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Exclusion Criterion (exclusion + criterion)
Selected AbstractsContribution of OCT to evaluate macular disease in JIA associated uveitisACTA OPHTHALMOLOGICA, Issue 2008B BODAGHI Purpose To examine the frequency and characteristics of macular lesions observed in Juvenile Idiopathic Arthritis (JIA) uveitis, using Optical Coherence Tomography (OCT). Methods In this cross-sectional study, 38 consecutive patients were recruited from a tertiary referral center in uveitis. All eyes with JIA uveitis underwent complete ophthalmic examination including OCT 3. Exclusion criterion was the inability to obtain OCT scans. Flare and visual acuity were also analyzed by using linear regression. Results We analyzed foveal thickness (FT) and central foveal thickness (CFT) using the software mapping, to describe macular lesions in 61 eyes. Maculopathy was observed in 51 eyes (84%), compared to 12% in the literature (P<0.0001) and comprised four types: perifoveolar thickening in 45 eyes (74%), macular edema in 29 eyes (48%), foveal detachment in 11 eyes (18%), and atrophic changes in 6 eyes (10%). Only 4 eyes did not demonstrate any lesion. Conclusion Among children with JIA-uveitis, macular involvement is frequent, and characterized by perifoveolar thickening and serous retinal detachment. OCT is a non-invasive instrument. It may easily show this maculopathy, which could impair visual function, and conditioned a therapeutic intensification. [source] Obsessive,compulsive disorder: a review of the diagnostic criteria and possible subtypes and dimensional specifiers for DSM-V,DEPRESSION AND ANXIETY, Issue 6 2010James F. Leckman M.D. Abstract Background: Since the publication of the DSM-IV in 1994, research on obsessive,compulsive disorder (OCD) has continued to expand. It is timely to reconsider the nosology of this disorder, assessing whether changes to diagnostic criteria as well as subtypes and specifiers may improve diagnostic validity and clinical utility. Methods: The existing criteria were evaluated. Key issues were identified. Electronic databases of PubMed, ScienceDirect, and PsycINFO were searched for relevant studies. Results: This review presents a number of options and preliminary recommendations to be considered for DSM-V. These include: (1) clarifying and simplifying the definition of obsessions and compulsions (criterion A); (2) possibly deleting the requirement that people recognize that their obsessions or compulsions are excessive or unreasonable (criterion B); (3) rethinking the clinical significance criterion (criterion C) and, in the interim, possibly adjusting what is considered "time-consuming" for OCD; (4) listing additional disorders to help with the differential diagnosis (criterion D); (5) rethinking the medical exclusion criterion (criterion E) and clarifying what is meant by a "general medical condition"; (6) revising the specifiers (i.e., clarifying that OCD can involve a range of insight, in addition to "poor insight," and adding "tic-related OCD"); and (7) highlighting in the DSM-V text important clinical features of OCD that are not currently mentioned in the criteria (e.g., the major symptom dimensions). Conclusions: A number of changes to the existing diagnostic criteria for OCD are proposed. These proposed criteria may change as the DSM-V process progresses. Depression and Anxiety, 2010. © 2010 Wiley-Liss, Inc. [source] Proposed diagnostic criteria for internet addictionADDICTION, Issue 3 2010Ran Tao ABSTRACT Objective The objective of this study was to develop diagnostic criteria for internet addiction disorder (IAD) and to evaluate the validity of our proposed diagnostic criteria for discriminating non-dependent from dependent internet use in the general population. Methods This study was conducted in three stages: the developmental stage (110 subjects in the survey group; 408 subjects in the training group), where items of the proposed diagnostic criteria were developed and tested; the validation stage (n = 405), where the proposed criteria were evaluated for criterion-related validity; and the clinical stage (n = 150), where the criteria and the global clinical impression of IAD were evaluated by more than one psychiatrist to determine inter-rater reliability. Results The proposed internet addiction diagnostic criteria consisted of symptom criterion (seven clinical symptoms of IAD), clinically significant impairment criterion (functional and psychosocial impairments), course criterion (duration of addiction lasting at least 3 months, with at least 6 hours of non-essential internet usage per day) and exclusion criterion (exclusion of dependency attributed to psychotic disorders). A diagnostic score of 2 + 1, where the first two symptoms (preoccupation and withdrawal symptoms) and at least one of the five other symptoms (tolerance, lack of control, continued excessive use despite knowledge of negative effects/affects, loss of interests excluding internet, and use of the internet to escape or relieve a dysphoric mood) was established. Inter-rater reliability was 98%. Conclusion Our findings suggest that the proposed diagnostic criteria may be useful for the standardization of diagnostic criteria for IAD. [source] Prospective Multicenter Study of Bronchiolitis: Predictors of an Unscheduled Visit After Discharge From the Emergency DepartmentACADEMIC EMERGENCY MEDICINE, Issue 4 2010Agatha Norwood MD Abstract Objectives:, There is little evidence about which children with bronchiolitis will have worsened disease after discharge from the emergency department (ED). The objective of this study was to determine predictors of post-ED unscheduled visits. Methods:, The authors conducted a prospective cohort study of patients discharged from 2004 to 2006 at 30 EDs in 15 U.S. states. Inclusion criteria were diagnosis of bronchiolitis, age <2 years, and discharge home; the exclusion criterion was previous enrollment. Unscheduled visits were defined as urgent visits to an ED/clinic for worsened bronchiolitis within 2 weeks. Results:, Of 722 patients eligible for the current analysis, 717 (99%) had unscheduled visit data, of whom 121 (17%; 95% confidence interval [CI] = 14% to 20%) had unscheduled visits. Unscheduled visits were more likely for children age <2 months (11% vs. 6%; p = 0.04), males (70% vs. 57%; p = 0.007), and those with history of hospitalization (27% vs. 18%; p = 0.01). The two groups were similar in other demographic and clinical factors (all p > 0.10). Using multivariable logistic regression, independent predictors of unscheduled visits were age <2 months, male, and history of hospitalization. Conclusions:, In this study of children age younger than 2 years with bronchiolitis, one of six children had unscheduled visits within 2 weeks of ED discharge. The three predictors of unscheduled visits were age under 2 months, male sex, and previous hospitalization. ACADEMIC EMERGENCY MEDICINE 2010; 17:376,382 © 2010 by the Society for Academic Emergency Medicine [source] The purpose and function of humour in health, health care and nursing: a narrative reviewJOURNAL OF ADVANCED NURSING, Issue 6 2008May McCreaddie Abstract Title.,The purpose and function of humour in health, health care and nursing: a narrative review Aim., This paper is a report of a review conducted to identify, critically analyse and synthesize the humour literature across a number of fields related to health, health care and nursing. Background., The humour,health hypothesis suggests that there is a positive link between humour and health. Humour has been a focus of much contention and deliberation for centuries, with three theories dominating the field: the superiority or tendentious theory, the incongruity theory and the relief theory. Data sources., A comprehensive literature search was carried out in January 2007 using a number of databases, keywords, manual recursive searching and journal alerts (January 1980,2007) cross-referenced with the bibliographic databases of the International Society of Humor Studies. An inclusion and exclusion criterion was identified. Review methods., A narrative review of evidence- and non-evidence-based papers was conducted, using a relevant methodological framework with additional scrutiny of secondary data sources in the latter. Humour theories, incorporating definition, process and impact constituted a significant part of the appraisal process. Results., A total of 1630 papers were identified, with 220 fully sourced and 88 included in the final review. There is a dearth of humour research within nursing yet, ironically, an abundance of non-evidence-based opinion citing prerequisites and exclusion zones. Examination of physician,patient interaction and the humour,health hypothesis demonstrates that use of humour by patients is both challenging and revealing, particularly with regard to self-deprecating humour. Conclusion., Nurses and nursing should adopt a circumspect and evidenced-based approach to humour use in their work. [source] The Surface Electrocardiogram Predicts Risk of Heart Block During Right Heart Catheterization in Patients With Preexisting Left Bundle Branch Block: Implications for the Definition of Complete Left Bundle Branch BlockJOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Issue 7 2010BENZY J. PADANILAM M.D. LBBB and Heart Block.,Background: Patients with left bundle branch block (LBBB) undergoing right heart catheterization can develop complete heart block (CHB) or right bundle branch block (RBBB) in response to right bundle branch (RBB) trauma. We hypothesized that LBBB patients with an initial r wave (,1 mm) in lead V1 have intact left to right ventricular septal (VS) activation suggesting persistent conduction over the left bundle branch. Trauma to the RBB should result in RBBB pattern rather than CHB in such patients. Methods: Between January 2002 and February 2007, we prospectively evaluated 27 consecutive patients with LBBB developing either CHB or RBBB during right heart catheterization. The prevalence of an r wave ,1 mm in lead V1 was determined using 118 serial LBBB electrocardiographs (ECGs) from our hospital database. Results: Catheter trauma to the RBB resulted in CHB in 18 patients and RBBB in 9 patients. All 6 patients with ,1 mm r wave in V1 developed RBBB. Among these 6 patients q wave in lead I, V5, or V6 were present in 3. Four patients (3 in CHB group and 1 in RBBB group) developed spontaneous CHB during a median follow-up of 61 months. V1 q wave ,1 mm was present in 28% of hospitalized complete LBBB patients. Conclusions: An initial r wave of ,1 mm in lead V1 suggests intact left to right VS activation and identifies LBBB patients at low risk of CHB during right heart catheterization. These preliminary findings indicate that an initial r wave of ,1 mm in lead V1, present in approximately 28% of ECGs with classically defined LBBB, may constitute a new exclusion criterion when defining complete LBBB. (J Cardiovasc Electrophysiol, Vol. pp. 781-785, July 2010) [source] Correlation of Left Atrial Diameter by Echocardiography and Left Atrial Volume by Computed TomographyJOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Issue 2 2009IRENE HOF M.D. Introduction: For patients undergoing catheter ablation of atrial fibrillation (AF), left atrial size is a predictor of recurrence of AF during follow-up. For this reason, major clinical trials have used a left atrial diameter (LAD) of more than 5.0 or 5.5 cm, assessed by echocardiography, as an exclusion criterion for patients deemed candidates for ablation of AF. However, whether LAD accurately reflects true left atrial size has not been systematically investigated. Therefore, the purpose of this study was to test the hypothesis that LAD, measured by echocardiography, accurately correlates to left atrial volume measured by computed tomography (CT). Methods and Results: We included 50 patients (mean age 56 ± 12 years, five female) with symptomatic AF (40% paroxysmal, 60% persistent), referred for catheter ablation. In each patient, transthoracic echocardiography was performed. Additionally, all patients underwent CT using a 64-slice CT scanner. Left atrial volume was calculated by manually tracing left atrial area on each CT cross-sectional image. Patients had a mean LAD measured by echocardiography of 4.5 ± 0.7 cm, ranging from 2.9 to 5.7 cm. Left atrial volume measured by CT ranged from 67 mL to 270 mL with a mean value of 146 ± 49 mL. A poor correlation was noted between LAD and left atrial volume, r = 0.49 (P < 0.001). Conclusion: LAD measured by echocardiography correlates poorly with left atrial volume measured by CT in patients with AF. As a result, selecting patients with AF for treatment with catheter ablation should not be based on an echocardiographic-derived LAD alone. [source] Preoperative risk assessment and prevention of complications in patients with esophageal cancerJOURNAL OF SURGICAL ONCOLOGY, Issue 3 2010Brechtje A. Grotenhuis MD Abstract In this review the preoperative risk assessment and prevention of complications in patients undergoing esophagectomy for cancer is discussed. Age, pulmonary and cardiovascular condition, nutritional status, and neoadjuvant chemo(radio)therapy are known predictive factors. None of these factors is a valid exclusion criterion for esophagectomy, but may help in careful patient selection. Both anesthetists and surgeons play an important role in intraoperative risk reduction by means of appropriate fluid management and application of optimal surgical techniques. J. Surg. Oncol. 2010; 101:270,278. © 2010 Wiley-Liss, Inc. [source] How Should Reading Disabilities be Operationalized?LEARNING DISABILITIES RESEARCH & PRACTICE, Issue 2 2002A Survey of Experts In the face of accumulating research and logic, the use of a discrepancy between intelligence and reading achievement test scores is becoming increasingly untenable as a marker of reading disabilities. However, it is not clear what criteria might replace the discrepancy requirement. We surveyed 218 members of journal editorial boards to solicit their opinions on current and proposed definitional components and exclusion criteria. Three components were selected by over two-thirds of the respondents: reading achievement, phonemic awareness, and treatment validity. However, only 30 percent believed IQ-reading achievement discrepancy should be a marker. More than 75 percent of the respondents believed exclusion criteria should remain part of the definition. Mental retardation was the most frequently selected exclusion criterion despite rejection of intelligence test scores as a definitional component. Although the findings reflect uncertainty among experts on what elements should comprise a definition, they do signal a willingness to consider new approaches to the conceptually difficult task of defining reading disabilities. [source] Caries-preventive effect of resin-based and glass ionomer sealants over time: a systematic reviewCOMMUNITY DENTISTRY AND ORAL EPIDEMIOLOGY, Issue 6 2006N. Beiruti Abstract,,, Introduction:, The difference in preventing dentine lesion development between resin-based and glass ionomer sealant materials is unclear. Two recently published reviews were unable to conclude on the difference because the comparison was an exclusion criterion in one review and there were statistical shortcomings in the relevant papers in the other (Cochrane) review. Objectives:, The aim of the present investigation was to carry out a systematic review on the caries-preventive effect of these two types of sealant materials under more liberal exclusion criteria concerning the statistical presentations in the publications. Methods:, Based on five exclusion criteria, the literature search in the electronic libraries PubMed and MEDLINE and the publications retrieved in the Cochrane review, revealed 12 eligible publications for analyses. A variety of glass ionomers and resin-based sealant materials had been applied in the included studies. Attributable risk (AR) was chosen rather than relative risk (RR), as used in the Cochrane review, because RR is very instable in a low caries population. Results:, There was no consistent pattern observed with respect to the caries-preventive effect of either resin-based or glass ionomer sealants. Therefore, it was impossible to calculate an overall AR. Conclusions:, There is no evidence that either resin-based or glass ionomer sealant material is superior to the other in preventing dentine lesion development in pits and fissures over time. [source] | ||||||||||