Appropriate use criteria for echocardiography in the Netherlands

Introduction Appropriate use criteria (AUC) for echocardiography based on clinical scenarios were previously published by an American Task Force. We determined whether members of the Dutch Working Group on Echocardiography (WGE) would rate these scenarios in a similar way. Methods All 32 members of the WGE were invited to judge clinical scenarios independently using a blanked version of the previously published American version of AUC for echocardiography. During a face-to-face meeting, consensus about the final rating was reached by open discussion for each indication. For reasons of simplicity, the scores were reduced from a 9-point scale to a 3-point scale (indicating an appropriate, uncertain or inappropriate echo indication, respectively). Results Nine cardiologist members of the WGE reported their judgment on the echo cases (n = 153). Seventy-one indications were rated as appropriate, 35 were rated as uncertain, and 47 were rated as inappropriate. In 5% of the cases the rating was opposite to that in the original (appropriate compared with inappropriate and vice versa), whereas in 20% judgements differed by 1 level of appropriateness. After the consensus meeting, the appropriateness of 7 (5%) cases was judged differently compared with the original paper. Conclusions Echocardiography was rated appropriate when it is applied for an initial diagnosis, a change in clinical status or a change in patient management. However, in about 5% of the listed clinical scenarios, members of the Dutch WGE rated the AUC for echocardiography differently as compared with their American counterparts. Further research is warranted to analyse this decreased external validity

Hand osteoarthritis: clinical phenotypes, molecular mechanisms and disease management

Osteoarthritis (OA) is a highly prevalent condition and the hand is the most commonly affected site. Patients with hand OA frequently report symptoms of pain, functional limitations, and frustration in undertaking everyday activities. The condition presents clinically with changes to the bone, ligaments, cartilage and synovial tissue, which can be observed using radiography, ultrasonography or MRI. Hand OA is a heterogeneous disorder and is considered to be multifactorial in aetiology. This review provides an overview of the epidemiology, presentation and burden of hand OA, including an update on hand OA imaging (including the development of novel techniques), disease mechanisms and management. In particular, areas for which new evidence has substantially changed the way we understand, consider and treat hand OA are highlighted. For example, genetic studies, clinical trials and careful prospective imaging studies from the past 5 years are beginning to provide insights into the pathogenesis of hand OA that might uncover new therapeutic targets in disease

A note on three species of Mitridae (Mollusca: Gastropoda)

Volume: 9Start Page: 441End Page: 44

Conus floridanus Gabb, 1869 (Mollusca, Gastropoda): proposed conservation of the specific name

Volume: 44Start Page: 21End Page: 2

Comments on the proposed validation of Voluta episcopalis Linnaeus, 1758, Z.N. (S.) 1728

Volume: 23Start Page: 80End Page: 8

Drupella Thiele, 1925, (Gastropoda):proposed designation of a type-species under the plenary powers. Z.N. (S.) 1891

Volume: 26Start Page: 233End Page: 23

CONTRIBUTION TO THE TAXONOMY OF THE MURICIDAE GASTROPODA PROSOBRANCHIA

Volume: 14Start Page: 187End Page: 19

THE DATE OF PUBLICATION OF ANTONS VERZEICHNISS DER CONCHYLIEN

Volume: 20Start Page: 299End Page: 29

Conus Fergusoni G.b. Sowerby Iii, 1873 (Gastropoda): Comment On Proposed Validation. Z.n.(S.) 2239

Volume: 36Start Page: 147End Page: 14