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Common Tests (common + test)
Selected AbstractsThe effect of concurrent pain on the management of patients with depression: an analysis of NHS healthcare resource utilisation using the GPRD databaseINTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 5 2009L. Watson Summary Introduction:, Patients with depression frequently report painful physical symptoms. However, there are scant data from the UK concerning differences in primary and secondary care resource use between depressed patients with and without pain treated in general practice. Methods:, Patients with depression codes were identified from the General Practice Research Database (GPRD) excluding those with psychoses. The observation period was 1st January 2000,31st December 2006. Patients were further categorised into three groups: (i) no painful physical symptom codes ever in the observation period (NO PAIN); (ii) patients with no other diagnostic or test codes 30 days either side of a pain code (PAIN MINUS DIAGNOSIS) and (iii) patients with pain codes and other diagnostic codes (PAIN PLUS DIAGNOSIS). Rates of general practitioner (GP) visits, antidepressant and concomitant prescribing and switching, secondary care referrals and diagnostic tests were reported per group with 95% confidence limits (CI). Results:, A total of 145,784 patients with depression aged 18,50 years were selected. Of these, 48,615 (33.3%) were classed as NO PAIN, the remaining 66.6% having pain. PAIN MINUS DIAGNOSIS patients constituted 5654 (5.8%) of those with pain. PAIN MINUS DIAGNOSIS and PAIN PLUS DIAGNOSIS had a significantly higher rate of GP visits than NO PAIN patients, 10.37 (95% CI 10.23, 10.52); 11.15 (11.11,11.20) and 7.04 (7.00, 7.08) respectively. Inter and intraclass drug switching was high with 13% of PAIN MINUS DIAGNOSIS and 14% of PAIN PLUS DIAGNOSIS patients having three or more switches compared with 7% of NO PAIN patients. Referral rates to secondary care were significantly higher in both pain groups compared with patients with no pain. Diagnostic testing was significantly greater in PAIN MINUS DIAGNOSIS and PAIN PLUS DIAGNOSIS groups than NO PAIN patients for all test types, with X-rays being the most common test; 3.85 (3.69,4.00); 2.77 (2.74,2.80); 0.91 (0.89, 0.94) respectively. Conclusion:, Patients in general practice diagnosed with depression and concurrent painful physical symptoms have higher resource use in primary and secondary care. [source] Antiepileptic monotherapy significantly impairs normative scores on common tests of executive functionsACTA NEUROLOGICA SCANDINAVICA, Issue 3 2009E. Hessen Background,,, Understanding how antiepileptic (AED) monotherapy influences normative test scores is of importance in the clinic for correct interpretation of neuropsychological profiles. Previous studies have primarily reported minor influence on neuropsychological raw scores, and the clinical relevance of these findings is unclear. Aim of the study ,To obtain a clinical valid answer to this question, we analysed changes in T-scores after AED withdrawal in a large group of well-controlled epilepsy patients, for tests previously shown to be sensitive to AED withdrawal. Methods ,We report outcomes on measures of choice reaction time from the California Computerized Assessment Package, on the Controlled Oral Word Association Test and on the Stroop Color-Word Interference Test. Results ,Significantly improved T-scores were revealed after AED withdrawal on five of the six tests of executive functions with mean improvement of 5 T-scores. Comparable results were achieved in the subgroup taking carbamazepine, with a mean improvement of 6.2 T-scores. Conclusion ,The present results suggest that T-scores for computerized tests of choice reaction time and tests of verbal fluency and response inhibition may be significantly impaired as a consequence of AED monotherapy, and that careful interpretation of these scores is required in diagnostic assessment of patients receiving AED monotherapy. [source] A Decision Rule for Predicting Bacterial Meningitis in Children with Cerebrospinal Fluid Pleocytosis When Gram Stain Is Negative or UnavailableACADEMIC EMERGENCY MEDICINE, Issue 5 2008Bema K. Bonsu MBChB Abstract Objectives:, Among children with cerebrospinal fluid (CSF) pleocytosis, the task of separating aseptic from bacterial meningitis is hampered when the CSF Gram stain result is unavailable, delayed, or negative. In this study, the authors derive and validate a clinical decision rule for use in this setting. Methods:, This was a review of peripheral blood and CSF test results from 78 children (<19 years) presenting to Children's Hospital Columbus from 1998 to 2002. For those with a CSF leukocyte count of >7/,L, a rule was created for separating bacterial from viral meningitis that was based on routine laboratory tests, but excluded Gram stain. The rule was validated in 158 subjects seen at the same site (Columbus, 2002,2004) and in 871 subjects selected from a separate site (Boston, 1993,1999). Results:, One point each (maximum, 6 points) was assigned for leukocytes >597/,L, neutrophils >74%, glucose <38 mg/dL, and protein >97 mg/dL in CSF and for leukocytes >17,000/mL and bands to neutrophils >11% in peripheral blood. Areas under receiver-operator-characteristic curves (AROCs) for the resultant score were 0.98 for the derivation set and 0.90 and 0.97, respectively, for validation sets from Columbus and Boston. Sensitivity and specificity pairs for the Boston data set were 100 and 44%, respectively, at a score of 0 and 97 and 81% at a score of 1. Likelihood ratios (LRs) increased from 0 at a score of 0 to 40 at a score of ,4. Conclusions:, Among children with CSF pleocytosis, a prediction score based on common tests of CSF and peripheral blood and intended for children with unavailable, negative, or delayed CSF Gram stain results has value for diagnosing bacterial meningitis. [source] 3421: Straylight and visionACTA OPHTHALMOLOGICA, Issue 2010TJTP VAN DEN BERG Purpose Straylight is considered an important source of patient complaints. They can be voiced like halos, glare, hazy vision and blinding at night. With visual acuity, contrast sensitivity and slit lamp examination little may be found. Yet increased large angle light scattering in the eye media not detected by common tests, may degrade the image projected on the retina, thus decreasing the quality of vision. Aging changes to the crystalline lens and cataract are the most common causes of increased straylight. This study aimed to quantify the importance of straylight for daily life on the basis of patient complaint scores. Methods In a duocenter setting questionnaires were administered before and after cataract surgery. The 37 questions VFQ as well as a self developed 5 question straylight questionnaire were used. A comparison was made between the importance of visual acuity and of straylight to explain the questionnaire outcomes. Results A total of 214 patients were included in the study. For the comparison correlation coefficients were calculated between a weighted average of the 2 functional measures visual acuity and straylight on the one hand, and the questionnaire outcomes on the other. In all 4 cases (2 questionnaires x 2 visits) correlation was lowest for both visual acuity and straylight used in isolation. When visual acuity and straylight were combined to one combined score, correlation improved. Maximum correlation was found when visual acuity and straylight were combined 1:1 (preop) to 2:1 (postop), for both questionnaires. Conclusion For cataract patients, straylight is of about equal importance compared to visual acuity for their appreciation of daily function. In this comparison both were quantified as logarithms (logMAR and log(s)). [source] | ||||||||||