Temporal validation of a clinical prediction rule for distinguishing locomotive syndromes in community-dwelling older adults: A cross-sectional study from the DETECt-L study

Objectives@#Clinical prediction rules are used to discriminate patients with locomotive syndrome and may enable early detection. This study aimed to validate the clinical predictive rules for locomotive syndrome in communitydwelling older adults. @*Methods@#We assessed the clinical prediction rules for locomotive syndrome in a cross-sectional setting. The age, sex, and body mass index of participants were recorded. Five physical function tests–grip strength, single-leg standing time, timed up-and-go test, and preferred and maximum walking speeds–were measured as predic tive factors. Three previously developed clinical prediction models for determining the severity of locomotive syndrome were assessed using a decision tree analysis. To assess validity, the sensitivity, specificity, likelihood ratio, and post-test probability of the clinical prediction rules were calculated using receiver operating charac teristic curve analysis for each model. @*Results@#Overall, 280 older adults were included (240 women; mean age, 74.8 ± 5.2 years), and 232 (82.9%), 68 (24.3%), and 28 (10.0%) participants had locomotive syndrome stages ≥ 1, ≥ 2, and = 3, respectively. The areas under the receiver operating characteristics curves were 0.701, 0.709, and 0.603, in models 1, 2, and 3, respectively. The accuracies of models 1 and 2 were moderate. @*Conclusions@#These findings indicate that the models are reliable for community-dwelling older adults.

Repeated Tricuspid Valvoplasty and Tricuspid Annuloplasty in a Case of Recurrent Isolated Tricuspid Regurgitation / 日本心臓血管外科学会雑誌

We treated a patient with recurrent isolated tricuspid regurgitation (TR) by repeated tricuspid valvoplasty (TVP) and tricuspid annuloplasty (TAP). The patient was a 56-year-old man who had undergone TVP eight years previously. Although the tricuspid annular dilatation was not seen in the first operation, the annular dilatation with elongation of chordae was apparent at this time. The chordal plasty with ePTFE threads and TAP with Carpentier-Edward's ring were carried out successfully. Since the annular dilatation may aggravate TR in the natural course of this disease, the combination of TVP and TAP is more effective than TVP alone.