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Combined Assessment (combined + assessment)
Selected AbstractsLongtime performance and reliability of two different PtcCO2 and SpO2 sensors in neonatesPEDIATRIC ANESTHESIA, Issue 9 2008VERA BERNET Summary Objectives:, Blood gas monitoring is necessary in treatment of critically ill neonates. Whereas SaO2 can be estimated by pulse oximetry, PaCO2 is still most often assessed from blood samples. Aim:, To compare long time performance of an ear sensor for combined assessment of transcutaneous carbon dioxide (PtcCO2) and oxygen saturation (SpO2) (TOSCA Monitor; Radiometer, Switzerland) with a conventional PtcCO2 monitor (MicroGas 7650-500 rapid, Radiometer, Switzerland) in critically ill neonates. Methods:, Prospective, observational study. Twenty critically ill neonates were monitored for PtcCO2 and SpO2 using the Tosca and the MicroGas monitor for 24 h. TOSCA ear sensor was changed to the other ear lobe after 12 h and the MicroGas sensor four hourly on the trunk. Values obtained were compared with SaO2 and PaCO2 from arterial blood gas analysis using Bland,Altman analysis. Data are presented as median (range). Results:, Eighty-two paired measurements were obtained. Median age of the 20 patients was 4.5 days (1,26 days) and weight was 3.05 kg (0.98,3.95 kg). Bias and precision between PaCO2 and PtcCO2 were 0.14 and 1.45 kPa for the Tosca monitor and ,0.08 and 1.2 kPa for the MicroGas monitor, respectively. The two biases were significantly different (P = 0.0036). SpO2 assessment by TOSCA was comparable to SaO2 values (bias 0.26% and precision 4.14%). Conclusion:, The TOSCA monitor allows safe estimation of PtcCO2 and SaO2 in neonates. Measurements of PtcCO2 were less reliable with TOSCA compared with conventional monitoring but still allow assessing a trend of ventilation status in newborn patients. [source] Assessment of risk for the development of pre-eclampsia by maternal characteristics and uterine artery DopplerBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 6 2005Aris T. Papageorghiou Objective To develop a method for the estimation of patient-specific risk for the development of pre-eclampsia by combining maternal history and uterine artery Doppler. Design Prospective multicentre observational study. Setting Antenatal clinics in seven hospitals in the UK and three overseas centres. Population Unselected women with singleton pregnancies attending for routine antenatal care. Methods Doppler studies of the uterine arteries were performed using colour flow mapping and pulsed wave Doppler at 23 weeks of gestation. The mean pulsatility index (PI) of the two uterine arteries was calculated. Doppler and maternal history variables were combined to develop a model for risk assessment. The incidence of pre-eclampsia was used to derive the prior risk for this complication. The posterior risk was derived by multiplying the prior odds with likelihood ratios (LRs) derived from independent risk factors identified from the maternal history, and the LR estimated from the heights of the frequency distributions of mean PI in affected and unaffected pregnancies. Main outcome measure Pre-eclampsia. Results There were 17,480 women recruited to the study, in which 17,319 (99.1%) of these Doppler examination of both uterine arteries were completed, and outcome data were available in 16,806 (97.0%). Pre-eclampsia occurred in 369 (2.20%) cases. Significant independent prediction of pre-eclampsia was provided by mean PI, ethnic origin, body mass index (BMI), parity, cigarette smoking, history of hypertension and family or personal history of pre-eclampsia. Models were derived allowing calculation of patient-specific risk for development of pre-eclampsia. For a false-positive rate of 25%, the detection rate of pre-eclampsia by screening using maternal history was 45.3%, with uterine artery Doppler it was 63.1% and with combined assessment it was 67.5%. Conclusions Combining risk factors in the mother's history with Doppler of the uterine arteries allows calculation of patient-specific risk for the development of pre-eclampsia. [source] Bilateral nasal allergen provocation monitored with acoustic rhinometry.CLINICAL & EXPERIMENTAL ALLERGY, Issue 3 2005Assessment of both nasal passages, the side reacting with greater congestion: relation to the nasal cycle Summary Background The effect of bilateral nasal provocation on nasal mucosa measured with the use of acoustic rhinometry (AR) can be assessed for both nasal passages or for the side responding with greater congestion. Assessment of changes in nasal congestion during the nasal provocation test (NPT) can be affected by the nasal cycle (NC). The aim of this study was to find out the most accurate method to evaluate changes observed during bilateral nasal provocation. Methods Cross-sectional areas (CSA) at the level of inferior nasal turbinate (CSA-2) were recorded by AR in 26 volunteers with allergic rhinitis during the NC for 5,7 h and subsequently during NPT. The risk of spontaneous total and unilateral CSA-2 decrease was established. Sensitivity of the NPT assessment for the total CSA-2 and for the side responding with greater congestion was evaluated at chosen thresholds. These thresholds were selected in a way that the risk levels of spontaneous decrease of unilateral and total CSA-2 were equal. Results The assessment of the total CSA-2 was found to be more sensitive than the assessment of the side responding with greater congestion. The highest sensitivity and specificity of the test was achieved by using a combination of both assessments. Optimum thresholds of the CSA-2 decrease for assessment at 15 min after provocation, with this method, were 27% and 40% for the side responding with greater congestion and for the total CSA-2, respectively. Conclusions Recognition of the risk of spontaneous unilateral and total CSA-2 decreases enables introduction of combined assessment of bilateral NPT. This assessment seems to be the most accurate method for evaluation of the test results. [source] Assessing the Severity of Hazardous Drinking and Related Consequences Among Incarcerated WomenALCOHOLISM, Issue 5 2010David R. Strong Background:, Recent epidemiological efforts have demonstrated the utility of measuring individual differences in the severity of alcohol use along a single severity continuum marked by alcohol-related problems, symptoms of alcohol dependence, and the social consequences of drinking. Translation of this utility to specialized clinical populations is not assured. The expected inter-relationships among problems, symptoms and consequences, and enhanced sensitivity of combined assessments require confirmation in applied clinical settings. Method:, Subjects were 245 incarcerated women who met Alcohol Use Disorders Identification Test criteria for hazardous use of alcohol. Participants were recruited from a statewide adult correctional facility for an ongoing clinical trial testing the effectiveness of brief motivational interviewing on alcohol use and HIV risk behaviors. Participants ranged in age from 18 to 56 (M = 34.1, SD = 8.9), 71.4% were Caucasian, and 65.7% reported <12 years of education. Results:, Analyses suggested that the 6 problems of alcohol abuse, 7 symptoms for alcohol dependence, and 14 alcohol-related social consequences loaded to a single factor (0.38 to 0.85) that formed a continuum of alcohol severity. Contrary to epidemiological studies, physical fights and being arrested were the most prevalent consequences and were associated with lower alcohol severity in this population. Three of the five items that discriminated best between higher and lower alcohol severity were related to familial and relationship consequences. Conclusions:, Consistent with epidemiological studies, alcohol severity can be measured among incarcerated hazardously drinking women on a single continuum that includes alcohol problems, symptoms, and social consequences. Replication of the expected alignment of problems and symptoms supports the construct validity of the continuum and further challenges the proposed hierarchical structure of abuse/dependence distinction. Large differences in rates of specific consequences and observed effectiveness of tailored social consequence items suggest the benefits of cross-sample validation to improve evaluation of clinical outcomes. [source] Combining descriptive and functional analyses to assess and treat screamingBEHAVIORAL INTERVENTIONS, Issue 2 2003G. Tracey Galiatsatos This study systematically examined the functional relation between screaming and environmental events in a 13-year-old boy diagnosed with autism and PDD-NOS. A functional analysis of screaming was conducted in study 1, with six conditions (attention, demand, play, alone, tangible,toy, and tangible,edible). Highest rates of screaming were observed during the tangible,toy and tangible,edible conditions. The analog assessment was followed by a descriptive assessment, which revealed the participant was most likely to scream when teacher attention was diverted to other students. Additionally, items found to maintain screaming during the analog assessment were never delivered contingent upon screaming in the participant's natural environment. The results of the descriptive assessment suggested that the analog assessment might have produced a false-positive outcome. A treatment based upon the results of the combined assessments led to a 50% reduction in screaming within four weeks. Two-year follow-up data indicated that screaming occurred at near-zero rates. Copyright © 2003 John Wiley & Sons, Ltd. [source] | ||||||||||