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Does A Diagnostic Algorithm Reduce The Overuse Of Chest Ct Angiography In Suspected Pulmonary Embolism? : A Pre- And Post-Intervention Retrospective Study In A Critical Access Hospital, Rattanaporn Mahatanan, Brianna Philbrick, William J. Hirschfeld, Gina Gomez 2020 Redington Fairview General Hospital

Does A Diagnostic Algorithm Reduce The Overuse Of Chest Ct Angiography In Suspected Pulmonary Embolism? : A Pre- And Post-Intervention Retrospective Study In A Critical Access Hospital, Rattanaporn Mahatanan, Brianna Philbrick, William J. Hirschfeld, Gina Gomez

Journal of Maine Medical Center

Background: Pulmonary embolism (PE) is a common and potentially fatal disease. Although CTA is a gold standard for diagnosis, it carries risks for patients. We sought to minimize the overutilization of chest CTA by implementing a diagnostic algorithm in the hospital to evaluate the likelihood of PE and determine the need for imaging with CTA.

Methods: A retrospective medical chart review was performed for all patients suspicious of PE at Redington-Fairview General Hospital 3 months before and after diagnostic algorithm implementation. Patients who underwent either D-dimer testing or chest CTA were included. Patients were excluded if d-dimer testing was performed ...


Frequency Of Monocyte Subsets Is Linked To The Severity Of Atherosclerosis In Patients With Ischemic Heart Disease: A Case-Control Study, Irina V. Kologrivova, Tatiana Suslova, Olga Koshelskaya, Oksana Trubacheva, Olga Haritonova, Irina Vinnitskaya 2020 Cardiology Research Institute, Tomsk National Research Medical Centre, Russian Academy of Sciences

Frequency Of Monocyte Subsets Is Linked To The Severity Of Atherosclerosis In Patients With Ischemic Heart Disease: A Case-Control Study, Irina V. Kologrivova, Tatiana Suslova, Olga Koshelskaya, Oksana Trubacheva, Olga Haritonova, Irina Vinnitskaya

BioMedicine

Background: Monocytes are recognized as central cells in the progression of atherosclerosis, and are subcategorized into classical (CD14++CD16lo), intermediate (CD14++CD16hi) and non-classical (CD14+CD16hi) subsets.

Purpose: The present study aimed to assess the relationships between different subsets of monocytes, metabolic and inflammatory factors in patients with stable coronary heart disease.

Methods: A total of 26 patients (both men and women) with stable ischemic heart disease (IHD). Among all the recruited patients, 17 patients had significant coronary artery disease defined as diameter stenosis more than 70%. Severity of CHD was assessed by the Gensini score (GS ...


Bedside Point Of Care Ultrasound Diagnosing Bilateral Valve Involvement In Infective Endocarditis, Corey Cole DO, Alfredo Tirado MD, Jonathan Schwadron DO 2020 HCA Healthcare

Bedside Point Of Care Ultrasound Diagnosing Bilateral Valve Involvement In Infective Endocarditis, Corey Cole Do, Alfredo Tirado Md, Jonathan Schwadron Do

West Florida Division Virtual Research Day

Endocarditis is a well known complication of intravenous drug abuse which classically affects the tricuspid valve. It is usually diagnosed by formal echocardiogram and positive blood cultures. Vegetations involving both the mitral and tricuspid valves are rare, occurring in less than 5% of all cases of infective endocarditis. 1 Here we report a case of a patient with vegetations on both valves which was discovered by point of care ultrasound.


Assisting Children With Velocardiofacial Syndrome Who Have Developmental Disabilities And Delays Associated With Speech, Communication, And Education, McKenzie K. Holty 2020 University of South Dakota

Assisting Children With Velocardiofacial Syndrome Who Have Developmental Disabilities And Delays Associated With Speech, Communication, And Education, Mckenzie K. Holty

Honors Thesis

Children with velocardiofacial syndrome (VCFS) have a variety of complex needs. Research shows that VCFS is characterized by a combination of medical problems, developmental delays, and learning disabilities, which vary from child to child. This syndrome also puts adolescents at a higher risk for developing psychiatric and psychotic disorders. The complexity of symptoms that can arise from VCFS can influence the ability of these children to communicate, socialize, and learn effectively. This literature review aims to discuss literature for caregivers, educators, and physicians to aid children effectively and understand their challenges relating to speech, communication, and education. This topic is ...


Audiologic Clinical Practice Patterns: Infant Assessment, Ursula M. Findlen, Nicole D. Schuller 2020 Nationwide Children's Hospital

Audiologic Clinical Practice Patterns: Infant Assessment, Ursula M. Findlen, Nicole D. Schuller

Journal of Early Hearing Detection and Intervention

The purpose of the present study was to report the current clinical practice patterns for assessment of infants after a referred newborn hearing screening within the context of available guidelines and to examine how the advent of newer stimuli, technology, and/or instrumentation has changed clinical practice patterns for audiologic infant assessment. A mixed-method survey that included both quantitative and qualitative questions was disseminated to pediatric audiologists in 2017. Quantitative data were analyzed via descriptive statistics while qualitative questions were analyzed via content analysis and combined with associated quantitative data. Lastly, infant assessment test battery categorization was completed to ascertain ...


Clinical Validation And Diagnostic Rate/Outcomes Of A Dual Molecular Diagnostic Assay For Myotonic Dystrophy 1., Maxime Cadieux-Dion, Isabelle Thiffault, Midhat S. Farooqi, Joseph Alaimo 2020 Children's Mercy Hospital

Clinical Validation And Diagnostic Rate/Outcomes Of A Dual Molecular Diagnostic Assay For Myotonic Dystrophy 1., Maxime Cadieux-Dion, Isabelle Thiffault, Midhat S. Farooqi, Joseph Alaimo

Research Days

No abstract provided.


Implementation Of A Computer-Vision System As A Supportive Diagnostic Tool For Parkinson’S Disease, Diego Machado Reyes 2020 University of Mississippi

Implementation Of A Computer-Vision System As A Supportive Diagnostic Tool For Parkinson’S Disease, Diego Machado Reyes

Honors Theses

Parkinson’s disease is the second most common neurodegenerative disorder, affecting nearly 1 million people in the US and it is predicted that the number will keep increasing. Parkinson’s disease is difficult to diagnose due to its similarity with other diseases that share the parkinsonian symptoms and the subjectivity of its assessment, thus increasing the probabilities of misdiagnosis. Therefore, it is relevant to develop diagnostic tools that are quantitatively based and monitoring tools to improve the patient’s quality of life. Computer-based assessment systems have shown to be successful in this field through diverse approaches that can be classified ...


Light Forge: A Microfluidic Dna Melting-Based Tuberculosis Test, Ian M. Mbano, Tawanda Mandizvo, Jerome Rogich, Tafara T. R. Kunota, Jared S. Mackenzie, Manormoney Pillay, Frederick K. Balagadde 2020 University of KwaZulu Natal

Light Forge: A Microfluidic Dna Melting-Based Tuberculosis Test, Ian M. Mbano, Tawanda Mandizvo, Jerome Rogich, Tafara T. R. Kunota, Jared S. Mackenzie, Manormoney Pillay, Frederick K. Balagadde

Open Access Articles

BACKGROUND: There is a well-documented lack of rapid, low-cost tuberculosis (TB) drug resistance diagnostics in low-income settings across the globe. It is these areas that are plagued with a disproportionately high disease burden and in greatest need of these diagnostics.

METHODS: In this study, we compared the performance of Light Forge, a microfluidic high-resolution melting analysis (HRMA) prototype for rapid low-cost detection of TB drug resistance with a commercial HRMA device, a predictive "nearest-neighbor" thermodynamic model, DNA sequencing, and phenotypic drug susceptibility testing (DST). The initial development and assessment of the Light Forge assay was performed with 7 phenotypically drug ...


Multimodal Photoplethysmography-Based Approaches For Improved Detection Of Hypertension, Kaylie Welykholowa, Richard Fletcher, Mohamed Elgendi 2020 University of British Columbia

Multimodal Photoplethysmography-Based Approaches For Improved Detection Of Hypertension, Kaylie Welykholowa, Richard Fletcher, Mohamed Elgendi

Open Access Articles

Elevated blood pressure (BP) is a major cause of death, yet hypertension commonly goes undetected. Owing to its nature, it is typically asymptomatic until later in its progression when the vessel or organ structure has already been compromised. Therefore, noninvasive and continuous BP measurement methods are needed to ensure appropriate diagnosis and early management before hypertension leads to irreversible complications. Photoplethysmography (PPG) is a noninvasive technology with waveform morphologies similar to that of arterial BP waveforms, therefore attracting interest regarding its usability in BP estimation. In recent years, wearable devices incorporating PPG sensors have been proposed to improve the early ...


Interpretation Of The Epigenetic Signature Of Facioscapulohumeral Muscular Dystrophy In Light Of Genotype-Phenotype Studies, Ana Nikolic, Louise Maranda, Rossella Ginevra Tupler 2020 University of Modena and Reggio Emilia

Interpretation Of The Epigenetic Signature Of Facioscapulohumeral Muscular Dystrophy In Light Of Genotype-Phenotype Studies, Ana Nikolic, Louise Maranda, Rossella Ginevra Tupler

Open Access Articles

Facioscapulohumeral muscular dystrophy (FSHD) is characterized by incomplete penetrance and intra-familial clinical variability. The disease has been associated with the genetic and epigenetic features of the D4Z4 repetitive elements at 4q35. Recently, D4Z4 hypomethylation has been proposed as a reliable marker in the FSHD diagnosis. We exploited the Italian Registry for FSHD, in which FSHD families are classified using the Clinical Comprehensive Evaluation Form (CCEF). A total of 122 index cases showing a classical FSHD phenotype (CCEF, category A) and 110 relatives were selected to test with the receiver operating characteristic (ROC) curve, the diagnostic and predictive value of D4Z4 ...


Hoarding: Beyond The Mess, A Training For Mental Health Professionals, Kelsi McClaflin 2020 Minnesota State University Moorhead

Hoarding: Beyond The Mess, A Training For Mental Health Professionals, Kelsi Mcclaflin

Dissertations, Theses, and Projects

This literature review examines hoarding disorder with a close lens. This is a diagnosis that is new to licensed professionals across the helping professions. This training will allow participants to better understand what it means to be diagnosed with hoarding disorder, assessments that aid in detecting severity, best practices that are continually emerging, and the impact it can have on clients, their loved ones, and the community. This training takes a collaborative approach as an integrated way of treatment for all individuals involved in the process.

Keywords: hoarding, behaviors, treatment


Diagnostic Category Prevalence In 3 Classification Systems Across The Transition To The International Classification Of Diseases, Tenth Revision, Clinical Modification, Randall P. Ellis, Heather E. Hsu, Chenlu Song, Tzu-Chun Kuo, Bruno Martins, Jeffrey J. Siracuse, Ying Liu, Arlene S. Ash 2020 Boston University

Diagnostic Category Prevalence In 3 Classification Systems Across The Transition To The International Classification Of Diseases, Tenth Revision, Clinical Modification, Randall P. Ellis, Heather E. Hsu, Chenlu Song, Tzu-Chun Kuo, Bruno Martins, Jeffrey J. Siracuse, Ying Liu, Arlene S. Ash

Open Access Articles

Importance: On October 1, 2015, the US transitioned to the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) for recording diagnoses, symptoms, and procedures. It is unknown whether this transition was associated with changes in diagnostic category prevalence based on diagnosis classification systems commonly used for payment and quality reporting.

Objective: To assess changes in diagnostic category prevalence associated with the ICD-10-CM transition.

Design, Setting, and Participants: This interrupted time series analysis and cross-sectional study examined level and trend changes in diagnostic category prevalence associated with the ICD-10-CM transition and clinically reviewed a subset of diagnostic categories with changes ...


Us Guided Management Of Undifferentiated Dyspneic Patient In The Ed, Kaleigh Miller 2020 University of Tennessee Health Science Center

Us Guided Management Of Undifferentiated Dyspneic Patient In The Ed, Kaleigh Miller

Longitudinal Scholar's Project

Intro: Undifferentiated dyspnea can be a complicated presentation muddled by patient comorbidities and similar symptomology shared among etiologies. Some studies have shown increased mortality and length of stay in the hospital when incorrectly initially diagnosed in the ED. US has been shown more effective at differentiating these causes and improves diagnostic accuracy. This study will implement US exam upon initial exam of patient and chart time to diagnosis/treatment, length of stay in ED, length of stay in hospital admissions versus discharge rates, and 30 day mortality. ADHF and COPD/asthma patient differentiation will be the focus. Methods: Prospective cohort ...


Don’T Call Me In The Morning: Why It Might Be Best To See Patients In-Person, A Case Report, Johnny Jarnagin, Jennifer Baima, Mathew J. Most, David A. Mazin 2020 University of Massachusetts Medical School

Don’T Call Me In The Morning: Why It Might Be Best To See Patients In-Person, A Case Report, Johnny Jarnagin, Jennifer Baima, Mathew J. Most, David A. Mazin

Orthopedics and Physical Rehabilitation Publications

Case Diagnosis: Post-irradiation Sarcoma

Case Description: A 58-year-old woman with a history of stage IIIB squamous cell carcinoma of the cervix who was treated with chemoradiation, considered in remission 5 years prior on PET CT, and was under every 6-months surveillance for recurrence by gynecology. She presented to the Emergency Department for severe back pain, left sided sciatica, and paresthesias. In the absence of fracture or cord compression, she was discharged with recommendations for primary care follow-up. This took place over the telephone with referral to the spine center. One week later, her pain progressed to 10+/10 with dense ...


A Quality Intervention To Reduce Telemetry, Alina Polonsky MD, Abdullah Alcharif MD, Andrew Maiolo MD 2020 HCA Healthcare

A Quality Intervention To Reduce Telemetry, Alina Polonsky Md, Abdullah Alcharif Md, Andrew Maiolo Md

Internal Medicine

No abstract provided.


A Comparison Of Models For Evaluation And Transfer Of Patients With Suspected Large Vessel Occlusions, Edward Jauch, Parita Bhuva, Alex Schneider, Jason Thurman, Josh Lewis, Kathryn McCarthy, Debra Philpot, Robin Jones, Albert Yoo, Don Frei 2020 HCA Healthcare

A Comparison Of Models For Evaluation And Transfer Of Patients With Suspected Large Vessel Occlusions, Edward Jauch, Parita Bhuva, Alex Schneider, Jason Thurman, Josh Lewis, Kathryn Mccarthy, Debra Philpot, Robin Jones, Albert Yoo, Don Frei

Neurology

Introduction: Mechanisms for the hospital identification of patients with suspected large vessel occlusions (LVO) vary widely based on referring and receiving stroke center resources. We compared processes for identifying patients with suspected LVO who may be candidates for endovascular therapy (EVT) at non-EVT hospitals and the criteria for interfacility transport to Comprehensive Stroke Centers (CSC) for potential EVT. Methods: Data were obtained from 4 CSC which serve distinct geographic regions, ranging from rural to urban environments, over a continuous 12 month period of time beginning year 2018. Patients transferred from all referring hospitals to these facilities were considered regardless of ...


Optimal Multi-Stage Arrhythmia Classification Approach, Jianwei Zhang, Huimin Chu, Daniele Struppa, Jianming Zhang, Sir Magdi Yacoub, Hesham el-Askary, Anthony Chang, Louis Ehwerhemuepha, Islam Abudayyeh, Alexander Barrett, Guohua Fu, Hai Yao, Dongbo Li, Hangyuan Guo, Cyril Rakovski 2020 Chapman University

Optimal Multi-Stage Arrhythmia Classification Approach, Jianwei Zhang, Huimin Chu, Daniele Struppa, Jianming Zhang, Sir Magdi Yacoub, Hesham El-Askary, Anthony Chang, Louis Ehwerhemuepha, Islam Abudayyeh, Alexander Barrett, Guohua Fu, Hai Yao, Dongbo Li, Hangyuan Guo, Cyril Rakovski

Mathematics, Physics, and Computer Science Faculty Articles and Research

Arrhythmia constitutes a problem with the rate or rhythm of the heartbeat, and an early diagnosis is essential for the timely inception of successful treatment. We have jointly optimized the entire multi-stage arrhythmia classification scheme based on 12-lead surface ECGs that attains the accuracy performance level of professional cardiologists. The new approach is comprised of a three-step noise reduction stage, a novel feature extraction method and an optimal classification model with finely tuned hyperparameters. We carried out an exhaustive study comparing thousands of competing classification algorithms that were trained on our proprietary, large and expertly labeled dataset consisting of 12-lead ...


A 12-Lead Electrocardiogram Database For Arrhythmia Research Covering More Than 10,000 Patients, Jianwei Zhang, Jianming Zhang, Sidy Daniako, Hai Yao, Hangyuan Guo, Cyril Rakovski 2020 Chapman University

A 12-Lead Electrocardiogram Database For Arrhythmia Research Covering More Than 10,000 Patients, Jianwei Zhang, Jianming Zhang, Sidy Daniako, Hai Yao, Hangyuan Guo, Cyril Rakovski

Mathematics, Physics, and Computer Science Faculty Articles and Research

This newly inaugurated research database for 12-lead electrocardiogram signals was created under the auspices of Chapman University and Shaoxing People’s Hospital (Shaoxing Hospital Zhejiang University School of Medicine) and aims to enable the scientific community in conducting new studies on arrhythmia and other cardiovascular conditions. Certain types of arrhythmias, such as atrial fibrillation, have a pronounced negative impact on public health, quality of life, and medical expenditures. As a non-invasive test, long term ECG monitoring is a major and vital diagnostic tool for detecting these conditions. This practice, however, generates large amounts of data, the analysis of which requires ...


A Rare Case Of Perforated Jejunal Diverticulitis, Mohamed Nagi MD, Stanley DeTurris MD, Ang Darwin 2020 HCA Healthcare

A Rare Case Of Perforated Jejunal Diverticulitis, Mohamed Nagi Md, Stanley Deturris Md, Ang Darwin

General Surgery

Introduction: Jejunal diverticulosis is a rare condition with clinical incidence of 0.5%. It is less common than colonic and duodenum diverticulosis. It is usually asymptomatic and diagnosed incidentally but it may cause chronic symptoms and acute complications. The aim of the case report to increase the awareness about the disease Case Report: This is a 56-year-old Caucasian male who presented with abdominal pain and fever and was diagnosed with transverse colon diverticulitis with microperforation on CT scan. Patient was treated nonoperatively with antibiotics and was discharged home. Two months later, he presented with similar recurrent abdominal pain and was ...


A Case Report Of Recurrent Spontaneous Coronary Artery Dissection And Takotsubo Cardiomyopathy: A Treatment Dilemma, Hafiz U. Ghafoor, Abhishek Bose, Amr El-Meligy, Joseph Hannan 2020 University of Massachusetts Medical School

A Case Report Of Recurrent Spontaneous Coronary Artery Dissection And Takotsubo Cardiomyopathy: A Treatment Dilemma, Hafiz U. Ghafoor, Abhishek Bose, Amr El-Meligy, Joseph Hannan

Open Access Articles

Background: Spontaneous coronary artery dissection (SCAD) is an uncommon cause of acute coronary syndrome in younger females with no pre-existing history of coronary artery disease. Recurrent SCAD is common after a first episode and can involve the same coronary artery or present as a new dissection unrelated to the initial lesion. Current recommendations advise for a conservative approach in the absence of haemodynamic compromise and flow limitations. Conversely, there are no clear guidelines for the management of early recurrent SCAD.

Case summary: A 52-year-old woman with history of obesity, asthma, and prediabetes presented with chest pain and electrocardiogram (ECG) showing ...


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