Intravenous flumazenil infusion to treat benzodiazepine dependence should be performed in the inpatient clinical setting for high risk of seizure

2011 ◽  
Vol 25 (6) ◽  
pp. 848-849 ◽  
Author(s):  
F Lugoboni ◽  
M Faccini ◽  
GL Quaglio ◽  
A Albiero ◽  
R Casari ◽  
...  
Keyword(s):  
High Risk ◽  
Clinical Setting ◽  
Benzodiazepine Dependence

scholarly journals Performance of Serology Assays for Diagnosing Celiac Disease in a Clinical Setting

2009 ◽  
Vol 16 (11) ◽  
pp. 1576-1582 ◽  
Author(s):  
Miriam Parizade ◽  
Yoram Bujanover ◽  
Batya Weiss ◽  
Vered Nachmias ◽  
Bracha Shainberg
Keyword(s):  
Celiac Disease ◽  
High Risk ◽  
Clinical Setting ◽  
Test Performance ◽  
Large Scale ◽  
Tissue Transglutaminase ◽  
Enzyme Linked Immunosorbent Assay ◽  
Predictive Values ◽  
Chemiluminescence Assay ◽  
Cutoff Points

ABSTRACT Diagnosis of celiac disease frequently depends upon serology assays. We set out to prospectively assess the diagnostic value of five serology tests: an enzyme-linked immunosorbent assay (ELISA) for tissue transglutaminase (tTG)-immunoglobulin A (IgA) and tTG-IgG, a chemiluminescence assay for tTG-IgA, an ELISA for deamidated gliadin peptide (DGP) IgG and IgA screening, and detection of endomysial antibodies (Abs) by indirect immunofluorescence. One hundred sixteen children at high risk for developing celiac disease were evaluated clinically and underwent small bowel biopsies and blood serology tests. We examined differences between younger and older children in terms of clinical presentation, test performance, and the ability of high Ab levels to correctly predict diagnosis of celiac disease. Celiac disease was diagnosed for 85 (73%) children. No significant clinical differences were observed between the biopsy-positive and biopsy-negative groups. Children ≤3 years of age revealed higher concentrations of tTG-IgA and DGP Abs than children >3 years old (P = 0.017 and 0.007, respectively). High Ab concentrations were predictive of villous atrophies, with sensitivities ranging from 92.8% to 97.9%, depending on the assay and the cutoff points applied. Sensitivities, specificities, positive predictive values, and negative predictive values varied among assays and improved after correction for best cutoff points. Assay specificities obtained in the clinical setting were lower than expected. The new tTG-IgA chemiluminescence assay demonstrated high throughput but low specificity (74.2%). The tTG-IgA ELISA exhibited the highest test efficiency, and the tTG-IgA chemiluminescence assay was suitable for large-scale screening, with reduced specificity. High concentrations of celiac disease-specific Abs bring into question the need for performance of biopsies on children at high risk.

Neuromuscular Ultrasound in the EMG Lab

2016 ◽  
pp. 484-494
Author(s):  
Andrea J. Boon
Keyword(s):  
Respiratory Failure ◽  
High Risk ◽  
Clinical Setting ◽  
Diagnostic Yield ◽  
Imaging Modality ◽  
Focal Lesions ◽  
Electrodiagnostic Testing

Neuromuscular ultrasound is a portable, relatively inexpensive, widely available imaging modality that can be used to enhance the electrodiagnostic evaluation by improving its safety and accuracy, particularly in high-risk settings such as obesity, altered anatomy, anticoagulation, or other technically challenging situations. Furthermore, the emerging field of neuromuscular ultrasound has the potential to significantly increase diagnostic yield in patients presenting for electrodiagnostic testing. Focal lesions affecting nerve or muscle as well as more generalized polyneuropathy and myopathy can be diagnosed and characterized with ultrasound, including certain cases in which electrodiagnostic testing is inconclusive or negative. This chapter will review the rationale for combining electrodiagnosis with sonography in the clinical setting, including use of ultrasound to enhance safety and diagnostic yield when evaluating for neuromuscular respiratory failure.

scholarly journals Predictive Value of General Movement Assessment for Cerebral Palsy in Routine Clinical Practice

2015 ◽  
Vol 95 (11) ◽  
pp. 1489-1495 ◽  
Author(s):  
Gunn Kristin Øberg ◽  
Bjarne Koster Jacobsen ◽  
Lone Jørgensen
Keyword(s):  
Cerebral Palsy ◽  
High Risk ◽  
Clinical Setting ◽  
Predictive Value ◽  
Normal Development ◽  
Likelihood Ratios ◽  
Motor Problems ◽  
Movement Assessment ◽  
General Movement ◽  
High Risk Infants

Background Early identification of children at high risk of future neurodevelopmental disability is important for the initiation of appropriate therapy. In research settings, the assessment of fidgety movements (FMs) at 3 months supports a general movement assessment (GMA) as a strong predictor for subsequent motor development, but there are few studies from routine clinical settings. Objective The study objective was to examine the relationship between FMs and neurodevelopmental outcome by the age of 2 years in high-risk infants in a routine hospital clinical setting. Design This was a prospective study. Methods A GMA was performed in 87 high-risk infants at 3 months after term age. The infants were clinically assessed for cerebral palsy (CP) at 2 years. Sensitivity, specificity, likelihood ratios, and positive and negative predictive values were computed. The relative risk of motor problems by the age of 2 years, according to the GMA, was estimated. Results Of the infants with normal FMs, 93% (50/54) had normal development and none was diagnosed with CP, whereas 75% (12/16) with abnormal or sporadic FMs had normal development. In contrast, 53% (9/17) of those without FMs had CP. When the GMA was considered to be a test for CP and absent FMs were considered to be a positive test result, the sensitivity was 90% and the specificity was 90%. The likelihood ratios for positive and negative test results were 8.7 and 0.1, respectively. The negative predictive value was 99%, and the positive predictive value was 53%. The risk of motor problems by the age of 2 years increased linearly with the extent of pathological results on the GMA and was 10 times higher when FMs were absent at 3 months than when FMs were normal. Limitations The relatively small study sample was a study limitation. Conclusions When applied in a routine clinical setting, the GMA strongly predicted neurodevelopmental impairments at 2 years in high-risk infants.

scholarly journals Acute kidney injury and sinus bradycardia associated with near-drowning

2020 ◽  
pp. 18-22
Author(s):  
Zeki Kemeç ◽  
Ali Gürel
Keyword(s):  
Acute Kidney Injury ◽  
High Risk ◽  
Clinical Setting ◽  
Sinus Bradycardia ◽  
Kidney Injury ◽  
Respiratory Disorders ◽  
Mortality And Morbidity ◽  
Near Drowning ◽  
Risk Of Mortality

Acute kidney injury (AKI) occurs in different situations and may have a variable prognosis due to underlying cause, clinical setting and comorbidity. Near-drowning is known to lead to bradycardic rhythms which can lead to hypoxia because of hypoperfusion. AKI has a high risk of mortality and morbidity. However, sequelae of sinus bradycardia are related to its underlying etiology. Urinary, cardiovascular and respiratory disorders are more frequently seen after near-drowning. Near-drowning related AKI and sinus bradycardia are not reported together in the literature. We aimed to emphasize these complications in near-drowning patients.

Identification of patients at high risk of fragility fractures in an Indian clinical setting using FRAX

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Vaibhav Singh ◽  
Ananda Kisor Pal ◽  
Dibyendu Biswas ◽  
Alakendu Ghosh ◽  
Brijesh P Singh
Keyword(s):  
High Risk ◽  
Clinical Setting ◽  
Fragility Fractures

scholarly journals Knowledge, attitude and practice of infection control from aerosol generating procedure in clinical setting among dentist during COVID-19 pandemic: A multi centric survey

2021 ◽  
Vol 11 (2) ◽  
pp. 96-98
Author(s):  
Mahvash Fatema ◽  
Sneha Puri ◽  
Akhilesh Shewale ◽  
Rashmi Bele ◽  
Aditi Wargantiwar
Keyword(s):  
High Risk ◽  
Infection Control ◽  
Clinical Setting ◽  
Direct Contact ◽  
Positive Attitude ◽  
Oral Fluids ◽  
Attitude And Practice ◽  
Dental Procedures ◽  
Current Survey ◽  
Knowledge Attitude And Practice

Dentistry is the profession in which there is a high risk of contagion due to the exposure to aerosol/droplets, saliva and blood which is produce during the majority of dental procedures. SARS-CoV-2 therefore can be transmitted from an infected individuals through inhalation of aerosol/droplets or by direct contact with mucous membrane, oral fluids, contaminated instruments and surfaces. The present study was proposed to assess the level of awareness, perception, and attitude regarding COVID-19 and infection control among dentists. It was concluded that the dentists involved in the current survey showed satisfactory knowledge and a positive attitude towards COVID-19 during the outbreak.

A retrospective study of azacitidine treatment in patients with intermediate-2 or high risk myelodysplastic syndromes in a real-world clinical setting in Greece

2016 ◽  
Vol 105 (2) ◽  
pp. 184-195 ◽  
Author(s):  
Vasiliki Pappa ◽  
Achilles Anagnostopoulos ◽  
Eleni Bouronikou ◽  
Evangelos Briasoulis ◽  
Ioannis Kotsianidis ◽  
...  
Keyword(s):  
Retrospective Study ◽  
High Risk ◽  
Myelodysplastic Syndromes ◽  
Real World ◽  
Clinical Setting

Consultation for total pain in high-risk obstetrics

2017 ◽  
Vol 8 (1) ◽  
pp. 64-66
Author(s):  
Warren Mackie-Jenkins ◽  
Regina M Tosca ◽  
Hunter Groninger
Keyword(s):  
Palliative Care ◽  
Abdominal Pain ◽  
High Risk ◽  
Clinical Setting ◽  
Acute Abdominal Pain ◽  
Interdisciplinary Approach ◽  
Fetal Tissue ◽  
Uterine Horn ◽  
Pain Scores ◽  
Total Pain

Palliative care (PC) consultation rarely takes place in the clinical setting of high-risk obstetrics, where ‘total pain’ may be undermanaged. Here, we present a case of a young woman carrying twins and hospitalised for acute abdominal pain. Workup for her pain revealed non-viable fetal tissue positioned in the uterine horn; the remaining fetus was viable. Initial attempts to control the patient’s pain with strong parenteral opioids by the obstetrics team and the acute pain service failed. The PC service was consulted to assist. Applying a customary interdisciplinary approach in a novel PC clinical setting, the PC service was able to identify and attend to the patient’s physical, psychosocial and spiritual pain, resulting in an overall decrease in reported pain scores, decreased opioid requirement and a plan for preservation of the viable fetus.

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