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Clinical Approach to Vision Loss

Visual loss describes temporary or permanent reduction in visual acuity and/or field. Its aetiology is diverse due to the contributions of the different neuro-ophthalmic structures (eye, optic nerve, and brain) to image formation and perception, but may be categorised into ocular causes (corneal, lenticular, vitreoretinal and macular) or optic neuropathies. Continue reading “Clinical Approach to Vision Loss”

Confusion Assessment Method (CAM) for Diagnosing Delirium

The Confusion Assessment Method (CAM) is a widely used diagnostic tool for identifying delirium. It was developed by researchers at the Yale University School of Medicine and has become the gold standard for diagnosing delirium in clinical settings. The CAM helps healthcare professionals systematically evaluate and identify the presence of delirium based on four key features. Continue reading “Confusion Assessment Method (CAM) for Diagnosing Delirium”

SARC-F Questionnaire for Sarcopenia

The SARC-F questionnaire is a screening tool that can be rapidly implemented by clinicians to identify probable sarcopenic patients. The questionnaire screens patients for self-reported signs suggestive of sarcopenia, which include deficiencies in strength, walking, rising from a chair, climbing stairs, and experiencing falls. Each of the self-reported parameters receives a minimum and maximum score of 0 and 2, respectively, with the greatest maximum SARC-F score being 10. Continue reading “SARC-F Questionnaire for Sarcopenia”

Edmonton Frail Scale (EFS)

The Edmonton Frail Scale (EFS) is an index used to measure alterations related to frailty. The EFS assesses nine subscales (1) cognition; (2) general health status; (3) functional independence; (4) social support; (5) medication use; (6) nutrition; (7) mood; (8) continence; and (9) functional performance (in 11 items). Continue reading “Edmonton Frail Scale (EFS)”

MODY subtypes: gene mutations, pathophysiology, and clinical characteristics

Maturity-onset diabetes of the young (MODY) is an autosomal dominantly inherited type of diabetes that results from heterozygous mutations in various transcription factors acting in the development and maturation of pancreatic β-cells. In addition, mutations in enzymes involved in glucose sensing of the β-cell have also been shown to result in early-onset diabetes. Characteristic features of MODY are autosomal inheritance, early onset of diabetes (with diagnosis generally before the age of 25 years), no signs related to the autoimmune process or insulin resistance, and preservation of endogenous insulin secretion. Continue reading “MODY subtypes: gene mutations, pathophysiology, and clinical characteristics”

Diagnostic Criteria for Allergic Bronchopulmonary Aspergillosis (ABPA)

The diagnostic criteria for ABPA include a history of asthma, evidence of Aspergillus fumigatus (A. fumigatus) IgE sensitisation on blood and/or skin tests, elevated total IgE levels and eosinophil counts, detection of Aspergillus precipitins or IgG, isolation of A. fumigatus in sputum cultures, presence of pulmonary infiltrates on chest x rays and distribution of bronchiectasis on CT chest scans. Continue reading “Diagnostic Criteria for Allergic Bronchopulmonary Aspergillosis (ABPA)”

Definition of Bronchiectasis Pulmonary Exacerbation

The definition for a bronchiectasis exacerbation was agreed as: a person with bronchiectasis with a deterioration in three or more of the following key symptoms for at least 48 h: cough; sputum volume and/or consistency; sputum purulence; breathlessness and/or exercise tolerance; fatigue and/or malaise; haemoptysis AND a clinician determines that a change in bronchiectasis treatment is required. Continue reading “Definition of Bronchiectasis Pulmonary Exacerbation”

Kocher Criteria for Septic Arthritis

Kocher identified four predictive factors that can aid in differentiating septic arthritis of the hip from transient synovitis. Fever >38.5 C, inability to bear weight, serum white blood cell count (WBC) >12,000/mm3, and an erythrocyte sedimentation rate (ESR) ≥40 mm/h were found to be associated with septic arthritis of the hip. The presence of all four factors was 99.6% predictive of septic hip. Continue reading “Kocher Criteria for Septic Arthritis”

Diagnostic Criteria for Rheumatoid Cachexia

Cachexia in RA (rheumatoid cachexia, RC), is mainly characterized by loss of muscle mass, in particular appendicular lean mass (ALM), and associated with accumulated fat mass (FM), situated mainly in the trunk area, indicating a shift towards the development of abdominal obesity. The loss of body cell mass (BCM) consists of an important issue of concern for patients with RA. BCM consists primarily of muscle and visceral mass (erythrocytes, serum proteins, lymphocytes, etc.), and is the part of the body with the greatest metabolic activity (95% of the total activity), determining protein requirements, energy expenditure, and the metabolic response to stress.

Continue reading “Diagnostic Criteria for Rheumatoid Cachexia”

Diagnostic Criteria for Wasting Disease (Cachexia) in Adults

Cachexia, is a complex metabolic syndrome associated with underlying illness and characterized by loss of muscle with or without loss of fat mass. The prominent clinical feature of cachexia is weight loss in adults (corrected for fluid retention) or growth failure in children (excluding endocrine disorders). Anorexia, inflammation, insulin resistance and increased muscle protein breakdown are frequently associated with wasting disease. Wasting disease is distinct from starvation, age-related loss of muscle mass, primary depression, malabsorption and hyperthyroidism and is associated with increased morbidity. Continue reading “Diagnostic Criteria for Wasting Disease (Cachexia) in Adults”

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