentially leading to app overload. Finding useful and accurate apps may be time-consuming and frustrating to gynecologic oncologists. The objective of this study is to identify and rate gynecologic oncology (gyn-onc) apps using the APPLICATIONS scoring system. A list of nonconsumer gyn-onc apps was identified from the Apple iTunes and Google Play Stores. Based on reliable references, inaccurate apps were excluded. The remaining apps were rated with the APPLICATIONS scoring system, which uses both objective and subjective measures. Of 748 apps identified, 11 (1.5%) were found to be both useful and accurate to gyn-onc providers. The apps with the lowest scores were calculator apps, while those with the highest scores were informational apps. We found useful and accurate calculator, screening, staging, and informational apps. However, a large number of the apps found were considered inaccurate or non-gyn-onc specific. Our systematic method for identifying and rating apps with the APPLICATIONS scoring system can be applied within other subspecialties of obstetrics and gynecology and other specialties of medicine to offer providers with apps in clinical care.

  6. Noninvasive scoring system for significant inflammation related to chronic hepatitis B

    Science.gov (United States)

    Hong, Mei-Zhu; Ye, Linglong; Jin, Li-Xin; Ren, Yan-Dan; Yu, Xiao-Fang; Liu, Xiao-Bin; Zhang, Ru-Mian; Fang, Kuangnan; Pan, Jin-Shui

    2017-03-01

    Although a liver stiffness measurement-based model can precisely predict significant intrahepatic inflammation, transient elastography is not commonly available in a primary care center. Additionally, high body mass index and bilirubinemia have notable effects on the accuracy of transient elastography. The present study aimed to create a noninvasive scoring system for the prediction of intrahepatic inflammatory activity related to chronic hepatitis B, without the aid of transient elastography. A total of 396 patients with chronic hepatitis B were enrolled in the present study. Liver biopsies were performed, liver histology was scored using the Scheuer scoring system, and serum markers and liver function were investigated. Inflammatory activity scoring models were constructed for both hepatitis B envelope antigen (+) and hepatitis B envelope antigen (-) patients. The sensitivity, specificity, positive predictive value, negative predictive value, and area under the curve were 86.00%, 84.80%, 62.32%, 95.39%, and 0.9219, respectively, in the hepatitis B envelope antigen (+) group and 91.89%, 89.86%, 70.83%, 97.64%, and 0.9691, respectively, in the hepatitis B envelope antigen (-) group. Significant inflammation related to chronic hepatitis B can be predicted with satisfactory accuracy by using our logistic regression-based scoring system.

  7. Congenital heart disease: interrelation between German diagnosis-related groups system and Aristotle complexity score.

    Science.gov (United States)

    Sinzobahamvya, Nicodème; Photiadis, Joachim; Arenz, Claudia; Kopp, Thorsten; Hraska, Viktor; Asfour, Boulos

    2010-06-01

    The Disease-Related Groups (DRGs) system postulates that inpatient stays with similar levels of clinical complexity are expected to consume similar amounts of resources. This, applied to surgery of congenital heart disease, suggests that the higher the complexity of procedures as estimated by the Aristotle complexity score, the higher hospital reimbursement should be. This study analyses how much case-mix index (CMI) generated by German DRG 2009 version correlates with Aristotle score. A total of 456 DRG cases of year 2008 were regrouped according to German DRG 2009 and related cost-weight values and overall CMI evaluated. Corresponding Aristotle basic and comprehensive complexity scores (ABC and ACC) and levels were determined. Associated surgical performance (Aristotle score times hospital survival) was estimated. Spearman 'r' correlation coefficients were calculated between Aristotle scores and cost-weights. Goodness of fit 'r(2)' from derived regression was determined. Correlation was estimated to be optimal if Spearman 'r' and derived goodness of fit 'r(2)' approached 1 value. CMI was 8.787 while mean ABC and ACC scores were 7.64 and 9.27, respectively. Hospital survival was 98.5%: therefore, surgical performance attained 7.53 (ABC score) and 9.13 (ACC score). ABC and ACC scores and levels positively correlated with cost-weights. With Spearman 'r' of 1 and goodness of fit 'r(2)' of 0.9790, scores of the six ACC levels correlated at best. The equation was y = 0.5591 + 0.939x, in which y stands for cost-weight (CMI) and x for score of ACC level. ACC score correlates almost perfectly with corresponding cost-weights (CMI) generated by the German DRG 2009. It could therefore be used as the basis for hospital reimbursement to compensate in conformity with procedures' complexity. Extrapolated CMI in this series would be 9.264. Modulation of reimbursement according to surgical performance could be established and thus 'reward' quality in congenital heart surgery

  8. A Comparison of Systemic Inflammation-Based Prognostic Scores in Patients on Regular Hemodialysis

    Directory of Open Access Journals (Sweden)

    Akihiko Kato

    2013-10-01

    Full Text Available Background/Aims: Systemic inflammation-based prognostic scores have prognostic power in patients with cancer, independently of tumor stage and site. Although inflammatory status is associated with mortality in hemodialysis (HD patients, it remains to be determined as to whether these composite scores are useful in predicting clinical outcomes. Methods: We calculated the 6 prognostic scores [Glasgow prognostic score (GPS, modified GPS (mGPS, neutrophil-lymphocyte ratio (NLR, platelet lymphocyte ratio (PLR, prognostic index (PI and prognostic nutritional index (PNI], which have been established as a useful scoring system in cancer patients. We enrolled 339 patients on regular HD (age: 64 ± 13 years; time on HD: 129 ± 114 months; males/females = 253/85 and followed them for 42 months. The area under the receiver-operating characteristics curve was used to determine which scoring system was more predictive of mortality. Results: Elevated GPS, mGPS, NLR, PLR, PI and PNI were all associated with total mortality, independent of covariates. If GPS was raised, mGPS, NLR, PLR and PI were also predictive of all-cause mortality and/or hospitalization. GPS and PNI were associated with poor nutritional status. Using overall mortality as an endpoint, the area under the curve (AUC was significant for a GPS of 0.701 (95% CI: 0.637-0.765; p Conclusion: GPS, based on serum albumin and highly sensitive C-reactive protein, has the most prognostic power for mortality prediction among the prognostic scores in HD patients. However, as the determination of serum albumin reflects mortality similarly to GPS, other composite combinations are needed to provide additional clinical utility beyond that of albumin alone in HD patients.

  9. Meningioma surgery in the very old-validating prognostic scoring systems.

    Science.gov (United States)

    Konglund, Ane; Rogne, Siril G; Helseth, Eirik; Meling, Torstein R

    2013-12-01

    Several studies acknowledge a higher risk of morbidity and mortality following intracranial meningioma surgery in the elderly, yet there is no consensus with regards to risk factors. Four prognostic scoring systems have been proposed. To evaluate their usefulness, we assess the very old meningioma patients in our neuro-oncological database according to the four methods, and correlate the findings with mortality and morbidity. We retrospectively calculated scores according to the Clinical-Radiological Grading System (CRGS), the Sex, Karnofsky Performance Scale, American Society of Anesthesiology Class, Location of Tumor, and Peritumoral Edema grading system (SKALE), the Geriatric Scoring System (GSS) and the Charlson Comorbidity Index (CCI) from all patients aged 80-90 years who had primary surgery for intracranial meningiomas 2003-2013 (n = 51), and related our findings to morbidity and mortality. The mortality rates were 3.9 %, 5.9 % and 15.7 % at 30-days, 3-months and 1-year post-surgery. The rate of complications requiring surgery was 13.7 %, 5.9 % had evacuation of intracerebral hematomas and two patients (3.9 %) had surgery for intracranial infection/osteitis. 15.7 % of the patients were neurologically worsened on discharge. The patients with SKALE scores ≤ 8 had significantly increased mortality rates. The GSS, the CRGS and the CCI were not found to correlate with mortality. Retrospectively evaluating four proposed scoring systems, we find that the SKALE score reflects the mortality at 1 month and 1 year following primary surgery for intracranial meningiomas in our very old patients. It may represent a helpful adjunct to their preoperative assessment.

  10. A Novel Risk Scoring System to Predict Cardiovascular Death in Patients With Acute Myocardial Infarction: CHA2DS2-VASc-CF Score.

    Science.gov (United States)

    Kundi, Harun; Kiziltunc, Emrullah; Korkmaz, Ahmet; Cicek, Gokhan; Ornek, Ender; Ileri, Mehmet

    2018-03-01

    The present study aimed to determine the long-term prognostic validity of the CHA 2 DS 2 -VASc score in patients with acute myocardial infarction (AMI). In addition, we formulated a novel scoring system, the CHA 2 DS 2 -VASc-CF (which includes cigarette smoking and a family history of coronary artery disease as risk factors). This study included 4373 consecutive patients with AMI who presented to the emergency department of our hospital and underwent cardiac catheterization procedures between December 2009 and September 2016. Among these patients, 1427 were diagnosed with ST elevation myocardial infarction (STEMI) and 2946 were diagnosed with non-STEMI. The study included 4373 patients. The study population was divided into 2 groups according to the occurrence of cardiovascular death during the follow-up period. Multivariate logistic regression analysis showed that the CHA 2 DS 2 -VASc-CF score, CHA 2 DS 2 -VASc score, major adverse cardiac events, current cigarette smoking, older age, hypertension, and family history of coronary artery disease were significantly higher, and that the left ventricular ejection fraction and glomerular filtration rate were significantly lower in the cardiovascular death (+) group. Using a cutoff score of >3 for the CHA 2 DS 2 -VASc-CF score, long-term cardiovascular death was predicted with a sensitivity of 78.4% and specificity of 76.4%. The CHA 2 DS 2 -VASc-CF score is suitable for use in all patients with AMI, regardless of the type of treatment, presence of atrial fibrillation, and type of AMI. This risk score, which is easy to calculate, provides important prognostic data. In the future, we think that interventional cardiologists will be able to use this novel scoring system to identify patients with a high risk of long-term cardiovascular death.

  11. Monitoring vital signs using early warning scoring systems: a review of the literature.

    Science.gov (United States)

    Kyriacos, U; Jelsma, J; Jordan, S

    2011-04-01

    To evaluate the need for, and the development and utility of, pen-and-paper (Modified) Early Warning Scoring (MEWS/EWS) systems for adult inpatients outside critical care and emergency departments, by reviewing published literature. Serious adverse events can be prevented by recognizing and responding to early signs of clinical and physiological deterioration. Of 534 papers reporting MEWS/EWS systems for adult inpatients identified, 14 contained useable data on development and utility of MEWS/EWS systems. Systems without aggregate weighted scores were excluded. MEWS/EWS systems facilitate recognition of abnormal physiological parameters in deteriorating patients, but have limitations. There is no single validated scoring tool across diagnoses. Evidence of prospective validation of MEWS/EWS systems is limited; neither is implementation based on clinical trials. There is no evidence that implementation of Westernized MEWS/EWS systems is appropriate in resource-poor locations. Better monitoring implies better care, but there is a paucity of data on the validation, implementation, evaluation and clinical testing of vital signs' monitoring systems in general wards. Recording vital signs is not enough. Patient safety continues to depend on nurses' clinical judgment of deterioration. Resources are needed to validate and evaluate MEWS/EWS systems in context. © 2011 The Authors. Journal compilation © 2011 Blackwell Publishing Ltd.

  12. Case complexity scores in congenital heart surgery: a comparative study of the Aristotle Basic Complexity score and the Risk Adjustment in Congenital Heart Surgery (RACHS-1) system.

    Science.gov (United States)

    Al-Radi, Osman O; Harrell, Frank E; Caldarone, Christopher A; McCrindle, Brian W; Jacobs, Jeffrey P; Williams, M Gail; Van Arsdell, Glen S; Williams, William G

    2007-04-01

    The Aristotle Basic Complexity score and the Risk Adjustment in Congenital Heart Surgery system were developed by consensus to compare outcomes of congenital cardiac surgery. We compared the predictive value of the 2 systems. Of all index congenital cardiac operations at our institution from 1982 to 2004 (n = 13,675), we were able to assign an Aristotle Basic Complexity score, a Risk Adjustment in Congenital Heart Surgery score, and both scores to 13,138 (96%), 11,533 (84%), and 11,438 (84%) operations, respectively. Models of in-hospital mortality and length of stay were generated for Aristotle Basic Complexity and Risk Adjustment in Congenital Heart Surgery using an identical data set in which both Aristotle Basic Complexity and Risk Adjustment in Congenital Heart Surgery scores were assigned. The likelihood ratio test for nested models and paired concordance statistics were used. After adjustment for year of operation, the odds ratios for Aristotle Basic Complexity score 3 versus 6, 9 versus 6, 12 versus 6, and 15 versus 6 were 0.29, 2.22, 7.62, and 26.54 (P Aristotle Basic Complexity (likelihood ratio chi2 = 162, P Aristotle Basic Complexity contributed much less predictive value over Risk Adjustment in Congenital Heart Surgery (likelihood ratio chi2 = 13.4, P = .009). Neither system fully adjusted for the child's age. The Risk Adjustment in Congenital Heart Surgery scores were more concordant with length of stay compared with Aristotle Basic Complexity scores (P Aristotle Basic Complexity. The use of Aristotle Basic Complexity or Risk Adjustment in Congenital Heart Surgery as risk stratification and trending tools to monitor outcomes over time and to guide risk-adjusted comparisons may be valuable.

  13. Neonatal facial coding system scores and spectral characteristics of infant crying during newborn circumcision.

    Science.gov (United States)

    Lehr, Victoria Tutag; Zeskind, Philip Sanford; Ofenstein, John P; Cepeda, Eugene; Warrier, Indulekha; Aranda, J V

    2007-06-01

    To determine the relations between Neonatal Facial Coding System (NFCS) scores and measures of infant crying during newborn circumcision. Video and audio recordings were made of infant facial activity and cry sounds, respectively, during the lysis phase of circumcisions of 44 healthy term males (analgesia before circumcision. NFCS scores were determined by blinded assistant from video recordings of facial activity. Measures of infant crying were determined via spectrum analysis of audio recordings by a blinded, independent researcher. Pearson product-moment correlations were used to examine relationship between NFCS scores and measures of crying. Principal component factor analysis detected dimensions underlying related measures of crying. Factor scores from a factor analysis were used in stepwise linear regression to predict NFCS scores. Higher NFCS scores correlated with lower peak fundamental frequency of crying (P<0.01) and with higher amplitudes of crying at peak fundamental frequency and dominant frequency and in overall cry sample (P<0.01). The factor analysis showed 3 significant orthogonal dimensions underlying measures of crying: Power and Velocity (amplitude and rapidity), Pitch of Crying (frequency characteristics), and Infant Arousal (turbulence and intensity) accounting for 42.3%, 17.8%, and 14.6% of variance, respectively. A regression analysis showed all 3 factor scores accounted for significant and separate portions of variance (P<0.001). The best predictor of NFCS score was Power and Velocity (P<0.002), followed by Infant Arousal (P<0.002), and Pitch of Crying (P<0.007). These data provide some of the first known evidence linking specific measures of infant crying with an independent, validated measure of pain.

  14. Liver stiffness measurement-based scoring system for significant inflammation related to chronic hepatitis B.

    Directory of Open Access Journals (Sweden)

    Mei-Zhu Hong

    Full Text Available Liver biopsy is indispensable because liver stiffness measurement alone cannot provide information on intrahepatic inflammation. However, the presence of fibrosis highly correlates with inflammation. We constructed a noninvasive model to determine significant inflammation in chronic hepatitis B patients by using liver stiffness measurement and serum markers.The training set included chronic hepatitis B patients (n = 327, and the validation set included 106 patients; liver biopsies were performed, liver histology was scored, and serum markers were investigated. All patients underwent liver stiffness measurement.An inflammation activity scoring system for significant inflammation was constructed. In the training set, the area under the curve, sensitivity, and specificity of the fibrosis-based activity score were 0.964, 91.9%, and 90.8% in the HBeAg(+ patients and 0.978, 85.0%, and 94.0% in the HBeAg(- patients, respectively. In the validation set, the area under the curve, sensitivity, and specificity of the fibrosis-based activity score were 0.971, 90.5%, and 92.5% in the HBeAg(+ patients and 0.977, 95.2%, and 95.8% in the HBeAg(- patients. The liver stiffness measurement-based activity score was comparable to that of the fibrosis-based activity score in both HBeAg(+ and HBeAg(- patients for recognizing significant inflammation (G ≥3.Significant inflammation can be accurately predicted by this novel method. The liver stiffness measurement-based scoring system can be used without the aid of computers and provides a noninvasive alternative for the prediction of chronic hepatitis B-related significant inflammation.

  15. Forecast skill score assessment of a relocatable ocean prediction system, using a simplified objective analysis method

    Science.gov (United States)

    Onken, Reiner

    2017-11-01

    A relocatable ocean prediction system (ROPS) was employed to an observational data set which was collected in June 2014 in the waters to the west of Sardinia (western Mediterranean) in the framework of the REP14-MED experiment. The observational data, comprising more than 6000 temperature and salinity profiles from a fleet of underwater gliders and shipborne probes, were assimilated in the Regional Ocean Modeling System (ROMS), which is the heart of ROPS, and verified against independent observations from ScanFish tows by means of the forecast skill score as defined by Murphy(1993). A simplified objective analysis (OA) method was utilised for assimilation, taking account of only those profiles which were located within a predetermined time window W. As a result of a sensitivity study, the highest skill score was obtained for a correlation length scale C = 12.5 km, W = 24 h, and r = 1, where r is the ratio between the error of the observations and the background error, both for temperature and salinity. Additional ROPS runs showed that (i) the skill score of assimilation runs was mostly higher than the score of a control run without assimilation, (i) the skill score increased with increasing forecast range, and (iii) the skill score for temperature was higher than the score for salinity in the majority of cases. Further on, it is demonstrated that the vast number of observations can be managed by the applied OA method without data reduction, enabling timely operational forecasts even on a commercially available personal computer or a laptop.

  16. A scoring system to predict the risk of prolonged air leak after lobectomy.

    Science.gov (United States)

    Brunelli, Alessandro; Varela, Gonzalo; Refai, Majed; Jimenez, Marcelo F; Pompili, Cecilia; Sabbatini, Armando; Aranda, Jose Luis

    2010-07-01

    Prolonged air leak (PAL) remains a frequent complication after lung resection. Perioperative preventative strategies have been tested, but their efficacy is often difficult to interpret due to heterogeneous inclusion criteria. The objective of this study was to develop and validate a practical score to stratify the risk of PAL after lobectomy. Six hundred fifty-eight consecutive patients were submitted to pulmonary lobectomy (2000 to 2008) in center A and were used to develop the risk-adjusted score predicting the incidence of PAL (> 5 days). Exclusion criteria were chest wall resection and postoperative assisted mechanical ventilation. No sealants, pleural tent, or buttressing material were used. To build the aggregate score numeric variables were categorized by receiver operating curve analysis. Variables were screened by univariate analysis and then used in stepwise logistic regression analysis (validated by bootstrap). The scoring system was developed by proportional weighing of the significant predictor estimates and was validated on patients operated on in a different center (center B). The incidence of PAL in the derivation set was 13% (87 of 658 cases). Predictive variables and their scores were the following: age greater than 65 years (1 point); presence of pleural adhesions (1 point); forced expiratory volume in one second less than 80% (1.5 points); and body mass index less than 25.5 kg/m(2) (2 points). Patients were grouped into 4 risk classes according to their aggregate scores, which were significantly associated with incremental risk of PAL in the validation set of 233 patients. The developed scoring system reliably predicts incremental risk of PAL after pulmonary lobectomy. Its use may help in identifying those high-risk patients in whom to adopt intraoperative prophylactic strategies; in developing inclusion criteria for future randomized clinical trials on new technologies aimed at reducing or preventing air leak; and for patient counseling

  17. Risk Factors and Scoring Systems for Patients with Candidemia at a Tertiary Hospital in Jakarta, Indonesia.

    Science.gov (United States)

    Mursinah, Mursinah; Ibrahim, Fera; Wahid, Mardiastuti H

    2016-07-01

    to identify the risk factors of candidemia and to develop a scoring system that could be implemented in Cipto Mangunkusumo Hospital (RSCM), Jakarta, Indonesia. this study was a retrospective study with case control design using the medical records of patients since 2011 to 2014. All sepsis patients hospitalized in the RSCM with a positive blood culture for Candida were included in this study as a case group. The control group was all of the sepsis patients without candidemia. The ratio for case and control groups was equal (1:1). from 234 patients who were analyzed, the risk factors that influenced the study were length of stay of 8-14 days (OR 3.464; 95% CI 1.458-7.800), length of stay of more than 14 days (OR 6.844; 95% CI 3.0-15.330), severe sepsis (OR 16.407; 95% CI 1.458-7.800), and surgery (OR 3.03; 95% CI 1.492-6.152). The predictors for candidemia in RSCM were length of stay in hospital for 8-14 days (score 1), a length of stay ≥14 days (score 2), severe sepsis (score 3), and surgery (score 1), with a cut off score of 3.5. the results of this study have indicated that a scoring system in order to guide an empirical treatment for candidemia can be developed by using the risk factors for candidemia from patients who have been identified as patients with risk at Cipto Mangunkusumo Hospital.

  18. A clinical scoring system to predict the development of intraventricular hemorrhage (IVH) in premature infants.

    Science.gov (United States)

    Coskun, Yesim; Isik, Semra; Bayram, Tevfik; Urgun, Kamran; Sakarya, Sibel; Akman, Ipek

    2018-01-01

    OBJECTıVE: The aim of this study is to develop a scoring system for the prediction of intraventricular hemorrhage (IVH) in preterm infants in the first 7 days of life. A prospective, clinical study was conducted in Bahcesehir University, Medical Park Goztepe Hospital Neonatal Intensive Care Unit, with the enrollment of 144 preterm infants with gestational age between 24 and 34 weeks. All preterms were followed up for IVH after birth until the 4th week of life. The demographic characteristics and clinical risk factors were noted. Risk factors were analyzed. The score was established after logistic regression analysis, considering the impact of each variable on the occurrence of IVH within the first 7 days of life. The IVH scores were further applied prospectively to 89 preterm infants as validation cohort. Low gestational age (GA), low Apgar score, and having bleeding diathesis were the most important risk factors for IVH. According to these risk factors, a scoring system was developed for IVH ranged from 0 to 5. According to the risk ratios (RR) obtained from the logistic regression model, low GA (≤ 28 gestational week), presence of bleeding diathesis within 7 days, and low Apgar score increased the risk of IVH (RR = 3.32 for GA ≤ 28 gestational week, RR = 6.7 for presence of bleeding diathesis in 7th day, RR = 3 for having low Apgar score). The score was validated successfully in 89 infants. The area under ROC curve was 0.85 for derivation cohort and 0.807 for validation cohort. The predictive ability of the IVH score for derivation and validation cohort was calculated. The negative predictive values of a score less than 4 were 96.4 and 59.1%. CONCLUSıON: Concerning IVH-related sequelae which continue to be a major public health problem, we have developed a feasible predictive model for evaluating the risk for developing IVH for preterm infants in the first 7 days of life.

  19. A simple alopecia scoring system for use in colony management of laboratory-housed primates.

    Science.gov (United States)

    Bellanca, Rita U; Lee, Grace H; Vogel, Keith; Ahrens, Joel; Kroeker, Rose; Thom, Jinhee P; Worlein, Julie M

    2014-06-01

    Alopecia in captive primates continues to receive attention from animal care personnel and regulatory agencies. However, a method that enables personnel to reliably score alopecia over time and under various conditions has proven difficult to achieve. The scoring system developed by the behavioral and veterinary staffs at the Washington National Primate Research Center (WaNPRC) uses the rule of 9s to estimate the percentage of the body affected with alopecia (severity) and how the alopecia presents itself (pattern). Training and scoring can conveniently be managed using photographic images, cage-side observations, and/or physical examinations. Personnel with varying degrees of experience were quickly trained with reliability scores ranging from 0.82 to 0.96 for severity and 0.82 to 0.89 for pattern using Cohen's κ. This system allows for reliable and consistent scoring across species, sex, age, housing condition, seasons, clinical or behavioral treatments, and level of personnel experience. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  20. Proposal of a CT scoring system of the paranasal sinuses in diagnosing cystic fibrosis

    Energy Technology Data Exchange (ETDEWEB)

    Eggesboe, H.B. [Department of Radiology, Aker University Hospital, 0514, Oslo (Norway); Soevik, S. [Department of Physiology, Department Group of Basic Medical Sciences, University of Oslo, 0317, Oslo (Norway); Doelvik, S. [Department of Otorhinolaryngology, Ullevaal University Hospital, 0407, Oslo (Norway); Eiklid, K. [Department of Medical Genetics, Ullevaal University Hospital, 0407, Oslo (Norway); Kolmannskog, F. [, Sentrum Roentgeninstitutt, 0155, Oslo (Norway)

    2003-06-01

    The purpose of this study was to develop a paranasal sinus CT scoring system that could be used as a diagnostic tool to discriminate cystic fibrosis (CF) patients from control patients examined for sinonasal disease. The model should include as few and easily applicable criteria as possible, supported by statistical analyses and clinical judgement. We used data from 116 CF and 136 control patients. The CF patients were grouped according to the number of confirmed CF mutations: genetically verified (CF-2), or based on sweat testing and clinical findings alone (CF-1, CF-0). Nine paranasal sinus CT criteria, including development, pneumatisation variants and inflammatory patterns, were evaluated. The final model included three criteria: (a) frontal and (b) sphenoid sinus development, and (c) absence of three pneumatisation variants. This model discriminated CF-2 from controls with overlap of summed scores in only 8 of 206 patients. When this model was applied in the CF-1 and CF-0 groups, two populations seemed to exist. A larger group with summed scores overlapping that of the CF-2 group and a smaller group with summed scores overlapping that of the control group. We conclude that this CT scoring system may support, as well as exclude, a CF diagnosis in cases of diagnostic uncertainty. (orig.)

  1. Modified TIME-H: a simplified scoring system for chronic wound management.

    Science.gov (United States)

    Lim, K; Free, B; Sinha, S

    2015-09-01

    Chronic wound assessment requires a systematic approach in order to guide management and improve prognostication. Following a pilot study using the original TIME-H scoring system in chronic wound management, modifications were suggested leading to the development of the Modified TIME-H scoring system. This study investigates the feasibility and reliability of chronic wound prognostication applying the Modified TIME-H score. Patients referred to the hospital's outpatient wound clinic over a 9-month period were categorised into one of three predicted outcome categories based on their Modified TIME-H score. This study shows a higher proportion of patients in the certain healing category achieved healed wounds, with a higher rate of reduction in wound size, when compared with the other categories. The three categories defined in this study are certain healing, uncertain healing and difficult healing. The Modified TIME-H score could be a useful tool for assessment, patient-centred management and prognostication of chronic wounds in clinical practice and requires further validation from other institutions. The authors have no conflict of interest to declare.

  2. Comparison of McCarthy and Goodenough-Harris Scoring Systems for Kindergarten Children's Human Figure Drawings.

    Science.gov (United States)

    Piersel, Wayne C.; Santos, Lande

    1982-01-01

    Comparison of the Goodenough-Harris and McCarthy scoring procedures for 60 kindergarten children's drawings yielded substantial agreement between the two scoring systems. The streamlined McCarthy scoring system should be utilized when large numbers of children are being evaluated with short periods of time. (Author)

  3. A scoring system to predict the severity of appendicitis in children

    NARCIS (Netherlands)

    Gorter, Ramon R.; van den Boom, Anne L oes; Heij, Hugo A.; Kneepkens, C. M Frank; Hulsker, Caroline C.|info:eu-repo/dai/nl/413663086; Tenhagen, Mark; Dawson, Imro; van der Lee, Johanna H.

    2016-01-01

    BACKGROUND: It appears that two forms of appendicitis exist. Preoperative distinction between the two is essential to optimize treatment outcome. This study aimed to develop a scoring system to accurately determine the severity of appendicitis in children. MATERIALS AND METHODS: Historical cohort

  4. A Score Function for Optimizing the Cycle-Life of Battery-Powered Embedded Systems

    NARCIS (Netherlands)

    Wognsen, Erik Ramsgaard; Haverkort, Boudewijn R.H.M.; Jongerden, M.R.; Hansen, René Rydhof; Larsen, K.G.; Sankaranarayanan, Sriram; Vicario, Enrico

    An ever increasing share of embedded systems is powered by rechargeable batteries. These batteries deteriorate with the number of charge/discharge cycles they are subjected to, the so-called cycle life. In this paper, we propose the wear score function to compare and evaluate the relative impact of

  5. Manual and automatic locomotion scoring systems in dairy cows: A review

    NARCIS (Netherlands)

    Schlageter-Tello, A.; Bokkers, E.A.M.; Groot Koerkamp, P.W.G.; Hertem, van T.; Viazzi, S.; Romanini Bites, E.; Halachmi, I.; Bahr, C.; Berckmans, D.; Lokhorst, K.

    2014-01-01

    The objective of this review was to describe, compare and evaluate agreement, reliability, and validity of manual and automatic locomotion scoring systems (MLSSs and ALSSs, respectively) used in dairy cattle lameness research. There are many different types of MLSSs and ALSSs. Twenty-five MLSSs were

  6. Assessment of a HER2 scoring system for gastric cancer: results from a validation study

    NARCIS (Netherlands)

    Hofmann, M.; Stoss, O.; Shi, D.; Büttner, R.; van de Vijver, M.; Kim, W.; Ochiai, A.; Rüschoff, J.; Henkel, T.

    2008-01-01

    AIMS: Human epidermal growth factor receptor 2 (HER2) overexpression/amplification is implicated in the development of various solid tumour types. Validated methods and scoring systems for evaluating HER2 status exist in breast cancer, but not in gastric cancer. The aim was to establish a HER2

  7. An integrative scoring system for survival prediction following umbilical cord blood transplantation in acute leukemia

    NARCIS (Netherlands)

    Shouval, Roni; Ruggeri, Annalisa; Labopin, Myriam; Mohty, Mohamad; Sanz, Guillermo; Michel, Gerard; Kuball, Jürgen; Chevallier, Patrice; Al-Seraihy, Amal; Milpied, Noel Jean; De Heredia, Cristina Diaz; Arcese, William; Blaise, Didier; Rocha, Vanderson; Fein, Joshua; Unger, Ron; Baron, Frederic; Bader, Peter; Gluckman, Eliane; Nagler, Arnon

    2017-01-01

    Purpose: Survival of acute leukemia (AL) patients following umbilical cord blood transplantation (UCBT) is dependent on an array of individual features. Integrative models for risk assessment are lacking. We sought to develop a scoring system for prediction of overall survival (OS) and leukemia-free

  8. Nurse-administered early warning score system can be used for emergency department triage

    DEFF Research Database (Denmark)

    Christensen, Dorthea; Jensen, Nanna Martin; Maaløe, Rikke

    2011-01-01

    Studies have shown that early warning score systems can identify in-patients at high risk of catastrophic deterioration and this may possibly be used for an emergency department (ED) triage. Bispebjerg Hospital has introduced a multidisciplinary team (MT) in the ED activated by the Bispebjerg Early...

  9. Cardiovascular risk stratification by means of the SCORE system in health care workers in Veracruz, Mexico.

    Science.gov (United States)

    González-Velázquez, Felipe; Mendez, Gustavo F

    2007-09-14

    To assess cardiovascular disease risk by means of the SCORE system (Systematic Coronary Risk Evaluation) in health care workers (HCW) from Veracruz, Mexico. A cross-sectional study was undertaken at the Mexican Institute of Social Security from Veracruz. Seventy six HCW without physical limitations (NYHA Functional Class I) were included. All HCW answered a standardised medical history questionnaire and were evaluated by physical examination and lab tests. The cardiovascular risk was assessed through the SCORE system. The median age of participants was 47 years (90% range 42-57 years), female HCW had higher prevalence of obesity and lower prevalence of overweight compared to male HCW (52% vs 23% for obesity and 26% vs 63% for overweight; p=0.014). The prevalence of hypertension was 22%, type 2 diabetes 8%, hypercholesterolemia 70%, hypertriglyceridemia 47% and mixed hyperlipidemia 26%. Cardiovascular risk assessed by the SCORE system showed that 14% of all patients had a cardiovascular risk higher than 2% and 51% had a risk lower than 1%. In this first study of cardiovascular risk assessment by means of the SCORE system in HCW in Mexico, we found that 14% of them have a cardiac risk higher than 2% and that it is double than expected for their age but it is lower than reported in a European population. Also, we found a higher prevalence of hypercholesterolemia and mixed hyperlipidemia showing poor education and treatment for cardiovascular prevention.

  10. Comparison of Glasgow-Blatchford score and full Rockall score systems to predict clinical outcomes in patients with upper gastrointestinal bleeding

    Directory of Open Access Journals (Sweden)

    Mokhtare M

    2016-10-01

    Full Text Available Marjan Mokhtare, Vida Bozorgi, Shahram Agah, Mehdi Nikkhah, Amirhossein Faghihi, Amirhossein Boghratian, Neda Shalbaf, Abbas Khanlari, Hamidreza Seifmanesh Colorectal Research Center, Rasoul Akram Hospital, Tehran, Iran Background: Various risk scoring systems have been recently developed to predict clinical outcomes in patients with upper gastrointestinal bleeding (UGIB. The two commonly used scoring systems include full Rockall score (RS and the Glasgow-Blatchford score (GBS. Bleeding scores were assessed in terms of prediction of clinical outcomes in patients with UGIB. Patients and methods: Two hundred patients (age >18 years with obvious symptoms of UGIB in the emergency department of Rasoul Akram Hospital were enrolled. Full RS and GBS were calculated. We followed the patients for records of rebleeding and 1-month mortality. A receiver operating characteristic curve by using areas under the curve (AUCs was used to statistically identify the best cutoff point. Results: Eighteen patients were excluded from the study due to failure to follow-up. Rebleeding and mortality rate were 9.34% (n=17 and 11.53% (n=21, respectively. Regarding 1-month mortality, full RS was better than GBS (AUC, 0.648 versus 0.582; P=0.021. GBS was more accurate in terms of detecting transfusion need (AUC, 0.757 versus 0.528; P=0.001, rebleeding rate (AUC, 0.722 versus 0.520; P=0.002, intensive care unit admission rate (AUC, 0.648 versus 0.582; P=0.021, and endoscopic intervention rate (AUC, 0.771 versus 0.650; P<0.001. Conclusion: We found the full RS system is better for 1-month mortality prediction while GBS system is better for prediction of other outcomes. Keywords: full Rockall score, Glasgow-Blatchford score, gastrointestinal bleeding, mortality, prognosis

  11. Excess atherosclerosis in systemic lupus erythematosus,-A matter of renal involvement: Case control study of 281 SLE patients and 281 individually matched population controls.

    Science.gov (United States)

    Gustafsson, Johanna T; Herlitz Lindberg, Marie; Gunnarsson, Iva; Pettersson, Susanne; Elvin, Kerstin; Öhrvik, John; Larsson, Anders; Jensen-Urstad, Kerstin; Svenungsson, Elisabet

    2017-01-01

    Systemic lupus erythematosus (SLE), is a heterogeneous disease which predominantly affects young females (90%). SLE is associated with a shorter life expectancy than in the general population. Standardized mortality ratios (SMR) of 2.4 have been reported, which is comparable to diabetes. In modern societies cardiovascular disease (CVD) is the major cause of premature mortality. Accelerated atherosclerosis is generally assumed to be the underlying cause for SLE related CVD. However, previous studies diverge regarding whether atherosclerosis is more common in SLE than in controls. With this in mind and based on own clinical experience we hypothesized that accelerated atherosclerosis is not a general feature of SLE, but prevails in SLE subgroups. 281 SLE patients and 281 individually age and sex matched population controls, were investigated clinically. Fasting blood samples and risk factor data were collected. All participants were subject to B-mode ultrasonography of the carotid arteries. Carotid plaque occurrence and mean intima media thickness (mIMT) were recorded. Two SLE subgroups previously described to be at high CVD risk; 1) patients with nephritis and 2) patients with anti-phospholipid antibodies (aPL), and one subgroup reported to be at comparatively lower CVD risk; patients positive for Sjögren´s syndrome antigens A/B (SSA/SSB) antibodies were analyzed separately in comparison with their respective matched controls. Median age was 49 (IQR 36-59) years, 93% were females. Manifest CVD; ischemic heart, cerebro- and peripheral vascular disease, prevailed in patients (12% vs. 1%, pnephritis (40%), but neither aPL (25%) nor SSA/SSB (40%) positive patients, had more plaques than their respective controls (23% vs. 11%, p = 0.008). Notably, patients with nephritis were younger than other SLE patients (45 vs.49 years, p = 0.02). To overcome the confounding effect of age we performed an age-matched nested case-control analysis, which demonstrated that patients with

  12. Ultrasonography-guided percutaneous radiofrequency ablation of hepatocellular carcinomas: A feasibility scoring system for planning sonography

    Energy Technology Data Exchange (ETDEWEB)

    Rhim, Hyunchul, E-mail: rhimhc@skku.ed [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Choi, Dongil; Kim, Young-sun; Lim, Hyo K. [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Choe, Bong-Keun [Department of Preventive Medicine, Kyung Hee University School of Medicine, Seoul (Korea, Republic of)

    2010-08-15

    Purpose: This study was designed to evaluate whether a feasibility scoring system for planning sonography is a reliable predictor of a safe and complete ablation in ultrasonography (US)-guided percutaneous radiofrequency ablation (RFA) of hepatocellular carcinomas (HCCs). Materials and methods: We retrospectively evaluated the therapeutic outcomes of 108 consecutive patients (M:F, 78:30; mean age, 57.4 years) with a single nodular HCC (mean diameter, 2.0 cm) treated by percutaneous RFA. All patients were assessed for the feasibility of performing an RFA at planning sonography prior to the ablation. The feasibility scoring system consisted of five categories: the safe electrode path (P); the vital organs adjacent to the RFA zone (O); tumor size (S); tumor conspicuity (C); and the heat-sink effect (H). Each category was divided into a four-point scale [1-4]. If a score of 4 in any category was determined, the patient was not considered to be a suitable candidate for percutaneous RFA. We assessed if the score of each category, safety score (P + O), and curability score (S + C + H) correlated with a safe and complete ablation using the chi-squared test and likelihood ratio test for trend. Results: The technical success rate was 100% (108/108) based on CT images obtained immediately after ablation. There was no 30-day mortality after RFA. There were major complications (one case of severe vasovagal reflex, one case of hemoperitoneum and one case of a pseudoaneurysm) in three (2.7%) patients, and minor complications (one case of a biloma, one case of subsegmental infarction and one case of abscess) in three (2.7%) patients. Post-ablation syndrome as a side effect was noted in 38 (35.1%) of 108 patients. The primary technique effectiveness rate at 1 month was 95.1% (105/108). Local tumor progression was noted in eight (7.6%) of 105 patients during the follow-up period (range, 3.0-11.5 months; median, 5.8 months; mean, 5.7 months). There was no significant single category

  13. Application of balanced score card in the development of performance indicator system in nuclear power plant

    International Nuclear Information System (INIS)

    Shen Shuguang; Huang Fang; Fang Zhaoxia

    2013-01-01

    Performance indicator, which is one of ten performance monitoring tools recommended by WANO performance improvement model, has become an effective tool for performance improvement of nuclear power plant. At present, performance indicator system has been built in nuclear power plant. However, how to establish the performance indicator system that is reasonable and applicable for plant is still a question to be discussed. Performance indictor is closely tied to the strategic direction of a corporation by a balanced score card, and the performance indicator system is established from the point of performance management and strategic development. The performance indicator system of nuclear power plant is developed by introducing the balanced score card, and can be as a reference for other domestic nuclear power plants. (authors)

  14. Nurse-administered early warning score system can be used for emergency department triage

    DEFF Research Database (Denmark)

    Christensen, Dorthea; Jensen, Nanna Martin; Maaløe, Rikke

    2011-01-01

    Studies have shown that early warning score systems can identify in-patients at high risk of catastrophic deterioration and this may possibly be used for an emergency department (ED) triage. Bispebjerg Hospital has introduced a multidisciplinary team (MT) in the ED activated by the Bispebjerg Early...... Warning Score (BEWS). The BEWS is calculated on the basis of respiratory frequency, pulse, systolic blood pressure, temperature and level of consciousness. The aim of this study is to evaluate the ability of the BEWS to identify critically ill patients in the ED and to examine the feasibility of using...

  15. [The scoring and rating system for the estimation of the teaching efficiency in forensic medicine].

    Science.gov (United States)

    Buromskiĭ, I V; Kil'diushov, E M

    2012-01-01

    The authors developed a system of criteria for the evaluation of the results of education of forensic medical students based on the scoring and rating scale. The major requirements for the organization of academic activities are considered. It is emphasized that the compliance with these requirements is an indispensable prerequisite for the introduction of the above system in the training routine at the Department of Forensic Medicine.

  16. Establishment of a general NAFLD scoring system for rodent models and comparison to human liver pathology.

    Directory of Open Access Journals (Sweden)

    Wen Liang

    Full Text Available The recently developed histological scoring system for non-alcoholic fatty liver disease (NAFLD by the NASH Clinical Research Network (NASH-CRN has been widely used in clinical settings, but is increasingly employed in preclinical research as well. However, it has not been systematically analyzed whether the human scoring system can directly be converted to preclinical rodent models. To analyze this, we systematically compared human NAFLD liver pathology, using human liver biopsies, with liver pathology of several NAFLD mouse models. Based upon the features pertaining to mouse NAFLD, we aimed at establishing a modified generic scoring system that is applicable to broad spectrum of rodent models.The histopathology of NAFLD was analyzed in several different mouse models of NAFLD to define generic criteria for histological assessment (preclinical scoring system. For validation of this scoring system, 36 slides of mouse livers, covering the whole spectrum of NAFLD, were blindly analyzed by ten observers. Additionally, the livers were blindly scored by one observer during two separate assessments longer than 3 months apart.The criteria macrovesicular steatosis, microvesicular steatosis, hepatocellular hypertrophy, inflammation and fibrosis were generally applicable to rodent NAFLD. The inter-observer reproducibility (evaluated using the Intraclass Correlation Coefficient between the ten observers was high for the analysis of macrovesicular steatosis and microvesicular steatosis (ICC = 0.784 and 0.776, all p<0.001, respectively and moderate for the analysis of hypertrophy and inflammation (ICC = 0.685 and 0.650, all p<0.001, respectively. The intra-observer reproducibility between the different observations of one observer was high for the analysis of macrovesicular steatosis, microvesicular steatosis and hypertrophy (ICC = 0.871, 0.871 and 0.896, all p<0.001, respectively and very high for the analysis of inflammation (ICC = 0.931, p

  17. Connective tissue diseases and noninvasive evaluation of atherosclerosis

    Directory of Open Access Journals (Sweden)

    Ardita G

    2014-06-01

    Full Text Available Giorgio Ardita, Giacomo Failla, Paolo Maria Finocchiaro, Francesco Mugno, Luigi Attanasio, Salvatore Timineri, Michelangelo Maria Di SalvoCardiovascular Department, Angiology Unit, Ferrarotto Hospital, Catania, ItalyAbstract: Connective tissue diseases (CTDs are associated with increased risk of cardiovascular disease due to accelerated atherosclerosis. In patients with autoimmune disorders, in addition to traditional risk factors, an immune-mediated inflammatory process of the vasculature seems to contribute to atherogenesis. Several pathogenetic mechanisms have been proposed, including chronic inflammation and immunologic abnormalities, both able to produce vascular damage. Macrovascular atherosclerosis can be noninvasively evaluated by ultrasound measurement of carotid or femoral plaque. Subclinical atherosclerosis can be evaluated by well-established noninvasive techniques which rely on ultrasound detection of carotid intima-media thickness. Flow-mediated vasodilatation and arterial stiffness are considered markers of endothelial dysfunction and subclinical atherosclerosis, respectively, and have been recently found to be impaired early in a wide spectrum of autoimmune diseases. Carotid intima-media thickness turns out to be a leading marker of subclinical atherosclerosis, and many studies recognize its role as a predictor of future vascular events, both in non-CTD individuals and in CTD patients. In rheumatic diseases, flow-mediated dilatation and arterial stiffness prove to be strongly correlated with inflammation, disease damage index, and with subclinical atherosclerosis, although their prognostic role has not yet been conclusively shown. Systemic lupus erythematosus, rheumatoid arthritis, and likely antiphospholipid syndrome are better associated with premature and accelerated atherosclerosis. Inconclusive results were reported in systemic sclerosis.Keywords: rheumatic disease, subclinical atherosclerosis, arterial stiffness

  18. New scoring system of an interview for the diagnosis of benign paroxysmal positional vertigo.

    Science.gov (United States)

    Imai, Takao; Higashi-Shingai, Kayoko; Takimoto, Yasumitsu; Masumura, Chisako; Hattori, Kenji; Inohara, Hidenori

    2016-01-01

    Conclusion This study investigated a novel instrument to diagnose benign paroxysmal positional vertigo (BPPV). Objective To develop a new scoring system of an interview for the diagnosis of BPPV. Methods The answers to questions on dizziness and/or vertigo (D/V) (571 patients) were analyzed and the questions for which the answers differed significantly between the patients with and without BPPV were selected. Results This study established an intensive questionnaire with a scoring system. It consists of the following questions: (1) Is rotary vertigo a characteristic of your D/V? (2) Is your D/V triggered when you roll your head over in a supine position? (3) Does your D/V disappear within 5 min? (4) Have you previously experienced hearing loss in one ear, or have you experienced hearing loss, tinnitus, or ear fullness with this D/V? One point each was given to an answer of 'yes' to questions (1) and (2). Two points were given to an answer of 'yes' to question (3). One point was subtracted upon an answer of 'yes' to question (4). When the total score was greater than two points, the patient was diagnosed with BPPV. The sensitivity of the diagnosis of BPPV by this scoring system was 81% and the specificity was 69%.

  19. Hypoxia in atherosclerosis and inflammation

    NARCIS (Netherlands)

    Marsch, Elke; Sluimer, Judith C.; Daemen, Mat J. A. P.

    2013-01-01

    Hypoxia triggers various cellular processes, both in physiological and pathological conditions, and has recently also been implicated in atherosclerosis. This review summarizes the recent evidence for the presence and the role of hypoxia in atherosclerosis. Additionally, it will elucidate on hypoxic

  20. Agreement in the assessment of metastatic spine disease using scoring systems

    International Nuclear Information System (INIS)

    Arana, Estanislao; Kovacs, Francisco M.; Royuela, Ana; Asenjo, Beatriz; Pérez-Ramírez, Ursula; Zamora, Javier; Abraira, Víctor

    2015-01-01

    Purpose: To assess variability in the use of Tomita and modified Bauer scores in spine metastases. Materials and methods: Clinical data and imaging from 90 patients with biopsy-proven spinal metastases, were provided to 83 specialists from 44 hospitals. Spinal levels involved and the Tomita and modified Bauer scores for each case were determined twice by each clinician, with a minimum of 6-week interval. Clinicians were blinded to every evaluation. Kappa statistic was used to assess intra and inter-observer agreement. Subgroup analyses were performed according to clinicians’ specialty (medical oncology, neurosurgery, radiology, orthopedic surgery and radiation oncology), years of experience (⩽7, 8–13, ⩾14), and type of hospital (four levels). Results: For metastases identification, intra-observer agreement was “substantial” (0.60 < k < 0.80) at sacrum, and “almost perfect” (k > 0.80) at the other levels. Inter-observer agreement was “almost perfect” at lumbar spine, and “substantial” at the other levels. Intra-observer agreement for the Tomita and Bauer scores was almost perfect. Inter-observer agreement was almost perfect for the Tomita score and substantial for the Bauer one. Results were similar across specialties, years of experience and type of hospital. Conclusion: Agreement in the assessment of metastatic spine disease is high. These scoring systems can improve communication among clinicians involved in oncology care

  1. Agreement in the assessment of metastatic spine disease using scoring systems.

    Science.gov (United States)

    Arana, Estanislao; Kovacs, Francisco M; Royuela, Ana; Asenjo, Beatriz; Pérez-Ramírez, Ursula; Zamora, Javier

    2015-04-01

    To assess variability in the use of Tomita and modified Bauer scores in spine metastases. Clinical data and imaging from 90 patients with biopsy-proven spinal metastases, were provided to 83 specialists from 44 hospitals. Spinal levels involved and the Tomita and modified Bauer scores for each case were determined twice by each clinician, with a minimum of 6-week interval. Clinicians were blinded to every evaluation. Kappa statistic was used to assess intra and inter-observer agreement. Subgroup analyses were performed according to clinicians' specialty (medical oncology, neurosurgery, radiology, orthopedic surgery and radiation oncology), years of experience (⩽7, 8-13, ⩾14), and type of hospital (four levels). For metastases identification, intra-observer agreement was "substantial" (0.600.80) at the other levels. Inter-observer agreement was "almost perfect" at lumbar spine, and "substantial" at the other levels. Intra-observer agreement for the Tomita and Bauer scores was almost perfect. Inter-observer agreement was almost perfect for the Tomita score and substantial for the Bauer one. Results were similar across specialties, years of experience and type of hospital. Agreement in the assessment of metastatic spine disease is high. These scoring systems can improve communication among clinicians involved in oncology care. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  2. Chromosome painting in biological dosimetry: Semi-automatic system to score stable chromosome aberrations

    International Nuclear Information System (INIS)

    Garcia-Sagredo, J.M.; Vallcorba, I.; Sanchez-Hombre, M.C.; Ferro, M.T.; San Roman Cos-Gayon, C.; Santos, A.; Malpica, N.; Ortiz, C.

    1997-01-01

    From the beginning of the description of the procedure of chromosome painting by fluorescence in situ hybridization (FISH), it was thought its possible application to score induced chromosomal aberrations in radiation exposition. With chromosome painting it is possible to detect changes between chromosomes that has been validated in radiation exposition. Translocation scoring by FISH, contrarily to the unstable dicentrics, mainly detect stable chromosome aberrations that do not disappear, it allows the capability of quantify delayed acute expositions or chronic cumulative expositions. The large number of cells that have to be analyzed for high accuracy, specially when dealing with low radiation doses, makes it almost imperative to use an automatic analysis system. After validate translocation scoring by FISH in our, we have evaluated the ability and sensitivity to detect chromosomal aberrations by chromosome using different paint probes used, showing that any combination of paint probes can be used to score induced chromosomal aberrations. Our group has developed a FISH analysis that is currently being adapted for translocation scoring analysis. It includes systematic error correction and internal control probes. The performance tests carried out show that 9,000 cells can be analyzed in 10 hr. using a Sparc 4/370. Although with a faster computer, a higher throughput is expected, for large population screening or very low radiation doses, this performance still has to be improved. (author)

  3. Weighing of risk factors for penetrating keratoplasty graft failure: application of Risk Score System

    Directory of Open Access Journals (Sweden)

    Abdo Karim Tourkmani

    2017-03-01

    Full Text Available AIM: To analyze the relationship between the score obtained in the Risk Score System (RSS proposed by Hicks et al with penetrating keratoplasty (PKP graft failure at 1y postoperatively and among each factor in the RSS with the risk of PKP graft failure using univariate and multivariate analysis. METHODS: The retrospective cohort study had 152 PKPs from 152 patients. Eighteen cases were excluded from our study due to primary failure (10 cases, incomplete medical notes (5 cases and follow-up less than 1y (3 cases. We included 134 PKPs from 134 patients stratified by preoperative risk score. Spearman coefficient was calculated for the relationship between the score obtained and risk of failure at 1y. Univariate and multivariate analysis were calculated for the impact of every single risk factor included in the RSS over graft failure at 1y. RESULTS: Spearman coefficient showed statistically significant correlation between the score in the RSS and graft failure (P0.05 between diagnosis and lens status with graft failure. The relationship between the other risk factors studied and graft failure was significant (P<0.05, although the results for previous grafts and graft failure was unreliable. None of our patients had previous blood transfusion, thus, it had no impact. CONCLUSION: After the application of multivariate analysis techniques, some risk factors do not show the expected impact over graft failure at 1y.

  4. Technical feasibility and validation of a coronary artery calcium scoring system using CT coronary angiography images

    Energy Technology Data Exchange (ETDEWEB)

    Pavitt, Christopher W. [Royal Brompton Hospital, Department of Cardiology, London (United Kingdom); Royal Brompton Hospital, Department of Radiology, London (United Kingdom); Harron, Katie [Institute of Child Health, UCL, Centre for Paediatric Epidemiology and Biostatistics, London (United Kingdom); Lindsay, Alistair C.; Ray, Robin [Royal Brompton Hospital, Department of Cardiology, London (United Kingdom); Zielke, Sayeh; Rubens, Michael B. [Royal Brompton Hospital, Department of Radiology, London (United Kingdom); Gordon, Daniel [Royal Marsden Hospital, Department of Physics, London (United Kingdom); Padley, Simon P. [Royal Brompton Hospital, Department of Radiology, London (United Kingdom); Imperial College, Faculty of Medicine, London (United Kingdom); Nicol, Edward D. [Royal Brompton Hospital, Department of Cardiology, London (United Kingdom); Royal Brompton Hospital, Department of Radiology, London (United Kingdom); Imperial College, Faculty of Medicine, London (United Kingdom)

    2016-05-15

    We validate a novel CT coronary angiography (CCTA) coronary calcium scoring system. Calcium was quantified on CCTA images using a new patient-specific attenuation threshold: mean + 2SD of intra-coronary contrast density (HU). Using 335 patient data sets a conversion factor (CF) for predicting CACS from CCTA scores (CCTAS) was derived and validated in a separate cohort (n = 168). Bland-Altman analysis and weighted kappa for MESA centiles and Agatston risk groupings were calculated. Multivariable linear regression yielded a CF: CACS = (1.185 x CCTAS) + (0.002 x CCTAS x attenuation threshold). When applied to CCTA data sets there was excellent correlation (r = 0.95; p < 0.0001) and agreement (mean difference -10.4 [95 % limits of agreement -258.9 to 238.1]) with traditional calcium scores. Agreement was better for calcium scores below 500; however, MESA percentile agreement was better for high risk patients. Risk stratification was excellent (Agatston groups k = 0.88 and MESA centiles k = 0.91). Eliminating the dedicated CACS scan decreased patient radiation exposure by approximately one-third. CCTA calcium scores can accurately predict CACS using a simple, individualized, semiautomated approach reducing acquisition time and radiation exposure when evaluating patients for CAD. This method is not affected by the ROI location, imaging protocol, or tube voltage strengthening its clinical applicability. (orig.)

  5. New scoring system for intra-abdominal injury diagnosis after blunt trauma

    Directory of Open Access Journals (Sweden)

    Shojaee Majid

    2014-02-01

    Full Text Available 【Abstract】Objective: An accurate scoring system for intra-abdominal injury (IAI based on clinical manifestation and examination may decrease unnecessary CT scans, save time, and reduce healthcare cost. This study is designed to provide a new scoring system for a better diagno- sis of IAI after blunt trauma. Methods: This prospective observational study was performed from April 2011 to October 2012 on patients aged above 18 years and suspected with blunt abdominal trauma (BAT admitted to the emergency department (ED of Imam Hussein Hospital and Shohadaye Hafte Tir Hospital. All patients were assessed and treated based on Advanced Trauma Life Support and ED protocol. Diagnosis was done according to CT scan findings, which was considered as the gold standard. Data were gathered based on patient's history, physical exam, ultrasound and CT scan findings by a general practitioner who was not blind to this study. Chisquare test and logistic regression were done. Factors with significant relationship with CT scan were imported in multivariate regression models, where a coefficient (β was given based on the contribution of each of them. Scoring system was developed based on the obtained total βof each factor. Results: Altogether 261 patients (80.1% male were enrolled (48 cases of IAI. A 24-point blunt abdominal trauma scoring system (BATSS was developed. Patients were divided into three groups including low (score<8, moderate (8≤score<12 and high risk (score≥12. In high risk group immediate laparotomy should be done, moderate group needs further assessments, and low risk group should be kept under observation. Low risk patients did not show positive CT-scans (specificity 100%. Conversely, all high risk patients had positive CT-scan findings (sensitivity 100%. The receiver operating characteristic curve indicated a close relationship between the results of CT scan and BATSS (sensitivity=99.3%. Conclusion: The present scoring system furnishes a

  6. The urgent need for a harmonized severity scoring system for acute allergic reactions.

    Science.gov (United States)

    Muraro, Antonella; Fernandez-Rivas, Montserrat; Beyer, Kirsten; Cardona, Victòria; Clark, Andrew; Eller, Esben; Hourihane, Jonathan O'B; Jutel, Marek; Sheikh, Aziz; Agache, Ioana; Allen, Katrina J; Angier, Liz; Ballmer-Weber, Barbara; Bilò, Maria Beatrice; Bindslev-Jensen, Carsten; Camargo, Carlos A; Cianferoni, Antonella; DunnGalvin, Audrey; Eigenmann, Philippe A; Halken, Susanne; Hoffmann-Sommergruber, Karin; Lau, Susanne; Nilsson, Caroline; Poulsen, Lars K; Rueff, Franziska; Spergel, Jonathan; Sturm, Gunter; Timmermans, Frans; Torres, Maria J; Turner, Paul; van Ree, Ronald; Wickman, Magnus; Worm, Margitta; Clare Mills, E N; Roberts, Graham

    2018-01-13

    The accurate assessment and communication of the severity of acute allergic reactions is important to patients, clinicians, researchers, the food industry, public health and regulatory authorities. Severity has different meanings to different stakeholders with patients and clinicians rating the significance of particular symptoms very differently. Many severity scoring systems have been generated, most focusing on the severity of reactions following exposure to a limited group of allergens. They are heterogeneous in format, none has used an accepted developmental approach and none has been validated. Their wide range of outcome formats has led to difficulties with interpretation and application. Therefore there is a persisting need for an appropriately developed and validated severity scoring system for allergic reactions that works across the range of allergenic triggers and addresses the needs of different stakeholder groups. We propose a novel approach to develop and then validate a harmonized scoring system for acute allergic reactions, based on a data-driven method that is informed by clinical and patient experience and other stakeholders' perspectives. We envisage two formats: (i) a numerical score giving a continuum from mild to severe reactions that is clinically meaningful and is useful for allergy healthcare professionals and researchers; and (ii) a three grade based ordinal format that is simple enough to be used and understood by other professionals and patients. Testing of reliability and validity of the new approach in a range of settings and populations will allow eventual implementation of a standardized scoring system in clinical studies and routine practice. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  7. A novel weighted scoring system for estimating the risk of rapid growth in untreated intracranial meningiomas.

    Science.gov (United States)

    Lee, Eun Jung; Kim, Jeong Hoon; Park, Eun Suk; Kim, Young-Hoon; Lee, Jae Koo; Hong, Seok Ho; Cho, Young Hyun; Kim, Chang Jin

    2017-11-01

    OBJECTIVE Advances in neuroimaging techniques have led to the increased detection of asymptomatic intracranial meningiomas (IMs). Despite several studies on the natural history of IMs, a comprehensive evaluation method for estimating the growth potential of these tumors, based on the relative weight of each risk factor, has not been developed. The aim of this study was to develop a weighted scoring system that estimates the risk of rapid tumor growth to aid treatment decision making. METHODS The authors performed a retrospective analysis of 232 patients with presumed IM who had been prospectively followed up in the absence of treatment from 1997 to 2013. Tumor volume was measured by imaging at each follow-up visit, and the growth rate was determined by regression analysis. Predictors of rapid tumor growth (defined as ≥ 2 cm 3 /year) were identified using a logistic regression model; each factor was awarded a score based on its own coefficient value. The probability (P) of rapid tumor growth was estimated using the following formula:[Formula: see text] RESULTS Fifty-nine tumors (25.4%) showed rapid growth. Tumor size (OR per cm 3 1.07, p = 0.000), absence of calcification (OR 3.87, p = 0.004), peritumoral edema (OR 2.74, p = 0.025), and hyperintense or isointense signal on T2-weighted MRI (OR 3.76, p = 0.049) were predictors of tumor growth rate. In the Asan Intracranial Meningioma Scoring System (AIMSS), tumor size was categorized into 3 groups of operating characteristic curve was 0.86. CONCLUSIONS The authors suggest a weighted scoring system (AIMSS) that predicts the specific probability of rapid tumor growth for patients with untreated IM. This scoring system will aid treatment decision making in clinical settings by screening out patients at high risk for rapid tumor growth.

  8. Scoring system to distinguish between rotavirus and non-rotavirus diarrhea in children

    Directory of Open Access Journals (Sweden)

    Atika Akbari

    2017-01-01

    Full Text Available Background Distinguishing rotavirus from non-rotavirus diarrhea is helpful for managing the illness. However, definitively diagnosing rotavirus diarrhea from serology is difficult and expensive. Objectives To distinguish between the clinical manifestations of rotavirus and non-rotavirus diarrhea, and to assess the accuracy of using such clinical manifestations to predict the type of diarrhea in children. Methods A cross-sectional study was performed from April to October 2015 in all children less than five years of age who presented with acute diarrhea at the Pediatric Outpatient Clinic of the Department of Child Health and Emergency Department, Dr. Mohammad Hoesin and Bari Hospitals, Palembang, South Sumatera. Clinical manifestations were collected from history and physical examinations; stool specimens were examined by immunochromatography. Clinical parameters were analyzed by multivariate analysis, and scores given to each significant parameter. The accuracy of the scoring system based in these parameters was analyzed by means of receiver-operating characteristic (ROC area under the curve (AUC. Results Of 184 children, 92 had rotavirus and 92 had non-rotavirus diarrhea. Multivariate analysis showed 3 clinical parameters commonly seen in the rotavirus diarrhea cases: male sex (OR 2.718; 95%CI 1.373 to 5.382, cough (OR 3.500; 95%CI 1.788 to 6.582, and yellow-greenish stool (OR 4.009; 95%CI 2.061 to 7.797. A scoring system was constructed based on the parameters: male (score of 1, cough (score of 2, and yellow-greenish stool (score of 3. From ROC analysis, the AUC was 0.755. Using a cut-off score of > 3, the sensitivity was 81.5%, specificity 51.1%, and PPV 62.5%. Conclusion Cough, yellow-greenish stool, and male are significant parameters for differentiating rotavirus from non-rotavirus diarrhea. A scoring system from these parameters is sensitive for predicting rotavirus vs. non-rotavirus diarrhea in children less than five years of age.

  9. A Standardized DNA Variant Scoring System for Pathogenicity Assessments in Mendelian Disorders.

    Science.gov (United States)

    Karbassi, Izabela; Maston, Glenn A; Love, Angela; DiVincenzo, Christina; Braastad, Corey D; Elzinga, Christopher D; Bright, Alison R; Previte, Domenic; Zhang, Ke; Rowland, Charles M; McCarthy, Michele; Lapierre, Jennifer L; Dubois, Felicita; Medeiros, Katelyn A; Batish, Sat Dev; Jones, Jeffrey; Liaquat, Khalida; Hoffman, Carol A; Jaremko, Malgorzata; Wang, Zhenyuan; Sun, Weimin; Buller-Burckle, Arlene; Strom, Charles M; Keiles, Steven B; Higgins, Joseph J

    2016-01-01

    We developed a rules-based scoring system to classify DNA variants into five categories including pathogenic, likely pathogenic, variant of uncertain significance (VUS), likely benign, and benign. Over 16,500 pathogenicity assessments on 11,894 variants from 338 genes were analyzed for pathogenicity based on prediction tools, population frequency, co-occurrence, segregation, and functional studies collected from internal and external sources. Scores were calculated by trained scientists using a quantitative framework that assigned differential weighting to these five types of data. We performed descriptive and comparative statistics on the dataset and tested interobserver concordance among the trained scientists. Private variants defined as variants found within single families (n = 5,182), were either VUS (80.5%; n = 4,169) or likely pathogenic (19.5%; n = 1,013). The remaining variants (n = 6,712) were VUS (38.4%; n = 2,577) or likely benign/benign (34.7%; n = 2,327) or likely pathogenic/pathogenic (26.9%, n = 1,808). Exact agreement between the trained scientists on the final variant score was 98.5% [95% confidence interval (CI) (98.0, 98.9)] with an interobserver consistency of 97% [95% CI (91.5, 99.4)]. Variant scores were stable and showed increasing odds of being in agreement with new data when re-evaluated periodically. This carefully curated, standardized variant pathogenicity scoring system provides reliable pathogenicity scores for DNA variants encountered in a clinical laboratory setting. © 2015 The Authors. **Human Mutation published by Wiley Periodicals, Inc.

  10. Hospital triage system for adult patients using an influenza-like illness scoring system during the 2009 pandemic--Mexico.

    Science.gov (United States)

    Rodriguez-Noriega, Eduardo; Gonzalez-Diaz, Esteban; Morfin-Otero, Rayo; Gomez-Abundis, Gerardo F; Briseño-Ramirez, Jaime; Perez-Gomez, Hector Raul; Lopez-Gatell, Hugo; Alpuche-Aranda, Celia M; Ramírez, Ernesto; López, Irma; Iguala, Miguel; Bojórquez Chapela, Ietza; Palacios Zavala, Ethel; Hernández, Mauricio; Stuart, Tammy L; Villarino, Margarita Elsa; Widdowson, Marc-Alain; Waterman, Steve; Uyeki, Timothy; Azziz-Baumgartner, Eduardo

    2010-05-14

    Pandemic influenza A (H1N1) virus emerged during 2009. To help clinicians triage adults with acute respiratory illness, a scoring system for influenza-like illness (ILI) was implemented at Hospital Civil de Guadalajara, Mexico. A medical history, laboratory and radiology results were collected on emergency room (ER) patients with acute respiratory illness to calculate an ILI-score. Patients were evaluated for admission by their ILI-score and clinicians' assessment of risk for developing complications. Nasal and throat swabs were collected from intermediate and high-risk patients for influenza testing by RT-PCR. The disposition and ILI-score of those oseltamivir-treated versus untreated, clinical characteristics of 2009 pandemic influenza A (H1N1) patients versus test-negative patients were compared by Pearson's Chi(2), Fisher's Exact, and Wilcoxon rank-sum tests. Of 1840 ER patients, 230 were initially hospitalized (mean ILI-score = 15), and the rest were discharged, including 286 ambulatory patients given oseltamivir (median ILI-score = 11), and 1324 untreated (median ILI-score = 5). Fourteen (1%) untreated patients returned, and 3 were hospitalized on oseltamivir (median ILI-score = 19). Of 371 patients tested by RT-PCR, 104 (28%) had pandemic influenza and 42 (11%) had seasonal influenza A detected. Twenty (91%) of 22 imaged hospitalized pandemic influenza patients had bilateral infiltrates compared to 23 (38%) of 61 imaged hospital test-negative patients (pinfluenza presented 6 days after symptom onset, required mechanical ventilation, and died. The triaging system that used an ILI-score complimented clinicians' judgment of who needed oseltamivir and inpatient care and helped hospital staff manage a surge in demand for services.

  11. Hospital triage system for adult patients using an influenza-like illness scoring system during the 2009 pandemic--Mexico.

    Directory of Open Access Journals (Sweden)

    Eduardo Rodriguez-Noriega

    2010-05-01

    Full Text Available Pandemic influenza A (H1N1 virus emerged during 2009. To help clinicians triage adults with acute respiratory illness, a scoring system for influenza-like illness (ILI was implemented at Hospital Civil de Guadalajara, Mexico.A medical history, laboratory and radiology results were collected on emergency room (ER patients with acute respiratory illness to calculate an ILI-score. Patients were evaluated for admission by their ILI-score and clinicians' assessment of risk for developing complications. Nasal and throat swabs were collected from intermediate and high-risk patients for influenza testing by RT-PCR. The disposition and ILI-score of those oseltamivir-treated versus untreated, clinical characteristics of 2009 pandemic influenza A (H1N1 patients versus test-negative patients were compared by Pearson's Chi(2, Fisher's Exact, and Wilcoxon rank-sum tests.Of 1840 ER patients, 230 were initially hospitalized (mean ILI-score = 15, and the rest were discharged, including 286 ambulatory patients given oseltamivir (median ILI-score = 11, and 1324 untreated (median ILI-score = 5. Fourteen (1% untreated patients returned, and 3 were hospitalized on oseltamivir (median ILI-score = 19. Of 371 patients tested by RT-PCR, 104 (28% had pandemic influenza and 42 (11% had seasonal influenza A detected. Twenty (91% of 22 imaged hospitalized pandemic influenza patients had bilateral infiltrates compared to 23 (38% of 61 imaged hospital test-negative patients (p<0.001. One patient with confirmed pandemic influenza presented 6 days after symptom onset, required mechanical ventilation, and died.The triaging system that used an ILI-score complimented clinicians' judgment of who needed oseltamivir and inpatient care and helped hospital staff manage a surge in demand for services.

  12. Advanced atherosclerosis is associated with increased medial degeneration in sporadic ascending aortic aneurysms.

    Science.gov (United States)

    Albini, Paul T; Segura, Ana Maria; Liu, Guanghui; Minard, Charles G; Coselli, Joseph S; Milewicz, Dianna M; Shen, Ying H; LeMaire, Scott A

    2014-02-01

    The pathogenesis of non-familial, sporadic ascending aortic aneurysms (SAAA) is poorly understood, and the relationship between ascending aortic atherosclerosis and medial degeneration is unclear. We evaluated the prevalence and severity of aortic atherosclerosis and its association with medial degeneration in SAAA. Atherosclerosis was characterized in ascending aortic tissues collected from 68 SAAA patients (mean age, 62.9 ± 12.0 years) and 15 controls (mean age, 56.6 ± 11.4 years [P = 0.07]) by using a modified American Heart Association classification system. Upon histologic examination, 97% of SAAA patients and 73% of controls showed atherosclerotic changes. Most SAAA samples had intermediate (types 2 and 3, 35%) or advanced atherosclerosis (types ≥ 4; 40%), whereas most control samples showed minimal atherosclerosis (none or type 1, 80%; P atherosclerosis grade. Advanced atherosclerosis was associated with higher grades of smooth muscle cell depletion (P atherosclerosis than in patients with minimal (P = 0.04) or intermediate atherosclerosis (P = 0.04). Immunostaining showed marked CD3+ T-cell and CD68+ macrophage infiltration, MMP-2 and MMP-9 production, and cryopyrin expression in the medial layer adjacent to atherosclerotic plaque. SAAA tissues exhibited advanced atherosclerosis that was associated with severe medial degeneration and increased aortic diameter. Our findings suggest a role for atherosclerosis in the progression of sporadic ascending aortic aneurysms. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  13. The role of the Pirani scoring system in the management of club foot by the Ponseti method.

    Science.gov (United States)

    Dyer, P J; Davis, N

    2006-08-01

    The Pirani scoring system, together with the Ponseti method of club foot management, was assessed for its predictive value. The data on 70 idiopathic club feet successfully treated by the Ponseti method and scored by Pirani's system between February 2002 and May 2004 were analysed. There was a significant positive correlation between the initial Pirani score and number of casts required to correct the deformity. A foot scoring 4 or more is likely to require at least four casts, and one scoring less than 4 will require three or fewer. A foot with a hindfoot score of 2.5 or 3 has a 72% chance of requiring a tenotomy. The Pirani scoring system is reliable, quick, and easy to use, and provides a good forecast about the likely treatment for an individual foot but a low score does not exclude the possibility that a tenotomy may be required.

  14. Evaluation of the Environmental Scoring System in Multiple Child Asthma Intervention Programs in Boston, Massachusetts.

    Science.gov (United States)

    Dong, Zhao; Nath, Anjali; Guo, Jing; Bhaumik, Urmi; Chin, May Y; Dong, Sherry; Marshall, Erica; Murphy, Johnna S; Sandel, Megan T; Sommer, Susan J; Ursprung, W W Sanouri; Woods, Elizabeth R; Reid, Margaret; Adamkiewicz, Gary

    2018-01-01

    To test the applicability of the Environmental Scoring System, a quick and simple approach for quantitatively measuring environmental triggers collected during home visits, and to evaluate its contribution to improving asthma outcomes among various child asthma programs. We pooled and analyzed data from multiple child asthma programs in the Greater Boston Area, Massachusetts, collected in 2011 to 2016, to examine the association of environmental scores (ES) with measures of asthma outcomes and compare the results across programs. Our analysis showed that demographics were important contributors to variability in asthma outcomes and total ES, and largely explained the differences among programs at baseline. Among all programs in general, we found that asthma outcomes were significantly improved and total ES significantly reduced over visits, with the total Asthma Control Test score negatively associated with total ES. Our study demonstrated that the Environmental Scoring System is a useful tool for measuring home asthma triggers and can be applied regardless of program and survey designs, and that demographics of the target population may influence the improvement in asthma outcomes.

  15. Non-invasive markers of atherosclerosis and their correlation with ...

    African Journals Online (AJOL)

    Aim : To investigate the relationship between non-invasive oscillometric methods that assesses subclinical atherosclerosis, and Framingham Risk Score (FRS), an independent predictor of CVD, in patients with type 2 DM, and age-matched hypertensive and healthy controls. Methods: The four study groups consisted of ...

  16. Is there an association between coronary atherosclerosis and ...

    African Journals Online (AJOL)

    2012-09-25

    Sep 25, 2012 ... Analysis of Variance was used to compare mean coronary artery atherosclerosis scores among ... Kilometer 8, Abakaliki Express Road, Emene,. Enugu ... [7] Multiple, serial, transverse, through and through, cut sections, at 0.5 to. 1.0 cm intervals were made along the entire length of each coronary artery.

  17. Early warning system scores for clinical deterioration in hospitalized patients: a systematic review.

    Science.gov (United States)

    Smith, M E Beth; Chiovaro, Joseph C; O'Neil, Maya; Kansagara, Devan; Quiñones, Ana R; Freeman, Michele; Motu'apuaka, Makalapua L; Slatore, Christopher G

    2014-11-01

    Early warning system (EWS) scores are used by hospital care teams to recognize early signs of clinical deterioration and trigger more intensive care. To systematically review the evidence on the ability of early warning system scores to predict a patient's risk of clinical deterioration and the impact of early warning system implementation on health outcomes and resource utilization. We searched the MEDLINE, CINAHL, and Cochrane Central Register of Controlled Trials databases through May 2014. We included English-language studies of early warning system scores used with adults admitted to medical or surgical wards. We abstracted study characteristics, including population, setting, sample size, duration, and criteria used for early warning system scoring. For predictive ability, the primary outcomes were modeled for discrimination on 48-hour mortality, cardiac arrest, or pulmonary arrest. Outcomes for the impact of early warning system implementation included 30-day mortality, cardiovascular events, use of vasopressors, respiratory failure, days on ventilator, and resource utilization. We assessed study quality using a modified Quality in Prognosis Studies assessment tool where applicable. Of 11,183 citations studies reviewed, one controlled trial and 20 observational studies of 13 unique models met our inclusion criteria. In eight studies, researchers addressed the predictive ability of early warning system tools and found a strong predictive value for death (area under the receiver operating characteristic curve [AUROC], 0.88-0.93) and cardiac arrest (AUROC, 0.74-0.86) within 48 hours. In 13 studies (one controlled trial and 12 pre-post observational studies), researchers addressed the impact on health outcomes and resource utilization and had mixed results. The one controlled trial was of good quality, and the researchers found no difference in mortality, transfers to the ICU, or length of hospital stay. The pre-post designs of the remaining studies have

  18. Predicting hospital-acquired infections by scoring system with simple parameters.

    Directory of Open Access Journals (Sweden)

    Ying-Jui Chang

    Full Text Available BACKGROUND: Hospital-acquired infections (HAI are associated with increased attributable morbidity, mortality, prolonged hospitalization, and economic costs. A simple, reliable prediction model for HAI has great clinical relevance. The objective of this study is to develop a scoring system to predict HAI that was derived from Logistic Regression (LR and validated by Artificial Neural Networks (ANN simultaneously. METHODOLOGY/PRINCIPAL FINDINGS: A total of 476 patients from all the 806 HAI inpatients were included for the study between 2004 and 2005. A sample of 1,376 non-HAI inpatients was randomly drawn from all the admitted patients in the same period of time as the control group. External validation of 2,500 patients was abstracted from another academic teaching center. Sixteen variables were extracted from the Electronic Health Records (EHR and fed into ANN and LR models. With stepwise selection, the following seven variables were identified by LR models as statistically significant: Foley catheterization, central venous catheterization, arterial line, nasogastric tube, hemodialysis, stress ulcer prophylaxes and systemic glucocorticosteroids. Both ANN and LR models displayed excellent discrimination (area under the receiver operating characteristic curve [AUC]: 0.964 versus 0.969, p = 0.507 to identify infection in internal validation. During external validation, high AUC was obtained from both models (AUC: 0.850 versus 0.870, p = 0.447. The scoring system also performed extremely well in the internal (AUC: 0.965 and external (AUC: 0.871 validations. CONCLUSIONS: We developed a scoring system to predict HAI with simple parameters validated with ANN and LR models. Armed with this scoring system, infectious disease specialists can more efficiently identify patients at high risk for HAI during hospitalization. Further, using parameters either by observation of medical devices used or data obtained from EHR also provided good prediction

  19. Interobserver Reliability of Three Validated Scoring Systems in the Assessment of Diabetic Foot Ulcers.

    Science.gov (United States)

    Forsythe, Rachael O; Ozdemir, Baris Ata; Chemla, Eric S; Jones, Keith G; Hinchliffe, Robert J

    2016-09-01

    Scoring systems for diabetic foot ulcers may be used for clinical purposes, research or audit, to help assess disease severity, plan management, and even predict outcomes. While many have been validated in study populations, little is known about their interobserver reliability. This prospective study aimed to evaluate interobserver reliability of 3 scoring systems for diabetic foot ulceration. After sharp debridement, diabetic foot ulcers were classified by a multidisciplinary pool of trained observers, using the PEDIS (Perfusion, Extent, Depth, Infection, Sensation), SINBAD (Site, Ischemia, Neuropathy, Bacterial infection, Depth), and University of Texas (UT) wound classification systems. Interobserver reliability was assessed using intraclass correlations (0 = no agreement; 1 = complete agreement). Thirty-seven patients (78.4% male) were assessed by a pool of 12 observers. Single observer reliability was slight to moderate for all scoring systems (UT 0.53; SINBAD 0.44; PEDIS 0.23-0.42), but multiple observer reliability was almost perfect (UT 0.94; SINBAD 0.91; PEDIS 0.80-0.90). The worst agreement for single observers was when scoring infection (SINBAD 0.28; PEDIS 0.28), ischemia (SINBAD 0.26; PEDIS 0.23), or both (UT 0.25); however, this improved to almost perfect agreement for multiple observers (infection: 0.83; ischemia: 0.80-0.82; both: 0.81). These classification systems may be reliably used by multiple observers, for example, when conducting research and audit. However, they demonstrate only slight to moderate reliability when used by a single observer on an individual subject and may therefore be less helpful in the clinical setting, when documenting ulcer characteristics or communicating between colleagues. © The Author(s) 2016.

  20. Intensive Care Nursing Scoring System Part 2: nursing interventions and nursing outcomes.

    Science.gov (United States)

    Pyykkö, A K; Laurila, J; Ala-Kokko, T I; Hentinen, M

    2001-02-01

    Different medical classifications and scoring systems have been developed to measure and compare intensive care outcomes in international contexts. Many of them, however, do not include outcome variables to describe autonomous nursing and its effects on the patient's experiences and restrictions as a result of the onset and process of illness, or relatives' or significant others' distress in the intensive care environment. The Intensive Care Nursing Scoring System (ICNSS) is a new instrument to describe and highlight nurses' work and its effects on the patients and their relatives in a way not allowed by medical classifications and scoring systems. ICNSS can be used to evaluate a single intensive care nursing process from admission to discharge or to compare patients in different intensive care units for certain variables. ICNSS can also be used to measure nurses' workload. The classification of nursing diagnoses was described in a previous article. This paper describes nursing outcomes and nursing interventions as well as the use of ICNSS in a computer-based information management system in three adult intensive care units in the Oulu University Hospital. Copyright2000 Harcourt Publishers Ltd Copyright DUMMY.

  1. Oxford NOTECHS II: a modified theatre team non-technical skills scoring system.

    Science.gov (United States)

    Robertson, Eleanor R; Hadi, Mohammed; Morgan, Lauren J; Pickering, Sharon P; Collins, Gary; New, Steve; Griffin, Damian; Griffin, Damien; McCulloch, Peter; Catchpole, Ken C

    2014-01-01

    We previously developed and validated the Oxford NOTECHS rating system for evaluating the non-technical skills of an entire operating theatre team. Experience with the scale identified the need for greater discrimination between levels of performance within the normal range. We report here the development of a modified scale (Oxford NOTECHS II) to facilitate this. The new measure uses an eight-point instead of a four point scale to measure each dimension of non-technical skills, and begins with a default rating of 6 for each element. We evaluated this new scale in 297 operations at five NHS sites in four surgical specialities. Measures of theatre process reliability (glitch count) and compliance with the WHO surgical safety checklist were scored contemporaneously, and relationships with NOTECHS II scores explored. Mean team Oxford NOTECHS II scores was 73.39 (range 37-92). The means for surgical, anaesthetic and nursing sub-teams were 24.61 (IQR 23, 27); 24.22 (IQR 23, 26) and 24.55 (IQR 23, 26). Oxford NOTECHS II showed good inter-rater reliability between human factors and clinical observers in each of the four domains. Teams with high WHO compliance had higher mean Oxford NOTECHS II scores (74.5) than those with low compliance (71.1) (p = 0.010). We observed only a weak correlation between Oxford NOTECHS II scores and glitch count; r = -0.26 (95% CI -0.36 to -0.15). Oxford NOTECHS II scores did not vary significantly between 5 different hospital sites, but a significant difference was seen between specialities (p = 0.001). Oxford NOTECHS II provides good discrimination between teams while retaining reliability and correlation with other measures of teamwork performance, and is not confounded by technical performance. It is therefore suitable for combined use with a technical performance scale to provide a global description of operating theatre team performance.

  2. Rating the methodological quality in systematic reviews of studies on measurement properties: a scoring system for the COSMIN checklist.

    Science.gov (United States)

    Terwee, Caroline B; Mokkink, Lidwine B; Knol, Dirk L; Ostelo, Raymond W J G; Bouter, Lex M; de Vet, Henrica C W

    2012-05-01

    The COSMIN checklist is a standardized tool for assessing the methodological quality of studies on measurement properties. It contains 9 boxes, each dealing with one measurement property, with 5-18 items per box about design aspects and statistical methods. Our aim was to develop a scoring system for the COSMIN checklist to calculate quality scores per measurement property when using the checklist in systematic reviews of measurement properties. The scoring system was developed based on discussions among experts and testing of the scoring system on 46 articles from a systematic review. Four response options were defined for each COSMIN item (excellent, good, fair, and poor). A quality score per measurement property is obtained by taking the lowest rating of any item in a box ("worst score counts"). Specific criteria for excellent, good, fair, and poor quality for each COSMIN item are described. In defining the criteria, the "worst score counts" algorithm was taken into consideration. This means that only fatal flaws were defined as poor quality. The scores of the 46 articles show how the scoring system can be used to provide an overview of the methodological quality of studies included in a systematic review of measurement properties. Based on experience in testing this scoring system on 46 articles, the COSMIN checklist with the proposed scoring system seems to be a useful tool for assessing the methodological quality of studies included in systematic reviews of measurement properties.

  3. The accuracy of Internet search engines to predict diagnoses from symptoms can be assessed with a validated scoring system.

    Science.gov (United States)

    Shenker, Bennett S

    2014-02-01

    To validate a scoring system that evaluates the ability of Internet search engines to correctly predict diagnoses when symptoms are used as search terms. We developed a five point scoring system to evaluate the diagnostic accuracy of Internet search engines. We identified twenty diagnoses common to a primary care setting to validate the scoring system. One investigator entered the symptoms for each diagnosis into three Internet search engines (Google, Bing, and Ask) and saved the first five webpages from each search. Other investigators reviewed the webpages and assigned a diagnostic accuracy score. They rescored a random sample of webpages two weeks later. To validate the five point scoring system, we calculated convergent validity and test-retest reliability using Kendall's W and Spearman's rho, respectively. We used the Kruskal-Wallis test to look for differences in accuracy scores for the three Internet search engines. A total of 600 webpages were reviewed. Kendall's W for the raters was 0.71 (psearch engine. We found a significant difference in scores based on the webpage's order on the Internet search engine webpage (p=0.007). Pairwise comparisons revealed higher scores in the first webpages vs. the fourth (corr p=0.009) and fifth (corr p=0.017). However, this significance was lost when creating composite scores. The five point scoring system to assess diagnostic accuracy of Internet search engines is a valid and reliable instrument. The scoring system may be used in future Internet research. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  4. Effect of 12-O-tetradecanoylphorbol-13-acetate-induced psoriasis-like skin lesions on systemic inflammation and atherosclerosis in hypercholesterolaemic apolipoprotein E deficient mice

    DEFF Research Database (Denmark)

    Madsen, Marie; Hansen, Peter Riis; Nielsen, Lars Bo

    2016-01-01

    BACKGROUND: Risk of cardiovascular disease is increased in patients with psoriasis, but molecular mechanisms linking the two conditions have not been clearly established. Lack of appropriate animal models has hampered generation of new knowledge in this area of research and we therefore sought...... to develop an animal model with combined atherosclerosis and psoriasis-like skin inflammation. METHODS: Topical 12-O-tetradecanoylphorbol-13-acetate (TPA) was applied to the ears twice per week for 8 weeks in atherosclerosis-prone apolipoprotein E deficient (ApoE(-/-)) mice. RESULTS: TPA led to localized...

  5. Comparison of the Framingham risk score, UK Prospective Diabetes Study (UKPDS) Risk Engine, Japanese Atherosclerosis Longitudinal Study-Existing Cohorts Combine (JALS-ECC) and maximum carotid intima-media thickness for predicting coronary artery stenosis in patients with asymptomatic type 2 diabetes.

    Science.gov (United States)

    Fujihara, Kazuya; Suzuki, Hiroaki; Sato, Akira; Ishizu, Tomoko; Kodama, Satoru; Heianza, Yoriko; Saito, Kazumi; Iwasaki, Hitoshi; Kobayashi, Kazuto; Yatoh, Shigeru; Takahashi, Akimitsu; Yahagi, Naoya; Sone, Hirohito; Shimano, Hitoshi

    2014-01-01

    To compare the efficacy of Framingham Risk Score (FRS), UK Prospective Diabetes Study (UKPDS) risk engine, a risk score based on the Japanese Atherosclerosis Longitudinal Study-Existing Cohorts Combine (JALS-ECC), the maximum intima-media thickness (max-IMT) determined on coronary computed tomography angiography (CCTA) and their combination in asymptomatic patients with type 2 diabetes. A total of 116 Japanese patients with type 2 diabetes underwent CCTA. The risk of coronary heart disease was calculated according to the FRS, UKPDS and JALS-ECC. We evaluated the reclassification of coronary artery stenosis (CAS) based on the risk score categories after adding each IMT related variable. Sixty-eight patients had CAS. The areas under the curves (AUCs) in the receiver operating characteristic curve analyses of FRS, UKPDS and JALS-ECC were 0.763 (95% confidence interval [CI]: 0.674-0.853), 0.785 (95% CI: 0.703-0.868) and 0.767 (95% CI: 0.681-0.853), respectively. The AUCs for FRS, UKPDS and JALS-ECC combined with the max-IMT were 0.788 (95% CI: 0.705-0.872), 0.800 (95% CI: 0.720-0.879) and 0.786 (95% CI: 0.703-0.869), respectively. Combining the max-IMT with the risk scores improved the identification of subjects with stenotic lesions, in particular, those in the first, second and third tertiles of the FRS, first and second tertiles of the UKPDS and first and second tertiles of the JALS-ECC (P=0.054, P=0.056, P=0.015, P=0.082, P=0.060, P=0.007, and P=0.080, respectively). The net reclassification improvement increased following the addition of a max-IMT of ≥ 1.9 mm (32.4% in FRS, 19.9% in UKPDS and 51.7% in JALS-ECC). These data suggest that combining a risk score with the max-IMT improves the prediction of CAS in comparison with the risk score alone.

  6. Similar performance of Brasfield and Wisconsin scoring systems in young children with cystic fibrosis

    Energy Technology Data Exchange (ETDEWEB)

    Cleveland, Robert H.; Stamoulis, Catherine [Boston Children' s Hospital, Harvard Medical School, Department of Radiology, Boston, MA (United States); Sawicki, Gregory S. [Boston Children' s Hospital, Harvard Medical School, Division of Respiratory Diseases, Department of Medicine, Boston, MA (United States)

    2015-10-15

    To assess the severity of lung disease in cystic fibrosis (CF), scoring systems based on chest radiographs (CXRs), CT and MRI have been used extensively, although primarily in research settings rather than for clinical purposes. It has recently been shown that those based on CXRs (primarily the Brasfield and Wisconsin systems) are as sensitive and valid as those based on CT. The reproducibility and correlation of both systems to pulmonary function tests (PFTs) were recently investigated and were found to be statistically identical. However, the relative performance of these systems has not been specifically assessed in children younger than 5 years old with mild lung disease, a critical age range in which PFTs is rarely performed. To investigate and compare the performance of the Brasfield and Wisconsin systems in children 0-5 years old with predominantly mild lung disease. Fifty-five patients 0-5 years old with 105 CXRs were included in the study. Given that the goal was to compare system performance in mild disease, only the first two CXRs from each patient were included (all but five patients had two images). When only one image was available in the target age range, it only was included. Agreement between the Brasfield and Wisconsin systems was assessed using a 2X2 contingency table assuming binary classification of CF lung disease using CXR scoring systems (mild vs. non-mild). In the absence of PFTs or another external gold standard for comparison, the Wisconsin system was used as an arbitrary gold standard against which the Brasfield was compared. Correlation between the two systems was assessed via a concordance correlation coefficient (CCC) for repeated measures. Scores were rated as mild or non-mild based on published numerical cutoffs for each system. The systems agreed on 89/105 (85%) and disagreed on 16/105 (15%) of the CXRs. Agreement between the two systems was statistically significant (P < 0.001). Relative sensitivity and specificity of the

  7. Early warning scores: a sign of deterioration in patients and systems.

    Science.gov (United States)

    Fox, Adrian; Elliott, Naomi

    2015-04-01

    The early warning score system is a decision-making tool that has a simple design, yet its implementation in healthcare organisations is proving complex. This article reports the results of a survey that evaluated nurses' experiences of using the National Early Warning Score (NEWS) in an acute hospital in Ireland. Staff reported that the NEWS was easy to use, did not increase workload and enhanced their ability to identify deteriorating patients. However, they also identified problems related to doctors' delayed response times, doctors' lack of training in the use of the tool, and a failure by doctors to modify trigger parameters for patients with chronic conditions. NEWS enhances nurses' roles in early detection of patient deterioration, but delays in response times by doctors expose systematic flaws in health care. This suggests that it is not only an indicator of patient deterioration, but also of deteriorating healthcare systems.

  8. A Score Function for Optimizing the Cycle-Life of Battery-Powered Embedded Systems

    DEFF Research Database (Denmark)

    Wognsen, Erik Ramsgaard; Haverkort, Boudewijn; Jongerden, Marijn

    2015-01-01

    An ever increasing share of embedded systems is powered by rechargeable batteries. These batteries deteriorate with the number of charge/discharge cycles they are subjected to, the so-called cycle life. In this paper, we propose the wear score function to compare and evaluate the relative impact...... of usage (charge and discharge) profiles on cycle life. The wear score function can not only be used to rank different usage profiles, these rankings can also be used as a criterion for optimizing the overall lifetime of a battery-powered system. We perform such an optimization on a nano-satellite case...... checking and reinforcement learning to synthesize near-optimal scheduling strategies subject to possible hard timing-constaints. We use this to study the trade-off between optimal short-term dynamic payload selection and the operational life of the satellite....

  9. A validated clinical MRI injury scoring system in neonatal hypoxic-ischemic encephalopathy

    Energy Technology Data Exchange (ETDEWEB)

    Trivedi, Shamik B.; Vesoulis, Zachary A.; Rao, Rakesh; Liao, Steve M.; Mathur, Amit M. [Washington University School of Medicine, Division of Newborn Medicine, Edward Mallinckrodt Department of Pediatrics, St. Louis, MO (United States); Shimony, Joshua S.; McKinstry, Robert C. [Washington University School of Medicine, Mallinckrodt Institute of Radiology, St. Louis, MO (United States)

    2017-10-15

    Deep nuclear gray matter injury in neonatal hypoxic-ischemic encephalopathy (HIE) is associated with worse neurodevelopmental outcomes. We previously published a qualitative MRI injury scoring system utilizing serial T1-weighted, T2-weighted and diffusion-weighted imaging (DWI), weighted for deep nuclear gray matter injury. To establish the validity of the MRI scoring system with neurodevelopmental outcome at 18-24 months. MRI scans from neonates with moderate to severe HIE treated with therapeutic hypothermia were evaluated. Signal abnormality was scored on T1-weighted, T2-weighted and DWI sequences and assessed using an established system in five regions: (a) subcortical: caudate nucleus, globus pallidus and putamen, thalamus and the posterior limb of the internal capsule; (b) white matter; (c) cortex, (d) cerebellum and (e) brainstem. MRI injury was graded as none, mild, moderate or severe. Inter-rater reliability was tested on a subset of scans by two independent and blinded neuroradiologists. Surviving infants underwent the Bayley Scales of Infant and Toddler Development-III (Bayley-III) at 18-24 months. Data were analyzed using univariate and multivariate linear and logistic regression. Fifty-seven eligible neonates underwent at least one MRI scan in the first 2 weeks of life. Mean postnatal age at scan 1 was 4±2 days in 50/57 (88%) neonates and 48/54 (89%) surviving infants underwent scan 2 at 10±2 days. In 54/57 (95%) survivors, higher MRI injury grades were significantly associated with worse outcomes in the cognitive, motor and language domains of the Bayley-III. A qualitative MRI injury scoring system weighted for deep nuclear gray matter injury is a significant predictor of neurodevelopmental outcome at 18-24 months in neonates with HIE. (orig.)

  10. A validated clinical MRI injury scoring system in neonatal hypoxic-ischemic encephalopathy

    International Nuclear Information System (INIS)

    Trivedi, Shamik B.; Vesoulis, Zachary A.; Rao, Rakesh; Liao, Steve M.; Mathur, Amit M.; Shimony, Joshua S.; McKinstry, Robert C.

    2017-01-01

    Deep nuclear gray matter injury in neonatal hypoxic-ischemic encephalopathy (HIE) is associated with worse neurodevelopmental outcomes. We previously published a qualitative MRI injury scoring system utilizing serial T1-weighted, T2-weighted and diffusion-weighted imaging (DWI), weighted for deep nuclear gray matter injury. To establish the validity of the MRI scoring system with neurodevelopmental outcome at 18-24 months. MRI scans from neonates with moderate to severe HIE treated with therapeutic hypothermia were evaluated. Signal abnormality was scored on T1-weighted, T2-weighted and DWI sequences and assessed using an established system in five regions: (a) subcortical: caudate nucleus, globus pallidus and putamen, thalamus and the posterior limb of the internal capsule; (b) white matter; (c) cortex, (d) cerebellum and (e) brainstem. MRI injury was graded as none, mild, moderate or severe. Inter-rater reliability was tested on a subset of scans by two independent and blinded neuroradiologists. Surviving infants underwent the Bayley Scales of Infant and Toddler Development-III (Bayley-III) at 18-24 months. Data were analyzed using univariate and multivariate linear and logistic regression. Fifty-seven eligible neonates underwent at least one MRI scan in the first 2 weeks of life. Mean postnatal age at scan 1 was 4±2 days in 50/57 (88%) neonates and 48/54 (89%) surviving infants underwent scan 2 at 10±2 days. In 54/57 (95%) survivors, higher MRI injury grades were significantly associated with worse outcomes in the cognitive, motor and language domains of the Bayley-III. A qualitative MRI injury scoring system weighted for deep nuclear gray matter injury is a significant predictor of neurodevelopmental outcome at 18-24 months in neonates with HIE. (orig.)

  11. A simple scoring system for breast MRI interpretation: does it compensate for reader experience?

    International Nuclear Information System (INIS)

    Marino, Maria Adele; Clauser, Paola; Woitek, Ramona; Wengert, Georg J.; Kapetas, Panagiotis; Bernathova, Maria; Pinker-Domenig, Katja; Helbich, Thomas H.; Baltzer, Pascal A.T.; Preidler, Klaus

    2016-01-01

    To investigate the impact of a scoring system (Tree) on inter-reader agreement and diagnostic performance in breast MRI reading. This IRB-approved, single-centre study included 100 patients with 121 consecutive histopathologically verified lesions (52 malignant, 68 benign). Four breast radiologists with different levels of MRI experience and blinded to histopathology retrospectively evaluated all examinations. Readers independently applied two methods to classify breast lesions: BI-RADS and Tree. BI-RADS provides a reporting lexicon that is empirically translated into likelihoods of malignancy; Tree is a scoring system that results in a diagnostic category. Readings were compared by ROC analysis and kappa statistics. Inter-reader agreement was substantial to almost perfect (kappa: 0.643-0.896) for Tree and moderate (kappa: 0.455-0.657) for BI-RADS. Diagnostic performance using Tree (AUC: 0.889-0.943) was similar to BI-RADS (AUC: 0.872-0.953). Less experienced radiologists achieved AUC: improvements up to 4.7 % using Tree (P-values: 0.042-0.698); an expert's performance did not change (P = 0.526). The least experienced reader improved in specificity using Tree (16 %, P = 0.001). No further sensitivity and specificity differences were found (P > 0.1). The Tree scoring system improves inter-reader agreement and achieves a diagnostic performance similar to that of BI-RADS. Less experienced radiologists, in particular, benefit from Tree. (orig.)

  12. The development and optimisation of a quantitative physical fitness scoring system for use amongst Naval Service personnel.

    Science.gov (United States)

    Sargent, Cliodhna; Lacey, Sean; Gebruers, Cormac; O'Mahony, Jim

    2016-01-01

    A lack of research currently exists in relation to the current physical fitness testing system that is used within the Irish Naval Service, not only in relation to the tests that are used but also in relation to the scores that should be achieved in order to pass the test. As such the aim of this study was to select tests for various components of physical fitness and create a scoring system that could be used to assess individuals more comprehensively. Seventy-five individuals took part in the study (71 males, 4 females). Each participant completed a battery of physical tests analysing the following physical fitness components: flexibility, power, agility, strength, speed, anaerobic conditioning and aerobic conditioning. The mean score ± 0.67 and ± 1 standard deviations were used for the selection of categories. A six category scoring system was produced for each component of physical fitness. Scores were assigned to each category allowing a total cumulative score and an overall percentage of the total to be calculated. The categories are as follows: Score 5, Score 10, Score 15, Score 20, Score 25, Score 30. A quantitative scoring system has been produced that allows comprehensive physical fitness testing to be conducted. In order to achieve a complete picture of a participant's physical fitness, all tests outlined should be included in the testing process. However, the flexible nature of this system allows for tests to be included or excluded to suit the needs of an individual or organisation. The fact that the scoring system is quantitative, the time involved is relatively short, multiple participants can be tested simultaneously and the pass rates can be decided upon by the host organisation makes this system versatile and comparable across multiple jurisdictions.

  13. AGE and their receptor RAGE in systemic autoimmune diseases : An inflammation propagating factor contributing to accelerated atherosclerosis

    NARCIS (Netherlands)

    Nienhuis, Hans L. A.; Westra, Johanna; Smit, Andries J.; Limburg, Pieter C.; Kallenberg, Cees G. M.; Bijl, Marc

    2009-01-01

    Systemic autoimmune diseases are associated with inflammation, and oxidative stress favouring the formation of advanced glycation endproducts (AGE), able to modulate cellular functions by activation of receptor for advanced glycation endproducts (RAGE). As RAGE expression is increased in an

  14. Dynamic Measurement of Disease Activity in Acute Pancreatitis: The Pancreatitis Activity Scoring System.

    Science.gov (United States)

    Wu, Bechien U; Batech, Michael; Quezada, Michael; Lew, Daniel; Fujikawa, Kelly; Kung, Jonathan; Jamil, Laith H; Chen, Wansu; Afghani, Elham; Reicher, Sonya; Buxbaum, James; Pandol, Stephen J

    2017-07-01

    Acute pancreatitis has a highly variable course. Currently there is no widely accepted method to measure disease activity in patients hospitalized for acute pancreatitis. We aimed to develop a clinical activity index that incorporates routine clinical parameters to assist in the measurement, study, and management of acute pancreatitis. We used the UCLA/RAND appropriateness method to identify items for inclusion in the disease activity instrument. We conducted a systematic literature review followed by two sets of iterative modified Delphi meetings including a panel of international experts between November 2014 and November 2015. The final instrument was then applied to patient data obtained from five separate study cohorts across Southern California to assess profiles of disease activity. From a list of 35 items comprising 6 domains, we identified 5 parameters for inclusion in the final weighted clinical activity scoring system: organ failure, systemic inflammatory response syndrome, abdominal pain, requirement for opiates and ability to tolerate oral intake. We applied the weighted scoring system across the 5 study cohorts comprising 3,123 patients. We identified several distinct patterns of disease activity: (i) overall there was an elevated score at baseline relative to discharge across all study cohorts, (ii) there were distinct patterns of disease activity related to duration of illness as well as (iii) early and persistent elevation of disease activity among patients with severe acute pancreatitis defined as persistent organ failure. We present the development and initial validation of a clinical activity score for real-time assessment of disease activity in patients with acute pancreatitis.

  15. Prognostic capability of different liver disease scoring systems for prediction of early mortality after transjugular intrahepatic portosystemic shunt creation.

    Science.gov (United States)

    Gaba, Ron C; Couture, Patrick M; Bui, James T; Knuttinen, M Grace; Walzer, Natasha M; Kallwitz, Eric R; Berkes, Jamie L; Cotler, Scott J

    2013-03-01

    To compare the performance of various liver disease scoring systems in predicting early mortality after transjugular intrahepatic portosystemic shunt (TIPS) creation. In this single-institution retrospective study, eight scoring systems were used to grade liver disease in 211 patients (male-to-female ratio = 131:80; mean age, 54 y) before TIPS creation from 1999-2011. Scoring systems included bilirubin level, Child-Pugh (CP) score, Model for End-Stage Liver Disease (MELD) and Model for End-Stage Liver Disease sodium (MELD-Na) score, Emory score, prognostic index (PI), Acute Physiology and Chronic Health Evaluation (APACHE) 2 score, and Bonn TIPS early mortality (BOTEM) score. Medical record review was used to identify 30-day and 90-day clinical outcomes. The relationship of scoring parameters with mortality outcomes was assessed with multivariate analysis, and the relative ability of systems to predict mortality after TIPS creation was evaluated by comparing area under receiver operating characteristic (AUROC) curves. TIPS were successfully created for variceal hemorrhage (n = 121), ascites (n = 72), hepatic hydrothorax (n = 15), and portal vein thrombosis (n = 3). All scoring systems had a significant association with 30-day and 90-day mortality (P<.050 in each case) on multivariate analysis. Based on 30-day and 90-day AUROC, MELD (0.878, 0.816) and MELD-Na (0.863, 0.823) scores had the best capability to predict early mortality compared with bilirubin (0.786, 0.749), CP (0.822, 0.771), Emory (0.786, 0.681), PI (0.854, 0.760), APACHE 2 (0.836, 0.735), and BOTEM (0.798, 0.698), with statistical superiority over bilirubin, Emory, and BOTEM scores. Several liver disease scoring systems have prognostic value for early mortality after TIPS creation. MELD and MELD-Na scores most effectively predict survival after TIPS creation. Copyright © 2013. Published by Elsevier Inc.

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

    Directory of Open Access Journals (Sweden)

    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

  17. An Objective Balance Error Scoring System for Sideline Concussion Evaluation Using Duplex Kinect Sensors

    Directory of Open Access Journals (Sweden)

    Mengqi Zhu

    2017-10-01

    Full Text Available Sports-related concussion is a common sports injury that might induce potential long-term consequences without early diagnosis and intervention in the field. However, there are few options of such sensor systems available. The aim of the study is to propose and validate an automated concussion administration and scoring approach, which is objective, affordable and capable of detecting all balance errors required by the balance error scoring system (BESS protocol in the field condition. Our approach is first to capture human body skeleton positions using two Microsoft Kinect sensors in the proposed configuration and merge the data by a custom-made algorithm to remove the self-occlusion of limbs. The standing balance errors according to BESS protocol were further measured and accessed automatically by the proposed algorithm. Simultaneously, the BESS test was filmed for scoring by an experienced rater. Two results were compared using Pearson coefficient r, obtaining an excellent consistency (r = 0.93, p < 0.05. In addition, BESS test–retest was performed after seven days and compared using intraclass correlation coefficients (ICC, showing a good test–retest reliability (ICC = 0.81, p < 0.01. The proposed approach could be an alternative of objective tools to assess postural stability for sideline sports concussion diagnosis.

  18. Introducing the Evaluation Tools for HSE Management System Performance Using Balanced Score Card Model

    Directory of Open Access Journals (Sweden)

    Ali Mohammadi

    2016-12-01

    Full Text Available Background: The performance of the HSE units has various dimensions Leading to different performances. Thus, any industry should be capable of evaluating these systems. The aim of this study was to design a standard questionnaire in the field of performance evaluation of HSE management system employing Balanced Score Card model. Methods: In this study we, first determined the criteria to be evaluated in the framework of Balanced Score Card model based on the objectives and strategies of HSE Management System and existing standards, and then designed questions on every criterion. We used content validity and Cronbach's Alpha to determine the reliability and validity of the questionnaire. Results: The primary questionnaire was comprised of 126 questions some of which were omitted regarding the results obtained from the CVR and CVI values. We obtained the CVI average of environmental dimension to be 0.75 and its CVI average 0.71. Conclusion: With respect to the results of the reliability and validity of this questionnaire,and its standardized design we can suggest using it for evaluation of HSE management system performance in organizations and industries with the mentioned system.

  19. Early warning scores: a sign of deterioration in patients and systems

    LENUS (Irish Health Repository)

    Fox, A

    2015-02-01

    The early warning score is a decision-making tool that has a simple design, yet its implementation in healthcare organisations is proving complex. This article reports the results of a survey that evaluated the nurses’ experiences of using the NEWS (National Early Warning Score) in an acute hospital in Ireland. Staff reported that the NEWS was easy to use, did not increase workload and enhanced their ability to identify deteriorating patients. However, they also identified problems related to doctors’ delayed response times, doctors lack of training in the use of the tool, and a failure by doctors to modify parameters for patients with chronic conditions. NEWS enhances nurses’ role in early detection of patient deterioration but delays in response times by doctors, exposes systematic flaws in healthcare. This suggests that it is not only an indicator of patient deterioration but also of deteriorating healthcare systems.

  20. A novel scoring system to measure radiographic abnormalities and related spirometric values in cured pulmonary tuberculosis.

    Directory of Open Access Journals (Sweden)

    Renata Báez-Saldaña

    Full Text Available BACKGROUND: Despite chemotherapy, patients with cured pulmonary tuberculosis may result in lung functional impairment. OBJECTIVE: To evaluate a novel scoring system based on the degree of radiographic abnormalities and related spirometric values in patients with cured pulmonary tuberculosis. METHODS: One hundred and twenty seven patients with cured pulmonary tuberculosis were prospectively enrolled in a referral hospital specializing in respiratory diseases. Spirometry was performed and the extent of radiographic abnormalities was evaluated twice by each of two readers to generate a novel quantitative score. Scoring reproducibility was analyzed by the intra-class correlation coefficient (ICC and the Bland-Altman method. Multiple linear regression models were performed to assess the association of the extent of radiographic abnormalities with spirometric values. RESULTS: The intra-observer agreement for scoring of radiographic abnormalities (SRA showed an ICC of 0.81 (CI:95%, 0.67-0.95 and 0.78 (CI:95%, 0.65-0.92, for reader 1 and 2, respectively. Inter-observer reproducibility for the first measurement was 0.83 (CI:95%, 0.71-0.95, and for the second measurement was 0.74 (CI:95%, 0.58-0.90. The Bland-Altman analysis of the intra-observer agreement showed a mean bias of 0.87% and -0.55% and an inter-observer agreement of -0.35% and -1.78%, indicating a minor average systematic variability. After adjustment for age, gender, height, smoking status, pack-years of smoking, and degree of dyspnea, the scoring degree of radiographic abnormalities was significantly and negatively associated with absolute and percent predicted values of FVC: -0.07 (CI:95%, -0.01 to -0.04; -2.48 (CI:95%, -3.45 to -1.50; and FEV1 -0.07 (CI:95%, -0.10 to -0.05; -2.92 (CI:95%, -3.87 to -1.97 respectively, in the patients studied. CONCLUSION: The extent of radiographic abnormalities, as evaluated through our novel scoring system, was inversely associated with spirometric values

  1. A Novel Scoring System for Diagnosing Acute Mesenteric Ischemia in the Emergency Ward.

    Science.gov (United States)

    Wang, Zhen; Chen, Jun-Qiang; Liu, Jin-Lu; Tian, Lei

    2017-08-01

    Early diagnosis of acute mesenteric ischemia (AMI) based on clinical judgment has been proved to be too difficult. Therefore, it is important for identifying clinical parameters that can differentiate AMI from other acute abdomen upon presentation. We analyzed a database of 106 consecutive patients admitted to the emergency ward for suspected AMI in whom diagnosis of AMI was confirmed by laparotomy, CT angiography or mesenteric angiography. The patients' demographics, previous history, clinical signs, results of laboratory investigations and ultrasonography were collected. Diagnostic cutoff value of quantitative indexes was derived from the receiver operating curve. Multivariate logistic regression was used to identify risk factors for AMI and formulated these risk factors into a scoring system. A total of 45 patients (42.5%) were confirmed to have AMI. Compared with other acute abdomen, AMI had significantly increased level of white blood cell (Odds ratio (OR) 16.11, 95% confidence interval (CI) 1.10-235.34), red cell distribution width (OR 27.65, 95% CI 1.53-501.02), mean platelet volume (OR 16.06, 95% CI 1.48-174.50) and D-dimer (OR 42.91, 95% CI 2.56-718.09). A diagnostic score was calculated by adding points assigned to the four parameters, and a cutoff score of four best identified patients with AMI, with sensitivity, specificity, positive and negative predictive values of 97.8, 91.8, 89.8 and 98.2%, respectively. This scoring system based on easily available parameters could be used as a useful tool for differentiating AMI from other acute abdomen in the emergency ward. Prospective studies with large sample remain needed for validating the results.

  2. Iterative development and reliability of the OMERACT hand osteoarthritis MRI scoring system.

    Science.gov (United States)

    Haugen, Ida K; Østergaard, Mikkel; Eshed, Iris; McQueen, Fiona M; Bird, Paul; Gandjbakhch, Frederique; Foltz, Violaine; Genant, Harry; Peterfy, Charles; Lillegraven, Siri; Haavardsholm, Espen A; Bøyesen, Pernille; Conaghan, Philip G

    2014-02-01

    To develop and test the interreader reliability of the OMERACT Hand Osteoarthritis Magnetic Resonance Scoring System (HOAMRIS) for assessment of structural and inflammatory hand OA features in the interphalangeal joints. The HOAMRIS was developed through an iterative process. Selection of features and their scaling was agreed upon through consensus by members of the OMERACT Magnetic Resonance Imaging (MRI) Task Force, using the Oslo Hand Osteoarthritis (OA) MRI Score system as a template. Two reliability exercises were performed, in which 6 and 4 readers participated, respectively. After the first exercise, an atlas was developed and used in the second exercise to facilitate reading. In each exercise, readers independently scored 8 MRI scans from the Oslo Hand OA cohort (coronal/axial short-tau inversion recovery and coronal/axial/sagittal T1-weighted fat-suppressed pre-/post-Gadolinium images). Interreader reliability was assessed by intraclass correlation coefficients (ICC), percentage exact and close agreement (PEA/PCA). The preliminary OMERACT HOAMRIS included assessment of synovitis, erosive damage, cysts, osteophytes, cartilage space loss, malalignment, and bone marrow lesions (BML), of which all were scored on a 0-3 scale for normal, mild, moderate, and severe (increments of 0.5 for synovitis, erosive damage, and BML). In the first exercise, most features showed good to very good ICC values (0.64-0.94), except synovitis (0.34). In the second exercise using the atlas, the ICC values were > 0.74 for all MRI features, and the PEA/PCA values were higher than in the first exercise. A preliminary HOAMRIS with good to very good interreader reliability was developed. Longitudinal studies are needed to assess its sensitivity to change.

  3. Clock Drawing Test and the diagnosis of amnestic mild cognitive impairment: can more detailed scoring systems do the work?

    Science.gov (United States)

    Rubínová, Eva; Nikolai, Tomáš; Marková, Hana; Siffelová, Kamila; Laczó, Jan; Hort, Jakub; Vyhnálek, Martin

    2014-01-01

    The Clock Drawing Test is a frequently used cognitive screening test with several scoring systems in elderly populations. We compare simple and complex scoring systems and evaluate the usefulness of the combination of the Clock Drawing Test with the Mini-Mental State Examination to detect patients with mild cognitive impairment. Patients with amnestic mild cognitive impairment (n = 48) and age- and education-matched controls (n = 48) underwent neuropsychological examinations, including the Clock Drawing Test and the Mini-Mental State Examination. Clock drawings were scored by three blinded raters using one simple (6-point scale) and two complex (17- and 18-point scales) systems. The sensitivity and specificity of these scoring systems used alone and in combination with the Mini-Mental State Examination were determined. Complex scoring systems, but not the simple scoring system, were significant predictors of the amnestic mild cognitive impairment diagnosis in logistic regression analysis. At equal levels of sensitivity (87.5%), the Mini-Mental State Examination showed higher specificity (31.3%, compared with 12.5% for the 17-point Clock Drawing Test scoring scale). The combination of Clock Drawing Test and Mini-Mental State Examination scores increased the area under the curve (0.72; p Drawing Test did not differentiate between healthy elderly and patients with amnestic mild cognitive impairment in our sample. Complex scoring systems were slightly more efficient, yet still were characterized by high rates of false-positive results. We found psychometric improvement using combined scores from the Mini-Mental State Examination and the Clock Drawing Test when complex scoring systems were used. The results of this study support the benefit of using combined scores from simple methods.

  4. Targeted therapeutics in inflammatory atherosclerosis

    NARCIS (Netherlands)

    Alaarg, Amr Muhmed Sabry Abdelhakeem

    2017-01-01

    Atherosclerosis, a chronic inflammatory vascular disease, which has been recently identified in 5000-year mummies, remains undefeated. It is the most common underlying cause of deadly cardiovascular diseases (CVD), including heart attacks, strokes, and peripheral vascular diseases. This tremendous

  5. Comparison of discrimination and prognostic value of two US Doppler scoring systems in rheumatoid arthritis patients

    DEFF Research Database (Denmark)

    Ellegaard, Karen; Terslev, Lene; Christensen, Robin

    2014-01-01

    OBJECTIVES: The aim of this paper is to investigate sensitivity to change (SRM), predictive validity and discriminative ability of a quantitative (QS) and a semi-quantitative (SQS) Doppler ultrasound scoring systems in patients with rheumatoid arthritis (RA) treated with anti-TNF-α therapy. METHODS......: RA patients with wrist joint affection treated with TNF-α inhibitor were followed for one year. The wrist was examined with Doppler before initiating therapy and after one year. DAS28 was determined at both visits. One person trained in the SQS system and one in the QS system evaluated the anonymised...... images. The SRM, predictive validity and discriminative ability for both systems were calculated using DAS28 as the measure of disease improvement. RESULTS: Fourty-six patients with RA (80% females) were included. The mean Doppler activity at baseline was QS:24.4% (SD=17.7%) and SQS:2.0 (SD=0...

  6. Prostate Cancer Patients' Understanding of the Gleason Scoring System: Implications for Shared Decision-Making.

    Science.gov (United States)

    Tagai, Erin K; Miller, Suzanne M; Kutikov, Alexander; Diefenbach, Michael A; Gor, Ronak A; Al-Saleem, Tahseen; Chen, David Y T; Fleszar, Sara; Roy, Gem

    2018-01-15

    The Gleason scoring system is a key component of a prostate cancer diagnosis, since it indicates disease aggressiveness. It also serves as a risk communication tool that facilitates shared treatment decision-making. However, the system is highly complex and therefore difficult to communicate: factors which have been shown to undermine well-informed and high-quality shared treatment decision-making. To systematically explore prostate cancer patients' understanding of the Gleason scoring system (GSS), we assessed knowledge and perceived importance among men who had completed treatment (N = 50). Patients were administered a survey that assessed patient knowledge and patients' perceived importance of the GSS, as well as demographics, medical factors (e.g., Gleason score at diagnosis), and health literacy. Bivariate analyses were conducted to identify associations with patient knowledge and perceived importance of the GSS. The sample was generally well-educated (48% with a bachelor's degree or higher) and health literate (M = 12.9, SD = 2.2, range = 3-15). Despite this, patient knowledge of the GSS was low (M = 1.8, SD = 1.4, range = 1-4). Patients' understanding of the importance of the GSS was moderate (M = 2.8, SD = 1.0, range = 0-4) and was positively associated with GSS knowledge (p importance of the GSS (p communication to maximize shared treatment decision-making. Future studies are needed to explore the potential utility of a simplified Gleason grading system and improved patient-provider communication.

  7. A model and scoring system to predict outcome of intrauterine pregnancies of uncertain viability.

    Science.gov (United States)

    Bottomley, C; Van Belle, V; Pexsters, A; Papageorghiou, A T; Mukri, F; Kirk, E; Van Huffel, S; Timmerman, D; Bourne, T

    2011-05-01

    To define the incidence and outcome of intrauterine pregnancy of uncertain viability (PUV) and to develop and assess the performance of a model and a scoring system to predict ongoing viability. Of 1881 consecutive women undergoing transvaginal ultrasonography, a cohort of 493 women with an empty gestational sac model and a 'simple' model in the prediction of viability at each outcome point, based on maternal demographics, ultrasound features and symptoms. The performance of each system was assessed by receiver-operating characteristics (ROC) curve analysis and calibration plots on a test dataset. The incidence of PUV in this population was 29.2% (549/1881). Of the 493 pregnancies with initial (7-14 days) follow-up available, 307 (62.3%) were viable at this time and of the 444 pregnancies with follow-up at the end of the first trimester, 225 (50.7%) were still viable. Initial (7-14-day) viability was predicted by the model with an area under the ROC curve (AUC) of 0.837 (95% CI, 0.791-0.884) in the training dataset and 0.821 (95% CI, 0.756-0.885) in the test dataset. First-trimester (11-14-week) viability was predicted by the model with an AUC of 0.788 (95% CI, 0.734-0.842) in the training dataset and 0.774 (95% CI, 0.701-0.848) in the test dataset. The scoring system performed slightly worse than did the model, but had the advantage of being easily applicable. When early pregnancy viability cannot be established immediately with ultrasound, use of either a logistic regression model or a scoring system allows an individualized prediction of first-trimester outcome. Copyright © 2011 ISUOG. Published by John Wiley & Sons, Ltd.

  8. Comparison of severity of illness scoring systems in the prediction of hospital mortality in severe sepsis and septic shock

    Directory of Open Access Journals (Sweden)

    Crowe Colleen

    2010-01-01

    Full Text Available Background : New scoring systems, including the Rapid Emergency Medicine Score (REMS, the Mortality in Emergency Department Sepsis (MEDS score, and the confusion, urea nitrogen, respiratory rate, blood pressure, 65 years and older (CURB-65 score, have been developed for emergency department (ED use in various patient populations. Increasing use of early goal directed therapy (EGDT for the emergent treatment of sepsis introduces a growing population of patients in which the accuracy of these scoring systems has not been widely examined. Objectives : To evaluate the ability of the REMS, MEDS score, and CURB-65 score to predict mortality in septic patients treated with modified EGDT. Materials and Methods : Secondary analysis of data from prospectively identified patients treated with modified EGDT in a large tertiary care suburban community hospital with over 85,000 ED visits annually and 700 inpatient beds, from May 2007 through May 2008. We included all patients with severe sepsis or septic shock, who were treated with our modified EGDT protocol. Our major outcome was in-hospital mortality. The performance of the scores was compared by area under the ROC curves (AUCs. Results : A total of 216 patients with severe sepsis or septic shock were treated with modified EGDT during the study period. Overall mortality was 32.9%. Calculated AUCs were 0.74 [95% confidence interval (CI: 0.67-0.81] for the MEDS score, 0.62 (95% CI: 0.54-0.69 for the REMS, and 0.59 (95% CI: 0.51-0.67 for the CURB-65 score. Conclusion : We found that all three ED-based systems for scoring severity of illness had low to moderate predictive capability. The MEDS score demonstrated the largest AUC of the studied scoring systems for the outcome of mortality, although the CIs on point estimates of the AUC of the REMS and CURB-65 scores all overlap.

  9. Scoring System Prognostic of Outcome in Patients Undergoing Allogeneic Hematopoietic Cell Transplantation for Myelodysplastic Syndrome.

    Science.gov (United States)

    Shaffer, Brian C; Ahn, Kwang Woo; Hu, Zhen-Huan; Nishihori, Taiga; Malone, Adriana K; Valcárcel, David; Grunwald, Michael R; Bacher, Ulrike; Hamilton, Betty; Kharfan-Dabaja, Mohamed A; Saad, Ayman; Cutler, Corey; Warlick, Erica; Reshef, Ran; Wirk, Baldeep Mona; Sabloff, Mitchell; Fasan, Omotayo; Gerds, Aaron; Marks, David; Olsson, Richard; Wood, William Allen; Costa, Luciano J; Miller, Alan M; Cortes, Jorge; Daly, Andrew; Kindwall-Keller, Tamila L; Kamble, Rammurti; Rizzieri, David A; Cahn, Jean-Yves; Gale, Robert Peter; William, Basem; Litzow, Mark; Wiernik, Peter H; Liesveld, Jane; Savani, Bipin N; Vij, Ravi; Ustun, Celalettin; Copelan, Edward; Popat, Uday; Kalaycio, Matt; Maziarz, Richard; Alyea, Edwin; Sobecks, Ron; Pavletic, Steven; Tallman, Martin; Saber, Wael

    2016-06-01

    To develop a system prognostic of outcome in those undergoing allogeneic hematopoietic cell transplantation (allo HCT) for myelodysplastic syndrome (MDS). We examined 2,133 patients with MDS undergoing HLA-matched (n = 1,728) or -mismatched (n = 405) allo HCT from 2000 to 2012. We used a Cox multivariable model to identify factors prognostic of mortality in a training subset (n = 1,151) of the HLA-matched cohort. A weighted score using these factors was assigned to the remaining patients undergoing HLA-matched allo HCT (validation cohort; n = 577) as well as to patients undergoing HLA-mismatched allo HCT. Blood blasts greater than 3% (hazard ratio [HR], 1.41; 95% CI, 1.08 to 1.85), platelets 50 × 10(9)/L or less at transplantation (HR, 1.37; 95% CI, 1.18 to 1.61), Karnofsky performance status less than 90% (HR, 1.25; 95% CI, 1.06 to 1.28), comprehensive cytogenetic risk score of poor or very poor (HR, 1.43; 95% CI, 1.14 to 1.80), and age 30 to 49 years (HR, 1.60; 95% CI, 1.09 to 2.35) were associated with increased hazard of death and assigned 1 point in the scoring system. Monosomal karyotype (HR, 2.01; 95% CI, 1.65 to 2.45) and age 50 years or older (HR, 1.93; 95% CI, 1.36 to 2.83) were assigned 2 points. The 3-year overall survival after transplantation in patients with low (0 to 1 points), intermediate (2 to 3), high (4 to 5) and very high (≥ 6) scores was 71% (95% CI, 58% to 85%), 49% (95% CI, 42% to 56%), 41% (95% CI, 31% to 51%), and 25% (95% CI, 4% to 46%), respectively (P < .001). Increasing score was predictive of increased relapse (P < .001) and treatment-related mortality (P < .001) in the HLA-matched set and relapse (P < .001) in the HLA-mismatched cohort. The proposed system is prognostic of outcome in patients undergoing HLA-matched and -mismatched allo HCT for MDS. © 2016 by American Society of Clinical Oncology.

  10. Assessment of three risk evaluation systems for patients aged ≥70 in East China: performance of SinoSCORE, EuroSCORE II and the STS risk evaluation system.

    Science.gov (United States)

    Shan, Lingtong; Ge, Wen; Pu, Yiwei; Cheng, Hong; Cang, Zhengqiang; Zhang, Xing; Li, Qifan; Xu, Anyang; Wang, Qi; Gu, Chang; Zhang, Yangyang

    2018-01-01

    To assess and compare the predictive ability of three risk evaluation systems (SinoSCORE, EuroSCORE II and the STS risk evaluation system) in patients aged ≥70, and who underwent coronary artery bypass grafting (CABG) in East China. Three risk evaluation systems were applied to 1,946 consecutive patients who underwent isolated CABG from January 2004 to September 2016 in two hospitals. Patients were divided into two subsets according to their age: elderly group (age ≥70) with a younger group (age evaluation system were 0.78(0.64)%, 1.43(1.14)% and 0.78(0.77)%, respectively. SinoSCORE achieved the best discrimination (the area under the receiver operating characteristic curve (AUC) = 0.829), followed by the STS risk evaluation system (AUC = 0.790) and EuroSCORE II (AUC = 0.769) in the entire cohort. In the elderly group, the observed mortality rate was 4.82% while it was 1.38% in the younger group. SinoSCORE (AUC = .829) also achieved the best discrimination in the elderly group, followed by the STS risk evaluation system (AUC = .730) and EuroSCORE II (AUC = 0.640) while all three risk evaluation systems all had good performances in the younger group. SinoSCORE, EuroSCORE II and the STS risk evaluation system all achieved positive calibrations in the entire cohort and subsets. The performance of the three risk evaluation systems was not ideal in the entire cohort. In the elderly group, SinoSCORE appeared to achieve better predictive efficiency than EuroSCORE II and the STS risk evaluation system.

  11. [The receptor theory of atherosclerosis].

    Science.gov (United States)

    Likhoded, V G; Bondarenko, V M; Gintsburg, A L

    2010-01-01

    Lipopolysaccharides of Gram-negative bacteria can interact with Toll-like receptor 4 (TLR4) and induce atheroma formation. The risk of atherosclerosis is decreased in case of TLR4 mutation. Other bacterial ligands and endogenous ligands of TLRs can also be involved in induction of atherogenesis. The general concept of atherosclerosis pathogentsis is presented. According to this concept atherogenesis can be initiated by some reactions resulting from interaction of exogenous and endogenous microbial ligands with Toll-like receptors.

  12. Validation of the Non-Union Scoring System in 300 long bone non-unions.

    Science.gov (United States)

    Calori, G M; Colombo, M; Mazza, E L; Mazzola, S; Malagoli, E; Marelli, N; Corradi, A

    2014-12-01

    Non-union of long bones is a significant consequence of fracture treatment. The ideal classification for non-union of long bones would give sufficient significant information to the orthopaedic surgeon to enable good management of the treatment required and to facilitate the creation of comparable study groups for research purposes. The Non-Union Scoring System (NUSS) is a new scoring system to assist surgeons in the choice of the correct treatment in non-union surgery. The aim of this study was to determine the evidence supporting the use of the NUSS classification in the treatment of non-unions of long bones and to validate the treatment algorithm suggested by this scoring system. A total of 300 patients with non-union of the long bones were included in the clinical study. A radiographic and clinical healing was reached in 60 of 69 non-unions (86%) in group 1 (0-25 points), in 102 of 117 non-unions (87%) in group 2 (26-50 points), and in 69 of 84 (82%) in group 3 (51-75 points). The mean time to clinical healing was 7.17 ± 1.85 months in group 1, 7.30 ± 1.72 months in group 2 and 7.60 ± 1.49 months in group 3. The mean time to radiographic healing was 8.78 ± 2.04 months in group 1, 9.02 ± 1.84 months in group 2 and 9.53 ± 1.40 months in group 3. There are few articles in the scientific literature that examine the classification systems for non-union. A statistical analysis of the first results we have obtained with the use of NUSS showed significant rates of union in all the evaluated groups. This indicates that NUSS could be an appropriate scoring system to classify and stratify non-unions and to enable the surgeon to choose the correct treatment. Copyright © 2014 Elsevier Ltd. All rights reserved.

  13. Oxford NOTECHS II: a modified theatre team non-technical skills scoring system.

    Directory of Open Access Journals (Sweden)

    Eleanor R Robertson

    Full Text Available BACKGROUND: We previously developed and validated the Oxford NOTECHS rating system for evaluating the non-technical skills of an entire operating theatre team. Experience with the scale identified the need for greater discrimination between levels of performance within the normal range. We report here the development of a modified scale (Oxford NOTECHS II to facilitate this. The new measure uses an eight-point instead of a four point scale to measure each dimension of non-technical skills, and begins with a default rating of 6 for each element. We evaluated this new scale in 297 operations at five NHS sites in four surgical specialities. Measures of theatre process reliability (glitch count and compliance with the WHO surgical safety checklist were scored contemporaneously, and relationships with NOTECHS II scores explored. RESULTS: Mean team Oxford NOTECHS II scores was 73.39 (range 37-92. The means for surgical, anaesthetic and nursing sub-teams were 24.61 (IQR 23, 27; 24.22 (IQR 23, 26 and 24.55 (IQR 23, 26. Oxford NOTECHS II showed good inter-rater reliability between human factors and clinical observers in each of the four domains. Teams with high WHO compliance had higher mean Oxford NOTECHS II scores (74.5 than those with low compliance (71.1 (p = 0.010. We observed only a weak correlation between Oxford NOTECHS II scores and glitch count; r = -0.26 (95% CI -0.36 to -0.15. Oxford NOTECHS II scores did not vary significantly between 5 different hospital sites, but a significant difference was seen between specialities (p = 0.001. CONCLUSIONS: Oxford NOTECHS II provides good discrimination between teams while retaining reliability and correlation with other measures of teamwork performance, and is not confounded by technical performance. It is therefore suitable for combined use with a technical performance scale to provide a global description of operating theatre team performance.

  14. Clinical performance of two visual scoring systems in detecting and assessing activity status of occlusal caries in primary teeth

    DEFF Research Database (Denmark)

    Braga, M M; Ekstrand, K R; Martignon, S

    2010-01-01

    This study aimed to compare the clinical performance of two sets of visual scoring criteria for detecting caries severity and assessing caries activity status in occlusal surfaces. Two visual scoring systems--the Nyvad criteria (NY) and the ICDAS-II including an adjunct system for lesion activity...

  15. Two-step calibration method for multi-algorithm score-based face recognition systems by minimizing discrimination loss

    NARCIS (Netherlands)

    Susyanto, N.; Veldhuis, Raymond N.J.; Spreeuwers, Lieuwe Jan; Klaassen, C.A.J.

    2016-01-01

    We propose a new method for combining multi-algorithm score-based face recognition systems, which we call the two-step calibration method. Typically, algorithms for face recognition systems produce dependent scores. The two-step method is based on parametric copulas to handle this dependence. Its

  16. Comparison of the Qualitative and Developmental Scoring Systems for the Modified Version of the Bender-Gestalt Test.

    Science.gov (United States)

    Brannigan, Gary G.; Brunner, Nancy A.

    1993-01-01

    Examined two scoring systems for Modified Version of the Bender-Gestalt Test. Administered Bender-Gestalt and Otis-Lennon School Ability Test to 75 first-grade and 84 second-grade students. Both systems were significantly correlated with school ability. Results of tests for differences between correlations indicated that Qualitative Scoring System…

  17. [Feasibility of SLEDAI-2000 and BILAG-2004 scoring systems for assessing renal disease activity in children with lupus nephritis].

    Science.gov (United States)

    Zhou, Jie-Qing; Jiang, Hong

    2012-10-01

    To study feasibility of Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2000) and British Isles Lupus Assessment Group 2004 (BILAG-2004) scoring systems for assessing renal disease activity in children with lupus nephritis (LN). The clinical data of 159 children with systemic lupus erythematosus (SLE) and LN were collected, and disease activity was assessed by SLEDAI-2000 and BILAG-2004 scoring systems. The correlations between SLEDAI-2000 and BILAG-2004 scores and 24-hour urinary protein excretion and renal pathology index were analyzed. The SLEDAI-2000 and BILAG-2004 scoring systems were evaluated using ROC curve. Approximately one third (31.5%) of the 159 children had a moderate level of 24-hour urinary protein excretion. Among the 37 patients undergoing renal biopsy, 46.0% had diffuse LN (type Ⅳ). 24-hour urinary protein excretion was positively correlated with both SLEDAI-2000 (r=0.36, P2000 scores (r=0.86, 0.88, 0.84, 0.77 respectively; P2000 score showed the best correlation with AI in patients with type Ⅱ LN, followed by those with type Ⅰ LN. BIILAG-2004 score showed the best correlation with AI in patients with type Ⅱ LN, followed by those with type Ⅳ LN. The BILAG-2004 scoring system had an area under the ROC curve (AUC) of 0.93, and the SLEDAI-2000 scoring system had an AUC of 0.88. BILAG-2004 and SLEDAI-2000 scoring systems can be used to assess renal disease activity of patients with LN. The BILAG-2004 scoring system can provide more reliable and comprehensive assessment.

  18. Multimodal Biometric System- Fusion Of Face And Fingerprint Biometrics At Match Score Fusion Level

    Directory of Open Access Journals (Sweden)

    Grace Wangari Mwaura

    2017-04-01

    Full Text Available Biometrics has developed to be one of the most relevant technologies used in Information Technology IT security. Unimodal biometric systems have a variety of problems which decreases the performance and accuracy of these system. One way to overcome the limitations of the unimodal biometric systems is through fusion to form a multimodal biometric system. Generally biometric fusion is defined as the use of multiple types of biometric data or ways of processing the data to improve the performance of biometric systems. This paper proposes to develop a model for fusion of the face and fingerprint biometric at the match score fusion level. The face and fingerprint unimodal in the proposed model are built using scale invariant feature transform SIFT algorithm and the hamming distance to measure the distance between key points. To evaluate the performance of the multimodal system the FAR and FRR of the multimodal are compared along those of the individual unimodal systems. It has been established that the multimodal has a higher accuracy of 92.5 compared to the face unimodal system at 90 while the fingerprint unimodal system is at 82.5.

  19. Comparison of the balance accelerometer measure and balance error scoring system in adolescent concussions in sports.

    Science.gov (United States)

    Furman, Gabriel R; Lin, Chia-Cheng; Bellanca, Jennica L; Marchetti, Gregory F; Collins, Michael W; Whitney, Susan L

    2013-06-01

    High-technology methods demonstrate that balance problems may persist up to 30 days after a concussion, whereas with low-technology methods such as the Balance Error Scoring System (BESS), performance becomes normal after only 3 days based on previously published studies in collegiate and high school athletes. To compare the National Institutes of Health's Balance Accelerometer Measure (BAM) with the BESS regarding the ability to detect differences in postural sway between adolescents with sports concussions and age-matched controls. Cohort study (diagnosis); Level of evidence, 2. Forty-three patients with concussions and 27 control participants were tested with the standard BAM protocol, while sway was quantified using the normalized path length (mG/s) of pelvic accelerations in the anterior-posterior direction. The BESS was scored by experts using video recordings. The BAM was not able to discriminate between healthy and concussed adolescents, whereas the BESS, especially the tandem stance conditions, was good at discriminating between healthy and concussed adolescents. A total BESS score of 21 or more errors optimally identified patients in the acute concussion group versus healthy participants at 60% sensitivity and 82% specificity. The BAM is not as effective as the BESS in identifying abnormal postural control in adolescents with sports concussions. The BESS, a simple and economical method of assessing postural control, was effective in discriminating between young adults with acute concussions and young healthy people, suggesting that the test has value in the assessment of acute concussions.

  20. Benign prostatic hyperplasia surgical scoring (BPHSS): an novel scoring system for the perioperative outcomes of holmium laser enucleation of the prostate.

    Science.gov (United States)

    Xu, Huan; Cai, Zhikang; Chen, Yanbo; Gu, Meng; Chen, Qi; Wang, Zhong

    2018-04-01

    To develop a standardized scoring system, the BPH surgical scoring (BPHSS) system, to quantify the ability to predict the perioperative outcomes resulting from an enlarged prostate. There are two parts included in this study: the retrospective observational study (875 patients treated with holmium laser enucleation of the prostate, HoLEP) and the prospective observational study (111 patient underwent HoLEP). All the outcome data included the following: the basic patient preoperative characteristics, operation time (OT), pre- and post- surgery hemoglobin decrease, Na + variation, hospital stay duration, duration of bladder irrigation, catheterization time, and hospitalization time. The BPHSS, consisting of prostatic volume (PV), prostate-specific antigen (PSA), bladder stones, intravesical prostatic protrusion (IPP), and metabolic syndrome (MetS), was observed regarding the perioperative outcomes. In the retrospective study, patients in high BPHSS group (6-8 points) showed significant increase in the OT (74.61, 95%CI = 16.98-327.84, P < 0.001), hemochrome reduction (416.50, 95%CI = 35.48-4889.88, P < 0.001), hospital stay (1.80, 95%CI = 1.35-2.41, P < 0.001), and bladder irrigation duration (4.04, 95%CI = 1.35-12.10, P = 0.013) compared with the low BPHSS group (0-2 points). In the prospective study, there also existed significant differences between the three scoring grades (P < 0.01) in OT, hemochrome decrease, and the hospital stay. The BPHSS is suitable to predict the perioperative outcomes in patients undergoing HoLEP. It may help urologist to prepare more before surgery to treat the enlarged prostates. Further studies are needed to validate this scoring system in BPH patients in multiple centers.

  1. Comparison of APACHE II and SAPS II Scoring Systems in Prediction of Critically ill Patients’ Outcome

    Directory of Open Access Journals (Sweden)

    Hamed Aminiahidashti

    2017-01-01

    Full Text Available Introduction: Using physiologic scoring systems for identifying high-risk patients for mortality has been considered recently. This study was designed to evaluate the values of Acute Physiology and Chronic Health Evaluation II (APACHE II and Simplified Acute Physiologic Score (SAPS II models in prediction of 1-month mortality of critically ill patients.Methods: The present prospective cross sectional study was performed on critically ill patients presented to emergency department during 6 months. Data required for calculation of the scores were gathered and performance of the models in prediction of 1-month mortality were assessed using STATA software 11.0.Results: 82 critically ill patients with the mean age of 53.45 ± 20.37 years were included (65.9% male. Their mortality rate was 48%. Mean SAPS II (p < 0.0001 and APACHE II (p = 0.0007 scores were significantly higher in dead patients. Area under the ROC curve of SAPS II and APACHE II for prediction of mortality were 0.75 (95% CI: 0.64 - 0.86 and 0.72 (95% CI: 0.60 - 0.83, respectively (p = 0.24. The slope and intercept of SAPS II were 1.02 and 0.04, respectively. In addition, these values were 0.92 and 0.09 for APACHE II, respectively.Conclusion: The findings of the present study showed that APACHE II and SAPS II had similar value in predicting 1-month mortality of patients. Discriminatory powers of the mentioned models were acceptable but their calibration had some amount of lack of fit, which reveals that APACHE II and SAPS II are partially perfect.

  2. Systemic Inflammatory Response Syndrome (SIRS) Score Independently Predicts Poor Outcome in Isolated Traumatic Brain Injury.

    Science.gov (United States)

    Jacome, Tomas; Tatum, Danielle

    2018-02-01

    Systemic inflammatory response syndrome (SIRS) is frequently observed after various types of acute cerebral injury and has been linked to clinical deterioration in non-traumatic brain injury (TBI). SIRS scores have also been shown to be predictive of length of stay and mortality in trauma patients. We aimed to determine the prognostic utility of SIRS present at admission in trauma patients with isolated TBI. This was a 5-year retrospective cohort study of adults (≥18 years) with isolated TBI admitted to a Level II trauma center. The prognostic value of SIRS, total SIRS scores, and each SIRS criterion was examined by Χ 2 and logistic regression analyses. Of the 330 patients identified, 50 (15.2%) met SIRS criteria. SIRS was significantly associated with poor outcome (P SIRS score of 2 on admission (P = 0.007) and increased significantly to 6.5 times in patients with a SIRS score of 3 (P = 0.002). Logistic regression demonstrated SIRS and each criterion to be significant independent prognostic factors (SIRS, P = 0.030; body temperature, P = 0.006; tachypnea, P = 0.022, tachycardia P = 0.023). SIRS at admission is an independent predictor of poor outcome in isolated TBI patients. These data demonstrate SIRS to be an important clinical tool that may be used in facilitating prognostication, particularly in elderly trauma patients. Future prospective studies aimed at therapeutic interventions to mitigate SIRS in TBI patients are warranted. Prognostic, Level III.

  3. Implementing paediatric early warning scores systems in the Netherlands: future implications.

    Science.gov (United States)

    de Groot, J F; Damen, N; de Loos, E; van de Steeg, L; Koopmans, L; Rosias, P; Bruijn, M; Goorhuis, J; Wagner, C

    2018-04-06

    Paediatric Early Warning Scores (PEWS) are increasingly being used for early identification and management of clinical deterioration in paediatric patients. A PEWS system includes scores, cut-off points and appropriate early intervention. In 2011, The Dutch Ministry of Health advised hospitals to implement a PEWS system in order to improve patient safety in paediatric wards. The objective of this study was to examine the results of implementation of PEWS systems and to gain insight into the attitudes of professionals towards using a PEWS system in Dutch non-university hospitals. Quantitative data were gathered at start, midway and at the end of the implementation period through retrospective patient record review (n = 554). Semi-structured interviews with professionals (n = 8) were used to gain insight in the implementation process and experiences. The interviews were transcribed and analysed using an inductive approach. Looking at PEWS systems of the five participating hospitals, different parameters and policies were found. While all hospitals included heart rate and respiratory rate, other variables differed among hospitals. At baseline, none of the hospitals used a PEWS system. After 1 year, PEWS were recorded in 69.2% of the patient records and elevated PEWS resulted in appropriate action in 49.1%. Three themes emerged from the interviews: 1) while the importance of using a PEWS system was acknowledged, professionals voiced some doubts about the effectiveness and validity of their PEWS system 2) registering PEWS required little extra effort and was facilitated by PEWS being integrated into the electronic patient record 3) Without a national PEWS system or guidelines, hospitals found it difficult to identify a suitable PEWS system for their setting. Existing systems were not always considered applicable in a non-university setting. After 1 year, hospitals showed improvements in the use of their PEWS system, although some were decidedly more successful

  4. The interface of inflammation and subclinical atherosclerosis in Granulomatosis with Polyangiitis (Wegener’s): a preliminary study

    Science.gov (United States)

    Hajj-Ali, RA; Major, J; Langford, CA; Hoffman, GS; Clark, T; Zhang, L; Sun, Z; Silverstein, RL

    2016-01-01

    The objective of this study is to assess the relationship between inflammatory disease in granulomatosis with polyangiitis (GPA, Wegener’s) with the development of subclinical atherosclerosis. 46 adult patients with GPA were enrolled. Disease status was measured by Birmingham Vasculitis Assessment Scores as modified for GPA (BVAS-WG), Vasculitis Damage Index (VDI), disease duration and number of relapses. Classic atherosclerotic risk factors, platelet aggregation responses and circulating microparticles (MP) levels were recorded. All patients underwent carotid artery intima media thickness (IMT) measurement as outcome for subclinical atherosclerosis. In univariate analyses, systolic and diastolic blood pressure, creatinine, and age were significantly associated with higher IMT [rho values: 0.37, 0.38, 0.35 and 0.054 respectively (p < 0.02 for all)]. In a multiple regression model, greater number of relapses, older age at onset of disease, and higher diastolic blood pressure were found to be associated with higher IMT (p values 0.003, <0.001 and 0.031 respectively). MP counts and platelet reactivity correlated well with disease activity in GPA. Furthermore, MP were found to activate vascular endothelial cells and platelets in vitro. The cumulative burden of systemic inflammation in GPA correlated with development of subclinical atherosclerosis. The correlation with subclinical atherosclerosis could be due to glucocorticoid use and not the inflammatory process in GPA, giving the inherent bias that exits with the use of glucocorticoid with each relapse. The findings of elevated levels of circulating leukocyte-derived MP and enhanced platelet reactivity during relapse suggest possible roles for MP and platelets in disease pathogenesis and support a growing literature that links inflammation, atherosclerosis, and platelet activation. This hypothesis is further substantiated by our demonstration that MP isolated from plasma of GPA patients can activate platelets and

  5. Development and Reliability of the OMERACT Thumb Base Osteoarthritis Magnetic Resonance Imaging Scoring System

    DEFF Research Database (Denmark)

    Kroon, Féline P B; Conaghan, Philip G; Foltz, Violaine

    2017-01-01

    : The TOMS assessed the first carpometacarpal (CMC-1) and scaphotrapeziotrapezoid (STT) joints for synovitis, subchondral bone defects (including erosions, cysts, and bone attrition), osteophytes, cartilage, and bone marrow lesions on a 0-3 scale (normal to severe). Subluxation was evaluated only in the CMC......, with better performance for subchondral bone defects, subluxation, and bone marrow lesions. CONCLUSION: A thumb base OA MRI scoring system has been developed. The OMERACT TOMS demonstrated good intrareader and interreader reliability. Longitudinal studies are warranted to investigate reliability of change...

  6. EVALUATION OF PRE-OPERATIVE DIAGNOSTIC EFFICACY OF MODIFIED ALVARADO SCORING SYSTEM IN ACUTE APPENDICITIS

    Directory of Open Access Journals (Sweden)

    Anand Kumar Jaiswal

    2017-05-01

    Full Text Available BACKGROUND Acute Appendicitis is the one of the most common acute surgical condition of abdomen. Acute Appendicitis may occur but is most commonly seen in the second and third decade of life. Acute Appendicitis if not diagnosed early and treated properly, may lead to fatal outcome. MATERIALS AND METHODS A prospective study of 100 patients, with a clinical diagnosis of acute appendicitis, admitted in the department of general surgery, B.R.D. Medical College Gorakhpur during a period of one year. RESULTS The age group in which acute appendicitis occurred commonly was between 18 to 30 years. It is clear that incidence is less in younger and older is group with peak incidence in second and third decade. Female to male ratio was 1.8:1. Pain was the commonest presenting symptom and has been observed in all the cases (100% in present series followed by nausea/vomiting in 87% cases and anorexia in 49% cases. CONCLUSION In the diagnosis of acute appendicitis the modified Alvarado Scoring System has a diagnostic value of 88.66%. This system is simple, reliable, cheap, non-invasive and safe diagnostic modality. The application of this scoring system improved diagnostic accuracy and consequently reduced negative appendectomy rate.

  7. Myeloproliferative Neoplasm (MPN) Symptom Assessment Form Total Symptom Score: Prospective International Assessment of an Abbreviated Symptom Burden Scoring System Among Patients With MPNs

    Science.gov (United States)

    Emanuel, Robyn M.; Dueck, Amylou C.; Geyer, Holly L.; Kiladjian, Jean-Jacques; Slot, Stefanie; Zweegman, Sonja; te Boekhorst, Peter A.W.; Commandeur, Suzan; Schouten, Harry C.; Sackmann, Federico; Kerguelen Fuentes, Ana; Hernández-Maraver, Dolores; Pahl, Heike L.; Griesshammer, Martin; Stegelmann, Frank; Doehner, Konstanze; Lehmann, Thomas; Bonatz, Karin; Reiter, Andreas; Boyer, Francoise; Etienne, Gabriel; Ianotto, Jean-Christophe; Ranta, Dana; Roy, Lydia; Cahn, Jean-Yves; Harrison, Claire N.; Radia, Deepti; Muxi, Pablo; Maldonado, Norman; Besses, Carlos; Cervantes, Francisco; Johansson, Peter L.; Barbui, Tiziano; Barosi, Giovanni; Vannucchi, Alessandro M.; Passamonti, Francesco; Andreasson, Bjorn; Ferarri, Maria L.; Rambaldi, Alessandro; Samuelsson, Jan; Birgegard, Gunnar; Tefferi, Ayalew; Mesa, Ruben A.

    2012-01-01

    Purpose Myeloproliferative neoplasm (MPN) symptoms are troublesome to patients, and alleviation of this burden represents a paramount treatment objective in the development of MPN-directed therapies. We aimed to assess the utility of an abbreviated symptom score for the most pertinent and representative MPN symptoms for subsequent serial use in assessing response to therapy. Patients and Methods The Myeloproliferative Neoplasm Symptom Assessment Form total symptom score (MPN-SAF TSS) was calculated as the mean score for 10 items from two previously validated scoring systems. Questions focus on fatigue, concentration, early satiety, inactivity, night sweats, itching, bone pain, abdominal discomfort, weight loss, and fevers. Results MPN-SAF TSS was calculable for 1,408 of 1,433 patients with MPNs who had a mean score of 21.2 (standard deviation [SD], 16.3). MPN-SAF TSS results significantly differed among MPN disease subtypes (P < .001), with a mean of 18.7 (SD, 15.3), 21.8 (SD, 16.3), and 25.3 (SD, 17.2) for patients with essential thrombocythemia, polycythemia vera, and myelofibrosis, respectively. The MPN-SAF TSS strongly correlated with overall quality of life (QOL; r = 0.59; P < .001) and European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire C30 (EORTC QLQ-C30) functional scales (all P < .001 and absolute r ≥ 0.50 except social functioning r = 0.48). No significant trends were present when comparing therapy subgroups. The MPN-SAF TSS had excellent internal consistency (Cronbach's α = .83). Factor analysis identified a single underlying construct, indicating that the MPN-SAF TSS is an appropriate, unified scoring method. Conclusion The MPN-SAF TSS is a concise, valid, and accurate assessment of MPN symptom burden with demonstrated clinical utility in the largest prospective MPN symptom study to date. This new prospective scoring method may be used to assess MPN symptom burden in both clinical practice and trial settings. PMID

  8. Performance Evaluation of a Dedicated Preclinical PET/CT System for the Assessment of Mineralization Process in a Mouse Model of Atherosclerosis.

    Science.gov (United States)

    Rucher, Guillaume; Cameliere, Lucie; Fendri, Jihene; Abbas, Ahmed; Dupont, Kevin; Kamel, Said; Delcroix, Nicolas; Dupont, Axel; Berger, Ludovic; Manrique, Alain

    2018-04-30

    The purpose of this study was to assess the impact of positron emission tomography/X-ray computed tomography (PET/CT) acquisition and reconstruction parameters on the assessment of mineralization process in a mouse model of atherosclerosis. All experiments were performed on a dedicated preclinical PET/CT system. CT was evaluated using five acquisition configurations using both a tungsten wire phantom for in-plane resolution assessment and a bar pattern phantom for cross-plane resolution. Furthermore, the radiation dose of these acquisition configurations was calculated. The PET system was assessed using longitudinal line sources to determine the optimal reconstruction parameters by measuring central resolution and its coefficient of variation. An in vivo PET study was performed using uremic ApoE -/- , non-uremic ApoE -/- , and control mice to evaluate optimal PET reconstruction parameters for the detection of sodium [ 18 F]fluoride (Na[ 18 F]F) aortic uptake and for quantitative measurement of Na[ 18 F]F bone influx (Ki) with a Patlak analysis. For CT, the use of 1 × 1 and 2 × 2 binning detector mode increased both in-plane and cross-plane resolution. However, resolution improvement (163 to 62 μm for in-plane resolution) was associated with an important radiation dose increase (1.67 to 32.78 Gy). With PET, 3D-ordered subset expectation maximization (3D-OSEM) algorithm increased the central resolution compared to filtered back projection (1.42 ± 0.35 mm vs. 1.91 ± 0.08, p PET resolution for preclinical study (FWHM = 0.98 mm). These PET reconstruction parameters allowed the detection of Na[ 18 F]F aortic uptake in 3/14 ApoE -/- mice and demonstrated a decreased Ki in uremic ApoE -/- compared to non-uremic ApoE -/- and control mice (p PET. In addition, improving the CT resolution was associated with a dramatic radiation dose increase.

  9. Reliability of ultrasound grading traditional score and new global OMERACT-EULAR score system (GLOESS): results from an inter- and intra-reading exercise by rheumatologists.

    Science.gov (United States)

    Ventura-Ríos, Lucio; Hernández-Díaz, Cristina; Ferrusquia-Toríz, Diana; Cruz-Arenas, Esteban; Rodríguez-Henríquez, Pedro; Alvarez Del Castillo, Ana Laura; Campaña-Parra, Alfredo; Canul, Efrén; Guerrero Yeo, Gerardo; Mendoza-Ruiz, Juan Jorge; Pérez Cristóbal, Mario; Sicsik, Sandra; Silva Luna, Karina

    2017-12-01

    This study aims to test the reliability of ultrasound to graduate synovitis in static and video images, evaluating separately grayscale and power Doppler (PD), and combined. Thirteen trained rheumatologist ultrasonographers participated in two separate rounds reading 42 images, 15 static and 27 videos, of the 7-joint count [wrist, 2nd and 3rd metacarpophalangeal (MCP), 2nd and 3rd interphalangeal (IPP), 2nd and 5th metatarsophalangeal (MTP) joints]. The images were from six patients with rheumatoid arthritis, performed by one ultrasonographer. Synovitis definition was according to OMERACT. Scoring system in grayscale, PD separately, and combined (GLOESS-Global OMERACT-EULAR Score System) were reviewed before exercise. Reliability intra- and inter-reading was calculated with Cohen's kappa weighted, according to Landis and Koch. Kappa values for inter-reading were good to excellent. The minor kappa was for GLOESS in static images, and the highest was for the same scoring in videos (k 0.59 and 0.85, respectively). Excellent values were obtained for static PD in 5th MTP joint and for PD video in 2nd MTP joint. Results for GLOESS in general were good to moderate. Poor agreement was observed in 3rd MCP and 3rd IPP in all kinds of images. Intra-reading agreement were greater in grayscale and GLOESS in static images than in videos (k 0.86 vs. 0.77 and k 0.86 vs. 0.71, respectively), but PD was greater in videos than in static images (k 1.0 vs. 0.79). The reliability of the synovitis scoring through static images and videos is in general good to moderate when using grayscale and PD separately or combined.

  10. Prostate ultrasound imaging: evaluation of a two-step scoring system in the diagnosis of prostate cancer.

    Science.gov (United States)

    Gao, Yong; Liao, Xin-Hong; Ma, Yan; Lu, Lu; Wei, Li-Yan; Yan, Xue

    2017-12-01

    This study aims to investigate the feasibility and performance of a two-step scoring system of ultrasound imaging in the diagnosis of prostate cancer. 75 patients with 888 consecutive histopathologically verified lesions were included in this study. Step 1, an initial 5-point scoring system was developed based on conventional transrectal ultrasound (TRUS). Step 2, a final scoring system was evaluated according to contrast-enhanced transrectal ultrasound (CE-TRUS). Each lesion was evaluated using the two-step scoring system (step 1 + step 2) and compared with only using conventional TRUS (step 1). 888 lesions were histologically verified: 315 of them were prostate cancer from 46 patients and 573 were benign prostatic hypertrophy (BPH) from 29 patients. According to the two-step scoring system, 284 lesions were upgraded and 130 lesions were downgraded from step 1 to step 2 (this means using step 2 to assess the results by step 1). However, 96 cases were improperly upgraded after step 2 and 48 malignant lesions were still missed after step 2 as score-1. For the two-step scoring system, the sensitivity, specificity, and accuracy were 84.7%, 83.2%, and 83.7%, respectively, versus 22.8%, 96.6%, and 70.4%, respectively, for conventional TRUS. The area under the ROC curve (AUC) for lesion diagnosis was 0.799-0.952 for the two-step scoring system, versus 0.479-0.712 for conventional TRUS. The difference in the diagnostic accuracy of the two-step scoring system and conventional TRUS was statistically significant (Pprostate cancer. The application of the two-step scoring system for prostate cancer is promising.

  11. [Severity of disease scoring systems and mortality after non-cardiac surgery].

    Science.gov (United States)

    Reis, Pedro Videira; Sousa, Gabriela; Lopes, Ana Martins; Costa, Ana Vera; Santos, Alice; Abelha, Fernando José

    2018-04-05

    Mortality after surgery is frequent and severity of disease scoring systems are used for prediction. Our aim was to evaluate predictors for mortality after non-cardiac surgery. Adult patients admitted at our surgical intensive care unit between January 2006 and July 2013 was included. Univariate analysis was carried using Mann-Whitney, Chi-square or Fisher's exact test. Logistic regression was performed to assess independent factors with calculation of odds ratio and 95% confidence interval (95% CI). 4398 patients were included. Mortality was 1.4% in surgical intensive care unit and 7.4% during hospital stay. Independent predictors of mortality in surgical intensive care unit were APACHE II (OR=1.24); emergent surgery (OR=4.10), serum sodium (OR=1.06) and FiO 2 at admission (OR=14.31). Serum bicarbonate at admission (OR=0.89) was considered a protective factor. Independent predictors of hospital mortality were age (OR=1.02), APACHE II (OR=1.09), emergency surgery (OR=1.82), high-risk surgery (OR=1.61), FiO 2 at admission (OR=1.02), postoperative acute renal failure (OR=1.96), heart rate (OR=1.01) and serum sodium (OR=1.04). Dying patients had higher scores in severity of disease scoring systems and longer surgical intensive care unit stay. Some factors influenced both surgical intensive care unit and hospital mortality. Copyright © 2017 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

  12. Technical note: The development of a reliable 5-point gait scoring system for use in dairy goats.

    Science.gov (United States)

    Deeming, L E; Beausoleil, N J; Stafford, K J; Webster, J R; Zobel, G

    2018-02-21

    Numerical rating scales are frequently used in gait scoring systems as indicators of lameness in dairy animals. The gait scoring systems commonly used in dairy goats are based on 4-point scales that focus on detecting and judging the severity of a definite limp. An uneven gait, such as a shortened stride or not "tracking up," is arguably the precursor to the development of a limp; thus, identifying such changes in gait could provide opportunity for early treatment. The objectives of this study were (1) to develop a 5-point gait scoring system that included an "uneven gait" category and compare the distribution of gait scores generated using this system to scores generated using a 4-point system, and (2) to determine whether this system could be reliably used. Forty-eight Saanen cross 2- and 3-yr-old lactating does were enrolled from a commercial dairy goat farm. Two observers carried out weekly live gait scoring sessions for 7 wk using the developed 5-point scoring system. The first 2 wk were used as training sessions (training sessions 1-2), with the subsequent 5 wk completed as gait assessments (assessments 1-5). In addition to training session 1 being lived scored, the goats were also video-recorded. This allowed observer 1 to re-score the session 4 times: twice using the developed 5-point system and twice using the previously used 4-point system. Comparisons of score distributions could then be made. Using the 4-point system, 81% of the goats were assigned score 1 (normal gait). Using the 5-point system, only 36% of the goats were assigned score 1 (normal gait), with 50% assigned score 2 (uneven gait). High levels of intra-observer reliability were achieved by observer 1 using both gait scoring systems [weighted kappa (κ w ) = 1.00: 4-point, κ w = 0.96: 5-point]. At training session 1 (wk 1), inter-observer reliability was only moderate (κ w = 0.54), but this was improved during the subsequent training session 2 (κ w = 0.89). Inter-observer reliability was

  13. A critical appraisal of radiographic scoring systems for assessment of juvenile idiopathic arthritis

    International Nuclear Information System (INIS)

    Doria, Andrea S.; Babyn, Paul S.; Feldman, Brian

    2006-01-01

    Assessing structural damage to joints over time is essential for evaluating the effectiveness of therapeutic interventions for patients with inflammatory arthritis. Although radiography is able to quantify joint damage, the changes found with conventional radiography early in the disease course are nonspecific, and late radiographic changes are often irreversible. Although many clinical trials on drug development for children still use radiographic scales as endpoints for the study, more specific therapies have been developed for juvenile idiopathic arthritis (JIA) that would enable imaging to ''fine-tune'' patients to placement into specific treatment algorithms. As a result, new imaging scales to identify early abnormalities are clearly needed. Many pediatric rheumatology centers around the world persistently apply adult-designed radiographic scoring systems to evaluate the progression of JIA. Few pediatric-targeted radiographic scales are available for assessment of progression of JIA in growing joints, and the clinimetric and psychometric properties of such scales have been poorly investigated. We present a critique to the evaluative, discriminative, and predictive roles of the van der Heijde modification of Sharp's radiographic method, a scale originally designed to assess damage to joints of adults with rheumatoid arthritis, when it is applied to a pediatric population. We discuss the advantages and drawbacks of this radiographic scoring system for assessing growing joints and the ability of MRI to overcome inadequacies of conventional radiography. (orig.)

  14. A score system for quality evaluation of RNA sequence tags: an improvement for gene expression profiling.

    Science.gov (United States)

    Pinheiro, Daniel G; Galante, Pedro A F; de Souza, Sandro J; Zago, Marco A; Silva, Wilson A

    2009-06-06

    High-throughput molecular approaches for gene expression profiling, such as Serial Analysis of Gene Expression (SAGE), Massively Parallel Signature Sequencing (MPSS) or Sequencing-by-Synthesis (SBS) represent powerful techniques that provide global transcription profiles of different cell types through sequencing of short fragments of transcripts, denominated sequence tags. These techniques have improved our understanding about the relationships between these expression profiles and cellular phenotypes. Despite this, more reliable datasets are still necessary. In this work, we present a web-based tool named S3T: Score System for Sequence Tags, to index sequenced tags in accordance with their reliability. This is made through a series of evaluations based on a defined rule set. S3T allows the identification/selection of tags, considered more reliable for further gene expression analysis. This methodology was applied to a public SAGE dataset. In order to compare data before and after filtering, a hierarchical clustering analysis was performed in samples from the same type of tissue, in distinct biological conditions, using these two datasets. Our results provide evidences suggesting that it is possible to find more congruous clusters after using S3T scoring system. These results substantiate the proposed application to generate more reliable data. This is a significant contribution for determination of global gene expression profiles. The library analysis with S3T is freely available at http://gdm.fmrp.usp.br/s3t/. S3T source code and datasets can also be downloaded from the aforementioned website.

  15. Intelligent query by humming system based on score level fusion of multiple classifiers

    Science.gov (United States)

    Pyo Nam, Gi; Thu Trang Luong, Thi; Ha Nam, Hyun; Ryoung Park, Kang; Park, Sung-Joo

    2011-12-01

    Recently, the necessity for content-based music retrieval that can return results even if a user does not know information such as the title or singer has increased. Query-by-humming (QBH) systems have been introduced to address this need, as they allow the user to simply hum snatches of the tune to find the right song. Even though there have been many studies on QBH, few have combined multiple classifiers based on various fusion methods. Here we propose a new QBH system based on the score level fusion of multiple classifiers. This research is novel in the following three respects: three local classifiers [quantized binary (QB) code-based linear scaling (LS), pitch-based dynamic time warping (DTW), and LS] are employed; local maximum and minimum point-based LS and pitch distribution feature-based LS are used as global classifiers; and the combination of local and global classifiers based on the score level fusion by the PRODUCT rule is used to achieve enhanced matching accuracy. Experimental results with the 2006 MIREX QBSH and 2009 MIR-QBSH corpus databases show that the performance of the proposed method is better than that of single classifier and other fusion methods.

  16. Development and validation of a prognostic scoring system for patients with chronic myelomonocytic leukemia.

    Science.gov (United States)

    Such, Esperanza; Germing, Ulrich; Malcovati, Luca; Cervera, José; Kuendgen, Andrea; Della Porta, Matteo G; Nomdedeu, Benet; Arenillas, Leonor; Luño, Elisa; Xicoy, Blanca; Amigo, Mari L; Valcarcel, David; Nachtkamp, Kathrin; Ambaglio, Ilaria; Hildebrandt, Barbara; Lorenzo, Ignacio; Cazzola, Mario; Sanz, Guillermo

    2013-04-11

    The natural course of chronic myelomonocytic leukemia (CMML) is highly variable but a widely accepted prognostic scoring system for patients with CMML is not available. The main aim of this study was to develop a new CMML-specific prognostic scoring system (CPSS) in a large series of 558 patients with CMML (training cohort, Spanish Group of Myelodysplastic Syndromes) and to validate it in an independent series of 274 patients (validation cohort, Heinrich Heine University Hospital, Düsseldorf, Germany, and San Matteo Hospital, Pavia, Italy). The most relevant variables for overall survival (OS) and evolution to acute myeloblastic leukemia (AML) were FAB and WHO CMML subtypes, CMML-specific cytogenetic risk classification, and red blood cell (RBC) transfusion dependency. CPSS was able to segregate patients into 4 clearly different risk groups for OS (P FAB and WHO subtypes, recognizes the importance of RBC transfusion dependency and cytogenetics, and offers a simple and powerful CPSS for accurately assessing prognosis and planning therapy in patients with CMML.

  17. Qualitative, quantitative and combination score systems in differential diagnosis of breast lesions by contrast-enhanced ultrasound.

    Science.gov (United States)

    Wang, YongMei; Fan, Wei; Zhao, Song; Zhang, Kai; Zhang, Li; Zhang, Ping; Ma, Rong

    2016-01-01

    To assess the feasibility of score systems in differential diagnosis of breast lesions by contrast-enhanced ultrasound (CEUS). CEUS was performed in 121 patients with 127 breast lesions by Philips iU22 with Sonovue as contrast agent. Pearson Chi-square χ(2) test, binary logistic regression analysis and Student's t-test are used to identify significant CEUS parameters in differential diagnosis. Based on these significant CEUS parameters, qualitative, quantitative and combination score systems were built by scoring 1 for benign characteristic and scoring 2 for malignant characteristic. Receiver operating characteristic (ROC) curve was applied to evaluate the diagnostic efficacy of different analytical methods. Pathological results showed 41 benign and 86 malignant lesions. Qualitative analysis and logistic regression analysis showed that there are significant differences in enhancement degree, enhancement order, internal homogeneity, enhancement margin, surrounding vessels and enlargement of diameters (PQuantitative analysis indicated that malignant lesions tended to show higher peak intensity (PI), larger area under the curve (AUC) and shorter time to peak (TTP) than benign ones (PQualitative score systems showed higher diagnostic efficacy than single quantitative CEUS parameters. The corresponding area under the ROC curve for qualitative, quantitative and combination score systems were 0.897, 0.716 and 0.903 respectively. Z test showed that area under the ROC curve of quantitative score system was statistically smaller than that of other score systems. Quantitative score system helps little in improving the diagnostic efficacy of CEUS. While qualitative score system improves the performance of CEUS greatly in discrimination of benign and malignant breast lesions. The application of qualitative could develop the diagnostic performance of CEUS which is clinically promising. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  18. The Rotterdam Scoring System Can Be Used as an Independent Factor for Predicting Traumatic Brain Injury Outcomes.

    Science.gov (United States)

    Talari, Hamid Reza; Fakharian, Esmaeil; Mousavi, Nooshin; Abedzadeh-Kalahroudi, Masoumeh; Akbari, Hossein; Zoghi, Sommayeh

    2016-03-01

    Predicting outcomes in patients with traumatic brain injury is critically important for making sound clinical decisions. This study aimed at determining the prognostic value of the Rotterdam scoring system to predict early death among these patients. This study was performed prospectively on 150 patients with traumatic brain injury hospitalized in Shahid Beheshti Hospital, Kashan, Iran. Patients' demographic and clinical characteristics such as age, sex, mechanism of trauma, initial Glasgow Coma Scale score, and accompanying lesions were documented. A brain computed tomography was performed for each patient and scored by use of the Rotterdam system. Patients were monitored for 2 weeks after hospital discharge, and their outcomes were documented. Univariate and multiple logistic regression analysis and prognostic values of Rotterdam system were conducted by SPSS software. Nineteen patients (12.7%) died during the course of the study. The mean age of the dead patients was significantly greater than those who survived (P = 0.037). The sensitivity and the specificity of the Rotterdam scoring system at the cutoff score of 4 were 84.2% and 96.2%, respectively. Rotterdam score was significantly correlated with patient outcomes (P patient outcomes. Rotterdam score is an independent factor for predicting outcomes among patients with traumatic brain injury. At the cutoff score of 4, the Rotterdam system can predict outcomes among patients suffering from traumatic brain injury with acceptable sensitivity and specificity. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Autoimmunity, infectious immunity, and atherosclerosis.

    Science.gov (United States)

    Matsuura, Eiji; Kobayashi, Kazuko; Matsunami, Yukana; Shen, Lianhua; Quan, Nanhu; Makarova, Marina; Suchkov, Sergey V; Ayada, Kiyoshi; Oguma, Keiji; Lopez, Luis R

    2009-11-01

    Vascular inflammation is common in certain systemic autoimmune diseases and contributes to the oxidation of low-density lipoprotein (oxLDL) and oxLDL/beta2-glycoprotein I (beta2GPI) complex formation. These complexes have been implicated as proatherogenic autoantigens that participate in the development of atherosclerotic disease. We have demonstrated that the in vitro macrophage uptake of oxLDL/beta2GPI complexes increases in the presence of IgG anti-beta2GPI antibodies and that IgG immune complexes containing oxLDL/beta2GPI upregulate the expression of both scavenger and Fcgamma receptors to activate beta2GPI specific T cells. Some persistent infections may cause immune responses that promote atherogenesis. Cellular immunity (Th1) against Helicobacter pylori (H. pylori) derived heat shock protein 60 (Hp-HSP60) cross-reacts with endogenous HSP60 to cause cardiovascular disease likely by molecular mimicry. Infectious cellular response may be proatherogenic,while the humoral response (antibody production) maybe protective. We review the recent progress in our understanding of autoimmunity and infectious immunity that promote atherosclerosis.

  20. Evaluation of atherosclerosis in the abdominal aorta by contrast enhanced helical CT

    International Nuclear Information System (INIS)

    Gong, Honghan; Hiraishi, Kumiko; Shimizu, Tadafumi; Adachi, Itaru; Sueyoshi, Kouzou; Narabayashi, Isamu

    1997-01-01

    We retrospectively evaluated helical CT findings of the abdominal aorta in 85 patients (47 men and 38 women) ranging from 21 to 84 years of age (mean±SD : 58.8±13.6) with nonvascular disease. The degree of atherosclerosis of the abdominal aorta was assessed by examining the imaging findings of the curvature, double contour (wall thickening), and calcification of the abdominal aorta. Each of the atherosclerosis findings was classified into one of four degree of severity: no atherosclerosis as 0, minimal atherosclerosis as 1, moderate atherosclerosis as 2, and severe atherosclerosis as 3. Findings of abdominal aortic sclerosis were given a score of 9. The mean score of the men was 2.8±1.8 and that of the women was 1.1±1.2. The mean score of patients below age 39 was 0.3±0.7, that of patients between ages 40 and 59 was 1.4±1.5, and that of patients over age 60 was 2.9±1.6. The results showed that atherosclerosis occurred earlier and more frequently, and was more severe, in the men than in the women. There are many nonsymptomatic patients with arteriosclerosis, and they should be carefully managed. Because of high resolusion and fast scanning, helical CT is useful for evaluating the severity of atherosclerosis. Double contour of the abdominal aorta at the later arterial phase of the contrast enhancement was an important finding, suggesting atherosclerosis of the abdominal aorta. (author)

  1. Understanding the Effect of Statins and Patient Adherence in Atherosclerosis via a Quantitative Systems Pharmacology Model Using a Novel, Hybrid, and Multi-Scale Approach

    Directory of Open Access Journals (Sweden)

    Cesar Pichardo-Almarza

    2017-09-01

    Full Text Available Background and Objective: Statins are one of the most prescribed drugs to treat atherosclerosis. They inhibit the hepatic HMG-CoA reductase, causing a reduction of circulating cholesterol and LDL levels. Statins have had undeniable success; however, the benefits of statin therapy crystallize only if patients adhere to the prescribed treatment, which is far away from reality since adherence decreases with time with around half of patients discontinue statin therapy within the first year. The objective of this work is to; firstly, demonstrate a formal in-silico methodology based on a hybrid, multiscale mathematical model used to study the effect of statin treatment on atherosclerosis under different patient scenarios, including cases where the influence of medication adherence is examined and secondly, to propose a flexible simulation framework that allows extensions or simplifications, allowing the possibility to design other complex simulation strategies, both interesting features for software development.Methods: Different mathematical modeling paradigms are used to present the relevant dynamic behavior observed in biological/physiological data and clinical trials. A combination of continuous and discrete event models are coupled to simulate the pharmacokinetics (PK of statins, their pharmacodynamic (PD effect on lipoproteins levels (e.g., LDL and relevant inflammatory pathways whilst simultaneously studying the dynamic effect of flow-related variables on atherosclerosis progression.Results: Different scenarios were tested showing the impact of: (1 patient variability: a virtual population shows differences in plaque growth for different individuals could be as high as 100%; (2 statin effect on atherosclerosis: it is shown how a patient with a 1-year statin treatment will reduce his plaque growth by 2–3% in a 2-year period; (3 medical adherence: we show that a patient missing 10% of the total number of doses could increase the plaque growth

  2. Body condition scoring system for greater one-horned rhino (Rhinoceros unicornis): Development and application.

    Science.gov (United States)

    Heidegger, Eva M; von Houwald, Friederike; Steck, Beatrice; Clauss, Marcus

    2016-09-01

    Preventing obesity in zoo animals is increasingly recognized as an important husbandry objective. To achieve this goal, body condition scoring (BCS) systems are available for an ever-increasing number of species. Here, we present a BCS for the greater one-horned rhinoceros (Rhinoceros unicornis) based on an evaluation (on a scale from 1 to 5) of seven different body regions, and report resulting scores for 62 animals from 27 facilities, based on digital photographs. In animals above 4 years of age, this BCS correlated with the body mass:shoulder height ratio. Although differences between the sexes for individual regions were noted (with consistently higher scores in males for the neck and shoulder and in parous females for the abdomen), the average BCS of all regions did not differ significantly between males (4.3 ± 0.4) and females (4.1 ± 0.5). Linking the BCS to results of a questionnaire survey and studbook information, there were no differences in BCS between animals with and without foot problems or between parous and non-parous females. In a very limited sample of 11 females, those eight that had been diagnosed with leiomyoma in a previous study had a higher BCS (range 3.9-4.9) than the three that had been diagnosed as leiomyoma-free (range 3.5-3.7). The BCS was correlated to the amount of food offered as estimated from the questionnaire. Adjusting the amounts and the nutritional quality of the diet components is an evident measure to maintain animals at a target BCS (suggested as 3-3.5). Zoo Biol. 35:432-443, 2016. © Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  3. Development of a novel scoring system for identifying emerging chemical risks in the food chain.

    Science.gov (United States)

    Oltmanns, J; Licht, O; Bitsch, A; Bohlen, M-L; Escher, S E; Silano, V; MacLeod, M; Serafimova, R; Kass, G E N; Merten, C

    2018-02-21

    The European Food Safety Authority (EFSA) is responsible for risk assessment of all aspects of food safety, including the establishment of procedures aimed at the identification of emerging risks to food safety. Here, a scoring system was developed for identifying chemicals registered under the European REACH Regulation that could be of potential concern in the food chain using the following parameters: (i) environmental release based on maximum aggregated tonnages and environmental release categories; (ii) biodegradation in the environment; (iii) bioaccumulation and in vivo and in vitro toxicity. The screening approach was tested on 100 data-rich chemicals registered under the REACH Regulation at aggregated volumes of at least 1000 tonnes per annum. The results show that substance-specific data generated under the REACH Regulation can be used to identify potential emerging risks in the food chain. After application of the screening procedure, priority chemicals can be identified as potentially emerging risk chemicals through the integration of exposure, environmental fate and toxicity. The default approach is to generate a single total score for each substance using a predefined weighting scenario. However, it is also possible to use a pivot table approach to combine the individual scores in different ways that reflect user-defined priorities, which enables a very flexible, iterative definition of screening criteria. Possible applications of the approaches are discussed using illustrative examples. Either approach can then be followed by in-depth evaluation of priority substances to ensure the identification of substances that present a real emerging chemical risk in the food chain.

  4. Differentiation of organics from functional psychiatric patients across various IQ ranges using the Bender-Gestalt and Hutt Scoring System.

    Science.gov (United States)

    Hellkamp, D T; Hogan, M E

    1985-03-01

    This study investigated the effectiveness of the Hutt Scoring System (Hutt, 1977) in differentiating organic from functional psychiatric patients, the relationship of IQ to Bender-Gestalt errors as measured by this scoring system, and examined the discriminative power of this scoring system for various IQ ranges. One hundred eighty patients were utilized, 90 of whom had been classified as organics and matched with the remaining 90 subjects on the basis of age, education, and IQ range. In addition, the organic subjects' secondary diagnosis was matched with the primary diagnosis of the nonorganic patients. Results between WAIS IQ and Hutt error scores for organic subjects yielded an r = -.34 (p less than .01); between WAIS IQ and Hutt error scores for the nonorganic subjects, r = -.61 (p less than .001). No significant results were obtained for organics and nonorganics simultaneously within the same IQ cells.

  5. Expanded Koppitz Scoring System of the Bender Gestalt Visual-Motor Test for Adolescents: A Pilot Study.

    Science.gov (United States)

    Bolen, Larry M.; And Others

    1992-01-01

    Examined use of Bender Gestalt Visual-Motor Test with school-age adolescents over age 11. Mean error scores suggest that visual-motor development is not maturationally complete by age 11 years, 11 months. Suggests additional research focusing on extending normative sample or developing new scoring system for adolescents. (Author/NB)

  6. Early Warning Scoring System for Early Recognition of and Timely Intervention in Deteriorating Patients in the Hospital.

    Science.gov (United States)

    Ravikirti

    2016-05-01

    Delay in recognizing clinical deterioration in acutely unwell patients often leads to cardiac arrests and unexpected admissions to the Intensive Care Unit. Early Warning Scoring Systems based on vital physiological parameters help in early detection of clinical deterioration. When combined with a system of prompt and appropriate clinical response, they have been shown to improve outcome. A standardised National Early Warning Score has been implemented in the United Kingdom. There is a need to implement an early warning scoring system in hospitals in India in order to ensure effective and judicious utilization of our overburdened acute services and to minimize adverse outcomes. © Journal of the Association of Physicians of India 2011.

  7. Scoring systems of cleft-related facial deformities: a review of literature.

    Science.gov (United States)

    Mosmuller, D G M; Griot, J P W Don; Bijnen, C L; Niessen, F B

    2013-05-01

    Objective :  There is a need for an internationally agreed objective method of assessing cleft-related deformities in order to compare the results of individual surgeons and different surgical techniques or to determine the optimal timing for primary lip closure. To assess the current methods, an overview of the recent developments in postoperative scoring systems of cleft-related deformities was made. Methods :  A Medline search from June 2003 through July 2011 was conducted, and references in the selected articles were checked. This search yielded 428 articles, and after application of the inclusion and exclusion criteria, 40 articles were included in this review. Results :  Twenty-five studies used two-dimensional (2D) photographs for the assessment of cleft-related deformities. Fourteen of these studies used a subjective method for the assessment and 11 performed anthropometric measurements. Good reliability has been found for subjective assessments and measurements from 2D photographs. Fifteen studies assessed three-dimensional (3D) imaging. Conclusions :  Although there is a wide variety in study design, 3D imaging seems most reliable in assessing cleft-related facial deformities. However, scoring on 2D photographs is easier to perform and more applicable in daily practice because all cleft patients are photographed through the course of their treatment.

  8. Clinical scoring systems in predicting health-related quality of life of children with injuries.

    Science.gov (United States)

    Mestrović, Julije; Mestrović, Marija; Polić, Branka; Markić, Josko; Kardum, Goran; Gunjaca, Grgo; Matas, Anita; Catipović, Tatjana; Radonić, Marija

    2013-06-01

    The aim of the study was to explore the association between Glasgow Coma Scale (GCS), Paediatric Index of Mortality (PIM2) and Injury Severity Score (ISS), and the long-term outcome of children with injuries. The health related quality of life (HRQL) was assessed by using the Royal Alexandra Hospital for children Measure of Function (RAHC MOF), 12 months post discharge. Out of 118 children with injuries (9% of all patients), 75 had injury of the head as the leading injury. There were no significant differences at admission in the severity of clinical condition, as expressed by PIM2 and ISS, between patients with head injuries and patients with other injured leading body regions. Children with head injuries had significantly worse HRQOL than children with other leading injured body region (p children from road traffic accidents had significantly worse HRQL (p = 0.004), compared to other mechanisms of injury. HRQL correlated significantly with GCS (p = 0.027), but not with ISS and PIM2. As the conclusion, among all scoring systems applied, only GCS, which demonstrates severity of head injury, showed significant impact on long-term outcome of injured children.

  9. The Pancreatitis Activity Scoring System predicts clinical outcomes in acute pancreatitis: findings from a prospective cohort study.

    Science.gov (United States)

    Buxbaum, James; Quezada, Michael; Chong, Bradford; Gupta, Nikhil; Yu, Chung Yao; Lane, Christianne; Da, Ben; Leung, Kenneth; Shulman, Ira; Pandol, Stephen; Wu, Bechien

    2018-03-15

    The Pancreatitis Activity Scoring System (PASS) has been derived by an international group of experts via a modified Delphi process. Our aim was to perform an external validation study to assess for concordance of the PASS score with high face validity clinical outcomes and determine specific meaningful thresholds to assist in application of this scoring system in a large prospectively ascertained cohort. We analyzed data from a prospective cohort study of consecutive patients admitted to the Los Angeles County Hospital between March 2015 and March 2017. Patients were identified using an emergency department paging system and electronic alert system. Comprehensive characterization included substance use history, pancreatitis etiology, biochemical profile, and detailed clinical course. We calculated the PASS score at admission, discharge, and at 12 h increments during the hospitalization. We performed several analyses to assess the relationship between the PASS score and outcomes at various points during hospitalization as well as following discharge. Using multivariable logistic regression analysis, we assessed the relationship between admission PASS score and risk of severe pancreatitis. PASS score performance was compared to established systems used to predict severe pancreatitis. Additional inpatient outcomes assessed included local complications, length of stay, development of systemic inflammatory response syndrome (SIRS), and intensive care unit (ICU) admission. We also assessed whether the PASS score at discharge was associated with early readmission (re-hospitalization for pancreatitis symptoms and complications within 30 days of discharge). A total of 439 patients were enrolled, their mean age was 42 (±15) years, and 53% were male. Admission PASS score >140 was associated with moderately severe and severe pancreatitis (OR 3.5 [95% CI 2.0, 6.3]), ICU admission (OR 4.9 [2.5, 9.4]), local complications (3.0 [1.6, 5.7]), and development of SIRS (OR 2.9 [1

  10. Biological markers in Helicobacter pylori-associated gastritis and carcinoma: the value of a scoring system

    International Nuclear Information System (INIS)

    Mourad, Walid A.; El-Husseiny, Gamal; Shoukri, Mohamed; Rezeig, Mohamed; Chianzentonieu, N.; Amin, Tarek

    2004-01-01

    Helicobacter pylori-associated gastritis has been linked to the pathogenesis of gastric adenocarcinoma (GA), especially when assciated with intestinal metaplasia (IM) and atypia/dysplasia (A/D). We examined p53 expression, ploidy and proliferative activity and assessed H.pylori infection in relationship to IM and A/Din case of gastritis not associated with GA and in cases of GA. We examined 53 gastric biopsies from patients with gastritis not associated with GA, including patients with IM and/or A/D (n=35) and with gastritis associated with IM and/or A/D (n=21). Thirty-six distal gastrectomy specimens from patients with GA constituted a third group of patients. A scoring system that encompassed the presence or absence of H.Pylori, degree of gastritis, IM and/or A/D, p53, MIB-1prolefarative index (MPI) and ploidy was estimated in the cases of gastritis and in cancer associated mucosa (CAM) and the adenocarcinoma from patients withGA. Patients with GA had a higher median age than those with gastritis without IM and more were males (ratio 2.2:1). H.pylori was detected in 75% (40/53) of gastritis specimen and in 55% (20/36) of GA cases. There was a statistically significant difference between the incidence of gastritis without IM and/or A/D and CAM (p=0.01). p53 expression was seen in 67% of the cases (14/21) of gastritis with IM and/or A/D and only in 5% (2 cases ) of gastritis without IM (p=0.0005). A statistically significant difference in MPI was seen between CAM and GA (p=0.01) and gastritis without IM and/or A/D and gastritis with IM(p=0.004). Cases of gastritis without IM and/or or A/D has a median score of 8 while cases of gastritis with IM and/or A/D had a median score of 12 (p=0.0003). CAM had a median score of 13, which was significantly different than gastritis without IM and/or A/D(p=0.0003) The presence of IM and/or A/D can be used in H.pylori -associated gastritis as as starting point to further investigate high risk lesions. Those showing p53 expression

  11. Accuracy, intra- and inter-rater reliability of three scoring systems for the glottic view at videolaryngoscopy.

    Science.gov (United States)

    O'Loughlin, E J; Swann, A D; English, J D; Ramadas, R

    2017-07-01

    An accurate and reproducible recording of laryngoscopic view at tracheal intubation is an important aspect of anaesthetic practice. Unlike direct laryngoscopy, in which the view achieved by the line of sight directly relates to the ease of intubating the trachea, videolaryngoscopy can create a situation in which the view is good, but intubation difficult or impossible. Communicating this to a subsequent anaesthetist is important. We compared three scoring systems: Cormack and Lehane; POGO (percentage of glottic opening); and the Fremantle score, as used by 74 critical care doctors rating 30 anonymised videos of videolaryngoscopic intubations. Accuracy (degree of agreement of score with an expert panel assessment) was higher for POGO (75.5%) and the Fremantle score (73.9%) than for Cormack and Lehane (65.4%; p scores and mean Cronbach's Alpha for continuous score) was higher for Fremantle score (0.796) and Cormack and Lehane (0.773) than POGO (0.693). Inter-rater reliability for Fremantle score (0.618) and POGO (0.614) were similar and higher than the inter-rater reliability of Cormack and Lehane 0.464 (p score suggest they are preferable to Cormack and Lehane for use when documenting videolaryngoscopy. The additional information about ease of intubation conveyed by the Fremantle score may support its routine use in recording videolaryngoscopic intubation. © 2017 The Association of Anaesthetists of Great Britain and Ireland.

  12. Prognostic Value and Development of a Scoring System in Horses With Systemic Inflammatory Response Syndrome

    OpenAIRE

    Roy, M.?F.; Kwong, G.P.S.; Lambert, J.; Massie, S.; Lockhart, S.

    2017-01-01

    Background Despite its widespread use in equine medicine, the clinical value of the systemic inflammatory response syndrome (SIRS) concept in horses remains unknown. Objectives To study the prognostic value of measures of SIRS in horses and identify the best model of severe SIRS to predict outcome. Animals A total of 479 consecutive adult horse emergency admissions to a private primary referral practice. Methods Prospective observational study. All adult horses admitted for emergency treatmen...

  13. Allegheny County Walk Scores

    Data.gov (United States)

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — Walk Score measures the walkability of any address using a patented system developed by the Walk Score company. For each 2010 Census Tract centroid, Walk Score...

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

    International Nuclear Information System (INIS)

    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; Widdowson, Marc-Alain; Grant, Cameron C.

    2015-01-01

    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 scoring system. We completed validation within an active SARI surveillance project, with SARI defined using the World Health Organization case definition of an acute respiratory infection with a history of fever, or measured fever of ≥ 38 °C; and cough; and with onset within the last 10 days; and requiring hospital admission. We randomly selected 250 SARI cases. Admission CXR findings were categorized as: 1 = normal; 2 = patchy atelectasis and/or hyperinflation and/or bronchial wall thickening; 3 = focal consolidation; 4 = multifocal consolidation; and 5 = diffuse alveolar changes. Initially, four radiologists scored CXRs independently. Subsequently, a pediatrician, physician, two residents, two medical students, and a research nurse independently scored CXR reports. Inter-observer reliability was determined using a weighted Kappa (κ) for comparisons between radiologists; radiologists and clinicians; and clinicians. Agreement was defined as moderate (κ > 0.4–0.6), good (κ > 0.6–0.8) and very good (κ > 0.8–1.0). Agreement between the two pediatric radiologists was very good (κ = 0.83, 95 % CI 0.65–1.00) and between the two adult radiologists was good (κ = 0.75, 95 % CI 0.57–0. 93). Agreement of the clinicians with the radiologists was moderate-to-good (pediatrician:κ = 0.65; pediatric resident:κ = 0.69; physician:κ = 0.68; resident:κ = 0.67; research nurse:κ = 0.49, medical students: κ = 0.53 and κ = 0.56). Agreement between clinicians was good-to-very good

  15. A cross-sectional study of the Birmingham Vasculitis Activity Score version 3 in systemic vasculitis

    DEFF Research Database (Denmark)

    Suppiah, Ravi; Mukhtyar, Chetan; Flossmann, Oliver

    2011-01-01

    Objective. Assessment of disease activity in vasculitis can be achieved using the BVAS, a clinical checklist of relevant symptoms, signs and features of active disease. The aim of this study was to revalidate the BVAS version 3 (BVAS v. 3) in a cohort of patients with systemic vasculitis. Methods....... A total of 238 patients with vasculitis from seven countries in Europe were evaluated at a single time point. Spearman's correlation coefficients were calculated between BVAS v. 3 scores, vasculitis activity index (VAI), physician's global assessment (PGA), the physician's treatment decision, CRP...... and the vasculitis damage index (VDI) to demonstrate that the BVAS v. 3 measures disease activity. Results. WG (63%), Churg-Strauss syndrome (9%) and microscopic polyangiitis (9%) were the most common diagnoses. The BVAS v. 3 showed convergent validity with the VAI [¿¿=¿0.82 (95% CI 0.77, 0.85)], PGA [¿¿=¿0.85 (95...

  16. Hip Inflammation MRI Scoring System (HIMRISS) to predict response to hyaluronic acid injection in hip osteoarthritis

    DEFF Research Database (Denmark)

    Deseyne, Nicolas; Conrozier, Thierry; Lellouche, Henri

    2018-01-01

    OBJECTIVE: To assess predictors of response, according to hip MRI inflammatory scoring system (HIMRISS), in a sample of patients with hip osteoarthritis (OA) treated by hyaluronic acid (HA) injection. METHOD: Sixty patients with hip OA were included. Clinical outcomes were assessed at baseline...... and three months after HA injection by WOMAC. On hip MRI performed before HA injection, bone marrow lesion (BML) and synovitis were assessed by HIMRISS by four readers. The inter-reader reliability of HIMRISS was for HIMRISS total, acetabular BML, femoral BML and synovitis-effusion respectively 0.86, 0.......64, 0.83 and 0.78. Associations between MRI features and clinical data were assessed. Logistic regression (univariate and multivariate) was used to explore associations between MRI features and response to HA injection, according to WOMAC50 response at three months. RESULTS: In total, 45.5% of patients...

  17. Evaluation of a risk factor scoring system for corneal ectasia after LASIK in eyes with normal topography.

    Science.gov (United States)

    Binder, Perry S; Trattler, William B

    2010-04-01

    To assess a previously published risk score system for predicting postoperative LASIK ectasia in eyes with normal preoperative topography. A retrospective review of one surgeon's LASIK database was performed for eyes with Randleman ectasia risk scores based on patient age corneal thickness -8.00 diopters that had a minimum follow-up of 1 year. RESULTS Of 1702 eyes with myopic errors and normal topographies, 35 (2.0%) eyes had a combined risk score between 5 and 9 points, 92 (5.4%) eyes had a combined risk score of 4 or higher, and 208 (12.2%) eyes had a combined score of 3 or higher. None of these eyes developed ectasia, whereas 3 eyes with preoperative topographic keratoconus with no other risk factors developed ectasia. The current risk score system would have eliminated 5.4% of eyes with 4 or more points from LASIK surgery, and would have also required the surgeon to advise an additional 6.8% of eyes with a score of 3 that they were at "moderate risk" and should "proceed with caution." In eyes with normal preoperative topographies, the scoring system may not accurately predict whether patients are at increased risk for developing postoperative LASIK ectasia.

  18. A score system for quality evaluation of RNA sequence tags: an improvement for gene expression profiling

    Directory of Open Access Journals (Sweden)

    Pinheiro Daniel G

    2009-06-01

    Full Text Available Abstract Background High-throughput molecular approaches for gene expression profiling, such as Serial Analysis of Gene Expression (SAGE, Massively Parallel Signature Sequencing (MPSS or Sequencing-by-Synthesis (SBS represent powerful techniques that provide global transcription profiles of different cell types through sequencing of short fragments of transcripts, denominated sequence tags. These techniques have improved our understanding about the relationships between these expression profiles and cellular phenotypes. Despite this, more reliable datasets are still necessary. In this work, we present a web-based tool named S3T: Score System for Sequence Tags, to index sequenced tags in accordance with their reliability. This is made through a series of evaluations based on a defined rule set. S3T allows the identification/selection of tags, considered more reliable for further gene expression analysis. Results This methodology was applied to a public SAGE dataset. In order to compare data before and after filtering, a hierarchical clustering analysis was performed in samples from the same type of tissue, in distinct biological conditions, using these two datasets. Our results provide evidences suggesting that it is possible to find more congruous clusters after using S3T scoring system. Conclusion These results substantiate the proposed application to generate more reliable data. This is a significant contribution for determination of global gene expression profiles. The library analysis with S3T is freely available at http://gdm.fmrp.usp.br/s3t/. S3T source code and datasets can also be downloaded from the aforementioned website.

  19. Validation of a new scoring system for the Weigl Color Form Sorting Test in a memory disorders clinic sample.

    Science.gov (United States)

    Byrne, L M; Bucks, R S; Cuerden, J M

    1998-04-01

    The Bristol Memory Disorders Clinic uses the Weigl Color Form Sorting Test (CFST) to appraise abstraction and the ability to shift set. The original scoring system for the CFST (Grewal & Haward, 1984), developed on the premise that sorting to form is more difficult than sorting to color, had no score for an individual able to sort to form and subsequently unable to shift to color with a cue. Clinical experience suggested that the performance of some individuals required such a score. A new scoring system was developed and validated in a memory-disorders-clinic sample. The validation showed the new score to be necessary and gave support to the original premise that people with organic brain damage show a preference for sorting to color.

  20. Long noncoding RNAs and atherosclerosis.

    Science.gov (United States)

    Zhou, Tian; Ding, Jia-wang; Wang, Xin-an; Zheng, Xia-xia

    2016-05-01

    Atherosclerosis is universally recognized as a chronic lipid-induced inflammation of the vessel wall in response to dyslipidemia and haemodynamic stress involving dysfunction and activation of resident vascular cells as well as infiltration of leukocytes. As members of nonprotein-coding RNAs, the long noncoding RNAs (lncRNAs) are implicated in various biological processes. Accumulating evidences suggest that lncRNAs regulate the function of vascular wall, activation of macrophages, lipid metabolism and immune response. Here, we review the effects of lncRNAs on the progress of atherosclerosis. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  1. A modified risk assessment scoring system for post laser in situ keratomileusis ectasia in topographically normal patients

    Directory of Open Access Journals (Sweden)

    Mohammad Miraftab

    2014-01-01

    Conclusion: Our modified ectasia risk scoring system for patients with normal corneal topography can predict post LASIK ectasia risk with acceptable sensitivity and specificity. However, there are still unidentified risk factors for which further studies are required.

  2. Evaluation and Development of Pavement Scores, Performance Models and Needs Estimates for the TXDOT Pavement Management Information System : Final Report

    Science.gov (United States)

    2012-10-01

    This project conducted a thorough review of the existing Pavement Management Information System (PMIS) database, : performance models, needs estimates, utility curves, and scores calculations, as well as a review of District practices : concerning th...

  3. Formulating A Performance Measurement System using Balanced Score Card in Islamic Philanthropy Institutions

    Directory of Open Access Journals (Sweden)

    Sani A’ieshah Abdullah

    2017-01-01

    Full Text Available The introduction of Balanced Score Card (BSC as one of the management accounting tool to measure the performance of companies in both aspect of financial and non-financial position has been predominantly used since 1992 and had resulted positive energies for the profit making companies. Hence, the extension of the BSC is also required to help the social business organisation in delivering their multiple bottom lines in the most effective ways and provide organisations a mechanism to track their performance holistically through both quantitative and qualitative information. The growing of Islamic Philanthropy Institutions (IPI especially in Malaysia with the objective to promote social development based on the charitable activities has been acknowledged by the society. Therefore, in order to ensure the sustainability of these institutions, a proper measurement system is required to ensure the final goal of the institutions is achievable and successful. Thus, the objective of this paper is to formulate the main indicators and variables that are suitable to measure the IPIs based on BSC system in four main perspectives which are financial perspective, stakeholder’s perspective, internal process perspective and learning and growth perspective. The uniqueness of the establishment of IPIs would require different indicators and variables which are more appropriate as compared with the profit sector organisations. The outcome of this study could provide clear picture and guidelines in designing a proper performance measurement system to be implemented by current IPIs in Malaysia in order to maintain the sustainability and competitiveness of this institutions in future.

  4. Biomarkers, lactate, and clinical scores as outcome predictors in systemic poisons exposures.

    Science.gov (United States)

    Lionte, C; Sorodoc, V; Tuchilus, C; Cimpoiesu, D; Jaba, E

    2017-07-01

    Acute exposure to systemic poisons represents an important challenge in clinical toxicology. We aimed to analyze the potential role of cardiac biomarkers, routine laboratory tests, and clinical scores as morbidity and in-hospital mortality predictors in patients intoxicated with various systemic poisons. We conducted a prospective study on adults acutely exposed to systemic poisons. We determined the PSS, Glasgow Coma Scale (GCS), and we performed electrocardiogram, laboratory tests, lactate and cardiac biomarkers (which were reassessed 4 h, respectively 6 h later). Of 120 patients included, 45% developed complications, 19.2% had a poor outcome, and 5% died. Multivariate logistic regression sustained lactate (odds ratio (OR) 1.58; confidence interval (CI) 95%: 0.97-2.59; p 0.066), MB isoenzyme of creatine kinase (6h-CKMB; OR 1.08; CI 95%: 1.02-1.16; p 0.018) as predictors for a poor outcome. A GCS poisons exposure. Receiver operating characteristic analysis showed that brain natriuretic peptide (area under the curve (AUC), 0.96; CI 95%: 0.92-0.99; p poisons exposure.

  5. Correlation of JAK2V617F mutational status in primary myelofibrosis with clinico-hematologic characteristics and international prognostic scoring system scoring: A single center experience

    Directory of Open Access Journals (Sweden)

    Neha Singh

    2015-01-01

    Full Text Available Introduction: Somatic mutation in the exon 14 of Janus Kinase 2 gene is an established diagnostic marker in bcr-abl negative myeloproliferative neoplasms, especially primary idiopathic myelofibrosis (PIMF. Aim: Our primary aim was to find out the correlation between the JAK2V617F mutational status and the clinico-hematologic characteristics, as well as the international prognostic scoring system (IPSS scoring of patients with PIMF. Materials and Methods: Clinical and hematologic features were reviewed for 68 patients with primary idiopathic myelofibrosis (PIMF. JAK2V617F mutation status was analyzed by amplification refractory mutation screening-polymerase chain reaction. The patients were further stratified into low, intermediate-1, intermediate-2 and high-risk groups on the basis of IPSS scoring. Results: The JAK2V617F mutation was detected in 58.8% patients. Univariate analysis of variables at presentation identified that JAK2V617F negative patients were significantly associated with more severe anemia (P = 0.045, younger age (P = 0.008, higher transfusion requirement (P = 0.017, and thrombocytopenia (P = 0.015. Patients who were homozygous for JAK2V617F mutation were associated with thrombocytosis (P = 0.014 and also had higher median total leucocyte count (P = 0.20 than the other groups. No significant correlation was detected between JAK2V617F mutational status and the presence of constitutional symptoms, spleen size, grade of bone marrow fibrosis or prognostic risk stratification of the PIMF patients. Conclusion: The variations in the prognostic implication of PIMF patients with mutation status as stated by various publications worldwide, reinstates the need for larger prospective studies using standardized JAK2V617F quantification methods as well as estimation of other newer molecular markers to develop deeper insight into various molecular alterations involving PIMF patients in India as well as worldwide.

  6. Elevated partial antiphospholipid score is a strong risk factor for thrombosis in patients with systemic lupus erythematosus: a validation study.

    Science.gov (United States)

    Chen, Jie; Sun, Shuhui; Yan, Qingran; Bao, Chunde; Fu, Qiong

    2016-02-01

    This study aims to identify risk factors for thrombosis in patients with systemic lupus erythematosus (SLE) and to validate the efficacy of the partial antiphospholipid (aPL) score for thrombosis prediction and diagnosis of antiphospholipid syndrome (APS). This study included 325 SLE patients, 188 of whom completed a follow-up of 31.01 months (range 23-48 months). Partial aPL score was calculated by adding up the individual scores for activated partial thromboplastin time (APTT), lupus anticoagulant, IgG/IgM anticardiolipin antibodies (aCL), and IgG/IgM anti-β2-glycoprotein I (anti-β2GPI). A simplified aPL score was developed using only APTT, IgG/IgM aCL, and IgG/IgM anti-β2GPI. Partial aPL scores were significantly higher in SLE patients with thrombosis (p thrombosis (p 10 (p thrombosis. For patients with a history of thrombosis, partial aPL score was the strongest risk factor for recurrent thrombosis (p thrombosis (p thrombosis in SLE patients and is a useful tool to predict recurrent thrombosis. Partial aPL score and simplified aPL score, although comprising fewer items than the original aPL score, also represent valuable quantitative indices for APS diagnosis.

  7. A new approach to scoring systems to improve identification of acute medical admissions that will require critical care.

    Science.gov (United States)

    Carmichael, H A; Robertson, E; Austin, J; McCruden, D; Messow, C M; Belcher, P R

    2011-11-01

    Removal of the intensive care unit (ICU) at the Vale of Leven Hospital mandated the identification and transfer out of those acute medical admissions with a high risk of requiring ICU. The aim of the study was to develop triaging tools that identified such patients and compare them with other scoring systems. The methodology included a retrospective analysis of physiological and arterial gas measurements from 1976 acute medical admissions produced PREEMPT-1 (PRE-critical Emergency Medical Patient Triage). A simpler one for ambulance use (PREAMBLE-1 [PRE-Admission Medical Blue-Light Emergency]) was produced by the addition of peripheral oxygen saturation to a modification of MEWS (Modified Early Warning Score). Prospective application of these tools produced a larger database of 4447 acute admissions from which logistic regression models produced PREEMPT-2 and PREAMBLE-2, which were then compared with the original systems and seven other early warning scoring systems. Results showed that in patients with arterial gases, the area under the receiver operator characteristic curve was significantly higher in PREEMPT-2 (89·1%) and PREAMBLE-2 (84.4%) than all other scoring systems. Similarly, in all patients, it was higher in PREAMBLE-2 (92·4%) than PREAMBLE-1 (88·1%) and the other scoring systems. In conclusion, risk of requiring ICU can be more accurately predicted using PREEMPT-2 and PREAMBLE-2, as described here, than by other early warning scoring systems developed over recent years.

  8. The predictive validity of grade point average scores in a partial lottery medical school admission system.

    Science.gov (United States)

    Cohen-Schotanus, Janke; Muijtjens, Arno M M; Reinders, Jan J; Agsteribbe, Jessica; van Rossum, Herman J M; van der Vleuten, Cees P M

    2006-10-01

    To ascertain whether the grade point average (GPA) of school-leaving examinations is related to study success, career development and scientific performance. The problem of restriction of range was expected to be partially reduced due to the use of a national lottery system weighted in favour of students with higher GPAs. We studied the students (n = 398) admitted to the Faculty of Medicine, University of Groningen, the Netherlands in 1982 and 1983. Data concerning drop-out and study progress were derived from the student administration. Data about career development were obtained from annual interviews with graduates (n = 318) between 1993 and 2000. Literature searches yielded data concerning scientific performance. Multiple linear regression and logistic regression were used to analyse the data. The variables 'gender' and 'cohort' and their interaction were included in the analyses to account for variation in the general level of the dependent variable and the effect of GPA on the dependent variable. GPA scores had no effect on drop-out rate. High GPA scores were associated with significantly less time to graduation, more chance of a preferred placement for specialist training and higher scientific output. GPA was not related to income. Gender differences were found for study duration and scientific output. Women graduated earlier and published less. The GPA of school-leaving examinations was found to be related to study success, career development and scientific performance. In this study the usual problem of restriction of range was shown to be absent. The weighted lottery procedure even resulted in an over-dispersion of candidates relative to the applicants. The resulting effect sizes were in agreement with those reported in other studies.

  9. Evaluation of a modified APACHE II Scoring System in the Intensive ...

    African Journals Online (AJOL)

    MAPA II format was designed from the APA II. The APA II score consists of 12 sets of acute physiological variables (A), age points (B) and chronic health points (C). Total APACHE II score of 71 was generated by adding A, B and C. (Appendix I). MAPA II score was generated by adding A, B and C but substituting PaO2 with ...

  10. RIP3-dependent necrosis induced inflammation exacerbates atherosclerosis

    Energy Technology Data Exchange (ETDEWEB)

    Meng, Lingjun, E-mail: menglingjun@nibs.ac.cn [College of Biological Sciences, China Agricultural University, Beijing 100094 (China); National Institute of Biological Sciences, Beijing 102206 (China); Jin, Wei [Institute for Immunology, Tsinghua University, Beijing 100084 (China); Wang, Yuhui [Institute of Cardiovascular Sciences, Health Science Center, Peking University, Beijing 100191 (China); Huang, Huanwei; Li, Jia; Zhang, Cai [National Institute of Biological Sciences, Beijing 102206 (China)

    2016-04-29

    Atherothrombotic vascular disease is already the leading cause of mortality worldwide. Atherosclerosis shares features with diseases caused by chronic inflammation. More attention should concentrates on the innate immunity effect atherosclerosis progress. RIP3 (receptor-interacting protein kinase 3) act through the transcription factor named Nr4a3 (Nuclear orphan receptors) to regulate cytokine production. Deletion RIP3 decreases IL-1α production. Injection of anti-IL-1α antibody protects against the progress of atherosclerosis in ApoE −/− mice. RIP3 as a molecular switch in necrosis, controls macrophage necrotic death caused inflammation. Inhibiting necrosis will certainly reduce atherosclerosis through limit inflammation. Necrotic cell death caused systemic inflammation exacerbated cardiovascular disease. Inhibition of necrosis may yield novel therapeutic targets for treatment in years to come. - Highlights: • RIP3 regulate the Nr4a3 to control cytokine production. • Deletion RIP3 decreases IL-1a production. • Injection anti-IL-1a antibody protects against the progress of atherosclerosis. • RIP3 controls macrophage necrotic dead caused inflammation.

  11. [Cerebral infarctions in vertebrobasilar artery atherosclerosis].

    Science.gov (United States)

    Anufriev, P L; Evdokimenko, A N; Gulevskaya, T S

    2018-01-01

    to obtain more specific information on the morphology and pathogenesis of cerebral infarctions occurring in vertebrobasilar artery (VBA) atherosclerosis. Macro- and microscopic investigations of the brain, its arterial system, and heart were conducted in 69 autopsy cases with infarctions located in the vertebrobasilar system (VBS) in atherosclerosis. 69 cases were found to have 206 VBA infarctions of various extent and locations. The detected infarctions were single and multiple in 27 and 42 cases, respectively. The detected infarctions included extensive (n=7), large (n=9), medium (n=63), small deep (lacunar) (n=97), and small superficial (n=30). The brain stem showed lacunar infarctions most frequently (76% of the infarctions at this site). Medium and small infarctions were identified at the same frequency in the cerebral hemispheres and cerebellum. The occurrence of 94% of the extensive and large infarctions was ascertained to be pathogenetically associated with atherothrombotic occlusion of the intracranial arteries in the VBS. 76% of the small infarctions occurred through the mechanism of cerebral vascular insufficiency in tandem atherostenosis of VBAs in conjunction with an additional decrease in cerebral blood flow under the influence of an extracerebral factor (coronary heart disease). Medium infarctions were approximately equifrequently due to the two aforementioned causes and, in some cases, to cardiogenic thromboembolism of VBAs. Infarctions were multiple in most cases; while recent large atherothrombotic infarctions were frequently concurrent with small organized infarctions resulting from tandem atherostenosis of VBAs. This investigation could establish the relationship between the site, extent, and pathogenetic factors of infarctions in the VBA bed in atherosclerosis, as well as the prognostic value of small infarctions as predictors for severe ischemic stroke.

  12. Supraclavicular scalenectomy for thoracic outlet syndrome--functional outcomes assessed using the DASH scoring system.

    LENUS (Irish Health Repository)

    Glynn, Ronan W

    2012-02-01

    To evaluate supraclavicular scalenectomy ± cervical rib excision for thoracic outlet syndrome (TOS), employing Disability of Arm, Shoulder, and Hand (DASH) scoring for functional assessment post-decompression.

  13. Cyclodextrin promotes atherosclerosis regression via macrophage reprogramming

    DEFF Research Database (Denmark)

    Zimmer, Sebastian; Grebe, Alena; Bakke, Siril S

    2016-01-01

    Atherosclerosis is an inflammatory disease linked to elevated blood cholesterol concentrations. Despite ongoing advances in the prevention and treatment of atherosclerosis, cardiovascular disease remains the leading cause of death worldwide. Continuous retention of apolipoprotein B...... that increases cholesterol solubility in preventing and reversing atherosclerosis. We showed that CD treatment of murine atherosclerosis reduced atherosclerotic plaque size and CC load and promoted plaque regression even with a continued cholesterol-rich diet. Mechanistically, CD increased oxysterol production...... of CD as well as for augmented reverse cholesterol transport. Because CD treatment in humans is safe and CD beneficially affects key mechanisms of atherogenesis, it may therefore be used clinically to prevent or treat human atherosclerosis....

  14. Development and Validation of the OMERACT Rheumatoid Arthritis Magnetic Resonance Tenosynovitis Scoring System in a Multireader Exercise.

    Science.gov (United States)

    Glinatsi, Daniel; Bird, Paul; Gandjbakhch, Frédérique; Haavardsholm, Espen A; Peterfy, Charles G; Vital, Edward M; Emery, Paul; Conaghan, Philip G; Østergaard, Mikkel

    2017-11-01

    To develop and validate a magnetic resonance imaging (MRI) tenosynovitis (TS) score for tendons at the wrist and metacarpophalangeal (MCP) joint levels in patients with rheumatoid arthritis (RA). Axial T1-weighted precontrast and postcontrast fat-saturated MR image sets of the hands of 43 patients with RA initiating rituximab therapy were obtained at baseline and after 14, 26, 38, or 52 weeks. The MR images were scored twice by 4 readers. Nine tendon compartments of the wrist and 4 flexor tendon compartments at the MCP joints were assessed. Tenosynovitis was scored as follows: 0: No; 1: The overall PEA/PCA intrareader and interreader agreements for change scores in all tendons were 73.8%/97.6% and 47.9%/85.0%, respectively. Average SRM was moderate for total scores and 60.5% of the patients had a tenosynovitis change score ≥ SDC. The TS score showed high intrareader and interreader agreement for wrist and finger tendons, with moderate responsiveness, and the majority of the patients showed a change above the SDC. This scoring system may be included as a component of the RAMRIS.

  15. Comparison of the four proposed Apgar scoring systems in the assessment of birth asphyxia and adverse early neurologic outcomes.

    Directory of Open Access Journals (Sweden)

    Hosein Dalili

    Full Text Available To compare the Conventional, Specified, Expanded and Combined Apgar scoring systems in predicting birth asphyxia and the adverse early neurologic outcomes.This prospective cohort study was conducted on 464 admitted neonates. In the delivery room, after delivery the umbilical cord was double clamped and a blood samples was obtained from the umbilical artery for blood gas analysis, meanwhile on the 1- , 5- and 10- minutes Conventional, Specified, Expanded, and Combined Apgar scores were recorded. Then the neonates were followed and intracranial ultrasound imaging was performed, and the following information were recorded: the occurrence of birth asphyxia, hypoxic Ischemic Encephalopathy (HIE, intraventricular hemorrhage (IVH, and neonatal seizure.The Combined-Apgar score had the highest sensitivity (97% and specificity (99% in predicting birth asphyxia, followed by the Specified-Apgar score that was also highly sensitive (95% and specific (97%. The Expanded-Apgar score was highly specific (95% but not sensitive (67% and the Conventional-Apgar score had the lowest sensitivity (81% and low specificity (81% in predicting birth asphyxia. When adjusted for gestational age, only the low 5-minute Combined-Apgar score was independently associated with the occurrence of HIE (B = 1.61, P = 0.02 and IVH (B = 2.8, P = 0.01.The newly proposed Combined-Apgar score is highly sensitive and specific in predicting birth asphyxia and also is a good predictor of the occurrence of HIE and IVH in asphyxiated neonates.

  16. Comparison of the Four Proposed Apgar Scoring Systems in the Assessment of Birth Asphyxia and Adverse Early Neurologic Outcomes

    Science.gov (United States)

    Dalili, Hosein; Nili, Firouzeh; Sheikh, Mahdi; Hardani, Amir Kamal; Shariat, Mamak; Nayeri, Fatemeh

    2015-01-01

    Objectives To compare the Conventional, Specified, Expanded and Combined Apgar scoring systems in predicting birth asphyxia and the adverse early neurologic outcomes. Methods This prospective cohort study was conducted on 464 admitted neonates. In the delivery room, after delivery the umbilical cord was double clamped and a blood samples was obtained from the umbilical artery for blood gas analysis, meanwhile on the 1- , 5- and 10- minutes Conventional, Specified, Expanded, and Combined Apgar scores were recorded. Then the neonates were followed and intracranial ultrasound imaging was performed, and the following information were recorded: the occurrence of birth asphyxia, hypoxic Ischemic Encephalopathy (HIE), intraventricular hemorrhage (IVH), and neonatal seizure. Results The Combined-Apgar score had the highest sensitivity (97%) and specificity (99%) in predicting birth asphyxia, followed by the Specified-Apgar score that was also highly sensitive (95%) and specific (97%). The Expanded-Apgar score was highly specific (95%) but not sensitive (67%) and the Conventional-Apgar score had the lowest sensitivity (81%) and low specificity (81%) in predicting birth asphyxia. When adjusted for gestational age, only the low 5-minute Combined-Apgar score was independently associated with the occurrence of HIE (B = 1.61, P = 0.02) and IVH (B = 2.8, P = 0.01). Conclusions The newly proposed Combined-Apgar score is highly sensitive and specific in predicting birth asphyxia and also is a good predictor of the occurrence of HIE and IVH in asphyxiated neonates. PMID:25811904

  17. 77 FR 47707 - Public Housing Assessment System (PHAS): Physical Condition Scoring Notice and Revised Dictionary...

    Science.gov (United States)

    2012-08-09

    ... should be automatic quality control reinspection when a score decreases by 20 points or more from one... automatic quality assurance re-inspection when the score changes by 20 or more points from the previous..., such as blocking egress by placement of furniture or adding additional locks after the PHA's inspection...

  18. Carpal erosions in children with juvenile idiopathic arthritis: repeatability of a newly devised MR-scoring system

    Energy Technology Data Exchange (ETDEWEB)

    Boavida, Peter [Great Ormond Street Hospital for Children, Department of Radiology, London (United Kingdom); Lambot-Juhan, Karen [Hospital Necker Enfants Malades, Department of Radiology, Paris (France); Ording Mueller, Lil-Sofie [Oslo University Hospital, Department of Radiology, Oslo (Norway); Damasio, Beatrice; Malattia, Clara [Ospedale Pediatrico Gaslini, Department of Rheumatology, Genoa (Italy); Tanturri de Horatio, Laura [Ospedale Pediatrico Bambino Gesu, Department of Radiology, Rome (Italy); Owens, Catherine M. [Great Ormond Street Hospital for Children, Department of Radiology, London (United Kingdom); UCL, Institute of Child Health, London (United Kingdom); Rosendahl, Karen [Haukeland University Hospital, Department of Radiology, Bergen (Norway); University of Bergen, Department of Clinical Medicine, Bergen (Norway)

    2015-12-15

    Juvenile idiopathic arthritis (JIA) is characterized by synovial inflammation, with potential risk of developing progressive joint destruction. Personalized state-of-the-art treatment depends on valid markers for disease activity to monitor response; however, no such markers exist. To evaluate the reliability of scoring of carpal bone erosions on MR in children with JIA using two semi-quantitative scoring systems. A total of 1,236 carpal bones (91 MR wrist examinations) were scored twice by two independent pediatric musculoskeletal radiologists. Bony erosions were scored according to estimated bone volume loss using a 0-4 scale and a 0-10 scale. An aggregate erosion score comprising the sum total carpal bone volume loss was calculated for each examination. The 0-4 scoring system resulted in good intra-reader agreement and moderate to good inter-observer agreement in the assessment of individual bones. Fair and moderate agreement were achieved for inter-reader and intra-reader agreement, respectively, using the 0-10 scale. Intra- and particularly inter-reader aggregate score variability were much less favorable, with wide limits of agreement. Further analysis of erosive disease patterns compared with normal subjects is required, and to facilitate the development of an alternative means of quantifying disease. (orig.)

  19. Carpal erosions in children with juvenile idiopathic arthritis: repeatability of a newly devised MR-scoring system

    International Nuclear Information System (INIS)

    Boavida, Peter; Lambot-Juhan, Karen; Ording Mueller, Lil-Sofie; Damasio, Beatrice; Malattia, Clara; Tanturri de Horatio, Laura; Owens, Catherine M.; Rosendahl, Karen

    2015-01-01

    Juvenile idiopathic arthritis (JIA) is characterized by synovial inflammation, with potential risk of developing progressive joint destruction. Personalized state-of-the-art treatment depends on valid markers for disease activity to monitor response; however, no such markers exist. To evaluate the reliability of scoring of carpal bone erosions on MR in children with JIA using two semi-quantitative scoring systems. A total of 1,236 carpal bones (91 MR wrist examinations) were scored twice by two independent pediatric musculoskeletal radiologists. Bony erosions were scored according to estimated bone volume loss using a 0-4 scale and a 0-10 scale. An aggregate erosion score comprising the sum total carpal bone volume loss was calculated for each examination. The 0-4 scoring system resulted in good intra-reader agreement and moderate to good inter-observer agreement in the assessment of individual bones. Fair and moderate agreement were achieved for inter-reader and intra-reader agreement, respectively, using the 0-10 scale. Intra- and particularly inter-reader aggregate score variability were much less favorable, with wide limits of agreement. Further analysis of erosive disease patterns compared with normal subjects is required, and to facilitate the development of an alternative means of quantifying disease. (orig.)

  20. Predictive value of the APACHE II, SAPS II, SOFA and GCS scoring systems in patients with severe purulent bacterial meningitis.

    Science.gov (United States)

    Pietraszek-Grzywaczewska, Iwona; Bernas, Szymon; Łojko, Piotr; Piechota, Anna; Piechota, Mariusz

    2016-01-01

    Scoring systems in critical care patients are essential for predicting of the patient outcome and evaluating the therapy. In this study, we determined the value of the Acute Physiology and Chronic Health Evaluation II (APACHE II), Simplified Acute Physiology Score II (SAPS II), Sequential Organ Failure Assessment (SOFA) and Glasgow Coma Scale (GCS) scoring systems in the prediction of mortality in adult patients admitted to the intensive care unit (ICU) with severe purulent bacterial meningitis. We retrospectively analysed data from 98 adult patients with severe purulent bacterial meningitis who were admitted to the single ICU between March 2006 and September 2015. Univariate logistic regression identified the following risk factors of death in patients with severe purulent bacterial meningitis: APACHE II, SAPS II, SOFA, and GCS scores, and the lengths of ICU stay and hospital stay. The independent risk factors of patient death in multivariate analysis were the SAPS II score, the length of ICU stay and the length of hospital stay. In the prediction of mortality according to the area under the curve, the SAPS II score had the highest accuracy followed by the APACHE II, GCS and SOFA scores. For the prediction of mortality in a patient with severe purulent bacterial meningitis, SAPS II had the highest accuracy.

  1. Probiotics and atherosclerosis – a new challenge?

    Directory of Open Access Journals (Sweden)

    Chan Yee Kwan

    2012-06-01

    Full Text Available Background Atherosclerosis is the major cause of cardiovascular disease and stroke, which are among the top 10 leading causes of death worldwide. Pathogen-associated molecular patterns (PAMPs can activate toll-like receptors (TLRs and activate nuclear factor kappa B (NFκB signaling, a central pathway in inflammation, which regulates genes that encode proinflammatory molecules essential in atherogenesis. Lipopolysaccharides (LPS, which is unique to gram negative bacteria, as well as peptidoglycan (PGN, which is found in gram positive bacteria are PAMPS and ligands of TLR4 and TLR2, respectively, both of which are essential in plaque progression in atherosclerosis. Gastrointestinal tract is suggested to be the major site for absorption and translocation of TLR2 and TLR4 stimulants. Inflammation can result in a ‘leaky gut’ that leads to higher bacterial translocation, eventually the accumulation of LPS and PGN would activate TLRs and trigger inflammation through NFκB and promote further systemic complication like atherosclerosis. Probiotics, can protect the intestinal barrier to reduce bacterial translocation and have potential systemic anti-inflammatory properties.To evaluate whether probiotics can help reduce atherosclerotic development using in vivo study.Apolipoprotein E knockout (ApoE−/ −  mice were fed on high fat diet alone, with telmisartan (Tel (1 or 5 mg/kg/day, positive controls or with probiotics (VSL#3/LGG with or without Tel (1 mg/kg/day for 12 weeks.Probiotics, Tel, or a combination of both reduced lesion size at the aortic root significantly; VSL#3 reduced serum inflammatory adhesion molecules soluble E- (sE-selectin, soluble intercellular adhesion molecule 1 (sICAM-1, soluble vascular cell adhesion molecule 1 (sVCAM-1, and plaque disrupting factor matrix metalloproteinase (MMP-9 significantly; probiotics and Tel at 5 mg/kg/day could induce changes in gut microbiota population; the efficiency of lesion reduction seemed

  2. Moderate precision of prognostic scoring systems in a consecutive, prospective cohort of 544 patients with metastatic spinal cord compression

    DEFF Research Database (Denmark)

    Morgen, Søren Schmidt; Nielsen, Dennis Hallager; Larsen, Claus Falck

    2014-01-01

    cohort of patients with metastatic spinal cord compression (MSCC). METHODS: In 2011, we conducted a prospective cohort study of 544 patients who were consecutively admitted with MSCC to one treatment facility. Patients estimated survival were assessed with the Tokuhashi Revised score and the Tomita score...... and compared to the observed survival. We assessed how precise the scoring systems predicted survival with McNemar's test. The prognostic value was illustrated with Kaplan-Meier curves, and the individual prognostic components were analyzed with Cox regression analysis. RESULTS: The mean age was 65 years...

  3. Management of radiation-induced accelerated carotid atherosclerosis

    International Nuclear Information System (INIS)

    Loftus, C.M.; Biller, J.; Hart, M.N.; Cornell, S.H.; Hiratzka, L.F.

    1987-01-01

    Patients with long survival following cervical irradiation are at risk for accelerated carotid atherosclerosis. The neurologic presentation in these patients mimics naturally occurring atheromatous disease, but patients often present at younger ages and with less concurrent coronary or systemic vascular disease. Hypercholesterolemia also contributes to this accelerated arteriosclerosis. Angiographic findings in this disorder include disproportionate involvement of the distal common carotid artery and unusually long carotid lesions. Pathologic findings include destruction of the internal elastic lamina and replacement of the normal intima and media with fibrous tissue. This article describes two surgical patients with radiation-induced accelerated carotid atherosclerosis who typify the presentation and characteristics of this disease

  4. Pediatric Early Warning Score Systems, Nurses Perspective - A Focus Group Study.

    Science.gov (United States)

    Jensen, Claus Sixtus; Nielsen, Pia Bonde; Olesen, Hanne Vebert; Kirkegaard, Hans; Aagaard, Hanne

    2018-02-14

    Pediatric early warning score (PEWS) systems are used to monitor pediatric patients' vital signs and facilitate the treatment of patients at risk of deteriorating. The aim of this study was to gain knowledge about nurses' experiences with PEWS and to highlight factors facilitating and impeding the use of PEWS tools in clinical practice. An exploratory qualitative design was chosen using focus group interviews to gain a deeper understanding of nurses' experiences with PEWS. A total of five focus group interviews were conducted at three hospitals, and a qualitative meaning condensation analysis as described by Kvale and Brinkmann was performed. Seven themes were identified, including i) lack of interdisciplinary awareness, ii) clinical judgment and PEWS-a multi-faceted approach, iii) PEWS supports a professional language, iv) monitoring the patient's - a challenge, v) PEWS helps to visualize the need for escalating care, vi) an inflexible and challenging tool, and vii) supportive tools enhance the nurses' experiences of PEWS positively. Our findings suggest that attention should be given to nurses' perceptions of how both clinical judgment and PEWS should be seen as essential in providing nurses with information about the patients' conditions. If not, the risk of failing to recognize patients' deteriorating conditions will remain as this can have an impeding influence on nurses' use of PEWS. From the nurses' perspective, medical doctors seemed unaware of their role in using PEWS. Copyright © 2018 Elsevier Inc. All rights reserved.

  5. Cytogenetics, molecular and ultrastructural characteristics of biphenotypic acute leukemia identified by the EGIL scoring system.

    Science.gov (United States)

    Owaidah, T M; Al Beihany, A; Iqbal, M A; Elkum, N; Roberts, G T

    2006-04-01

    Biphenotypic acute leukemia (BAL) is a rare, difficult to diagnose entity. Its identification is important for risk stratification in acute leukemia (AL). The scoring proposal of the European Group for the Classification of Acute Leukemia (EGIL) is useful for this purpose, but its performance against objective benchmarks is unclear. Using the EGIL system, we identified 23 (3.4%) BAL from among 676 newly diagnosed AL patients. Mixed, small and large blast cells predominated, with FAB M2 and L1 constituting the majority. All patients were positive for myeloid (M) markers and either B cell (B) (17 or 74%) or T cell (T) (8 or 34%) markers with two exceptional patients demonstrating trilineage phenotype. Six (50%) of studied M-B cases were positive for both IGH and TCR. In six (26%) patients myeloid lineage commitment was also demonstrable by electron cytochemistry. Abnormal findings were present in 19 (83%) patients by cytogenetics/FISH/molecular analysis as follows: t(9;22) (17%); MLL gene rearrangement (26%); deletion(6q) (13%); 12p11.2 (9%); numerical abnormalities (13%), and three (13%) new, previously unreported translocations t(X;6)(p22.3;q21); t(2;6)(q37;p21.3); and t(8;14)(p21;q32). In conclusion, the EGIL criteria for BAL appear robust when compared against molecular techniques that, if applied routinely, could aid in detecting BAL and help in risk stratification.

  6. Rating the quality of intensive care units: is it a function of the intensive care unit scoring system?

    Science.gov (United States)

    Glance, Laurent G; Osler, Turner M; Dick, Andrew

    2002-09-01

    Intensive care units (ICUs) use severity-adjusted mortality measures such as the standardized mortality ratio to benchmark their performance. Prognostic scoring systems such as Acute Physiology and Chronic Health Evaluation (APACHE) II, Simplified Acute Physiology Score II, and Mortality Probability Model II0 permit performance-based comparisons of ICUs by adjusting for severity of disease and case mix. Whether different risk-adjustment methods agree on the identity of ICU quality outliers within a single database has not been previously investigated. The objective of this study was to determine whether the identity of ICU quality outliers depends on the ICU scoring system used to calculate the standardized mortality ratio. Retrospective cohort study of 16,604 patients from 32 hospitals based on the outcomes database (Project IMPACT) created by the Society of Critical Care Medicine. The ICUs were a mixture of medical, surgical, and mixed medical-surgical ICUs in urban and nonurban settings. Standardized mortality ratios for each ICU were calculated using APACHE II, Simplified Acute Physiology Score II, and Mortality Probability Model II. ICU quality outliers were defined as ICUs whose standardized mortality ratio was statistically different from 1. Kappa analysis was used to determine the extent of agreement between the scoring systems on the identity of hospital quality outliers. The intraclass correlation coefficient was calculated to estimate the reliability of standardized mortality ratios obtained using the three risk-adjustment methods. Kappa analysis showed fair to moderate agreement among the three scoring systems in identifying ICU quality outliers; the intraclass correlation coefficient suggested moderate to substantial agreement between the scoring systems. The majority of ICUs were classified as high-performance ICUs by all three scoring systems. All three scoring systems exhibited good discrimination and poor calibration in this data set. APACHE II

  7. Manual and automatic locomotion scoring systems in dairy cows: a review.

    Science.gov (United States)

    Schlageter-Tello, Andrés; Bokkers, Eddie A M; Koerkamp, Peter W G Groot; Van Hertem, Tom; Viazzi, Stefano; Romanini, Carlos E B; Halachmi, Ilan; Bahr, Claudia; Berckmans, Daniël; Lokhorst, Kees

    2014-09-01

    The objective of this review was to describe, compare and evaluate agreement, reliability, and validity of manual and automatic locomotion scoring systems (MLSSs and ALSSs, respectively) used in dairy cattle lameness research. There are many different types of MLSSs and ALSSs. Twenty-five MLSSs were found in 244 articles. MLSSs use different types of scale (ordinal or continuous) and different gait and posture traits need to be observed. The most used MLSS (used in 28% of the references) is based on asymmetric gait, reluctance to bear weight, and arched back, and is scored on a five-level scale. Fifteen ALSSs were found that could be categorized according to three approaches: (a) the kinetic approach measures forces involved in locomotion, (b) the kinematic approach measures time and distance of variables associated to limb movement and some specific posture variables, and (c) the indirect approach uses behavioural variables or production variables as indicators for impaired locomotion. Agreement and reliability estimates were scarcely reported in articles related to MLSSs. When reported, inappropriate statistical methods such as PABAK and Pearson and Spearman correlation coefficients were commonly used. Some of the most frequently used MLSSs were poorly evaluated for agreement and reliability. Agreement and reliability estimates for the original four-, five- or nine-level MLSS, expressed in percentage of agreement, kappa and weighted kappa, showed large ranges among and sometimes also within articles. After the transformation into a two-level scale, agreement and reliability estimates showed acceptable estimates (percentage of agreement ≥ 75%; kappa and weighted kappa ≥ 0.6), but still estimates showed a large variation between articles. Agreement and reliability estimates for ALSSs were not reported in any article. Several ALSSs use MLSSs as a reference for model calibration and validation. However, varying agreement and reliability estimates of MLSSs make a

  8. New Combined Scoring System for Predicting Respiratory Failure in Iraqi Patients with Guillain-Barré Syndrome

    Directory of Open Access Journals (Sweden)

    Zaki Noah Hasan

    2010-09-01

    Full Text Available The Guillain-Barré syndrome (GBS is an acute post-infective autoimmune polyradiculoneuropathy, it is the commonest peripheral neuropathy causing respiratory failure. The aim of the study is to use the New Combined Scoring System in anticipating respiratory failure in order to perform elective measures without waiting for emergency situations to occur.
    Patients and methods: Fifty patients with GBS were studied. Eight clinical parameters (including progression of patients to maximum weakness, respiratory rate/minute, breath holding
    count (the number of digits the patient can count in holding his breath, presence of facial muscle weakness (unilateral or bilateral, presence of weakness of the bulbar muscle, weakness of the neck flexor muscle, and limbs weakness were assessed for each patient and a certain score was given to
    each parameter, a designed combined score being constructed by taking into consideration all the above mentioned clinical parameters. Results and discussion: Fifteen patients (30% that were enrolled in our study developed respiratory failure. There was a highly significant statistical association between the development of respiratory failure and the lower grades of (bulbar muscle weakness score, breath holding count scores, neck muscle weakness score, lower limbs and upper limbs weakness score , respiratory rate score and the total sum score above 16 out of 30 (p-value=0.000 . No significant statistical difference was found regarding the progression to maximum weakness (p-value=0.675 and facial muscle weakness (p-value=0.482.
    Conclusion: The patients who obtained a combined score (above 16’30 are at great risk of having respiratory failure.

  9. Checklist and Scoring System for the Assessment of Soft Tissue Preservation in CT Examinations of Human Mummies.

    Directory of Open Access Journals (Sweden)

    Stephanie Panzer

    Full Text Available The purpose of this study was to develop a checklist for standardized assessment of soft tissue preservation in human mummies based on whole-body computed tomography examinations, and to add a scoring system to facilitate quantitative comparison of mummies. Computed tomography examinations of 23 mummies from the Capuchin Catacombs of Palermo, Sicily (17 adults, 6 children; 17 anthropogenically and 6 naturally mummified and 7 mummies from the crypt of the Dominican Church of the Holy Spirit of Vilnius, Lithuania (5 adults, 2 children; all naturally mummified were used to develop the checklist following previously published guidelines. The scoring system was developed by assigning equal scores for checkpoints with equivalent quality. The checklist was evaluated by intra- and inter-observer reliability. The finalized checklist was applied to compare the groups of anthropogenically and naturally mummified bodies. The finalized checklist contains 97 checkpoints and was divided into two main categories, "A. Soft Tissues of Head and Musculoskeletal System" and "B. Organs and Organ Systems", each including various subcategories. The complete checklist had an intra-observer reliability of 98% and an inter-observer reliability of 93%. Statistical comparison revealed significantly higher values in anthropogenically compared to naturally mummified bodies for the total score and for three subcategories. In conclusion, the developed checklist allows for a standardized assessment and documentation of soft tissue preservation in whole-body computed tomography examinations of human mummies. The scoring system facilitates a quantitative comparison of the soft tissue preservation status between single mummies or mummy collections.

  10. Checklist and Scoring System for the Assessment of Soft Tissue Preservation in CT Examinations of Human Mummies.

    Science.gov (United States)

    Panzer, Stephanie; Mc Coy, Mark R; Hitzl, Wolfgang; Piombino-Mascali, Dario; Jankauskas, Rimantas; Zink, Albert R; Augat, Peter

    2015-01-01

    The purpose of this study was to develop a checklist for standardized assessment of soft tissue preservation in human mummies based on whole-body computed tomography examinations, and to add a scoring system to facilitate quantitative comparison of mummies. Computed tomography examinations of 23 mummies from the Capuchin Catacombs of Palermo, Sicily (17 adults, 6 children; 17 anthropogenically and 6 naturally mummified) and 7 mummies from the crypt of the Dominican Church of the Holy Spirit of Vilnius, Lithuania (5 adults, 2 children; all naturally mummified) were used to develop the checklist following previously published guidelines. The scoring system was developed by assigning equal scores for checkpoints with equivalent quality. The checklist was evaluated by intra- and inter-observer reliability. The finalized checklist was applied to compare the groups of anthropogenically and naturally mummified bodies. The finalized checklist contains 97 checkpoints and was divided into two main categories, "A. Soft Tissues of Head and Musculoskeletal System" and "B. Organs and Organ Systems", each including various subcategories. The complete checklist had an intra-observer reliability of 98% and an inter-observer reliability of 93%. Statistical comparison revealed significantly higher values in anthropogenically compared to naturally mummified bodies for the total score and for three subcategories. In conclusion, the developed checklist allows for a standardized assessment and documentation of soft tissue preservation in whole-body computed tomography examinations of human mummies. The scoring system facilitates a quantitative comparison of the soft tissue preservation status between single mummies or mummy collections.

  11. Examining the Relationship Between the Functional Movement Screen and the Landing Error Scoring System in an Active, Male Collegiate Population.

    Science.gov (United States)

    Everard, Eoin M; Harrison, Andrew J; Lyons, Mark

    2017-05-01

    Everard, EM, Harrison, AJ, and Lyons, M. Examining the relationship between the functional movement screen and the landing error scoring system in an active, male collegiate population. J Strength Cond Res 31(5): 1265-1272, 2017-In recent years, there has been an increasing focus on movement screening as the principal aspect of preparticipation testing. Two of the most common movement screening tools are the Functional Movement Screen (FMS) and the Landing Error Scoring System (LESS). Several studies have examined the reliability and validity of these tools, but so far, there have been no studies comparing the results of these 2 screening tools against each other. Therefore, the purpose of this study was to determine the relationship between FMS scores and LESS scores. Ninety-eight male college athletes actively competing in sport (Gaelic games, soccer, athletics, boxing/mixed martial arts, Olympic weightlifting) participated in the study and performed the FMS and LESS screens. Both the 21-point and 100-point scoring systems were used to score the FMS. Spearman's correlation coefficients were used to determine the relationship between the 2 screening scores. The results showed a significant moderate correlation between FMS and LESS scores (rho 100 and 21 point = -0.528; -0.487; p < 0.001). In addition, r values of 0.26 and 0.23 indicate a poor shared variance between the 2 screens. The results indicate that performing well in one of the screens does not necessarily equate to performing well in the other. This has practical implications as it highlights that both screens may assess different movement patterns and should not be used as a substitute for each other.

  12. Prevalence, Vascular Distribution, and Multiterritorial Extent of Subclinical Atherosclerosis in a Middle-Aged Cohort

    DEFF Research Database (Denmark)

    Fernández-Friera, Leticia; Peñalvo, José L; Fernández-Ortiz, Antonio

    2015-01-01

    BACKGROUND: Data are limited on the presence, distribution, and extent of subclinical atherosclerosis in middle-aged populations. METHODS AND RESULTS: The PESA (Progression of Early Subclinical Atherosclerosis) study prospectively enrolled 4184 asymptomatic participants 40 to 54 years of age (mean...... Study (FHS) 10-year risk, subclinical disease was detected in 58%, with intermediate or generalized disease in 36%. When longer-term risk was assessed (30-year FHS), 83% of participants at high risk had atherosclerosis, with 66% classified as intermediate or generalized. CONCLUSIONS: Subclinical...... age, 45.8 years; 63% male) to evaluate the systemic extent of atherosclerosis in the carotid, abdominal aortic, and iliofemoral territories by 2-/3-dimensional ultrasound and coronary artery calcification by computed tomography. The extent of subclinical atherosclerosis, defined as presence of plaque...

  13. A comprehensive scoring system to measure healthy community design in land use plans and regulations.

    Science.gov (United States)

    Maiden, Kristin M; Kaplan, Marina; Walling, Lee Ann; Miller, Patricia P; Crist, Gina

    2017-02-01

    Comprehensive land use plans and their corresponding regulations play a role in determining the nature of the built environment and community design, which are factors that influence population health and health disparities. To determine the level in which a plan addresses healthy living and active design, there is a need for a systematic, reliable and valid method of analyzing and scoring health-related content in plans and regulations. This paper describes the development and validation of a scoring tool designed to measure the strength and comprehensiveness of health-related content found in land use plans and the corresponding regulations. The measures are scored based on the presence of a specific item and the specificity and action-orientation of language. To establish reliability and validity, 42 land use plans and regulations from across the United States were scored January-April 2016. Results of the psychometric analysis indicate the scorecard is a reliable scoring tool for land use plans and regulations related to healthy living and active design. Intraclass correlation coefficients (ICC) scores showed strong inter-rater reliability for total strength and comprehensiveness. ICC scores for total implementation scores showed acceptable consistency among scorers. Cronbach's alpha values for all focus areas were acceptable. Strong content validity was measured through a committee vetting process. The development of this tool has far-reaching implications, bringing standardization of measurement to the field of land use plan assessment, and paving the way for systematic inclusion of health-related design principles, policies, and requirements in land use plans and their corresponding regulations. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. External validation of the ROSC after cardiac arrest (RACA) score in a physician staffed emergency medical service system.

    Science.gov (United States)

    Kupari, Petteri; Skrifvars, Markus; Kuisma, Markku

    2017-03-29

    The return of spontaneous circulation (ROSC) after cardiac arrest (RACA) score may have implications as a quality indicator for the emergency medical services (EMS) system. We aimed to validate this score externally in a physician staffed urban EMS system. We conducted a retrospective cohort study. Data on resuscitation attempts from the Helsinki EMS cardiac arrest registry from 1.1.2008 to 31.12.2010 were collected and analyzed. For each attempted resuscitation the RACA score variables were collected and the score calculated. The endpoint was ROSC defined as palpable pulse over 30 s. Calibration was assessed by comparing predicted and observed ROSC rates in the whole sample, separately for shockable and non-shockable rhythm, and separately for resuscitations lead by a specialist, registrar or medical supervisor (i.e., senior paramedic). Data are presented as medians and interquartile ranges. Statistical testing included chi-square test, the Mann-Whitney U test, Hosmer-Lemeshow goodness of fit test and calculation of 95% confidence intervals (CI) for proportions. A total of 680 patients were included of whom 340 attained ROSC. The RACA score was higher in patients with ROSC (0.62 [0.46-0.69] than in those without (0.46 [0.36-0.57]) (p system for out-of-hospital cardiac arrest patients would allow patient heterogeneity adjustment and measurement of quality of care in analogy to commoly used severity-of-illness- scores developed for the similar purposes for the general intensive care unit population. However, transferring RACA score to another country with different population and EMS system might affect the performance and generalizability of the score. This study found a good overall calibration and moderate discrimination of the RACA score in a physician staffed urban EMS system which suggests external validity of the score. Calibration was suboptimal in patients with a non-shockable rhythm which may due to a local do-not-attempt-resuscitation policy. The lower

  15. Scoring System Development and Validation for Prediction Choledocholithiasis before Open Cholecystectomy.

    Science.gov (United States)

    Pejović, Tomislav; Stojadinović, Miroslav M

    2015-01-01

    Accurate precholecystectomy detection of concurrent asymptomatic common bile duct stones (CBDS) is key in the clinical decision-making process. The standard preoperative methods used to diagnose these patients are often not accurate enough. The aim of the study was to develop a scoring model that would predict CBDS before open cholecystectomy. We retrospectively collected preoperative (demographic, biochemical, ultrasonographic) and intraoperative (intraoperative cholangiography) data for 313 patients at the department of General Surgery at Gornji Milanovac from 2004 to 2007. The patients were divided into a derivation (213) and a validation set (100). Univariate and multivariate regression analysis was used to determine independent predictors of CBDS. These predictors were used to develop scoring model. Various measures for the assessment of risk prediction models were determined, such as predictive ability, accuracy, the area under the receiver operating characteristic curve (AUC), calibration and clinical utility using decision curve analysis. In a univariate analysis, seven risk factors displayed significant correlation with CBDS. Total bilirubin, alkaline phosphatase and bile duct dilation were identified as independent predictors of choledocholithiasis. The resultant total possible score in the derivation set ranged from 7.6 to 27.9. Scoring model shows good discriminatory ability in the derivation and validation set (AUC 94.3 and 89.9%, respectively), excellent accuracy (95.5%), satisfactory calibration in the derivation set, similar Brier scores and clinical utility in decision curve analysis. Developed scoring model might successfully estimate the presence of choledocholithiasis in patients planned for elective open cholecystectomy.

  16. Predictive value of semi-quantitative MRI-based scoring systems for future knee replacement: data from the osteoarthritis initiative

    Energy Technology Data Exchange (ETDEWEB)

    Hafezi-Nejad, Nima; Eng, John; Demehri, Shadpour [Johns Hopkins University School of Medicine, Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science, Baltimore, MD (United States); Zikria, Bashir [Johns Hopkins University, Department of Orthopedic Surgery, Baltimore, MD (United States); Carrino, John A. [Hospital for Special Surgery, Department of Radiology and Imaging, New York, NY (United States)

    2015-11-15

    To evaluate, in a confirmatory fashion, whether baseline and change from baseline to 24-month follow-up in cartilage damage, bone marrow lesions and meniscal damage are predictors of knee replacement (KR) in subjects with a high risk of osteoarthritis (OA), independent of the level of physical activity, symptom severity and radiographic abnormalities. Data from the Osteoarthritis Initiative's (OAI) baseline and 24-month follow-up knee MRIs of 115 patients (age range: 45-78 years; 48 % female; BMI: 20.9-48.7) were analyzed. Cartilage, bone marrow and menisci were semi-quantitatively scored according to the Whole-Organ Magnetic Resonance Imaging Score (WORMS) and Boston-Leeds Osteoarthritis Knee Score (BLOKS) systems in all compartments. Baseline and 24-month interval changes in structural tissue damage assessed by BLOKS and WORMS were used as predictors of KR independent of clinical and radiographic parameters using Cox hazard analysis. Adjustments were performed for age, gender, BMI and physical activity (Physical Activity Scale for the Elderly: PASE), Western Ontario and McMaster Questionnaire (WOMAC) total score and radiographic Kellgren-Lawrence (KL) score. BLOKS and WORMS baseline cartilage scores were predictors of KR independent of the PASE, WOMAC and KL score. One score increase in the average baseline BLOKS full-thickness cartilage defect score was associated with a [hazard ratio (95 % CI)] 13.55 (3.61-50.89) times greater risk of KR independent of the PASE, WOMAC and KL score. Net reclassification improvements (NRIs) of the additional evaluation of 24-month follow-up MRI scores and assessment of changes were not significant for prediction of KR (NRI range: - 7.23 - 24.8 %). The BLOKS cartilage score for full-thickness cartilage defects had the highest hazard for KR. Follow-up MRI changes in structural tissue damage, detected by BLOKS and WORMS cartilage, bone marrow or meniscus scores (up to 24 months) had no significant predictive value in addition

  17. Colon cancer with unresectable synchronous metastases: the AAAP scoring system for predicting the outcome after primary tumour resection.

    Science.gov (United States)

    Li, Z M; Peng, Y F; Du, C Z; Gu, J

    2016-03-01

    The aim of this study was to develop a prognostic scoring system to predict the outcome of patients with unresectable metastatic colon cancer who received primary colon tumour resection. Patients with confirmed metastatic colon cancer treated at the Peking University Cancer Hospital between 2003 and 2012 were reviewed retrospectively. The correlation of clinicopathological factors with overall survival was analysed using the Kaplan-Meier method and the log-rank test. Independent prognostic factors were identified using a Cox proportional hazards regression model and were then combined to form a prognostic scoring system. A total of 110 eligible patients were included in the study. The median survival time was 10.4 months and the 2-year overall survival (OS) rate was 21.8%. Age over 70 years, an alkaline phosphatase (ALP) level over 160 IU/l, ascites, a platelet/lymphocyte ratio (PLR) above 162 and no postoperative therapy were independently associated with a shorter OS in multivariate analysis. Age, ALP, ascites and PLR were subsequently combined to form the so-called AAAP scoring system. Patients were classified into high, medium and low risk groups according to the score obtained. There were significant differences in OS between each group (P colonic cancer who underwent primary tumour resection. The AAAP scoring system may be a useful tool for surgical decision making. Colorectal Disease © 2015 The Association of Coloproctology of Great Britain and Ireland.

  18. Validation of the Rockall scoring system for outcomes from non-variceal upper gastrointestinal bleeding in a Canadian setting.

    Science.gov (United States)

    Enns, Robert-A; Gagnon, Yves-M; Barkun, Alan-N; Armstrong, David; Gregor, Jamie-C; Fedorak, Richard-N

    2006-12-28

    To validate the Rockall scoring system for predicting outcomes of rebleeding, and the need for a surgical procedure and death. We used data extracted from the Registry of Upper Gastrointestinal Bleeding and Endoscopy including information of 1869 patients with non-variceal upper gastrointestinal bleeding treated in Canadian hospitals. Risk scores were calculated and used to classify patients based on outcomes. For each outcome, we used chi2 goodness-of-fit tests to assess the degree of calibration, and built receiver operating characteristic curves and calculated the area under the curve (AUC) to evaluate the discriminative ability of the scoring system. For rebleeding, the chi2 goodness-of-fit test indicated an acceptable fit for the model [chi2 (8) = 12.83, P = 0.12]. For surgical procedures [chi2 (8) = 5.3, P = 0.73] and death [chi2 (8) = 3.78, P = 0.88], the tests showed solid correspondence between observed proportions and predicted probabilities. The AUC was 0.59 (95% CI: 0.55-0.62) for the outcome of rebleeding and 0.60 (95% CI: 0.54-0.67) for surgical procedures, representing a poor discriminative ability of the scoring system. For the outcome of death, the AUC was 0.73 (95% CI: 0.69-0.78), indicating an acceptable discriminative ability. The Rockall scoring system provides an acceptable tool to predict death, but performs poorly for endpoints of rebleeding and surgical procedures.

  19. Validation of the Rockall scoring system for outcomes from non-variceal upper gastrointestinal bleeding in a Canadian setting

    Science.gov (United States)

    Enns, Robert A; Gagnon, Yves M; Barkun, Alan N; Armstrong, David; Gregor, Jamie C; Fedorak, Richard N; Group, RUGBE Investigators

    2006-01-01

    AIM: To validate the Rockall scoring system for predicting outcomes of rebleeding, and the need for a surgical procedure and death. METHODS: We used data extracted from the Registry of Upper Gastrointestinal Bleeding and Endoscopy including information of 1869 patients with non-variceal upper gastrointestinal bleeding treated in Canadian hospitals. Risk scores were calculated and used to classify patients based on outcomes. For each outcome, we used χ2 goodness-of-fit tests to assess the degree of calibration, and built receiver operating characteristic curves and calculated the area under the curve (AUC) to evaluate the discriminative ability of the scoring system. RESULTS: For rebleeding, the χ2 goodness-of-fit test indicated an acceptable fit for the model [χ2 (8) = 12.83, P = 0.12]. For surgical procedures [χ2 (8) = 5.3, P = 0.73] and death [χ2 (8) = 3.78, P = 0.88], the tests showed solid correspondence between observed proportions and predicted probabilities. The AUC was 0.59 (95% CI: 0.55-0.62) for the outcome of rebleeding and 0.60 (95% CI: 0.54-0.67) for surgical procedures, representing a poor discriminative ability of the scoring system. For the outcome of death, the AUC was 0.73 (95% CI: 0.69-0.78), indicating an acceptable discriminative ability. CONCLUSION: The Rockall scoring system provides an acceptable tool to predict death, but performs poorly for endpoints of rebleeding and surgical procedures. PMID:17203520

  20. Redundancy in the Pascal-Suttell Bender-Gestalt scoring system: discriminating organicity with only one design.

    Science.gov (United States)

    Wagner, E E; Marsico, D S

    1991-03-01

    The eight Bender-Gestalt (B-G) designs scored by the Pascal-Suttell (P-S) system proved to be highly intercorrelated, while the ninth component, the Configuration score, was modestly related to only design one. A factor analysis of the eight designs revealed one significant factor, which was interpreted as reflecting general reproductive accuracy rather than special gestalt properties of the drawings. While the P-S Total score could discriminate between organic (n = 52) and nonorganic (n = 52) clinical outpatient groups with a 74% hit rate, only one design (seven) yielded a 73% discrimination. It was suggested that a quick and reliable method for screening for organicity with the B-G would be to calculate the P-S score for design seven only.

  1. An acoustic feature-based similarity scoring system for speech rehabilitation assistance.

    Science.gov (United States)

    Syauqy, Dahnial; Wu, Chao-Min; Setyawati, Onny

    2016-08-01

    The purpose of this study is to develop a tool to assist speech therapy and rehabilitation, which focused on automatic scoring based on the comparison of the patient's speech with another normal speech on several aspects including pitch, vowel, voiced-unvoiced segments, strident fricative and sound intensity. The pitch estimation employed the use of cepstrum-based algorithm for its robustness; the vowel classification used multilayer perceptron (MLP) to classify vowel from pitch and formants; and the strident fricative detection was based on the major peak spectral intensity, location and the pitch existence in the segment. In order to evaluate the performance of the system, this study analyzed eight patient's speech recordings (four males, four females; 4-58-years-old), which had been recorded in previous study in cooperation with Taipei Veterans General Hospital and Taoyuan General Hospital. The experiment result on pitch algorithm showed that the cepstrum method had 5.3% of gross pitch error from a total of 2086 frames. On the vowel classification algorithm, MLP method provided 93% accuracy (men), 87% (women) and 84% (children). In total, the overall results showed that 156 tool's grading results (81%) were consistent compared to 192 audio and visual observations done by four experienced respondents. Implication for Rehabilitation Difficulties in communication may limit the ability of a person to transfer and exchange information. The fact that speech is one of the primary means of communication has encouraged the needs of speech diagnosis and rehabilitation. The advances of technology in computer-assisted speech therapy (CAST) improve the quality, time efficiency of the diagnosis and treatment of the disorders. The present study attempted to develop tool to assist speech therapy and rehabilitation, which provided simple interface to let the assessment be done even by the patient himself without the need of particular knowledge of speech processing while at the

  2. Risk stratification in cardiovascular disease primary prevention - scoring systems, novel markers, and imaging techniques.

    LENUS (Irish Health Repository)

    Zannad, Faiez

    2012-04-01

    The aim of this paper is to review and discuss current methods of risk stratification for cardiovascular disease (CVD) prevention, emerging biomarkers, and imaging techniques, and their relative merits and limitations. This report is based on discussions that took place among experts in the area during a special CardioVascular Clinical Trialists workshop organized by the European Society of Cardiology Working Group on Cardiovascular Pharmacology and Drug Therapy in September 2009. Classical risk factors such as blood pressure and low-density lipoprotein cholesterol levels remain the cornerstone of risk estimation in primary prevention but their use as a guide to management is limited by several factors: (i) thresholds for drug treatment vary with the available evidence for cost-effectiveness and benefit-to-risk ratios; (ii) assessment may be imprecise; (iii) residual risk may remain, even with effective control of dyslipidemia and hypertension. Novel measures include C-reactive protein, lipoprotein-associated phospholipase A(2) , genetic markers, and markers of subclinical organ damage, for which there are varying levels of evidence. High-resolution ultrasound and magnetic resonance imaging to assess carotid atherosclerotic lesions have potential but require further validation, standardization, and proof of clinical usefulness in the general population. In conclusion, classical risk scoring systems are available and inexpensive but have a number of limitations. Novel risk markers and imaging techniques may have a place in drug development and clinical trial design. However, their additional value above and beyond classical risk factors has yet to be determined for risk-guided therapy in CVD prevention.

  3. An alternative method for quantifying coronary artery calcification: the multi-ethnic study of atherosclerosis (MESA

    Directory of Open Access Journals (Sweden)

    Liang C

    2012-07-01

    Full Text Available Abstract Background Extent of atherosclerosis measured by amount of coronary artery calcium (CAC in computed tomography (CT has been traditionally assessed using thresholded scoring methods, such as the Agatston score (AS. These thresholded scores have value in clinical prediction, but important information might exist below the threshold, which would have important advantages for understanding genetic, environmental, and other risk factors in atherosclerosis. We developed a semi-automated threshold-free scoring method, the spatially weighted calcium score (SWCS for CAC in the Multi-Ethnic Study of Atherosclerosis (MESA. Methods Chest CT scans were obtained from 6814 participants in the Multi-Ethnic Study of Atherosclerosis (MESA. The SWCS and the AS were calculated for each of the scans. Cox proportional hazards models and linear regression models were used to evaluate the associations of the scores with CHD events and CHD risk factors. CHD risk factors were summarized using a linear predictor. Results Among all participants and participants with AS > 0, the SWCS and AS both showed similar strongly significant associations with CHD events (hazard ratios, 1.23 and 1.19 per doubling of SWCS and AS; 95% CI, 1.16 to 1.30 and 1.14 to 1.26 and CHD risk factors (slopes, 0.178 and 0.164; 95% CI, 0.162 to 0.195 and 0.149 to 0.179. Even among participants with AS = 0, an increase in the SWCS was still significantly associated with established CHD risk factors (slope, 0.181; 95% CI, 0.138 to 0.224. The SWCS appeared to be predictive of CHD events even in participants with AS = 0, though those events were rare as expected. Conclusions The SWCS provides a valid, continuous measure of CAC suitable for quantifying the extent of atherosclerosis without a threshold, which will be useful for examining novel genetic and environmental risk factors for atherosclerosis.

  4. An alternative method for quantifying coronary artery calcification: the multi-ethnic study of atherosclerosis (MESA).

    Science.gov (United States)

    Liang, C Jason; Budoff, Matthew J; Kaufman, Joel D; Kronmal, Richard A; Brown, Elizabeth R

    2012-07-02

    Extent of atherosclerosis measured by amount of coronary artery calcium (CAC) in computed tomography (CT) has been traditionally assessed using thresholded scoring methods, such as the Agatston score (AS). These thresholded scores have value in clinical prediction, but important information might exist below the threshold, which would have important advantages for understanding genetic, environmental, and other risk factors in atherosclerosis. We developed a semi-automated threshold-free scoring method, the spatially weighted calcium score (SWCS) for CAC in the Multi-Ethnic Study of Atherosclerosis (MESA). Chest CT scans were obtained from 6814 participants in the Multi-Ethnic Study of Atherosclerosis (MESA). The SWCS and the AS were calculated for each of the scans. Cox proportional hazards models and linear regression models were used to evaluate the associations of the scores with CHD events and CHD risk factors. CHD risk factors were summarized using a linear predictor. Among all participants and participants with AS > 0, the SWCS and AS both showed similar strongly significant associations with CHD events (hazard ratios, 1.23 and 1.19 per doubling of SWCS and AS; 95% CI, 1.16 to 1.30 and 1.14 to 1.26) and CHD risk factors (slopes, 0.178 and 0.164; 95% CI, 0.162 to 0.195 and 0.149 to 0.179). Even among participants with AS = 0, an increase in the SWCS was still significantly associated with established CHD risk factors (slope, 0.181; 95% CI, 0.138 to 0.224). The SWCS appeared to be predictive of CHD events even in participants with AS = 0, though those events were rare as expected. The SWCS provides a valid, continuous measure of CAC suitable for quantifying the extent of atherosclerosis without a threshold, which will be useful for examining novel genetic and environmental risk factors for atherosclerosis.

  5. Comparison of L-system applications towards plant modelling, music rendering and score generation using visual language programming

    Science.gov (United States)

    Lim, Chen Kim; Tan, Kian Lam; Yusran, Hazwanni; Suppramaniam, Vicknesh

    2017-10-01

    Visual language or visual representation has been used in the past few years in order to express the knowledge in graphic. One of the important graphical elements is fractal and L-Systems is a mathematic-based grammatical model for modelling cell development and plant topology. From the plant model, L-Systems can be interpreted as music sound and score. In this paper, LSound which is a Visual Language Programming (VLP) framework has been developed to model plant to music sound and generate music score and vice versa. The objectives of this research has three folds: (i) To expand the grammar dictionary of L-Systems music based on visual programming, (ii) To design and produce a user-friendly and icon based visual language framework typically for L-Systems musical score generation which helps the basic learners in musical field and (iii) To generate music score from plant models and vice versa using L-Systems method. This research undergoes a four phases methodology where the plant is first modelled, then the music is interpreted, followed by the output of music sound through MIDI and finally score is generated. LSound is technically compared to other existing applications in the aspects of the capability of modelling the plant, rendering the music and generating the sound. It has been found that LSound is a flexible framework in which the plant can be easily altered through arrow-based programming and the music score can be altered through the music symbols and notes. This work encourages non-experts to understand L-Systems and music hand-in-hand.

  6. Metabolic syndrome, inflammation and atherosclerosis

    OpenAIRE

    Rodolfo Paoletti; Chiara Bolego; Andrea Poli; Andrea Cignarella

    2006-01-01

    Rodolfo Paoletti1,2, Chiara Bolego1, Andrea Poli2, Andrea Cignarella1,31Department of Pharmacological Sciences, University of Milan, Italy; 2Nutrition Foundation of Italy (NFI), Milan; 3Department of Pharmacology and Anesthesiology, University of Padova, ItalyAbstract: The inflammatory component of atherogenesis has been increasingly recognized over the last decade. Inflammation participates in all stages of atherosclerosis, not only during initiation and during evolution of lesions, but also...

  7. SF-36 summary and subscale scores are reliable outcomes of neuropsychiatric events in systemic lupus erythematosus

    Science.gov (United States)

    Hanly, J. G.; Urowitz, M. B.; Jackson, D.; Bae, S.C.; Gordon, C.; Wallace, D.J.; Clarke, A.; Bernatsky, S.; Vasudevan, A.; Isenberg, D.; Rahman, A.; Sanchez-Guerrero, J.; Romero-Diaz, J.; Merrill, J. T.; Fortin, P.R.; Gladman, D.D.; Bruce, I. N.; Steinsson, K.; Khamashta, M.; Alarcón, G.S.; Fessler, B.; Petri, M.; Manzi, S.; Nived, O.; Sturfelt, G.; Ramsey-Goldman, R.; Dooley, M.A.; Aranow, C.; Van Vollenhoven, R.; Ramos-Casals, M.; Zoma, A.; Kalunian, K.; Farewell, V.

    2013-01-01

    Objective To examine change in health-related quality of life (HRQoL) in association with clinical outcomes of neuropsychiatric (NP) events in SLE. Methods An international study evaluated newly diagnosed SLE patients for NP events attributed to SLE and non-SLE causes. Outcome of events was determined by physician-completed 7-point scale and compared to patient-completed SF-36 questionnaires. Statistical analysis used linear mixed-effects regression models with patient specific random effects. Results 274 patients (92% female; 68% Caucasian), from a cohort of 1400, had ≥ 1 NP event where the interval between assessments was 12.3 ± 2 months. The overall difference in change between visits in mental component summary (MCS) scores of the SF-36 was significant (p<0.0001) following adjustments for gender, ethnicity, center and previous score. A consistent improvement in NP status (N=295) was associated with an increase in the mean(SD) adjusted MCS score of 3.66(0.89) in SF-36 scores. Between paired visits where NP status consistently deteriorated (N=30), the adjusted MCS score decreased by 4.00(1.96). For the physical component summary (PCS) scores the corresponding changes were +1.73(0.71) and −0.62(1.58) (p<0.05) respectively. Changes in SF-36 subscales were in the same direction (p<0.05; with the exception of role physical). Sensitivity analyses confirmed these findings. Adjustment for age, education, medications, SLE disease activity, organ damage, disease duration, attribution and characteristics of NP events did not substantially alter the results. Conclusion Changes in SF-36 summary and subscale scores, in particular those related to mental health, are strongly associated with the clinical outcome of NP events in SLE patients. PMID:21342917

  8. Scoring system in the assessment of the clinical severity of reflex sympathetic dystrophy of the hand.

    Science.gov (United States)

    Zyluk, Andrzej

    2003-08-01

    A scoring classification for assessment of the clinical severity of reflex sympathetic dystrophy (RSD) and rating the presence and clinical expression of each feature is proposed. The following were included: pain, reduction of finger flexion, swelling, temperature changes, discoloration, sensory disturbances, shoulder pain and loss of movement, increased sweating, and hair/nail growth changes. For most of these features one point was assigned for strong expression, half a point for moderate expression, and zero points if the feature was absent. A score of four points was assumed, empirically, to indicate a minimal degree of RSD, and the maximum score of 10.5 to indicate fully symptomatic condition. One hundred forty-six patients with RSD of the hand were classified according to those criteria. Seventy-four patients (51%) had a score of 4-6, 51 patients (35%) of 6.5-8, and 21 patients (14%) of 8.5-10. This classification was then used to investigate the influence of clinical severity of RSD on the intensity of uptake of the tracer in three-phase bone scintigraphy. No correlation between RSD score values and intensity of fixation of the radionuclide was found.

  9. The impact of Early Warning Score and Rapid Response Systems on nurses' competence: An integrative literature review and synthesis.

    Science.gov (United States)

    Jensen, Jørghild Karlotte; Skår, Randi; Tveit, Bodil

    2017-12-23

    To describe, interpret and synthesise the current research findings on the impact of the Early Warning Score and Rapid Response Systems on nurses' competence in identifying and managing deteriorating patients in general hospital wards. As patient safety initiatives designed to ensure the early identification and management of deteriorating patients, the Early Warning Score and Rapid Response Systems have broad appeal. However, it is still unclear how these systems impact nurses' competence when these systems are used in general hospital wards. CINAHL, PubMed, Cochrane, EMBASE and Ovid MEDLINE databases were systematically searched for relevant articles. Articles were appraised, a thematic analysis was conducted, and similar and divergent perspectives on emergent themes and subthemes were extracted by a team of researchers. Thirty-six studies met the inclusion criteria. The analysis of findings showed how the Early Warning Score and Rapid Response Systems impacted three competence areas: (i) Nurses' competence in assessing and caring for patients related to the subthemes: (a) sensing clinical deterioration and (b) the development of skills and knowledge. (ii). Nurses' competence in referring patients, related to the subthemes: (a) deciding whether to summon help and (b) the language and communication lines in the referral process. (ii) Nurses' coping and mastery experiences. The impact of the Early Warning Score and Rapid Response Systems on nurses' competence in identifying and managing deteriorating patients is beneficial but also somewhat contradictory. A greater understanding of nurses' development of competence when using the Early Warning Score and Rapid Response Systems will facilitate the design of implementation strategies and the use of these systems to improve practice. © 2017 John Wiley & Sons Ltd.

  10. A meta-analysis-derived proposal for a clinical, ultrasonographic, and cytological scoring system to evaluate thyroid nodules: the "CUT" score.

    Science.gov (United States)

    Ianni, Francesca; Campanella, Paolo; Rota, Carlo Antonio; Prete, Alessandro; Castellino, Laura; Pontecorvi, Alfredo; Corsello, Salvatore Maria

    2016-05-01

    The purpose of this study is to develop a new cancer risk score for preoperative assessment of thyroid nodules (TN) trying to reduce unnecessary thyroidectomies. On the basis of a recent meta-analysis of published literature, we assigned a matching value to the clinical (C) and ultrasonographic (U) features of TN with increased malignancy risk (MR). The created "CUT" score derived from "C+U" score, (CU[1-10] ), along with the five-tiered "T" (T[1-5] ), represents the cytologic result of the fine-needle aspiration. The C+U score was prospectively applied to 683 consecutive patients with 705 TN and validated through a ROC curve analysis. The CUT score was correlated with the histopathological diagnoses of 110 surgically resected TN. Fifty-five histologically benign TN had a mean C+U score of 2.4 versus 5.7 of 55 malignant TN (p 2.5, and 69 and 96 % for >5. The "CUT" score can be easily applied, aiding clinicians in the evaluation of TN, especially in cases with indeterminate or repeated non-diagnostic FNA.

  11. Screening applicants for risk of poor academic performance: a novel scoring system using preadmission grade point averages and graduate record examination scores.

    Science.gov (United States)

    Luce, David

    2011-01-01

    The purpose of this study was to develop an effective screening tool for identifying physician assistant (PA) program applicants at highest risk for poor academic performance. Prior to reviewing applications for the class of 2009, a retrospective analysis of preadmission data took place for the classes of 2006, 2007, and 2008. A single composite score was calculated for each student who matriculated (number of subjects, N=228) incorporating the total undergraduate grade point average (UGPA), the science GPA (SGPA), and the three component Graduate Record Examination (GRE) scores: verbal (GRE-V), quantitative (GRE-Q), analytical (GRE-A). Individual applicant scores for each of the five parameters were ranked in descending quintiles. Each applicant's five quintile scores were then added, yielding a total quintile score ranging from 25, which indicated an excellent performance, to 5, which indicated poorer performance. Thirteen of the 228 students had academic difficulty (dismissal, suspension, or one-quarter on academic warning or probation). Twelve of the 13 students having academic difficulty had a preadmission total quintile score 12 (range, 6-14). In response to this descriptive analysis, when selecting applicants for the class of 2009, the admissions committee used the total quintile score for screening applicants for interviews. Analysis of correlations in preadmission, graduate, and postgraduate performance data for the classes of 2009-2013 will continue and may help identify those applicants at risk for academic difficulty. Establishing a threshold total quintile score of applicant GPA and GRE scores may significantly decrease the number of entering PA students at risk for poor academic performance.

  12. Scoring system development and validation for prediction choledocholithiasis before open cholecystectomy

    Directory of Open Access Journals (Sweden)

    Pejović Tomislav

    2015-01-01

    Full Text Available Introduction. Accurate precholecystectomy detection of concurrent asymptomatic common bile duct stones (CBDS is key in the clinical decision-making process. The standard preoperative methods used to diagnose these patients are often not accurate enough. Objective. The aim of the study was to develop a scoring model that would predict CBDS before open cholecystectomy. Methods. We retrospectively collected preoperative (demographic, biochemical, ultrasonographic and intraoperative (intraoperative cholangiography data for 313 patients at the department of General Surgery at Gornji Milanovac from 2004 to 2007. The patients were divided into a derivation (213 and a validation set (100. Univariate and multivariate regression analysis was used to determine independent predictors of CBDS. These predictors were used to develop scoring model. Various measures for the assessment of risk prediction models were determined, such as predictive ability, accuracy, the area under the receiver operating characteristic curve (AUC, calibration and clinical utility using decision curve analysis. Results. In a univariate analysis, seven risk factors displayed significant correlation with CBDS. Total bilirubin, alkaline phosphatase and bile duct dilation were identified as independent predictors of choledocholithiasis. The resultant total possible score in the derivation set ranged from 7.6 to 27.9. Scoring model shows good discriminatory ability in the derivation and validation set (AUC 94.3 and 89.9%, respectively, excellent accuracy (95.5%, satisfactory calibration in the derivation set, similar Brier scores and clinical utility in decision curve analysis. Conclusion. Developed scoring model might successfully estimate the presence of choledocholithiasis in patients planned for elective open cholecystectomy. [Projekat Ministarstva nauke Republike Srbije, br. 175014

  13. End points for validating early warning scores in the context of rapid response systems

    DEFF Research Database (Denmark)

    Pedersen, N. E.; Oestergaard, D.; Lippert, A.

    2016-01-01

    INTRODUCTION: When investigating early warning scores and similar physiology-based risk stratification tools, death, cardiac arrest and intensive care unit admission are traditionally used as end points. A large proportion of the patients identified by these end points cannot be saved, even...... the items receiving highest ratings. CONCLUSIONS: End points relating to death, cardiac arrest and intensive care unit admission currently comprise the most obvious compromises for investigating early warning scores and similar risk stratification tools. Additional end points from the gross list...

  14. Toll-Like Receptor-2 Mediates Diet and/or Pathogen Associated Atherosclerosis: Proteomic Findings

    OpenAIRE

    Madan, Monika; Amar, Salomon

    2008-01-01

    Accumulating evidence implicates a fundamental link between the immune system and atherosclerosis. Toll-like receptors are principal sensors of the innate immune system. Here we report an assessment of the role of the TLR2 pathway in atherosclerosis associated with a high-fat diet and/or bacteria in ApoE(+/-) mice.To explore the role of TLR2 in inflammation- and infection-associated atherosclerosis, 10 week-old ApoE(+/-)-TLR2(+/+), ApoE(+/-)-TLR2(+/-) and ApoE(+/-)-TLR2(-/-) mice were fed eit...

  15. Subclinical coronary atherosclerosis identified by coronary computed tomographic angiography in asymptomatic morbidly obese patients

    Directory of Open Access Journals (Sweden)

    Peter A. McCullough

    2010-09-01

    Full Text Available Obesity is a common public health problem and obese individuals in particular have a disproportionate incidence of acute coronary events. This study was undertaken to identify coronary artery lesions as well as associated clinical features, risk factors and demographics in patients with a body mass index (BMI >40 kg/m2 without known coronary artery disease (CAD. Morbidly obese subjects were prospectively recruited to undergo coronary computed tomographic angiography (CCTA using a dual-source computed tomography (CT system. CAD was defined as the presence of any atherosclerotic lesion in any one coronary artery segment. The presence, location, and severity of atherosclerosis were related to patient characteristics. Forty-one patients (28 women, mean age, 50.4±10.0 years, mean BMI, 43.8±4.8 kg/m2 served as the study population. Of these, 25 patients (61% had at least one coronary stenosis. All but 2 patients within the CAD cohort had coronary artery calcium (CAC scores >0, and most plaques identified (75.4% were non-calcified. There was a predilection of calcified and non-calcified atherosclerosis involving the left anterior descending (LAD coronary artery compared with other coronary segments. Univariate predictors of CAD included older age, dyslipidemia, and diabetes. In this preliminary study of young morbidly obese patients, CCTA detected a high prevalence of calcified and non-calcified CAD, although the later predominated.

  16. Relation between intracranial artery calcifications and aortic atherosclerosis in ischemic stroke patients.

    Science.gov (United States)

    Bugnicourt, Jean-Marc; Chillon, Jean-Marc; Tribouilloy, Christophe; Canaple, Sandrine; Lamy, Chantal; Massy, Ziad A; Godefroy, Olivier

    2010-08-01

    We previously demonstrated a strong relation between carotid atherosclerosis (defined as carotid artery stenosis > or =50%) and intracranial artery calcification (IAC) in ischemic stroke patients. The purpose of this study was to evaluate the relation between aortic atherosclerosis and IAC. Four hundred fifty-four patients with ischemic stroke were included. Complex aortic plaques (CAP) were assessed by transesophageal echocardiography (TEE) and defined as plaques > or =4 mm thick or with mobile components in the proximal aorta. IAC were assessed in the seven major cerebral arteries and a semiquantitative score system was applied, ranging from 0 (no calcification) to 7. Forty-two patients (9.3%) had CAP. Patients with CAP were older compared with patients without CAP (73.6 vs. 63.6 years, p vs. 1.8; p stroke or TIA (OR 3.3; 95%CI 1.5-7.0; p = 0.002), carotid artery stenosis > or =50% (OR 3.7; 95%CI 1.7-8.0; p = 0.001), chronic kidney disease (OR 3.8; 95%CI 1.9-7.8; p stroke patients, the absence of IAC strongly points to the lack of CAP. However, these results warrant confirmation in prospective studies before concluding the non-utility of the use of TEE to exclude CAP as a potential source of cerebral embolism in patients without IAC.

  17. Crosscultural Adaptation and Validation of the Korean Version of the New Knee Society Knee Scoring System.

    Science.gov (United States)

    Kim, Seok Jin; Basur, Mohnish Singh; Park, Chang Kyu; Chong, Suri; Kang, Yeon Gwi; Kim, Moon Ju; Jeong, Jeong Seong; Kim, Tae Kyun

    2017-06-01

    The 2011 Knee Society Score © (2011 KS Score © ) is used to characterize the expectations, symptoms, physical activity, and satisfaction of patients who undergo TKA and is widely used to assess the outcome of TKA. However, it has not been adapted or validated for use in Korea. We developed a Korean version of the 2011 KS Score and evaluated the (1) test-retest reliability, (2) convergent validity, and (3) responsiveness of the Korean version. The Korean version of the 2011 KS Score was derived by using a well-established translational procedure based on international guidelines, which include translation, synthesis, back-translation, expert committee review, pretesting, and submission for appraisal. A total of 123 patients with knee osteoarthritis who were scheduled to undergo TKA were recruited for the study. Ninety percent of the patients (111 of 123) were women, which is an exact representation of the Korean population having TKAs. To evaluate reliability, the patients were evaluated twice during a 4-week interval using the questionnaire. Reliability was assessed by using intraclass correlation coefficients (ICCs) and internal consistency by using Cronbach's alpha to determine the validity of the Korean version of the 2011 KS Score. The patients were evaluated by using the validated Korean versions of the WOMAC and SF-36 questionnaires. Spearman's correlation coefficient was used for validation. Responsiveness was determined by calculating the standardized response mean from the preoperative and postoperative test scores in the Korean version of the 2011 KS Score. To address the gender disparity in our study we identified 53 males who underwent TKA for osteoarthritis after completion of this study and generated age-matched controlled groups to evaluate construct validity and responsiveness in Korean males. The reliability proved good to excellent with an ICC between 0.69 and 0.85, depending on the clinical properties tested, which included the following

  18. Assessing new terminal body and facial hair growth during pregnancy: toward developing a simplified visual scoring system for hirsutism.

    Science.gov (United States)

    Yang, Yabo; Han, Yang; Wang, Wenjun; Du, Tao; Li, Yu; Zhang, Jianping; Yang, Dongzi; Zhao, Xiaomiao

    2016-02-01

    To study the distribution and progression of terminal hair growth in pregnant women and to determine the feasibility of a simplified scoring system for assessing hirsutism. Prospective follow-up observational study. Academic hospital. A total of 115 pregnant women (discovery cohort) and 1,159 women with polycystic ovary syndrome (PCOS) (validation cohort). Facial and body terminal hair growth assessed by modified Ferriman and Gallwey score system (mFG score), and total testosterone (TT) level detected by liquid chromatography with tandem mass spectrometry. Degree of facial and body terminal hair growth. The serum TT level and mFG score increased as pregnancy progressed. Both the prospective study and receiver operating characteristics curve indicated that the body areas with the greatest contribution to hirsutism (defined as an mFG score ≥5) with new terminal hair growth were the upper lip, lower back, lower abdomen, and thigh. A simplified mFG scoring system (sFG) was developed, and a cutoff value of ≥3 was defined as hirsutism. Pregnant hirsute women were distinguished from nonhirsute women with an accuracy of 95.2%, sensitivity of 96.8%, and specificity of 94.3% for detecting hirsutism. This was further validated in the PCOS population with a sensitivity, specificity, and positive predictive value of 97.6%, 96.4%, and 96.4%, respectively. This study suggests that the upper lip, lower back, lower abdomen, and thigh may be an effective simplified combination of the mFG system for the evaluation of excess hair growth in Chinese women. ChiCTR-OCH-14005012. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  19. Digital Three-Dimensional Automation of the Modified Huddart and Bodenham Scoring System for Patients With Cleft Lip and Palate.

    Science.gov (United States)

    Ma, Xinhui; Martin, Catherine; McIntyre, Grant; Lin, Ping; Mossey, Peter

    2017-07-01

    The modified Huddart and Bodenham scoring system assesses maxillary arch constriction and surgical outcomes in cleft lip and palate. This project automates modified Huddart and Bodenham scoring using three-dimensional digital models. Development of a novel software tool. The design, construction, development, and testing of the system was carried out at Dundee Dental Hospital. Subjects with cleft lip and palate. A plug-in has been developed using an open three-dimensional development platform: Rhinoceros, version 5 ( http://www.rhino3d.co.uk ). Users select cusps on mandibular and maxillary teeth on three-dimensional digital models. A three-dimensional cubic spline generates a mandibular curve, and a best-fit horizontal mandibular reference plane is produced using a least-squares method. Horizontal distances projected from the shortest three-dimensional distances were subsequently calculated between the maxillary cusps and the mandibular curve to calculate the modified Huddart and Bodenham score. Automatic scoring of digital models using the modified Huddart and Bodenham system produces similar results to manual scoring. By standardizing outcome assessment in cleft care, multicenter comparisons for audit and research can be simplified, allowing centers throughout the world to upload three-dimensional digital models or intraoral scans of the dental arches for remote scoring. Thereafter, these data can feed back into the global database on orofacial clefting as part of the World Health Organization's international collaborative "Global Burden of Disease" research project for craniofacial anomalies. The automated system facilitates quicker and more reliable outcome assessments by minimizing human errors.

  20. The value of the new scoring system for predicting neoplastic pericarditis in the patients with large pericardial effusion.

    Science.gov (United States)

    Szturmowicz, M; Pawlak-Cieślik, A; Fijałkowska, A; Gątarek, J; Skoczylas, A; Dybowska, M; Błasińska-Przerwa, K; Langfort, R; Tomkowski, W

    2017-08-01

    Early recognition of neoplastic pericarditis (npe) is crucial for the planning of subsequent therapy. The aim of the present study was to construct the scoring system assessing the probability of npe, in the patients requiring pericardial fluid (pf) drainage due to large pericardial effusion. One hundred forty-six patients, 74 males and 72 females, entered the study. Npe based on positive pf cytology and/or pericardial biopsy specimen was recognised in 66 patients, non-npe in 80. Original scoring system was constructed based on parameters with the highest diagnostic value: mediastinal lymphadenopathy on chest CT scan, increased concentration of tumour markers (cytokeratin 19 fragments-Cyfra 21-1 and carcinoembryonic antigen-CEA) in pf, bloody character of pf, signs of imminent cardiac tamponade on echocardiography and tachycardia exceeding 90 beats/min on ECG. Each parameter was scored with positive or negative points depending on the positive and negative predictive values (PPV, NPV). The area under curve (AUC) for the scoring system was 0.926 (95%CI 0.852-0.963) and it was higher than AUC for Cyfra 21-1 0.789 (95%CI 0.684-0.893) or CEA 0.758 (95%CI 0.652-0.864). The score optimally discriminating between npe and non-npe was 0 points (sensitivity 0.84, specificity 0.91, PPV 0.9, NPV 0.85). Despite chest CT and tumour marker evaluation in pericardial fluid were good discriminators between npe and non-npe, the applied scoring system further improved the predicting of neoplastic disease in the studied population.

  1. Role of maxillofacial trauma scoring systems in determining the economic burden to maxillofacial trauma patients in India.

    Science.gov (United States)

    Ramalingam, Sundar

    2015-04-01

    The objective of this study was to evaluate the association between severity of maxillofacial injuries determined by trauma scoring systems and its economic burden to patients in terms of cost and duration of hospitalization. Following ethical approval a retrospective chart review was undertaken at Meenakshi Ammal Dental College and Hospital to identify patients admitted with maxillofacial injuries between January 2006 and December 2008. Patients with incomplete records, associated injuries, debilitating systemic diseases and patients treated under local anesthesia were excluded. Details regarding the nature and severity of injury and treatment were recorded in addition to the total treatment cost and duration of hospitalization. Maxillofacial injury severity was scored using maxillofacial injury severity score (MFISS) and facial injury severity scale (FISS). The MFISS and FISS scores were correlated with two surrogate markers of the economic burden namely cost and duration of hospitalization. A total of 162 patients with maxillofacial injuries were identified (108 males, 54 females; mean age = 32.4 years). Road traffic accidents were the cause of injury in 114 patients (70.4%) and only 29 patients (17.9%) had medical insurance coverage. The mean MFISS and FISS scores were 14.04 (standard deviation [SD] = 9.19; range = 3-42) and 4.40 (SD = 3.17; range = 1-14), respectively. The mean cost and duration of hospitalization of the patients were Indian rupees (INR) 13877.28 (SD = 8252.59; range = INR 5250-42960) and 4.12 days (SD = 1.5; range = 2-8 days) respectively. Pearson's correlation between the MFISS and FISS scores and the cost and duration of hospitalization, revealed statistically significant correlations (MFISS vs. cost - R = 0.862, P maxillofacial injury severity measured by MFISS and FISS scores are predictable indicators of the economic burden to the patients.

  2. [Prospective validation of the Rockall Scoring System in patients with upper gastrointestinal bleeding in Cayetano Heredia Hospital Lima- Peru].

    Science.gov (United States)

    Espinoza Ríos, Jorge; Huerta-Mercado Tenorio, Jorge; Huerta-Mercado Tenorio, Jorge; Lindo Ricce, Mayra; García Encinas, Carlos; Rios Matteucci, Sathya; Vila Gutierrez, Sandro; Pinto Valdivia, José; De Los Rios Senmache, Raúl; Piscoya Rivera, Alejandro; Bussalleu Rivera, Alejandro

    2009-01-01

    The present study intends to validate the Rockall Score in patients with upper gastrointestinal bleeding (UGB) in our current medical setting and to find the value that best discriminates between patients with high or low risk of mortality, rebleeding and the need of more than two units of packed red blood cells (PRBC). A descriptive prospective study was made from patients who arrived to Cayetano Heredia Hospital's emergency department between February 2007 and January 2008 due to UGB symptoms (hematemesis, coffe ground remit melena or hematoquezia). The Rockall score was used to determine severity of UGB and to stratify patients with higher risk of mortality or rebleeding. All patients were interviewed and any additional information was gathered from medical history records and emergency and hospitalization endoscopic procedure reports. During the study all patients were evaluated for rebleeding, the number of units of PRBCs needed and mortality rate. 163 patients were included in our study, 107 (65.64%) were male and 56 (34.36%) female, 8 were excluded due to lack of an endoscopic procedure. The remaining 155 patients were studied to evaluate the discriminative ability of the scoring system, and to determine which value best distinguishes high and low severity patients using Receiver Operating Characteristic curve (ROC) and calculated area under the curve. The data analysis showed patients with a Rockall Score e 5 had an increased mortality rate compared to lower score with an area under the curve of 0.807, meaning an accurate relationship between mortality and a score e 5. For rebleeding and the need of two packed red blood cells for transfusion, the area under the curve were 0.65 and 0.64 respectively showing a low predictive value. The Rockall scoring system is useful to identify patients with high mortality risk, but not to predict rebleeding or the need for blood transfusion in our hospital.

  3. Evaluation of the effects of implementing an electronic early warning score system: protocol for a stepped wedge study.

    Science.gov (United States)

    Bonnici, Timothy; Gerry, Stephen; Wong, David; Knight, Julia; Watkinson, Peter

    2016-02-09

    An Early Warning Score is a clinical risk score based upon vital signs intended to aid recognition of patients in need of urgent medical attention. The use of an escalation of care policy based upon an Early Warning Score is mandated as the standard of practice in British hospitals. Electronic systems for recording vital sign observations and Early Warning Score calculation offer theoretical benefits over paper-based systems. However, the evidence for their clinical benefit is limited. Previous studies have shown inconsistent results. The majority have employed a "before and after" study design, which may be strongly confounded by simultaneously occurring events. This study aims to examine how the implementation of an electronic early warning score system, System for Notification and Documentation (SEND), affects the recognition of clinical deterioration occurring in hospitalised adult patients. This study is a non-randomised stepped wedge evaluation carried out across the four hospitals of the Oxford University Hospitals NHS Trust, comparing charting on paper and charting using SEND. We assume that more frequent monitoring of acutely ill patients is associated with better recognition of patient deterioration. The primary outcome measure is the time between a patient's first observations set with an Early Warning Score above the alerting threshold and their subsequent set of observations. Secondary outcome measures are in-hospital mortality, cardiac arrest and Intensive Care admission rates, hospital length of stay and system usability measured using the System Usability Scale. We will also measure Intensive Care length of stay, Intensive Care mortality, Acute Physiology and Chronic Health Evaluation (APACHE) II acute physiology score on admission, to examine whether the introduction of SEND has any effect on Intensive Care-related outcomes. The development of this protocol has been informed by guidance from the Agency for Healthcare Research and Quality (AHRQ

  4. 76 FR 16350 - Medical Devices; Ovarian Adnexal Mass Assessment Score Test System; Labeling; Black Box Restrictions

    Science.gov (United States)

    2011-03-23

    ... a risk identified in the special controls guidance document must be in a black box and must appear... (special controls). DATES: Submit either electronic or written comments by May 23, 2011. ADDRESSES: You may... gynecologic oncologist for surgery. B. Identified Risk to Health The ovarian adnexal mass assessment score...

  5. 77 FR 34399 - Public Housing Assessment System (PHAS): Capital Fund Interim Scoring Notice; Request for Comment

    Science.gov (United States)

    2012-06-11

    ... Division at (202) 708-3055 (this is not a toll-free number). Individuals with speech or hearing impairments... impairments may access this number through TTY by calling the toll-free Federal Relay Service at 800-877-8339... score PHAs under the asset management model. Because the rule was effective for PHA fiscal years ending...

  6. A cross-sectional study of the Birmingham Vasculitis Activity Score version 3 in systemic vasculitis

    NARCIS (Netherlands)

    Suppiah, Ravi; Mukhtyar, Chetan; Flossmann, Oliver; Alberici, Federico; Baslund, Bo; Batra, Rajbir; Brown, Denise; Holle, Julia; Hruskova, Zdenka; Jayne, David R. W.; Judge, Andrew; Little, Mark A.; Palmisano, Alessandra; Stegeman, Coen; Tesar, Vladimir; Vaglio, Augusto; Westman, Kerstin; Luqmani, Raashid

    Methods. A total of 238 patients with vasculitis from seven countries in Europe were evaluated at a single time point. Spearman's correlation coefficients were calculated between BVAS v. 3 scores, vasculitis activity index (VAI), physician's global assessment (PGA), the physician's treatment

  7. In of illness severIty scorIng care Systems for IntensIve

    African Journals Online (AJOL)

    1989-07-01

    Jul 1, 1989 ... failure secondary to sepsis) or delayed effects (paraquat poisoning). In certain individual diseases, notably pneumonia, the rela- tion between severity of illness scores and mortality is excellent. However, in the group of patients with ARDS the relation between organ failure and APACHE 11 is very poor.

  8. A Clinical and Biomarker Scoring System to Predict the Presence of Obstructive Coronary Artery Disease

    NARCIS (Netherlands)

    Ibrahim, N.E.; Januzzi, J.L., Jr.; Magaret, C.A.; Gaggin, H.K.; Rhyne, R.F.; Gandhi, P.U.; Kelly, N.; Simon, M.L.; Motiwala, S.R.; Belcher, A.M.; Kimmenade, R.R. van

    2017-01-01

    BACKGROUND: Noninvasive models to predict the presence of coronary artery disease (CAD) may help reduce the societal burden of CAD. OBJECTIVES: From a prospective registry of patients referred for coronary angiography, the goal of this study was to develop a clinical and biomarker score to predict

  9. An Inmate Classification System Based on PCL: SV Factor Scores in a Sample of Prison Inmates

    Science.gov (United States)

    Wogan, Michael; Mackenzie, Marci

    2007-01-01

    Psychopaths represent a significant management challenge in a prison population. A sample of ninety-five male inmates from three medium security prisons was tested using the Hare Psychopathy Checklist: Screening Version (PCL:SV). Using traditional criteria, 22% of the inmates were classified as psychopaths. Scores on the two factor dimensions of…

  10. Effect of a Publicly Accessible Disclosure System on Food Safety Inspection Scores in Retail and Food Service Establishments.

    Science.gov (United States)

    Choi, Jihee; Scharff, Robert L

    2017-07-01

    The increased frequency with which people are dining out coupled with an increase in the publicity of foodborne disease outbreaks has led the public to an increased awareness of food safety issues associated with food service establishments. To accommodate consumer needs, local health departments have increasingly publicized food establishments' health inspection scores. The objective of this study was to estimate the effect of the color-coded inspection score disclosure system in place since 2006 in Columbus, OH, by controlling for several confounding factors. This study incorporated cross-sectional time series data from food safety inspections performed from the Columbus Public Health Department. An ordinary least squares regression was used to assess the effect of the new inspection regime. The introduction of the new color-coded food safety inspection disclosure system increased inspection scores for all types of establishments and for most types of inspections, although significant differences were found in the degree of improvement. Overall, scores increased significantly by 1.14 points (of 100 possible). An exception to the positive results was found for inspections in response to foodborne disease complaints. Scores for these inspections declined significantly by 10.2 points. These results should be useful for both food safety researchers and public health decision makers.

  11. Heightened clinical utility of smartphone versus body-worn inertial system for shoulder function B-B score.

    Directory of Open Access Journals (Sweden)

    Claude Pichonnaz

    Full Text Available The B-B Score is a straightforward kinematic shoulder function score including only two movements (hand to the Back + lift hand as to change a Bulb that demonstrated sound measurement properties for patients for various shoulder pathologies. However, the B-B Score results using a smartphone or a reference system have not yet been compared. Provided that the measurement properties are comparable, the use of a smartphone would offer substantial practical advantages. This study investigated the concurrent validity of a smartphone and a reference inertial system for the measurement of the kinematic shoulder function B-B Score.Sixty-five patients with shoulder conditions (with rotator cuff conditions, adhesive capsulitis and proximal humerus fracture and 20 healthy participants were evaluated using a smartphone and a reference inertial system. Measurements were performed twice, alternating between two evaluators. The B-B Score differences between groups, differences between devices, relationship between devices, intra- and inter-evaluator reproducibility were analysed.The smartphone mean scores (SD were 94.1 (11.1 for controls and 54.1 (18.3 for patients (P < 0.01. The difference between devices was non-significant for the control (P = 0.16 and the patient group (P = 0.81. The analysis of the relationship between devices showed 0.97 ICC, -0.6 bias and -13.2 to 12.0 limits of agreement (LOA. The smartphone intra-evaluator ICC was 0.92, the bias 1.5 and the LOA -17.4 to 20.3. The smartphone inter-evaluator ICC was 0.92, the bias 1.5 and the LOA -16.9 to 20.0.The B-B Score results measured with a smartphone were comparable to those of an inertial system. While single measurements diverged in some cases, the intra- and inter-evaluator reproducibility was excellent and was equivalent between devices. The B-B score measured with a smartphone is straightforward and as efficient as a reference inertial system measurement.

  12. Comparison of Two Scoring Systems in the Assessment of Nasolabial Appearance in Cleft Lip and Palate Patients

    NARCIS (Netherlands)

    Mosmuller, D.G.M.; Bijnen, C.L.; don Griot, J.P.W.; Kramer, G.; Disse, M.; Prahl, C.; Kuik, D.J.; Niessen, F.B.

    2014-01-01

    OBJECTIVE: The aim of this study was to determine the reliability of 2 scoring systems. DESIGN: This study used a retrospective analysis of the results of complete unilateral cleft lip and palate patients. SETTING: The study was conducted at the VU Medical Center and the Academic Center for

  13. A quantified risk-scoring system and rating model for postsurgical gastroparesis syndrome in gastric cancer patients.

    Science.gov (United States)

    Chen, Xiao-Dong; Mao, Chen-Chen; Zhang, Wei-Teng; Lin, Ji; Wu, Rui-Sen; Zhang, Feng-Min; Sun, Xiang-Wei; Chi, Chu-Huai; Shen, Xian; Wang, Peng-Fei

    2017-09-01

    The study aimed to investigate the relationship between obesity and postsurgical gastroparesis syndrome (PGS), and to construct a scoring system and a risk model to identify patients at high risk. A total of 634 patients were retrospectively analyzed. Clinical characteristics were evaluated via receiver operating characteristic (ROC) curve analysis. Logistic analysis was performed to determine the independent predictive indicators of PGS. A scoring system consisting of these indicators and a risk-rating model were constructed and evaluated via ROC curve analysis. Based on the ROC curves, the visceral fat area (VFA) cutoff value for PGS was 94.00. Logistic analysis showed that visceral obesity (VFA ≥ 94.00 cm 2 ), the reconstruction technique, and tumor size were independent prognostic factors for PGS. The scoring system could predict PGS reliably with a high area under the ROC curve ([AUC] = 0.769). A high-risk rating had a high AUC (AUC I = 0.56, AUC II = 0.65, and AUC III = 0.77), indicating that the risk-rating model could effectively screen patients at high risk of PGS. Visceral obesity defined by VFA effectively predicted PGS. Our scoring system may be a reliable instrument for identifying patients most at risk of PGS. © 2017 Wiley Periodicals, Inc.

  14. Failure of available scoring systems to predict ongoing infection in patients with abdominal sepsis after their initial emergency laparotomy

    NARCIS (Netherlands)

    van Ruler, Oddeke; Kiewiet, Jordy J. S.; Boer, Kimberly R.; Lamme, Bas; Gouma, Dirk J.; Boermeester, Marja A.; Reitsma, Johannes B.

    2011-01-01

    To examine commonly used scoring systems, designed to predict overall outcome in critically ill patients, for their ability to select patients with an abdominal sepsis that have ongoing infection needing relaparotomy. Data from a RCT comparing two surgical strategies was used. The study population

  15. Identification of the optimal donor quality scoring system and measure of early renal function in kidney transplantation.

    LENUS (Irish Health Repository)

    Moore, Jason

    2009-02-27

    The early identification of kidney allografts at risk of later dysfunction has implications for clinical practice. Donor quality scoring systems (preoperative) and measures of early allograft function (first week postoperative) have previously shown practical utility. This study aimed to determine the optimal parameter(s) (preoperative and postoperative) with greatest predictive power for the development of subsequent allograft dysfunction.

  16. Application of different prognostic scoring systems and comparison of the FAB and WHO classifications in Korean patients with myelodysplastic syndrome.

    Science.gov (United States)

    Lee, J-H; Lee, J-H; Shin, Y-R; Lee, J-S; Kim, W-K; Chi, H-S; Park, C-J; Seo, E-J; Lee, K-H

    2003-02-01

    We retrospectively studied 227 patients with MDS (1) to identify the prognostic factors of survival and acute leukemia evolution in Korean patients with MDS, (2) to apply different prognostic scoring systems to the same group of patients, and (3) to compare the FAB with the WHO classification. Six scoring systems were applied to the patients, and the FAB and WHO classifications were compared. The patients' median age was 57 years. The median survival time was 21 months, and age, dysgranulopoiesis and the IPSS cytogenetic groups were independent prognostic factors for survival. Acute leukemia occurred in 34 patients, and the cumulative incidence was 27.1% at 3 years. Marrow blast percentage was the only independent prognostic factor for acute leukemia evolution. Most scoring systems successfully discriminated risk groups for survival and acute leukemia evolution, but patient distribution into risk groups varied according to the scoring systems. Refractory cytopenia with multilineage dysplasia and RAEB II seemed to have different prognoses from RA or RARS and RAEB I, respectively. In summary, our MDS patients had different disease natures from those of Western countries regarding clinical features, prognostic factors and cytogenetic profiles. Although the WHO classification seems to improve the FAB classification, further studies are warranted to validate the utility of the WHO classification before it is accepted for routine clinical use. Our study has the limitations of retrospective analysis, and our results should be verified in future prospective studies.

  17. A systematic comparison of clinically viable nanomedicines targeting HMG-CoA reductase in inflammatory atherosclerosis

    NARCIS (Netherlands)

    Alaarg, Amr; Senders, Max L.; Varela-Moreira, Aida; Pérez-Medina, Carlos; Zhao, Yiming; Tang, Jun; Fay, Francois; Reiner, Thomas; Fayad, Zahi A.; Hennink, Wim E.; Metselaar, Josbert M.; Mulder, Willem J.M.; Storm, Gert

    2017-01-01

    Atherosclerosis is a leading cause of worldwide morbidity and mortality whose management could benefit from novel targeted therapeutics. Nanoparticles are emerging as targeted drug delivery systems in chronic inflammatory disorders. To optimally exploit nanomedicines, understanding their biological

  18. Cutting Edge: BAFF Overexpression Reduces Atherosclerosis via TACI-Dependent B Cell Activation.

    Science.gov (United States)

    Jackson, Shaun W; Scharping, Nicole E; Jacobs, Holly M; Wang, Shari; Chait, Alan; Rawlings, David J

    2016-12-15

    Patients with systemic lupus erythematosus exhibit accelerated atherosclerosis, a chronic inflammatory disease of the arterial wall. The impact of B cells in atherosclerosis is controversial, with both protective and pathogenic roles described. For example, natural IgM binding conserved oxidized lipid epitopes protect against atherosclerosis, whereas anti-oxidized low-density lipoprotein (oxLDL) IgG likely promotes disease. Because BAFF promotes B cell class-switch recombination and humoral autoimmunity, we hypothesized that excess BAFF would accelerate atherosclerosis. In contrast, BAFF overexpression markedly reduced hypercholesterolemia and atherosclerosis in hyperlipidemic mice. BAFF-mediated atheroprotection required B cells and was associated with increased protective anti-oxLDL IgM. Surprisingly, high-titer anti-oxLDL IgM production and reduced atherosclerosis was dependent on the BAFF family receptor transmembrane activator and CAML interactor. In summary, we identified a novel role for B cell-specific, BAFF-dependent transmembrane activator and CAML interactor signals in atherosclerosis pathogenesis, of particular relevance to the use of BAFF-targeted therapies in systemic lupus erythematosus. Copyright © 2016 by The American Association of Immunologists, Inc.

  19. Comparison of Two Embryo Scoring Systems for Prediction of Outcome in Assisted Reproductive Techniques Cycles

    Directory of Open Access Journals (Sweden)

    Navid Fotoohi Ghiam

    2011-12-01

    Full Text Available Cumulative embryo score (CES is one of the many embryo scoring methods which have been developed to help clinicians to transfer high quality embryos and predict pregnancy rate in assisted reproductive techniques (ART cycles. Regarding the existing difference in CES calculation this study was done to compare two methods in order to determine the more practical and preferable one. In a retrospective, cross sectional descriptive analytical study, a total of 508 ART cycles in infertile patients treated from November 2002 until March 2004, were evaluated using two methods of CES calculation in embryonic scoring to predict ART outcome. According to one method, CES was obtained by adding the individual scores of all transferred embryos. Whereas in the other reference method, CES was calculated by the sum of each embryo score multiplied by its number of blastomeres on the day of transfer. The mean score of transferred embryos (MSTE was referred to CES divided by the total number of embryos transferred in either method. A total of 109 clinical pregnancies (pregnancy rate 21.5% including 96 singletons, 10 twins and triplets occurred in the 508 ART cycles. The pregnancy rate was strongly correlated to CES & MSTE. According to one method, CES was 12.6±6.4 in pregnant versus 9.2±5.8 in non-pregnant group (P<0.0001. According to the other one, in the pregnant group CES was 86.7±48 versus 68.7±55 in the non-pregnant group (P<0.002. Both methods showed a significant difference. Regarding MSTE, using the first method, in the pregnant group it was 3±0.6 versus 2.8±0.7 in the non-pregnant group (P<0.011 whereas with the other approach it was 21.3±8.6 in the pregnant group versus 19.9±9.07 in non-pregnant (P<0.152 showing that the first method can also predict pregnancy outcome with MSTE. Considering that both MSTE and CES in the first method can significantly predict outcome in ART cycles, it seems this method is preferable and more useful in practice

  20. NT-proBNP levels, atherosclerosis and vascular function in asymptomatic type 2 diabetic patients with microalbuminuria: peripheral reactive hyperaemia index but not NT-proBNP is an independent predictor of coronary atherosclerosis

    DEFF Research Database (Denmark)

    Reinhard, Henrik; Wiinberg, Niels; Hansen, Peter R

    2011-01-01

    for atherosclerosis is unclear. We examined the interrelationship between P-NT-proBNP, presence of atherosclerosis and/or vascular dysfunction in the coronary, carotid and peripheral arteries in asymptomatic type 2 diabetic patients with microalbuminuria that received intensive multifactorial treatment. METHODS...... AND RESULTS: P-NT-proBNP was measured in 200 asymptomatic type 2 patients without known cardiac disease that received intensive multifactorial treatment for CV risk reduction. Patients were examined for coronary, carotid and peripheral atherosclerosis, as defined by coronary calcium score=400, carotid intima...

  1. Testing an OMERACT MRI scoring system for peripheral psoriatic arthritis in cross-sectional and longitudinal settings

    DEFF Research Database (Denmark)

    McQueen, Fiona; Lassere, Marissa; Duer-Jensen, Anne

    2009-01-01

    OBJECTIVE: Magnetic resonance imaging (MRI) is increasingly used to measure articular inflammation and damage in patients with psoriatic arthritis (PsA). We evaluated the reliability of a new OMERACT PsA MRI scoring system, PsAMRIS, in PsA fingers. METHODS: In 2 separate studies, MRI scans were o......, reliability for change scores was acceptable only for synovitis and tenosynovitis. CONCLUSION: Further development and testing of the PsAMRIS is planned to improve its performance as a clinical and research tool to identify and measure pathology in peripheral joint PsA....

  2. Periodontal disease and atherosclerosis

    Directory of Open Access Journals (Sweden)

    Jeferson Freitas Toregeani

    2014-09-01

    Full Text Available Atherosclerotic disease (AD is one of the most important causes of morbidity and mortality in the world. It expresses inflammatory markers such as C-reactive protein (CRP and can provoke arterial wall thickening, which can be evaluated using Doppler ultrasound. Risk factors associated with AD include diabetes mellitus, systemic arterial hypertension, dyslipidemia and smoking. More recently, periodontal disease (PD has been identified as a factor related to AD. Periodontal disease has a high prevalence in the global population and the inflammatory process and bacterial activity at the periodontium appear to increase the risk of AD. Encouraging good oral hygiene can reduce expression of inflammatory markers of AD. A review of literature on PD, AD and inflammatory markers and the interrelationships between the two diseases was conducted using data published in articles indexed on the PUBMED, SCIELO and BIREME databases.

  3. Improved risk stratification by the integration of the revised international prognostic scoring system with the myelodysplastic syndromes comorbidity index.

    Science.gov (United States)

    van Spronsen, M F; Ossenkoppele, G J; Holman, R; van de Loosdrecht, A A

    2014-12-01

    Myelodysplastic syndromes (MDS) comprise bone marrow failure diseases with a diverse clinical outcome. For improved risk stratification, the International Prognostic Scoring System (IPSS) has recently been revised (IPSS-R). This single-centre study aimed to validate the IPSS-R and to evaluate prior prognostic scoring systems for MDS. We retrospectively analysed 363 patients diagnosed with MDS according to the FAB criteria between 2000 and 2012. The IPSS, MD Anderson Risk Model Score (MDAS), World Health Organisation (WHO)-classification based Prognostic Scoring System (WPSS), refined WPSS (WPSS-R), IPSS-R and MDS-Comorbidity Index (MDS-CI) were applied to 222 patients considered with primary MDS following the WHO criteria and their prognostic power was investigated. According to the IPSS-R, 18 (8%), 81 (37%), 50 (23%), 43 (19%) and 30 (13%) patients were classified as very low, low, intermediate, high and very high risk with, respectively, a median overall survival of 96 (95% Confidence interval (CI) not reached), 49 (95% CI 34-64), 22 (95% CI 0-49), 19 (95% CI 11-27) and 10 (95% CI 6-13) months (pMDS-CI refined the risk stratification of MDS patients stratified according to the IPSS-R. In conclusion, accounting for the disease status by means of the IPSS-R and comorbidity through the MDS-CI considerably improves the prognostic assessment in MDS patients. Copyright © 2014 Elsevier Ltd. All rights reserved.

  4. Development of a questionnaire weighted scoring system to target diagnostic examinations for asthma in adults: a modelling study

    Directory of Open Access Journals (Sweden)

    Hazell Michelle L

    2004-12-01

    Full Text Available Abstract Background Identification and treatment of unrecognised asthmatics in the community is important for improving the health of the individual and minimising cost and quality of life burden. It is not practical to offer clinical diagnostic assessment to whole communities, and a simple tool such as a questionnaire is required to identify a smaller target group. Conventional questionnaire screening methods which separate individuals into positive and negative categories have resulted in large numbers of individuals requiring clinical assessment. This study has therefore developed and tested a weighted scoring system that prioritises those most urgently in need, based on their questionnaire responses. Methods A stratified random sample of adult respondents to a general practice postal questionnaire survey were categorised 'asthmatic' or 'non-asthmatic' according to three expert physicians' opinions. Based on this categorisation, logistic regression was used to derive weights reflecting the relative importance of each question in predicting asthma, allowing calculation of weighted scores reflecting likelihood of asthma. Respondents scoring higher than a chosen threshold would be offered diagnostic examination. Results Age and presence of wheeze were most influential (weight 3 and overall weighted scores ranged from -1 to 13. Positive predictive values (PPV were estimated. For example, setting the threshold score at nine gave an estimated PPV for asthma diagnosis of 93.5%, a threshold score of seven corresponded to PPV 78.8%. PPV estimates were supported by examining 145 individuals from a new survey. Conclusion Weighted scoring of questionnaire responses provides a method for evaluating the priority level of an individual 'at a glance', minimising the resource wastage of examining false positives.

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

    Energy Technology Data Exchange (ETDEWEB)

    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. Development of a new scoring system to predict 5-year incident diabetes risk in middle-aged and older Chinese.

    Science.gov (United States)

    Han, Xu; Wang, Jing; Li, Yaru; Hu, Hua; Li, Xiulou; Yuan, Jing; Yao, Ping; Miao, Xiaoping; Wei, Sheng; Wang, Youjie; Liang, Yuan; Zhang, Xiaomin; Guo, Huan; Pan, An; Yang, Handong; Wu, Tangchun; He, Meian

    2018-01-01

    The aim of this study was to develop a new risk score system to predict 5-year incident diabetes risk among middle-aged and older Chinese population. This prospective study included 17,690 individuals derived from the Dongfeng-Tongji cohort. Participants were recruited in 2008 and were followed until October 2013. Incident diabetes was defined as self-reported clinician diagnosed diabetes, fasting glucose ≥7.0 mmol/l, or the use of insulin or oral hypoglycemic agent. A total of 1390 incident diabetic cases were diagnosed during the follow-up period. β-Coefficients were derived from Cox proportional hazard regression model and were used to calculate the risk score. The diabetes risk score includes BMI, fasting glucose, hypertension, hyperlipidemia, current smoking status, and family history of diabetes. The β-coefficients of these variables ranged from 0.139 to 1.914, and the optimal cutoff value was 1.5. The diabetes risk score was calculated by multiplying the β-coefficients of the significant variables by 10 and rounding to the nearest integer. The score ranges from 0 to 36. The area under the receiver operating curve of the score was 0.751. At the optimal cutoff value of 15, the sensitivity and specificity were 65.6 and 72.9%, respectively. Based upon these risk factors, this model had the highest discrimination compared with several commonly used diabetes prediction models. The newly established diabetes risk score with six parameters appears to be a reliable screening tool to predict 5-year risk of incident diabetes in a middle-aged and older Chinese population.

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

    International Nuclear Information System (INIS)

    Inci, Ercan; Hocaoglu, Elif; Aydin, Sibel; Palabiyik, Figen; Cimilli, Tan; Turhan, Ahmet Nuray; Ayguen, Ersan

    2011-01-01

    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.

  8. Who to handover: a case-control study of a novel scoring system to prioritise handover of internal medicine inpatients.

    Science.gov (United States)

    Bittman, Jesse; Tam, Penny; Little, Chris; Khan, Nadia

    2017-06-01

    Handover of patients between care providers is a critical event in patient care. There is, however, little evidence to guide the handover process, including determining which patients to handover. Compare the ability of gestalt-based handover with two structured scores, the modified early warning score (MEWS) and our novel iHAND clinical decision support system, to predict which patients will be assessed by a physician overnight. This case-control study included 90 inpatients, comprising 32 patients assessed overnight (cases) and 58 patients not assessed overnight (controls) at a teaching hospital in British Columbia, Canada (May 2012). Gestalt, MEWS and iHAND scores were analysed against patients seen overnight using logistic regression and receiver-operating characteristic (ROC) curves. Neither current gestalt-based handover practice (odds ratio (OR) 1.50, 95% CI 0.89 to 3.83) nor MEWS (OR 0.96, 95% CI 0.75 to 1.24, area under the ROC curve (AUC) 0.61, 95% CI 0.49 to 0.73) were significantly associated with need to be seen overnight. The iHAND score was associated with need to be seen (OR 1.93, 95% CI 1.24 to 3.02, AUC 0.70, 95% CI 0.60 to 0.81). The iHAND score had moderate ability to predict which patients required assessment overnight, while MEWS score and current gestalt approach correlated poorly, suggesting the iHAND score may help prioritisation of patients likely to be seen overnight for handover. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  9. The Generic Impact Scoring System (GISS): a standardized tool to quantify the impacts of alien species

    Czech Academy of Sciences Publication Activity Database

    Nentwig, W.; Bacher, S.; Pyšek, Petr; Vila, M.; Kumschick, S.

    2016-01-01

    Roč. 188, č. 5 (2016), s. 1-13, č. článku 315. ISSN 0167-6369 R&D Projects: GA ČR GB14-36079G Grant - others:AV ČR(CZ) AP1002 Program:Akademická prémie - Praemium Academiae Institutional support: RVO:67985939 Keywords : scoring * impact * biological invasions Subject RIV: EH - Ecology, Behaviour Impact factor: 1.687, year: 2016

  10. Imperfect implementation of an early warning scoring system in a Danish teaching hospital

    DEFF Research Database (Denmark)

    Niegsch, Mark; Fabritius, Maria Louise; Anhøj, Jacob

    2013-01-01

    In 2007, the initiation of a patient safety campaign led to the introduction of Ward Observational Charts (WOC) and Medical Early Warning Score (MEWS) at Naestved Regional Hospital. This included systematic measuring of vital signs of all patients in order to prevent patient deterioration and ass...... and assure timely and correct initiation of treatment. The aim of this study was to assess to what degree WOC guidelines being followed by ward staff....

  11. Are simple noninvasive scoring systems for fibrosis reliable in patients with NAFLD and normal ALT levels?

    Science.gov (United States)

    McPherson, Stuart; Anstee, Quentin M; Henderson, Elsbeth; Day, Christopher P; Burt, Alastair D

    2013-06-01

    Nonalcoholic fatty liver disease (NAFLD) is common and many affected individuals have normal-range alanine aminotransferase (ALT) levels. There is a need for a robust screening tool to triage individuals with advanced fibrosis for specialist care. The aim of this study was to assess the performance of noninvasive fibrosis tests in patients with biopsy-proven NAFLD and normal levels of ALT. Patients presenting at a fatty liver clinic between 1999 and 2009 were included in the study. Liver biopsies were assessed using the Kleiner score. The aspartate aminotransferase (AST)/ALT ratio, BARD, FIB-4 and NAFLD fibrosis scores were calculated. A total of 305 patients were included [70 with normal ALT levels (women: ALT≤30 IU/l, men: ALT≤45 IU/l) and 235 with elevated levels]. In total, 24% of patients with normal ALT levels and 17% of those with elevated ALT levels had advanced fibrosis (Kleiner stage 3-4). The FIB-4 performed best in identifying advanced fibrosis in patients with normal ALT (area under receiver operating characteristic curve=0.86, 82% sensitivity, 77% specificity and 92% negative predictive value). The sensitivity of the AST/ALT ratio and BARD and NAFLD fibrosis scores for advanced fibrosis was good in patients with normal ALT levels (94, 94 and 82%, respectively), but the specificity was low (44, 26 and 51%, respectively). The FIB-4 yielded best results in patients with elevated ALT levels. Using the FIB-4, 61% of patients with normal ALT levels and 63% of those with elevated ALT levels could avoid liver biopsy to exclude advanced fibrosis. In contrast, AST/ALT ratio and BARD and NAFLD scores would have led to a high proportion of patients with mild disease having to undergo a biopsy. The FIB-4 yielded good results in patients with normal or elevated ALT levels, reliably excluding advanced fibrosis and reducing the need for liver biopsy.

  12. Analysis of Surgical Site Infection after Musculoskeletal Tumor Surgery: Risk Assessment Using a New Scoring System

    Directory of Open Access Journals (Sweden)

    Satoshi Nagano

    2014-01-01

    Full Text Available Surgical site infection (SSI has not been extensively studied in musculoskeletal tumors (MST owing to the rarity of the disease. We analyzed incidence and risk factors of SSI in MST. SSI incidence was evaluated in consecutive 457 MST cases (benign, 310 cases and malignant, 147 cases treated at our institution. A detailed analysis of the clinical background of the patients, pre- and postoperative hematological data, and other factors that might be associated with SSI incidence was performed for malignant MST cases. SSI occurred in 0.32% and 12.2% of benign and malignant MST cases, respectively. The duration of the surgery (P=0.0002 and intraoperative blood loss (P=0.0005 was significantly more in the SSI group than in the non-SSI group. We established the musculoskeletal oncological surgery invasiveness (MOSI index by combining 4 risk factors (blood loss, operation duration, preoperative chemotherapy, and the use of artificial materials. The MOSI index (0–4 points score significantly correlated with the risk of SSI, as demonstrated by an SSI incidence of 38.5% in the group with a high score (3-4 points. The MOSI index score and laboratory data at 1 week after surgery could facilitate risk evaluation and prompt diagnosis of SSI.

  13. [Does the GHQ-12 scoring system affect its factor structure? An exploratory study of Ibero American students].

    Science.gov (United States)

    Urzúa, Alfonso; Caqueo-Urízar, Alejandra; Bargsted, Mariana; Irarrázaval, Matías

    2015-06-01

    This study aimed to evaluate whether the scoring system of the General Health Questionnaire (GHQ-12) alters the instrument's factor structure. The method considered 1,972 university students from nine Ibero American countries. Modeling was performed with structural equations for 1, 2, and 3 latent factors. The mechanism for scoring the questions was analyzed within each type of structure. The results indicate that models with 2 and 3 factors show better goodness-of-fit. In relation to scoring mechanisms, procedure 0-1-1-1 for models with 2 and 3 factors showed the best fit. In conclusion, there appears to be a relationship between the response format and the number of factors identified in the instrument's structure. The model with the best fit was 3-factor 0-1-1-1-formatted, but 0-1-2-3 has acceptable and more stable indicators and provides a better format for two- and three-dimensional models.

  14. Bender-Gradual Scoring System (B-SPG: Analysis of the maturation of visual-motor perception of children

    Directory of Open Access Journals (Sweden)

    Lariana Paula Pinto

    2013-12-01

    Full Text Available This study aimed to investigate the maturational aspect of visual motor perception ability, assessed by Bender - Gradual Scoring System (B-SPG in relation to age and educational level. Analyses of variance were made between the total score and the punctuation received on each reproduction of the figures, being compared according to age and educational level. Participants were 361 students, of both genders, between 6 and 10 years, from 1st to 5th years of primary education from public and private schools. The total scores obtained in the test differed significantly in relation to age and educational level. Confirming the proposal of instrument, it became clear that the B-GSP proved to be sensitive to capture the maturational aspect of visual motor perception ability.

  15. A new Leukemia Prognostic Scoring System for refractory/relapsed adult acute myelogeneous leukaemia patients: a GOELAMS study.

    Science.gov (United States)

    Chevallier, P; Labopin, M; Turlure, P; Prebet, T; Pigneux, A; Hunault, M; Filanovsky, K; Cornillet-Lefebvre, P; Luquet, I; Lode, L; Richebourg, S; Blanchet, O; Gachard, N; Vey, N; Ifrah, N; Milpied, N; Harousseau, J-L; Bene, M-C; Mohty, M; Delaunay, J

    2011-06-01

    A simplified prognostic score is presented based on the multivariate analysis of 138 refractory/relapsed acute myeloid leukaemia (AML) patients (median age 55 years, range: 19-70) receiving a combination of intensive chemotherapy+Gemtuzumab as salvage regimen. Overall, 2-year event-free survival (EFS) and overall survival (OS) were 29±4% and 36±4%, respectively. Disease status (relapse Leukemia Prognostic Scoring System was then validated on an independent cohort of 111 refractory/relapsed AML patients. This new simplified prognostic score, using three clinical and biological parameters routinely applied, allow to discriminate around two third of the patients who should benefit from a salvage intensive regimen in the setting of refractory/relapsed AML patients. The other one third of the patients should receive investigational therapy.

  16. Optimization of a Scoring System to Predict Microscopic Colitis in a Cohort of Patients With Chronic Diarrhea.

    Science.gov (United States)

    Cotter, Thomas G; Binder, Moritz; Harper, Eugene P; Smyrk, Thomas C; Pardi, Darrell S

    2017-03-01

    Our aim was to develop a scoring system to predict risk of microscopic colitis (MC), to identify patients at low risk, potentially avoiding unnecessary biopsies. Patients with chronic diarrhea often undergo colonoscopy with biopsy, but few have histologic abnormalities. We conducted a retrospective study of patients with chronic diarrhea and a macroscopically normal colonoscopy at our institution over a 9-month period. Multivariable logistic regression assessed the association between predictors and the presence of biopsy-proven MC. The derivation cohort included 617 patients. Median age was 55.1 (39.6 to 68.1) years; 397 (64.3%) were female and 81 (13.1%) had MC. Age ≥55 years, duration of diarrhea ≤6 months, ≥5 bowel movements per day, body mass index <30 kg/m, current smoking, and current use of selective serotonin reuptake inhibitors/serotonin-norepinephrine reuptake inhibitorss an