European journal of internal medicine
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Eur. J. Intern. Med. · May 2009
A French national research project to the creation of an auscultation's school: the ASAP project.
Auscultation of pulmonary sounds provides valuable clinical information but has been regarded as a tool of low diagnostic value due to the inherent subjectivity in the evaluation of these sounds. This paper describes an ambitious study of in the so-called ASAP project or "Analyse de Sons Auscultatoires et Pathologiques". ⋯ ASAP aims at making evolve the auscultation technics: by 1) the development objective tools for the analyse of auscultation sounds: electronic stethoscopes paired with computing device; 2) the creation of an auscultation sounds' database in order to compare and identify the acoustical and visual signatures of the pathologies; and 3) the capitalisation of these new auscultation techniques around the creation of a teaching unit: "Ecole de l'Auscultation". This auscultation's school will be destined to the initial and continuous formation of the medical attendants.
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Eur. J. Intern. Med. · May 2009
The additive value of N-terminal pro-B-type natriuretic peptide testing at the emergency department in patients with acute dyspnoea.
B-type natriuretic peptide (BNP) and its inactive counterpart NT-proBNP can help to identify or rule out heart failure in patients presenting with acute dyspnoea. It is not well known whether measurement of these peptides can be omitted in certain patient groups. ⋯ NT-proBNP measurement has additive value in a substantial number of patients presenting with acute dyspnoea, but can possibly be omitted in patients with a clinical probability of heart failure of >70%.
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Eur. J. Intern. Med. · May 2009
Not all obese subjects of multiethnic origin are at similar risk for developing hypertension and type 2 diabetes.
Whether insulin resistance and not obesity per se is the major contributor to clinical outcomes associated with obesity has not been fully established. This study evaluated in a group of obese Brazilians of multiethnic origin to what extent the prevalence of hypertension and other cardiometabolic risk factors varies as a function of the degree of insulin sensitivity. ⋯ In conclusion, our findings have shown that the risk of developing essential hypertension, type 2 diabetes, and cardiovascular disease is accentuated in obese individuals who are also more insulin resistant.