Glossary entry (derived from question below)
English term or phrase:
assessment for unevaluable patients
Russian translation:
оценка для пациентов, состояние которых невозможно определить обычными методами
Added to glossary by
Andrew Tishin
May 20, 2022 11:25
1 yr ago
14 viewers *
English term
Russian Federation
"Золотое копьё" 2021. 13 лет опыта.
Native in: Russian 
Works in: English to Russian, Russian to English, German to Russian, and 1 more.
assessment for unevaluable patients
English to Russian
Medical
Medical: Health Care
Obtunded and Unevaluable Patient
The proper radiographic ***assessment for obtunded or unevaluable patients*** is extremely important given the difficulty in accurate clinical assessment and concern for an unidentified injury causing catastrophic neurological damage. The 2013 guidelines highlighted the inadequacy of dynamic imaging (flexion-extension films), and its use was not recommended for initial clearance. 19,25,32-37 An 11 study meta-analysis (1550 total patients) determined that the diagnostic utility of MRI in CT-negative obtunded patients was clinically significant, altering management in 6 percent of patients (Level II evidence). 38 A second meta-analysis by Muchow et al., determined that MRI identified 20.9 percent of injuries not diagnosed on initial radiograph or CT imaging, and recommended that MRI become the gold standard. 39
These studies were criticized because of serious design flaws, including false endpoints, poorly matched populations, inclusion of a pediatric study, and dissimilar imaging protocols. 19 The 2013 guidelines recommended the possible use of MRI after a normal CT for patients who are obtunded/unevaluable. 19
The proper radiographic ***assessment for obtunded or unevaluable patients*** is extremely important given the difficulty in accurate clinical assessment and concern for an unidentified injury causing catastrophic neurological damage. The 2013 guidelines highlighted the inadequacy of dynamic imaging (flexion-extension films), and its use was not recommended for initial clearance. 19,25,32-37 An 11 study meta-analysis (1550 total patients) determined that the diagnostic utility of MRI in CT-negative obtunded patients was clinically significant, altering management in 6 percent of patients (Level II evidence). 38 A second meta-analysis by Muchow et al., determined that MRI identified 20.9 percent of injuries not diagnosed on initial radiograph or CT imaging, and recommended that MRI become the gold standard. 39
These studies were criticized because of serious design flaws, including false endpoints, poorly matched populations, inclusion of a pediatric study, and dissimilar imaging protocols. 19 The 2013 guidelines recommended the possible use of MRI after a normal CT for patients who are obtunded/unevaluable. 19
Proposed translations
1 hr
Selected
оценка для пациентов, состояние которых невозможно определить обычными методами
Как я понимаю, в заданном контексте речь идёт об оценке состояния поступившего пациента, который находится без сознания, например, и поэтому невозможно провести обычный стандартный неврологический тест.
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Вот отрывок из заданного текста, в котором противопоставляются normal neurological exam и obtunded/unevaluable.
"CERVICAL COLLAR CLEARANCE
KEY POINTS
— The cervical collar can be discontinued without additional radiographic imaging in an awake, asymptomatic, adult trauma patient presenting with all of the following: a normal neurological exam, no high-risk injury mechanism, free range of cervical motion, and no neck tenderness.
— Removal of a cervical collar is recommended for adult blunt trauma patients who are neurological asymptomatic and have a negative helical cervical computed tomography (CT) imaging.
— A negative helical cervical CT scan is recommended as sufficient to remove a C-collar in an adult blunt trauma patient who is obtunded/unevaluable".
https://www.facs.org/media/3dpbdqkm/spine_injury_guidelines....
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Neurologic examination
"The neurologic examination is typically divided into eight components: mental status; skull, spine and meninges; cranial nerves; motor examination; sensory examination; coordination; reflexes; and gait and station.
The mental status is an extremely important part of the neurologic examination that is often overlooked. It should be assessed first in all patients. Mental status testing can be divided into five parts: level of alertness; focal cortical functioning; cognition; mood and affect; and thought content".
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Note added at 1 hr (2022-05-20 12:50:43 GMT)
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https://www.urmc.rochester.edu/MediaLibraries/URMCMedia/neur...
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Вот отрывок из заданного текста, в котором противопоставляются normal neurological exam и obtunded/unevaluable.
"CERVICAL COLLAR CLEARANCE
KEY POINTS
— The cervical collar can be discontinued without additional radiographic imaging in an awake, asymptomatic, adult trauma patient presenting with all of the following: a normal neurological exam, no high-risk injury mechanism, free range of cervical motion, and no neck tenderness.
— Removal of a cervical collar is recommended for adult blunt trauma patients who are neurological asymptomatic and have a negative helical cervical computed tomography (CT) imaging.
— A negative helical cervical CT scan is recommended as sufficient to remove a C-collar in an adult blunt trauma patient who is obtunded/unevaluable".
https://www.facs.org/media/3dpbdqkm/spine_injury_guidelines....
---
Neurologic examination
"The neurologic examination is typically divided into eight components: mental status; skull, spine and meninges; cranial nerves; motor examination; sensory examination; coordination; reflexes; and gait and station.
The mental status is an extremely important part of the neurologic examination that is often overlooked. It should be assessed first in all patients. Mental status testing can be divided into five parts: level of alertness; focal cortical functioning; cognition; mood and affect; and thought content".
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Note added at 1 hr (2022-05-20 12:50:43 GMT)
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https://www.urmc.rochester.edu/MediaLibraries/URMCMedia/neur...
4 KudoZ points awarded for this answer.
Comment: "Спасибо, поскольку в данном тексте речь идёт о начальной оценке пациентов, поступивших в травмцентр, которые ещё не проходили лечения, выбрал этот вариант."
1 hr
cherepanov
Ukraine
Ukraine
Native in Russian
Specializes in field
Ukraine
20 years in translations, Ph.D. (Chem)
Native in: Russian 
Works in: English to Russian, English to Ukrainian
Related KudoZ points
:
80
(рентгенографическая) оценка пациентов, ответ которых на лечение не может быть определен
О том, кто такие unevaluable patients, пишут здесь:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4569274/
...Here, an unevaluable patient is defined as a patient whose response to treatment cannot be determined due to the occurrence of some concurrent uncontrolled event which modifies the therapeutic evaluation schedule.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4569274/
...Here, an unevaluable patient is defined as a patient whose response to treatment cannot be determined due to the occurrence of some concurrent uncontrolled event which modifies the therapeutic evaluation schedule.
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