1,141 results match your criteria stricter diagnostic

Diagnosis and treatment of refractory pituitary adenomas: a narrative review.

Gland Surg 2021 Apr;10(4):1499-1507

Chinese Pituitary Specialists Congress, Beijing, China.

Although aggressive pituitary adenomas (PAs) have been proposed and widely discussed for more than a decade, there is no general agreement regarding their definition, diagnosis or management. As one of the largest pituitary centers in China, we have diagnosed and treated more than fifty cases of aggressive PA and 3 pituitary carcinomas in the past 5 years and proposed a new term, i.e. Read More

View Article and Full-Text PDF

Impact of modification to DSM-5 criterion A for hypomania/mania in newly diagnosed bipolar patients: findings from the prospective BIO study.

Int J Bipolar Disord 2021 May 3;9(1):14. Epub 2021 May 3.

Copenhagen Affective Disorders Research Centre (CADIC), Psychiatric Centre Copenhagen, Department O, 6233, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark.

Background: DSM-IV states that criterion A for diagnosing hypomania/mania is mood change. The revised DSM-5 now states that increased energy or activity must be present alongside mood changes to diagnose hypomania/mania, thus raising energy/activity to criterion A. We set out to investigate how the change in criterion A affects the diagnosis of hypomanic/manic visits in patients with a newly diagnosed bipolar disorder. Read More

View Article and Full-Text PDF

Evidence for biological markers of tinnitus: A systematic review.

Prog Brain Res 2021 19;262:345-398. Epub 2021 Mar 19.

National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, United Kingdom.

Subjective tinnitus is a phantom sound heard only by the affected person and may be a symptom of various diseases. Tinnitus diagnosis and monitoring is based on subjective audiometric and psychometric methods. This review aimed to synthesize evidence for tinnitus presence or its severity. Read More

View Article and Full-Text PDF

How to Classify and Define Pituitary Tumors: Recent Advances and Current Controversies.

Front Endocrinol (Lausanne) 2021 17;12:604644. Epub 2021 Mar 17.

Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Pituitary tumors are very complex and heterogeneous and have a very wide range of proliferative and aggressive behaviors, and how to define and classify these tumors remains controversial. This review summarizes the epidemiology and progress in the classification and definition of pituitary tumors, as well as controversial issues. Based on the results of radiologic and autopsy studies, the prevalence of pituitary tumors has recently increased significantly. Read More

View Article and Full-Text PDF

Adaptive sample size determination for the development of clinical prediction models.

Diagn Progn Res 2021 Mar 22;5(1). Epub 2021 Mar 22.

Department of Development & Regeneration, KU Leuven, Leuven, Belgium.

Background: We suggest an adaptive sample size calculation method for developing clinical prediction models, in which model performance is monitored sequentially as new data comes in.

Methods: We illustrate the approach using data for the diagnosis of ovarian cancer (n = 5914, 33% event fraction) and obstructive coronary artery disease (CAD; n = 4888, 44% event fraction). We used logistic regression to develop a prediction model consisting only of a priori selected predictors and assumed linear relations for continuous predictors. Read More

View Article and Full-Text PDF

Appendicitis during the COVID-19 lockdown: results of a multicenter analysis in Germany.

Langenbecks Arch Surg 2021 Mar 7;406(2):367-375. Epub 2021 Feb 7.

Klinik und Poliklinik für Allgemein-, Viszeral-, Transplantations-, Gefäß- und Kinderchirurgie, Universitätsklinikum Würzburg, Würzburg, Germany.

Purpose: The COVID-19 pandemic has transformed medical care worldwide. General surgery has been affected in elective procedures, yet the implications for emergency surgery are unclear. The current study analyzes the effect of the COVID-19 lockdown in spring 2020 on appendicitis treatment in Germany. Read More

View Article and Full-Text PDF

A model for COVID-19 with isolation, quarantine and testing as control measures.

Epidemics 2021 03 21;34:100437. Epub 2021 Jan 21.

Escola de Matemática Aplicada, FGV EMAp, Rio de Janeiro, Brazil. Electronic address:

In this article we propose a compartmental model for the dynamics of Coronavirus Disease 2019 (COVID-19). We take into account the presence of asymptomatic infections and the main policies that have been adopted so far to contain the epidemic: social distancing, isolation of a portion of the population, quarantine for confirmed cases and testing. We refer to quarantine as strict isolation, and it is applied to confirmed infected cases. Read More

View Article and Full-Text PDF

Implementation and Evolution of Mitigation Measures, Testing, and Contact Tracing in the National Football League, August 9-November 21, 2020.

MMWR Morb Mortal Wkly Rep 2021 Jan 29;70(4):130-135. Epub 2021 Jan 29.

The National Football League (NFL) and the NFL Players Association (NFLPA) began the 2020 football season in July, implementing extensive mitigation and surveillance measures in facilities and during travel and gameplay. Mitigation protocols* were evaluated and modified based on data from routine reverse transcription-polymerase chain reaction (RT-PCR) tests for SARS-CoV-2, the virus that causes coronavirus 2019 (COVID-19); proximity tracking devices; and detailed interviews. Midseason, transmission was observed in persons who had cumulative interactions of <15 minutes' duration, leading to a revised definition of high-risk contacts that required consideration of mask use, setting and room ventilation in addition to proximity and duration of interaction. Read More

View Article and Full-Text PDF
January 2021

Physical Activity, Mental Health, and Technology Preferences to Support Cancer Survivors During the COVID-19 Pandemic: Cross-sectional Study.

JMIR Cancer 2021 Feb 3;7(1):e25317. Epub 2021 Feb 3.

Division of Health Informatics and Implementation Science, Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, United States.

Background: COVID-19 has had significant health-related and behavioral impacts worldwide. Cancer survivors (hereafter referred to as "survivors") are particularly prone to behavioral changes and are encouraged to be more vigilant and observe stricter social distancing measures.

Objective: We explored (1) changes in physical activity and sedentary behaviors since the onset of COVID-19, along with changes in mental health status, and (2) alternative strategies to support survivors' physical activity and social health during and after COVID-19, along with the role of digital health in such strategies. Read More

View Article and Full-Text PDF
February 2021

Thrombolytic strategies versus standard anticoagulation for acute deep vein thrombosis of the lower limb.

Cochrane Database Syst Rev 2021 01 19;1:CD002783. Epub 2021 Jan 19.

Department of General Surgery, Norfolk and Norwich University Hospital, Norwich, UK.

Background: Standard treatment for deep vein thrombosis (DVT) aims to reduce immediate complications. Use of thrombolytic clot removal strategies (i.e. Read More

View Article and Full-Text PDF
January 2021

Predictors of recognition of out of hospital cardiac arrest by emergency medical services call handlers in England: a mixed methods diagnostic accuracy study.

Scand J Trauma Resusc Emerg Med 2021 Jan 6;29(1). Epub 2021 Jan 6.

School of Nursing, University of Central Lancashire, Brook Building, Preston, PR1 2HE, UK.

Background: The aim of this study was to identify key indicator symptoms and patient factors associated with correct out of hospital cardiac arrest (OHCA) dispatch allocation. In previous studies, from 3% to 62% of OHCAs are not recognised by Emergency Medical Service call handlers, resulting in delayed arrival at scene.

Methods: Retrospective, mixed methods study including all suspected or confirmed OHCA patients transferred to one acute hospital from its associated regional Emergency Medical Service in England from 1/7/2013 to 30/6/2014. Read More

View Article and Full-Text PDF
January 2021

Migraine in transient global amnesia: a meta-analysis of observational studies.

J Neurol 2021 Jan 2. Epub 2021 Jan 2.

Department of Neurology, School of Medicine, University Hospital of Larissa, University of Thessaly, Larissa, Greece.

Background: PURPOSE: Although many studies have investigated the relationship between transient global amnesia (TGA) and migraine, to date, no meta-analysis has confirmed the existence and size of their association.

Methodology: Literature search involved MEDLINE, EMBASE, CENTRAL and PsycINFO. Observational controlled studies including TGA patients (Caplan, Hodges and Warlow) were retrieved. Read More

View Article and Full-Text PDF
January 2021

[Proposals for the diagnosis and treatment of andrologic diseases during the novel coronavirus pneumonia epidemic].

Zhonghua Nan Ke Xue 2020 Mar;26(3):200-204

Department of Andrology, The First Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510080, China.

In December, 2019, several cases of novel coronavirus pneumonia (NCP) were reported in Wuhan, Hubei. Since then, more and more NCP cases, confirmed or suspected, have been found in China and other parts of the world, and the virus is now showing a tendency towards a wider spread. During the NCP epidemic, all medical workers are confronted with special challenges in the diagnosis and treatment of various diseases and required of even more accurate therapeutic protocols as well as stricter observation of the principles for the prevention and control of NCP. Read More

View Article and Full-Text PDF

Predementia constructs: Mild cognitive impairment or mild neurocognitive disorder? A narrative review.

Int J Geriatr Psychiatry 2020 Nov 26. Epub 2020 Nov 26.

Research Institute (Imas12), University Hospital "12 de Octubre", Madrid, Spain.

Background: Predementia is a heuristic umbrella concept to classify older adults with cognitive impairment who do not suffer dementia. Many diagnostic entities have been proposed to address this concept, but most of them have not had widespread acceptance.

Aims: To review clinical definitions, epidemiologic data (prevalence, incidence) and rate of conversion to dementia of the main predementia constructs, with special interest in the two most frequently used: mild cognitive impairment (MCI) and minor neurocognitive disorder (miNCD). Read More

View Article and Full-Text PDF
November 2020

Determinants and Trends of Adherence to a Gluten-Free Diet in Adult Celiac Patients on a Long-Term Follow-Up (2000-2020).

Clin Gastroenterol Hepatol 2020 Dec 15. Epub 2020 Dec 15.

Istituti Clinici Scientifici Maugeri, IRCCS, Gastroenterology Unit of Pavia Institute, University of Pavia, Pavia, Italy.

Background & Aims: Data on factors governing long-term adherence to a gluten-free diet (GFD) in celiac disease (CD) are scarce. We aimed to determine trends and clinical predictors of long-term GFD adherence in adult CD.

Methods: Initial and long-term (>3 years) GFD adherence, clinical characteristics at baseline and follow-up were collected retrospectively from patients with celiac followed-up over 20 years (2000-2020). Read More

View Article and Full-Text PDF
December 2020

Association Between Blood Pressure Control and Coronavirus Disease 2019 Outcomes in 45 418 Symptomatic Patients With Hypertension: An Observational Cohort Study.

Hypertension 2021 03 16;77(3):846-855. Epub 2020 Dec 16.

From the Nuffield Department of Primary Care Health Sciences, University of Oxford, United Kingdom (J.P.S., B.D.N., J.L., D.M., J.S., C.K., J.O., N.R.J., W.H., L.A., O.V.H., S.L.-F., C.R.B., H.L., J.W., F.F., M.D.F., M.P.J., S.d.L., F.D.R.H.).

Hypertension has been identified as a risk factor for coronavirus disease 2019 (COVID-19) and associated adverse outcomes. This study examined the association between preinfection blood pressure (BP) control and COVID-19 outcomes using data from 460 general practices in England. Eligible patients were adults with hypertension who were tested or diagnosed with COVID-19. Read More

View Article and Full-Text PDF

Nuclear magnetic resonance spectroscopy of biofluids for osteoarthritis.

Br Med Bull 2021 Mar;137(1):28-41

Institute of Life Course and Medical Sciences, Musculoskeletal and Ageing Science, William Henry Duncan Building, 6 West Derby Street, Liverpool L7 8TX, UK.

Background: Osteoarthritis is a common degenerative musculoskeletal disease of synovial joints. It is characterized by a metabolic imbalance resulting in articular cartilage degradation, reduced elastoviscosity of synovial fluid and an altered chondrocyte phenotype. This is often associated with reduced mobility, pain and poor quality of life. Read More

View Article and Full-Text PDF

Endonasal endoscopic surgery for sinonasal squamous cell carcinoma from an oncological perspective.

Auris Nasus Larynx 2021 Feb 4;48(1):41-49. Epub 2020 Dec 4.

International Head and Neck Scientific Group, Padua, Italy.

Endonasal endoscopic surgery (EES) has been applied to the management of sinonasal (SN) tumors based on recent advances in endoscopic surgical techniques and technologies over the past three decades. EES has been mainly indicated for benign tumors and less aggressive malignant tumors. Notwithstanding this, EES has been gradually adopted for squamous cell carcinoma (SCC), which is the most common histology among SN malignancies. Read More

View Article and Full-Text PDF
February 2021

External Validation of Five Scores to Predict Stroke-Associated Pneumonia and the Role of Selected Blood Biomarkers.

Stroke 2021 01 7;52(1):325-330. Epub 2020 Dec 7.

Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; Center for Stroke Research Berlin, NeuroCure Clinical Research Center and Department of Neurology, Charité University Hospital Berlin, Germany (B.H., S.H., L.U., A.M.).

Background And Purpose: Several clinical scoring systems as well as biomarkers have been proposed to predict stroke-associated pneumonia (SAP). We aimed to externally and competitively validate SAP scores and hypothesized that 5 selected biomarkers would improve performance of these scores.

Methods: We pooled the clinical data of 2 acute stroke studies with identical data assessment: STRAWINSKI and PREDICT. Read More

View Article and Full-Text PDF
January 2021

Clinical implications of differences between real world and clinical trial usage of left ventricular assist devices for end stage heart failure.

PLoS One 2020 3;15(12):e0242928. Epub 2020 Dec 3.

Section of Cardiovascular Medicine, Yale University School of Medicine, New Haven, CT, United States of America.

Importance: Patient outcomes in heart failure clinical trials are generally better than those observed in real-world settings. This may be related to stricter inclusion and exclusion criteria in clinical trials.

Objective: We study sought to characterize the clinical implications of differences between patients in clinical trials and those in a real-world registry of patients receiving left ventricular assist devices (LVADs). Read More

View Article and Full-Text PDF
January 2021

[Impact of the novel in vitro diagnostic regulation (IVDR) of the European Union on pathology laboratories. What's important?]

Pathologe 2020 Dec;41(Suppl 2):129-133

Institut für Pathologie, Technische Universität München, München, Deutschland.

In 2022 the new in vitro diagnostic regulation (IVDR) of the European Union will come into full effect. This complex regulatory framework aims at a stricter regulation and monitoring of industrial diagnostic assay production. The IVDR defines many new methodological requirements and includes an additional entirely new focus on the clinical validity of diagnostic assays as well as a novel tighter vigilance system. Read More

View Article and Full-Text PDF
December 2020

Giant intracranial aneurysm following radiation therapy: literature review with a novel case discussion.

Acta Biomed 2020 09 23;91(10-S):e2020005. Epub 2020 Sep 23.

Operative Unit of Neuroradiology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy. Via Francesco Sforza 35, 20122, Milano, Italy.

Background: The aim of this paper is to report the results of our review of the literature of published cases of intracranial aneurysms appearing after radiotherapy, and to present our case to add it to the current literature, in order to discuss the role of inflammation.

Methods: We searched the PubMed database using combinations of the following MeSH terms: intracranial aneurysm, radiosurgery, radiotherapy, inflammatory changes in aneurysmal walls from 1967 to 2019.

Results: 51 studies, for a total cohort of 60 patients, are described. Read More

View Article and Full-Text PDF
September 2020

Increased and unjustified CT usage in paediatric C-spine clearance in a level 2 trauma centre.

Eur J Trauma Emerg Surg 2020 Oct 27. Epub 2020 Oct 27.

Department of Trauma Surgery, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands.

Purpose: Cervical spine injury after blunt trauma in children is rare but can have severe consequences. Clear protocols for diagnostic workup are, therefore, needed, but currently not available. As a step in developing such a protocol, we determined the incidence of cervical spine injury and the degree of protocol adherence at our level 2 trauma centre. Read More

View Article and Full-Text PDF
October 2020

Interpretation of serial interferon-gamma test results to measure new tuberculosis infection among household contacts in Zambia and South Africa.

BMC Infect Dis 2020 Oct 15;20(1):760. Epub 2020 Oct 15.

Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK.

Background: A more stringent QuantiFERON-TB Gold In-Tube (QFT) conversion (from negative to positive) definition has been proposed to allow more definite detection of recent tuberculosis (TB) infection. We explored alternative conversion definitions to assist the interpretation of serial QFT results and estimate incidence of TB infection in a large cohort study.

Methods: We used QFT serial results from TB household contacts aged ≥15 years, collected at baseline and during two follow-up visits (2006-2011) as part of a cohort study in 24 communities in Zambia and South Africa (SA). Read More

View Article and Full-Text PDF
October 2020

Early Prediction of Malignant Cerebellar Edema in Posterior Circulation Stroke Using Quantitative Lesion Water Uptake.

Neurosurgery 2021 02;88(3):531-537

Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

Background: Malignant cerebellar edema (MCE) is a life-threatening complication of ischemic posterior circulation stroke that requires timely diagnosis and management. Yet, there is no established imaging biomarker that may serve as predictor of MCE. Early edematous water uptake can be determined using quantitative lesion water uptake, but this biomarker has only been applied in anterior circulation strokes. Read More

View Article and Full-Text PDF
February 2021

Adrenal Venous Sampling-Guided Adrenalectomy Rates in Primary Aldosteronism: Results of an International Cohort (AVSTAT).

J Clin Endocrinol Metab 2021 Mar;106(3):e1400-e1407

Division of Diabetes and Endocrinology, National International Center for Global Health and Medicine, Tokyo, Japan.

Context: Adrenal venous sampling (AVS) is the current criterion standard lateralization technique in primary aldosteronism (PA). Japanese registry data found that 30% of patients with unilateral PA did not undergo adrenalectomy, but the reasons for this and whether the same pattern is seen internationally are unknown.

Objective: To assess the rate of AVS-guided adrenalectomy across an international cohort and identify factors that resulted in adrenalectomy not being performed in otherwise eligible patients. Read More

View Article and Full-Text PDF

Sluggish cognitive tempo (SCT) in an adult outpatient sample seeking an attention-deficit/hyperactivity disorder assessment: Age of onset and assessment method impact on SCT rates.

J Psychiatr Res 2020 12 17;131:203-208. Epub 2020 Sep 17.

Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA.

Background: Sluggish cognitive tempo (SCT) is associated with-but distinct from-attention-deficit/hyperactivity disorder (ADHD). This study examined SCT rates in adult outpatients seeking an ADHD assessment, differences in rates based on ADHD status, impact of assessment method (i.e. Read More

View Article and Full-Text PDF
December 2020

Elucidating the Causes of Improved Survival in Clinical Trials of Randomized Adjuvant Pancreatic Ductal Adenocarcinoma (PDAC).

Ann Surg Oncol 2021 Feb 23;28(2):1060-1068. Epub 2020 Sep 23.

University Hospitals Cleveland Medical Center, 11100 Euclid Avenue, Cleveland, OH, 44107, USA.

Background: Overall survival (OS) has increased in recent adjuvant clinical trials of pancreatic ductal adenocarcinoma (PDAC). Although oncologists have taken notice, the root causes have not been fully examined.

Methods: All phase 3 adjuvant PDAC clinical trials were screened (n = 13), and eight trials (2007-2019) that met a study requirement of having a gemcitabine monotherapy arm to serve as a uniform comparative anchor across trials were identified. Read More

View Article and Full-Text PDF
February 2021

Late Diagnosis of Infants with PCD and Neonatal Respiratory Distress.

J Clin Med 2020 Sep 4;9(9). Epub 2020 Sep 4.

Institute of Social and Preventive Medicine, University of Bern, 3012 Bern, Switzerland.

Neonatal respiratory distress (NRD) is common among infants with primary ciliary dyskinesia (PCD), but we do not know whether affected neonates receive a timely diagnosis. We used data from the international PCD cohort and assessed the proportion of patients with PCD who had a history of NRD and their age at diagnosis, stratifying by presence of laterality defects. First we analyzed data from all participants diagnosed after 2000, followed by individuals from a subgroup diagnosed using stricter criteria. Read More

View Article and Full-Text PDF
September 2020

In-Vivo Microsystems: A Review.

Paddy French

Sensors (Basel) 2020 Sep 1;20(17). Epub 2020 Sep 1.

Laboratory for Bioelectronics, Faculty of Electrical Engineering, Mathematics and Computer Science, TU Delft, Mekelweg 4, 2628CD Delft, The Netherlands.

sensors yield valuable medical information by measuring directly on the living tissue of a patient. These devices can be surface or implant devices. Electrical activity in the body, from organs or muscles can be measured using surface electrodes. Read More

View Article and Full-Text PDF
September 2020