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Headfirst slide into cooperstown on a bad bet youtube Improvements in public health surveillance in child care settings will depend on acceptability to providers. Hochman, Ira. Kuhn, Matthias. But a month later, it had grown larger, and she realized she should get it checked. Ninety-eight patients were recruited and divided into hemorrhage and non-hemorrhage groups. The model identified the areas with higher risk for AIV introduction from MW, aiming at selecting poultry premises for the application of risk-based surveillance.
In play betting football predictions BRAND 98 Harler, Alan. Efforts to expand PA-related surveillancepolicy, and research in lower income countries are needed. Geringas, David. We evaluated 64 patients with chronic pain taking opioids undergoing nononcologic surgery. Guida, Guido Maria. Ryan M.

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Heller, Alfred. Hellmann, Diethard. Helmut Froschauer. Hemberg, Eskil. Henneberg, Albert. Henneberger, Jurg. Hennig, Heinz. Henry Brant. Henschen, Jurgen. Herbert Kegel. Herbig, Gunther. Hermann, Alexander. Hermus, Antony. Herreweghe, Philippe. Herrmann, Bernard. Herrmann, Timo Jouko. Hertz, Alfred. Heyghen, Peter van. Each parameter was assigned a score of 1 best to 4 worst , generating a total score of Five physicians with burns training scored representative photographs using the original and modified scales.

Reliability was analyzed using coefficient of agreement, Cronbach alpha, intraclass correlation coefficient, variance, and coefficient of variance. Analysis of variance was performed using the Kruskal-Wallis test. Color mismatch and scar height scores were validated by analyzing actual height and color differences. The intraclass correlation coefficient, the coefficient of agreement, and Cronbach alpha were higher for the modified scale than those of the original scale.

The original scale produced more variance than that in the modified scale. Subanalysis demonstrated that, for all categories, the modified scale had greater correlation and reliability than the original scale. The correlation between color mismatch scores and actual color differences was 0.

The modified scar scale is a simple, reliable, and useful scale for evaluating photographs of burn patients. Gait Profile Score in multiple sclerosis patients with low disability. Gait abnormalities are subtle in multiple sclerosis MS patients with low disability and need to be better determined.

As a biomechanical approach, the Gait Profile Score GPS is used to assess gait quality by combining nine gait kinematic variables in one single value. This study aims i to establish if the GPS can detect gait impairments and ii to compare GPS with discrete spatiotemporal and kinematic parameters in low-disabled MS patients. No significant difference in GPS values and in spatiotemporal parameters was found between patients and controls.

However patients showed a significant alteration at the ankle and pelvis level. GPS fails to identify gait abnormalities in low-disabled MS patients , although kinematic analysis revealed subtle gait alterations. Future studies should investigate other methods to assess gait impairments with a gait score in low-disabled MS patients.

The purpose of this study is to evaluate the association of MASCC score Multinational Association for Supportive Care in Cancer Score in patients with febrile neutropenia as resultant treatment of hematological disorders for risk assessment of morbidity and mortality. Patients presenting with Febrile Neutropenia from November till December were enrolled in the study.

Initially all patients were hospitalized and their MASCC score was calculated, however those with high risk stayed in hospital till full ANC recovery while low risk group was discharged earlier and keenly followed as out- patient while being on prophylactic oral antibiotics. There was no mortality documented in low risk group while eight patients died in high risk group. The MASCC risk score is a valuable tool in determining the outcome in patients with febrile neutropenia.

Kawai, Vivian K. Risk scores and standard risk prediction models used in the general population do not adequately identify many RA patients with elevated cardiovascular risk. Challenging patient safety culture: survey results. The purpose of this paper is to measure patient safety culture in five Belgian general hospitals. Safety culture plays an important role in the approach towards greater patient safety in hospitals. The Patient Safety Culture Hospital questionnaire was distributed hospital-wide in five general hospitals.

It evaluates ten patient safety culture dimensions and two outcomes. The scores were expressed as the percentage of positive answers towards patient safety for each dimension. The survey was conducted from March through November The dimensional positive scores were found to be low to average in all the hospitals.

The lowest scores were "hospital management support for patient safety" 35 per cent , "non-punitive response to error" 36 per cent , "hospital transfers and transitions" 36 per cent , "staffing" 38 per cent , and "teamwork across hospital units" 40 per cent.

The dimension "teamwork within hospital units" generated the highest score 70 per cent. Although the same dimensions were considered problematic in the different hospitals, important variations between the five hospitals were observed. A comprehensive and tailor-made plan to improve patient safety culture in these hospitals can now be developed. Results indicate that important aspects of the patient safety culture in these hospitals need improvement.

This is an important challenge to all stakeholders wishing to improve patient safety. Scoring systems of severity in patients with multiple trauma. 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. Breast cancer-specific survival in patients with lymph node-positive hormone receptor-positive invasive breast cancer and Oncotype DX Recurrence Score results in the SEER database.

BCSS, assessed by RS category and number of positive lymph nodes, was calculated using the actuarial method. Whom to Treat? Fjetland, Lars, E-mail: lars. Purpose: Intra-arterial therapy IAT is used increasingly as a treatment option for acute stroke caused by central large vessel occlusions. Despite high rates of recanalization, the clinical outcome is highly variable. We combined the scores in an additional analysis. The correlations were limited to patients successfully recanalized and to patients scores additional Both scores were insufficient to identify patients with a good clinical outcome.

Conclusions: Both scores showed a strong correlation to poor clinical outcome in patients scores could be enhanced by combining them. Results with cochlear implantation in adults with speech recognition scores exceeding current criteria. The primary purpose of this study was to evaluate a group of postlingually deafened adults, whose aided speech recognition exceeded commonly accepted candidacy criteria for implantation.

The study aimed to define performance and qualitative outcomes of cochlear implants in these individuals compared with their optimally fitted hearing aid s. Retrospective case series. Tertiary referral center. We compared patients ' preoperative performance HINT score with hearing aids to postoperative performance with the cochlear implant after 12 months of device use.

In addition, the Hearing Handicap Inventory questionnaire was used to quantify the hearing-related handicap change perceived after the implantation. The study group demonstrated significant postoperative improvement on all outcome measures; most notably, the mean HINT score improved from Additionally, there was a significant improvement in hearing-related handicap perceived by all patients.

The envelope of implantation candidacy criteria continues to expand as shown by this study's cohort. Patient satisfaction and speech recognition results are very encouraging in support of treating those who currently perform at a level above the conventional candidacy threshold but struggle with optimally fitted hearing aids. Radiological score for hemorrhage in the patients with portal hypertension.

To analyze the risk factors from radiological indices for hemorrhage in the patients with portal hypertension and weight risk factors. We retrospectively analyzed all cases of portal hypertension with hepatitis B from June to June in Nanjing Drum Tower hospital. Patients with hepatocellular carcinoma, portal vein thrombosis, or portal hypertension with other causes, such as autoimmune hepatitis, pancreatitis, or hematological diseases were excluded.

Ninety-eight patients were recruited and divided into hemorrhage and non-hemorrhage groups. There were no statistical differences in clinical indexes such as age, prothrombin time, serum albumin, serum creatinine, serum sodium, hemameba, and blood platelet count. However, the differences were statistically significant in total bilirubin, hemoglobin, and liver function with the p values of 0.

Logistic procedure was used to construct the model with stepwise selection and finally inferior mesenteric vein, posterior gastric vein, esophageal varices, and short gastric vein were enrolled into the model. These veins were scored according to the diameters and the rates of hemorrhage were increased with the score. We then validated the model with 26 patents from July to December The AUC value was 0. A risk model was constructed including inferior mesenteric vein, esophageal varices, posterior gastric vein, and short gastric vein.

This radiological scoring model may be a valuable indicator for hemorrhage of portal hypertension. This cross-sectional study analyzed consecutive patients undergoing arthroscopic rotator cuff repair. Descriptive statistics were produced, and Pearson correlation coefficients were calculated between each of the outcome measures. PROMIS computerized adaptive tests allow for more efficient patient -reported outcome data collection compared with traditional outcome scores.

Outcome in patients with bacterial meningitis presenting with a minimal Glasgow Coma Scale score. Objective: In bacterial meningitis, a decreased level of consciousness is predictive for unfavorable outcome, but the clinical features and outcome in patients presenting with a minimal score on the Glasgow Coma Scale are unknown.

Methods: We assessed the incidence, clinical characteristics, and outcome of patients with bacterial meningitis presenting with a minimal score on the Glasgow Coma Scale from a nationwide cohort study of adults with community-acquired bacterial meningitis in the Netherlands from to Patients presenting with a minimal Glasgow Coma Scale score on admission and bilaterally absent pupillary light responses, bilaterally absent corneal reflexes, or signs of septic shock on admission all died.

Conclusions: Patients with community-acquired bacterial meningitis rarely present with a minimal score on the Glasgow Coma Scale, but this condition is associated with high rates of morbidity and mortality. However, 1 out of 5 of these severely ill patients will make a full recovery, stressing the continued need for aggressive supportive care in these patients. Use of scoring systems for assessing and reporting the outcome results from shoulder surgery and arthroplasty.

To investigate shoulder scoring systems used in Europe and North America and how outcomes might be classified after shoulder joint replacement. All research papers published in four major journals in and were reviewed for the shoulder scoring systems used in their published papers. A method of identifying how outcomes after shoulder arthroplasty might be used to categorize patients into fair, good, very good and excellent outcomes was explored using the outcome evaluations from patients treated in our own unit.

A total of research articles that were published in the four journals used some form of shoulder scoring system. The outcome from shoulder arthroplasty in our unit has been evaluated using the constant score CS and the oxford shoulder score and these scores have been used to evaluate individual patient outcomes. ABSTRACT Introduction: Liver transplantation is intended to increase the survival of patients with chronic liver disease in terminal phase, as well as improved quality of life.

Since the first transplant until today many changes have occurred in the organ allocation system. Were included eight studies related to the MELD score and its impact on liver transplant. Results : There was predominance of transplants in male between y. The main indications were hepatitis C, hepatocellular carcinoma and alcoholic cirrhosis. The most important factors post-surgery were related to the MELD score , the recipient age, expanded donor criteria and hemotransfusion.

However, this score by itself is not a good predictor of survival after liver transplantation. Psychosocial and demographic factors influencing pain scores of patients with knee osteoarthritis. Pain levels in patients with osteoarthritis OA of the knee are commonly assessed by using a numeric scoring system, but results may be influenced by factors other than the patient 's actual physical discomfort or disease severity, including psychosocial and demographic variables. We examined the possible relation between knee-pain scores and several psychosocial, sociodemographic, disease, and treatment variables in patients with knee OA.

The pain-evaluation instrument was a 0- to point rating scale. Data obtained retrospectively from the patients ' medical records were demographic characteristics, body mass index BMI , concomitant disorders, illicit and prescription drug use, alcohol use, smoking, knee OA treatment, and severity of knee OA indicated by Kellgren-Lawrence KL radiographic grade. Univariate and multivariate analyses were performed to determine whether these variables correlated with reported pain scores.

On univariate analysis, higher pain scores were significantly associated with Native American or Hispanic ethnicity; a higher BMI; current prescription for an opioid, antidepressant, or gabapentinoid medication; depression; diabetes mellitus; fibromyalgia; illicit drug use; lack of health insurance; smoking; previous knee injection; and recommendation by the clinician that the patient undergo knee surgery. Neither the patient 's sex nor the KL grade showed a correlation.

On multivariate analysis, depression, current opioid prescription, and Native American or Hispanic ethnicity retained a significant association with higher pain scores. Our results in a large, ethnically diverse group of patients with knee OA suggest that psychosocial and sociodemographic factors may be important determinants of pain levels reported by patients with knee OA. Anaortic off-pump versus clampless off-pump using the PAS-Port device versus conventional coronary artery bypass grafting: mid-term results from a matched propensity score analysis of unselected patients.

Meta-analyses from observational and randomized studies have demonstrated benefits of off-pump surgery for hard and surrogate endpoints. In some of them, increased re-revascularization was noted in the off-pump groups, which could impact their long-term survival.

Therefore, we analyzed the course of all patients undergoing isolated coronary surgery regarding the major cardiac and cerebrovascular event MACCE criteria. Propensity Score Matching was performed based on 28 preoperative risk variables. Both off-pump clampless techniques were associated with lower in-hospital mortality compared with conventional CABG. Predicting the need for massive transfusion in trauma patients : the Traumatic Bleeding Severity Score.

The ability to easily predict the need for massive transfusion may improve the process of care, allowing early mobilization of resources. There are currently no clear criteria to activate massive transfusion in severely injured trauma patients. The aims of this study were to create a scoring system to predict the need for massive transfusion and then to validate this scoring system.

We reviewed the records of severely injured trauma patients and identified massive transfusion predictors using statistical methods. Each predictor was converted into a simple score based on the odds ratio in a multivariate logistic regression analysis. The predictive value of the TBSS for massive transfusion was then validated, using data from severely injured trauma patients. In the development phase, five predictors of massive transfusion were identified, including age, systolic blood pressure, the Focused Assessment with Sonography for Trauma scan, severity of pelvic fracture, and lactate level.

The maximum TBSS is 57 points. In the validation study, the average TBSS in patients who received massive transfusion was significantly greater The TBSS is simple to calculate using an available iOS application and is accurate in predicting the need for massive transfusion.

Additional multicenter studies are needed to further validate this scoring system and further. Non-alcoholic fatty liver disease NAFLD can progress from simple steatosis to hepatocellular carcinoma. None of tools have been developed specifically for high-risk patients.

A total of patients with MetS were recruited. All were diagnosed by clinicians with ultrasonography-confirmed whether they were patients with NAFLD. To develop the risk score , clinical risk indicators measured at the time of recruitment were built by logistic regression. Regression coefficients were transformed into item scores and added up to a total score. The scoring scheme was applied in validation cohort to test the performance. The scheme explained, by area under the receiver operating characteristic curve AuROC , The positive likelihood ratio of NAFLD in patients with low risk scores below 3 and high risk scores 5 and over were 2.

When applied in validation cohort, the score showed good performance with AuROC This scheme may help clinicians in order to take further appropriate action. Rockall score in predicting outcomes of elderly patients with acute upper gastrointestinal bleeding. AIM: To validate the clinical Rockall score in predicting outcomes rebleeding, surgery and mortality in elderly patients with acute upper gastrointestinal bleeding AUGIB.

The Rockall scores were calculated, and the association between clinical Rockall scores and patient outcomes rebleeding, surgery and mortality was assessed. The area under the receiver operating characteristic ROC curve was calculated to assess the validity of the Rockall system in predicting rebleeding, surgery and mortality of patients with AUGIB.

For rebleeding, the area under the ROC curve was 0. Abstract Objective This study examined the impact of palliative home nursing care on rates of hospital day readmissions. Methods The electronic health record based retrospective cohort study was performed within home care and palliative home care programs. Participants were home care patients discharged from one of three urban teaching hospitals.

Outcome measures were propensity score matched rates of hospital readmissions within 30 days of hospital discharge. Of 15, home care patients , were used at least once as a match for palliative care patients , for a total final sample of Using the matched sample we calculated the average treatment effect for treated patients. In this sample, palliative care patients had a day readmission probability of 9.

This effect persisted after adjustment for visit frequency. Conclusions Palliative home care may offer benefits to health systems by allowing patients to remain at home and thereby avoiding day rehospitalizations. Health care index score and risk of death following tuberculosis diagnosis in HIV-positive patients. A weighted HCI score range , based on independent prognostic factors identified in multivariable Cox models and the final score , included performance of TB drug susceptibility testing DST , an initial TB regimen containing a rifamycin, isoniazid and pyrazinamide, and start of combination antiretroviral treatment cART.

This study aimed to assess the predictive value of GCS and FOUR score on the outcome of multiple trauma patients admitted to the emergency department. The present prospective cross-sectional study was conducted on multiple trauma patients admitted to the emergency department. Then the receiver operating characteristic ROC curve, sensitivity, specificity, as well as positive and negative predictive value of GCS and FOUR score were evaluated to predict patients ' outcome.

Patients ' outcome was divided into discharge with and without a medical injury motor deficit, coma or death. Finally, 89 patients were studied. Sensitivity and specificity of GCS in predicting adverse outcome motor deficit, coma or death were These values for the FOUR score were Findings of this study indicate that the predictive value of FOUR score and GCS on the outcome of multiple trauma patients admitted to the emergency department is similar.

Total knee arthroplasty: good agreement of clinical severity scores between patients and consultants. One of the problems faced by the health services of many developed countries is the length of time patients spend waiting for elective treatment. We therefore report the results of a study in which the Salisbury Priority Scoring System SPSS was used by both the surgeon and their patients to ascertain whether there were differences between the surgeon generated and patient generated Salisbury Priority Scores.

The Salisbury Priority Scoring System SPSS was used to assign relative priority to patients with knee osteoarthritis as part of a randomised controlled trial comparing the standard medial parapatellar approach versus the sub-vastus approach in TKA. The operating surgeons and each patient completed the SPSS at the same pre-assessment clinic. The SPSS assesses four criteria, namely progression of disease, pain or distress, disability or dependence on others, and loss of usual occupation.

Crosstabs and agreement measures Cohen's kappa were performed. Overall, the four SPSS criteria showed a kappa value of 0. Male patients showed better agreement than female patients. The Salisbury Priority Scoring System is a good means of assessing patients ' needs in relation to elective surgery, with high agreement between the patient and the operating surgeon.

A prospective study. However, with many of these sources collecting satisfaction data reluctant to disclose detailed information, little remains known about the potential determinants of patient satisfaction. Two hundred patients were contacted via phone within 3 weeks of new patient encounter with 11 spine providers. Standardized patient satisfaction phone survey consisting of 25 questions rating scale was administered.

Potential associations between these factors and three main outcome measures were investigated: 1 provider satisfaction, 2 overall clinic visit satisfaction, and 3 quality of care. The use of patient -reported outcomes continues to expand beyond the scope of clinical research to involve standard of care assessments across orthopedic practices. It is currently unclear how to interpret and apply this information in the daily care of patients in a foot and ankle clinic.

We prospectively examined the relationship between preoperative patient -reported outcomes PROMIS Physical Function, Pain Interference and Depression scores , determined minimal clinical important differences for these values, and assessed if these preoperative values were predictors of improvement after operative intervention. Prospective collection of all consecutive patient visits to a multisurgeon tertiary foot and ankle clinic was obtained between February and April PROMIS physical function, pain interference, and depression scores were assessed at initial and follow-up visits.

Minimum clinically important differences MCIDs were calculated using a distribution-based method. Prognostic pre- and posttest probabilities based off these cutoffs were calculated. Patients with a minimum of 7-month follow-up mean 9.

ROC curves demonstrated that preoperative physical function scores were predictive of postoperative improvement in physical function area under the curve [AUC] 0. Similarly, preoperative pain interference scores were predictive of postoperative pain improvement AUC 0. Continual monitoring of patients utilizing mHealth-based telemonitoring applications are more and more used for individual management of patients. A new approach in risk assessment called Rolling Score Concept uses standardized questionnaires for continual scoring of individuals' health state through electronic patient reported outcome ePRO.

Using self-rated questionnaires and adding a specific Time Schedule to each question result in a movement of the questionnaires' scores over time, the Rolling Score. A text-processing pipeline was implemented with KNIME analytics platform to extract a Score Mapping Rule Set for three standardized screening questionnaires in the field of sleep medicine. A feasibility study was performed in 10 healthy volunteers equipped with a mHealth application on a smartphone and a sleep tracker.

However, further studies are required for verification. In addition, parameter quantification could avoid incorrect subjective evaluation by substitution of questions with sensor data. Objectives Because acute complicated pyelonephritis can easily cause sepsis and concomitant shock status, it is a potentially lethal disease. However, the predictors for the severity of pyelonephritis is not well analyzed.

In this study, we aimed at clarifying the clinical characteristic risk factors associated with septic shock in patients with acute complicated pyelonephritis. Materials and methods From May to March , patients with acute complicated pyelonephritis were treated at our institution.

We investigated the characteristics of the patients associated with septic shock, and assessed risk factors in these patients. By using these risk factors, we established a novel scoring system to predict septic shock. Results patients included patients with ureteral calculi and 75 patients with stent-related pyelonephritis. Importantly, patients with P. Conclusions These results suggest that P. Immunization-based scores as independent prognostic predictors in soft tissue sarcoma patients. Background: The purpose of this study was to examine and compare the prognostic value of different immunization-based scoring systems in patients with soft tissue sarcoma STS.

Methods: We conducted a retrospective study evaluating a cohort of patients diagnosed with STS between July and July Then, we evaluated the relationships between each GPS system and clinicopathological characteristics. The mean follow-up for survivors in the cohort was Results : The most favorable overall survival OS rate was associated with the score 0 groups, and the poorest progression-free survival PFS rate was associated with the score 2 groups, regardless of which system was used to calculate the score.

Moreover, the same effect was observed in a separate analysis restricted to patients with metastases. Remarkably, in patients with a score of 2 as measured by all 3 systems, local treatment resulted in a poorer prognosis compared to patients with a score of 2 who did not receive local treatment.

Conclusion: The GPS is a valuable prognostic marker and has the capability to predict the appropriate treatment strategy for STS patients with metastases. The modified GPS systems demonstrated superior prognostic and predictive value compared with the traditional GPS system. Introduction It has been shown that mortality rates of coeliac patients correlate with age at diagnosis of coeliac disease, diagnostic delay for coeliac disease, pattern of clinical presentation and HLA typing.

Our aim was to create a tool that identifies coeliac patients at higher risk of developing complications. Methods To identify predictors of complications in patients with coeliac disease, we organised an observational multicenter case-control study based on a retrospective collection of clinical data.

Clinical data from cases patients with complicated coeliac disease and controls coeliac patients without any complications were collected from seven European centres. For each case, one or two controls, matched to cases according to the year of assessment, gender and age, were selected.

Diagnostic delay, pattern of clinical presentation, HLA typing and age at diagnosis were used as predictors. Results Differences between cases and controls were detected for diagnostic delay and classical presentation. Conditional logistic models based on these statistically different predictors allowed the development of a score system.

Tertiles analysis showed a relationship between score and risk of developing complications. Discussion A score that shows the risk of a newly diagnosed coeliac patient developing complications was devised for the first time. This will make it possible to set up the follow-up of coeliac patients with great benefits not only for their health but also for management of economic resources. Conclusions We think that our results are very encouraging and represent the first attempt to build a prognostic score for coeliac patients.

To determine which metrics from the Press Ganey patient satisfaction survey best correlate with "likelihood to recommend" among patients in an academic tertiary medical center practice setting. Cross-sectional study.

A total of patients were recruited. A item abridged version of the Press Ganey survey typically distributed to patients via mail or e-mail after visiting the Stanford University Hospital was administered privately to each eligible patient of 2 different attending clinics at the conclusion of his or her visit.

The 26 survey items were not modified for the purposes of the study and were administered such that participants could not be individually identified. The arithmetic mean score for the item "Likelihood of your recommending our practice to others" was calculated by assigning a value to the Likert value associated with survey responses and correlated with the 25 other items using the differences in the mean scores.

Response to survey items graded on a 1 to 5 standard Likert scale. The weighted mean patient survey score for the "likelihood to recommend" item for the junior faculty member was The perception of time spent with the practitioner and ease of appointment. A retroprospective analysis was conducted in the medical intensive care unit of a tertiary university hospital.

A total of patients were enrolled; of these patients The median SSS was 80 range The SSS needs to be adapted and modified with new parameters to improve its performance. Background The revascularization strategy of the left main disease is determinant for clinical outcomes. Objective We sought to 1 validate and compare the performance of the SYNTAX Score 1 and 2 for predicting major cardiovascular events at 4 years in patients who underwent unprotected left main angioplasty and 2 evaluate the long-term outcome according to the SYNTAX score 2-recommended revascularization strategy.

Methods We retrospectively studied patients from a single-centre registry who underwent unprotected left main angioplasty between March and December Discrimination and calibration of both models were assessed by ROC curve analysis, calibration curves and the Hosmer-Lemeshow test. Results Total event rate was Coronary artery by-pass graft risk estimation greater than 5.

Conclusion The SYNTAX Score 2 may allow a better and individualized risk stratification of patients who need revascularization of an unprotected left main coronary artery. Prospective studies are needed for further validation.

Prediction scores do not correlate with clinically adjudicated categories of pulmonary embolism in critically ill patients. The chance-corrected agreement between adjudicated categories and each score was calculated. Research is needed to develop prediction scores for this population. The Routine Assessment of Patient Index Data 3 RAPID3 is a patient -reported disease activity measure used to assess physical function, pain, and global health in patients with rheumatoid arthritis RA without formal joint counts.

Since hand involvement and its decreased function are hallmarks of RA, the aim of our study was to investigate the performance of RAPID3 scores with regard to hand function and to confirm previous findings that the RAPID3 score as a disease activity measure is strongly correlated with the DAS28 score. Pearson's correlation coefficient, Student's t test and linear regression were used in the statistical analysis of the results. Our preliminary study showed that RAPID3 scores were strongly correlated with measurements of the functional ability of the hand, demonstrating that RAPID3 can be used as a measure of disease activity in clinical practice and to characterize hand function.

Further studies are needed to confirm this result. Chiong, Terri; Cheow, Esther S. Aims: The SYNTAX score correlate with major cardiovascular events post-revascularization, although the histopathological basis is unclear. We aim to evaluate the association between syntax score and extracellular matrix histological characteristics of aortic punch tissue obtained during coronary artery bypass surgery CABG.

This analysis compares coronary artery bypass surgery patients with High and Low syntax score which were followed up for one year period. Baseline clinical characteristics and surgical risks were well matched. This identifies aortic punches collected during CABG as another biomarker source related with atherosclerosis severity and possible clinical outcome.

Severity of erectile dysfunction is highly correlated with the syntax score in patients undergoing coronariography. Material and Methods We studied males who underwent coronary angiography for first time between January and November Results We identified 86 patients with and 46 without CAD. Conclusions ED severity is strongly and independently correlated with CAD complexity, as assessed by the Syntax score in patients undergoing coronariography for evaluation of new onset coronary symptoms.

A new score for screening of malnutrition in patients with inoperable gastric adenocarcinoma. Malnutrition is common in patients with gastric cancer. Early identification of malnourished patients results in improving quality of life. We aimed to assess the nutritional status of patients with inoperable gastric adenocarcinoma IGA and finding a precise malnutrition screening score for these patients before the onset of chemotherapy.

Nutritional status was assessed using patient generated subjective global assessment PG-SGA , visceral proteins, and high-sensitivity C reactive protein. Tumor markers of carcinoembryonic antigen CEA , carbohydrate antigen CA and CA and their association with nutritional status were assessed.

Then a new score for malnutrition screening was defined. Seventy-one patients with IGA completed the study. The best cut-off value for prealbumin for prediction of malnutrition was determined at 0. MS- score has been suggested as an available and easy-to-use tool for malnutrition screening in patients with IGA.

Published by Oxford University Press. For permissions, please e-mail: journals. It has been shown that mortality rates of coeliac patients correlate with age at diagnosis of coeliac disease, diagnostic delay for coeliac disease, pattern of clinical presentation and HLA typing. To identify predictors of complications in patients with coeliac disease, we organised an observational multicenter case-control study based on a retrospective collection of clinical data.

Differences between cases and controls were detected for diagnostic delay and classical presentation. A score that shows the risk of a newly diagnosed coeliac patient developing complications was devised for the first time. We think that our results are very encouraging and represent the first attempt to build a prognostic score for coeliac patients.

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 years in our paediatric ward from February to September The maximum score was 6.

The data were collected from all patients admitted. The scale was measured 7, times, with Very few 1. One patient scored 2 required PICU admission. There were no deaths. 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. Published by Elsevier Espana. The relationship between a model of end stage liver disease score MELD score and the occurrence of spontaneous bacterial peritonitis in liver cirrhotic patients.

To determine relationship between MELD score and the occurrence of SBP, prevalence of SBP, pattern of bacterial culture and antibiotic susceptibility of causative bacteria of liver cirrhotic patients at Sanglah Hospital. Study design was a cross-sectional analytic study. The population in this study consists of liver cirrhotic patients admitted at Sanglah Hospital Denpasar from June to February Prevalence of SBP was Thirteen patients Common causes of SBP mostly were Escherichia coli and Acinettobacter baumanii, which were sensitive to antibiotic treatment of Cefoperazone, Cefotaxime and Ciprofloxacin.

The clinical characteristics of patients with and without VTE were compared, and multivariable logistic regression analysis was used to identify independent risk factors for VTE. Weighted risk assessment scoring systems were developed based on these and previously identified factors from patients in the National Trauma Data Bank NTDB ; the scoring systems were validated in this cohort from Johns Hopkins as well as a cohort of pediatric admissions from the NTDB These and additional factors were identified in , pediatric patients from the NTDB from ; independent risk factors from the logistic regression analysis of this NTDB cohort were selected and incorporated into weighted risk assessment scoring systems.

Two models were developed and were cross-validated in 2 separate pediatric trauma cohorts: 1 , patients in the NTDB from to 2 17, patients from Johns Hopkins. We developed weighted scoring systems to stratify pediatric trauma patients at risk for VTE.

These systems may have potential to guide risk-appropriate VTE prophylaxis in children after. With technological advances in ankle arthroplasty, there has been parallel development in the outcome instruments used to assess the results of surgery.

The literature recommends the use of valid, reliable, and responsive ankle scores , but the ankle scores commonly used in clinical practice remain undefined. An internet survey of members of the American Orthopaedic Foot and Ankle Society AOFAS was conducted to determine which three ankle scores they perceived as most commonly used in the literature, which ones they believe are validated, which ones they prefer, and which they use in practice.

The data were collected prospectively on consecutive ICU admissions over a 24 month period from July1, until June 30, The calibration was assessed by the Hosmer-Lemeshow goodness-of-fit H statistic. The overall fit of the model was evaluated by the Brier's score. Overall, 1, patients were enrolled during the study period. The mortality in the ICU was The median ICU and hospital lengths of stay were 3 and 18 days, respectively, for all patients.

Both models showed excellent discrimination. Thus, the LOD score was found to be accurate for predicting hospital mortality for general critically ill patients in Thailand. Purpose: To create and validate scoring systems for intracerebral control IC and overall survival OS of patients irradiated for brain metastases.

Two scoring systems were developed, one for IC and another for OS. The scores included prognostic factors found significant on multivariate analyses. Age, performance status, extracerebral metastases, interval tumor diagnosis to RT, and number of brain metastases were associated with OS. Tumor type, performance status, interval, and number of brain metastases were associated with IC.

The total score represented the sum of the scores for each factor. The score groups of the test group were compared with the corresponding score groups of the validation group. IC and OS rates of the validation group were similar to the test group demonstrating the validity and reproducibility of both scores. Sepsis patients in the emergency department: stratification using the Clinical Impression Score , Predisposition, Infection, Response and Organ dysfunction score or quick Sequential Organ Failure Assessment score?

This was a prospective observational study in the ED of a tertiary care teaching hospital. Adult nontrauma patients with suspected infection and at least two Systemic Inflammatory Response Syndrome criteria were included. The secondary outcomes were in-hospital, day and 6-month mortality, indirect ICU admission and length of stay. Clinical judgement was recorded using the Clinical Impression Scores CIS , appraised by a nurse and the attending physician.

We included patients : presented with sepsis, 81 with severe sepsis and nine with septic shock. Fifteen patients required direct ICU admission. The CIS scores did not predict any of the mortality endpoints. Clinical judgement is a fast and reliable method to stratify between ICU and general ward admission in ED patients with sepsis.

In sepsis patients , therefore, the principle of 'treat first what kills first' can be supplemented with 'judge first and calculate later'. This is an open-access article distributed under the terms of the Creative Commons. Patients and methods A total of patients mean age: Logistic regression analysis was conducted to determine the risk factors predicting increased mortality.

Results Median D-dimer levels were ObjectiveTo provide a tutorial for using propensity score methods with complex survey data. Methods are compared in terms of bias and 95 percent confidence interval coverage. In Example 2, we used these methods to estimate the effect on health care spending of having a generalist versus a specialist as a usual source of care.

Principal FindingsIn general, combining a propensity score method and survey weighting is necessary to achieve unbiased treatment effect estimates that are generalizable to the original survey target population. ConclusionsPropensity score methods are an essential tool for addressing confounding in observational studies. Ignoring survey weights may lead to results that are not generalizable to the survey target population. Generalizing observational study results : applying propensity score methods to complex surveys.

To provide a tutorial for using propensity score methods with complex survey data. Simulated data and the Medical Expenditure Panel Survey. In general, combining a propensity score method and survey weighting is necessary to achieve unbiased treatment effect estimates that are generalizable to the original survey target population. Propensity score methods are an essential tool for addressing confounding in observational studies.

This paper clarifies the appropriate inferences for different propensity score methods and suggests guidelines for selecting an appropriate propensity score method based on a researcher's goal. Background: Lip cancer and its treatment have considerable functional and cosmetic effects with resultant nutritional and physical detriments.

As we continue to investigate new treatment regimens, we are simultaneously required to assess postoperative outcomes to design interventions that lessen the adverse impact of this disease process. Methods: Fifty patients affected by lip squamous cell carcinoma were recruited between and Patients were asked to fill the FLiGS questionnaire before surgery, 1 month, 6 months, and 1 year after surgery.

The subscores were used to calculate a total FLiGS score of global oral disability. Statistical analysis was performed to test validity and reliability. Conclusions: FLiGS score is a simple way of assessing functional impairment related to lip cancer before and after surgery; it is sensitive, valid, reliable, and clinically relevant: it provides useful information to orient the physician in the postoperative management and in the rehabilitation program. A biomarker-based risk score to predict death in patients with atrial fibrillation: the ABC age, biomarkers, clinical history death risk score.

Abstract Aims In atrial fibrillation AF , mortality remains high despite effective anticoagulation. A model predicting the risk of death in these patients is currently not available. We developed and validated a risk score for death in anticoagulated patients with AF including both clinical information and biomarkers. External validation was performed in patients with AF randomized to dabigatran vs.

Biomarker samples were obtained at study entry. Variables significantly contributing to the prediction of all-cause mortality were assessed by Cox-regression. Each variable obtained a weight proportional to the model coefficients. There were all-cause deaths in the derivation and in the validation cohort.

The most important predictors of death were N-terminal pro B-type natriuretic peptide, troponin-T, growth differentiation factor, age, and heart failure, and these were included in the ABC Age, Biomarkers, Clinical history -death risk score. The score was well-calibrated and yielded higher c-indices than a model based on all clinical variables in both the derivation 0.

The reduction in mortality with apixaban was most pronounced in patients with a high ABC-death score. Conclusion A new biomarker-based score for predicting risk of death in anticoagulated AF patients was developed, internally and externally validated, and well-calibrated in two large cohorts.

The use of inflammatory markers to follow up critically ill patients is controversial. The short time frame, the need for frequent and serial measurement of biomarkers, the presence of soluble receptor and their relatively high cost are the major drawbacks.

Patients and Methods. A total of ninety patients were included in the study. Forty-five patients developed septic complication sepsis group. Forty-five patients were critically ill without evidence of infectious organism SIRS group. Patients ' data include clinical status, central venous pressure, and laboratory analysis were measured. Positive predictive ability of SOFA score was demonstrated in critically ill patients.

Persistent elevation of SOFA score was detected in nonsurvivor septic patients. SOFA score is an independent prognostic value in critically ill patients. The Aristotle score : a complexity-adjusted method to evaluate surgical results. It is particularly needed, considering the potential adverse outcomes associated with complex cases.

The aim of this project was to develop a new method based on the complexity of the procedures. It is based on three factors: the potential for mortality, the potential for morbidity and the anticipated technical difficulty. A questionnaire was completed by the 50 centers. The second step was the development of the Comprehensive Aristotle Score , which further adjusts the complexity according to the specific patient characteristics. It includes two categories of complexity factors, the procedure dependent and independent factors.

The Aristotle score , allows precise scoring of the complexity for CHS procedures. One interesting notion coming out of this study is that complexity is a constant value for a given patient regardless of the center where he is operated. A new display of centers is presented based on the comparison of hospital survival to complexity and to our proposed definition of performance.

A complexity-adjusted method named the Aristotle Score , based on the complexity of the surgical procedures has been developed by an international group of experts. The Aristotle score. Methods The pain-evaluation instrument was a 0- to point rating scale. Results On univariate analysis, higher pain scores were significantly associated with Native American or Hispanic ethnicity; a higher BMI; current prescription for an opioid, antidepressant, or gabapentinoid medication; depression; diabetes mellitus; fibromyalgia; illicit drug use; lack of health insurance; smoking; previous knee injection; and recommendation by the clinician that the patient undergo knee surgery.

Conclusions and implications Our results in a large, ethnically diverse group of patients with knee OA suggest that psychosocial and sociodemographic factors may be important determinants of pain levels reported by patients with knee OA. Assessment of nutritional status using abridged scored patient -generated subjective global assessment in cancer patient.

Malnutrition is a common problem among cancer patients , usually occurs due to poor appetite, low food intake, and changes in body metabolism. The aim of this study is to determine the prevalence of malnutrition in patients receiving chemotherapy on an outpatient basis. This cross-sectional study conducted on cancer patients referred to hospital. The prevalence of malnutrition among patients was assessed using the abridged scored patient -generated subjective global assessment abPG-SGA standard questionnaire.

Moreover, patient 's weight and 24 h dietary recall were measured. Descriptive statistics were used to present characteristics of patients and dietary recalls. For revealing the correlation, Spearman correlation was used. Patients mean age and mean duration of illness were The most common complaint of patients included fatigue Reduction in food intake in past month was reported by According to the high prevalence of cancers and increasing growth of them in recent years with regard to outpatient treatment development for cancer patients , using the abPG-SGA standard questionnaire by nutritionist or nurses can be effective to detect malnourished patients and reduce complications caused by disease.

Inflammation scores predict survival for hepatitis B virus-related hepatocellular carcinoma patients after transarterial chemoembolization. The association of inflammation scores with clinicopathologic variables and overall survival OS were analyzed, and receiver operating characteristic curves were generated, and the area under the curve AUC was calculated to evaluate the discriminatory ability of each inflammation score and staging system, including tumor-node-metastasis, Barcelona Clinic Liver Cancer, and Cancer of the Liver Italian Program CLIP scores.

Problem-solving therapy to improve depression scores among older hemodialysis patients : a pilot randomized trial. Depression is common among dialysis patients and is associated with adverse outcomes. Problem-solving therapy PST is effective for treating depression in older patients with chronic illness, but its effectiveness has never been reported in hemodialysis HD patients.

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