influenced by several technical factors including testing environment, walkway design, the need of an accompanying evaluator who provides verbal encouragements. [ 3 ] These technical limitations not only have hindered adoption of 6MWT in routine clinical use but limited its utility as a screening tool in tracking physical capability changes during large scale community based research and services. [ 1 , 2 , 3 ]
Recent research on wearable technology in Parkinson’s disease has shown that sixminute walking test can be automated using wearable technology to eliminate
Guoxin Wang, Xiang Liu, Sheng Wang, Nan Ge, Jintao Guo and Siyu Sun
additional assistive tools may be required. Another challenge is the potential loss of visualization and access to the small bowel due to the advancement of the wire through the needle pushing the small bowel away from the stomach. Both the need for extra steps and the loss of visualization can potentially result in technical failure and stent misdeployment. [ 36 , 39 , 40 ]
Rendezvous endoscopic ultrasound-guided gastroenterostomy
This technique consists of capturing the guidewire in the duodenum or proximal jejunum and pulling it back through the obstruction and
Rajesh Kumar Wadhwa, Zaigham Abbas, Syed Mujahid Hasan, Nasir Hasan Luck, Mahira Younus, Sabiha Anis and Muhammed Mubarak
Background: Esophageal varices (EVs) are serious consequences of liver cirrhosis. Several studies have evaluated the possible non-invasive markers for the diagnosis of EVs to reduce the number of endoscopic procedures in patients with cirrhosis but without varices. This study was performed to evaluate the diagnostic performance of two such parameters (platelet count to splenic diameter ratio and splenoportal index) for the detection of EVs. Materials and Methods: A total of 111 patients with liver cirrhosis were analyzed after performing upper gastrointestinal endoscopy and non-invasive tests including platelet count and ultrasound abdomen including Doppler study. Appropriate statistical tests were applied to compare the non-invasive tests with the gold standard of endoscopy. Results: Of 111 liver cirrhotics, 80 (72.1%) were male and 31 (27.9%) were female. EVs were present in 68 (61.3%) patients and absent in 43 (38.7%) patients. In platelet count to splenic diameter ratio, a cut-off value of 1014 was obtained, which gave a sensitivity of 75.0%, specificity of 65.1%, positive predictive value (PPV) of 77.3%, negative predictive value (NPV) of 62.2% and diagnostic accuracy of 71.2%. In the splenoportal index, a cut-off value of 3.5 cm/s was obtained, which gave a sensitivity of 79.4%, specificity of 72.0%, PPV of 81.8%, NPV of 68.8% and diagnostic accuracy of 76.5% for the diagnosis of EVs. Conclusions: The platelet count to spleen diameter ratio and splenoportal index are non-invasive and fairly accurate alternatives in identifying the presence or absence of EVs in patients with compensated cirrhosis.
Brain dysfunction is a frequent complication of sepsis even in cases of extra-cranial origin and is related to several underlying mechanisms. Encephalography (EEG) seems to be a useful tool in detecting the presence of encephalopathy in patients with sepsis. Although EEG is not a specific test, it is sensitive and can detect abnormalities even when clinical neurologic examination is normal. The aim of this study was to document the EEG abnormalities and search for correlations between EEG findings and commonly used severity and prognostic scores
Hongting Wang, Zuan-tao Lin, Yulin Yuan and Tianfu Wu
and the risk of death and end-stage renal disease across diverse populations.[ 21 ] The renal transplant recipients and most of the cystatin C-based equations showed improvements in 30% and 50% accuracy compared with the creatinine-based MDRD equation. The cystatin C-based equations may offer an advantage over the MDRD equation in kidney transplant recipients.[ 22 ] The elevated levels of urinary CYSC are associated with interstitial fibrosis and tubular atrophy in renal transplant recipients, and may become a useful tool for monitoring kidney allografts.[ 23
Gianluca Rigatelli, Marco Zuin, Fabio Dell’Avvocata, Aravinda Nanjundappa, Ramesh Daggubati and Thach Nguyen
pathologic models. In the same way, different stent types and configurations seem to impact the local fluid dynamic. High kissing appears to be more favourable in respect of the aortic Carrefour, in particular at 45° angle, than low kissing.
CFD, being able to be derived both from computed tomography scan or invasive angiography, appears to be an ideal tool to predict fluid dynamic profile before and after stenting in aortoiliac bifurcation.
Conflict of Interest : None of the other authors have identified a conflict of interest.
1 Deswal A
This article reviews the application of contrast-enhanced ultrasound (CEUS) in gauging renal microvascular perfusion in diverse renal diseases. The unique nature of the contrast agents used in CEUS provides real-time and quantitative imaging of the vasculature. In addition to the traditional use of CEUS for evaluation of kidney masses, it also emerges as a safe and effective imaging approach to assess microvascular perfusion in diffuse renal lesions, non-invasively. Although the precise CEUS parameters that may best predict disease still warrant systematic evaluation, animal models and limited clinical trials in humans raise hopes that CEUS could outcompete competing modalities as a first-line tool for assessing renal perfusion non-invasively, even in ailments such as acute kidney injury and chronic kidney disease.
Zahra Abrishami, Mitra Mahdavi-Mazdeh, Farzanehsadat Minoo and Monireh Amerian
Introduction. Glomerular Filtration Rate (GFR) is the main tool to assess kidney function. Some experts suggest cystatin C as a more precise and accurate indicator than creatinine to calculate GFR. This study is designed to assess if cystatin C is more helpful in early diagnosis and better follow-up of Chronic Kidney Disease (CKD) patients who may benefit more from appropriate and timely management.
Methods. We studied 312 patients in different stages of CKD and normal kidney function as control. GFR based on creatinine (Jaffe and enzymatic) and cystatin C were calculated and compared.
Results. A total of 146(46.8%) patients were male with a mean age of 53±17.5 years. The patients were divided into 3 groups based on GFR (>60 cc/min/1.73m
2, 30< GFR<60cc/min/1.73m
2). No significant differences in GFR estimation based on creatinine and cystatin C were found.
Conclusions. There were no significant differences between serum cystatin C-based formula and creatinine-based formula for GFR calculation. Therefore, they can be used interchangeably.
Rebecca J. Fisk, Disha Kumar, Daniel R. Murphy and Monisha Arya
3 MGMA Stat. Text messaging remains an effective tool for patient appointment reminders [EB/OL]. Available from: https://www.mgma.com/data/data-stories/text-messaging-remains-an-effective-tool-for-patient-appointment-remindersAccessed on August 15, 2018.
MGMA Stat. Text messaging remains an effective tool for patient appointment reminders [EB/OL] Available from https://www.mgma.com/data/data-stories/text-messaging-remains-an-effective-tool-for-patient-appointment-remindersAccessed on August 15 2018
4 Nitsche B, Miller SC, Giorgio M, Berry CA
20. Kimmel PL. Depression in patients with chronic renal disease: What we know and what we need to know. J Psychom Res 2002; 53 : 951-956.
21. Kimmel PL, Peterson RA: Depression in end stage renal disease patients: Tools, correlates, outcomes and needs. Semin Dial 2005; 18: 91-97.
22. Kimmel P, Peterson, R. Depression in End-Stage Renal Disease Patients Treated With Hemodialysis: Tools, Correlates, Outcomes, and Needs. Seminars in Dialysis 2005; 18(2): 91-97.
23. Knight EL, Ofsthun N, Teng M, et al. The association