ABSTRACT
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.
ABSTRACT
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.
ABSTRACT
This study investigated whether significant coronary artery stenosis in 231 consecutive unstable angina patients can be diagnosed by thoroughgoing history-taking initial electorocardiography and symptom- or sign-limited treadmill exercise ECG after medication. The unstable angina patients were divided into those with accelerated angina, those with new-onset effort angina and those with angina at rest based on the findings of detailed inquiry. Initial ECG showed that the sensitivity and specificity of detecting significant coronary artery stenosis in all patients were 55.2% and 63.2%, respectively. In accelerated angina, sensitivity and specificity were 52.2% and 50.0%, respectively. In new-onset effort angina, sensitivity and specificity were 46.7% and 57.1%, respectively. In angina at rest, sensitivity and specificity were 69.0% and 68.3%, respectively. Initial ECG provided valuable diagnostic information about angina at rest. Treadmill exercise ECG offered 66.0% sensitivity and 89.2% specificity in all patients, respectively. In accelerated angina, sensitivity and specificity were 80.0% and 66.7%, respectively. In new-onset effort angina, sensitivity and specificity were 70.8% and 87.8%, respectively. In angina at rest, sensitivity and specificity were 48.3% and 91.4%, respectively. Thus, treadmill exercise electrocardiograms provided valuable diagnostic information in the case of unstable angina, especially accelerated angina and new-onset effort angina. For patients with angina at rest, this testing was very useful for excluding significant coronary artery stenosis.<BR>In conclusion, detailed inquiry, initial ECG and symptom- or sign-limited treadmill exercise ECG after medical stabilization proved to be of great value for diagnosing unstable angina patients with significant coronary artery stenosis.
