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McMurray Test

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281. Guidelines for the management of dyslipidaemias

Gotcheva (Bulgaria), Kathryn Grif?th (UK), Guido Francesco Guida (Italy), Sadi Gulec (Turkey), Yaakov Henkin (Israel), Kurt Huber (Austria), Y. Antero Kesaniemi (Finland), John Lekakis (Greece), Athanasios J. Manolis (Greece), Pedro Marques-Vidal (Switzerland), Luis Masana (Spain), John McMurray (UK), Miguel Mendes (Portugal), Zurab Pagava (Georgia), Terje Pedersen (Norway), Eva Prescott (Denmark), Quite ´ria Rato (Portugal), Giuseppe Rosano (Italy), Susana Sans (Spain), Anton Stalenhoef (...) with a 10 year risk of CV death of =5% has an increased risk. The reasons for retaining a system that estimates fatal as opposed to total fatal+ non-fatal events are that non-fatal events are dependent on de?nition, developments in diagnostic tests,andmethodsofascertainment,allofwhich canvary, resulting in very variable multipliers to convert fatal to total events. In addition, total event charts, in contrast to those based on mor- tality, cannot easily be re-calibrated to suit different populations

2011 European Society of Cardiology

282. Acute Coronary Syndromes (ACS) in patients presenting without persistent ST-segment elevation

. There is no fundamental difference between troponin T and troponin I. Differences between study results are explained by varying inclusion criteria, variances in sampling patterns, and the use of assays with different diagnostic cut-offs. In the clinical setting, a test with high ability to rule out (negative predictive value) and correctly diagnose ACS (positive predictive value) is of paramount interest. The diagnostic cut-off for MI is de?ned as a cardiac troponin measurement exceeding the 99th per- centile (...) or ultrasensitive assays have been introduced that have a 10- to 100-fold lower limit of detection and ful?l the require- ments of analytical precision. Therefore, MI can now be detected more frequently and earlier in patients presenting with chest pain. 20,21 The superiority of these new assays, particularly in the early phase of pain onset, was prospectively demonstrated. 20,21 The negative predictive value for MI with a single test on admission is .95% and thereby at least as high as with previous assays

2011 European Society of Cardiology

283. Cardiovascular Diseases during Pregnancy

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3150 2. General considerations . . . . . . . . . . . . . . . . . . . . . . . . . .3151 2.1. Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3151 2.2. Methods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3151 2.3. Epidemiology . . . . . . . . . . . . . . . . . . . . . . . . . . . .3151 2.4. Haemodynamic, haemostatic, and metabolic alterations during pregnancy . . . . . . . . . . . . . . . . . . . . . . . . . .3151 2.5. Genetic testing and counselling (...) and resorption of leg oedema. In conclusion, the physiological adaptations to pregnancy in?u- ence the evaluation and interpretation of cardiac function and clini- cal status. 2.5 Genetic testing and counselling An important aspect concerning the care of young women with CVD is the consultation about the risk of inheritance of cardiac defects for their descendants. The risk is raised signi?cantly in com- parison with parents without CVD where the risk is 1%. In addition, there are large differences between

2011 European Society of Cardiology

284. Treatment of Anemia in Patients with Heart Disease

numbers with CHF; type and severity of CHF not reported. Venous thrombosis (–) Moderate Based on two large trials including large numbers with CHF; type and severity of CHF not reported; effects of more moderate hemoglobin targets not tested. Hypertension, cerebrovascular events (–) Low Based on one large trial including large numbers with CHF, but CHF subgroup data not separately reported for this outcome. Iron All outcomes (0) No evidence. Blood transfusions All outcomes (0) No evidence (...) , most commonly NYHA class, 6-minute walk test), quality of life, cardiovascular events (myocardial infarction, heart failure exacerbation, need for revascularization) Setting: Inpatient or outpatient Figure 1 illustrates the analytic framework that guided our review and synthesis.8 Treatment of Anemia in Patients with Heart Disease: A Systematic Review Evidence-based Synthesis Program Figure 1. Analytic Framework Patients with CHF and/or CHD AND Anemia and/or Iron Deficiency Treatment harms

2011 Veterans Affairs Evidence-based Synthesis Program Reports

285. Management of Pulmonary Arterial Hypertension

HYPERTENSION (PAH) 9 Proposed Clinical indicators for quality management i. Exercise Capacity – 6 Minute Walk Distance Percentage of Number of PAH patients who show PAH patients improvement in 6MWD who show = _______________________________ x 100% improvement in Total number of PAH patients serial 6MWD* tested with 6MWD *Serial 6MWD at baseline and after 3 to 6 months post treatment ii. Survival Rate 2 year survival Number of PAH patients on therapy alive rate on therapy (...) . Contrast enhanced spiral CT and pulmonary angiography 32 6.4. PAH evaluation 34 6.4.1. Blood tests and immunology 34 6.4.2. Assessment of exercise capacity 34 6.4.3. Right-heart catheterisation 34 7. Treatment 36 7.1. Conventional treatment 36 7.1.1. Oxygen (Level of evidence C) 36 7.1.2. Anticoagulation (Level of evidence C) 36 7.1.3. Digoxin (Level of evidence C) 37 7.1.4 Diuretics (Level of evidence C) 37 7.1.5. Calcium channel blockers (Level of evidence C) 38 7.1.6. Vaccination (Level of evidence

2011 Ministry of Health, Malaysia

286. Treatment and recommendations for homeless people with Chronic Non-Malignant Pain

Assessment, Screening & Diagnostic Testing 13 PLAN & MANAGEMENT Plan of Care 18 Education, Self-Management 20 Treatment, Management 24 Associated Problems, Complications 30 Follow-up 34 MODEL OF CARE Service Delivery Design 36 Outreach and Engagement 40 Standards of Care 42 Transitions in Care 43 CASE STUDIES Integrated Group Medical Visits for Challenging Patients 44 Managing Chronic Pain with Comorbid Addiction 45 SOURCES & RESOURCES Primary Sources 46 References on Homeless/Underserved Populations 46 (...) exams (as tolerated), if needed. Look for evidence of occult alcoholism or addiction. ? Practice Trauma-Informed Care during the physical examination and in all patient encounters, recognizing that individuals who are homeless are likely to have experienced some form of previous trauma. ASSESSMENT, SCREENING & DIAGNOSTIC TESTING ? Assess every chronic pain patient for substance use and mental health issues. Based on prevalence of behavioral health issues in the patient population served as well

2011 National Health Care for the Homeless Council

287. 2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease (Full text)

With Chest Pain: Recommendations. . . . . . . .e367 2.1.2. History. . . . . . . . . . . . . . . . . . . . . . . . . .e367 2.1.3. Physical Examination. . . . . . . . . . . . . . .e368 2.1.4. Electrocardiography. . . . . . . . . . . . . . . .e368 2.1.4.1. Resting Electrocardiography to Assess Risk: Recommendation. . . . . . . . . . .e369 2.1.5. Differential Diagnosis. . . . . . . . . . . . . .e370 2.1.6. Developing the Probability Estimate. . .e370 2.2. Noninvasive Testing for Diagnosis of IHD. . . .e371 (...) 2.2.1. Approach to the Selection of Diagnostic Tests to Diagnose SIHD. . . .e371 2.2.1.1. Assessing Diagnostic Test Characteristics. . . . . . . . . .e372 2.2.1.2. Safety and Other Considerations Potentially Affecting Test Selection. . . . . .e373 2.2.1.3. Exercise Versus Pharmacological Testing. . . . . .e374 2.2.1.4. Concomitant Diagnosis of SIHD and Assessment of Risk. . . . . . . . . . . . . . . . . . .e374 2.2.1.5. Cost-Effectiveness. . . . . . . . . . .e375 2.2.2. Stress Testing and Advanced

2011 American Heart Association PubMed abstract

288. Secondary Prevention For Patients With Coronary and Other Atherosclerotic Vascular Disease: 2011 Guideline Update

patients, risk assessment with a physical activity history and/or an exercise test is recommended to guide prognosis and prescription (47–52,58). (Level of Evidence: B) 3. The clinician should counsel patients to report and be evaluated for symptoms related to exercise. (Level of Evidence: C) Class IIa 1. It is reasonable for the clinician to recommend complementary resistance training at least 2 days per week (59). (Level of Evidence: C) Weight management Class I Goals: 1. Body mass index and/or waist (...) . For patients with triglyceride levels200 mg/dL, non–high-density lipo- protein cholesterol values should be used as a guide to therapy. Although no studies have directly tested treatment to target strategies, the target LDL-C and non–HDL-C levels are derived from several randomized controlled trials where the LDL-C levels achieved for patients showing bene?t are used to suggest targets. Thus, references for the studies from which targets are derived are listed and targets are considered as level

2011 American College of Cardiology

289. 2011 update to NHFA and CSANZ guidelines for the prevention, detection and management of chronic heart failure in Australia

% of cases). Diagnosis is based on clinical features, chest X-ray and objective measurement of ventricular function (e.g. echocardiography). Plasma levels of B-type natriuretic peptide (BNP) may have a role in diagnosis, primarily as a test for exclusion. Diagnosis may be strengthened by improvement in symptoms in response to treatment. Management involves prevention, early detection, slowing of disease progression, relief of symptoms, minimisation of exacerbations, and prolongation of survival. Key (...) structural or functional cardiac disorder that impairs the ability of the ventricle to fill with or eject blood. European Task Force on Heart Failure, 2005 2 A syndrome in which the patients should have the following features: symptoms of heart failure, typically breathlessness or fatigue, either at rest or during exertion, or ankle swelling and objective evidence of cardiac dysfunction at rest. Adapted from Byrne J, Davie AP and McMurray JJV, 2004. 10 CHF is a complex clinical syndrome with typical

2011 Clinical Practice Guidelines Portal

290. Guidelines for the prevention, detection and management of chronic heart failure (updated October 2011)

, chest X-ray and objective measurement of ventricular function (e.g. echocardiography). Plasma levels of B-type natriuretic peptide (BNP) may have a role in diagnosis, primarily as a test for exclusion. Diagnosis may be strengthened by improvement in symptoms in response to treatment. Management involves prevention, early detection, slowing of disease progression, relief of symptoms, minimisation of exacerbations, and prolongation of survival. Key therapeutic approaches or considerations include (...) structural or functional cardiac disorder that impairs the ability of the ventricle to fill with or eject blood. European Task Force on Heart Failure, 2005 2 A syndrome in which the patients should have the following features: symptoms of heart failure, typically breathlessness or fatigue, either at rest or during exertion, or ankle swelling and objective evidence of cardiac dysfunction at rest. Adapted from Byrne J, Davie AP and McMurray JJV, 2004. 10 CHF is a complex clinical syndrome with typical

2011 Clinical Practice Guidelines Portal

291. Diabetes landmark outcome trials: Glycemic Control & Prevention Summary

that intensive glucose control increased mortality among adults in the ICU: a blood glucose target of 180 mg or less per deciliter resulted in lower mortality than did a target of 81 to 108 mg per deciliter. 31 Home PD, Pocock SJ, Beck-Nielsen H, Curtis PS, Gomis R, Hanefeld M, Jones NP, Komajda M, McMurray JJ; RECORD Study Team. Rosiglitazone evaluated for cardiovascular outcomes in oral agent combination therapy for type 2 diabetes (RECORD): a multicentre, randomised, open-label trial. Lancet. 2009 Jun (...) 20;373(9681):2125-35. {Commentary & limitations: http://www.medscape.com/viewarticle/704038 } Komajda M, McMurray JJ, Beck-Nielsen H, et al. Heart failure events with rosiglitazone in type 2 diabetes: data from the RECORD clinical trial. Eur Heart J 2010; DOI: 10.1093/eurheartj/ehp604. Home PD, Pocock SJ, Beck-Nielsen H, et al. Rosiglitazone evaluated for cardiovascular outcomes in oral agent combination therapy for type 2 diabetes (RECORD): a multicentre, randomised, open-label trial. Lancet

2010 RxFiles

292. Risk factors for lesions of the knee menisci among workers in South Korea’s national parks (Full text)

Risk factors for lesions of the knee menisci among workers in South Korea’s national parks This study was designed to investigate the prevalence of the menisci lesions in national park workers and work factors affecting this prevalence.The study subjects were 698 workers who worked in 20 Korean national parks in 2014. An orthopedist visited each national park and performed physical examinations. Knee MRI was performed if the McMurray test or Apley test was positive and there was a complaint (...) of pain in knee area. An orthopedist and a radiologist respectively read these images of the menisci using a grading system based on the MRI signals. To calculate the cumulative intensity of trekking of the workers, the mean trail distance, the difficulty of the trail, the tenure at each national parks, and the number of treks per month for each worker from the start of work until the present were investigated. Chi-square tests was performed to see if there were differences in the menisci lesions

2016 Annals of occupational and environmental medicine PubMed abstract

293. Newly learned word forms are abstract and integrated immediately after acquisition (Full text)

). Recently, however, Kapnoula, Packard, Gupta, and McMurray, (Cognition, 134, 85-99, 2015) showed that interference can be observed immediately after a word is first learned, implying very rapid integration of new words into the lexicon. It is an open question whether these kinds of effects derive from episodic traces of novel words or from more abstract and lexicalized representations. Here we addressed this question by testing inhibition for newly learned words using training and test stimuli presented (...) in different talker voices. During training, participants were exposed to a set of nonwords spoken by a female speaker. Immediately after training, we assessed the ability of the novel word forms to inhibit familiar words, using a variant of the visual world paradigm. Crucially, the test items were produced by a male speaker. An analysis of fixations showed that even with a change in voice, newly learned words interfered with the recognition of similar known words. These findings show that lexical

2016 Psychonomic bulletin & review PubMed abstract

294. Meniscal Tear and Osteoarthritis Risk (MenTOR)

: Male or female aged 30-60 years. Participant able and willing to give informed consent. Clinical assessment demonstrates mechanical symptoms suggestive of meniscal pathology (focal knee pain +/- 1 or more of: catching/locking, giving way, focal joint-line tenderness, effusion, McMurray's positive) within last 12 months. Evidence on clinical MRI knee of meniscal tear. Participant is either in secondary care or has the potential to be referred to secondary care due to severity of symptoms. Patient (...) of inflammatory/septic arthritis of index knee. Knee replacement or other non-arthroscopic knee surgery (e.g. high tibial osteotomy) - previous or planned within 1 year of study start. Index knee surgery within last 3 months, including meniscectomy. Steroid injection to index knee in last 3 months. Active other (treated) inflammatory disease or infection. Positive pregnancy test. Unable to provide blood samples. Unable to give informed written consent. Contacts and Locations Go to Information from

2016 Clinical Trials

295. Device Therapy in Heart Failure

device LVEDD left ventricular end-diastolic diameter LVEF left ventricular ejection fraction LVESi left ventricular stroke volume index LVESV left ventricular end-systolic volume 6MWT 6 min walk test NA not applicable NIH National Institutes of Health NS not signi?cant NYHA New York Heart Association OMT optimal medical therapy pVO 2 peak oxygen consumption QoL quality of life RBBB right bundle branch block RCT randomized clinical trial SR sinus rhythm VE/CO 2 ventilation/carbon dioxide ratio 1 (...) ¼ implantable cardioverterde?brillator; LV¼ leftventricular; LVEDD¼ left ventricularend diastolicdiameter; LVEF¼ left ventricularejectionfraction;LVESi¼ leftventricular strokevolumeindex,LVESV¼ leftventricularend-systolicvolume; 6MWT¼ 6 min walk test; NYHA¼ New York Heart Association; NS¼ not signi?cant; OMT¼ optimal medical therapy; pVO 2 ¼ peak oxygen consumption; QoL¼ quality of life; SR¼ sinus rhythm; VE/CO 2 ¼ ventilation/carbon dioxide ratio. ESC Guidelines 2685 Downloaded from https

2010 European Society of Cardiology

296. Grown-Up Congenital Heart Disease

Cardiopulmonary exercise testing . . . . . . . . . . . . . .2920 3.2.5 Cardiac catheterization . . . . . . . . . . . . . . . . . . . . .2920 3.3 Therapeutic considerations . . . . . . . . . . . . . . . . . . . . .2920 3.3.1 Heart failure . . . . . . . . . . . . . . . . . . . . . . . . . . . .2920 3.3.2 Arrhythmias and sudden cardiac death . . . . . . . . . . .2920 3.3.3 Surgical treatment . . . . . . . . . . . . . . . . . . . . . . . .2921 3.3.4 Catheter intervention (...) valve area AVSD atrioventricular septal defect BAV bicuspid aortic valve BNP B-type natriuretic peptide BSA body surface area CAD coronary artery disease ccTGA congenitally corrected transposition of the great arteries CHD congenital heart disease CMR cardiac magnetic resonance CoA coarctation of the aorta CPET cardiopulmonary exercise testing CRT cardiac resynchronization therapy CT computed tomography DCRV double-chambered right ventricle ECG electrocardiogram EF ejection fraction EP

2010 European Society of Cardiology

297. PHYSICAL EXAMINATIONS FOR DIAGNOSING MENISCAL INJURIES: CORRELATION WITH SURGICAL FINDINGS (Full text)

PHYSICAL EXAMINATIONS FOR DIAGNOSING MENISCAL INJURIES: CORRELATION WITH SURGICAL FINDINGS A set of five maneuvers for meniscal injuries (McMurray, Apley, Childress and Steinmann 1 and 2) was evaluated and their sensitivity, specificity, accuracy and likelihood were calculated. The same methods were applied to each test individually.One hundred and fifty-two patients of both sexes who were going to undergo videoarthroscopy on the knee were examined blindly by one of five residents (...) at this hospital, without knowledge of the clinical data and why the patient was going to undergo an operation. This examination was conducted immediately before the videoarthroscopy and its results were recorded in an electronic spreadsheet. The set of maneuvers was considered positive when one was positive. In the individual analysis, it was enough for the test to be positive.The analysis showed that the set of five meniscal tests presented sensitivity of 89%, specificity of 42%, accuracy of 75%, positive

2015 Revista brasileira de ortopedia PubMed abstract

298. Improving the Stewardship of Diagnostic Imaging Resources in Alberta Emergency Departments

diagnoses in low-risk patients, patient expectations, and the tendency to associate more testing with a higher quality of care. However, this rise in the use of diagnostic imaging, particularly in low-risk patients, may not be taking into account the risk of radiation exposure to patients, or the impact on finite health system resources. The objective of this project is to improve the appropriateness of CT imaging in Alberta Emergency Departments by advancing awareness of, and adherence to, evidence (...) for a period of 30 months (15 months pre-intervention administrative data, and 15 months of administrative date during the intervention) ] Proportion of patients with suspected pulmonary embolism who undergo a CTPA scan for which a CTPA scan is recommended after applying the Well's Score, the Pulmonary Embolism Rule-Out Criteria (PERC), and receiving D-Dimer test results. [ Time Frame: All presenting patients for a period of 30 months (15 months pre-intervention administrative data, and 15 months

2015 Clinical Trials

299. Arthroscopic Meniscal Repair: “Modified Outside-In Technique” (Full text)

tenderness, absence of locking, negative McMurray test and no need for meniscectomy. Patients' satisfaction was evaluated using the visual analogue scale (VAS). Patients were followed for 26±1.7 months.Clinical success was achieved in 61 patients (92.4%) and 5 candidates required meniscectomy (7.6%). IKDC Subjective Knee Evaluation Form score increased significantly from 54.2±12.7 preoperatively to 90.8±15.6 postoperatively (P<0.001). Lysholm score was excellent and good in 49 (80.3%) patients and fair

2015 Archives of bone and joint surgery PubMed abstract

300. Colorectal Cancer Prevention

-controlled trial tested the effect of calcium supplementation (3 g calcium carbonate daily [1,200 mg elemental calcium]) on the risk of recurrent adenoma.[ ] The primary endpoint was the proportion of patients (72% of whom were male) in whom at least one adenoma was detected following a first and/or second follow-up endoscopy. A modest decrease in risk was found for both developing at least one recurrent adenoma (adjusted risk ratio [ARR], 0.81; 95% CI, 0.67–0.99) and in the average number of adenomas

2012 PDQ - NCI's Comprehensive Cancer Database

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