Examination of the abdomen

Reuben, Adrian

doi:10.1002/cld.556

Cited by 16 publications

(14 citation statements)

References 17 publications

(19 reference statements)

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“…Our research also found that an AWT of 2.73-2.97 N/mm is a risk factor for death for the following reasons: palpation is a traditional examination for the detection of abdominal diseases. Patients with abdominal hypertension and peritonitis can experience an increase in AWT, but routine examinations are only preliminary judgments and cannot quantitatively and qualitatively diagnose AWT [13,32,35]. AWT can re ect not only the degree of stretch but also the condition of abdominal cavity infection.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, the quantitative measurement of AWT is particularly important [4,11]. AWT not only can re ect the pressure of the abdominal cavity but also is related to intra-abdominal diseases such as peritonitis [13][14]. Considering the complexity of the abdominal wall structure and its possible nonlinear relationship with IVP, we improved the linear regression model and used a new mechanism to t the data.…”

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confidence: 99%

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A Clinical Study of AWT Measurement and Polynomial Regression Model Analysis in Critically Ill patients: A Retrospective Study

Tang

Zhao

Zhang

et al. 2021

Preprint

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Background：In this study, a new measurement device was used to measure the AWT in critically ill patients and a polynomial regression model was applied to analyze the correlation between intra-abdominal hypertension (IAH) and AWT in critically ill patients.Methods: A retrospective analysis was conducted in critically ill patients who were admitted to the Department of Critical Care Medicine of Daping Hospital of Army Medical University from March 13, 2019, to May 23, 2020. According to the intravesical pressure (IVP) on the first day of ICU admission and death within 28 days, the patients were divided into the IAH group (IVP ≥12 mmHg), the non-IAH group, the survival group and the nonsurvival group. The demographic and clinical data, prognostic indicators, AWT and IVP on days 1-7 after entering the ICU, IAH risk factors, and 28-day death risk factors were collected.Results: The AWT on the 1st and mean 7th day of the IAH group was (2.89±0.32)N/mm and (2.82±0.46) N/mm, respectively, which was higher than that of the non-IAH group [ (2.45±0.29) N/mm, (2.43±0.39) N/mm], p＜0.001. The average IVP on the 1st and mean 7th day of all patients were 12.78 (6.14, 18.99) and 11.49 (6.66, 19.43) mmHg, and the AWT on the 1st and mean 7th days were (2.75±0.38) and (2.75±0.47) N/mm, respectively, with significant differences (p< 0.0001). The polynomial regression models showed that the average AWT and IVP on the 1st and mean 7th were AWTday1=-2.450×10-3, IVP2+9.695×10-2 IVP+2.046，r=0.667（p＜0.0001），and AWTmean=-2.293×10-3, IVP2+9.273×10-2 IVP+2.081, respectively. The logistic regression analysis showed that AWTday1 2.73-2.97N/mm increased the patient's 28-day mortality risk (OR: 6.834; 95%: 1.105-42.266, p=0.010).Conclusion: There is a nonlinear correlation between AWT and IVP in critically ill patients, and a high AWT may indicate poor prognosis.Trial registration：ChiCTR，ChiCTR1900020562. Registered 8 January 2019，http://www.chictr.org.cn/showproj.aspx?proj=34441

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

A Clinical Study of AWT Measurement and Polynomial Regression Model Analysis in Critically Ill patients: A Retrospective Study

Tang

Zhao

Zhang

et al. 2021

Preprint

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“…Поиски новых диагностических решений продолжаются, самые современные и сложные методы исследований не решают проблемы. Острый аппендицит в детском возрасте в своем клиническом проявлении симулирует большое число заболеваний, в подавляющем большинстве не требующих оперативного вмешательства [1,11,14,15]. В свою очередь, значительно большее число заболеваний, как соматических, так и хирургических (локализующихся как в брюшной полости, так и вне ее), протекают с абдоминальным синдромом и маскируются под ОА [1,11,14,15,16].…”

Section: оригінальні дослідження абдомінальна хірургіяunclassified

Analysis of the results of using the Pediatric Appendicitis Score in the differential diagnosis of abdominal pain in children aged 5–17 years

Вакульчик¹,

Statskevich²,

Polityko³

2019

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Оригінальні дослідження. Абдомінальна хірургія Читайте нас на сайті: http://med-expert.com.ua В.Г. Вакульчик1, С.Ю. Стацкевич2, Д.Д. Политыко1 Анализ результатов применения Pediatric Appendicitis Score в дифференциальной диагностике болей в животе у детей в возрасте 5-17 лет 1УО «Гродненский государственный медицинский университет», Беларусь 2УЗ «Гродненская областная детская клиническая больница», БеларусьТочная и своевременная диагностика острого аппендицита у детей остается актуальным вопросом. Одним из направлений является разработка стандартных диагностических шкал, включающих клинические симптомы и лабораторные данные.Цель: анализ результатов применения Pediatric Appendicitis Score (PAS) в дифференциальной диагностике болей в животе у детей в возрасте 5-17 лет.Материалы и методы. Проспективное рандомизированное слепое клиническое исследование. Обследовано 326 детей с болями в животе в возрасте 5-17 лет.Результаты. Обнаружено, что Pediatric Appendicitis Score имеет различную диагностическую значимость в рекомендуемых диапазонах значений. При заключении «низкий риск ОА» уровень ошибок первого рода составит 6% (ДИ 0,0-12,6). Ошибки второго рода (негативные аппендэктомии) составят 20% (ДИ 7,6-32,4) при значениях больше 7 баллов.Выводы. Представляется целесообразным дальнейший анализ диагностических возможностей Pediatric Appendicitis Score. Полученные данные диктуют необходимость исследования Pediatric Appendicitis Score в различных возрастных группах с целью снижения количества неопределенных заключений, повышения точности диагностики деструктивных форм.Ключевые слова: острый аппендицит, дети, диагностика, шкала PAS.

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“…[7][8][9][10] Thus, palpation of AWT is often used to infer the clinical diseases of abdominal hypertension or abdominal infection, but the disadvantage of this physical examination is that it is only qualitative and cannot be used for quantitative diagnosis. 11,12 According to the latest literature, noninvasive IAP measurement techniques can be generally classified into three categories: 1) strain gauge, respiratory inductance plethysmography (RIP) and tensiometer; 2) ultrasoundbased techniques (ultrasound tonometry, ultrasound assessment of the abdominal wall in combination with external pressure, ultrasound Doppler tonometry, laser-ultrasound, microwave reflection); and 3) bio-electrical impedance and microwave reflectometry. 13 Currently, wireless motility capsules, digital image correlation, and laser ultrasound cannot be proposed as the best measurement techniques, mainly due to the lack of validation and clinical research.…”

Section: Introductionmentioning

confidence: 99%

A New Device for Measuring Abdominal Wall Tension and Its Value in Screening Abdominal Infection

Tang

Liu

et al. 2021

MDER

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Objective: This study is the largest clinical study of noninvasive Abdominal wall tension (AWT) measurement with a tensiometer to date. It also initially applies a polynomial regression equation to analyze the correlation between AWT measurement and intravesical pressure (IVP) measurement and remarkably finds interesting changes between different IVP intervals and AWT. Methods: Critically ill patients who were treated in the intensive care unit (ICU) of Daping Hospital, Army Medical University, from August 30, 2018, to June 30, 2020, and met the inclusion criteria were prospectively included in this study. The patients were divided into an intra-abdominal hypertension group and a non-intra-abdominal hypertension group and an abdominal infection group and no abdominal infection group. AWT and IVP were measured at 9 points on the abdominal wall on the first day after admission to the ICU. The correlations between AWTs and IVP were analyzed, and the role of AWT in the diagnosis of complications of abdominal infection and the prediction of adverse prognosis were analyzed. Results: A total of 127 patients were included. The average AWT and IVP were 2.77±0.38 N/mm and 12.31±7.01 mmHg, respectively, on the first day of admission. There was a positive correlation between AWT and IVP (correlation coefficient r = 0.706, p < 0.05). The polynomial regression model was AWT= -1.616×10 −3 IVP 2 +8.323×10 −2 IVP+2.094. The cutoff value of the sensitivity and specificity of AWT for the diagnosis of abdominal infection was 2.57 N/mm. Furthermore, AWT = 2.57 N/mm had the best diagnostic efficiency, which was better than that of IAH and lactate. Conclusion:There was a correlation between AWT and IVP. AWT measurement was helpful in the diagnosis of IAH and abdominal infection complications and can therefore serve as a new method for the clinical diagnosis of IVP and abdominal infection.

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Examination of the abdomen

Abstract: http://aasldpubs.onlinelibrary.wiley.com/hub/journal/10.1002/(ISSN)2046-2484/video/7-6-reading-reuben.html a video presentation of this article http://aasldpubs.onlinelibrary.wiley.com/hub/journal/10.1002/(ISSN)2046-2484/video/7-6-interview-reuben.html the interview with the author

Cited by 16 publications

References 17 publications

A Clinical Study of AWT Measurement and Polynomial Regression Model Analysis in Critically Ill patients: A Retrospective Study

A Clinical Study of AWT Measurement and Polynomial Regression Model Analysis in Critically Ill patients: A Retrospective Study

Analysis of the results of using the Pediatric Appendicitis Score in the differential diagnosis of abdominal pain in children aged 5–17 years

A New Device for Measuring Abdominal Wall Tension and Its Value in Screening Abdominal Infection

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