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Josef Parnas - One of the best experts on this subject based on the ideXlab platform.
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Variability in clinical diagnoses during the ICD-8 and ICD-10 era
Social Psychiatry and Psychiatric Epidemiology, 2016Co-Authors: Julie Nordgaard, Kasper Jessen, Ditte Sæbye, Josef ParnasAbstract:Aims To explore whether the diagnostic homogeneity in a daily, routine clinical activity changed visibly over two historical periods (the ICD-8 and the ICD-10 era) across and within five psychiatric in-patient clinics. Methods In this register study, we analyzed the discharge diagnoses from five university-affiliated departments of psychiatry in Denmark in two time periods: 1980–1985 (ICD-8) and 2001–2010 (ICD-10). Results The synchronic inter-departmental diagnostic differences did not decrease in the ICD-10 era compared with ICD-8 era. Nor did the diachronic stability within each department become more homogeneous. Conclusion The diagnostic variability reflected by the diagnostic differences between the departments and by the diagnostic homogeneity within each department remained similar in the two historical periods with no evidence of an increased homogeneity of diagnostic habits after the introduction of the ICD-10. Limitations There is a myriad of variables that affects the diagnostic variability over time that we were not able to control.
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Variability in clinical diagnoses during the ICD-8 and ICD-10 era.
Social psychiatry and psychiatric epidemiology, 2016Co-Authors: Julie Nordgaard, Kasper Jessen, Ditte Sæbye, Josef ParnasAbstract:Aims To explore whether the diagnostic homogeneity in a daily, routine clinical activity changed visibly over two historical periods (the ICD-8 and the ICD-10 era) across and within five psychiatric in-patient clinics.
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Premorbid IQ varies across different definitions of schizophrenia.
World psychiatry : official journal of the World Psychiatric Association (WPA), 2007Co-Authors: Annick Urfer Parnas, Ditte Sæbye, Lennart Jansson, Peter Handest, Jan Nielsen, Josef ParnasAbstract:The nature of the association between IQ and schizophrenia is still unclear. So far no study addressed this issue in relation to the breadth or scope of the very concept of schizophrenia. We examined the premorbid IQ in a polydiagnostic study with four classifications of schizophrenia: ICD-8/9, ICD-10, St. Louis and Flexible System-Wide. Only the ICD-10 schizophrenia patients exhibited a significantly lower premorbid IQ. There were suggestive differences between the four examined systems as well as between the ICD-10 paranoid and non-paranoid subtypes. Exploration of crucial diagnostic features of schizophrenia in relation to IQ revealed associations between low premorbid IQ and hallucinations as well as negative symptoms. It is concluded that premorbid IQ varies across different definitions of schizophrenia.
Daniel P Morin - One of the best experts on this subject based on the ideXlab platform.
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natural history and implantable cardioverter defibrillator implantation after revascularization for stable coronary artery disease with depressed ejection fraction
Clinical Cardiology, 2015Co-Authors: Geoffrey F Lewis, Adam C Harless, Lauren Vazquez, Freddy M Abisamra, Michael L Bernard, Sammy Khatib, Glenn M Polin, Daniel P MorinAbstract:Background Following revascularization, most payors require 3 months of medical therapy, followed by left ventricular ejection fraction (LVEF) reassessment, before implantable cardioverter-defibrillator (ICD) implantation possibly contributing to incomplete follow-up and suboptimal utilization of ICD therapy. The natural history of these patients, and their fate regarding ICD implantation, is unknown. Hypothesis We hypothesized that a waiting period after revascularization for stable CAD results in missed opportunities to provide care with regard to ICD implantation. Methods We followed patients with LVEF ≤ 35% and no ICD who underwent revascularization (coronary artery bypass grafting [CABG] or percutaneous coronary intervention [PCI]) for stable CAD. Follow-up used chart review and scripted telephone interviews. Results Among 3164 revascularized patients (2198 [69%] PCI, 966 [31%] CABG), only 62 (2%; 33 [53%] male, age 67 ± 12 y, LVEF 28% ± 6%) had stable CAD, depressed LVEF, and no ICD. Over 35 ± 19 months, 35 (56%) of these 62 patients were no longer candidates for ICD based on improved LVEF, 14 (23%) received an ICD, 5 (8%) declined ICD despite physician recommendation, 3 (5%) were not offered ICD despite continued eligibility, 2 (3%) died, 1 (2%) was not a candidate due to substance abuse, and 1 (2%) had ICD implantation temporarily deferred. Only 1 (2%) was lost to follow-up. Conclusions Following revascularization for stable CAD with depressed LVEF, ≥50% of patients' ventricular function improved enough to make ICD implantation unnecessary. A waiting period after revascularization prior to ICD implantation appears appropriate and does not significantly negatively impact follow-up or the rate of appropriate ICD implantation.
Emma Guttmanyassky - One of the best experts on this subject based on the ideXlab platform.
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atopic dermatitis results in intrinsic barrier and immune abnormalities implications for contact dermatitis
The Journal of Allergy and Clinical Immunology, 2013Co-Authors: Julia K Gittler, James G Krueger, Emma GuttmanyasskyAbstract:Atopic dermatitis (AD), as well as irritant contact dermatitis (ICD) and allergic contact dermatitis (ACD), are common skin diseases. These diseases are characterized by skin inflammation mediated by activated innate immunity or acquired immune mechanisms. Although AD, ICD, and ACD can be encountered in pure forms by allergists and dermatologists, patients with AD often present with increased frequency of ICD and ACD. Although a disturbed barrier alone could potentiate immune reactivity in patients with AD through increased antigen penetration, additional immune mechanisms might explain the increased susceptibility of atopic patients to ICD and ACD. This review discusses cellular pathways associated with increased skin inflammation in all 3 conditions and presents mechanisms that might contribute to the increased rate of ICD and ACD in patients with AD.
Luz Fonacier - One of the best experts on this subject based on the ideXlab platform.
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Irritant Contact Dermatitis
Clinical Reviews in Allergy & Immunology, 2019Co-Authors: Sonia N. Bains, Pembroke Nash, Luz FonacierAbstract:Contact dermatitis accounts for 95% of occupational skin disorders. Irritant contact dermatitis (ICD) is often caused by cumulative exposure to weak irritants, accounting for 80% of all cases of contact dermatitis. ICD can co-exist with atopic dermatitis (AD) and allergic contact dermatitis (ACD). Patients with AD and ACD may have a lower inflammatory threshold for developing ICD. Therefore, it needs to be distinguished from lesions of AD and ACD. ICD Patients report stinging and burning in excess of pruritus. Pruritus is classically reported by patients with AD and ACD. ICD lesions are typically well-demarcated unlike AD and ACD. ICD is diagnosed by exclusion. Patients undergo testing to rule out type I and type IV hypersensitivity. Negative results suggest a diagnosis of ICD. Management consists of irritant identification and avoidance with regular emollient use. Although ICD is more common in certain occupations, genetics and environment play significant roles in its development.
Julie Nordgaard - One of the best experts on this subject based on the ideXlab platform.
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Variability in clinical diagnoses during the ICD-8 and ICD-10 era
Social Psychiatry and Psychiatric Epidemiology, 2016Co-Authors: Julie Nordgaard, Kasper Jessen, Ditte Sæbye, Josef ParnasAbstract:Aims To explore whether the diagnostic homogeneity in a daily, routine clinical activity changed visibly over two historical periods (the ICD-8 and the ICD-10 era) across and within five psychiatric in-patient clinics. Methods In this register study, we analyzed the discharge diagnoses from five university-affiliated departments of psychiatry in Denmark in two time periods: 1980–1985 (ICD-8) and 2001–2010 (ICD-10). Results The synchronic inter-departmental diagnostic differences did not decrease in the ICD-10 era compared with ICD-8 era. Nor did the diachronic stability within each department become more homogeneous. Conclusion The diagnostic variability reflected by the diagnostic differences between the departments and by the diagnostic homogeneity within each department remained similar in the two historical periods with no evidence of an increased homogeneity of diagnostic habits after the introduction of the ICD-10. Limitations There is a myriad of variables that affects the diagnostic variability over time that we were not able to control.
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Variability in clinical diagnoses during the ICD-8 and ICD-10 era.
Social psychiatry and psychiatric epidemiology, 2016Co-Authors: Julie Nordgaard, Kasper Jessen, Ditte Sæbye, Josef ParnasAbstract:Aims To explore whether the diagnostic homogeneity in a daily, routine clinical activity changed visibly over two historical periods (the ICD-8 and the ICD-10 era) across and within five psychiatric in-patient clinics.
