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Bedside Test (bedside + test)
Selected AbstractsThe Focused Abdominal Sonography for Trauma (FAST) Examination: Considerations and Recommendations for Training Physicians in the Use of a New Clinical ToolACADEMIC EMERGENCY MEDICINE, Issue 2 2000Philip N. Salen MD Abstract. Focused abdominal sonography for trauma (FAST) is being used by growing numbers of emergency physicians and surgeons because it has proven to be an accurate, rapid, and repeatable bedside test for evaluating abdominal trauma victims. Controversy exists about the optimal means of FAST education and the number of examinations necessary to demonstrate competency. Most FAST educators agree that FAST education should consist of three phases: didactic, practical, and experiential. This article summarizes options and preliminary recommendations suitable for developing a FAST curriculum. [source] Decreased Platelet Function in Cavalier King Charles Spaniels with Mitral Valve RegurgitationJOURNAL OF VETERINARY INTERNAL MEDICINE, Issue 5 2003Inge Tarnow With aggregometry, increased platelet activity has been reported in Cavalier King Charles Spaniels (CKCS) without mitral regurgitation (MR). In contrast, dogs with MR have been found to have decreased platelet activity. The purpose of this study was to test an easy bedside test of platelet function (the Platelet Function Analyzer [PFA-100]) to see if it could detect an increase in platelet activity in CKCS without MR and a decrease in platelet activity in CKCS with MR. This study included 101 clinically healthy dogs 1 year of age: 15 control dogs of different breeds and 86 CKCS. None of the dogs received medication or had a history of bleeding. The PFA-100 evaluates platelet function in anticoagulated whole blood under high shear stress. Results are given as closure times (CT): the time it takes before a platelet plug occludes a hole in a membrane coated by agonists. The CT with collagen and adenosine-diphosphate as agonists was similar in control dogs (median 62 seconds; interquartile interval 55,66 seconds) and CKCS with no or minimal MR (55; 52,64 seconds). The CT was higher in CKCS with mild MR (regurgitant jet occupying 15,50% of the left atrial area) (75; 60,84 seconds; P= .0007) and in CKCS with moderate to severe MR (jet 50%) (87; 66,102 seconds; P < .0001). CKCS with mild, moderate, and severe, clinically inapparent MR have decreased platelet function. The previous finding of increased platelet reactivity in nonthrombocytopenic CKCS without MR could not be reproduced with the PFA-100 device. [source] The influence of folate serum levels on depressive mood and mental processing in patients with epilepsy treated with enzyme-inducing anti-epileptic drugsACTA NEUROPSYCHIATRICA, Issue 2 2003J. Rösche Background: Folate deficiency is common in patients with epilepsy and also occurs in patients with depression or cognitive deficits. Objective: This study investigates whether low serum folate levels may contribute to depressive mood and difficulties in mental processing in patients with epilepsy treated with anti-epileptic drugs inducing the cytochrome P450. Methods: We analysed the serum folate levels, the score in the Self Rating Depression Scale (SDS) and the results of a bedside test in mental processing in 54 patients with epilepsy. Results: There was a significant negative correlation between the serum folate levels and the score in SDS and significant positive correlations between the score in SDS and the time needed to process an interference task or a letter-reading task. Conclusions: Low serum folate levels may contribute to depressive mood and therefore to difficulties in mental processing. Further studies utilizing total plasma homocysteine as a sensitive measure of functional folate deficiency and more elaborate tests of mental processing are required to elucidate the impact of folate metabolism on depressive mood and cognitive function in patients with epilepsy. [source] The value of the Rydel-Seiffer tuning fork as a predictor of diabetic polyneuropathy compared with a neurothesiometerDIABETIC MEDICINE, Issue 6 2004T. Kästenbauer Abstract Aims The aim of the study was to investigate the predictive value of the Rydel-Seiffer tuning fork for detecting diabetic neuropathy and to compare it with an electronic neurothesiometer. Methods In 2022 consecutive diabetic subjects, peripheral polyneuropathy was diagnosed by vibration perception threshold (VPT) at the tip of both great toes using a 128-Hz tuning fork and a neurothesiometer, by simple bedside tests and by the presence of neuropathic symptoms. These evaluations were further combined to diagnose peripheral nerve dysfunction (abnormal bedside tests) and symptomatic neuropathy. VPT was also measured in 175 non-diabetic control subjects to define normal values. Results VPT was normal in 1917 subjects and abnormal in 105 (5.2%) patients when measured by the tuning fork. Patients with an abnormal vibration test were significantly (P < 0.0001) older than subjects with a normal vibration sense, while diabetes duration and HbA1c of the former were also significantly elevated. The same was true for the percentages of an abnormal 10-g monofilament test (66.7% vs. 7.2%, P < 0.0001) and a missing Achilles' tendon reflex (68.6% vs. 24.8%, P < 0.0001). Finally, the VPT measured by the neurothesiometer was 2.5 times higher in patients with an abnormal tuning fork test (32.0 ± 9.8 vs. 12.5 ± 6.4 V, P < 0.0001). The plot of the difference of both methods against their mean yielded a good agreement of the two VPT measurements, and the tuning fork had a high sensitivity and positive predictive value for the diagnosis of abnormal bedside tests and for symptomatic neuropathy. Conclusion The tuning fork reliably detected peripheral neuropathy in comparison with the neurothesiometer. A tuning fork is a useful screening test for diabetic neuropathy. [source] Bedside screening for executive dysfunction in patients with subcortical ischemic vascular diseaseINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 9 2009Nils Margraf Objective We investigated several executive bedside tests for their effectiveness in the routine clinical diagnostics of dysexecutive syndrome in subcortical ischemic vascular disease (SIVD). Methods Five executive tests, CLOX, the Tower of London (ToL), a cognitive estimation test (CET), a verbal fluency test, and the Five-Point Test, were examined in 17 patients with marked cerebral microangiopathy in cranial MRI and clinical symptoms of SIVD. The test accuracy for discriminating the patients from 17 healthy comparison subjects closely matched for age, gender and level of education was determined. Results Aside from the CET we found a significant lower performance of the patients with SIVD in four of the five used executive tests. In receiver operating characteristic (ROC) analyses the accuracy of CLOX 1 showed excellent results for distinguishing between patients and comparison subjects (area under the curve (AUC) 0.901), while the ToL (AUC up to 0.845) and the productivity in the phonemic verbal fluency test (AUC 0.829) achieved a good accuracy. Differently the accuracy of the figural fluency was only poor to fair (AUC 0.706). However, the Youden Indices of the significant executive variables showed a wide range from 0.25 to 0.82. Conclusions Based on our data we consider CLOX, the ToL and the verbal fluency test promising executive bedside test concepts for diagnosing the dysexecutive syndrome in SIVD in clinical routine. Particularly for CLOX and the ToL a further psychometric evaluation is required. Copyright © 2009 John Wiley & Sons, Ltd. [source] Clinical probability and alveolar dead space measurement for suspected pulmonary embolism in patients with an abnormal D-dimer test resultJOURNAL OF THROMBOSIS AND HAEMOSTASIS, Issue 7 2006O. SANCHEZ Summary.,Background: Most patients with suspected pulmonary embolism (PE) have a positive D-dimer test and undergo diagnostic imaging. Additional non-invasive bedside tests are required to reduce the need for further diagnostic tests. Objectives: We aimed to determine whether a combination of clinical probability assessment and alveolar dead space fraction measurement can confirm or exclude PE in patients with an abnormal D-dimer test. Methods: We assessed clinical probability of PE and alveolar dead space fraction in 270 consecutive in- and outpatients with suspected PE and positive D-dimer. An alveolar dead space fraction < 0.15 was considered normal. PE was subsequently excluded or confirmed by venous compression ultrasonography, spiral computed tomography and a 3-month follow-up. Radiologists were unaware of the results of clinical probability and capnography. Results: PE was confirmed in 108 patients (40%). Capnography had a sensitivity of 68.5% (95% confidence interval [CI]: 58.9,77.1%) and a specificity of 81.5% (95% CI: 74.6,87.1%) for PE. Forty-five patients (16.6%) had both a low clinical probability and normal capnography (sensitivity: 99.1%, 95% CI: 94.9,100%) and 34 patients (12.6%) had both a high clinical probability and abnormal capnography (specificity: 100%, 95% CI: 97.7,100%). Conclusion: Capnography alone does not exclude PE accurately. The combination of clinical probability and capnography accurately excludes or confirms PE and avoids further testing in up to 30% of patients. [source] | ||||||||||