Articles: sensitivity-specificity.
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Acute anterior myocardial infarctions caused by proximal left anterior descending (LAD) artery occlusions are associated with a higher morbidity and mortality. Early identification of high-risk patients via the 12-lead electrocardiogram (ECG) could assist physicians and emergency response teams in providing early and aggressive care for patients with anterior ST-elevation myocardial infarctions (STEMI). Approximately 25% of US hospitals have primary percutaneous coronary intervention (PCI) capability for the treatment of acute myocardial infarctions. Given the paucity of hospitals capable of PCI, early identification of more severe myocardial infarction may prompt emergency medical service routing of these patients to PCI-capable hospitals. We sought to determine if the 12 lead ECG is capable of predicting proximal LAD artery occlusions. ⋯ The sum STE (V1-V6) and STD (II, III, aVF) on a 12-lead ECG can be used to predict proximal LAD occlusions if performed within the first hour of symptom onset. This should be considered a high-risk finding and may prompt prehospital direction of such patients to PCI-capable hospitals.
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Zhonghua yi xue za zhi · Sep 2011
[Correlation of transcutaneous oxygen challenge test and central venous oxygen saturation in septic shock patients].
To investigate the correlation of transcutaneous oxygen challenge test (OCT) [the degree of PtcO2 response to increased fractional inspired oxygen concentration (FiO2) of 1.0 is identified as transcutaneous OCT] and central venous oxygen saturation (ScvO2) in septic shock patients after resuscitation. ⋯ OCT may improve the diagnostic accuracy of PtcO2 in assessing the low ScvO2 values in septic shock patients after resuscitation.
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Intensive care medicine · Sep 2011
Review Meta AnalysisSeverity assessment tools to guide ICU admission in community-acquired pneumonia: systematic review and meta-analysis.
The aim of this meta-analysis was to determine if severity assessment tools can be used to guide decisions regarding intensive care unit (ICU) admission of patients with community-acquired pneumonia. ⋯ Large variations exist in the use of ICU resources between different studies and different healthcare systems. Scoring systems designed to predict 30-day mortality perform less well when ICU admission is taken into account. Further studies of dedicated ICU admission scores are required.
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Plasma gelsolin depletion has been associated with poor outcome of critically ill patients. However, there is a paucity of data available on circulating plasma gelsolin concentration in traumatic brain injury (TBI). Thus, we sought to investigate change in plasma gelsolin level after TBI and to evaluate its relation with disease outcome. ⋯ Decreased plasma gelsolin level is associated with GCS scores and an independent prognostic marker of mortality after TBI. Reversing plasma gelsolin deficiency may be an effective treatment for TBI.
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Clinical endocrinology · Jul 2011
Performance of a third-generation TSH-receptor antibody in a UK clinic.
UK national guidelines recommend the measurement of TSH receptor antibodies (TRAb) in certain clinical scenarios. A commercial third-generation TRAb autoantibody M22-biotin ELISA assay was introduced in May 2008 in our centre. ⋯ The assay studied specifically identifies patients with Graves' disease. It is a reliable tool in the initial clinical assessment to determine the aetiology of hyperthyroidism and has the potential for cost-savings.