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Age and Ageing Feb 2024Older adults with postprandial hypotension (PPH) increase susceptibility to falls, syncope, stroke, acute cardiovascular diseases and even death. However, the prevalence... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Older adults with postprandial hypotension (PPH) increase susceptibility to falls, syncope, stroke, acute cardiovascular diseases and even death. However, the prevalence of this condition varies significantly across studies. We aimed to determine the prevalence of PPH in older adults.
METHODS
Web of Science, PubMed, Cochrane Library, Embase and CINAHL were searched from their inception until February 2023. Search terms included 'postprandial period', 'hypotension' and 'postprandial hypotension'. Eligible studies were assessed using the Joanna Briggs Institute tool. Meta-analyses were performed among similar selected studies.
RESULTS
Thirteen eligible studies were included, and data from 3,021 participants were pooled. The meta-analysis revealed a PPH prevalence of 40.5% [95% confidence interval (CI): 0.290-0.519] in older adults, and this was prevalent in the community (32.8%, 95% CI: 0.078-0.647, n = 1,594), long-term healthcare facility (39.4%, 95% CI: 0.254-0.610, n = 1,062) and geriatrics department of hospitals (49.3%, 95% CI: 0.357-0.630, n = 365). The pooled results showed significant heterogeneity (I2 > 90%), partially related to the different ages, sex, pre-prandial systolic blood pressure levels of participants, or the different criteria and methodology used to diagnose PPH.
CONCLUSIONS
PPH is a prevalent condition in older adults. Further research is needed to confirm this result, and priority should be given to establishing international consensus on PPH diagnostic criteria and designing its diagnostic procedure.
Topics: Humans; Aged; Prevalence; Hypotension; Cardiovascular Diseases; Consensus; Hospitals
PubMed: 38411408
DOI: 10.1093/ageing/afae022 -
Bulletin of the World Health... Aug 2023Human African trypanosomiasis is a life-threatening parasitic infection endemic to sub-Saharan Africa. Around 95% of cases are due to , found in western and central...
Human African trypanosomiasis is a life-threatening parasitic infection endemic to sub-Saharan Africa. Around 95% of cases are due to , found in western and central Africa. Clinical signs and symptoms are nonspecific, current diagnostic tests are not sufficiently accurate, and parasitological confirmation of infection requires microscopic examination of body fluids and specialized techniques for concentrating parasites. Moreover, current treatment is not recommended on the basis of suspicion alone because it is not sufficiently safe. The availability of a simple and accurate diagnostic test to identify individuals harbouring parasites would widen treatment and help decrease disease prevalence. A subcommittee of the World Health Organization's Neglected Tropical Diseases Diagnostics Technical Advisory Group has developed a target product profile for a diagnostic tool to identify infection. This tool should have a high sensitivity for detecting but be simple enough to use in rural Africa. Ideally, the tool could be applied by any minimally trained individual in an unsophisticated peripheral health facility, or a mobile team in a village with little infrastructure. The test should be able to function under hot and humid conditions. Basic training should take under 2 hours and the test should involve fewer than five steps. There should be no need for instrumentation or precision liquid handling. The test should yield a qualitative result in under 20 minutes that can be easily observed, and one test should be sufficient for determining treatment. A unit cost below 1 United States dollar (US$) would enable mass screening.
Topics: Animals; Humans; Trypanosoma brucei gambiense; Trypanosomiasis, African; Africa; Body Fluids; Diagnostic Tests, Routine
PubMed: 37529027
DOI: 10.2471/BLT.23.290172 -
L'Encephale Mar 2024The primary objective of this study was to determine the effects of permanent, mediated parental presence during all autism spectrum disorder diagnostic evaluations on...
OBJECTIVES
The primary objective of this study was to determine the effects of permanent, mediated parental presence during all autism spectrum disorder diagnostic evaluations on parental adjustment (perceived parental stress and sense of parental competence) compared with procedures that traditionally only involve parents in pivotal periods of the diagnosis. The level of satisfaction with the diagnostic procedure and parents' needs were also evaluated to complete this first objective. The secondary objective was to assess the effects of psychosocial, individual, and contextual variables on perceived parental stress and sense of parental competence.
METHODS
The total sample of 49 parents was divided (using simple randomization) into two subgroups, each for a different procedure. Participants were met with once before the first consultation and once after. They completed self-reported questionnaires on parental stress, sense of parental competence, satisfaction with the procedure, social support, locus of control, and appraisal of life events. Statistical analysis was conducted using SPAD and SPSS software.
RESULTS
There was no difference between the two groups in the variables assessed. Satisfaction with the diagnostic procedure was high in both groups, but parents highlighted that they had important needs following the diagnosis. The child's level of autonomy, the presence of disruptive behaviors, and satisfaction with social support were found to be important for determining parental adjustment.
CONCLUSIONS
Several hypotheses may explain the lack of differences between the two groups, including that parents may not yet have been in a position to benefit from the procedure aimed at integrating them. Our suggestion is that professional interventions should focus on improving the child's autonomy and helping the parent to develop a satisfactory support network. Finally, parents' needs for the post-diagnosis phase should be given greater consideration, particularly in future research.
PubMed: 38523027
DOI: 10.1016/j.encep.2024.01.002 -
PloS One 2023Ischemic strokes in young adults have been a significant concern due to various potential etiologies and had substantial clinical and public health impacts. We aimed to... (Observational Study)
Observational Study
BACKGROUND AND OBJECTIVES
Ischemic strokes in young adults have been a significant concern due to various potential etiologies and had substantial clinical and public health impacts. We aimed to study the diagnostic tests, etiologies, and functional outcomes of acute ischemic stroke (AIS) and transient ischemic attack (TIA) in young adult patients.
METHODS
The data were retrieved from the Chiang Mai University Hospital Stroke Registry between January 2018 and December 2021. Consecutive AIS or TIA patients were included if they were 18-50 years and had no stroke mimics. Study outcomes were proportions of positive diagnostic tests, and 90-day modified Rankin Scale (mRS).
RESULTS
Of 244 enrolled patients, 59.0% (n = 144) were male, and 38.1% (n = 93) were aged 18-40, classified as the younger age group. There was a high incidence of diabetes (24.5%) and dyslipidemia (54.3%) among patients aged 41-50, associated with small-vessel occlusion and large-artery atherosclerosis stroke classification in this age group. Patients aged 18-40 years had more other determined etiologies (39.8%), with hypercoagulability (8.2%), arterial dissection (7.8%), and cardiac sources (6.6%) being the first three causes, which were associated with higher anticoagulant treatment. The cerebrovascular study, cardiac evaluation using echocardiography, and antiphospholipid syndrome testing were commonly performed, of which computed tomography angiography provided a high proportion of positive results (80.3%). 76.3% of young adult patients had excellent functional outcomes (mRS 0-1) with a median mRS of 0 (interquartile range 0-1) at 90-day follow-up.
CONCLUSIONS
Stroke of other determined etiology remained the common cause of stroke in young adults, and most affected individuals had excellent clinical outcomes. Blood tests for arterial hypercoagulability and noninvasive vascular and cardiac evaluations are encouraged in selected patients to determine the stroke etiology and guide for appropriate preventive strategies.
Topics: Female; Humans; Male; Young Adult; Diagnostic Tests, Routine; Hospitals; Ischemic Attack, Transient; Ischemic Stroke; Risk Factors; Stroke; Thrombophilia; Adolescent; Adult; Middle Aged
PubMed: 37792783
DOI: 10.1371/journal.pone.0292274 -
Journal of Korean Medical Science Feb 2024Tinnitus is a bothersome condition associated with various symptoms. However, the mechanisms of tinnitus are still uncertain, and a standardized assessment of the... (Review)
Review
BACKGROUND
Tinnitus is a bothersome condition associated with various symptoms. However, the mechanisms of tinnitus are still uncertain, and a standardized assessment of the diagnostic criteria for tinnitus is required. We aimed to reach a consensus on diagnosing tinnitus with professional experts by conducting a Delphi study with systematic review of the literature.
METHODS
Twenty-six experts in managing tinnitus in Korea were recruited, and a two-round modified Delphi study was performed online. The experts evaluated the level of agreement of potential criteria for tinnitus using a scale of 1-9. After the survey, a consensus meeting was held to establish agreement on the results obtained from the Delphi process. Consensus was defined when over 70% of the participants scored 7-9 (agreement) and fewer than 15% scored 1-3 (disagreement). To analyze the responses of the Delphi survey, the content validity ratio and Kendall's coefficient of concordance were evaluated.
RESULTS
Consensus was reached for 22 of the 38 statements. For the definition of tinnitus, 10 out of 17 statements reached consensus, with three statements achieving complete agreement including; 1) Tinnitus is a conscious perception of an auditory sensation in the absence of a corresponding external stimulus, 2) Tinnitus can affect one's quality of life, and 3) Tinnitus can be associated with hearing disorders including sensorineural hearing loss, vestibular schwannoma, Meniere's disease, otosclerosis, and others. For the classification of tinnitus, 11 out of 18 statements reached consensus. The participants highly agreed with statements such as; 1) Vascular origin is expected in pulse-synchronous tinnitus, and 2) Tinnitus can be divided into acute or chronic tinnitus. Among three statements on the diagnostic tests for tinnitus only Statement 3, "There are no reliable biomarkers for sensory or emotional factors of tinnitus." reached consensus. All participants agreed to perform pure-tone audiometry and tinnitus questionnaires, including the Tinnitus Handicap Inventory and Tinnitus Questionnaire.
CONCLUSION
We used a modified Delphi method to establish a consensus-based definition, a classification, and diagnostic tests for tinnitus. The expert panel reached agreement for several statements, with a high level of consensus. This may provide practical information for clinicians in managing tinnitus.
Topics: Humans; Tinnitus; Delphi Technique; Quality of Life; Diagnostic Tests, Routine; Republic of Korea
PubMed: 38317449
DOI: 10.3346/jkms.2024.39.e49 -
Central-European Journal of Immunology 2024Eosinophilia is a feature of multiple conditions, both hematologic and non-hematologic, and may be associated with organ damage. The pathogenesis of eosinophilia can... (Review)
Review
Eosinophilia is a feature of multiple conditions, both hematologic and non-hematologic, and may be associated with organ damage. The pathogenesis of eosinophilia can follow two distinct pathways. Primary eosinophilia is caused by a cell-intrinsic mechanism originating from clonal expansion of eosinophils through acquisition of a somatic mutation, such as FIP1L1-PDGFRA. In recent years, great progress has been made in the field of pathogenesis and molecularly targeted therapy of neoplastic eosinophilia. The diagnostic procedure should include, among other things, morphologic analysis of blood and bone marrow samples, cytogenetics and fluorescence in situ-hybridization tests to detect evidence of an acute or chronic myeloid or lymphoid disorder. Secondary eosinophilia follows a cell-extrinsic mechanism as a response to exogenous cytokines. In most clinical cases, peripheral blood eosinophilia is reactive and typically associated with non-hematological disorders such as infections, allergic conditions, connective tissue disorders, vasculitis, malignancy, or endocrinopathies. Nonetheless, the cause of most cases of hypereosinophilic syndrome remains unknown. In this article, we present a short review focused on differential diagnosis of eosinophilia and eosinophilic disorders. The diagnosis of eosinophilia is a challenge for physicians; thus this review may be useful in clinical practice.
PubMed: 38812609
DOI: 10.5114/ceji.2024.136512 -
Infection and Drug Resistance 2024The diagnosis of tubercular orthopedic implant-associated infection (TB-IAI) is challenging. This study evaluated the value of metagenomic next-generation sequencing...
OBJECTIVE
The diagnosis of tubercular orthopedic implant-associated infection (TB-IAI) is challenging. This study evaluated the value of metagenomic next-generation sequencing (mNGS) for the diagnosis of TB-IAI and developed a standardized diagnostic procedure for TB-IAI.
METHODS
The records of all patients with TB-IAI diagnosed and treated at our institution between December 2018 and September 2022 were retrospectively reviewed. Patient demographic characteristics, medical history, laboratory test, microbial culture, histopathology, and mNGS results, and time to diagnosis were recorded. The diagnostic efficiency of mNGS for TB-IAI was assessed by comparing the results and diagnostic time with that of other diagnostic modalities.
RESULTS
Ten patients were included in the analysis, including eight with prosthetic joint infections and two with fracture-related infections. The mNGS positivity rate was 100% (10/10), which was higher than that of TB-antibody (11%, 1/9), real-time quantitative polymerase chain reaction (22%, 2/9), T-SPOT.TB (25%, 2/8), purified protein derivative (50%, 4/8), microbial culture (50%, 5/10), and histopathology (20%, 2/10). mNGS shortened the time to diagnosis of TB-IAI. A standardized diagnostic procedure for TB-IAI was developed based on the findings.
CONCLUSION
mNGS is useful for the diagnosis of TB-IAI. mNGS is recommended in cases where it is difficult to identify a pathogen using routine diagnostic tests. The standardized diagnostic procedure might improve TB-IAI diagnosis.
IMPORTANCE
TB-IAI is a rare infection, which occurs after orthopedic surgery and hard to diagnose microbiologically. mNGS is a new detection technique not yet discussed in current literature as a means for TB-IAI diagnostics. Here we describe a cohort of patients with TB-IAI diagnosed by mNGS show high efficiency of mNGS for detection of this pathology and present a clinical algorithm supplementing conventional methods for TB-IAI assessment.
PubMed: 38774035
DOI: 10.2147/IDR.S441940 -
Nature Communications Jul 2023Bluetooth-enabled wearables can be linked to form synchronized networks to provide insightful and representative data that is exceptionally beneficial in healthcare...
Bluetooth-enabled wearables can be linked to form synchronized networks to provide insightful and representative data that is exceptionally beneficial in healthcare applications. However, synchronization can be affected by inevitable variations in the component's performance from their ideal behavior. Here, we report an application-level solution that embeds a Neural network to analyze and overcome these variations. The neural network examines the timing at each wearable node, recognizes time shifts, and fine-tunes a virtual clock to make them operate in unison and thus achieve synchronization. We demonstrate the integration of multiple Kinematics Detectors to provide synchronized motion capture at a high frequency (200 Hz) that could be used for performing spatial and temporal interpolation in movement assessments. The technique presented in this work is general and independent from the physical layer used, and it can be potentially applied to any wireless communication protocol.
Topics: Wireless Technology; Wearable Electronic Devices; Neural Networks, Computer; Time; Motion Capture
PubMed: 37491365
DOI: 10.1038/s41467-023-40114-2 -
Journal of Neuroengineering and... Jan 2024Technological advancements in functional neuroimaging and motion capture have led to the development of novel methods that facilitate the diagnosis and rehabilitation of... (Review)
Review
BACKGROUND
Technological advancements in functional neuroimaging and motion capture have led to the development of novel methods that facilitate the diagnosis and rehabilitation of motor deficits. These advancements allow for the synchronous acquisition and analysis of complex signal streams of neurophysiological data (e.g., EEG, fNIRS) and behavioral data (e.g., motion capture). The fusion of those data streams has the potential to provide new insights into cortical mechanisms during movement, guide the development of rehabilitation practices, and become a tool for assessment and therapy in neurorehabilitation.
RESEARCH OBJECTIVE
This paper aims to review the existing literature on the combined use of motion capture and functional neuroimaging in motor rehabilitation. The objective is to understand the diversity and maturity of technological solutions employed and explore the clinical advantages of this multimodal approach.
METHODS
This paper reviews literature related to the combined use of functional neuroimaging and motion capture for motor rehabilitation following the PRISMA guidelines. Besides study and participant characteristics, technological aspects of the used systems, signal processing methods, and the nature of multimodal feature synchronization and fusion were extracted.
RESULTS
Out of 908 publications, 19 were included in the final review. Basic or translation studies were mainly represented and based predominantly on healthy participants or stroke patients. EEG and mechanical motion capture technologies were most used for biomechanical data acquisition, and their subsequent processing is based mainly on traditional methods. The system synchronization techniques at large were underreported. The fusion of multimodal features mainly supported the identification of movement-related cortical activity, and statistical methods were occasionally employed to examine cortico-kinematic relationships.
CONCLUSION
The fusion of motion capture and functional neuroimaging might offer advantages for motor rehabilitation in the future. Besides facilitating the assessment of cognitive processes in real-world settings, it could also improve rehabilitative devices' usability in clinical environments. Further, by better understanding cortico-peripheral coupling, new neuro-rehabilitation methods can be developed, such as personalized proprioceptive training. However, further research is needed to advance our knowledge of cortical-peripheral coupling, evaluate the validity and reliability of multimodal parameters, and enhance user-friendly technologies for clinical adaptation.
Topics: Humans; Stroke Rehabilitation; Motion Capture; Reproducibility of Results; Stroke; Functional Neuroimaging
PubMed: 38172799
DOI: 10.1186/s12984-023-01294-6 -
Bulletin of the World Health... Aug 2023Rhodesiense human African trypanosomiasis is a lethal parasitic infection caused by and transmitted by tsetse flies in eastern and southern Africa. It accounts for...
Rhodesiense human African trypanosomiasis is a lethal parasitic infection caused by and transmitted by tsetse flies in eastern and southern Africa. It accounts for around 5% of all cases of human African trypanosomiasis. Currently, there is no simple serological test for rhodesiense human African trypanosomiasis and diagnosis relies on microscopic confirmation of trypanosomes in samples of blood or other tissues. The availability of a simple and accurate diagnostic test would aid the control, surveillance and treatment of the disease. A subcommittee of the World Health Organization's Neglected Tropical Diseases Diagnostics Technical Advisory Group has developed a target product profile for a diagnostic tool to identify infection. The optimum tool would have a sensitivity and specificity above 99% for detecting but be simple enough for use by minimally trained health-care workers in unsophisticated peripheral health facilities or mobile teams in villages. The test should yield a qualitative result that can be easily observed and can be used to determine treatment. An antigen test would be preferable, with blood collected by finger-prick. Ideally, there should be no need for a cold chain, instrumentation or precision liquid handling. The test should be usable between 10 °C and 40 °C and between 10% and 88% relative humidity. Basic training should take under 2 hours and the test should involve fewer than five steps. The unit cost should be less than 1 United States dollar.
Topics: Animals; Humans; Trypanosoma brucei rhodesiense; Trypanosomiasis, African; Africa, Southern; Sensitivity and Specificity; Diagnostic Tests, Routine
PubMed: 37529024
DOI: 10.2471/BLT.23.290173