Eliminating Discrepancies Between Assessments of Left Ventricular Wall Motion on Echocardiograms / 日本農村医学会雑誌

Echocardiographic assessment of wall motion is prone to interrater variability because it requires subjective visual evaluation. Echocardiography technicians were divided into 2 groups by years of experience, and their assessments of left ventricular wall motion on previously recorded echocardiograms were scored and compared. Scores did not differ within the more experienced group but differed significantly between technicians in the less experienced group. However, this difference disappeared after 3 months of training. This suggests that training can eliminate discrepancies between technicians, even inexperienced ones, in a relatively short period of time.

Involvement of Medical Technologists in Outpatient Care for Memory Loss and Dementia by Pre-Appointment Testing / 日本農村医学会雑誌

Medical technologists at our hospital have begun to conduct tests before outpatient appointments for memory loss and dementia. They administer the Mini-Mental State Examination (MMSE) and the Geriatric Depression Scale (GDS-15), take patients' medical history, and perform auxiliary diagnostic tests for cognitive function. Technologists at our hospital assessed 365 patients (mean age 80 years; 172 men and 193 women) in this way between May 2018 and May 2019. We determined a cutoff value for the MMSE and tested the validity of the technologists’ assessments of these patients by comparing them against physicians' clinical diagnosis. Our hospital sees many patients with Alzheimer’s disease, and 85% of patients diagnosed with dementia had an MMSE score of 23 or lower. The MMSE is a highly reliable screening test for dementia, and technologists scored it similarly to physicians. Addition of the GDS-15 showed that outpatients with dementia had underlying anxiety symptoms and depression. It is important that technologists continue their involvement in outpatient care as certified dementia specialists while also continuing to consider which tests they should conduct.

Diagnostic Efficacy of FeNO Testing in Patients With Cough / 日本農村医学会雑誌

Cough is one of the most common respiratory complaints leading to medical consultation. Fractional exhaled nitric oxide (FeNO) testing detects eosinophilic inflammation of the airway. We evaluated the diagnostic efficacy of FeNO testing in patients with cough. Patients who presented to the respiratory medicine department of our hospital with a chief complaint of cough and underwent FeNO testing were included in this study and divided into asthma and non-asthma groups. Patients with confounding factors such as allergic rhinitis and atopic predispositions were also identified and those with and without confounding factors, respectively, were further divided into the asthma and non-asthma groups. Median FeNO in the asthma and non-asthma groups was respectively 31 and 19 ppb in all patients and 31 and 18 ppb in those without confounding factors, with significant differences between the groups in both populations. The corresponding values in patients with confounding factors were 46 and 23 ppb, with no significant difference between the groups. A cut-off of 27 ppb differentiated between the asthma and non-asthma groups with sensitivity of 0.603 and specificity of 0.776. These results suggest FeNO testing is effective in the differential diagnosis of cough in patients without confounding factors.