(Press-News.org) Algorithms improve certainty in ruling out deep and pelvic vein thrombosis at the primary level of patient care, say Lobna El Tabei and her co-authors in the current issue of the Deutsches Ärzteblatt International (Dtsch Arztebl Int 2012; 109[45]: 761-6).
Deep vein thrombosis (DVT) can lead to fatal pulmonary embolism or chronic post-thrombotic syndrome. To improve differential diagnostic certainty, scores have been developed that allow the clinical probability of DVT to be calculated on the basis of weighted combinations of individual clinical findings. Items of these scores are, for example, cancer, paresis of the leg, extended periods of bed rest, swelling, and pain.
The primary aim of the study was to determine diagnostic accuracy regarding exclusion of DVT using a treatment algorithm consisting of one of these scores, the Wells score, followed by either a D-dimer test and/or compression sonography—depending on the result of the Wells score—and to compare this with the diagnostic accuracy of the primary care physician's clinical judgment alone.
The algorithm investigated by the authors allows the primary care physician to rule out DVT with a high degree of probability. In this study, which included 395 patients, only 1% of cases of DVT were missed, compared with 5% when relying on clinical judgment alone.
###
http://www.aerzteblatt.de/pdf.asp?id=132189
Ruling out deep vein thrombosis at the primary care level
2012-11-27
ELSE PRESS RELEASES FROM THIS DATE:
Tracking down smallest biomarkers
2012-11-27
Microvesicles are smallest cell elements which are present in all body fluids and are different, depending on whether a person is healthy or sick. This could contribute to detecting numerous diseases, such as, e.g., carcinomas, at an early stage, and to treating them more efficiently. The problem is that the diameter of the relevant microvesicles generally lies below 100 nm, which makes them technically detectable, but their exact size and concentration hardly possible to determine. A new device is now to provide the metrological basis for these promising biomarkers. The ...
Early intervention prevents behavioral problems
2012-11-27
"In Norway, we almost employ the opposite strategy. The main chunk of resources in special education in Norway is earmarked for secondary schools. We must look more closely at how we can shift and distribute these resources to the primary schools and kindergartens, without automatically removing them from the secondary school classes," says Pål Roland at the Centre for Behavioural Research.
Through "The Challenging Children", a project that aims to reveal, remedy and prevent psychosocial problems among children, aged four to eight years, Roland has seen that teachers ...
New mechanism for cancer progression discovered by UNC and Harvard researchers
2012-11-27
The protein Ras plays an important role in cellular growth control. Researchers have focused on the protein because mutations in its gene are found in more than 30 percent of all cancers, making it the most prevalent human oncogene.
University of North Carolina Lineberger Comprehensive Cancer Center and Harvard researchers have discovered an alternative mechanism for activating Ras that does not require mutation or hormonal stimulus. In healthy cells, Ras transmits hormone signals into the cell that prompt responses such as cell growth and the development of organs and ...
Being bullied can cause trauma symptoms
2012-11-27
This study of 963 children aged 14 and 15 in Norwegian schools found a high incidence of post-traumatic stress disorder (PTSD) symptoms among bullied pupils. These signs were seen in roughly 33 per cent of respondents who said they had been victims of bullying.
"This is noteworthy, but nevertheless unsurprising," says psychologist Thormod Idsøe from the Universitiy of Stavanger (UiS) and Bergen's Center for Crisis Psychology. "Bullying is defined as long-term physical or mental violence by an individual or group.
"It's directed at a person who's not able to defend themselves ...
Scientists at the Institute of Molecular Biology identify key event for sex determination
2012-11-27
Scientists at the Institute of Molecular Biology (IMB) in Mainz have identified a protein essential for initiating the development of male sex organs. Loss of the gene Gadd45g results in complete sex reversal of male mice, making them appear female. The researchers' finding uncovers a novel signaling cascade, which acts early in development to determine the gonads in males. This discovery sheds light on the genetic network that controls how embryos develop as males or females. The research has just been published in the high-impact journal Developmental Cell.
Research ...
Research reveals new understanding of X chromosome inactivation
2012-11-27
Chapel Hill, NC – In a paper published in the Nov. 21 issue of Cell, a team led by Mauro Calabrese, a postdoctoral fellow at the University of North Carolina in the lab of Terry Magnuson, chair of the department of genetics and member of the UNC Lineberger Comprehensive Cancer Center, broadens the understanding of how cells regulate silencing of the X chromosome in a process known as X-inactivation.
"This is a classic example of a basic research discovery. X-inactivation is a flagship model for understanding how non-coding RNAs orchestrate large-scale control of gene ...
Preventing posttraumatic stress disorder by facing trauma memories
2012-11-27
Philadelphia, PA, November 27, 2012 – Posttraumatic stress disorder (PTSD) is a form of learning that begins at the moment of the exposure to extremely stressful situations and that grows in impact as trauma-related memories are rehearsed and strengthened repeatedly. This somewhat oversimplified view of PTSD yields a powerful prediction: if one could disrupt the rehearsal and strengthening of traumatic memories, a process called reconsolidation of memories, then one might reduce PTSD risk or PTSD severity after potentially traumatic events.
To be certain, it is tricky ...
Enzyme explains angina in diabetics
2012-11-27
In a new study published in the scientific journal Circulation, scientists at Karolinska Institutet and Karolinska University Hospital in Sweden show that an enzyme called arginase might have a key part to play in the development of cardiovascular disease in patients who already have type II diabetes. According to the team, arginase prevents the formation of protective nitrogen oxide in the blood vessels, and treatments that inhibit this enzyme reduce the risk of angina in diabetics.
"The fact that we could demonstrate the presence of arginase in several types of cell ...
New method for diagnosing malaria
2012-11-27
Malaria is a life-threatening disease that strikes more than 200 million people every year – mainly in Africa, Asia and Latin America. The disease is caused by the Plasmodium parasite, which is spread by infected mosquito bites. Today, malaria can be prevented and successfully treated, but more than half a million people nevertheless die every year from the disease.
Large-scale monitoring and treatment programmes during the past decade have reduced the distribution of the disease, and the frequency of actual epidemics has fallen. However, the number of malaria patients ...
A rather thin and long new snake crawls out of one of Earth's biodiversity hotspots
2012-11-27
Field and laboratory work by a group of zoologists led by Omar Torres-Carvajal from Museo de Zoología QCAZ, Pontificia Universidad Católica del Ecuador, has resulted in the discovery of a new species of blunt-headed vine snake from the Chocoan forests in northwestern Ecuador. This region is part of the 274,597 km2 Tumbes-Chocó-Magdalena hotspot that lies west of the Andes. The study was published in the open access journal ZooKeys.
Blunt-headed vine snakes live in an area comprising Mexico and Argentina, and are different from all other New World snakes in having a very ...