Sample records for correlation questions clinical

  1. Automated question answering for clinical comparison questions 

    E-print Network

    Leonhard, Annette Christa

    2012-06-25

    This thesis describes the development and evaluation of new automated Question Answering (QA) methods tailored to clinical comparison questions that give clinicians a rank-ordered list of MEDLINE® abstracts targeted to ...

  2. Answering Clinical Questions with Knowledge-Based and Statistical Techniques

    E-print Network

    Lin, Jimmy

    Answering Clinical Questions with Knowledge-Based and Statistical Techniques Dina Demner physicians. Experiments on a collection of real-world clinical questions show that our approach significantly to explore complex question answering in the domain of clinical medicine. This article presents a system

  3. Rural Health Clinics Frequently Asked Questions

    MedlinePLUS

    ... Typically, clinic staff are willing to assist new start-ups as long as the new clinic is not in competition for clients. How do I get certified as an RHC? The first step is to determine if the site is eligible. ...

  4. Developing Good Clinical Questions and Finding the Best Evidence to Answer Those Questions

    PubMed Central

    Burns, Patricia B.; Chung, Kevin C.

    2015-01-01

    Evidence based medicine (EBM) involves the integration of the best scientific evidence available with physician experience and patient preferences. One of the first steps in EBM involves developing a question based on issues encountered with patients or a disease and finding evidence to answer the question. This paper is a guide to plastic surgeons in how to begin the practice of EBM by developing clinical questions and finding evidence to answer these questions. PMID:20679843

  5. Automatically Extracting Information Needs from Complex Clinical Questions

    PubMed Central

    Cao, Yong-gang; Cimino, James J; Ely, John; Yu, Hong

    2010-01-01

    Objective Clinicians pose complex clinical questions when seeing patients, and identifying the answers to those questions in a timely manner helps improve the quality of patient care. We report here on two natural language processing models, namely, automatic topic assignment and keyword identification, that together automatically and effectively extract information needs from ad hoc clinical questions. Our study is motivated in the context of developing the larger clinical question answering system AskHERMES (Help clinicians to Extract and aRrticulate Multimedia information for answering clinical quEstionS). Design and Measurements We developed supervised machine-learning systems to automatically assign predefined general categories (e.g., etiology, procedure, and diagnosis) to a question. We also explored both supervised and unsupervised systems to automatically identify keywords that capture the main content of the question. Results We evaluated our systems on 4,654 annotated clinical questions that were collected in practice. We achieved an F1 score of 76.0% for the task of general topic classification and 58.0% for keyword extraction. Our systems have been implemented into the larger question answering system AskHERMES. Our error analyses suggested that inconsistent annotation in our training data have hurt both question analysis tasks. Conclusion Our systems, available at http://www.askhermes.org, can automatically extract information needs from both short (the number of word tokens <20) and long questions (the number of word tokens >20), and from both well-structured and ill-formed questions. We speculate that the performance of general topic classification and keyword extraction can be further improved if consistently annotated data are made available. PMID:20670693

  6. Trustworthiness and relevance in web-based clinical question answering.

    PubMed

    Cruchet, Sarah; Boyer, Célia; van der Plas, Lonneke

    2012-01-01

    Question answering systems try to give precise answers to a user's question posed in natural language. It is of utmost importance that the answers returned are relevant to the user's question. For clinical QA, the trustworthiness of answers is another important issue. Limiting the document collection to certified websites helps to improve the trustworthiness of answers. On the other hand, limited document collections are known to harm the relevancy of answers. We show, however, in a comparative evaluation, that promoting trustworthiness has no negative effect on the relevance of the retrieved answers in our clinical QA system. On the contrary, the answers found are in general more relevant. PMID:22874315

  7. Clinical correlations of photoparoxysmal responses.

    PubMed

    Jayakar, P; Chiappa, K H

    1990-03-01

    Reilly and Peters (1973) reported that photoparoxysmal responses (PPRs) that outlasted the stimulus correlated significantly with seizures as compared to self-limited PPRs. However, they defined a wide range of activity, including occipital spikes and slow wave bursts, as PPR. We examined EEGs of 3557 patients and 48 normal subjects for PPRs defined only as generalized spikes or spike-wave activity. None of the 48 normal subjects showed a PPR. PPRs were seen in 35 (1%) patients, 27 (77%) of these had a definite history of epilepsy, 3 (9%) had a questionable history, and 5 (14%) had had no seizures. PPRs were prolonged more than 100 msec beyond the stimulus in 11, and self-limited in 24. The incidence of seizures was not statistically different in these 2 groups. Furthermore, the classification of PPRs into these 2 groups could be influenced by the time at which the stimulus was stopped after the appearance of the PPR. PPRs are rare in normal subjects and non-epileptic patients and have a high correlation with seizures irrespective of their relationship to the strobe stimulus. PMID:1689648

  8. AskHERMES: An online question answering system for complex clinical questions

    PubMed Central

    Cao, YongGang; Liu, Feifan; Simpson, Pippa; Antieau, Lamont; Bennett, Andrew; Cimino, James J.; Ely, John; Yu, Hong

    2012-01-01

    Objective Clinical questions are often long and complex and take many forms. We have built a clinical question answering system named AskHERMES to perform robust semantic analysis on complex clinical questions and output question-focused extractive summaries as answers. Design This paper describes the system architecture and a preliminary evaluation of AskHERMES, which implements innovative approaches in question analysis, summarization, and answer presentation. Five types of resources were indexed in this system: MEDLINE abstracts, PubMed Central full-text articles, eMedicine documents, clinical guidelines and Wikipedia articles. Measurement We compared the AskHERMES system with Google (Google and Google Scholar) and UpToDate and asked physicians to score the three systems by ease of use, quality of answer, time spent, and overall performance. Results AskHERMES allows physicians to enter a question in a natural way with minimal query formulation and allows physicians to efficiently navigate among all the answer sentences to quickly meet their information needs. In contrast, physicians need to formulate queries to search for information in Google and UpToDate. The development of the AskHERMES system is still at an early stage, and the knowledge resource is limited compared with Google or UpToDate. Nevertheless, the evaluation results show that AskHERMES’ performance is comparable to the other systems. In particular, when answering complex clinical questions, it demonstrates the potential to outperform both Google and UpToDate systems. Conclusions AskHERMES, available at http://www.AskHERMES.org, has the potential to help physicians practice evidence-based medicine and improve the quality of patient care. PMID:21256977

  9. Respiratory microbiota: addressing clinical questions, informing clinical practice

    PubMed Central

    Rogers, Geraint B; Shaw, Dominick; Marsh, Robyn L; Carroll, Mary P; Serisier, David J; Bruce, Kenneth D

    2015-01-01

    Over the last decade, technological advances have revolutionised efforts to understand the role played by microbes in airways disease. With the application of ever more sophisticated techniques, the literature has become increasingly inaccessible to the non-specialist reader, potentially hampering the translation of these gains into improvements in patient care. In this article, we set out the key principles underpinning microbiota research in respiratory contexts and provide practical guidance on how best such studies can be designed, executed and interpreted. We examine how an understanding of the respiratory microbiota both challenges fundamental assumptions and provides novel clinical insights into lung disease, and we set out a number of important targets for ongoing research. PMID:25035125

  10. Respiratory microbiota: addressing clinical questions, informing clinical practice.

    PubMed

    Rogers, Geraint B; Shaw, Dominick; Marsh, Robyn L; Carroll, Mary P; Serisier, David J; Bruce, Kenneth D

    2015-01-01

    Over the last decade, technological advances have revolutionised efforts to understand the role played by microbes in airways disease. With the application of ever more sophisticated techniques, the literature has become increasingly inaccessible to the non-specialist reader, potentially hampering the translation of these gains into improvements in patient care. In this article, we set out the key principles underpinning microbiota research in respiratory contexts and provide practical guidance on how best such studies can be designed, executed and interpreted. We examine how an understanding of the respiratory microbiota both challenges fundamental assumptions and provides novel clinical insights into lung disease, and we set out a number of important targets for ongoing research. PMID:25035125

  11. Questions to Ask When Selecting an Assisted Reproductive Technology (ART) Clinic

    MedlinePLUS

    ... Questions to Ask When Selecting an Assisted Reproductive Technology (ART) Clinic These questions will help you learn ... a member of the Society for Assisted Reproductive Technology (SART)? If not, what is the clinic’s affiliation ...

  12. Bronchiectasis: CT\\/clinical correlations

    Microsoft Academic Search

    Georgeann McGuinness; David P Naidich

    1995-01-01

    The association between bronchiectasis and human immunodeficiency virus infection, the resurgence of tuberculosis, especially in urban and immunocompromised patients, and the recognition of bronchiectasis as a manifestation of rejection in the transplant population are emerging clinical settings in which establishing the diagnosis of bronchiectasis is becoming increasingly important. High-resolution CT, by virtue of its well-established accuracy, is currently accepted as

  13. Accessing heterogeneous sources of evidence to answer clinical questions.

    PubMed

    Mendonça, E A; Cimino, J J; Johnson, S B; Seol, Y H

    2001-04-01

    The large and rapidly growing number of information sources relevant to health care, and the increasing amounts of new evidence produced by researchers, are improving the access of professionals and students to valuable information. However, seeking and filtering useful, valid information can be still very difficult. An online information system that conducts searches based on individual patient data can have a beneficial influence on the particular patient's outcome and educate the healthcare worker. In this paper, we describe the underlying model for a system that aims to facilitate the search for evidence based on clinicians' needs. This paper reviews studies of information needs of clinicians, describes principles of information retrieval, and examines the role that standardized terminologies can play in the integration between a clinical system and literature resources, as well as in the information retrieval process. The paper also describes a model for a digital library system that supports the integration of clinical systems with online information sources, making use of information available in the electronic medical record to enhance searches and information retrieval. The model builds on several different, previously developed techniques to identify information themes that are relevant to specific clinical data. Using a framework of evidence-based practice, the system generates well-structured questions with the intent of enhancing information retrieval. We believe that by helping clinicians to pose well-structured clinical queries and including in them relevant information from individual patients' medical records, we can enhance information retrieval and thus can improve patient-care. PMID:11515415

  14. Therapeutic applications of extracellular vesicles: clinical promise and open questions.

    PubMed

    György, Bence; Hung, Michelle E; Breakefield, Xandra O; Leonard, Joshua N

    2015-01-01

    This review provides an updated perspective on rapidly proliferating efforts to harness extracellular vesicles (EVs) for therapeutic applications. We summarize current knowledge, emerging strategies, and open questions pertaining to clinical potential and translation. Potentially useful EVs comprise diverse products of various cell types and species. EV components may also be combined with liposomes and nanoparticles to facilitate manufacturing as well as product safety and evaluation. Potential therapeutic cargoes include RNA, proteins, and drugs. Strategic issues considered herein include choice of therapeutic agent, means of loading cargoes into EVs, promotion of EV stability, tissue targeting, and functional delivery of cargo to recipient cells. Some applications may harness natural EV properties, such as immune modulation, regeneration promotion, and pathogen suppression. These properties can be enhanced or customized to enable a wide range of therapeutic applications, including vaccination, improvement of pregnancy outcome, and treatment of autoimmune disease, cancer, and tissue injury. PMID:25292428

  15. Preferred question types for computer-based assessment of clinical reasoning: a literature study.

    PubMed

    van Bruggen, Lisette; Manrique-van Woudenbergh, Margreet; Spierenburg, Emely; Vos, Jacqueline

    2012-11-01

    Clinical reasoning is a core competence of doctors. Therefore, the assessment of clinical reasoning of undergraduate students is an important part of medical education. Three medical universities in the Netherlands wish to develop a shared question database in order to assess clinical reasoning of undergraduate students in Computer-Based Assessments (CBA). To determine suitable question types for this purpose a literature study was carried out. Search of ERIC and PubMed and subsequent cross referencing yielded 30 articles which met the inclusion criteria of a focus on question types suitable to assess clinical reasoning of medical students and providing recommendations for their use. Script Concordance Tests, Extended Matching Questions, Comprehensive Integrative Puzzles, Modified Essay Questions/Short Answer Questions, Long Menu Questions, Multiple Choice Questions, Multiple True/False Questions and Virtual Patients meet the above-mentioned criteria, but for different reasons not all types can be used easily in CBA. A combination of Comprehensive Integrative Puzzles and Extended Matching Questions seems to assess most aspects of clinical reasoning and these question types can be adapted for use in CBA. Regardless of the question type chosen, patient vignettes should be used as a standard stimulus format to assess clinical reasoning. Further research is necessary to ensure that the combination of these question types produces valid assessments and reliable test results. PMID:23205341

  16. Clinical questions raised by providers in the care of older adults: a prospective observational study

    PubMed Central

    Del Fiol, Guilherme; Weber, Alice I; Brunker, Cherie P; Weir, Charlene R

    2014-01-01

    Objective To characterise clinical questions raised by providers in the care of complex older adults in order to guide the design of interventions that can help providers answer these questions. Materials and methods To elicit clinical questions, we observed and audio recorded outpatient visits at three healthcare organisations. At the end of each appointment, providers were asked to identify clinical questions raised in the visit. Providers rated their questions based on their urgency, importance to the patient's care and difficulty in finding a useful answer to. Transcripts of the audio recordings were analysed to identify ageing-specific factors that may have contributed to the nature of the questions. Results We observed 36 patient visits with 10 providers at the three study sites. Providers raised 70 clinical questions (median of 2 clinical questions per patient seen; range 0–12), pursued 50 (71%) and successfully answered 34 (68%) of the questions they pursued. Overall, 36 (51%) of providers’ questions were not answered. Over one-third of the questions were about treatment alternatives and adverse effects. All but two clinical questions were motivated either directly or indirectly by issues related to ageing, such as the normal physiological changes of ageing and diseases with higher prevalence in the elderly. Conclusions The frequency of clinical questions was higher than in previous studies conducted in general primary care patient populations. Clinical questions were predominantly influenced by ageing-related issues. We propose a series of recommendations that may be used to guide the design of solutions to help providers answer their clinical questions in the care of older adults. PMID:24996915

  17. The persistence of clinical questions across shifts on an intensive care unit: an observational pilot study.

    PubMed

    Anton, Blair; Woodson, Sue M; Twose, Claire; Roderer, Nancy K

    2014-07-01

    How do clinical questions emerge and move toward resolution in the intensive care setting over the course of 24 hours? In a 20-bed surgical intensive care unit in a large, tertiary-care teaching hospital, informationists shadowed clinicians for 2 48-hour periods to record questions, noting when they were asked and whether they were answered. Thirty-eight percent of 112 recorded questions remained unanswered. Some unanswered questions persisted across shifts, and clinicians' information-seeking behaviors changed over time. Clinical information services can be improved and integrated more fully into clinical workflows based on a fuller understanding of the life cycle of clinical inquiry. PMID:25031562

  18. Children of Divorce: The Question of Clinically Significant Problems.

    ERIC Educational Resources Information Center

    Warren, Nancy J.; And Others

    1986-01-01

    Reports results of a study of a non-clinical sample of children (N=112) from families (N=86) after divorce filing using criteria to assess clinically significant levels of problems in children aged 7-12. Results suggest children may adapt better to divorce than some studies suggest. Children with behavior problems were less likely to have regular…

  19. [Intercultural communication in the clinical context: a question of partnership].

    PubMed

    Vissandjée, B; Dupére, S

    2000-06-01

    This article is intended to promote reflection on the intercultural competence of nurses and other health professionals. It discusses the different types of interpretation used to communicate with patients who do not speak English or French, legal and ethical consequences, and impact on health-care quality. The authors offer recommendations for both research and clinical nursing, as well as the health-care system in general, and highlight the challenges faced by nurses in a pluralist society. The literature review reveals an inherent complexity in the use of diverse types of interpreters. Finally, the authors argue that the intricacy of the cross-cultural communication trio is intensified by a lack of adequate preparation of nurses and other health professionals and interpreters regarding cross-cultural communication. PMID:11141819

  20. Utilization of the PICO framework to improve searching PubMed for clinical questions

    PubMed Central

    Schardt, Connie; Adams, Martha B; Owens, Thomas; Keitz, Sheri; Fontelo, Paul

    2007-01-01

    Background Supporting 21st century health care and the practice of evidence-based medicine (EBM) requires ubiquitous access to clinical information and to knowledge-based resources to answer clinical questions. Many questions go unanswered, however, due to lack of skills in formulating questions, crafting effective search strategies, and accessing databases to identify best levels of evidence. Methods This randomized trial was designed as a pilot study to measure the relevancy of search results using three different interfaces for the PubMed search system. Two of the search interfaces utilized a specific framework called PICO, which was designed to focus clinical questions and to prompt for publication type or type of question asked. The third interface was the standard PubMed interface readily available on the Web. Study subjects were recruited from interns and residents on an inpatient general medicine rotation at an academic medical center in the US. Thirty-one subjects were randomized to one of the three interfaces, given 3 clinical questions, and asked to search PubMed for a set of relevant articles that would provide an answer for each question. The success of the search results was determined by a precision score, which compared the number of relevant or gold standard articles retrieved in a result set to the total number of articles retrieved in that set. Results Participants using the PICO templates (Protocol A or Protocol B) had higher precision scores for each question than the participants who used Protocol C, the standard PubMed Web interface. (Question 1: A = 35%, B = 28%, C = 20%; Question 2: A = 5%, B = 6%, C = 4%; Question 3: A = 1%, B = 0%, C = 0%) 95% confidence intervals were calculated for the precision for each question using a lower boundary of zero. However, the 95% confidence limits were overlapping, suggesting no statistical difference between the groups. Conclusion Due to the small number of searches for each arm, this pilot study could not demonstrate a statistically significant difference between the search protocols. However there was a trend towards higher precision that needs to be investigated in a larger study to determine if PICO can improve the relevancy of search results. PMID:17573961

  1. Factors associated with successful answering of clinical questions using an information retrieval system

    Microsoft Academic Search

    William R. Hersh; Lynetta Sacherek; David Hickam; Linda Rose; Charles Friedman

    Context: Despite the growing use of on-line databases by clinicians, there is very little research documenting how effectively they are used. This study assessed the ability of medical and nurse practitioner students to answer clinical questions and attempted to identify factors associated with that ability. Objective: Identify the demographic, experience, cognitive, personality, search mechanics, and user satisfaction factors associated with

  2. Endotoxemia: methods of detection and clinical correlates.

    PubMed Central

    Hurley, J C

    1995-01-01

    As an assay for endotoxin, the Limulus amebocyte lysate assay has several desirable properties: sensitivity, specificity, and potential for adaptation to a quantitative format. Several modifications have been developed to enhance its potential for clinical application. The modifications that allow quantitative measurement of endotoxin and also improve its application to blood samples are described in this review. In fluids other than blood, the detection of endotoxin with the Limulus amebocyte lysate assay can be used as an aid to identify the presence of gram-negative bacteria, and the assay has established utility. With blood, however, there are a range of factors that interfere with the detection of endotoxemia and there are disparate views with respect to the diagnostic and prognostic significance of the test results. In general, the clinical significance of the finding of endotoxemia broadly parallels the frequency and importance of gram-negative sepsis in the patient groups studied and a decline in endotoxin levels accompanies clinical improvement. However, with therapies designed to reduce levels of endotoxin, or to antagonize its effects, it is unclear whether clinical improvement occurs as a consequence of changes in the levels of endotoxemia. PMID:7621402

  3. Increasing the practice of questioning among pediatric nurses: "The Growing Culture of Clinical Inquiry" project.

    PubMed

    Laibhen-Parkes, Natasha

    2014-01-01

    This paper describes an innovative methodology implemented in an acute care pediatric setting to build nurses' confidence and competence in questioning practice. The Growing Culture of Clinical Inquiry (GCCI) project was composed of several evidence-based strategies to attain and maintain a spirit of clinical inquiry. These strategies included PowerPoint presentations, evidence-based practice (EBP) unit champions, patient-intervention-comparison-outcome (PICO) boxes, Clinical Inquiry Posters, summaries of evidence (SOE), layman's SOE, medical librarian in-services, and journal clubs. After 1 year of implementation, the GCCI project was evaluated and found to be a promising methodology for fostering a culture of inquiry among pediatric nurses. PMID:24188785

  4. Clinical correlation between hypercoagulability and thrombo-embolic phenomena

    Microsoft Academic Search

    Alain Robert; Michel Olmer; Jean Sampol; Jean-E Gugliotta; Paul Casanova

    1987-01-01

    Clinical correlation between hypercoagulability and thrombo-embolic phenomena. A study of the coagulolytic balance as well as platelet aggregation was carried out in 64 nephrotic patients. The data were correlated, in a prospective attempt, with the clinical demonstration of thrombo-embolic events. Activating factors (factors I, VIIIc, VIIIr:Ag) were increased as well as certain clotting inhibitors, ?-1-antitrypsin and ?-2-macroglobulin. There was a

  5. Gene expression correlates of clinical prostate cancer behavior

    Microsoft Academic Search

    Dinesh Singh; Phillip G. Febbo; Kenneth Ross; Donald G. Jackson; Judith Manola; Christine Ladd; Pablo Tamayo; Andrew A. Renshaw; Anthony V. D'Amico; Jerome P. Richie; Eric S. Lander; Massimo Loda; Philip W. Kantoff; Todd R. Golub; William R. Sellers

    2002-01-01

    Prostate tumors are among the most heterogeneous of cancers, both histologically and clinically. Microarray expression analysis was used to determine whether global biological differences underlie common pathological features of prostate cancer and to identify genes that might anticipate the clinical behavior of this disease. While no expression correlates of age, serum prostate specific antigen (PSA), and measures of local invasion

  6. Atypical lytic lesions of skull: Clinical and radiological correlation

    PubMed Central

    Binit, Sureka; Mittal, Mahesh Kumar; Mittal, Aliza; Thukral, Brij Bhushan

    2015-01-01

    Imaging alone cannot differentiate various isolated atypical lytic lesions involving the skull. Clinical and radiological correlation is mandatory in reaching to a diagnosis. Histopathology remains the gold standard. We describe few atypical cases presenting as isolated lytic lesions of skull with characteristic imaging findings and a brief clinical approach to reach towards the diagnosis.

  7. Hemoglobin Variants: Biochemical Properties and Clinical Correlates

    PubMed Central

    Thom, Christopher S.; Dickson, Claire F.; Gell, David A.; Weiss, Mitchell J.

    2013-01-01

    Diseases affecting hemoglobin synthesis and function are extremely common worldwide. More than 1000 naturally occurring human hemoglobin variants with single amino acid substitutions throughout the molecule have been discovered, mainly through their clinical and/or laboratory manifestations. These variants alter hemoglobin structure and biochemical properties with physiological effects ranging from insignificant to severe. Studies of these mutations in patients and in the laboratory have produced a wealth of information on hemoglobin biochemistry and biology with significant implications for hematology practice. More generally, landmark studies of hemoglobin performed over the past 60 years have established important paradigms for the disciplines of structural biology, genetics, biochemistry, and medicine. Here we review the major classes of hemoglobin variants, emphasizing general concepts and illustrative examples. PMID:23388674

  8. Questioning the relationship between the $?$4 susceptibility and the dynamical correlation length in a glass former

    E-print Network

    Rémy Colin; Ahmed Alsayed; Cyprien Gay; Bérengère Abou

    2015-03-13

    Clusters of fast and slow correlated particles, identified as dynamical heterogeneities (DHs), constitute a central aspect of glassy dynamics. A key ingredient of the glass transition scenario is a significant increase of the cluster size $\\xi$4 as the transition is approached. In need of easy-to-compute tools to measure $\\xi$4, the dynamical susceptibility $\\chi$4 was introduced recently. Here, we investigate DHs in dense microgel suspensions using image correlation, and compute both $\\chi$4 and the four-point correlation function G4. The spatial decrease of G4 provides a direct access to $\\xi$4, which is found to grow significantly with increasing volume fraction. However, this increase is not captured by $\\chi$4. We show that the assumptions that validate the connection between $\\chi$4 and $\\xi$4 are not fulfilled in our experiments. Our findings question the relevance of the broadly used $\\chi$4 in describing DHs.

  9. Correlation of clinical and molecular features in spinal bulbar muscular atrophy

    PubMed Central

    Nirmalananthan, Niranjanan; Masset, Luc; Skorupinska, Iwona; Collins, Toby; Cortese, Andrea; Pemble, Sally; Malaspina, Andrea; Fisher, Elizabeth M.C.; Greensmith, Linda; Hanna, Michael G.

    2014-01-01

    Objectives: To characterize the clinical and genetic features of spinal bulbar muscular atrophy (SBMA), a rare neurodegenerative disorder caused by the expansion of a CAG repeat in the first exon of the androgen receptor gene, in the United Kingdom. Methods: We created a national register for SBMA in the United Kingdom and recruited 61 patients between 2005 and 2013. In our cross-sectional study, we assessed, by direct questioning, impairment of activities of daily living (ADL) milestones, functional rating, and subjective disease impact, and performed correlations with both CAG repeat size and degree of somatic mosaicism. Ten patients were deceased, 46 patients participated in the study, and 5 declined. Results: Subjects had an average age at onset of 43.4 years, and weakness onset most frequently occurred in the lower limbs (87%). Impaired mobility was the most frequently reported problem by patients, followed by bulbar dysfunction. Age distribution of the impairment of ADL milestones showed remarkable overlap with a Japanese study. We have identified a significant correlation between the number of CAG repeats and both age at onset and ADL milestones. Somatic mosaicism also showed a correlation with CAG expansion size and age at onset. Conclusions: Clinical features in SBMA show a substantial overlap when comparing populations with different genetic backgrounds. This finding has major implications, because multicenter trials will be necessary to obtain sufficient power in future clinical trials. Clinical-genetic correlations are strong in SBMA and should inform any clinical research strategy in this condition. PMID:24814851

  10. Accepted Manuscript Title: Anatomo-clinical atlases correlate clinical data and

    E-print Network

    Boyer, Edmond

    - Atlases help acquire a better understanding of functional mapping in deep structures *Highlights (for region. Such atlases and associated analysis may help better understanding of functional mapping in deepAccepted Manuscript Title: Anatomo-clinical atlases correlate clinical data and electrode contact

  11. Malaria real-time PCR: correlation with clinical presentation.

    PubMed

    Dormond, L; Jaton, K; de Vallière, S; Genton, B; Greub, G

    2015-05-01

    Among 112 patients infected only by Plasmodium falciparum, WHO criteria of severity were compared with parasite load assessed by microscopy and quantitative PCR. Clinical severity was significantly correlated with higher parasite load as determined by microscopy (p < 0.001) and by PCR (p < 0.001). Hence, quantitative PCR might be useful to predict outcome. PMID:25905022

  12. Malaria real-time PCR: correlation with clinical presentation

    PubMed Central

    Dormond, L.; Jaton, K.; de Vallière, S.; Genton, B.; Greub, G.

    2015-01-01

    Among 112 patients infected only by Plasmodium falciparum, WHO criteria of severity were compared with parasite load assessed by microscopy and quantitative PCR. Clinical severity was significantly correlated with higher parasite load as determined by microscopy (p < 0.001) and by PCR (p < 0.001). Hence, quantitative PCR might be useful to predict outcome.

  13. Correlation of Angiographic Morphology and Clinical Presentation in Unstable Angina

    Microsoft Academic Search

    George Dangas; Roxana Mehran; Sylvan Wallenstein; Nikolaos A Courcoutsakis; Venu Kakarala; Jacqueline Hollywood; John A Ambrose

    1997-01-01

    Objectives. This study sought to correlate angiographically detected complex lesions and intracoronary thrombus with the severity of clinical presentation in unstable angina (UA).Background. Unstable angina is usually related to acute thrombosis superimposed on a disrupted plaque. Complex and thrombotic lesions are more prevalent in UA and have been associated with a worse prognosis. The highest levels of the Braunwald classification

  14. Upper Limb Assessment in Tetraplegia: Clinical, Functional and Kinematic Correlations

    ERIC Educational Resources Information Center

    Cacho, Enio Walker Azevedo; de Oliveira, Roberta; Ortolan, Rodrigo L.; Varoto, Renato; Cliquet, Alberto

    2011-01-01

    The aim of this study was to correlate clinical and functional evaluations with kinematic variables of upper limp reach-to-grasp movement in patients with tetraplegia. Twenty chronic patients were selected to perform reach-to-grasp kinematic assessment using a target placed at a distance equal to the arm's length. Kinematic variables (hand peak…

  15. Using existing data to address important clinical questions in critical care

    PubMed Central

    Cooke, Colin R.; Iwashyna, Theodore J.

    2013-01-01

    Objective With important technological advances in healthcare delivery and the internet, clinicians and scientists now have access to overwhelming number of available databases capturing patients with critical illness. Yet investigators seeking to answer important clinical or research questions with existing data have few resources that adequately describe the available sources and the strengths and limitations of each. This article reviews an approach to selecting a database to address health services and outcomes research questions in critical care, examines several databases that are commonly used for this purpose, and briefly describes some strengths and limitations of each. Data Sources Narrative review of the medical literature. Summary The available databases that collect information on critically ill patients are numerous and vary in the types of questions they can optimally answer. Selection of a data source must not only consider accessibility, but also the quality of the data contained within the database, and the extent to which it captures the necessary variables for the research question. Questions seeking causal associations (e.g. effect of treatment on mortality) usually either require secondary data that contain detailed information about demographics, laboratories, and physiology to best address non-random selection or sophisticated study design. Purely descriptive questions (e.g. incidence of respiratory failure) can often be addressed using secondary data with less detail such as administrative claims. Though each database has its own inherent limitations, all secondary analyses will be subject to the same challenges of appropriate study design and good observational research. Conclusion The literature demonstrates that secondary analyses can have significant impact on critical care practice. While selection of the optimal database for a particular question is a necessary part of high-quality analyses, it is not sufficient to guarantee an unbiased study. Thoughtful and well-constructed study design and analysis approaches remain equally important pillars of robust science. Only through responsible use of existing data will investigators ensure that their study has the greatest impact on critical care practice and outcomes. PMID:23328262

  16. UNMASKING MASKED HYPERTENSION: PREVALENCE, CLINICAL IMPLICATIONS, DIAGNOSIS, CORRELATES, AND FUTURE DIRECTIONS

    PubMed Central

    Peacock, James; Diaz, Keith M.; Viera, Anthony J.; Schwartz, Joseph E.; Shimbo, Daichi

    2014-01-01

    ‘Masked hypertension’ is defined as having non-elevated clinic blood pressure (BP) with elevated out-of-clinic average BP, typically determined by ambulatory BP monitoring. Approximately 15–30% of adults with non-elevated clinic BP have masked hypertension. Masked hypertension is associated with increased risks of cardiovascular morbidity and mortality compared to sustained normotension (non-elevated clinic and ambulatory BP), which is similar to or approaching the risk associated with sustained hypertension (elevated clinic and ambulatory BP). The confluence of increased cardiovascular risk and a failure to be diagnosed by the conventional approach of clinic BP measurement makes masked hypertension a significant public health concern. However, many important questions remain. First, the definition of masked hypertension varies across studies. Further, the best approach in the clinical setting to exclude masked hypertension also remains unknown. It is unclear whether home BP monitoring is an adequate substitute for ambulatory BP monitoring in identifying masked hypertension. Few studies have examined the mechanistic pathways that may explain masked hypertension. Finally, scarce data are available on the best approach to treating individuals with masked hypertension. Herein, we review the current literature on masked hypertension including definition, prevalence, clinical implications, special patient populations, correlates, issues related to diagnosis, treatment, and areas for future research. PMID:24573133

  17. Disorientation following stroke: Frequency, course, and clinical correlates

    Microsoft Academic Search

    David W. Desmond; Thomas K. Tatemichi; Miguel Figueroa; Toby I. Gropen; Yaakov Stern

    1994-01-01

    To investigate the frequency, course, and clinical correlates of disorientation following stroke, we administered the Mini-Mental State Examination orientation subtest to 177 alert patients 7–10 days and 3 months after stroke and 240 stroke-free nondemented subjects. Disorientation was defined as a score = 8\\/10. Seventy-two (40.7%) of the patients were disoriented 7–10 days after stroke and 39 patients (22.0% of

  18. Correlation between knee roentgenogram changes and clinical symptoms in osteoarthritis.

    PubMed

    Pavelka, K; Gatterová, J; Pavelka, K; Pelítskova, Z; Svarcová, Z; Janousek, J; Fencl, F; Urbanová, Z; Gollerová, V; Sedlacková, M

    1992-10-01

    The main purpose of this study was to analyze the relationship between clinical symptoms and roentgenographic changes in patients with incipient osteoarthritis of the knees (OA). One hundred and sixty-two patients (126 women, 36 men, mean age 59 years) with established osteoarthritis of the knee were examined. Patients performed subjective self-assessment using Lequesne's questionnaire (index of severity for OA of the knee) and had frontal and lateral roentgenograms of both knees. Validity of the indices as reflections of individual symptoms was documented. A statistically significant correlation was found between clinical and patient indices (r = 0.327, p < 0.0001) as well as a very weak correlation between the clinical and roentgenogram indices (r = 0.196, p = 0.286). However, there was no correlation between the patient index and roentgenogram index (r = 0.065, p = 0.47). For the assessment of severity and progression of the disease, items reflecting acute irritation (swelling, effusion, increased joint temperature, pain during passive motion) were more reliable than items reflecting chronicity (muscular atrophy, decreased range of motion, crepitus). This study confirmed that Lequesne's questionnaire is a suitable tool for assessing subjective symptoms as well as for generating a condensed measure of disease severity. In addition, sclerosis, narrowing and osteophytes were proved to be important features characterizing the OA process. PMID:1494737

  19. Infectious complications of pancreatic islet transplantation: clinical experience and unanswered questions.

    PubMed

    Pouch, Stephanie M

    2015-05-01

    Pancreatic islet transplantation is an evolving treatment modality for type I diabetes mellitus. While the field has advanced significantly over the course of the past three decades, our understanding of the infectious complications of pancreatic islet transplantation remains quite limited. This review aims to describe the current literature relating to infectious complications of pancreatic islet transplantation, including the role of microbiologically contaminated islet preparations in disease pathogenesis, our current understanding of the epidemiology and outcomes of cytomegalovirus and other infectious complications of pancreatic islet transplantation, and infectious concerns related to the use of porcine pancreatic islet cell xenografts. This review also highlights unanswered clinical questions and suggests areas of future research to mitigate infectious complications in recipients of islet transplantation. PMID:25896753

  20. Clinical correlations of potential activity markers in systemic sclerosis.

    PubMed

    Becvár, R; Stork, J; Pesáková, V; Stánová, A; Hulejová, H; Rysová, L; Zatloukalová, A; Zatloukal, P; Jáchymová, M; Pourová, L

    2005-06-01

    The objectives of the project were the following: (1) to establish a group of patients with a confirmed diagnosis of systemic sclerosis (Ssc), (2) to perform a detailed entrance examination of each patient, (3) to determine concentrations of potential activity markers, and (4) to make a comprehensive examination of each patient 1 year after inclusion into the study. A total of 49 patients were examined, 36 with a limited form of SSc, 9 with diffuse SSc, and 4 with other forms of SSc. We determined plasma or serum levels of the N-terminal propeptide of procollagen type III (NPIIIP), interleukin-6 (IL-6), soluble receptor for interleukin-2 (sIL-2r), soluble intercellular adhesion molecule-1 (sICAM-1), soluble vascular adhesion molecule-1 (sVCAM-1), von Willebrand factor antigen (vWFAg), and big endothelin-1 (BET-1) using commercial kits, and urinary excretion of pyridinoline (PYR) and deoxypyridinoline (D-PYR) using high-performance liquid chromatography. Correlations of these markers with selected clinical data were calculated. The mean levels of all potential activity markers were increased compared with normal values, but differences were not significant. The levels of NPIIIP, D-PYR, and IL-6 were normal. The measured values after 1 year did not differ from the entry values. At entry, NPIIIP concentrations correlated with the finger-to-palm distance, and D-PYR corresponded with findings on a simplified health assessment questionnaire (FQ). IL-6 levels correlated with the leukocyte count, sIL-2r with the FQ, and ET-1 with the diffuse lung capacity for carbon monoxide. In general, we found only a few clinical correlates of potential activity markers. Our data confirmed the correlations of collagen metabolism markers with skin involvement and FQ, as was reported previously. Larger studies in this field are needed. PMID:16126982

  1. Distinctive Clinical Correlates of Psychotic Major Depression: The CRESCEND Study

    PubMed Central

    Park, Seon-Cheol; Lee, Hwa-Young; Sakong, Jeong-Kyu; Jun, Tae-Youn; Lee, Min-Soo; Kim, Jae-Min; Kim, Jung-Bum; Yim, Hyeon-Woo

    2014-01-01

    Objective The purpose of this investigation was to identify distinctive clinical correlates of psychotic major depression (PMD) as compared with non-psychotic major depression (NPMD) in a large cohort of Korean patients with major depressive disorder (MDD). Methods We recruited 966 MDD patients of age over 18 years from the Clinical Research Center for Depression of South Korea (CRESCEND) study. Diagnoses of PMD (n=24) and NPMD (n=942) were made with the DSM-IV definitions and confirmed with SCID. Psychometric scales were used to assess overall psychiatric symptoms (BPRS), depression (HAMD), anxiety (HAMA), global severity (CGI-S), suicidal ideation (SSI-Beck), functioning (SOFAS), and quality of life (WHOQOL-BREF). Using independent t-tests and ?2 tests, we compared clinical characteristics of patients with PMD and NPMD. A binary logistic regression model was constructed to identify factors independently associated with increased likelihood of PMD. Results PMD subjects were characterized by a higher rate of inpatient enrollment, and higher scores on many items on BPRS (somatic concern, anxiety, emotional withdrawal, guilt feelings, tension, depression, suspiciousness, hallucination, motor retardation, blunted affect and excitement) global severity (CGI-s), and suicidal ideation (SSI-Beck). The explanatory factor model revealed that high levels of tension, excitement, and suicidal ideation were associated with increased likelihood of PMD. Conclusion Our findings partly support the view that PMD has its own distinctive clinical manifestation and course, and may be considered a diagnostic entity separate from NPMD. PMID:25110501

  2. Prodromal posterior cortical atrophy: clinical, neuropsychological, and radiological correlation.

    PubMed

    Chan, Lung Tat Andrew; Lynch, Whitney; De May, Mary; Horton, Jonathan C; Miller, Bruce L; Rabinovici, Gil D

    2015-02-01

    We present longitudinal clinical, cognitive, and neuroimaging data from a 63-year-old woman who enrolled in research as a normal control and evolved posterior cortical atrophy (PCA) over 5 year follow-up. At baseline she reported only subtle difficulty driving and performed normally on cognitive tests, but already demonstrated atrophy in left visual association cortex. With follow-up she developed insidiously progressive visuospatial and visuoperceptual deficits, correlating with progressive atrophy in bilateral visual areas. Amyloid PET was positive. This case tracks the evolution of PCA from the prodromal stage, and illustrates challenges to early diagnosis as well as the utility of imaging biomarkers. PMID:24308559

  3. Cardiac Trauma: Clinical and Experimental Correlations of Myocardial Contusion

    PubMed Central

    Doty, Donald B.; Anderson, Alan E.; Rose, Earl F.; Go, Raymundo T.; Chiu, Chiang L.; Ehrenhaft, J. L.

    1974-01-01

    Clinical and experimental observations in myocardial contusion have been correlated. Cardiac arrhythmia is always an important consequence and may be fatal. Reduction in cardiac output often accompanies significant cardiac injury. The coronary arterial circulation is not interrupted and is generally enhanced to the area of injury. Healing of the injury under these circulatory conditions may result in patchy scarring and peculiar adynamic areas of myocardium. Early diagnosis of myocardial contusion may be aided using radionuclide imaging with 99mTc-Sn-polyphosphate. ImagesFig. 1.Fig. 2.Fig. 3.Fig. 4.Fig. 5.Fig. 6.Fig. 7.Fig. 8. PMID:4412327

  4. Prodromal Posterior Cortical Atrophy: Clinical, Neuropsychological and Radiological Correlation

    PubMed Central

    Chan, Lung Tat Andrew; Lynch, Whitney; De May, Mary; Horton, Jonathan C.; Miller, Bruce L.

    2015-01-01

    We present longitudinal clinical, cognitive and neuroimaging data from a 63-year-old woman who enrolled in research as a normal control and evolved posterior cortical atrophy (PCA) over five year follow-up. At baseline she reported only subtle difficulty driving and performed normally on cognitive tests, but already demonstrated atrophy in left visual association cortex. With follow-up she developed insidiously progressive visuospatial and visuoperceptual deficits, correlating with progressive atrophy in bilateral visual areas. Amyloid PET was positive. This case tracks the evolution of PCA from the prodromal stage, and illustrates challenges to early diagnosis as well as the utility of imaging biomarkers. PMID:24308559

  5. B cells in Cardiac Transplants: From Clinical Questions to Experimental Models

    PubMed Central

    Baldwin, William M; Halushka, Marc K; Valujskikh, Anna; Fairchild, Robert L

    2011-01-01

    After many years of debate, there is now general agreement that B cells can participate in the immune response to cardiac transplants. Acute antibody-mediated rejection (AMR) is the best defined manifestation of B cell responses, but diagnostic and mechanistic questions still surround AMR. Many complement dependent mechanisms of antibody-mediated injury have been elucidated. C5 has become a therapeutic target that may not just truncate complement activation, but also may tip the balance away from inflammation by altering macrophage function. More complement independent effects have been identified. These may escape diagnosis and progress to chronic graft injury. The function of B cell infiltrates in cardiac transplants is even more enigmatic. Nodular endocardial infiltrates that contain B cells and plasma cells have been described in protocol biopsies of cardiac transplants for decades, but an understanding of their significance is still evolving based on more critical morphological and molecular evaluation of these infiltrates. A range of infiltrates containing B cells has also been described in the epicardial fat in transplants with advanced chronic rejection. B cells have been observed in endocardial and epicardial tertiary lymphoid nodules, but their impact on antigen presentation or antibody production remains to be determined. Experimental models in small and large animals suggest that B cells could be essential for the formation of lymphoid nodules through cytokine production. Similarly, the role of proinflammatory adipokines in the formation or function of epicardial lymphoid nodules has not been studied. These clinical observations provide critical questions to be addressed in experimental models. PMID:21937238

  6. Ascitic Microbiota Composition Is Correlated with Clinical Severity in Cirrhosis with Portal Hypertension

    PubMed Central

    Rogers, Geraint B.; van der Gast, Christopher J.; Bruce, Kenneth D.; Marsh, Peter; Collins, Jane E.; Sutton, Julian; Wright, Mark

    2013-01-01

    Identification of pathogenic bacteria in ascites correlates with poor clinical outcomes. Ascites samples are commonly reported culture-negative, even where frank infection is indicated. Culture-independent methods have previously reported bacterial DNA in ascites, however, whether this represents viable bacterial populations has not been determined. We report the first application of 16S rRNA gene pyrosequencing and quantitative PCR in conjunction with propidium monoazide sample treatment to characterise the viable bacterial composition of ascites. Twenty five cirrhotic patients undergoing paracentesis provided ascites. Samples were treated with propidium monoazide to exclude non-viable bacterial DNA. Total bacterial load was quantified by 16S rRNA Q-PCR with species identity and relative abundance determined by 16S rRNA gene pyrosequencing. Correlation of molecular microbiology data with clinical measures and diagnostic microbiology was performed. Viable bacterial signal was obtained in 84% of ascites samples, both by Q-PCR and pyrosequencing. Approximately 190,000 ribosomal pyrosequences were obtained, representing 236 species, including both gut and non gut-associated species. Substantial variation in the species detected was observed between patients. Statistically significant relationships were identified between the bacterial community similarity and clinical measures, including ascitic polymorphonuclear leukocyte count and Child-Pugh class. Viable bacteria are present in the ascites of a majority of patients with cirrhosis including those with no clinical signs of infection. Microbiota composition significantly correlates with clinical measures. Entry of bacteria into ascites is unlikely to be limited to translocation from the gut, raising fundamental questions about the processes that underlie the development of spontaneous bacterial peritonitis. PMID:24086392

  7. Correlation of quality of life with clinical symptoms and signs at the time of glaucoma diagnosis.

    PubMed Central

    Mills, R P

    1998-01-01

    PURPOSE: To examine the relationship between clinical measures of visual function and patient-reported measures of symptoms and health status in a large cohort of glaucoma patients at the time of diagnosis. SUBJECTS AND METHODS: The 607 patients in the Collaborative Initial Glaucoma Treatment Study (CIGTS) received standardized examinations of visual acuity and visual field at enrollment. In addition, they completed a health-related quality-of-life instrument, which included the Visual Activities Questionnaire (VAQ), Sickness Impact Profile (SIP), a symptom and a comorbidity chart, a question about their degree of worry about becoming blind, and many other items. RESULTS: The SIP total and dimension scores correlated only weakly, and not significantly, with visual acuity and visual field measures. The VAQ total and subscale scores, particularly the peripheral vision subscale, correlated weakly and significantly with visual acuity and visual field scores, especially those from the better eye. Worry about blindness and symptoms attributed to glaucoma correlated weakly but significantly to visual field scores from the worse eye. Attempts to improve correlations by scoring the visual fields differently, including only paracentral and pericentral test locations in the scores, and simulating binocular visual field scores were largely unsuccessful. CONCLUSIONS: At diagnosis, most patients were relatively free of glaucoma-induced impairments, so clinical measures were poor predictors of a patient's perception of health-related quality of life. The vision-specific VAQ and glaucoma-related symptom score correlated better than the generic SIP with clinical measures at the time of enrollment into CIGTS. PMID:10360308

  8. Clinical correlations of microstructural changes in progressive supranuclear palsy.

    PubMed

    Tessitore, Alessandro; Giordano, Alfonso; Caiazzo, Giuseppina; Corbo, Daniele; De Micco, Rosa; Russo, Antonio; Liguori, Sara; Cirillo, Mario; Esposito, Fabrizio; Tedeschi, Gioacchino

    2014-10-01

    In patients with progressive supranuclear palsy (PSP), previous reports have shown a severe white matter (WM) damage involving supra and infratentorial regions including cerebellum. In the present study, we investigated potential correlations between WM integrity loss and clinical-cognitive features of patients with PSP. By using magnetic resonance imaging and diffusion tensor imaging with tract based spatial statistic analysis, we analyzed WM volume in 18 patients with PSP and 18 healthy controls (HCs). All patients and HCs underwent a detailed clinical and neuropsychological evaluation. Relative to HCs, patients with PSP showed WM changes encompassing supra and infratentorial areas such as corpus callosum, fornix, midbrain, inferior fronto-occipital fasciculus, anterior thalamic radiation, superior cerebellar peduncle, superior longitudinal fasciculus, uncinate fasciculus, cingulate gyrus, and cortico-spinal tract bilaterally. Among different correlations between motor-cognitive features and WM structural abnormalities, we detected a significant association between fronto-cerebellar WM loss and executive cognitive impairment in patients with PSP. Our findings, therefore, corroborate the hypothesis that cognitive impairment in PSP may result from both "intrinsic" and "extrinsic" frontal lobe dysfunction, likely related to cerebellar disconnection. PMID:24786632

  9. Coordinated Surgical Immune Signatures Contain Correlates of Clinical Recovery

    PubMed Central

    Gaudilliere, Brice; Fragiadakis, Gabriela K; Bruggner, Robert V; Nicolau, Monica; Finck, Rachel; Tingle, Martha; Silva, Julian; Ganio, Edward A; Yeh, Christine G; Maloney, William J; Huddleston, James I; Goodman, Stuart B; Davis, Mark M; Bendall, Sean C; Fantl, Wendy J; Angst, Martin S; Nolan, Garry P

    2015-01-01

    Delayed recovery from surgery causes personal suffering and substantial societal and economic costs. Whether immune mechanisms determine recovery after surgical trauma remains ill-defined. Single-cell mass cytometry was applied to serial whole blood samples from 32 patients undergoing hip replacement to comprehensively characterize the phenotypical and functional immune response to surgical trauma. The simultaneous analysis of 14,000 phosphorylation events in precisely phenotyped immune cell subsets revealed uniform signaling responses among patients, demarcating a surgical immune signature. When regressed against clinical parameters of surgical recovery, including functional impairment and pain, strong correlations were found with STAT3, CREB and NF-kB signaling responses in subsets of CD14+ monocytes (R=0.7–0.8, FDR < 0.01). These sentinel results demonstrate the capacity of mass cytometry to survey the human immune system in a relevant clinical context. The mechanistically derived immune correlates point to diagnostic signatures, and potential therapeutic targets, that could postoperatively improve patient recovery. PMID:25253674

  10. Small Group Teaching: Clinical Correlation with a Human Patient Simulator

    NSDL National Science Digital Library

    Dr. Tammy Y. Euliano (University of Florida College of Medicine Dept. of Anesthesiology)

    2001-03-01

    The popularity of the problem-based learning paradigm has stimulated new interest in small group, interactive teaching techniques. Medical educators of physiology have long recognized the value of such methods, using animal-based laboratories to demonstrate difficult physiological principles. Due to ethical and other concerns, a replacement of this teaching tool has been sought. Here, the author describes the use of a full-scale human patient simulator for such a workshop. The simulator is a life-size mannequin with physical findings (palpable pulses, breath/heart sounds, blinking eyes, etc.) and sophisticated mechanical and software models of the cardiovascular and pulmonary systems. It can be connected to standard physiological monitors to reproduce a realistic clinical environment. In groups of 10, first-year medical students explore StarlingÂ?s law of the heart, the physiology of the Valsalva maneuver, and the function of the baroreceptor in a clinically realistic context using the simulator. With the use of a novel pre-/postworkshop assessment instrument that included student confidence in their answers, student confidence improved for all questions and survey items following the simulator session (P 85% of the students rating the workshop "very good" or "excellent."

  11. A question-based approach to adopting pharmacogenetics to understand risk for clinical variability in pharmacokinetics in early drug development.

    PubMed

    Evers, R; Blanchard, R L; Warner, A W; Cutler, D; Agrawal, N G B; Shaw, P M

    2014-09-01

    Understanding genetic variations that influence pharmacokinetics (PK) in humans is important for optimal clinical use of drugs. Guidances for making decisions on when to conduct pharmacogenetic research during drug development have been proposed by regulatory agencies, but their uniform adoption presents problems due to an inherent lack of flexibility. A questions-based approach (QBA) was developed to enable drug development teams at Merck to iteratively and flexibly evaluate the potential impact of pharmacogenetics (PGx) on clinical pharmacokinetic variability. PMID:25141952

  12. Enhancing decision making about participation in cancer clinical trials: development of a question prompt list. | accrualnet.cancer.gov

    Cancer.gov

    This paper examines the usefulness of question prompt lists (QPLs) in aiding doctor-patient communication during discussions of clinical trials. The QPL presents patients with a menu of potential issues to discuss with a physician. Focus groups were conducted to assess the perceived utility of QPLs with trial-experienced and trial-naïve patients. All patients viewed the QPL as a valuable tool to support their decision-making regarding clinical trials.

  13. The effect of Tomm's therapeutic questioning styles on therapeutic alliance: a clinical analog study.

    PubMed

    Dozier, R M; Hicks, M W; Cornille, T A; Peterson, G W

    1998-01-01

    Tomm (1988) suggests that circular and reflexive questions tend to elicit feelings of freedom/acceptance whereas lineal and strategic questions usually trigger feelings of judgment/constraint. Employing an analog methodology, each of Tomm's four questioning styles was portrayed in the form of a 5-minute videotaped intake scenario. Forty family triads with a mother, father, and adolescent son were randomly assigned to one of four experimental conditions with ten families each. Each condition involved viewing one of four questioning style scenarios. All participants (N = 120 individuals--40 mothers, 40 fathers, and 40 adolescent sons) completed the Family Therapy Alliance Scale (FTAS; Pinsof & Catherall, 1986) and a validity-check instrument. The results indicated that circular and reflexive questioning styles elicited significantly higher (p < 0.001) alliance scores on the FTAS than did either lineal or strategic questions. Implications for the use of different types of questions in family therapy are discussed. PMID:9693949

  14. Is obesity a risk factor for low back pain? An example of using the evidence to answer a clinical question

    Microsoft Academic Search

    Timothy A Mirtz; Leon Greene

    2005-01-01

    BACKGROUND: Obesity as a causal factor for low back pain has been controversial with no definitive answer to this date. The objective of this study was to determine whether obesity is associated with low back pain. In addition this paper aims to provide a step-by-step guide for chiropractors and osteopaths on how to ask and answer a clinical question using

  15. Phenylketonuria: MR imaging of the brain with clinical correlation.

    PubMed

    Pearsen, K D; Gean-Marton, A D; Levy, H L; Davis, K R

    1990-11-01

    Fifteen patients with biochemically documented phenylketonuria (PKU) were studied with use of magnetic resonance (MR) imaging with spin-echo T2-weighted pulse sequences. The resulting images demonstrated varying degrees of symmetric high signal intensity of the white matter within the posterior cerebral hemispheres. Involvement of the anterior hemispheres was seen only in cases with severe signal intensity changes. There was no involvement of the cerebral cortex, brain stem, or cerebellum. Moreover, no anatomic structural abnormalities were observed. Mild cortical atrophy was observed in eight of the 15 patients. There was no significant correlation between the patients' IQ scores and the level of MR signal intensity changes. Although MR imaging routinely shows relatively distinct abnormalities in patients with PKU, the clinical severity of the disease does not parallel its imaging severity. PMID:2217781

  16. Microscopic Enteritis; clinical features and correlations with symptoms

    PubMed Central

    Shahraki, Touran; Shahraki, Mansour; Bold, Justine; Danciu, Mihai; Al Dulaimi, David; Villanacci, Vincenzo; Bassotti, Gabrio

    2012-01-01

    Aim To assess the clinical characteristic of CD as well as correlation of symptoms and the degrees of intestinal mucosal lesions in Iranian children. Background Microscopic Enteritis (Marsh 0-II) is associated with malabsorption. Patients and methods From August 2005 to September 2009, 111 cases with malabsorption and classical gastrointestinal symptoms were evaluated. Results The mean (±SD) age of children with CD was 4.9±3.5 years (range, 6 month - 16 years) and the mean duration of symptoms was 8 ± 20.5 months. 50 cases (45%) were female and 61 cases (55%) were male. The most common clinical presentation was failure to thrive in 72%, chronic diarrhea in 65.8% and Iron deficiency anemia in 59.5%. Sensitivity of EMA was 100% in patients with Marsh IIIb and Marsh IIIc. EMA was also positive in 77% of cases with Marsh 0, 18% in Marsh I, 44% in Marsh II and 81.8% in patients with Marsh IIIa. Conclusion Histopathology did not reflect the severity of gluten sensitivity. This would suggest that the degree of intestinal mucosal damage might not be a reliable prognostic factor. Significant symptoms can be present with minor histological change on biopsy. PMID:24834216

  17. Clinical correlates of prescription opioid analgesic use in pregnancy.

    PubMed

    Smith, Megan V; Costello, Darce; Yonkers, Kimberly A

    2015-03-01

    A 2012 committee opinion from the American College of Obstetricians and Gynecologists highlights the considerable increase in opioid addiction in recent years, yet little is known about clinical correlates of prescribed opioids among pregnant women. This study examines clinical and demographic factors associated with the use of opioid analgesics in pregnancy. Data were derived from a prospective cohort study of pregnant women. Participants were administered the Composite International Diagnostic Interview to identify depressive and anxiety disorders and data on medication use were gathered at three assessment points and classified according to the Anatomical Therapeutic Chemical Code (ATC) classification system ATC group N02A. Participants included 2,748 English or Spanish speaking pregnant women. Six percent (n = 165) of women used opioid analgesics at any point in pregnancy. More pregnant women using opioids met diagnostic criteria for major depressive disorder (16 vs. 8 % for non users), generalized anxiety disorder (18 vs. 9 % for non users), post-traumatic stress disorder (11 vs. 4 % for non users) and panic disorder (6 vs. 4 % for non users). Women who reported opioid use were also significantly more likely than non users to report using illicit drugs and almost three times as likely to report smoking cigarettes in the second or third trimester of pregnancy (4 and 23 %, respectively) as compared to non-opioid users (0.5 and 8 %). The use of opioids in pregnancy was associated with higher levels of psychiatric comorbidity and use of other substances as compared to non-opioid users. PMID:24951127

  18. About Provocative Questions — Provocative Questions

    Cancer.gov

    The provocative questions initiative has assembled a list of 24 important questions from the research community to stimulate the NCI’s research communities to use laboratory, clinical and populations sciences in especially effective and imaginative ways to answer the questions. The questions are not simple restatements of long-term goals of the National Cancer Program, which are to improve the prevention, detection, diagnosis, and treatment of all forms of cancer.

  19. Infantile hemangioendothelioma of the liver: a radiologic-pathologic-clinical correlation

    SciTech Connect

    Dachman, A.H.; Lichtenstein, J.E.; Friedman, A.C.; Hartman, D.S.

    1983-06-01

    Infantile hemangioendothelioma is the most common symptomatic vascular liver tumor of infancy. It is considered a benign tumor; however, aggressive behavior is occasionally seen microscopically, and rarely distant metastases have been reported. The exact incidence of infantile hemangioendothelioma is difficult to determine because often it has been either misdiagnosed or mislabeled as cavernous hemangioma in the literature. Cavernous hemangioma is the most common primary liver tumor in older age groups but is rarely found in infants as a clinically significant tumor. Levick and Rubie were the first to recognize an association between hemangioendothelioma of the liver and congestive heart failure, and there were subsequent reports substantiating this association. However, it is our impression and the finding of others that congestive heart failure is distinctly less common than abdominal mass or hepatomegaly as the presenting sign in infantile hemangioendothelioma. Congestive heart failure is rarely a feature of cavernous hemangioma. Because of the errors in terminology and questions regarding clinical presentation, a radiologic-pathologic-clinical correlation study of infantile hemangioendothelioma and review of the literature was undertaken.

  20. Hemimegalencephaly: Clinical, EEG, neuroimaging, and IMP-SPECT correlation

    SciTech Connect

    Konkol, R.J.; Maister, B.H.; Wells, R.G.; Sty, J.R. (Medical College of Wisconsin, Milwaukee (USA))

    1990-11-01

    Iofetamine-single photon emission computed tomography (IMP-SPECT) was performed on 2 girls (5 1/2 and 6 years of age) with histories of intractable seizures, developmental delay, and unilateral hemiparesis secondary to hemimegalencephaly. Electroencephalography (EEG) revealed frequent focal discharges in 1 patient, while a nearly continuous burst suppression pattern over the malformed hemisphere was recorded in the other. IMP-SPECT demonstrated a good correlation with neuroimaging studies. In spite of the different EEG patterns, which had been proposed to predict contrasting clinical outcomes, both IMP-SPECT scans disclosed a similar decrease in tracer uptake in the malformed hemisphere. These results are consistent with the pattern of decreased tracer uptake found in other interictal studies of focal seizures without cerebral malformations. In view of recent recommendations for hemispherectomy in these patients, we suggest that the IMP-SPECT scan be used to compliment EEG as a method to define the extent of abnormality which may be more relevant to long-term prognosis than EEG alone.

  1. Adiposity in children and adolescents: correlates and clinical consequences of fat stored in specific

    E-print Network

    Southern California, University of

    Adiposity in children and adolescents: correlates and clinical consequences of fat stored, CA, USA; 9 Department of Nutrition and Diabetes, Durand Hospital, Buenos Aires, Argentina; 10 Unit of Pediatric Diabetes, Clinical Nutrition & Metabolism, Department of Science of Life & Reproduction

  2. Primary sleep disorders in people with epilepsy: clinical questions and answers.

    PubMed

    Grigg-Damberger, Madeleine M; Foldvary-Schaefer, Nancy

    2015-01-01

    The questions facing clinicians with patients with sleep disorder and epilepsy are addressed in this article. Both adult and child epilepsy are discussed in the context of the most typical questions a clinician would have, such as "Are parasomnias more common in people with epilepsy?", "Is sleep architecture abnormal in children with epilepsy", along with outcomes of numerous questionnaire-based, case-based, and double-blind placebo studies on such aspects as sleep duration, daytime sleepiness, anxiety and fears, limb movement, nocturnal seizures, agitation, behavioral disorders, and learning disorders. PMID:25455580

  3. Childhood Ataxia: Clinical Features, Pathogenesis, Key Unanswered Questions, and Future Directions

    PubMed Central

    Ashley, Claire N.; Hoang, Kelly D.; Lynch, David R.; Perlman, Susan L.; Maria, Bernard L.

    2013-01-01

    Childhood ataxia is characterized by impaired balance and coordination primarily due to cerebellar dysfunction. Friedreich ataxia, a form of childhood ataxia, is the most common multisystem autosomal recessive disease. Most of these patients are homozygous for the GAA repeat expansion located on the first intron of the frataxin gene on chromosome 9. Mutations in the frataxin gene impair mitochondrial function, increase reactive oxygen species, and trigger redistribution of iron in the mitochondria and cytosol. Targeted therapies for Friedreich ataxia are undergoing testing. In addition, a centralized database, patient registry, and natural history study have been launched to support clinical trials in Friedreich ataxia. The 2011 Neurobiology of Disease in Children symposium, held in conjunction with the 40th annual Child Neurology Society meeting, aimed to (1) describe clinical features surrounding Friedreich ataxia, including cardiomyopathy and genetics; (2) discuss recent advances in the understanding of the pathogenesis of Friedreich ataxia and developments of clinical trials; (3) review new investigations of characteristic symptoms; (4) establish clinical and biochemical overlaps in neurodegenerative diseases and possible directions for future basic, translational, and clinical studies. PMID:22859693

  4. CORRELATION BETWEEN CLINICAL ASSESSMENT AND FORCE PLATE MEASUREMENT OF POSTURAL CONTROL AFTER STROKE

    Microsoft Academic Search

    Gunilla Elmgren Frykberg; Birgitta Lindmark; Håkan Lanshammar; Jörgen Borg

    2007-01-01

    Objectives: To explore the correlation between clinical as- sessment and force plate measurement of postural control after stroke when selected balance tasks are performed un- der similar spatial and temporal conditions, and to examine the inter-rater agreement of assessment of weight distribu- tion during quiet stance in subjects with stroke. Design: A descriptive and correlational study. Methods: Clinical assessment of

  5. Clinical and neuroimaging correlation of movement disorders in multiple sclerosis: case series and review of the literature.

    PubMed

    Potulska-Chromik, Anna; Rudzinska, Monika; Nojszewska, Monika; Podlecka-Pi?towska, Aleksandra; Szczudlik, Andrzej; Zakrzewska-Pniewska, Beata; Go??biowski, Marek

    2014-01-01

    Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease of the central nervous system, in which movement disorders (MD) have been reported very rarely. Anatomopathological studies of MS indicate two main processes: inflammation and neurodegeneration. The occurrence of the movement disorders symptoms in MS revises the question of aetiology of these two diseases. During the 10 years of observation in our out-patient clinic and MS units we examined about 2500 patients with clinically definite MS diagnosed according to the revised McDonald's criteria. Only in 10 cases we found coexistence of MS and MD signs. Below we present rare cases of patients with coexistence of MS and chorea, pseudoathetosis, dystonia and parkinsonism. Searching for the strategic focal lesion in our case series showed demyelinating plaques placed in the thalamus most often. Detailed analysis of the clinical, pharmacological and neuroimaging correlations may help to explain the character of movement disorders in MS. PMID:24729346

  6. Sample Test Questions for General Clinical Trials Education Class | accrualnet.cancer.gov

    Cancer.gov

    Skip to content The National Cancer Institute www.cancer.gov The National Institutes of Health AccrualNetTM STRATEGIES, TOOLS AND RESOURCES TO SUPPORT ACCRUAL TO CLINICAL TRIALS User menu Register Sign In Search form Search Main menu Protocol Accrual

  7. A Widely Used In Vitro Biofilm Assay Has Questionable Clinical Significance for Enterococcal Endocarditis

    PubMed Central

    Leuck, Anne-Marie; Johnson, James R.; Dunny, Gary M.

    2014-01-01

    Biofilm formation may play an important role in the pathogenesis of infections caused by Enterococcus faecalis, including endocarditis. Most biofilm studies use a polystyrene dish assay to quantify biofilm biomass. However, recent studies of E. faecalis strains in tissue and animal models suggest that polystyrene dish results need to be interpreted with caution. We evaluated 158 clinical E. faecalis isolates using a polystyrene dish assay and found variation in biofilm formation, with many isolates forming little biofilm even when different types of media were used. However, all tested clinical isolates were able to form biofilms on porcine heart valve explants. Dextrose-enhanced biofilm formation in the polystyrene dish assay was found in 6/12 (50%) of clinical isolates tested and may explain some, but not all of the differences between the polystyrene dish assay and the heart valve assay. These findings suggest that in studies assessing the clinical relevance of enterococcal biofilm-forming ability, ex vivo biofilm formation on a relevant tissue surface may be warranted to validate results of in vitro assays. PMID:25255085

  8. question_1303305591 — Provocative Questions

    Cancer.gov

    This is an outstanding and intellectually-stimulating question which introduces a new way to translate more effectively metastasis research to the clinic. It is certainly worth exploring and badly needed. because, if positive, drugs could be immediately useful to help defined populations of patients. Per points, we agree that these are limited metastasis groups; however, results could at minimum justify moving forward to full adjuvant trials. Worthy cause given the "bottleneck" we experience nowadays since drugs are mostly not tested in metastasis prevention.

  9. Aromatase inhibition 2013: clinical state of the art and questions that remain to be solved.

    PubMed

    Lønning, Per Eystein; Eikesdal, Hans Petter

    2013-08-01

    Following their successful implementation for the treatment of metastatic breast cancer, the 'third-generation' aromatase inhibitors (anastrozole, letrozole, and exemestane) have now become standard adjuvant endocrine treatment for postmenopausal estrogen receptor-positive breast cancers. These drugs are characterized by potent aromatase inhibition, causing >98% inhibition of estrogen synthesis in vivo. A recent meta-analysis found no difference in anti-tumor efficacy between these three compounds. As of today, aromatase inhibitor monotherapy and sequential treatment using tamoxifen followed by an aromatase inhibitor for a total of 5 years are considered equipotent treatment options. However, current trials are addressing the potential benefit of extending treatment duration beyond 5 years. Regarding side effects, aromatase inhibitors are not found associated with enhanced risk of cardiovascular disease, and enhanced bone loss is prevented by adding bisphosphonates in concert for those at danger of developing osteoporosis. However, arthralgia and carpal tunnel syndrome preclude drug administration among a few patients. While recent findings have questioned the use of aromatase inhibitors among overweight and, in particular, obese patients, this problem seems to focus on premenopausal patients treated with an aromatase inhibitor and an LH-RH analog in concert, questioning the efficacy of LH-RH analogs rather than aromatase inhibitors among overweight patients. Finally, recent findings revealing a benefit from adding the mTOR inhibitor everolimus to endocrine treatment indicate targeted therapy against defined growth factor pathways to be a way forward, by reversing acquired resistance to endocrine therapy. PMID:23625614

  10. Aromatase inhibition 2013: clinical state of the art and questions that remain to be solved

    PubMed Central

    Lønning, Per Eystein; Eikesdal, Hans Petter

    2013-01-01

    Following their successful implementation for the treatment of metastatic breast cancer, the ‘third-generation’ aromatase inhibitors (anastrozole, letrozole, and exemestane) have now become standard adjuvant endocrine treatment for postmenopausal estrogen receptor-positive breast cancers. These drugs are characterized by potent aromatase inhibition, causing >98% inhibition of estrogen synthesis in vivo. A recent meta-analysis found no difference in anti-tumor efficacy between these three compounds. As of today, aromatase inhibitor monotherapy and sequential treatment using tamoxifen followed by an aromatase inhibitor for a total of 5 years are considered equipotent treatment options. However, current trials are addressing the potential benefit of extending treatment duration beyond 5 years. Regarding side effects, aromatase inhibitors are not found associated with enhanced risk of cardiovascular disease, and enhanced bone loss is prevented by adding bisphosphonates in concert for those at danger of developing osteoporosis. However, arthralgia and carpal tunnel syndrome preclude drug administration among a few patients. While recent findings have questioned the use of aromatase inhibitors among overweight and, in particular, obese patients, this problem seems to focus on premenopausal patients treated with an aromatase inhibitor and an LH-RH analog in concert, questioning the efficacy of LH-RH analogs rather than aromatase inhibitors among overweight patients. Finally, recent findings revealing a benefit from adding the mTOR inhibitor everolimus to endocrine treatment indicate targeted therapy against defined growth factor pathways to be a way forward, by reversing acquired resistance to endocrine therapy. PMID:23625614

  11. Short sleep is a questionable risk factor for obesity and related disorders: Statistical versus clinical significance

    Microsoft Academic Search

    Jim Horne

    2008-01-01

    Habitually insufficient sleep could contribute towards obesity, metabolic syndrome, etc., via sleepiness-related inactivity and excess energy intake; more controversially, through more direct physiological changes. Epidemiological studies in adult\\/children point to small clinical risk only in very short (around 5h in adults), or long sleepers, developing over many years, involving hundreds of hours of ‘too little’ or ‘too much’ sleep. Although

  12. Answering the question, "what is a clinical nurse leader?": transition experience of four direct-entry master's students.

    PubMed

    Bombard, Emily; Chapman, Kimberly; Doyle, Marcy; Wright, Danielle K; Shippee-Rice, Raelene V; Kasik, Dot Radius

    2010-01-01

    Understanding the experience of students learning the clinical nurse leader (CNL) role can be useful for faculty, preceptors, staff nurses, and interdisciplinary team members who guide them. This article analyzes the experience of four direct-entry master's students in the first cohort to complete the CNL curriculum and to sit for the pilot CNL certification examination. Using action research methodology, the students worked with the clinical immersion practicum faculty and a writing consultant to develop the study purpose, collect and analyze data, and prepare a manuscript. The main theme that emerged was, answering the question, "what is a CNL?" Subthemes supporting the main theme involved coming to the edge, trusting the process, rounding the corner, and valuing becoming. The analysis confirmed the value the CNL offers as a new vision to nursing education and practice. The students offered suggestions for the CNL curriculum and practicum. PMID:21078501

  13. Symptomatic spondylolysis: correlation of CT and SPECT with clinical outcome.

    PubMed

    Raby, N; Mathews, S

    1993-08-01

    Twenty-seven patients with spondylolysis and back pain were considered for spinal fusion. All patients underwent clinical evaluation, multiplanar computed tomography (CT) and single photon emission computed tomography (SPECT). After clinical evaluation 12 patients were not considered suitable for fusion on clinical grounds. SPECT was normal in these patients. Fifteen underwent a trial of lumbar immobilization and nine of those rendered pain free subsequently underwent spinal fusion. The results of clinical examination, lumbar immobilization, imaging and final outcome were compared in these patients. Those patients rendered pain free by surgery all had positive SPECT scans. Those with persistent pain after surgery had negative scans. This small series suggests a positive relationship between SPECT scanning and patient outcome following fusion. These findings need to be confirmed by larger studies with longer periods of follow-up. PMID:8004904

  14. Correlation between clinical clerkship achievement and objective structured clinical examination (OSCE) scores of graduating dental students on conservative dentistry

    PubMed Central

    Bang, Jae-Beum

    2013-01-01

    Objectives This study aimed to investigate the effect of clinical clerkship-associated achievements, such as performance of procedures at the student clinic, observation, and attitude towards a clerkship, on the objective structured clinical examination (OSCE) scores of dental students graduating in restorative dentistry. Materials and Methods The OSCEs consisted of two stations designed to assess students' clinical skills regarding cavity preparation for a class II gold inlay and a class IV composite restoration. The clerkship achievements, consisting of the number of student clinical procedures performed, observation-related OSCE, and scores of their attitudes towards a conservative dentistry clerkship, were assessed. Correlation and multiple regression analyses were conducted. Results The correlation coefficient between the OSCE scores for cavity preparation for a class II gold restoration and clerkship attitude scores was 0.241 (p < 0.05). Regarding a class IV composite restoration, OSCE scores showed statistically significant correlations with the observation (r = 0.344, p < 0.01) and attitude (r = 0.303, p < 0.01) scores. In a multiple regression analysis, attitudes towards a clerkship (p = 0.033) was associated with the cavity preparation for a class II gold inlay OSCE scores, while the number of procedure observations (p = 0.002) was associated with the class IV composite restoration OSCE scores. Conclusions The number of clinical procedures performed by students, which is an important requirement for graduation, showed no correlation with either of the OSCEs scores. PMID:23741710

  15. [Correlation between various autoantibodies in scleroderma patients and their clinical features].

    PubMed

    Su, L D

    1993-11-01

    We studied the antibodies of cell structural localized antibody and the correlation between the new classifications and their clinical features. The results suggest that antikinetochore antibody is the apparent indicator of CREST syndrome, anticentrosome antibody the apparent indicator of local scleroderma with mild clinical features and better prognosis, antinucleous antibody the apparent indicator of diffuse scleroderma with most severe clinical features, high mortality and poor prognosis. New classifications 13 of diagnostic value in clinical grouping and prognosis estimation. PMID:8124613

  16. Seasonality and its distinct clinical correlates in bipolar II disorder.

    PubMed

    Kim, Ji Sun; Ha, Tae Hyon; Chang, Jae Seung; Park, Yoon Seong; Huh, Iksoo; Kim, Jayoun; Hong, Kyung Sue; Park, Taesung; Ha, Kyooseob

    2015-02-28

    Seasonality is one of the key features in subjects with mood disorders and is involved in the multi-faceted nature of the clinical course. However, few studies have explored the clinical implications of seasonality in bipolar disorders. We examined the differential effects of seasonality on clinical variables between bipolar I and II disorder (BD I and II). Seasonality was assessed using the Seasonal Pattern Assessment Questionnaire (SPAQ) in 204 subjects with BD I and 308 with BD II. Following the comparisons between BD I and II groups, clinical characteristics related to seasonality were explored. Next, to predict the presence of seasonality, a logistic regression model was applied. The global seasonality score on the SPAQ was significantly higher in the BD II group than in the BD I group. In the BD I group, seasonality was associated with suicide attempt history. In the BD II group, on the other hand, seasonality was associated with female gender, depressive predominance, and premenstrual dysphoric disorder (PMDD). In the regression models, the presence of PMDD and female gender was significantly associated with seasonality in the BD II group. Our findings suggest that high seasonality tendency, a vulnerability maker for cyclic worsening, may contribute to a differential pattern of clinical characteristics in BD II. PMID:25537487

  17. Testing the utility of a cancer clinical trial specific Question Prompt List (QPL-CT) during oncology consultations. | accrualnet.cancer.gov

    Cancer.gov

    A QPL is a proven intervention to aid patients to be active participants in consultations with their physicians by asking questions. This study tested the efficacy of a targeted QPL for clinical trials.

  18. Finding Evidence-Based Answers to Clinical Questions Quickly and Effectively See also the Biomedical Libraries' Evidence-Based Medicine Research Guide

    E-print Network

    to a narrower, focused clinical question In a 70 year old woman with primary insomnia and a previous adverse-based information about alternative therapies Is melatonin safe and effective for treating insomnia? Does music

  19. A Case of Sanfillippo's Disease Correlating Clinical and Biochemical Findings.

    PubMed

    Datta, Priyanka; Prasad, Anushre; Shenoy, Vijetha; Hebbar, Shrikiran; Mundkur, Suneel C; Rao, Pragna

    2014-10-01

    The mucopolysaccharidoses (MPSs) are a heterogeneous group of rare inherited disorders caused by deficiency of lysosomal enzyme necessary to break down mucopolysaccharides or glycosaminoglycans (GAGs). We had combined clinical findings and ophthalmological features. Biochemical test for urine glycosaminoglycans was done for confirmation of diagnosis in the patient. The case of Sanfillippo's disease was characterized by delayed development, hyperactivity with aggressive behaviour. Coarse facial feature, hirsutism and sleep disorder. Urine GAG tests for MPS was positive in the case. Based on clinical findings and biochemical tests for MPS, this case was diagnosed as a type III mucopolysaccharidoses. Urinary GAG's electrophoresis is an important screening test for MPS suspected cases. PMID:25298638

  20. Upper gastrointestinal bleeding in cirrhosis: clinical and endoscopic correlations

    Microsoft Academic Search

    J Terés; J M Bordas; C Bru; F Diaz; M Bruguera; J Rodes

    1976-01-01

    The clinical data of 180 episodes of upper gastrointestinal bleeding in 168 patients with cirrhosis of the liver are examined. The source of bleeding had been determined by early endoscopy in all cases. In men under the age of 50 years, and without symptoms of liver failure, bleeding was due to ruptured gastro-oesophageal varices in 84% of cases. Severe liver

  1. Identifying questions in the American Association of Swine Veterinarian's PRRS risk assessment survey that are important for retrospectively classifying swine herds according to whether they reported clinical PRRS outbreaks in the previous 3 years.

    PubMed

    Holtkamp, Derald J; Lin, Hui; Wang, Chong; O'Connor, Annette M

    2012-09-01

    The American Association of Swine Veterinarian's (AASV) Production Animal Disease Risk Assessment Program (PADRAP) is a web-based program that offers a set of risk assessment surveys being used by veterinarians who are members of the AASV. Members use PADRAP to help producers systematically assess risk factors that may be associated with clinical outcomes. As assessments are performed the completed surveys are added to the dataset maintained at the Iowa State University College of Veterinary Medicine. One of the surveys included in PADRAP is the porcine reproductive and respiratory syndrome (PRRS) Risk Assessment for the Breeding Herd. The aim of the study was to categorize questions in version 2 of the PRRS Risk Assessment for the Breeding Herd survey as important or unimportant for classifying herds according to whether they reported clinical PRRS outbreaks in the previous 3 years. The results elucidate the relative importance of risk factors and areas of risk factors for clinical outcomes and removing unimportant questions may reduce the time required to complete the survey without affecting the quality of information obtained. Surveys from 896 sow herd sites in the United States and Canada completed between March 2005 and March 2009 were included in the analysis. The survey contained a large number of questions with a complex correlation structure among the questions. Responses for several questions were dependent upon responses to others. To address these issues, an approach was developed using a series of statistical methods including random forest, principle component analysis, logistic regression and receiver operating characteristic (ROC) analysis to classify the herds using the questions in the survey as explanatory variables. Questions were ranked by importance and systematically excluded from least important to most important. The questions excluded, without significantly affecting the performance of the model for classifying herds were identified as unimportant. Thirty-eight of the 127 questions analyzed were identified as unimportant for classifying herds according to whether they reported clinical PRRS outbreaks in the previous 3 years. Sections of the survey where a large number of questions were identified as unimportant included (1) entry of semen into the breeding herd and (2) transportation of live animals. Sections with a high percentage of questions identified as unimportant included (1) characteristics of the site, (2) disposal of dead animals and waste management and (3) employee and visitors. PMID:22475927

  2. Correlates of Successful Response to a Behavioral Weight Control Clinic.

    ERIC Educational Resources Information Center

    And Others; Gormally, Jim

    1980-01-01

    Initial weight-loss success was correlated with two severity variables. Persons reporting frequent binge eating and histories of previous dieting weight loss lost the most weight. Persons who were successful at maintenance used frequent exercise. Those who relapsed reported high levels of stress during follow-up. (Author)

  3. Staging of localized prostate cancer: a clinical-pathologic correlation.

    PubMed

    Mukamel, E; de Kernion, J B; Hannah, J; Barbaric, Z

    1988-01-01

    Sixty consecutive patients were staged clinically by digital rectal examination, acid phosphatase and bone scan prior to radical retropubic prostatectomy and pelvic lymphadenectomy. Twenty-one patients also had magnetic resonance imaging (MRI) and computerized tomography (CT) of the pelvic. The surgical specimens were step-sectioned for pathologic staging. Understaging was documented in 0% of A2 patients, 27% of B1 patients and 67% of B2 patients. Capsular invasion was found in 12% of B1 and 52% of B2 patients, while seminal vesicle extension was documented in 18% of B1 and 52% of B2 patients. Lymph node metastases occurred in 3% of B1 and 29% of B2 patients. Clinical staging error was related to tumor size, tumor grade and history of prior TURP or radiotherapy. Neither CT scan nor MRI improved the accuracy of the digital rectal examination. PMID:3241091

  4. Eosinophilic/T-cell Chorionic Vasculitis: Histological and Clinical Correlations.

    PubMed

    Cheek, Bradley; Heinrich, Stephen; Ward, Kenneth; Craver, Randall

    2014-10-22

    Eosinophilic T-cell chorionic vasculitis (E/TCV) is composed of eosinophils and T-lymphocytes originating within chorionic vessels, radiating toward the intervillous space and away from the amnion in a fashion different from the fetal vascular response seen in amnionitis. Clinical significance and risk factors are not well established. We report four pregnancies (five infants, one triplet was spared) with E/TCV, gestational ranging from 23 weeks to term. All had concurrent acute chorioamnionitis, three had the typical acute fetal inflammatory response. One had placental fetal obstructive vasculopathy and an upper extremity reduction defect (radio-ulnar synostosis), the mother had pre-eclampsia. A second case involved 2 of 3 23 week previable triplets. Our third case had a metatarsus varus resistant to casting, the mother had gestational diabetes. The last case was a normal infant. We review the literature, discuss the clinical findings and present the histologic characteristics of this infrequently recognized lesion. PMID:25338020

  5. Late-onset pathological gambling: clinical correlates and gender differences.

    PubMed

    Grant, Jon E; Kim, Suck Won; Odlaug, Brian L; Buchanan, Stephanie N; Potenza, Marc N

    2009-01-01

    Age at illness onset has significant clinical implications for psychiatric disorders. Prior research has not systematically examined age at illness onset and its relationship to the clinical characteristics of pathological gambling (PG). Among a sample of 322 consecutive subjects with current DSM-IV PG, those with late-onset (at or after age 55 years) PG were compared to those with earlier onsets (at or prior to age 25, 26-54 years old) on measures of PG severity, co-occurring disorders, social and legal problems, and family history. Forty-two (13.4%) subjects reported onset of PG at or after age 55 years, 63 (19.6%) reported onset prior to age 25 years, and the majority (n=217; 67.4%) reported onset between the ages of 26 and 54 years. The late-onset group were less likely to declare bankruptcy (p=.029) or have credit card debt attributable to gambling (p=.006). Late-onset PG subjects were significantly more likely to have an anxiety disorder (p<.001) and significantly less likely to have a father (p=.025) or a mother (p=.048) with a gambling problem. Exploratory analyses identified an age-by-gender interaction with respect to treatment-seeking, with more pronounced age-related shortening in the duration between problem onset and treatment seeking observed in men. Age at onset of PG is associated with multiple important clinical features. Long durations of PG prior to treatment-seeking indicate the need for improved prevention efforts among individuals with early PG onset. Late-onset PG is relatively common and has distinct clinical characteristics suggesting that this population might benefit from unique prevention and treatment strategies. PMID:18499125

  6. Computed tomography in cases of coccidioidal meningitis, with clinical correlation

    SciTech Connect

    Shetter, A.G.; Fischer, D.W.; Flom, R.A.

    1985-06-01

    Cranial computed tomographic (CT) scans of 22 patients with coccidioidal meningitis were reviewed and their clinical course was analyzed. Abnormalities of the ventricular system or the basilar cisterns or both were present in 16 instances. Although it is not a definitive diagnostic tool, the CT scan is helpful in suggesting a diagnosis of coccidioidal meningitis and in predicting the prognosis of patients affected by the disease. 19 references, 4 figures, 2 tables.

  7. Correlation of Clinical Features with Argyrophilic Grains at Autopsy

    PubMed Central

    Sabbagh, Marwan N.; Sandhu, Sonny S.; Farlow, Martin R.; Vedders, Linda; Shill, Holly A.; Caviness, John N.; Connor, Donald J; Sue, Lucia; Adler, Charles H.; Beach, Thomas G.

    2009-01-01

    Argyrophilic grains (AGs) are a pathologic feature found in association with neurodegenerative disease. Some have suggested that these features may occur as a distinctive condition. We reviewed 80 subjects from our tissue bank with pathologically confirmed AGs and identified their clinical features. We compared these subjects' features to the features of subjects with matched clinical diagnoses but without AGs. Subjects with AGs represented 21.7% of the entire autopsy sample from 1999 through 2005 (80/367). Of AD subjects, 43 /233 had AGs (18.4% of AD subjects); 11 /42 PD-D subjects had AGs (26.1% of PDD subjects); 2 / 9 DLB subjects had AGs (22.2% of DLB subjects); 4 /15 MCI subjects had AGs (26.7% of MCI subjects); and 20 /68 cognitively normal subjects had AGs (29.4% of NC). Subjects with AGs tended to be older but only significantly so in AD. Many co-morbid non-neurological health conditions were seen in cases of AGs without any single predilection emerging. AGs occur in approximately 22% of the entire autopsy cohort and likely are associated with advanced age. No distinctive antemortem clinical features were overrepresented in the AG cases. AGs can occur with or without neurodegenerative conditions and can occur in the absence of significant cognitive decline. AGs are not clearly associated with any single co-morbid health condition. PMID:19812464

  8. The role of Clinical Officers in the Kenyan health system: a question of perspective

    PubMed Central

    2013-01-01

    Background Despite the increasing interest in using non-physician clinicians in many low-income countries, little is known about the roles they play in typical health system settings. Prior research has concentrated on evaluating their technical competencies compared to those of doctors. This work explored perceptions of the roles of Kenyan non-physician clinicians (Clinical Officers (COs). Methods Qualitative methods including in-depth interviews (with COs, nurses, doctors, hospital management, and policymakers, among others), participant observation and document analysis were used. A nomothetic-idiographic framework was used to examine tensions between institutions and individuals within them. A comparative approach was used to examine institutional versus individual notions of CO roles, how these roles play out in government and faith-based hospital (FBH) settings as well as differences arising from three specific work settings for COs within hospitals. Results The main finding was the discrepancy between policy documents that outline a broad role for COs that covers both technical and managerial roles, while respondents articulated a narrow technical role that focused on patient care and management. Respondents described a variety of images of COs, ranging from ‘filter’ to ‘primary healthcare physician’, when asked about CO roles. COs argued for a defined role associated with primary healthcare, feeling constrained by their technical role. FBH settings were found to additionally clarify CO roles when compared with public hospitals. Tensions between formal prescriptions of CO roles and actual practice were reported and coalesced around lack of recognition over COs work, role conflict among specialist COs, and role ambiguity. Conclusions Even though COs are important service providers their role is not clearly understood, which has resulted in role conflict. It is suggested that their role be redefined, moving from that of ‘substitute clinician’ to professional ‘primary care clinician’, with this being supported by the health system. PMID:23866692

  9. Clinical correlates of common corneal neovascular diseases: a literature review

    PubMed Central

    Abdelfattah, Nizar Saleh; Amgad, Mohamed; Zayed, Amira A; Salem, Hamdy; Elkhanany, Ahmed E; Hussein, Heba; Abd El-Baky, Nawal

    2015-01-01

    A large subset of corneal pathologies involves the formation of new blood and lymph vessels (neovascularization), leading to compromised visual acuity. This article aims to review the clinical causes and presentations of corneal neovascularization (CNV) by examining the mechanisms behind common CNV-related corneal pathologies, with a particular focus on herpes simplex stromal keratitis, contact lenses-induced keratitis and CNV secondary to keratoplasty. Moreover, we reviewed CNV in the context of different types of corneal transplantation and keratoprosthesis, and summarized the most relevant treatments available so far. PMID:25709930

  10. [Diffuse parenchymal lung diseases: clinical-radiological correlation].

    PubMed

    Pralong, Jacques-André; Martins-Favre, Martina; Howarth, Nigel; Montet, Xavier; Rochat, Thierry

    2009-11-18

    Diffuse parenchymal lung diseases can have various clinical and radiological presentations. The high-resolution CT scan has a central role in the diagnostic process of an interstitial disease. As a first step in the analysis of such an exam, one has to look for the major radiological sign and then to describe it to build a differential diagnosis in order to guide the management. The goal of this article is to illustrate this approach with examples of diffuse parenchymal lung diseases. PMID:20052866

  11. The clinical and microbiological correlates of premature rupture of membranes.

    PubMed

    Karat, C; Madhivanan, P; Krupp, K; Poornima, S; Jayanthi, N V; Suguna, J S; Mathai, E

    2006-10-01

    Prematurity is the cause of 85% of neonatal morbidity and mortality. Premature rupture of the membranes (PROM) is associated with 30-40% of preterm deliveries. A case-control study conducted between July 2002 and 2003 examined the correlates and risk factors for PROM in Mysore, India. WBCs in vaginal fluid, leucocytes in urine, UTI and infection with E. coli, S. aureus, C. albicans and BV were significantly associated with PROM. BV, E. coli and WBCs in vaginal fluid were independent risk factors. Screening and treatment of BV and E. coli infection in pregnancy may reduce the risk of PROM. PMID:17185848

  12. Clinical correlates of graph theory findings in temporal lobe epilepsy

    PubMed Central

    Haneef, Zulfi; Chiang, Sharon

    2014-01-01

    Purpose Temporal lobe epilepsy (TLE) is considered a brain network disorder, additionally representing the most common form of pharmaco-resistant epilepsy in adults. There is increasing evidence that seizures in TLE arise from abnormal epileptogenic networks, which extend beyond the clinico-radiologically determined epileptogenic zone and may contribute to the failure rate of 30–50% following epilepsy surgery. Graph theory allows for a network-based representation of TLE brain networks using several neuroimaging and electrophysiologic modalities, and has potential to provide clinicians with clinically useful biomarkers for diagnostic and prognostic purposes. Methods We performed a review of the current state of graph theory findings in TLE as they pertain to localization of the epileptogenic zone, prediction of pre- and post-surgical seizure frequency and cognitive performance, and monitoring cognitive decline in TLE. Results Although different neuroimaging and electrophysiologic modalities have yielded occasionally conflicting results, several potential biomarkers have been characterized for identifying the epileptogenic zone, pre-/post-surgical seizure prediction, and assessing cognitive performance. For localization, graph theory measures of centrality have shown the most potential, including betweenness centrality, outdegree, and graph index complexity, whereas for prediction of seizure frequency, measures of synchronizability have shown the most potential. The utility of clustering coefficient and characteristic path length for assessing cognitive performance in TLE is also discussed. Conclusions Future studies integrating data from multiple modalities and testing predictive models are needed to clarify findings and develop graph theory for its clinical utility. PMID:25127370

  13. Surgical Clinical Correlates in Anatomy: Design and Implementation of a First-Year Medical School Program

    ERIC Educational Resources Information Center

    Haubert, Lisa M.; Jones, Kenneth; Moffatt-Bruce, Susan D.

    2009-01-01

    Medical students state the need for a clinically oriented anatomy class so to maximize their learning experience. We hypothesize that the first-year medical students, who take the Surgical Clinical Correlates in Anatomy program, will perform better than their peers in their anatomy course, their surgical clerkships and ultimately choose surgical…

  14. Clinical Correlates of Comorbid Obsessive-Compulsive Disorder and Depression in Youth

    ERIC Educational Resources Information Center

    Canavera, Kristin E.; Ollendick, Thomas H.; Ehrenreich May, Jill T.; Pincus, Donna B.

    2010-01-01

    A burgeoning body of literature addresses the comorbidity of depression and OCD in adults. The purpose of this study was to extend this area of research to children and adolescents by examining the clinical correlates associated with co-occurring depressive disorders in a clinical sample of youth with OCD. Participants included children and…

  15. Cavum Septum Pellucidum in Schizophrenia: Clinical and Neuropsychological Correlates

    PubMed Central

    Flashman, Laura A.; Roth, Robert M.; Pixley, Heather S.; Cleavinger, Howard B.; McAllister, Thomas W.; Vidaver, Robert; Saykin, Andrew J.

    2007-01-01

    Increased frequency of cavum septum pellucidum (CSP) has been inconsistently observed in schizophrenia, and little is known about its functional implications. We investigated whether patients with schizophrenia were more likely than healthy controls to have CSP, and among patients assessed the relationship between CSP, psychiatric symptoms, and selected neuropsychological functions. Seventy-seven patients with diagnoses of DSM-IV schizophrenia spectrum disorders and 55 healthy controls were studied and completed a 1.5 T MRI scan. Two raters, blind to group membership, determined the presence, length and grade of the CSP. A subset of participants also underwent neuropsychological testing. A CSP of at least 1 mm in length was present in 68.8% of patients and 76.4% of controls, and the groups did not differ significantly with respect to presence or absence, length, overall size, or percent with an abnormally large CSP (? 6 mm). Patients with an abnormally large CSP demonstrated poorer performance on measures of verbal learning and memory than patients with smaller CSP. Among patients, CSP length was significantly correlated with negative symptoms, verbal learning, and sentence comprehension. Among patients with abnormally large CSP, CSP length was correlated with reaction time on two conditions of a Continuous Performance Test. CSP, while prevalent, was not more frequent in our sample of patients with schizophrenia, and had few associations with symptom severity or neuropsychological deficits. PMID:17291728

  16. Anger in pathological gambling: clinical, psychopathological, and personality correlates.

    PubMed

    Aymamí, Neus; Granero, Roser; Penelo, Eva; Fernández-Aranda, Fernando; Krug, Isabel; Gunnard, Katarina; Santamaría, Juan José; Bueno, Blanca; Jaurrieta, Nuria; Gómez-Peña, Mónica; Álvarez-Moya, Eva; Claes, Laurence; Fagundo, Ana Beatriz; Menchón, José Manuel; Jiménez-Murcia, Susana

    2014-01-01

    The aim of this study was to explore the association between pathological gambling (PG) and anger by assessing whether psychopathology and personality are related to PG and to evaluate gender differences. The sample comprised 71 PGs and 37 healthy controls. Anger, psychopathology and personality were assessed with the STAXI-2, SCL-90-R and TCI-R respectively. Gender did not affect anger expression after stratifying by diagnostic condition (p > .05). Among PG patients, anger, psychopathology and personality measures were correlated with good effect-size (r > .30). Scores in the Anger Temperament (B = 0.21, p = .038) and Anger External-Expression (B = 0.27, p = .029) scales were positively associated with PG severity scores. Anger expression in PG should be considered in future treatment programs. PMID:25011386

  17. Questioning the Questions

    ERIC Educational Resources Information Center

    Tienken, Christopher H.; Goldberg, Stephanie; DiRocco, Dominic

    2010-01-01

    Historical accounts of questioning used in the education process trace back to Socrates. One of the best examples of his use of questioning is found in Plato's "The Republic." Socrates used a series of strategic questions to help his student Glaucon come to understand the concept of justice. Socrates purposefully posed a series of questions to…

  18. Hemosiderotic fibrohistiocytic lipomatous lesion: clinical correlation with venous stasis.

    PubMed

    Kazakov, Dmitry V; Sima, Radek; Michal, Michal

    2005-07-01

    Hemosiderotic fibrohistiocytic lipomatous lesion (HFLL) is a recently proposed lipomatous entity. HFLL was originally suggested to be a benign reactive lesion arising due to an antecedent trauma. We report two patients with HFLL who also suffered from chronic vein insufficiency due to varicose involving deep veins of the low limbs. Both patients were middle-aged women with solitary, poorly circumscribed subcutaneous lesions on the lower extremities. Histopathological examination revealed typical features of HFLL. We think that the consistent clinical features such as advanced age, female sex predilection, and specific location along with distinctive histopathological features allow the suggestion that impaired blood circulation, to wit, venous stasis is involved in the pathogenesis of HFLL. We hypothesize that the proliferation of spindled fibroblastic and myofibroblastic cells and capillaries, erythrocyte extravasation, and hemosiderin deposition with lipomatous tissue of HFLL may simply represent an exaggerated tissue response to venous stasis in which elevated venous and capillary pressures, oxygen saturation, and edema stimulate the proliferation of the above mentioned elements and lead to erythrocyte extravasation. A similar histopathological pattern is seen in acroangiodermatitis of Mali and vascular transformation of lymph node sinuses, and these conditions are also associated with impaired blood circulation. PMID:15947948

  19. Clinical correlates of childhood abuse and neglect in substance dependents.

    PubMed

    Evren, Cuneyt; Kural, Sevil; Cakmak, Duran

    2006-03-01

    The aim of this study was to evaluate the prevalence of childhood abuse and neglect (CAN) in Turkish substance dependents and to investigate the relationship between CAN with axis I disorders, personality disorders and severity of depression and anxiety symptoms. Among 132 substance dependents, 56.1% met dichotomous criteria for some form of CAN. Current age was lower, whereas rate of suicide attempt, self-destructive behavior, divorce of parents, major depression, posttraumatic stress disorder (PTSD), lifetime specific phobia and personality disorders were higher in patients with history of CAN. Severity of depression and anxiety symptoms were also higher in group with CAN and number of abuse type was correlated with depression and anxiety scores. Lifetime major depression, lifetime PTSD, suicide attempt, self-destructive behavior and divorce of parents predicted CAN. The high rate of CAN found among Turkish substance dependents suggests that special attention must be given to identify CAN in this group. Findings of this study showed that there is a relationship between history of CAN and some axis I disorders, personality disorders and severity of depression and anxiety symptoms. PMID:15964150

  20. A review of subclavian steal syndrome with clinical correlation

    PubMed Central

    Osiro, Stephen; Zurada, Anna; Gielecki, Jerzy; Shoja, Mohammadali M.; Tubbs, R. Shane; Loukas, Marios

    2012-01-01

    Summary Subclavian ‘steal’ phenomenon is a function of the proximal subclavian artery (SA) steno-occlusive disease, with subsequent retrograde blood flow in the ipsilateral vertebral artery (VA). The symptoms from the compromised vertebrobasilar and brachial blood flows constitute the subclavian steal syndrome (SSS), and include paroxysmal vertigo, drop attacks and/or arm claudication. Once thought to be rare, the emergence of new imaging techniques has drastically improved its diagnosis and prevalence. The syndrome, however, remains characteristically asymptomatic and solely poses no serious danger to the brain. Recent studies have shown a linear correlation between increasing arm blood pressure difference with the occurrence of symptoms. Atherosclerosis of the SA remains the most common cause. Doppler ultrasound is a useful screening tool, but the diagnosis must be confirmed by CT or MR angiography. Conservative treatment is the initial best therapy for this syndrome, with surgery reserved for refractory symptomatic cases. Percutaneous angioplasty and stenting, rather than bypass grafts of the subclavian artery, is the widely favored surgical approach. Nevertheless, large, prospective, randomized, controlled trials are needed to compare the long-term patency rates between the endovascular and open surgical techniques. PMID:22534720

  1. Focal and segmental glomerulosclerosis: clinical and kidney biopsy correlations

    PubMed Central

    Sethi, Sanjeev; Zand, Ladan; Nasr, Samih H.; Glassock, Richard J.; Fervenza, Fernando C.

    2014-01-01

    Background Primary focal segmental glomerulosclerosis (FSGS) is a common glomerular disease in adults and ranks among the top causes of a primary glomerular disease causing end-stage renal disease (ESRD). Primary FSGS is, however, a diagnosis of exclusion and distinction between primary versus secondary FSGS is not always obvious, resulting in a number of patients with secondary FSGS undergoing unnecessary immunosuppressive therapy. Methods We reviewed the Mayo Clinic Renal Pathology Database for patients with a diagnosis of FSGS on native renal biopsy and divided the patients into nephrotic syndrome-associated (NS-associated) and non-nephrotic syndrome-associated (NNS-associated) FSGS as a first approximation followed by dividing the lesion according to the degree of foot process effacement (FPE) on electron microscopy (EM) examination. Results A total of 41 patients with FSGS with complete evaluation were identified. Of these, 18 were classified as having NS and 23 were classified as having NNS. Baseline characteristics (age, gender, body mass index, serum creatinine and hematuria) were not different between the groups. All of the patients with NS showed diffuse FPE ranging from 80 to 100% (mean 96%). On the other hand, of the 23 patients in the NNS group, 22 had segmental FPE and showed patchy effacement, with all cases showing 20–60% FPE (mean of 48%). Conclusion Adult patients presenting with NS, an FSGS lesion on LM, extensive FPE (?80%) on EM examination and no risk factors associated with secondary FSGS are likely to have primary FSGS. Conversely, the absence of NS in a patient with segmental FPE on EM strongly suggests a secondary FSGS. Dividing FSGS into the presence or absence of NS together with the degree of FPE on EM examination is more helpful as it provides a more practical way to separate patients into cases of primary versus secondary FSGS. PMID:25503953

  2. Social cognition in psychosis: multidimensional structure, clinical correlates, and relationship with functional outcome.

    PubMed

    Mancuso, Francesco; Horan, William P; Kern, Robert S; Green, Michael F

    2011-02-01

    Social cognitive impairments are common, detectable across a wide range of tasks, and appear to play a key role in explaining poor outcome in schizophrenia and related psychotic disorders. However, little is known about the underlying factor structure of social cognition in people with psychotic disorders due to a lack of exploratory factor analyses using a relatively comprehensive social cognitive assessment battery. In a sample of 85 outpatients with psychosis, we examined the factor structure and clinical/functional correlates of eight indexes derived from five social cognition tasks that span the domains of emotional processing, social perception, attributional style, and Theory of Mind. Exploratory factor analysis revealed three factors with relatively low inter-correlations that explained a total of 54% of the variance: (1) Hostile attributional style, (2) Lower-level social cue detection, and (3) Higher-level inferential and regulatory processes. None of the factors showed significant correlations with negative symptoms. Factor 1 significantly correlated with clinical symptoms (positive, depression-anxiety, agitation) but not functional outcome, whereas Factors 2 and 3 significantly correlated with functional outcome (functional capacity and real-world social and work functioning) but not clinical symptoms. Furthermore, Factor 2 accounted for unique incremental variance in functional capacity, above and beyond non-social neurocognition (measured with MATRICS Consensus Cognitive Battery) and negative symptoms. Results suggest that multiple separable dimensions of social cognition can be identified in psychosis, and these factors show distinct patterns of correlation with clinical features and functional outcome. PMID:21112743

  3. Questioning the Questions

    ERIC Educational Resources Information Center

    Tienken, Christopher H.; Goldberg, Stephanie; DiRocco, Dominic

    2009-01-01

    Well-known historical accounts of questioning used in the education process trace back to Socrates. One of the best examples of his use of questioning is found in Plato's classic work "The Republic" (2003). Today, teachers still use questions as one way to help students develop productive thinking skills and to understand concepts and topics.…

  4. A retrospective study of peanut and tree nut allergy: Sensitization and correlations with clinical manifestations

    PubMed Central

    Yang, Lihua; Clements, Stacy

    2015-01-01

    Peanut (PN) and tree nut (TN) allergies are among the leading causes of fatal food-induced anaphylaxis and are increasing in prevalence, especially in children. Their cosensitization and concurrent clinical allergy have been understudied. This retrospective study investigated the correlation between PN and TN allergy, both in terms of in vitro sensitization (IVS) and clinical allergic manifestations. We conducted a retrospective medical record review at the Allergy Clinic at University Hospital of Brooklyn. Fourteen hundred six charts were reviewed, of which 76 (5.4%) had documented relevant clinical allergy: PN allergy but not TN allergy (n = 29) or TN allergy but not PN allergy (n = 11) or both (n = 30). Six patients with PN allergy but no TN exposure history were not included in the analysis. The majority of patients (67/76, 88.1%) had a concurrent history of asthma, rhinoconjunctivitis, or AD. Sensitivity of TN IVS predicting PN IVS was 38/39 (97%). Similarly, sensitivity of PN IVS predicting TN IVS was 38/42 (91%). Sensitivity of TN clinical allergy predicting PN allergy was 30/59 (51%). Sensitivity of PN clinical allergy predicting TN allergy was 30/41 (73%). The total number of organ systems involved in reported clinical reactions correlated with IVS to TN (p = 0.004) but not IVS to PN (p = 0.983). In summary, we found PN sensitization predicts TN sensitization in vitro, with lower predictability for clinical reactions.

  5. Clinically relevant correlates of accurate perception of patients' thoughts and feelings.

    PubMed

    Hall, Judith A; Ship, Amy N; Ruben, Mollie A; Curtin, Elizabeth M; Roter, Debra L; Clever, Sarah L; Smith, C Christopher; Pounds, Karen

    2015-05-01

    The goal was to explore the clinical relevance of accurate understanding of patients' thoughts and feelings. Between 2010 and 2012, four groups of participants (nursing students, medical students, internal medicine residents, and undergraduate students) took a test of accuracy in understanding the thoughts and feelings of patients who were videorecorded during their actual medical visits and who afterward reviewed their video to identify their thoughts and feelings as they occurred (Test of Accurate Perception of Patients' Affect, or TAPPA). Participants' accuracy scores were then correlated with participants' attitudes toward patient-centered care, clinical course background, recall of clinical conversation, evaluations of clinical performance made by preceptors, evaluations of interpersonal skill made by standardized patients in clinical encounters, and independent coding of behavior in a clinical encounter. Accuracy in understanding patients' thoughts and feelings was significantly correlated with nursing students' clinical course experience, clinicians' favorable attitudes to psychosocial discussion, standardized patients' evaluations of medical students' interpersonal skill, independent coding of medical students' patient-centered behavior while taking a social history, and undergraduates' more accurate recall of what an actor-physician said on video. Accuracy in perceiving patients' thoughts and feelings can be objectively measured and is a skill relevant to clinical performance. PMID:24949868

  6. Do Workshops in Evidence-Based Practice Equip Participants to Identify and Answer Questions Requiring Consideration of Clinical Research? A Diagnostic Skill Assessment

    ERIC Educational Resources Information Center

    Wyer, Peter C,; Naqvi, Zoon; Dayan, Peter S.; Celentano, James J.; Eskin, Barnet; Graham, Mark J.

    2009-01-01

    Evidence-based practice (EBP) requires practitioners to identify and formulate questions in response to patient encounters, and to seek, select, and appraise applicable clinical research. A standardized workshop format serves as the model for training of medical educators in these skills. We developed an evaluation exercise to assess the ability…

  7. Submaximal delayed-onset muscle soreness: correlations between MR imaging findings and clinical measures

    NASA Technical Reports Server (NTRS)

    Evans, G. F.; Haller, R. G.; Wyrick, P. S.; Parkey, R. W.; Fleckenstein, J. L.; Blomqvist, C. G. (Principal Investigator)

    1998-01-01

    PURPOSE: To assess correlations between muscle edema on magnetic resonance (MR) images and clinical indexes of muscle injury in delayed-onset muscle soreness (DOMS) produced by submaximal exercise protocols. MATERIALS AND METHODS: Sixteen subjects performed 36 elbow flexions ("biceps curls") at one of two submaximal workloads that emphasized eccentric contractions. Changes in MR imaging findings, plasma levels of creatine kinase, and pain scores were correlated. RESULTS: Both exercise protocols produced DOMS in all subjects. The best correlation was between change in creatine kinase level and volume of muscle edema on MR images, regardless of the workload. Correlations tended to be better with the easier exercise protocol. CONCLUSION: Whereas many previous studies of DOMS focused on intense exercise protocols to ensure positive results, the present investigation showed that submaximal workloads are adequate to produce DOMS and that correlations between conventionally measured indexes of injury may be enhanced at lighter exercise intensities.

  8. Study on Correlative Dimension of HRV Signals and Its Clinical Applications

    Microsoft Academic Search

    Dongping Xiao; Wei He; Hao Yang; Chuanxiang Yu

    2005-01-01

    In this paper an advanced algorithm based on G-P algorithm is introduced to calculate the correlative dimension (CD) of HRV signals. Moreover, Theiler's correction is considered to avoid the autocorrelation effect of the time serials. It will reduce the possibility to get spurious dimension. The algorithm is applied to clinical HRV data which are collected from twelve young healthy subjects

  9. Rage Attacks in Pediatric Obsessive-Compulsive Disorder: Phenomenology and Clinical Correlates

    ERIC Educational Resources Information Center

    Storch, Eric A.; Jones, Anna M.; Lack, Caleb W.; Ale, Chelsea M.; Sulkowski, Michael L.; Lewin, Adam B.; De Nadai, Alessandro S.; Murphy, Tanya K.

    2012-01-01

    Objective: Rage attacks have been documented in youth with varied psychiatric disorders, but few data have been reported on the clinical characteristics and correlates of rage attacks among children with obsessive-compulsive disorder (OCD). Method: Participants were 86 children (ages 6-16 years) with a primary diagnosis of OCD. Patients and their…

  10. Clinical Correlates and Repetition of Self-Harming Behaviors among Female Adolescent Victims of Sexual Abuse

    ERIC Educational Resources Information Center

    Cyr, Mireille; McDuff, Pierre; Wright, John; Theriault, Chantal; Cinq-Mars, Caroline

    2005-01-01

    This study investigated self-harming behaviors in 149 female adolescent victims of sexual abuse, first, by determining the rates of nine types of self-mutilating behavior at intake and nine months later and, second, by investigating comorbidity of clinical correlates associated with these behaviors. The adolescents were divided into three groups…

  11. Prevalence and Clinical Correlates of Deliberate Self-Harm among a Community Sample of Italian Adolescents

    ERIC Educational Resources Information Center

    Cerutti, R.; Manca, M.; Presaghi, F.; Gratz, Kim L.

    2011-01-01

    The aims of this study were to investigate the rates of deliberate self-harm (DSH) behavior among an Italian adolescent sample, as well as to explore its clinical correlates. On a sample of 234 adolescents in Italian secondary schools (Mean age = 16.47; SD = 1.7) were assessed the DSH as well as externalizing symptoms (including both conduct…

  12. Demographic and Clinical Correlates of Autism Symptom Domains and Autism Spectrum Diagnosis

    ERIC Educational Resources Information Center

    Frazier, Thomas W.; Youngstrom, Eric A.; Embacher, Rebecca; Hardan, Antonio Y.; Constantino, John N.; Law, Paul; Findling, Robert L.; Eng, Charis

    2014-01-01

    Demographic and clinical factors may influence assessment of autism symptoms. This study evaluated these correlates and also examined whether social communication and interaction and restricted/repetitive behavior provided unique prediction of autism spectrum disorder diagnosis. We analyzed data from 7352 siblings included in the Interactive…

  13. Mental Health and Clinical Correlates in Lesbian, Gay, Bisexual, and Queer Young Adults

    ERIC Educational Resources Information Center

    Grant, Jon E.; Odlaug, Brian L.; Derbyshire, Katherine; Schreiber, Liana R. N.; Lust, Katherine; Christenson, Gary

    2014-01-01

    Objective: This study examined the prevalence of mental health disorders and their clinical correlates in a university sample of lesbian, gay, bisexual, and queer (LGBQ) students. Participants: College students at a large public university. Methods: An anonymous, voluntary survey was distributed via random e-mail generation to university students…

  14. R E P O R T Gene expression correlates of clinical prostate cancer behavior

    E-print Network

    Jin, Jiashun

    R E P O R T Gene expression correlates of clinical prostate cancer behavior Dinesh Singh,1 of Miami, Miami, Florida 33176 Summary Prostate tumors are among the most heterogeneous of cancers, both differences underlie common pathological features of prostate cancer and to identify genes that might

  15. The Correlation of Learning Styles with Student Performance In Academic and Clinical Course Work.

    ERIC Educational Resources Information Center

    Cunningham, M. Jo; Trickey, Becki A.

    1983-01-01

    The purpose of this study was to determine any correlation between learning styles and performance in the academic and clinical course work of occupational therapy students at the Medical University of South Carolina. (Availability: RAM Associates LTD., P.O. Box N, Laurel, MD 20707) (SSH)

  16. Gadolinium delayed enhancement cardiovascular magnetic resonance correlates with clinical measures of myocardial infarction

    Microsoft Academic Search

    W. Patricia Ingkanisorn; Kenneth L. Rhoads; Anthony H. Aletras; Peter Kellman; Andrew E. Arai

    2004-01-01

    ObjectivesThe current study tested the hypothesis that gadolinium delayed enhancement assessment of infarct size correlates with clinical indices of myocardial infarction (MI) in humans. Acute infarct mass by cardiac magnetic resonance (CMR) was compared with peak troponin I, acute and chronic left ventricular (LV) systolic function, and chronic infarct mass in patients imaged after recent acute MI.

  17. Atherosclerosis in angiographically “normal” coronary artery reference segments: An intravascular ultrasound study with clinical correlations

    Microsoft Academic Search

    Gary S. Mintz; Jack A. Painter; Augusto D. Pichard; Kenneth M. Kent; Lowell F. Satler; Jeffrey J. Popma; Ya Chien Chuang; Theresa A. Bucher; Lisa E. Sokolowicz; Martin B. Leon

    1995-01-01

    Objectives. This study evaluated the magnitude, patterns and clinical correlates of atherosclerosis in angiographically “normal” reference segments in patients undergoing transcatheter therapy for symptomatic coronary artery disease.Background. Pathologic studies indicate that the extent of coronary atherosclerosis is underestimated by visual analysis of angiographically normal coronary artery segments. Intravascular ultrasound allows detailed, high quality cross-sectional imaging of the coronary arteries in

  18. Suicidal Behaviors among Adolescents in Puerto Rico: Rates and Correlates in Clinical and Community Samples

    ERIC Educational Resources Information Center

    Jones, Jennifer; Ramirez, Rafael Roberto; Davies, Mark; Canino, Glorisa; Goodwin, Renee D.

    2008-01-01

    This study examined rates and correlates of suicidal behavior among youth on the island of Puerto Rico. Data were drawn from two probability samples, one clinical (n = 736) and one community-based sample (n = 1,896), of youth ages 12 to 17. Consistent with previous studies in U.S. mainland adolescent populations, our results demonstrate that most…

  19. Correlations of Theory of Mind Deficits with Clinical Patterns and Quality of Life in Schizophrenia

    PubMed Central

    Urbach, Mathieu; Brunet-Gouet, Eric; Bazin, Nadine; Hardy-Baylé, Marie-Christine; Passerieux, Christine

    2013-01-01

    Background: Numerous studies have demonstrated the existence of theory of mind (ToM) impairments in patients with schizophrenia. The clinical consequences of these impairments are currently under debate. Accumulated evidence suggests that ToM deficits are linked to negative and disorganization symptoms, but direct correlations are lacking. Moreover, it is unclear whether ToM deficits are related to reduced quality of life (QoL). Methods: To extend the understanding of objective (i.e., clinical symptoms) and subjective (QoL) correlates of impaired ToM, we assessed 206 patients with schizophrenia based on performance of an ecological task (Versailles-Situational Intention Reading, V-SIR), a Communication Disorders Scale (SCD), the Positive and Negative Syndrome Scale (PANSS), the Clinical Global Impression rating, and a QoL questionnaire (S-QoL). Statistical inferences were drawn from correlations analyses considering both factors/subscales aggregates and single items. Results: ToM performance was negatively correlated to disorganization and negative PANSS factors. Poor V-SIR performance was correlated with “conceptual disorganization,” “difficulties in abstract thinking,” and “apathy/social withdrawal.” The SCD was correlated with “negative,” “disorganization,” and “anxiety/depression” PANSS factors. The S-QoL total score was not significantly correlated with ToM performance. Only the item “difficulties in expressing feelings” was significantly correlated with poorer V-SIR performance. Conclusion: We discuss the intriguing paucity of the results and what they reveal about the difficulties faced by psychiatrists with patients not expressing complaints about lack of social skills. PMID:23653606

  20. Clinical pathologic correlation in viral hepatitis. The effect of the virus on the liver.

    PubMed Central

    Popper, H.

    1975-01-01

    In clinical pathologic correlations, including the potential effect of the virus on the liver, the morphologic features of the various stages of viral hepatitis are the firm information available today. With acute hepatitis being an inflammatory reaction to cell injury and necrosis, and chronic hepatitis being sustained inflammation, correlation with clinical features and functional defects is good in acute hepatitis and less so in the chronic stages. The pathogenesis of the diseases-including cell necrosis, inflammation, fibrosis, and cirrhosis formation-is reasonably well understood, and this knowledge assists both in prognosis and in monitoring of therapy. The localization of the components of the hepatitis B antigen and their effects, including the nature of the immune response, is the most exciting aspect of the clinical pathologic problem. Today's interpretations offer, at best, a working hypothesis promising further understanding of the evolution of the disease. Images Figure 1 Figure 2 PMID:1108667

  1. question_1296837100 — Provocative Questions

    Cancer.gov

    While the causal mechanisms that link excess body weight to increased risk for certain cancers are largely unknown (as noted in other questions), we pose an associated question -- what are the causal mechanisms that link excess body weight to decreased risk of certain other cancers?

  2. HIV/AIDS Information Needs of Sexually Transmitted Infection Clinic Patients: Content Analysis of Questions Asked during Prevention Counseling

    ERIC Educational Resources Information Center

    Kalichman, Seth C.; Cain, Demetria; Knecht, Joanna; Hill, Justin

    2008-01-01

    Basic factual information about disease is the cornerstone of health promotion and disease prevention interventions. Previous studies have shown that content analysis of the questions asked of service providers can elucidate the information needs of service consumers. Questions asked by individuals at known high risk for HIV infection have not…

  3. CT densitovolumetry in children with obliterative bronchiolitis: correlation with clinical scores and pulmonary function test results*,**

    PubMed Central

    Mocelin, Helena; Bueno, Gilberto; Irion, Klaus; Marchiori, Edson; Sarria, Edgar; Watte, Guilherme; Hochhegger, Bruno

    2013-01-01

    OBJECTIVE: To determine whether air trapping (expressed as the percentage of air trapping relative to total lung volume [AT%]) correlates with clinical and functional parameters in children with obliterative bronchiolitis (OB). METHODS: CT scans of 19 children with OB were post-processed for AT% quantification with the use of a fixed threshold of ?950 HU (AT%950) and of thresholds selected with the aid of density masks (AT%DM). Patients were divided into three groups by AT% severity. We examined AT% correlations with oxygen saturation (SO2) at rest, six-minute walk distance (6MWD), minimum SO2 during the six-minute walk test (6MWT_SO2), FVC, FEV1, FEV1/FVC, and clinical parameters. RESULTS: The 6MWD was longer in the patients with larger normal lung volumes (r = 0.53). We found that AT%950 showed significant correlations (before and after the exclusion of outliers, respectively) with the clinical score (r = 0.72; 0.80), FVC (r = 0.24; 0.59), FEV1 (r = ?0.58; ?0.67), and FEV1/FVC (r = ?0.53; r = ?0.62), as did AT%DM with the clinical score (r = 0.58; r = 0.63), SO2 at rest (r = ?0.40; r = ?0.61), 6MWT_SO2 (r = ?0.24; r = ?0.55), FVC (r = ?0.44; r = ?0.80), FEV1 (r = ?0.65; r = ?0.71), and FEV1/FVC (r = ?0.41; r = ?0.52). CONCLUSIONS: Our results show that AT% correlates significantly with clinical scores and pulmonary function test results in children with OB. PMID:24473764

  4. question_1312912193 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  5. question_1409921534 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  6. question_1297533065 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  7. question_1296071530 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  8. question_1410545293 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  9. question_1328803566 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  10. question_1309292190 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  11. question_1296157694 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  12. question_1298857225 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  13. question_1297435384 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  14. question_1296786566 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  15. question_1314022426 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  16. question_1410236285 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  17. question_1310150051 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  18. question_1302545047 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  19. question_1410878914 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  20. question_1297107652 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  1. question_1411972022 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  2. question_1411972090 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  3. question_1413444261 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  4. question_1309214151 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  5. question_1299510834 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  6. question_1295643225 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  7. question_1309209288 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  8. question_1296508079 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  9. question_1299508744 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  10. question_1409064725 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  11. question_1409064112 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  12. question_1312382828 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  13. question_1411014068 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  14. question_1411474796 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  15. question_1410251969 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  16. question_1410563953 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  17. question_1296669988 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  18. question_1296850328 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  19. question_1302126805 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  20. question_1310868762 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  1. question_1410865099 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  2. question_1411052189 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  3. question_1412100531 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  4. question_1301530459 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  5. question_1410246408 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  6. question_1410245819 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  7. question_1414049861 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  8. question_1298409202 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  9. question_1412830344 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  10. question_1408110976 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  11. question_1297499720 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  12. question_1411460063 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  13. question_1337049045 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  14. question_1295444776 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  15. question_1298674892 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  16. question_1412833175 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  17. question_1309532294 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  18. question_1309291793 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  19. question_1309291860 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  20. question_1296657942 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  1. question_1296786622 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  2. question_1414062103 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  3. question_1297424940 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  4. question_1297460130 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  5. question_1309209336 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  6. question_1297125849 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  7. question_1328804555 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  8. question_1296513894 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  9. question_1298614465 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  10. question_1333398119 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  11. question_1296786512 — Provocative Questions

    Cancer.gov

    An exciting development in this area that would be encouraged by attempting to answer this important question, is the connection between the observations of cancer risk modulation by epidemiologists and immune mechanisms that appear to be involved, described by immunologists.

  12. question_1296759663 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  13. question_1296830406 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  14. question_1302559585 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  15. question_1296401928 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  16. question_1302203772 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  17. question_1413469312 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  18. question_1297190968 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  19. question_1410546275 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  20. question_1409976519 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  1. question_1302099820 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  2. question_1298942394 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  3. question_1296826063 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  4. question_1309291494 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  5. question_1302560270 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  6. question_1410844360 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  7. question_1329194782 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  8. question_1299173164 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  9. question_1296849841 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  10. question_1314052528 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  11. question_1410954604 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  12. question_1410954609 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  13. question_1412835958 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  14. question_1299539367 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  15. question_1296057192 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  16. question_1412859595 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  17. question_1409740665 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  18. question_1309292133 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  19. question_1411079495 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  20. question_1309360864 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  1. question_1414730345 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  2. question_1313450002 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  3. question_1409209586 — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  4. Correlation of clinical outcome to the estimated radiation dose from Boron Neutron Capture Therapy (BNCT)

    SciTech Connect

    Chadha, M. [Beth Israel Medical Center, NY (United States). Dept. of Radiation Oncology; Coderre, J.A.; Chanana, A.D. [Brookhaven National Lab., Upton, NY (United States)] [and others

    1996-12-31

    A phase I/II trial delivering a single fraction of BNCT using p-Boronophenylalanine-Fructose and epithermal neutrons at the the Brookhaven Medical Research Reactor was initiated in September 1994. The primary endpiont of the study was to evaluate the feasibility and safety of a given BNCT dose. The clinical outcome of the disease was a secondary endpoint of the study. The objective of this paper is to evaluate the correlation of the clinical outcome of patients to the estimated radiation dose from BNCT.

  5. Integrated fluorescence correlation spectroscopy device for point-of-care clinical applications

    PubMed Central

    Olson, Eben; Torres, Richard; Levene, Michael J.

    2013-01-01

    We describe an optical system which reduces the cost and complexity of fluorescence correlation spectroscopy (FCS), intended to increase the suitability of the technique for clinical use. Integration of the focusing optics and sample chamber into a plastic component produces a design which is simple to align and operate. We validate the system by measurements on fluorescent dye, and compare the results to a commercial instrument. In addition, we demonstrate its application to measurements of concentration and multimerization of the clinically relevant protein von Willebrand factor (vWF) in human plasma. PMID:23847733

  6. Modeling Clinical Outcome Using Multiple Correlated Functional Biomarkers: A Bayesian Approach

    PubMed Central

    Long, Qi; Zhang, Xiaoxi; Zhao, Yize; Johnson, Brent A.; Bostick, Roberd M.

    2012-01-01

    In some biomedical studies, biomarkers are measured repeatedly along some spatial structure or over time and are subject to measurement error. In these studies, it is often of interest to evaluate associations between a clinical endpoint and these biomarkers (also known as functional biomarkers). There are potentially two levels of correlation in such data, namely, between repeated measurements of a biomarker from the same subject and between multiple biomarkers from the same subject; none of the existing methods accounts for correlation between multiple functional biomarkers. We propose a Bayesian approach to model a clinical outcome of interest (e.g., risk for colorectal cancer) in the presence of multiple functional biomarkers while accounting for potential correlation. Our simulations show that the proposed approach achieves good performance in finite samples under various settings. In the presence of substantial or moderate correlation, the proposed approach outperforms an existing approach that does not account for correlation. The proposed approach is applied to a study of biomarkers of risk for colorectal neoplasms and our results show that the risk for colorectal cancer is associated with two functional biomarkers, APC and TGF-?, in particular, with their values in the region between the proliferating zone and the differentiating zone of colorectal crypts. PMID:23070593

  7. What is the clinical significance of finding cells from a primary tumor at another site? — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  8. Anatomo-clinical atlases correlate clinical data and electrode contact coordinates: application to subthalamic deep brain stimulation.

    PubMed

    Lalys, Florent; Haegelen, Claire; Mehri, Maroua; Drapier, Sophie; Vérin, Marc; Jannin, Pierre

    2013-01-30

    For patients suffering from Parkinson's disease with severe movement disorders, functional surgery may be required when medical therapy is not effective. In Deep Brain Stimulation (DBS), electrodes are implanted within the brain to stimulate deep structures such as SubThalamic Nucleus (STN). The quality of patient surgical outcome is generally related to the accuracy of nucleus targeting during surgery. In this paper, we focused on identifying optimum sites for STN DBS by studying symptomatic motor improvement along with neuropsychological side effects. We described successive steps for constructing digital atlases gathering patient's location of electrode contacts automatically segmented from postoperative images, and clinical scores. Three motor and five neuropsychological scores were included in the study. Correlations with active contact locations were carried out using an adapted hierarchical ascendant classification. Such analysis enabled the extraction of representative clusters to determine the optimum site for therapeutic STN DBS. For each clinical score, we built an anatomo-clinical atlas representing its improvement or deterioration in relation with the anatomical location of electrodes and from a population of implanted patients. To the best of our knowledge, we reported for the first time a discrepancy between a very good motor improvement by targeting the postero-superior region of the STN and an inevitable deterioration of the categorical and phonemic fluency in the same region. Such atlases and associated analysis may help better understanding of functional mapping in deep structures and may help pre-operative decision-making process and especially targeting. PMID:23147008

  9. Postoperative Expansion of Dural Sac Cross-Sectional Area after Unilateral Laminotomy for Bilateral Decompression: Correlation with Clinical Symptoms

    PubMed Central

    Chung, Seok-Won; Shin, Yong-Hwan; Baek, Oon-Ki; Lee, Sang-Ho

    2014-01-01

    Objective Dural sac cross-sectional area (DSCSA) is a way to measure the degree of central spinal canal compression. The objective was to investigate the correlation between the expansion ratio of DSCSA after unilateral laminotomy for bilateral decompression (ULBD) and the clinical results for lumbar spinal stenosis. Methods We retrospectively reviewed the clinical data and radiographs of 103 patients who underwent ULBD for symptomatic spinal stenosis in one year. We compared preoperative and postoperative clinical data and DSCSA and evaluated the correlation between clinical and radiographic measurements. Results There was a significant increase of DSCSA after ULBD (p=0.000) and mean expansion ratio of DSCSA was 203.7±147.2%(range -32.9-826.1%). Clinical outcomes, measured by VAS and ODI were improved significantly not only in early postoperative period, but also in the last follow-up. However, there were no statistically significant correlations between the preoperative DSCSA and clinical symptoms, Perioperative expansion ratio of DSCSA and clinical parameters were also not correlated to the improvement of clinical symptoms significantly in both early postoperative phase and last follow-up. Conclusion Our result indicates that the DSCSA itself has a definite limitation to be correlated to the clinical symptoms, and thus meticulous correlation between the clinical presentation and MRI imaging is essential in determination of surgical treatment. PMID:25620982

  10. Clinical Correlates and Heritability of Flow-Mediated Dilation in the Community The Framingham Heart Study

    Microsoft Academic Search

    Emelia J. Benjamin; Martin G. Larson; Michelle J. Keyes; Gary F. Mitchell; Ramachandran S. Vasan; John F. Keaney; Birgitta T. Lehman; Shuxia Fan; Ewa Osypiuk; Joseph A. Vita

    Background—Studies in selected samples have linked impaired endothelial function with cardiovascular disease and its risk factors. The clinical correlates and heritability of endothelial function in the community have not been described. Methods and Results—We examined a measure of endothelial function, brachial artery flow-mediated dilation (FMD), expressed as both percent (FMD%) and actual dilation by ultrasound with the occlusion cuff below

  11. Clinical, Psychopathological and Personality Correlates of Interoceptive Awareness in Anorexia nervosa, Bulimia nervosa and Obesity

    Microsoft Academic Search

    Secondo Fassino; Andrea Pierò; Carla Gramaglia; Giovanni Abbate-Daga

    2004-01-01

    Objective: To determine the levels of interoceptive awareness (IA), which measures the ability of an individual to discriminate between sensations and feelings, and between the sensations of hunger and satiety, in eating disorder patients and to identify the clinical, psychopathological and personal variables correlated with IA. Sampling andMethods: Sixty-one restrictor anorectics, 61 binge-purging anorectics, 104 purging bulimics, 49 obese subjects

  12. Clinical correlation of MGMT protein expression and promoter methylation in Chinese glioblastoma patients

    Microsoft Academic Search

    Kai TangQiang; Qiang Jin; Wei Yan; Wei Zhang; Gan You; Yanwei Liu; Tao Jiang

    Promoter methylation of O6-methylguanine-DNA methyltransferase (MGMT) gene has been considered as a prognostic maker and increasingly\\u000a emphasized in the treatment of glioblastoma multiforme (GBM). Contrastingly, the correlation of MGMT with clinical outcomes\\u000a in Chinese glioblastoma patients has not been elucidated systematically. In the present study, tumor tissues from 172 GBM\\u000a patients were analyzed for MGMT protein expression by immunohistochemistry. Of

  13. Brown-Sequard syndrome after blunt cervical spine trauma: clinical and radiological correlations

    PubMed Central

    Gomez, Pedro; Alday, Rafael; Kaen, Ariel; Ramos, Ana

    2007-01-01

    The objective of this study was to describe clinical and radiological features of a series of patients presenting with Brown-Sequard syndrome after blunt spinal trauma and to determine whether a correlation exists between cervical plain films, CT, MRI and the clinical presentation and neurological outcome. A retrospective review was done of the medical records and analysis of clinical and radiological features of patients diagnosed of BSS after blunt cervical spine trauma and admitted to our hospital between 1995 and 2005. Ten patients were collected for study, three with upper- and seven with lower-cervical spine fracture. ASIA impairment scale and motor score were determined on admission and at last follow-up (6 months–9 years, mean 30 months). Patients with lower cervical spine fracture presented with laminar fracture ipsilateral to the side of cord injury in five out of six cases. T2-weighted hyperintensity was present in seven patients showing a close correlation with neurological deficit in terms of side and level but not with the severity of motor deficit. Patients with Brown-Sequard syndrome secondary to blunt cervical spine injury commonly presented T2-weighted hyperintensity in the clinically affected hemicord. A close correlation was observed between these signal changes in the MR studies and the neurologic level. Effacement of the anterior cervical subarachnoid space was present in all patients, standing as a highly sensitive but very nonspecific finding. In the present study, craniocaudal extent of T2-weighted hyperintensity of the cord failed to demonstrate a positive correlation with neurological impairment. PMID:17394028

  14. Sexual obsessions and clinical correlates in adults with obsessive-compulsive disorder

    Microsoft Academic Search

    Jon E. Grant; Anthony Pinto; Matthew Gunnip; Maria C. Mancebo; Jane L. Eisen; Steven A. Rasmussen

    2006-01-01

    Because little is known about sexual obsessions in individuals with obsessive-compulsive disorder (OCD), we examined rates and clinical correlates of sexual obsessions in 293 consecutive subjects with primary lifetime Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, OCD (54.6% females; mean age, 40.5 ± 12.9 years). Symptom severity was examined using the Yale-Brown Obsessive Compulsive Scale. Comorbidity, treatment response,

  15. Diffusion-Weighted MRI in Acute Lacunar Syndromes A Clinical-Radiological Correlation Study

    Microsoft Academic Search

    Wouter J. Schonewille; Michael B. Singer; Scott W. Atlas

    Background and Purpose—Clinical-radiological correlation studies in lacunar syndromes have been handicapped by the low sensitivity of CT and standard MRI for acute small-vessel infarction and their difficulty in differentiating between acute and chronic lesions. Methods—We prospectively studied 43 patients presenting with a classic lacunar syndrome using diffusion-weighted MRI, a technique with a high sensitivity and specificity for acute small-vessel infarction.

  16. Clinical Correlations With Lewy Body Pathology in LRRK2-Related Parkinson Disease

    PubMed Central

    Kalia, Lorraine V.; Lang, Anthony E.; Hazrati, Lili-Naz; Fujioka, Shinsuke; Wszolek, Zbigniew K.; Dickson, Dennis W.; Ross, Owen A.; Van Deerlin, Vivianna M.; Trojanowski, John Q.; Hurtig, Howard I.; Alcalay, Roy N.; Marder, Karen S.; Clark, Lorraine N.; Gaig, Carles; Tolosa, Eduardo; Ruiz-Martínez, Javier; Marti-Masso, Jose F.; Ferrer, Isidre; de Munain, Adolfo López; Goldman, Samuel M.; Schüle, Birgitt; Langston, J. William; Aasly, Jan O.; Giordana, Maria T.; Bonifati, Vincenzo; Puschmann, Andreas; Canesi, Margherita; Pezzoli, Gianni; De Paula, Andre Maues; Hasegawa, Kazuko; Duyckaerts, Charles; Brice, Alexis; Stoessl, A. Jon; Marras, Connie

    2015-01-01

    IMPORTANCE Mutations in leucine-rich repeat kinase 2 (LRRK2) are the most common cause of genetic Parkinson disease (PD) known to date. The clinical features of manifesting LRRK2 mutation carriers are generally indistinguishable from those of patients with sporadic PD. However, some PD cases associated with LRRK2 mutations lack Lewy bodies (LBs), a neuropathological hallmark of PD. We investigated whether the presence or absence of LBs correlates with different clinical features in LRRK2-related PD. OBSERVATIONS We describe genetic, clinical, and neuropathological findings of 37 cases of LRRK2-related PD including 33 published and 4 unpublished cases through October 2013. Among the different mutations, the LRRK2 p.G2019S mutation was most frequently associated with LB pathology. Nonmotor features of cognitive impairment/dementia, anxiety, and orthostatic hypotension were correlated with the presence of LBs. In contrast, a primarily motor phenotype was associated with a lack of LBs. CONCLUSIONS AND RELEVANCE To our knowledge, this is the first report of clinicopathological correlations in a series of LRRK2-related PD cases. Findings from this selected group of patients with PD demonstrated that parkinsonian motor features can occur in the absence of LBs. However, LB pathology in LRRK2-related PD may be a marker for a broader parkinsonian symptom complex including cognitive impairment. PMID:25401511

  17. Classification system for flexor digitorum accessorius longus muscle variants within the leg: clinical correlations.

    PubMed

    Hur, Mi-Sun; Won, Hyung-Sun; Oh, Chang-Seok; Chung, In-Hyuk; Lee, Woo-Chun; Yoon, Young Cheol

    2014-10-01

    The flexor digitorum accessorius longus (FDAL), a variant leg muscle, can cause tarsal tunnel syndrome. This study was performed to classify the variants of the FDAL by dissection and to correlate the dissection results with clinical cases of tarsal tunnel syndrome caused by this muscle. Eighty lower limbs of embalmed Korean cadavers were dissected. MR images of two clinical cases of tarsal tunnel syndrome caused by the FDAL were correlated with the dissection results. The FDAL was observed in nine out of 80 specimens (11.3%) and it was classified into three types depending on its site of origin and its relationship to the posterior tibial neurovascular bundle (PTNV) in the leg. In Type I (6.3%), the FDAL originated in the leg and ran superficially along the PTNV, either not crossing (Type Ia, 3.8%) or crossing (Type Ib, 2.5%) the neurovascular bundle. In Type II (6.3%), it originated in the tarsal tunnel. Most FDALs followed a similar course in the tarsal tunnel and the plantar pedis. On correlating the MR images of the clinical cases with this classification, the FDAL corresponded to Types Ia and II. All three types of FDAL can compress the tibial nerve in the tarsal tunnel or the distal leg. Clarification of the topographical relationship between this muscle and the PTNV would help to improve the results of surgery for tarsal tunnel syndrome caused by the FDAL. PMID:24535960

  18. Clinical Correlates of Awareness for Balance, Function, and Memory: Evidence for the Modality Specificity of Awareness

    PubMed Central

    O'Connell, Megan E.; Crossley, Margaret; Morgan, Debra

    2014-01-01

    Awareness in dementia is increasingly recognized not only as multifactorial, but also as domain specific. We demonstrate differential clinical correlates for awareness of daily function, awareness of memory, and the novel exploration of awareness of balance. Awareness of function was higher for participants with mild cognitive impairment (aMCI and non-aMCI) than for those with dementia (due to Alzheimer disease; AD and non-AD), whereas awareness of memory was higher for both non-aMCI and non-AD dementia patients than for those with aMCI or AD. Balance awareness did not differ based on diagnostic subgroup. Awareness of function was associated with instrumental activities of daily living and caregiver burden. In contrast, awareness of balance was associated with fall history, balance confidence, and instrumental activities of daily living. Clinical correlates of awareness of memory depended on diagnostic group: associations held with neuropsychological variables for non-AD dementia, but for patients with AD dementia, depression and instrumental activities of daily living were clinical correlates of memory awareness. Together, these data provide support for the hypothesis that awareness and dementia are not unitary and are, instead, modality specific. PMID:24551452

  19. Noncompaction cardiomyopathy: A new mechanism for mitral regurgitation with distinct clinical, echocardiographic features and pathological correlations

    PubMed Central

    Ali, Sulafa K.M.; Abu-Sulaiman, Riyadh; Agouba, Rihab Beshir

    2014-01-01

    Noncompaction cardiomyopathy (NCCM) is a primary, genetic cardiomyopathy with variable clinical manifestations that include mitral regurgitation (MR). Methods This study comprised patients diagnosed with NCCM and MR in two cardiac centers (King Abdul-Aziz Cardiac Center, Riyadh, Kingdom of Saudi Arabia and Sudan Heart Institute, Khartoum, Sudan), and seen in the period between 2002 and 2013. The study describes follow up, clinical, echocardiographic, and histopathological findings. Results Nineteen cases (85% females) were identified. Ten percent of the cases had relapses and remissions of heart failure. Echocardiographic features included leaflet retraction in all patients, characteristic malcoaptation, and a zigzag deformity of anterior leaflet in 57% of patients. Ruptured chordae were found in 15% of the patients. One patient had pathological examination of the mitral valve which showed myxomatous degeneration, and sclerotic and calcific changes. Conclusion We describe and discuss a new mechanism for MR caused by NCCM with identifiable clinical and echocardiographic features, and pathological correlations.

  20. Oral side effects of head and neck irradiation: correlation between clinical manifestations and laboratory data.

    PubMed

    Kuten, A; Ben-Aryeh, H; Berdicevsky, I; Ore, L; Szargel, R; Gutman, D; Robinson, E

    1986-03-01

    Salivary flow rate and composition, oral microflora and clinical manifestations of radiation damage were studied in 32 patients treated with external irradiation to head and neck areas. Several parameters were investigated: field arrangement, amount of salivary glands irradiated, clinical manifestations such as dryness of the mouth, taste impairment, dysphagia, salivary secretion and composition, and oral yeast flora. The salivary glands have a greater sensitivity to radiation damage than the gustatory tissues. The decrease in salivary secretion is accompanied by a rise in salivary sodium concentration, and in oral yeast flora. The clinical symptomatology was correlated with the amount of salivary glands irradiated. We found that most of the parotids have to be outside of the treated volume, when the rest of the major salivary glands are irradiated, to prevent severe dryness phenomena. PMID:3957738

  1. NCI Workshop Report: Clinical and Computational Requirements for Correlating Imaging Phenotypes with Genomics Signatures

    PubMed Central

    Colen, Rivka; Foster, Ian; Gatenby, Robert; Giger, Mary Ellen; Gillies, Robert; Gutman, David; Heller, Matthew; Jain, Rajan; Madabhushi, Anant; Madhavan, Subha; Napel, Sandy; Rao, Arvind; Saltz, Joel; Tatum, James; Verhaak, Roeland; Whitman, Gary

    2014-01-01

    The National Cancer Institute (NCI) Cancer Imaging Program organized two related workshops on June 26–27, 2013, entitled “Correlating Imaging Phenotypes with Genomics Signatures Research” and “Scalable Computational Resources as Required for Imaging-Genomics Decision Support Systems.” The first workshop focused on clinical and scientific requirements, exploring our knowledge of phenotypic characteristics of cancer biological properties to determine whether the field is sufficiently advanced to correlate with imaging phenotypes that underpin genomics and clinical outcomes, and exploring new scientific methods to extract phenotypic features from medical images and relate them to genomics analyses. The second workshop focused on computational methods that explore informatics and computational requirements to extract phenotypic features from medical images and relate them to genomics analyses and improve the accessibility and speed of dissemination of existing NIH resources. These workshops linked clinical and scientific requirements of currently known phenotypic and genotypic cancer biology characteristics with imaging phenotypes that underpin genomics and clinical outcomes. The group generated a set of recommendations to NCI leadership and the research community that encourage and support development of the emerging radiogenomics research field to address short-and longer-term goals in cancer research. PMID:25389451

  2. NCI Workshop Report: Clinical and Computational Requirements for Correlating Imaging Phenotypes with Genomics Signatures.

    PubMed

    Colen, Rivka; Foster, Ian; Gatenby, Robert; Giger, Mary Ellen; Gillies, Robert; Gutman, David; Heller, Matthew; Jain, Rajan; Madabhushi, Anant; Madhavan, Subha; Napel, Sandy; Rao, Arvind; Saltz, Joel; Tatum, James; Verhaak, Roeland; Whitman, Gary

    2014-10-01

    The National Cancer Institute (NCI) Cancer Imaging Program organized two related workshops on June 26-27, 2013, entitled "Correlating Imaging Phenotypes with Genomics Signatures Research" and "Scalable Computational Resources as Required for Imaging-Genomics Decision Support Systems." The first workshop focused on clinical and scientific requirements, exploring our knowledge of phenotypic characteristics of cancer biological properties to determine whether the field is sufficiently advanced to correlate with imaging phenotypes that underpin genomics and clinical outcomes, and exploring new scientific methods to extract phenotypic features from medical images and relate them to genomics analyses. The second workshop focused on computational methods that explore informatics and computational requirements to extract phenotypic features from medical images and relate them to genomics analyses and improve the accessibility and speed of dissemination of existing NIH resources. These workshops linked clinical and scientific requirements of currently known phenotypic and genotypic cancer biology characteristics with imaging phenotypes that underpin genomics and clinical outcomes. The group generated a set of recommendations to NCI leadership and the research community that encourage and support development of the emerging radiogenomics research field to address short-and longer-term goals in cancer research. PMID:25389451

  3. question_1413867548 — Provocative Questions

    Cancer.gov

    PQ-1 Large amount of genomic data have been generated in last decade or so for various cancers. There are drugs and clinical trials data as well. Also, clinical data of patients are available in electronic medical record (EMR). Can we normalize and combine all these data to create a knowledge-base?

  4. question_1410159378 — Provocative Questions

    Cancer.gov

    Looking at cell to cell differences within a tumor bed, contributed by either DNA mutations, epigenetic or post-translational modifications (PTM) or miRNA mediated control switches or even a combination of all these, the question rise how to best design a personalized drug trial?

  5. question_1296796037 — Provocative Questions

    Cancer.gov

    If this important question is answered we would be able to develop a highly tailored therapeutic approach for cancers. Actually, inflammatory type of the anti-tumor immune response such as IFN-g can also induce initial tumor inhibition but eventual tumor escape and progression.

  6. question_1411473029 — Provocative Questions

    Cancer.gov

    Gemcitabine is a widely used drug for pancreatic cancer therapy, but due to poor prognosis this drug is now in question. Cells resistance to gemcitabine activates EMT in the background, but the drug itself is a potential replication blocker and activates apoptosis, then why gemcitabine induced apoptosis activates a kind of fleeting mechanism (EMT) to get protection from apoptotic threat?

  7. Clinical, radiological and molecular diagnosis correlation in serum samples from patients with osteoarticular tuberculosis

    PubMed Central

    García-Elorriaga, Guadalupe; Martínez-Elizondo, Olga; del Rey-Pineda, Guillermo; González-Bonilla, César

    2014-01-01

    Objective To assess the role of polymerase chain reaction (PCR) in serum samples, in the diagnosis of osteoarticular tuberculosis (OTB) in a setting where only clinical and imaging diagnoses determine the treatment. Methods A total of 44 consecutive serum specimens were collected from clinically suspected OTB patients, based on clinical and radiological [X-ray or magnetic resonance imaging/computed tomography] features. They were screened by in-house nested PCR. In addition, a few specimens were examined by Gram stain, acid-fast bacilli stain, histopathology and routine bacterial culture. A total of 39 specimens were collected from patients suffering from other bone diseases of nontuberculous origin and included as negative controls. Results Of the 44 clinically suspected OTB patients, in-house nested PCR was positive in 40 (91%) cases; PCR was negative in 38 (97%) negative controls. Sensitivity and specificity of our in-house nested PCR was 90.9% and 97.4%, respectively. The PCR report was available within 48 h. It was possible to standardize serum PCR technique and in positive cases, a good correlation was observed in terms of an adequate treatment response. Conclusions Nested PCR in serum samples is a rapid, highly sensitive and specific modality for OTB detection. PCR should be performed in addition to clinical evaluation, imaging studies, acid-fast bacilli staining, culture and histopathology diagnosis, if possible. PMID:25183281

  8. Prevalence and Clinical Correlates of Insomnia in Depressive Disorders: The CRESCEND Study

    PubMed Central

    Park, Seon-Cheol; Kim, Jae-Min; Jun, Tae-Youn; Lee, Min-Soo; Kim, Jung-Bum; Jeong, Seung-Hee

    2013-01-01

    Objective To investigate the prevalence, clinical manifestations, and clinical correlates of insomnia in a large cohort of Korean patients with depressive disorders. Methods We recruited 944 patients with depressive disorders from the Clinical Research Center for Depression of South Korea (CRESCEND) study. Psychometric scales were used to assess depression (HAMD), anxiety (HAMA), psychotic symptoms (BPRS), global severity (CGI-S), and functioning (SOFAS). Insomnia levels were determined by adding the scores for all items on the HAMD insomnia subscale. The clinical characteristics of the patients with 'low insomnia' (summed score ?3 on the HAMD subscale) and 'high insomnia' (score ?4) were compared using statistical analyses. A logistic regression model was constructed to identify factors associated with 'high insomnia' status. Results Symptoms of insomnia were present in 93% of patients, while simultaneous early, middle, and late insomnia affected 64.1%. The high insomnia patients were characterized by significantly greater age, higher symptom levels (including core, gastrointestinal somatic and anxiety symptoms, and suicidal ideation), higher global severity and incidence of physical disorders, and greater insight. Explanatory factors of 'high insomnia' status were older age, higher gastrointestinal somatic and anxiety symptom levels, higher global severity, and greater insight. Conclusion In clinical psychiatry, insomnia has been significantly underdiagnosed and undertreated. It affects most patients with depressive disorders, and is indicative of the global severity of depression. Active efforts to diagnose and treat insomnia in patients with depressive disorders should be strongly encouraged. Further research is needed to improve the diagnosis and treatment of insomnia in depressive patients. PMID:24474986

  9. Frequencies of circulating MDSC correlate with clinical outcome of melanoma patients treated with ipilimumab.

    PubMed

    Meyer, Christiane; Cagnon, Laurène; Costa-Nunes, Carla M; Baumgaertner, Petra; Montandon, Nicole; Leyvraz, Loredana; Michielin, Olivier; Romano, Emanuela; Speiser, Daniel E

    2014-03-01

    Metastatic melanoma has a poor prognosis with high resistance to chemotherapy and radiation. Recently, the anti-CTLA-4 antibody ipilimumab has demonstrated clinical efficacy, being the first agent to significantly prolong the overall survival of inoperable stage III/IV melanoma patients. A major aim of patient immune monitoring is the identification of biomarkers that predict clinical outcome. We studied circulating myeloid-derived suppressor cells (MDSC) in ipilimumab-treated patients to detect alterations in the myeloid cell compartment and possible correlations with clinical outcome. Lin(-) CD14(+) HLA-DR(-) monocytic MDSC were enriched in peripheral blood of melanoma patients compared to healthy donors (HD). Tumor resection did not significantly alter MDSC frequencies. During ipilimumab treatment, MDSC frequencies did not change significantly compared to baseline levels. We observed high inter-patient differences. MDSC frequencies in ipilimumab-treated patients were independent of baseline serum lactate dehydrogenase levels but tended to increase in patients with severe metastatic disease (M1c) compared to patients with metastases in skin or lymph nodes only (M1a), who had frequencies comparable to HD. Interestingly, clinical responders to ipilimumab therapy showed significantly less lin(-) CD14(+) HLA-DR(-) cells as compared to non-responders. The data suggest that the frequency of monocytic MDSC may be used as predictive marker of response, as low frequencies identify patients more likely benefitting from ipilimumab treatment. Prospective clinical trials assessing MDSC frequencies as potential biomarkers are warranted to validate these observations. PMID:24357148

  10. Welcome to Provocative Questions: The Unanswered Questions in Cancer Research — Provocative Questions

    Cancer.gov

    The provocative questions initiative has assembled a list of 20 important questions from the research community to stimulate the NCI's research communities to use laboratory, clinical and population sciences in especially effective and imaginative ways to answer the questions.

  11. Wear of a dental composite in an artificial oral environment: A clinical correlation.

    PubMed

    DeLong, Ralph; Pintado, Maria R; Douglas, William H; Fok, Alex S; Wilder, Aldridge D; Swift, Edward J; Bayne, Stephen C

    2012-11-01

    The study objective was to correlate wear between an in vitro method for simulating wear and in vivo wear of a posterior dental composite. Ten subjects (12 restorations) were selected from a five-year clinical study (University of North Carolina, School of Dentistry) that assessed wear of SureFil composite (Caulk, Dentsply). Subject casts were digitized and changes in volume and mean depth with time were calculated from the 3D digital models for contact and contact-free wear. SureFil composite disks were mounted in the University of Minnesota's Artificial Oral Environment, opposed by natural enamel, subjected to mandibular-like movements for 150 K, 300 K, 600 K, 1.2 M, and 1.5 M cycles, and loaded with peak forces of 13 N (n = 7) or 30 N (n = 3). Wear rates were calculated as the slope of the linear regressions fitting the wear data. Data were analyzed using one-way ANOVAs and post hoc t-tests where appropriate (p = 0.05). Clinical restorations included contact wear on seven restorations and contact-free wear on all restorations. Contact-free wear was less than contact wear (p < 0.01). SureFil clinical wear rates were 0.012 mm/year (mean depth) and 0.023 mm(3)/year (volume). Clinical restorations expanded slightly during the first year. Using a conversion rate of one year equals 3 × 10(5) cycles, there were no significant differences between the clinical and simulated data except depths at Year 5 and 13 N volume at Year 4. The 30 N simulation reproduced the clinical data if contact-free wear was taken into account. Good agreement between simulated and clinical wear implies that in vitro simulation can screen new composite formulations. PMID:22997090

  12. Mobilization of circulating endothelial progenitor cells correlates with the clinical course of hantavirus disease.

    PubMed

    Krautkrämer, Ellen; Grouls, Stephan; Hettwer, David; Rafat, Neysan; Tönshoff, Burkhard; Zeier, Martin

    2014-01-01

    Infections with hemorrhagic fever viruses are characterized by increased permeability leading to capillary leakage. Hantavirus infection is associated with endothelial dysfunction, and the clinical course is related to the degree of vascular injury. Circulating endothelial progenitor cells (cEPCs) play a pivotal role in the repair of the damaged endothelium. Therefore, we analyzed the number of cEPCs and their mobilizing growth factors in patients suffering from hantavirus disease induced by infection with Puumala virus. The numbers of EPCs of 36 hantavirus-infected patients and age- and gender-matched healthy controls were analyzed by flow cytometry. Concentrations of cEPC-mobilizing growth factors in plasma were determined by enzyme-linked immunosorbent assay. Laboratory parameters were correlated with the number of cEPCs. In patients infected with hantavirus, the number of cEPCs was significantly higher than that in healthy controls. Levels of mobilizing cytokines were upregulated in patients, and the mobilization of cEPCs is paralleled with the normalization of clinical parameters. Moreover, higher levels of cEPCs correlated with higher serum albumin levels and platelet concentrations. Our data indicate that cEPCs may play a role in the repair of hantavirus-induced endothelial damage, thereby influencing the clinical course and the severity of symptoms. PMID:24155401

  13. Mobilization of Circulating Endothelial Progenitor Cells Correlates with the Clinical Course of Hantavirus Disease

    PubMed Central

    Grouls, Stephan; Hettwer, David; Rafat, Neysan; Tönshoff, Burkhard; Zeier, Martin

    2014-01-01

    Infections with hemorrhagic fever viruses are characterized by increased permeability leading to capillary leakage. Hantavirus infection is associated with endothelial dysfunction, and the clinical course is related to the degree of vascular injury. Circulating endothelial progenitor cells (cEPCs) play a pivotal role in the repair of the damaged endothelium. Therefore, we analyzed the number of cEPCs and their mobilizing growth factors in patients suffering from hantavirus disease induced by infection with Puumala virus. The numbers of EPCs of 36 hantavirus-infected patients and age- and gender-matched healthy controls were analyzed by flow cytometry. Concentrations of cEPC-mobilizing growth factors in plasma were determined by enzyme-linked immunosorbent assay. Laboratory parameters were correlated with the number of cEPCs. In patients infected with hantavirus, the number of cEPCs was significantly higher than that in healthy controls. Levels of mobilizing cytokines were upregulated in patients, and the mobilization of cEPCs is paralleled with the normalization of clinical parameters. Moreover, higher levels of cEPCs correlated with higher serum albumin levels and platelet concentrations. Our data indicate that cEPCs may play a role in the repair of hantavirus-induced endothelial damage, thereby influencing the clinical course and the severity of symptoms. PMID:24155401

  14. Improving the clinical correlation of multiple sclerosis black hole volume change by paired-scan analysis.

    PubMed

    Tam, Roger C; Traboulsee, Anthony; Riddehough, Andrew; Li, David K B

    2012-01-01

    The change in T 1-hypointense lesion ("black hole") volume is an important marker of pathological progression in multiple sclerosis (MS). Black hole boundaries often have low contrast and are difficult to determine accurately and most (semi-)automated segmentation methods first compute the T 2-hyperintense lesions, which are a superset of the black holes and are typically more distinct, to form a search space for the T 1w lesions. Two main potential sources of measurement noise in longitudinal black hole volume computation are partial volume and variability in the T 2w lesion segmentation. A paired analysis approach is proposed herein that uses registration to equalize partial volume and lesion mask processing to combine T 2w lesion segmentations across time. The scans of 247 MS patients are used to compare a selected black hole computation method with an enhanced version incorporating paired analysis, using rank correlation to a clinical variable (MS functional composite) as the primary outcome measure. The comparison is done at nine different levels of intensity as a previous study suggests that darker black holes may yield stronger correlations. The results demonstrate that paired analysis can strongly improve longitudinal correlation (from -0.148 to -0.303 in this sample) and may produce segmentations that are more sensitive to clinically relevant changes. PMID:24179734

  15. question_1410236555 — Provocative Questions

    Cancer.gov

    This is a great question. Gene-based targeting has contributed significantly to decrease mortality. Despite the unexplored black box of molecular mechanisms, these drugs were highly effective as first line of therapy. However over time, a percentage of patients were either non-responders or developed resistance. Our deep knowledge of molecular mechanisms has helped redesign some of the drugs, or established diagnostic tests to stratify patients that would benefit from such drugs.

  16. question_1332002134 — Provocative Questions

    Cancer.gov

    Sequencing of natural human tumors is teaching us invaluable lessons. It is becoming clear that the new dogmas created in the post genome era are being questioned. The previously suspected genetic heterogeneity of tumors is now proven on the sequence level. The extreme genetic heterogeneity of individual tumors and the existence of multiple tumors (not metastases) pose fundamental doubt on the prevailing dogma of targeted drug(s) and personalized treatments.

  17. [CT in normal pressure hydrocephalus--correlation between CT and clinical response to shunting (author's transl)].

    PubMed

    Fujita, K; Nogaki, H; Noda, M; Kusunoki, T; Tamaki, N; Matsumoto, S

    1981-02-01

    CT scans were obtained on 33 patients (age 73y. to 31y.) with the diagnosis of normal pressure hydrocephalus. In each case, the diagnosis was made on the basis of the symptoms, CT and cisternographic findings. Underlying diseases of normal pressure hydrocephalus are ruptured aneurysms (21 cases), arteriovenous malformations (2 cases), head trauma (1 case), cerebrovascular accidents (1 case) and idiopathy (8 cases). Sixteen of 33 patients showed marked improvement, five, moderate or minimal improvement, and twelve, no change. The results were compared with CT findings and clinical response to shunting. CT findings were classified into five types, bases on the degree of periventricular hypodensity (P.V.H.), the extent of brain damage by underlying diseases, and the degree of cortical atrophy. In 17 cases of type (I), CT shows the presence of P.V.H. with or without minimal frontal lobe damage and no cortical atrophy. The good surgical improvements were achieved in all cases of type (I) by shunting. In 4 cases of type (II), CT shows the presence of P.V.H. and severe brain damage without cortical atrophy. The fair clinical improvements were achieved in 2 cases (50%) by shunting. In one case of type (III), CT shows the absence of P.V.H. without brain damage nor cortical atrophy. No clinical improvement was obtained by shunting in this type. In 9 cases of type (IV) with mild cortical atrophy, the fair clinical improvement was achieved in two cases (22%) and no improvement in 7 cases. In 2 cases of type (V) with moderate or marked cortical atrophy, no clinical improvement was obtained by shunting. In conclusion, it appeared from the present study that there was a good correlation between the result of shunting and the type of CT, and clinical response to shunting operation might be predicted by classification of CT findings. PMID:7242797

  18. High level of chromosomal aberration in ovarian cancer genome correlates with poor clinical outcome

    PubMed Central

    Cope, Leslie; Wu, Ren-Chin; Shih, Ie-Ming; Wang, Tian-Li

    2015-01-01

    Objectives Structural aberration in chromosomes characterizes almost all human solid cancers and analysis of those alterations may reveal the history of chromosomal instability. However, the clinical significance of massive chromosomal abnormality in ovarian high-grade serous carcinoma (HGSC) remains elusive. In this study, we addressed this issue by analyzing the genomic profiles in 455 ovarian HGSCs available from The Cancer Genome Atlas (TCGA). Methods DNA copy number, mRNA expression, and clinical information were downloaded from the TCGA data portal. A chromosomal disruption index (CDI) was developed to summarize the extent of copy number aberrations across the entire genome. A Cox regression model was applied to identify factors associated with poor prognosis. Genes whose expression was associated with CDI were identified by a 2-stage multivariate linear regression and were used to find enriched pathways by Ingenuity Pathway Analysis. Results Multivariate survival analysis showed that a higher CDI was significantly associated with a worse overall survival in patients. Interestingly, the pattern of DNA copy number alterations across all the chromosomes was similar between tumors with high and low CDI, suggesting they did not arise from different mechanisms. We also observed that expression of several genes was highly correlated with the CDI, even after adjusting for local copy number variation. We found that molecular pathways involving DNA damage response and mitosis were significantly enriched in these CDI-correlated genes. Conclusion Our results provide a new insight into the role of chromosomal rearrangement in the development of HGSC and the promise of applying CDI in risk-stratifying HGSC patients, perhaps for different clinical managements. The genes whose expression is correlated with CDI are worthy of further study to elucidate the mechanism of chromosomal instability in HGSC. PMID:23200914

  19. [Correlation 111In-labeled leukocyte scintigraphy with clinical and laboratory findings].

    PubMed

    Uchida, Y; Uno, K; Minoshima, S; Kitakata, Y; Arimizu, N

    1993-05-01

    This study was evaluated relationship 111In-labeled leukocyte scintigraphy and clinical information and laboratory findings in twenty-four patients with bone infection and thirty-five patients with abdominal infection. Fifty-nine scintigrams were retrospectively reviewed and classified into positive or negative results. As the laboratory findings, C-reactive protein (CRP) level, erythrocyte sedimentation rate (ESR) at sixty minutes, and peripheral blood leukocyte counts (WBCC) were evaluated. Clinical information such as presence of fever and administration of antibiotics was also compared. No significant relationship between the scintigraphic results and clinical as well as laboratory findings was observed in bone infection patients. CRP levels in positive scintigraphic patients were significantly higher than those in negative scintigraphic patients in the abdominal infection group, otherwise the other indices were not correlated with the scintigraphic results. A few patients with slightly increased CRP (mostly chronic cases) did not show positive scintigrams, suggesting an increased false negative rate of leukocyte scintigraphy in such circumstances. These results suggest that it is inappropriate to determine the application of leukocyte scintigraphy depending on clinical as well as laboratory findings, and leukocyte scintigraphy would yield additional information different from other indices when evaluating inflammatory foci. PMID:8336408

  20. Molecular Subtypes of Uterine Leiomyosarcoma and Correlation with Clinical Outcome12

    PubMed Central

    Barlin, Joyce N.; Zhou, Qin C.; Leitao, Mario M.; Bisogna, Maria; Olvera, Narciso; Shih, Karin K.; Jacobsen, Anders; Schultz, Nikolaus; Tap, William D.; Hensley, Martee L.; Schwartz, Gary K.; Boyd, Jeff; Qin, Li-Xuan; Levine, Douglas A.

    2015-01-01

    The molecular etiology of uterine leiomyosarcoma (ULMS) is poorly understood, which accounts for the wide disparity in outcomes among women with this disease. We examined and compared the molecular profiles of ULMS and normal myometrium (NL) to identify clinically relevant molecular subtypes. Discovery cases included 29 NL and 23 ULMS specimens. RNA was hybridized to Affymetrix U133A 2.0 transcription microarrays. Differentially expressed genes and pathways were identified using standard methods. Fourteen NL and 44 ULMS independent archival samples were used for external validation. Molecular subgroups were correlated with clinical outcome. Pathway analyses of differentially expressed genes between ULMS and NL samples identified overrepresentation of cell cycle regulation, DNA repair, and genomic integrity. External validation confirmed differential expression in 31 genes (P < 4.4 × 10? 4, Bonferroni corrected), with 84% of the overexpressed genes, including CDC7, CDC20, GTSE1, CCNA2, CCNB1, and CCNB2, participating in cell cycle regulation. Unsupervised clustering of ULMS identified two clades that were reproducibly associated with progression-free (median, 4.0 vs 26.0 months; P = .02; HR, 0.33) and overall (median, 18.2 vs 77.2 months; P = .04; HR, 0.33) survival. Cell cycle genes play a key role in ULMS sarcomagenesis, providing opportunities for therapeutic targeting. Reproducible molecular subtypes associated with clinical outcome may permit individualized adjuvant treatment after clinical trial validation. PMID:25748237

  1. Cutting a Long Story Short? The Clinical Relevance of Asking Parents, Nurses, and Young Children Themselves to Identify Children's Mental Health Problems by One or Two Questions

    PubMed Central

    Joukamaa, Matti; Tamminen, Tuula

    2014-01-01

    Background and Aims. Assessing young children's mental health is a crucial and challenging task. The aim of the study was to evaluate the clinical relevance of asking parents, nurses, and young children themselves to identify children's mental health problems by only one or two questions. Methods. In regular health check-ups of 4- to 9-year-old children (n = 2682), parents and public health nurses assessed by one question whether the child had any emotional or behavioral difficulties. The child completed a self-evaluation enquiry on his/her emotional well-being. A stratified proportion of the participating parents were invited to a diagnostic interview. Results. Sensitivities were fairly good for the parents' (68%), nurses' (65%), and their combined (79%) one-question screens. Difficulties identified by parents and nurses were major risks (OR 10–14) for any child psychiatric disorders (P < 0.001). The child's self-evaluation was related to 2-fold to 3-fold risks (P < 0.05) for any psychiatric diagnosis, for any emotional diagnosis, and for negative situational factors. Conclusion. The one-question screen for parents and public health nurses together quite adequately identified the young children with mental health problems. The child's self-evaluation provided relevant and complementary information on his/her mental health and especially emotional problems. PMID:25614880

  2. Progression of autoimmune inner ear disease to labyrinthitis ossificans: Clinical and radiologic correlation.

    PubMed

    Khoo, Jenn Nee; Tan, Tiong Yong

    2015-03-01

    We report the case of a 42-year-old man who presented with fluctuating bilateral sensorineural hearing loss that subsequently progressed to a complete hearing loss, and we describe the correlation between the clinical and radiologic features of this case. To the best of our knowledge, this is the first report to demonstrate imaging evidence of progression from autoimmune inner ear disease to labyrinthitis ossificans. This is also the first reported case of a reversal of a loss of labyrinthine CISS (constructive interference in a steady state) signal, suggesting that T2-weighted hyposignal may be attributable to an alteration in labyrinthine fluid content and not to fibrosis only. PMID:25738715

  3. Clinical correlates of decreased anteroposterior metabolic gradients in positron emission tomography (PET) of schizophrenic patients

    SciTech Connect

    DeLisi, L.E.; Buchsbaum, M.S.; Holcomb, H.H.; Dowling-Zimmerman, S.; Pickar, D.; Boronow, J.; Morihisa, J.M.; van Kammen, D.P.; Carpenter, W.; Kessler, R.

    1985-01-01

    The finding in schizophrenic patients of a reversal of the normal frontal to posterior pattern of brain metabolic activity with positron emission tomography (PET) is of interest, but its relevance to psychopathology is unknown. Using PET, the authors studied 21 patients with chronic schizophrenia and 21 age- and sex-matched control subjects. Although eight of the 21 patients and only one of the control subjects showed a relatively lower anteroposterior metabolic gradient, no clinical correlates of this finding were noted. In addition, cerebral atrophy, as determined by CAT scan, was not associated with this aberrant metabolic pattern.

  4. Clinical spectrum of SIX3-associated mutations in holoprosencephaly: correlation between genotype, phenotype and function

    PubMed Central

    Lacbawan, F; Solomon, B D; Roessler, E; El-Jaick, K; Domené, S; Vélez, J I; Zhou, N; Hadley, D; Balog, J Z; Long, R; Fryer, A; Smith, W; Omar, S; McLean, S D; Clarkson, K; Lichty, A; Clegg, N J; Delgado, M R; Levey, E; Stashinko, E; Potocki, L; VanAllen, M I; Clayton-Smith, J; Donnai, D; Bianchi, D W; Juliusson, P B; Njølstad, P R; Brunner, H G; Carey, J C; Hehr, U; Müsebeck, J; Wieacker, P F; Postra, A; Hennekam, R C M; van den Boogaard, M-J H; van Haeringen, A; Paulussen, A; Herbergs, J; Schrander-Stumpel, C T R M; Janecke, A R; Chitayat, D; Hahn, J; McDonald-McGinn, D M; Zackai, E H; Dobyns, W B; Muenke, M

    2012-01-01

    Background Holoprosencephaly (HPE) is the most common structural malformation of the human forebrain. There are several important HPE mutational target genes, including the transcription factor SIX3, which encodes an early regulator of Shh, Wnt, Bmp and Nodal signalling expressed in the developing forebrain and eyes of all vertebrates. Objective To characterise genetic and clinical findings in patients with SIX3 mutations. Methods Patients with HPE and their family members were tested for mutations in HPE-associated genes and the genetic and clinical findings, including those for additional cases found in the literature, were analysed. The results were correlated with a mutation-specific functional assay in zebrafish. Results In a cohort of patients (n = 800) with HPE, SIX3 mutations were found in 4.7% of probands and additional cases were found through testing of relatives. In total, 138 cases of HPE were identified, 59 of whom had not previously been clinically presented. Mutations in SIX3 result in more severe HPE than in other cases of non-chromosomal, non-syndromic HPE. An over-representation of severe HPE was found in patients whose mutations confer greater loss of function, as measured by the functional zebrafish assay. The gender ratio in this combined set of patients was 1.5:1 (F:M) and maternal inheritance was almost twice as common as paternal. About 14% of SIX3 mutations in probands occur de novo. There is a wide intrafamilial clinical range of features and classical penetrance is estimated to be at least 62%. Conclusions Our data suggest that SIX3 mutations result in relatively severe HPE and that there is a genotype–phenotype correlation, as shown by functional studies using animal models. PMID:19346217

  5. Increased cerebrospinal fluid concentrations of asymmetric dimethylarginine correlate with adverse clinical outcome in subarachnoid hemorrhage patients.

    PubMed

    Li, Hua; Wu, Wei; Liu, Ming; Zhang, Xin; Zhang, Qing-Rong; Ni, Li; Hang, Chun-Hua

    2014-08-01

    Elevated cerebrospinal fluid (CSF) concentrations of asymmetric dimethylarginine (ADMA), an endogenous inhibitor of nitric oxide synthase, have been found in patients with subarachnoid hemorrhage (SAH). In addition, CSF levels of ADMA are associated with the severity of vasospasm. However, the relation between CSF ADMA levels and the clinical outcome of SAH patients is still unclear. We hypothesized that elevated ADMA levels in CSF might be related to the clinical outcome of SAH patients. CSF ADMA levels were measured in 20 SAH patients at days 3-5, days 7-9 and days 12-14 after SAH onset using high-performance liquid chromatography. Cerebral vasospasm was assessed by transcranial Doppler ultra sonography. Clinical outcome at 2year follow-up was evaluated using the Karnofsky Performance Status scale (KPS). CSF ADMA concentrations in all SAH patients were significantly increased at days 3-5 (p=0.002) after SAH, peaked on days 7-9 (p<0.001) and remained elevated until days 12-14 (p<0.001). In subgroup analysis, significant increases of CSF ADMA levels were found in patients both with and without vasospasm. The KPS scores significantly correlated with CSF levels of ADMA at days 7-9 (correlation coefficient=-0.55, p=0.012; 95% confidence interval -0.80 to -0.14). Binary logistic regression analysis indicated that higher ADMA level at days 7-9 predicted a poor clinical outcome at 2year follow-up after SAH (odds ratio=1.722, p=0.039, 95% confidence interval 1.029 to 2.882). ADMA may be directly involved in the pathological process and future adverse prognosis of SAH. PMID:24814854

  6. Spinocerebellar Ataxia Type 7: Clinical Course, Phenotype-Genotype Correlations, and Neuropathology

    PubMed Central

    Horton, Laura C.; Frosch, Matthew P.; Vangel, Mark G.; Weigel-DiFranco, Carol; Berson, Eliot L.; Schmahmann, Jeremy D.

    2012-01-01

    INTRODUCTION Spinocerebellar ataxia type 7 is a neurodegenerative polyglutamine disease characterized by ataxia and retinal degeneration. The longitudinal course is unknown, and relationships between repeat expansion, clinical manifestations, and neuropathology remain uncertain. METHODS We followed 16 affected individuals of a 61-member kindred over 27 years with electroretinograms, neurological examinations including the Brief Ataxia Rating Scale, neuroimaging in 5, and autopsy in 4 cases. RESULTS We identified 4 stages of the illness. Stage 0; gene positive but phenotypically silent. Stage 1; no symptoms, but hyperreflexia and/or abnormal electroretinograms. Stage 2; symptoms and signs progress modestly. Stage 3; rapid clinical progression. CAG repeat length correlated inversely with age of onset of visual or motor signs (r=-0.74, p=0.002). Stage 3 rate of progression did not differ between cases (p=0.18). Electroretinograms correlated with Brief Ataxia Rating Scale score and were a biomarker of disease onset and progression. All symptomatic patients developed gait ataxia, extremity dysmetria, dysarthria, dysrhythmia, and oculomotor abnormalities. Funduscopy revealed pale optic discs and pigmentary disturbances. Visual acuity declined to blindness in those with longer CAG expansions. Hyperreflexia was present from Stage 1 onwards. Restless legs syndrome and sensory impairment were common. Neuropathological hallmarks were neuronal loss in cerebellar cortex, deep cerebellar nuclei, inferior olive, and anterior horns of the spinal cord, and axonal loss in spinocerebellar tracts, dorsal nerve roots and posterior columns. Retinal pathology included photoreceptor degeneration and disruption of retinal pigment epithelium. DISCUSSION Spinocerebellar ataxia type 7 evolves through 4 clinical stages; neuropathological findings underlie the clinical presentation; electroretinograms are a potential biomarker of disease progression. PMID:22915085

  7. Preclinical and Clinical In Vitro In Vivo Correlation of an hGH Dextran Microsphere Formulation

    PubMed Central

    de Vrueh, R.; Gresnigt, M. G.; Hoogerbrugge, C. M.; van Buul-Offers, S. C.; de Leede, L. G. J.; Sterkman, L. G. W.; Crommelin, D. J. A.; Hennink, W. E.; Verrijk, R.

    2007-01-01

    Purpose To investigate the in vitro in vivo correlation of a sustained release formulation for human growth hormone (hGH) based on hydroxyethyl methacrylated dextran (dex-HEMA) microspheres in Pit-1 deficient Snell dwarf mice and in healthy human volunteers. Materials and Methods A hGH-loaded microsphere formulation was developed and tested in Snell dwarf mice (pharmacodynamic study) and in healthy human volunteers (pharmacokinetic study). Results Single subcutaneous administration of the microspheres in mice resulted in a good correlation between hGH released in vitro and in vivo effects for the hGH-loaded microsphere formulation similar to daily injected hGH indicating a retained bioactivity. Testing the microspheres in healthy volunteers showed an increase (over 7–8 days) in hGH serum concentrations (peak concentrations: 1–2.5 ng/ml). A good in vitro in vivo correlation was obtained between the measured and calculated (from in vitro release data) hGH serum concentrations. Moreover, an increased serum concentration of biomarkers (insulin-like growth factor-I (IGF-I), IGF binding protein-3 (IGFBP-3) was found again indicating that bioactive hGH was released from the microspheres. Conclusions Good in vitro in vivo correlations were obtained for hGH-loaded dex-HEMA microspheres, which is an important advantage in predicting the effect of the controlled drug delivery product in a clinical situations. PMID:17929148

  8. Correlation between brain volume loss and clinical and MRI outcomes in multiple sclerosis

    PubMed Central

    Radue, Ernst-Wilhelm; Barkhof, Frederik; Sprenger, Till; Häring, Dieter A.; de Vera, Ana; von Rosenstiel, Philipp; Bright, Jeremy R.; Francis, Gordon; Cohen, Jeffrey A.

    2015-01-01

    Objective: We investigated the determinants and clinical correlations of MRI-detected brain volume loss (BVL) among patients with relapsing-remitting multiple sclerosis from the phase 3 trials of fingolimod: FREEDOMS, FREEDOMS II, and TRANSFORMS. Methods: Post hoc analyses were conducted in the intent-to-treat populations from each trial and in a combined dataset of 3,635 patients from the trials and their extensions. The relationship between brain volume changes and demographic, clinical, and MRI parameters was studied in pairwise correlations (Pearson) and in multiple regression models. The relative frequency of confirmed disability progression was evaluated in the combined dataset by strata of concurrent BVL at up to 4 years. Results: Increasing age, disease duration, T2 lesion volume, T1-hypointense lesion volume, and disability were associated with reduced brain volume (p < 0.001, all). The strongest individual baseline predictors of on-study BVL were T2 lesion volume, gadolinium-enhancing lesion count, and T1-hypointense lesion volume (p < 0.01, all). During each study, BVL correlated most strongly with cumulative gadolinium-enhancing lesion count, new/enlarged T2 lesion count (p < 0.001, both), and number of confirmed on-study relapses (p < 0.01). Over 4 years in the combined dataset (mean exposure to study drug, 2.4 years), confirmed disability progression was most frequent in patients with greatest BVL. Conclusions: Rate of BVL in patients during the fingolimod trials correlated with disease severity at baseline and new disease activity on study, and was associated with worsening disability. PMID:25632085

  9. Screening, assessment, and treatment of osteoporosis for the nurse practitioner: Key questions and answers for clinical practice—A Canadian perspective

    PubMed Central

    Rice, Peggy; Mehan, Upender; Hamilton, Celeste; Kim, Sandra

    2014-01-01

    Purpose Using a case-based approach, we review key clinical questions relevant to nurse practitioners (NPs) regarding the screening, assessment, and treatment of patients at risk for osteoporosis and fractures in a Canadian general practice setting. Data sources A case presentation with relevant questions and answers to guide management of a patient. Conclusions Osteoporosis is a common condition in both the aging male and female populations. Screening, diagnosis, and treatment of osteoporosis is lagging behind relative to other chronic disease states. NPs have a unique opportunity to help reduce this care gap by playing an integral role in the identification, risk stratification, and treatment of patients at risk for osteoporosis and fractures. Implications for practice This case highlights the important role an NP can have in screening a patient previously not diagnosed or managed for osteoporosis. Performing a focused history and physical exam of the patient to determine appropriate screening tests and fracture risk will help in guiding treatment decisions. PMID:24911524

  10. Guest Expert Connie Ulrich: Ethics of clinical research participation~three questions for us to discuss | accrualnet.cancer.gov

    Cancer.gov

    Dr. Connie Ulrich, is an Associate Professor of Bioethics and Nursing at the University of Pennsylvania School of Nursing. Connie's research is all about clinical trial participation. I hope you find her insights as useful as we have. Please review her comments below and let us know your thoughts.

  11. question_1408193863 — Provocative Questions

    Cancer.gov

    Epidemiological and experimental evidence has shown the usefulness of fasting or dietary interventions as potential cancer preventive and therapeutic approach. Fasting itself is known to suppress many cancer cells growth and increases chemo-sensitivity. Likewise, ketogenic diets are also known to suppress cancer cells growth. The potential of such kind of approaches has motivated many clinicians and researchers to carry out experimental and clinical studies at different parts of the world.

  12. The Clinical COPD Questionnaire Correlated with BODE Index-A Cross-Sectional Study

    PubMed Central

    Liu, Shih-Feng; Tseng, Ching-Wan; Tu, Mei-Lien; Wang, Chin-Chou; Tseng, Chia-Cheng; Chin, Chien-Hung; Lin, Meng-Chih; Liu, Jien-Wei

    2012-01-01

    The Global initiative for Chronic Obstructive Lung Disease (GOLD) staging has widely used in the stratification of the severity of COPD, while BODE (body mass index, airflow obstruction, dyspnea, and exercise capacity) index was proven superior to FEV1 in predicting mortality, exacerbation and disease severity in patients with COPD. Clinical COPD Questionnaire (CCQ), a questionnaire with ten items categorized into three domains (symptoms, functional state and mental state) was developed to measure health status of COPD patients. However, little is known about the relationship between CCQ score and BODE index. We performed a prospective study with the inclusion of 89 patients who were clinically stable after a 6-week-therapy for COPD symptoms comparing their health status assessed by CCQ, BODE index and GOLD staging. We found that the total CCQ score was correlated with BODE score (P < 0.001) and GOLD staging (P < 0.001); of three CCQ domains, the functional status correlated the most with BODE index (rS = 0.670) and GOLD staging (rS = 0.531), followed by symptoms (rS = 0.482; rS = 0.346, respectively), and mental status (rS = 0.340; rS = 0.236, respectively). Our data suggest that CCQ is a reliable and convenient alternative tool to evaluate the severity of COPD. PMID:22654594

  13. HbF in HbE/?-thalassemia: A clinical and laboratory correlation.

    PubMed

    Lim, Wai Feng; Muniandi, Logeswaran; George, Elizabeth; Sathar, Jameela; Teh, Lai Kuan; Lai, Mei I

    2014-09-22

    Introduction Fetal hemoglobin (HbF) is the predominant hemoglobin in red cells during fetal life. Just after birth, the level of HbF decreases gradually to <1%, and is replaced mainly by adult hemoglobin (HbA) (?97%). However, higher HbF levels could be associated with HbE/?-thalassemia, a complex thalassemia intermedia with a diverse clinical severity ranging from mild-to-severe anemia. This study investigates the correlation of HbF level with the clinical and laboratory data of HbE/?-thalassemia individuals. Methods Peripheral blood samples from 30 HbE/?-thalassemia subjects were subjected to a full blood count, genomic as well as quantitative real-time polymerase chain reaction gene expression studies. Statistical analyses were performed using SPSS17.0. Results HbF levels were influenced by age, mean cell volume, mean cell hemoglobin, HbA, ?-globin, and ?/?-globin expressions. Discussion HbF production is affected by the ?/?-globin chain imbalance due to the lack of ?-globin gene expression as well as inversely correlates to the amount of functional hemoglobin available in the cells. PMID:25243862

  14. Correlation of the NBME Advanced Clinical Examination in EM and the National EM M4 exams

    PubMed Central

    Hiller, Katherine; Miller, Emily S.; Lawson, Luan; Wald, David; Beeson, Michael; Heitz, Corey; Morrissey, Thomas; House, Joseph; Poznanski, Stacey

    2015-01-01

    Introduction Since 2011 two online, validated exams for fourth-year emergency medicine (EM) students have been available (National EM M4 Exams). In 2013 the National Board of Medical Examiners offered the Advanced Clinical Examination in Emergency Medicine (EM-ACE). All of these exams are now in widespread use; however, there are no data on how they correlate. This study evaluated the correlation between the EM-ACE exam and the National EM M4 Exams. Methods From May 2013 to April 2014 the EM-ACE and one version of the EM M4 exam were administered sequentially to fourth-year EM students at five U.S. medical schools. Data collected included institution, gross and scaled scores and version of the EM M4 exam. We performed Pearson’s correlation and random effects linear regression. Results 303 students took the EM-ACE and versions 1 (V1) or 2 (V2) of the EM M4 exams (279 and 24, respectively). The mean percent correct for the exams were as follows: EM-ACE 74.8 (SD-8.83), V1 83.0 (SD-6.41), V2 78.5 (SD-7.70). Pearson’s correlation coefficient for the V1/EM-ACE was 0.51 (0.42 scaled) and for the V2/EM-ACE was 0.59 (0.41 scaled). The coefficient of determination for V1/EM-ACE was 0.72 and for V2/EM-ACE = 0.71 (0.86 and 0.49 for scaled scores). The R-squared values were 0.25 and 0.30 (0.18 and 0.13, scaled), respectively. There was significant cluster effect by institution. Conclusion There was moderate positive correlation of student scores on the EM-ACE exam and the National EM M4 Exams. PMID:25671023

  15. Evaluation of loss of heterozygosity and microsatellite instability in human pterygium: clinical correlations

    PubMed Central

    Detorakis, E; Sourvinos, G; Tsamparlakis, J; Spandidos, D

    1998-01-01

    AIMS—To evaluate the incidence of loss of heterozygosity (LOH) and microsatellite instability (MI) in pterygia and their possible correlation with clinical variables.?METHODS—50 pterygia, blood, and conjunctival specimens were obtained. A personal and family history was recorded for each patient. Amplification of 15 microsatellite markers at regions 17p, 17q, 13q, 9p, and 9q was performed using the polymerase chain reaction. The electrophoretic pattern of DNA from pterygia was compared with the respective pattern from blood and conjunctiva.?RESULTS—LOH incidence was the highest at 9p (48%), followed by 17q (42%). Only three cases displayed MI. LOH incidence at individual markers was positively correlated with recurrence (D9S59, p=0.11 and D9S270, p=0.16), family history of neoplasia (D13S175, p=0.09), altitude of present residence ( D9S112, p=0.1), duration of the existence of pterygium (D9S144, p=0.06), and inversely correlated with age (D9S59, p=0.09). Concerning chromosome arms, LOH was positively correlated with the altitude of present residence (13q and 17p, p=0.03) and duration of the existence of pterygium (13q and 17p, p=0.09).?CONCLUSIONS—LOH is a common event whereas MI is a very uncommon one at the examined markers in pterygium, indicating the presence of putative tumour suppressor genes implicated in the aetiopathogenesis of the disease. The fact that LOH at 9q31-33 was more frequent in recurrent pterygia and also correlated with known risk factors such as young age and high altitude of residence, implies a possible predictive value of this finding for postoperative recurrence.?? Keywords: heterozygosity; microsatellite instability; pterygium PMID:9924343

  16. Correlates of Depressive Symptoms Among Women Seeking Cancer Genetic Counseling and Risk Assessment at a High-Risk Cancer Clinic

    Microsoft Academic Search

    Molly Middlecamp Kodl; Judith W. Lee; Alicia K. Matthews; Shelly A. Cummings; Olufunmilayo I. Olopade

    2006-01-01

    The aims of this study were to (1) assess the level of depression among women seeking cancer genetic counseling and risk assessment and to (2) identify and describe the demographic, health history, and health behavior correlates of clinically significant depression. Participants were 280 women presenting for an intake appointment at a university cancer risk clinic. During intake, participants completed questionnaires

  17. Adjusting head circumference for covariates in autism: clinical correlates of a highly heritable continuous trait

    PubMed Central

    Chaste, Pauline; Klei, Lambertus; Sanders, Stephan J.; Murtha, Michael T.; Hus, Vanessa; Lowe, Jennifer K.; Willsey, A. Jeremy; Moreno-De-Luca, Daniel; Yu, Timothy W.; Fombonne, Eric; Geschwind, Daniel; Grice, Dorothy E.; Ledbetter, David H.; Lord, Catherine; Mane, Shrikant M.; Martin, Christa Lese; Martin, Donna M.; Morrow, Eric M.; Walsh, Christopher A.; Sutcliffe, James S.; State, Matthew W.; Devlin, Bernie; Cook, Edwin H.; Kim, Soo-Jeong

    2013-01-01

    BACKGROUND Brain development follows a different trajectory in children with Autism Spectrum Disorders (ASD) than in typically developing children. A proxy for neurodevelopment could be head circumference (HC), but studies assessing HC and its clinical correlates in ASD have been inconsistent. This study investigates HC and clinical correlates in the Simons Simplex Collection cohort. METHODS We used a mixed linear model to estimate effects of covariates and the deviation from the expected HC given parental HC (genetic deviation). After excluding individuals with incomplete data, 7225 individuals in 1891 families remained for analysis. We examined the relationship between HC/genetic deviation of HC and clinical parameters. RESULTS Gender, age, height, weight, genetic ancestry and ASD status were significant predictors of HC (estimate of the ASD effect=0.2cm). HC was approximately normally distributed in probands and unaffected relatives, with only a few outliers. Genetic deviation of HC was also normally distributed, consistent with a random sampling of parental genes. Whereas larger HC than expected was associated with ASD symptom severity and regression, IQ decreased with the absolute value of the genetic deviation of HC. CONCLUSIONS Measured against expected values derived from covariates of ASD subjects, statistical outliers for HC were uncommon. HC is a strongly heritable trait and population norms for HC would be far more accurate if covariates including genetic ancestry, height and age were taken into account. The association of diminishing IQ with absolute deviation from predicted HC values suggests HC could reflect subtle underlying brain development and warrants further investigation. PMID:23746936

  18. Clinical Correlates of Hwa-Byung and a Proposal for a New Anger Disorder

    PubMed Central

    2008-01-01

    This paper reviewed the studies on hwa-byung (HB), which literally means anger disorder and this is known as the culture-related chronic anger syndrome of Koreans. Based on these studies and a review of the literature on the anger syndromes of other cultures, I have proposed a new anger disorder. The rationale for this proposition is first that the clinical correlates of HB, including the epidemiological data, the etiological factors, the symptoms and the clinical course, are unique and different from those of the depressive disorders, which have been postulated to be similar to HB. Second, the symptoms of HB are characterized by pent-up anger and somatic and behavioral symptoms related to the release and suppression of anger. Third, a group of patients with only HB and who visit psychiatrists for treatment have been identified. Fourth, anger is thought to be the basic target of treatment for HB patients. Last, anger syndromes like HB have been identified, with various names, in other cultures. By reducing the cultural variation of HB and integrating the common clinical correlates of the syndromes related to anger, a new anger disorder for the mood of anger can be conceptualized, like that for other mood disorders for the corresponding pathological moods. The research diagnostic criteria for HB and the new anger disorder are also suggested. I propose that the new anger disorder to be included in the new international classification system as a member of the larger family of mood disorders. International collaborative studies are needed not only to identify such anger disorder in various cultures, but also to explore giving better treatment to these patients based on the bio-psycho-social model of anger disorder. PMID:20046356

  19. Molecular analysis of sarcoidosis lymph nodes for microorganisms: a case–control study with clinical correlates

    PubMed Central

    Robinson, Lary A; Smith, Prudence; SenGupta, Dhruba J; Prentice, Jennifer L; Sandin, Ramon L

    2013-01-01

    Introduction Sarcoidosis is an incurable, chronic granulomatous disease primarily involving the lungs and lymph nodes of unknown aetiology, treated with non-specific anti-inflammatory/immunosuppressive drugs. Persistently symptomatic patients worsen with a disabling, potentially fatal clinical course. To determine a possible infectious cause, we correlated in a case-control study the clinical information with the presence of bacterial DNA in sarcoidosis mediastinal lymph nodes compared with control lymph nodes resected during cancer surgery. Methods We retrospectively studied formalin-fixed, paraffin-embedded, mediastinal lymph nodes from 30 patients with sarcoidosis and 30 control patients with lung cancer. Nucleic acids were extracted from nodes, evaluated by ribosomal RNA PCR for bacterial 16S ribosomal DNA and the results were sequenced and compared with a bacterial sequence library. Clinical information was correlated. Results 11/30 (36.7%) of lymph nodes from patients with sarcoidosis had detectable bacterial DNA, significantly more than control patient lymph nodes (2/30, 6.7%), p=0.00516. At presentation, 19/30 (63.3%) patients with sarcoidosis were symptomatic including all patients with detectable bacterial DNA. Radiographically, there were 18 stage I and 12 stage II patients. All stage II patients were symptomatic and 75% had PCR-detectable bacteria. After a mean follow-up of 52.8±32.8?months, all patients with PCR-detectable bacteria in this series were persistently symptomatic requiring treatment. Discussion 36.6% of patients with sarcoidosis had detectable bacterial DNA on presentation, all of these patients were quite symptomatic and most were radiographically advanced stage II. These findings suggest that bacterial DNA-positive, symptomatic patients have more aggressive sarcoidosis that persists long term and might benefit from antimicrobial treatment directed against this presumed chronic granulomatous infection. PMID:24366580

  20. Cytomorphologic spectrum of Hashimoto's thyroiditis and its clinical correlation: A retrospective study of 52 patients

    PubMed Central

    Chandanwale, Shirish S.; Gore, Charusheela R.; Bamanikar, Sunita A.; Gupta, Nidhi; Gupta, Kanika

    2014-01-01

    Background: Hashimoto's thyroiditis (HT) is an autoimmune disease and it is more prevalent in Asians. The incidence of HT seems to be increasing in the recent times. It is one of the most common cause of hypothyroidism. The purpose of this study is to review the cytomorphologic spectrum of HT and correlate it with clinical findings including thyroid function and antibody profile. Materials and Methods: We retrospectively analyzed the fine-needle aspiration (FNA) features of 52 HT patients. Based on cytomorphologic features patients were categorized into three groups. Clinical findings including thyroid function and thyroid peroxidase (TPO) antibody profile were correlated with cytomorphologic features in all three groups. Results: Majority of the patients were females and in 2nd, 3rd and 4th decades. Diffuse goiter and thyroid hypofunction were the common findings. Significant number of patients had thyroid hyperfunction. Increased lymphocytes on the background and lymphocytic infiltration of thyroid follicular cell clusters in cytology smears were diagnostic of HT. The 32 patients showed elevated titers of TPO antibodies. In the early stages and mild form of the disease, results of thyroid function and anti TPO antibodies are quite variable. Conclusions: HT is a disease of young and middle age and mostly occur in females. Clinical findings alone may not be adequate for definitive diagnosis. FNA is the gold standard for diagnosis. In the presence of abundant colloid, follicular hyperplasia or co-existing neoplasm, careful interpretation of cytology smears should be done. Aspiration from more than one site minimizes the diagnostic pitfalls. PMID:24987440

  1. Radiological progression of hip osteoarthritis: definition, risk factors and correlations with clinical status.

    PubMed Central

    Dougados, M; Gueguen, A; Nguyen, M; Berdah, L; Lequesne, M; Mazieres, B; Vignon, E

    1996-01-01

    OBJECTIVES: To determine a cut off value for changes in radiological joint space width that allowed definition of radiological progression of hip osteoarthritis not related to measurement method errors and, thereafter, to determine factors predictive of radiological progression of hip osteoarthritis and to evaluate the correlations between clinical and radiological parameters. METHODS: A prospective, longitudinal (one year duration), multicentre study was made of patients with osteoarthritis of the hip (American College of Rheumatology criteria). Data on clinical activity (pain, functional impairment), demographic data (age, gender, body mass index), and femoral head migration (superolateral, superomedial, concentric) were collected when the patient entered the study; radiological grade (joint space width in millimetres at the narrowest point using a 0.1 mm graduated magnifying glass, evaluated by a single observer unaware of the chronology of the films) was recorded at the patient's entry to the study and after one year. RESULTS: Analysis of the means of the differences between two analyses performed by a single observer of 30 pairs of radiographs (one performed after an interval of one year) (0.06 (SD 0.23)) suggested that a change of more than 0.56 mm (2 SD) after a one year follow up could define progression of osteoarthritis of the hip. Of the 508 patients recruited, 461 (91%) completed the one year follow up and radiological progression was observed in 102 (22%). The factors predictive of radiological progression that were identified in the multivariate analysis were: radiological joint space width at entry < or = 2 mm, superolateral migration of the femoral head, female gender, Lequesne's functional index > 10, age at entry > 65 years (odds ratios 2.11, 4.25, 2.51, 2.66, 1.90, respectively). The level of clinical parameters (pain, functional impairment) and the amount of symptomatic treatment required (non-steroidal anti-inflammatory drugs and analgesic intake) accounted for 20% (p < 0.0001) of the variability of the changes in radiological joint space width over the one year study period. CONCLUSION: These data suggest that radiological progression of hip osteoarthritis could be defined by a change in joint space width of at least 0.6 mm after a one year follow up period, is correlated with the changes in clinical status of the patients, and is related not only to demographic data (age, gender), but also to some specific characteristics of osteoarthritis (localisation, radiological severity, clinical activity). PMID:8694574

  2. Microbiological Profile of Adenoid Hypertrophy Correlates to Clinical Diagnosis in Children

    PubMed Central

    Szalmás, Anita; Csomor, Péter; Kónya, József; Sziklai, István; Szekanecz, Zoltán; Karosi, Tamás

    2013-01-01

    Objective. Adenoid hypertrophy is a common condition in childhood, which may be associated with recurring acute otitis media (RAOM), otitis media with effusion (OME), and obstructive sleep apnea syndrome (OSAS). These different clinical characteristics have some clinical overlap; however, they might be explained by distinct immunologic and infectious profiles and result in various histopathologic findings of adenoid specimens. Methods. A total of 59 children with adenoid hypertrophy undergoing adenoidectomy were studied. Three series of identical adenoid specimens were processed to hematoxylin-eosin (H.E.) and Gram staining and to respiratory virus specific real-time PCR, respectively. Results. According to the clinical characteristics, patients were recruited into three groups: RAOM (n = 25), OME (n = 19), and OSAS (n = 15). Bacterial biofilms were detected in 21 cases, while at least one of the studied respiratory viruses was detected in 52 specimens. RAOM cases were significantly associated with biofilm existence (n = 20, P < 0.001). In contrast, OME group was characterized by the absence of bacterial biofilm and by normal mucosa. Showing a statistically significant correlation, all OME cases were positive for human bocavirus (HBoV, P < 0.001). Conclusions. Bacterial biofilms might contribute to the damage of respiratory epithelium and recurring acute infections resulting in RAOM. In OME cases persisting respiratory viruses, mainly HBoV, can cause subsequent lymphoid hyperplasia leading to ventilation disorders and impaired immunoreactivity of the middle ear cleft. PMID:24175295

  3. Correlation between SPINK5 gene mutations and clinical manifestations in Netherton syndrome patients.

    PubMed

    Komatsu, Nahoko; Saijoh, Kiyofumi; Jayakumar, Arumugam; Clayman, Gary L; Tohyama, Mikiko; Suga, Yasushi; Mizuno, Yuki; Tsukamoto, Katsuhiko; Taniuchi, Katsushige; Takehara, Kazuhiko; Diamandis, Eleftherios P

    2008-05-01

    Netherton syndrome (NS) is a congenital ichthyosiform dermatosis caused by serine protease inhibitor Kazal-type 5 (SPINK5) mutations. Tissue kallikreins (KLKs) and lymphoepithelial Kazal-type-related inhibitor (LEKTI) (SPINK5 product) may contribute to the balance of serine proteases/inhibitors in skin and influence skin barrier function and desquamation. SPINK5 mutations, causing NS, lead to truncated LEKTI; each NS patient possesses LEKTI of a different length, depending on the location of mutations. This study aims to elucidate genotype/phenotype correlations in Japanese NS patients and to characterize the functions of each LEKTI domain. Since we were unable to demonstrate truncated proteins in tissue from patients with NS, we used recombinant protein to test the hypothesis that the length of LEKTI correlated with protease inhibitory activity. Genotype/phenotype correlations were observed with cutaneous severity, growth retardation, skin infection, stratum corneum (SC) protease activities, and KLK levels in the SC. Predominant inhibition by LEKTI domains against overall SC protease activities was trypsin-like (Phe-Ser-Arg-) activity by LEKTI domains 6-12, plasmin- and trypsin-like (Pro-Phe-Arg-) activities by domains 12-15, chymotrypsin-like activity by all domains, and furin-like activity by none. KLK levels were significantly elevated in the SC and serum of NS patients. These data link LEKTI domain deficiency and clinical manifestations in NS patients and pinpoints to possibilities for targeted therapeutic interventions. PMID:17989726

  4. question_1309956298 — Provocative Questions

    Cancer.gov

    Cell culture, the propagation of cells in artificial environment conducive to growth, has become one of the major tools in life sciences. Human cells grown in laboratory, subjected to various (single or multiple) perturbations, are serving well in elucidating physico-biochemical mechanisms of response in investigations of physiology and biochemistry. In addition, cell strains and cell lines have extensively been used to identify molecular markers of disease, and recent advances in cell culture have facilitated propagating stem cells for clinical and research purposes.

  5. Answering relevant research questions via careful observation of clinical practice: a fresh look at the old way forward.

    PubMed

    Matino, D; Iorio, A

    2014-09-01

    Although many aspects of inhibitor development have been elucidated, the role of switching FVIII product concentrate in the risk of inhibitors development in previously treated patients is still under discussion. To provide their contribution, Aznar et al [9] transparently showed the numerous different brands used over time and the number of patients treated with one or another class of concentrates in their center. This way of inclusively reporting data as generated in routine clinical practice would need to be adopted more broadly among hemophilia treater and scientists. Strength and limitations of the approach are discussed. PMID:25154445

  6. Correlation between fundamental binding forces and clinical prognosis of Staphylococcus aureus infections of medical implants

    SciTech Connect

    Yongsunthon, Ruchirej; Fowler, Vance; Lower, Brian H.; Vellano, Francis P.; Alexander, Emily; Reller, L. Barth; Corey, G. Ralph; Lower, Steven

    2007-02-01

    Implanted medical devices (e.g., prosthetic heart valves, permanent pacemakers) significantly improve the quality of life for many humans. However, a common clinical observation is that such devices become colonized with potentially life-threatening Staphylococcus aureus biofilms, which are difficult to combat with host defenses or antibiotics. This study attempts to draw a correlation between the clinical outcome of patients with implanted cardiac devices and the fundamental binding forces ultimately responsible for the initiation of an S. aureus biofilm in-situ. Atomic force microscopy was used to measure forces between a fibronectin-coated probe (simulating a prosthetic implant) and 15 different strains of S. aureus isolated from either patients with infected cardiac devices (invasive population) or healthy human subjects (control population). The fibronectin-coated probe was repeatedly brought into and out of contact with a bacterium’s surface, “fishing” for a reaction with the cell’s fibronectin-binding proteins. More than 40,000 force profiles were measured on 5-10 different cells for each of the 15 clinical strains. A unique force-signature was observed for a binding event between the fibronectin-coated probe and the bacteria. When grouped by the frequency of this force-signature, there was a strong distinction (p=0.01) between the invasive and control populations of S. aureus. This discovery suggests that biofilm forming bacteria may be classified according to their “force taxonomy”, which could have a positive effect on health care as it bridges the long-standing disconnect between macroscopic, clinical investigations and nanometer-scale forces ultimately responsible for a bond between S. aureus and the surface of a prosthetic device.

  7. Demonstration of correlations between clinical and physical image quality measures in chest and lumbar spine screen-film radiography.

    PubMed

    Sandborg, M; Tingberg, A; Dance, D R; Lanhede, B; Almén, A; McVey, G; Sund, P; Kheddache, S; Besjakov, J; Mattsson, S; Månsson, L G; Alm Carlsson, G

    2001-06-01

    The ability to predict clinical image quality from physical measures is useful for optimization in diagnostic radiology. In this work, clinical and physical assessments of image quality are compared and correlations between the two are derived. Clinical assessment has been made by a group of expert radiologists who evaluated fulfillment of the European image criteria for chest and lumbar spine radiography using two scoring methods: image criteria score (ICS) and visual grading analysis score (VGAS). Physical image quality measures were calculated using a Monte Carlo simulation model of the complete imaging system. This model includes a voxelized male anatomy and was used to calculate contrast and signal-to-noise ratio of various important anatomical details and measures of dynamic range. Correlations between the physical image quality measures on the one hand and the ICS and VGAS on the other were sought. 16 chest and 4 lumbar spine imaging system configurations were compared in frontal projection. A statistically significant correlation with clinical image quality was found in chest posteroanterior radiography for the contrast of blood vessels in the retrocardiac area and a measure of useful dynamic range. In lumbar spine anteroposterior radiography, a similar significant correlation with clinical image quality was found between the contrast and signal-to-noise ratio of the trabecular structures in the L1-L5 vertebrae. The significant correlation shows that clinical image quality can, at least in some cases, be predicted from appropriate measures of physical image quality. PMID:11459731

  8. [Coefficients of correlation of clinical laboratory data as signs of mechanisms of regulation].

    PubMed

    Genkin, A A

    1996-01-01

    Differences in the coefficients of correlation of clinical laboratory signs in patients with diseases of the blood and lymph, respiratory organs, and cardiovascular system were analyzed using OMIS research biomedical system (Intellectual Systems, St. Petersburg. 1993). Correlation coefficient is interpreted not as a measure of relationship between signs, but as an indicator of regulation processes in a live organism. The coefficients of correlation are most frequently different for the signs whose mean values are unchanged under the same conditions. This means that a comparative analysis of relationship between the signs largely contributes to such branches of medicine in which the conclusions are based on analysis of the mean tendencies. Such branches are primarily new tests for early diagnosis of tumorous diseases, assessment of dissemination and malignancy of the process, understanding of the processes of malignant degeneration, etc. Automated analysis of differences in correlations may be useful to decipher the ambiguous and dynamic relationships between different submultiplicities of immunocompetent elements in different forms of immune response (and in various states of the organism). Use of the new system opens new vistas in studies of the signs of vital activity of cardiovascular and respiratory systems. Not only new mechanisms regulating the hemodynamics, respiration, and cardiorespiratory relationships were disclosed; relationships between physiological parameters and cellular elements were revealed, which could be hardly suspected before. A fragment of a study of survival factors in acute nonlymphoblastic leukemia (carried out in cooperation with N.N. Mamayev) is presented for illustration. A close positive relationship between the humoral and cellular immunity (at least of their components analyzed in this study) is demonstrated to be destructive for patients with acute nonlymphoblastic leukemia. An optimal variant is their independent regulation or regulation leading to variously directed changes. PMID:8925219

  9. Evidence-based practice, step by step: asking the clinical question: a key step in evidence-based practice.

    PubMed

    Stillwell, Susan B; Fineout-Overholt, Ellen; Melnyk, Bernadette Mazurek; Williamson, Kathleen M

    2010-03-01

    This is the third article in a series from the Arizona State University College of Nursing and Health Innovation's Center for the Advancement of Evidence-Based Practice. Evidence-based practice (EBP) is a problem-solving approach to the delivery of health care that integrates the best evidence from studies and patient care data with clinician expertise and patient preferences and values. When delivered in a context of caring and in a supportive organizational culture, the highest quality of care and best patient outcomes can be achieved.The purpose of this series is to give nurses the knowledge and skills they need to implement EBP consistently, one step at a time. Articles will appear every two months to allow you time to incorporate information as you work toward implementing EBP at your institution. Also, we've scheduled "Ask the Authors" call-ins every few months to provide a direct line to the experts to help you resolve questions. Details about how to participate in the next call will be published with May's Evidence-Based Practice, Step by Step. PMID:20179464

  10. Episodic ataxia type 1: clinical characterization, quality of life and genotype–phenotype correlation

    PubMed Central

    Graves, Tracey D.; Cha, Yoon-Hee; Hahn, Angelika F.; Barohn, Richard; Salajegheh, Mohammed K.; Griggs, Robert C.; Bundy, Brian N.; Jen, Joanna C.; Baloh, Robert W.

    2014-01-01

    Episodic ataxia type 1 is considered a rare neuronal ion channel disorder characterized by brief attacks of unsteadiness and dizziness with persistent myokymia. To characterize the natural history, develop outcome measures for future clinical trials, and correlate genotype with phenotype, we undertook an international, prospective, cross-sectional study. Thirty-nine individuals (51% male) were enrolled: median age 37 years (range 15–65 years). We identified 10 different pathogenic point mutations in KCNA1 that accounted for the genetic basis of 85% of the cohort. Participants with KCNA1 mutations were more likely to have a positive family history. Analysis of the total cohort showed that the first episode of ataxia occurred before age 20 in all but one patient, with an average age of onset of 7.9 years. Physical exertion, emotional stress and environmental temperature were the most common triggers for attacks. Attack frequency ranged from daily to monthly, even with the same KCNA1 genotype. Average attack duration was in the order of minutes. Ten participants (26%) developed permanent cerebellar signs, which were related to disease duration. The average Scale for the Assessment and Rating of Ataxia score (SARA, a standardized measure of cerebellar dysfunction on clinical examination, scores range from 0–40) was an average of 3.15 for all participants (range 0–14), but was only 2 in those with isolated episodic ataxia compared with 7.7 in those with progressive cerebellar ataxia in addition to episodic ataxia. Thirty-seven participants completed the SF-36, a quality of life survey; all eight domain norm-based average scores (mean = 50) were below normal with mental health being the lowest (41.3) in those with mutation positive episodic ataxia type 1. Scores on SF-36 correlated negatively with attack frequency. Of the 39 participants in the study, 33 harboured mutations in KCNA1 whereas the remaining six had no mutation identified. Episodic ataxia type 1 phenocopies have not been described previously and we report their clinical features, which appear to be different to those with a KCNA1 mutation. This large prospective study of both genetically confirmed episodic ataxia type 1 and episodic ataxia type 1 phenocopies provides detailed baseline characteristics of these disorders and their impact on participants. We found that attacks had a significant effect on quality of life. Unlike previous studies, we found that a significant number of individuals with genetically confirmed episodic ataxia type 1 (21%) had accumulated persistent cerebellar symptoms and signs. These data will enable the development of outcome measures for clinical trials of treatment. PMID:24578548

  11. Clinical, Functional and Health-Related Quality of Life Correlates of Clinically Significant Symptoms of Anxiety and Depression in Patients with Systemic Sclerosis: A Cross-Sectional Survey

    PubMed Central

    Nguyen, Christelle; Ranque, Brigitte; Baubet, Thierry; Bérezné, Alice; Mestre-Stanislas, Caroline; Rannou, François; Papelard, Agathe; Morell-Dubois, Sandrine; Revel, Michel; Moro, Marie-Rose; Guillevin, Loïc; Poiraudeau, Serge; Mouthon, Luc

    2014-01-01

    Objectives To identify clinical, functional and health-related quality of life (HRQoL) correlates of clinically significant symptoms of anxiety and depression in patients with systemic sclerosis (SSc). Methods Three-hundred-and-eighty-one patients fulfilling the American College of Rheumatology and/or the Leroy and Medsger criteria for SSc were assessed for visceral involvement, disability and HRQoL (assessed by SF-36). Clinically significant symptoms of anxiety and depression were evaluated with the Hospital Anxiety Depression Scale (HAD) (defined cut-off?8). Results 9.2% the patients had limited SSc, 50.5% limited cutaneous SSc (lcSSc), and 40.3% diffuse cutaneous SSc (dcSSc). Overall, 40.4% and 58.8% of the patients had clinically significant symptoms of depression and anxiety, respectively. Compared to patients without clinically significant symptoms of depression, patients with clinically significant symptoms of depression had poorer health status, HRQoL mental and physical component, and greater global disability, hand disability and aesthetic impairment. Compared to patients without clinically significant symptoms of anxiety, patients with clinically significant symptoms of anxiety had poorer SF-36 mental and physical component scores. On multivariable analysis, excluding mental component score of SF-36, variables independently associated with clinically significant symptoms of depression and anxiety were global disability and physical component of SF-36, plus female gender for clinically significant symptoms of anxiety only. Remarkably, patients with and without clinically significant psychiatric symptoms were comparable for all disease-related clinical features assessed. Conclusion High levels of clinically significant symptoms of anxiety and depression are observed among SSc patients. Clinically significant psychiatric symptoms are rather associated with increased disability and altered HRQoL, than with disease-specific organ manifestations. PMID:24587375

  12. Correlations of Clinical and Laboratory Measures of Balance in Older Men and Women: The MOBILIZE Boston Study

    PubMed Central

    Nguyen, Uyen-Sa D.T.; Kiel, Douglas P.; Li, Wenjun; Galica, Andrew M.; Kang, Hyun Gu; Casey, Virginia A.; Hannan, Marian T.

    2012-01-01

    Objective Impaired balance is associated with falls in older adults. However, there is no accepted gold standard on how balance should be measured. Few studies have examined measures of postural sway and clinical balance concurrently in large samples of community-dwelling older adults. We examined the associations among four types of measures of laboratory- and clinic-based balance in a large population-based cohort of older adults. Methods We evaluated balance measures in the MOBILIZE Boston Study (276 men, 489 women, 64–97 years). Measures included: (1) laboratory-based anteroposterior (AP) path length and average sway speed, mediolateral (ML) average sway and root-mean-square, and area of ellipse postural sway; (2) Short Physical Performance Battery (SPPB); (3) Berg Balance Scale; and (4) one-leg stand. Spearman Rank Correlation Coefficients (r) were assessed among the balance measures. Results Area of ellipse sway was highly correlated with the ML sway measures (r >0.9, p < 0.0001), and sway speed was highly correlated with AP sway (r=0.97, p < 0.0001). The Berg Balance Scale was highly correlated with SPPB (r=0.7, p<0.001), and one-leg stand (r=0.8, p<0.001). Correlations between the laboratory- and clinic-based balance measures were low but statistically significant (0.2 < r < 0.3, p<0.0001). Conclusion Clinic-based balance measures, and laboratory-based measures comparing area of ellipse with ML sways or sway speed with AP sway, are highly correlated. Clinic- with laboratory-based measures are less correlated. As both laboratory- and clinic-based measures inform balance in older adults but are not highly correlated with each other, future work should investigate the differences. PMID:22745045

  13. Fermi Questions

    NSDL National Science Digital Library

    Math Forum

    2001-01-01

    Fermi questions emphasize estimation, numerical reasoning, communicating in mathematics, and questioning skills. Students often believe that word problems have one exact answer and that the answer is derived in a unique manner. Fermi questions encourage multiple approaches, emphasize process rather than the answer, and promote non-traditional problem solving strategies. The a href= /workshops/sum96/interdisc/sheila3.html Fermi Questions Library/a features classic Fermi questions with annotated solutions, a list of Fermi questions for use with students, Fermi questions with a Louisiana twist, and Fermi activities for the K-12 classroom. A Louisiana Lessons Web Activity.

  14. Clinical assessment of speech correlates well with lung function during induced bronchoconstriction.

    PubMed

    Tayler, Nicholas; Grainge, Christopher; Gove, Kerry; Howarth, Peter; Holloway, Judith

    2015-01-01

    Clinical assessment of asthma often includes a crude assessment of speech, for example whether the patient can speak in full sentences. To date, this statement, despite appearing in national asthma guidelines, has not been related to lung function testing in asthma exacerbation. Seven asthmatics underwent a bronchial challenge and were then recorded reading a standardised text for 1?min. The recordings were played to 88 healthcare professionals who were asked to estimate FEV1% predicted. Health care professionals' estimations showed moderate correlation to FEV1% predicted (rho=0.61 P<0.01). There were no significant differences between professionals grouped by seniority or speciality. Speech can intuitively be estimated by health care professionals with moderate accuracy. This gives an evidence basis for the assessment in speech in acute asthma and may provide a new avenue for monitoring. PMID:25719976

  15. The Phenomenology and Clinical Correlates of Suicidal Thoughts and Behaviors in Youth with Autism Spectrum Disorders

    PubMed Central

    Storch, Eric A.; Sulkowski, Michael L.; Nadeau, Josh; Lewin, Adam B.; Arnold, Elysse B.; Mutch, P. Jane; Jones, Anna M.; Murphy, Tanya K.

    2013-01-01

    This study investigated the phenomenology and clinical correlates of suicidal thoughts and behaviors in youth with ASD (N=102; range=7–16 years). The presence of suicidal thoughts and behavior was assessed through the Anxiety Disorders Interview Schedule-Child and Parent Versions. Children and parents completed measures of anxiety severity, functional impairment, and behavioral and emotional problems. Approximately 11% of youth displayed suicidal thoughts and behaviors. Children with autism were more likely to have suicidal thoughts and behaviors whereas children with Asperger’s disorder were less likely. Suicidal thoughts and behaviors were associated with the presence of depression and post-traumatic stress disorder. Overall, results suggest that suicidal thoughts and behaviors are common in youth with ASD, and may be related to depression and trauma. PMID:23446993

  16. Sex differences in cognitive domains and their clinical correlates in higher-functioning autism spectrum disorders.

    PubMed

    Bölte, Sven; Duketis, Eftichia; Poustka, Fritz; Holtmann, Martin

    2011-07-01

    Despite the skewed sex ratio, few studies have addressed possible cognitive sex differences in autism spectrum disorders (ASDs). This study compared visual attention to detail (ATTD) and selected executive functions (EF) in 35 males and 21 females with higher-functioning ASD and unaffected sibling controls. Females with ASD outperformed males on EF as assessed by the Trail Making Test B-A. Males with ASD showed superior performance for ATTD as measured by the Block Design Test (BD) when compared with females. EF difficulties in males were correlated with more stereotypic behaviours and interests on the Autism Diagnostic Interview-Revised or the Autism Diagnostic Observation Schedule. The results indicated clinically meaningful cognitive sex differences in ASD, particularly an association between EF and stereotypic behaviours and interests. ATTD as a potential basis for specific cognitive strengths (e.g. scientific/savant skills) might be more pronounced in males with ASD. PMID:21454389

  17. Computed Tomography Appearance of Early Radiation Injury to the Lung: Correlation With Clinical and Dosimetric Factors

    SciTech Connect

    Jenkins, Peter, E-mail: peter.jenkins@glos.nhs.uk [Gloucestershire Oncology Centre, Cheltenham General Hospital, Cheltenham (United Kingdom); Welsh, Anne [Gloucestershire Oncology Centre, Cheltenham General Hospital, Cheltenham (United Kingdom)

    2011-09-01

    Purpose: To systematically assess the spectrum of radiologic changes in the lung after radiation therapy for non-small-cell lung cancer. Methods and Materials: We reviewed the cases of 146 patients treated with radical radiotherapy at our institution. All patients had computed tomography (CT) scans performed 3 months after completion of therapy. Radiographic appearances were categorized using a standard grading system. The association of these abnormalities with pretreatment factors and clinical radiation pneumonitis (RP) was investigated. Results: New intrapulmonary abnormalities were seen in 92 patients (63%). These were ground-glass opacity in 16 (11%), patchy consolidation in 19 (13%), and diffuse consolidation in 57 (39%). Twenty-five patients (17%) developed clinical symptoms of RP. Although 80% of the patients with RP had areas of consolidation seen on the posttreatment CT scan, the majority (74%) of patients with such radiographic changes were asymptomatic. For patients with lung infiltrates, the minimum isodose encompassing the volume of radiologic abnormality was usually {>=}27 Gy. Traditional dose-volume metrics, pulmonary function tests, and the coadministration of angiotensin converting enzyme inhibitors (ACE-I) were all strongly correlated with the presence of radiologic injury on univariate analysis (p {<=} 0.002). There was also an inverse correlation between prior smoking history and CT scan changes (p = 0.02). On multivariate analysis, dosimetric parameters and the use of ACE-I retained significance (p = 0.005). Conclusions: Our findings suggest that there is substantial interindividual variation in lung radiosensitivity. ACE-I prevented the radiologic changes seen after high-dose radiation therapy, and their role as radioprotectants warrants further investigation.

  18. Clinical correlates of parametric digit-symbol substitution test in schizophrenia

    PubMed Central

    Amaresha, Anekal C.; Danivas, Vijay; Shivakumar, Venkataram; Agarwal, Sri Mahavir; Kalmady, Sunil V.; Narayanaswamy, Janardhanan C.; Venkatasubramanian, Ganesan

    2014-01-01

    Processing speed deficit, ascertained by digit-symbol substitution test (DSST), is considered as a fundamental impairment in schizophrenia. Clinical correlates of processing speed abnormalities, especially using the parametric version of DSST is yet to be evaluated comprehensively. In this study, we examined schizophrenia patients (N = 66) and demographically matched healthy controls (N = 72) using computer-administered parametric DSST (pDSST) with fixed (pDSSTF) as well as random (pDSSTR) conditions and analysed the relationship between pDSST performance and clinical symptoms. Psychopathology was assessed using Scale for Assessment of Positive Symptoms (SAPS)/Negative Symptoms (SANS) with good inter-rater reliability. In comparison with healthy controls, patients demonstrated significantly lesser number of correct responses (CN) in pDSSTF (t = 8.0; p < 0.001) and pDSSTR (t = 7.8; p < 0.001) as well as significantly prolonged reaction time in pDSSTF (t = 7.1; p < 0.001) and pDSSTR (t = 7.0; p < 0.001). The difference in CN between pDSSTF and pDSSTR [?CN] was significantly lesser in patients than healthy controls (t = 2.61; p = 0.01). The pDSST reaction time had significant positive correlation with negative syndrome scores as well as bizarre behaviour score. Significantly greater processing speed deficits in pDSST suggest potential relational memory/visual scanning abnormalities in schizophrenia. Furthermore, pDSST deficits demonstrated a significant association with the psychopathology, especially with the various negative symptoms and bizarre behaviour. PMID:25042951

  19. Correlations between endoscopic and clinical disease activity indices in intestinal Behcet's disease

    PubMed Central

    Lee, Hyun Jung; Kim, Youn Nam; Jang, Hui Won; Jeon, Han Ho; Jung, Eun Suk; Park, Soo Jung; Hong, Sung Pil; Kim, Tae Il; Kim, Won Ho; Nam, Chung Mo; Cheon, Jae Hee

    2012-01-01

    AIM: To develop a novel endoscopic severity model of intestinal Behcet's disease (BD) and to evaluate its feasibility by comparing it with the actual disease activity index for intestinal Behcet's disease (DAIBD). METHODS: We reviewed the medical records of 167 intestinal BD patients between March 1986 and April 2011. We also investigated the endoscopic parameters including ulcer locations, distribution, number, depth, shape, size and margin to identify independent factors associated with DAIBD. An endoscopic severity model was developed using significant colonoscopic variables identified by multivariate regression analysis and its correlation with the DAIBD was evaluated. To determine factors related to the discrepancy between endoscopic severity and clinical activity, clinical characteristics and laboratory markers of the patients were analyzed. RESULTS: A multivariate regression analysis revealed that the number of intestinal ulcers (? 2, P = 0.031) and volcanoshaped ulcers (P = 0.001) were predictive factors for the DAIBD. An endoscopic severity model (Y) was developed based on selected endoscopic variables as follows: Y = 47.44 + 9.04 × non-Ileocecal area + 11.85 × ? 2 of intestinal ulcers + 5.03 × shallow ulcers + 12.76 × deep ulcers + 4.47 × geographic-shaped ulcers + 26.93 × volcano-shaped ulcers + 8.65 × ? 20 mm of intestinal ulcers. However, endoscopic parameters used in the multivariate analysis explained only 18.9% of the DAIBD variance. Patients with severe DAIBD scores but with moderately predicted disease activity by the endoscopic severity model had more symptoms of irritable bowel syndrome (21.4% vs 4.9%, P = 0.026) and a lower rate of corticosteroid use (50.0% vs 75.6%, P = 0.016) than those with severe DAIBD scores and accurately predicted disease by the model. CONCLUSION: Our study showed that the number of intestinal ulcers and volcano-shaped ulcers were predictive factors for severe DAIBD scores. However, the correlation between endoscopic severity and DAIBD (r = 0.434) was weak. PMID:23155319

  20. Correlation between Clinical Characteristics and Chest Computed Tomography Findings of Pulmonary Cryptococcosis

    PubMed Central

    Yoshida, Masahiro; Yabe, Masami; Baba, Emiri; Okuda, Keitaro; Fujimoto, Shota; Katagi, Hiroaki; Takagi, Masamichi; Kuwano, Kazuyoshi

    2015-01-01

    Objective. The aim of this study was to review HIV-negative patients with pulmonary cryptococcosis to analyze the correlations between clinical characteristics and chest computed tomography (CT) findings. Methods. We retrospectively analyzed medical records of 16 HIV-negative patients with pulmonary cryptococcosis diagnosed at our institution, and clinical characteristics of the patients with nodules or masses without ground-glass attenuation (GGA)/consolidation type were compared with those of patients with inclusive GGA or consolidation type. Results. Host status was immunocompromised (81.2%) in most of the patients, and 6 (37.5%) were asymptomatic. The most frequent radiologic abnormalities on chest CT scans were one or more nodules (87.5%), GGA (37.5%), and consolidations (18.8%). Most lesions were located in the lower lung. Levels of hemoglobin and platelets were significantly lower in patients with inclusive GGA or consolidation type. Although the differences were not significant, patients with inclusive GGA or consolidation type tended to have a C-reactive protein level of ?1.0?mg/dL. Conclusion. If a patient with anemia and thrombocytopenia shows GGA or consolidation in the lung, pulmonary cryptococcosis should be given careful consideration.

  1. Loneliness correlates in advanced alcohol abusers. II. Clinical and psychological factors.

    PubMed

    Hörnquist, J O; Akerlind, I

    1987-01-01

    The current study was performed in order to extend a preceding correlational analysis of loneliness to clinical and psychological parameters in a sample of 95 alcohol abusers. The alcoholics were examined twice with an approximate interval fo two years. In the preceding analysis of social factors and needs, the lonely abuser appeared as discontented and somewhat passive in essential life-spheres. This pattern was highly confirmed in the current study. In the psychological part, life-dissatisfaction and indolence were especially pronounced by the lonely abusers. The association between loneliness and lack of self-esteem was also extraordinarily marked, while the relations to some neurotic-tinged parameters were at a more ordinary level. In the clinical psychiatric part of the study, a number of relations of medium degree confirmed the link to psychopathology. Achievements on the intellectual tests were nonrelated to loneliness, as were also most of the biochemical laboratory test results. The main conclusion was that loneliness primarily is a sensitive indicator of perceived quality of life and attitude to life as a whole. PMID:3685923

  2. Thompson calf squeezing test: clinical and ultrasound correlations in the follow up of Achille's tenorraphy.

    PubMed

    Leigheb, M; Conte, P; Neri, P; Zorzolo, I; Martinelli, D; Martino, F; Carriero, A; Grassi, F

    2014-01-01

    In the follow up of Achille's tenorraphy, negativization of Thompson calf queezing test is not always omogeneous and absolute. Aim of the paper is to correlate Thompson test to different anatomical-ultrasound and functional parameters. We investigated clinically and by ultrasound 61 patients operated on of Achille's tenorraphy at Novara Hospital with follow-up of 10 to 46 months. Negative controls were contralateral tendons. We excluded patients with previous and/or contralateral Achille's tendon ruptures, those operated after 7 days, diabetics or with autoimmune diseases, if used topic steroids, < 18 years, those rejecting the study. Measured parameters were: age, gender, height, weight, side, open vs percutaneous approach, time from operation, neutral angle and range of motion of the ankle, maximal circumference of the leg, Single Heel Rise Test, Visual-Analogue-Scale Foot and Ankle (VAS FA) score; with ultrasound: length of tendons, mio-tendinous U.S.-structure, dynamic diastasis of tendon scar, tendon sliding. Thompson test is positive if no plantar-flexion of the foot occurs at calf squeezing, negative if plantar-flexion is normal (75% patients) and intermediate if reduced or slight reactive (25%).We found correlation of Thompson test with age (p<0,05) and with tendon length (p>0,05), being intermediate tests more represented in older patients and in those with longer healed tendons. In conclusion post-operative negativization of Thompson test can be incomplete as observed in older patients and in those healed with elongated tendon. PMID:25409728

  3. Preschool anxiety disorders: comprehensive assessment of clinical, demographic, temperamental, familial, and life stress correlates.

    PubMed

    Dougherty, Lea R; Tolep, Marissa R; Bufferd, Sara J; Olino, Thomas M; Dyson, Margaret; Traditi, Jennifer; Rose, Suzanne; Carlson, Gabrielle A; Klein, Daniel N

    2013-01-01

    This study examined correlates of preschoolers' anxiety disorders using a comprehensive, multimethod design. Participants included a community sample of 541 three-year-old children, of whom 106 (19.6%) met criteria for at least 1 anxiety disorder. Child and parental psychopathology and life stress were assessed with clinical interviews. Child temperament and parenting behavior were assessed with laboratory observations. Mothers and fathers reported on their parenting styles. Compared to preschoolers with no anxiety disorder, preschoolers with an anxiety disorder were more likely to meet criteria for comorbid depressive and oppositional defiant disorders and to exhibit greater temperamental behavioral inhibition and lower positive affectivity, and more sleep problems. Children with anxiety disorders also experienced more stressful life events in the previous 6 months, and their mothers had a higher rate of current anxiety disorders. Compared to children with other anxiety disorders, children with only specific phobia exhibited a somewhat different pattern of associations than children with other anxiety disorders. Overall, the findings suggest that many of the correlates observed in older youth with anxiety disorders are also observed in preschoolers. PMID:23368788

  4. Spastic cerebral palsy: clinical magnetic resonance imaging correlation of 129 children.

    PubMed

    Ku?ak, Wojciech; Sobaniec, Wojciech; Kubas, Bozena; Walecki, Jerzy; Smigielska-Kuzia, Joanna; Bockowski, Leszek; Artemowicz, Barbara; Sendrowski, Krzysztof

    2007-01-01

    A prospective study was undertaken of 129 children with spastic cerebral palsy to clarify the relationship between magnetic resonance imaging (MRI) findings and clinical features of cerebral palsy. Low birth weight, asphyxia, prematurity, seizures, mental development, Gross Motor Function Classification System, and MRI findings were analyzed. Significant abnormalities relevant to the cerebral palsy were evident on imaging in 123 (95.3%). A similar percentage of MRI abnormalities were detected in the groups, 45 (100%) in patients with tetraplegic cerebral palsy, 37 (92.5%) in children with diplegic cerebral palsy, and 42 (95.4%) with hemiplegic cerebral palsy. Periventricular leukomalacia was detected more frequently in the children with spastic diplegia than in the patients with tetraplegia or hemiplegia. Cerebral atrophy was found more often in the tetraplegic group compared to the diplegic patients. Porencephalic cysts were detected more frequently in children with spastic hemiplegia. Congenital brain anomalies were found in a higher proportion in tetraplegic children. Significant correlations between the MRI findings and Gross Motor Function Classification System in the diplegic and tetraplegic patients were found. No correlations between the MRI results and risk factors for cerebral palsy in the tetraplegic patients were noted. Early detection of brain abnormalities in children with cerebral palsy may help in the prognosis and in the initiation of appropriate therapy PMID:17608298

  5. Physiological knock-knee in preschool children: prevalence, correlating factors, gait analysis, and clinical significance.

    PubMed

    Lin, C J; Lin, S C; Huang, W; Ho, C S; Chou, Y L

    1999-01-01

    Physiological knock-knee (PKK) was categorized by measuring intermalleolar distance (IMD), a clinically simple method, to evaluate the prevalence and correlating factors in 305 preschool children. The prevalence in this cross-sectional study was relatively high, and it was age related (p = 0.002; 64, 44, and 34% for ages 3-4, 4-5, and 5-6 years, respectively). The following factors were correlated with PKK: use of walking chair early (p = 0.0001), independently walked late (p = 0.0005), dependently walked longer (p = 0.0001), concurrence with flatfoot (p = 0.001), and angular deformity (toe in/out, p = 0.03). Gait analysis, with spatiotemporal, kinematics, and kinetics parameters, was performed to evaluate the ambulatory significance. Preschool children with PKK have a shorter stride length (p = 0.02) and a slower walking speed (p = 0.004). Dynamic hyperextension of the knee is noted for 8 degrees during the whole gait cycle (p < 0.05). We conclude that PKK is a variable that should be considered in the development of mature gait for preschool children. PMID:10488869

  6. Analysis and clinical correlates of 20 Hz photic driving on routine EEG in migraine.

    PubMed

    Fogang, Y; Gérard, P; De Pasqua, V; Pepin, J L; Ndiaye, M; Magis, D; Schoenen, J

    2015-03-01

    Enhanced photic driving (PD) during high-frequency flicker stimulation, the so-called H response, is a classical feature of migraine patients between attacks, but is thought to be of poor clinical utility. Visual inspection of the EEG for its detection may not be reliable, however, data on its possible correlations with clinical features and migraine pathophysiology are scarce. We have compared visual inspection and EEG spectral analysis to detect abnormal PD in 280 consecutive migraine patients of our headache clinic (episodic migraine without aura, n = 171; chronic migraine, n = 48; migraine with aura, n = 61) and in a group of 24 non-migrainous neurological controls. Spectral frequency analyses were performed blindly by one of us (YF). On visual inspection, 50.4 % of migraineurs were thought to have increased 20 Hz PD. After spectral analysis, only 62.4 % of them had PD power superior to the mean + 95 % CI of the control group. Sensitivity of visually identified PD was 82.24 %, specificity 69.36 %. Increased PD on spectral analysis was more prevalent in episodic migraine than in chronic migraine, in patients with low attack frequency, in those with ictal autonomic symptoms in addition to nausea and in those with a strong family history of migraine. We confirm therefore that 20 Hz photic driving is of little diagnostic utility and its prevalence in migraine overestimated on visual inspection. Its presence on spectral analysis of the EEG, however, might be of pathophysiological interest, as it identifies subgroups of migraineurs of whom the common denominator could be lack of habituation of cortical responses during repetitive stimulation. PMID:24858629

  7. Input functions for 6-[fluorine-18]Fluorodopa quantitation in parkinsonism: Comparative studies and clinical correlations

    SciTech Connect

    Takikawa, S.; Dhawan, V.; Chaly, T.; Robeson, W.; Dahl, R.; Zanzi, I.; Mandel, F.; Spetsieris, P.; Eidelberg, D. [North Shore Univ. Hospital/Cornell Univ., Medical College, Manhasset, NY (United States)

    1994-06-01

    PET has been used to quantify striatal 6-[{sup 18}F]fluro-L-dopa (FDOPA) uptake as a measure of presynaptic dopaminergic function. Striatal FDOPA uptake rate constants (K{sub 1}) can be calculated using dynamic PET imaging with measurements of the plasma FDOPA input function determined either directly or by several estimation procedures. The authors assessed the comparative clinical utility of these methods by calculating the striato-occipital ratio (SOR) and striatal K{sub 1} values in 12 patients with mild to moderate PD and 12 age-matched normal volunteers. The plasma FDOPA time-activity curve (K{sub 1}{sup FD}); the plasma {sup 18}F time-activity curve (K{sub i}{sup P}); the occipital time-activity curve (K{sub i}{sup OCC}); and a simplified population-derived FDOPA input function (K{sub i}{sup EFD}) were used to calculate striatal K{sub i}. Mean values for all striatal K{sub i} estimates and SOR were significantly lower in the PD group. Although all measured parameters discriminated PD patients with normals, K{sub i}{sup FD} and K{sub i}{sup EFD} provided the best between-group separation. K{sub i}{sup FD}, K{sub i}{sup EFD}, and K{sub i}{sup OCC} measures correlated significantly with quantitative disease severity ratings, although K{sub i}{sup FD} predicted quantitative clinical disability most accurately. These results suggest that K{sub i}{sup FD} may be an optimal marker of the parkinsonian disease process. K{sub i}{sup EFD} may be a useful alternative to K{sub i}{sup FD} for most clinical research applications. 40 refs., 4 figs., 7 tabs.

  8. Predictors of outcome of stroke in infants and children based on clinical data and radiologic correlates.

    PubMed

    Keidan, I; Shahar, E; Barzilay, Z; Passwell, J; Brand, N

    1994-07-01

    Outcome predictors were analyzed in 45 infants and children with cerebrovascular disorders (CVD), based on clinical features and radiological correlates. The clinical features at presentation could be categorized into three major groups: (1) generalized: alteration of consciousness with or without seizures--24 patients (54%); (2) focal: acute hemiplegia or monoplegia with or without focal seizures--18 patients (40%); (3) cerebellar disturbances--3 patients (6%). The underlying etiology was detected in 80% of children. Thirty-seven patients (82%) survived the initial debilitating event, of whom 11 (29.7%) recovered completely and the rest had either motor or cognitive handicaps during an average follow-up period of 4.2 years (range 1.5-11 years). A head CT performed in all children revealed ischemic infarction in 29 patients (64.4%), while the others had hemorrhagic infarction. Of those with an initial generalized neurological presentation, as many as 50% had multi-focal lesions on CT. All children with focal neurological findings had a solitary localized lesion on CT, mainly in the distribution of the middle cerebral artery. Statistical analysis for outcome prediction showed that the following variables were associated with increased risk of immediate death: (1) hemorrhagic infarction demonstrated by brain CT (p = 0.031); (2) patients who presented with a generalized neurological disorder, namely alteration of consciousness, with or without seizures (p = 0.036). No other clinical or laboratory variables were predictive of imminent death, motor or cognitive handicaps. These may therefore serve as outcome predictors of stroke in the pediatric age group. PMID:7949809

  9. Mucocutaneous Manifestations of HIV and the Correlation with WHO Clinical Staging in a Tertiary Hospital in Nigeria

    PubMed Central

    Oninla, Olumayowa Abimbola

    2014-01-01

    Skin diseases are indicators of HIV/AIDS which correlates with WHO clinical stages. In resource limited environment where CD4 count is not readily available, they can be used in assessing HIV patients. The study aims to determine the mucocutaneous manifestations in HIV positive patients and their correlation with WHO clinical stages. A prospective cross-sectional study of mucocutaneous conditions was done among 215 newly diagnosed HIV patients from June 2008 to May 2012 at adult ART clinic, Wesley Guild Hospital Unit, OAU Teaching Hospitals Complex, Ilesha, Osun State, Nigeria. There were 156 dermatoses with oral/oesophageal/vaginal candidiasis (41.1%), PPE (24.4%), dermatophytic infections (8.9%), and herpes zoster (3.8%) as the most common dermatoses. The proportions of dermatoses were 4.5%, 21.8%, 53.2%, and 20.5% in stages 1–4, respectively. A significant relationship (using Pearson's Chi square with P value <0.05) was obtained between dermatoses and WHO clinical stages. Pearson's correlation coefficient showed a positive correlation between the number of dermatoses and the WHO clinical stages. Dermatoses can therefore serve as diagnostic and prognostic markers in resource limited settings to initiate HAART in clinical stages 3 and 4. PMID:25587439

  10. Tower of Hanoi and WCST performance in schizophrenia: problem-solving capacity and clinical correlates.

    PubMed

    Bustini, M; Stratta, P; Daneluzzo, E; Pollice, R; Prosperini, P; Rossi, A

    1999-01-01

    We administered a computerized version of WCST, a well established test, sensitive to executive function deficits in schizophrenia that involves many features of cognitive processing, and of Tower of Hanoi, a test that may offer cognitive challenges more specifically related to planning and sequencing, to 28 schizophrenic patients and 28 matched controls to examine a worthwhile question regarding the relative ability of these two tasks to differentiate schizophrenia and normal groups as well as exploring the relationship of these two instruments to clinical variables. The schizophrenic patients performed significantly worse than normal subjects both on Tower of Hanoi test and on WCST. The discriminant analysis identified in a multivariate way a pattern of indexes that differentiate the two groups. This pattern, characterized by specific indexes of WCST and TOH, could suggest the existence of a common underlying factor that determines the cognitive impairment in problem-solving of schizophrenics. These findings and the relationship with positive and negative symptoms have been discussed in the light of the model of the impairment in the internal representation of context information. PMID:10367995

  11. Circulating Fibrocytes Correlate with Bronchiolitis Obliterans Syndrome Development Following Lung Transplantation: A Novel Clinical Biomarker

    PubMed Central

    LaPar, Damien J.; Burdick, Marie D.; Emaminia, Abbas; Harris, David A.; Strieter, Brett A.; Liu, Ling; Robbins, Mark; Kron, Irving L.; Strieter, Robert M.; Lau, Christine L

    2011-01-01

    Background Development of bronchiolitis obliterans syndrome (BOS) following lung transplantation confers increased patient morbidity and mortality. Fibrocytes are circulating, bone marrow derived mesenchymal cell progenitors that influence tissue repair and fibrosis. Accumulated evidence has implicated fibrocytes in chronic pulmonary inflammatory processes. We investigated the correlation of circulating fibrocyte number with BOS development in lung transplant patients. Methods We prospectively quantified circulating fibrocyte levels among human lung transplant patients. Patients were stratified according to the development of BOS as indicated by predicted forced expiratory volume in one second (FEV1). Fibrocyte activity was analyzed by flow cytometry (CD45+, collagen 1+) in a blinded manner related to clinical presentation. Results A total of 39 patients previously underwent double (33.3%), left (25.6%), or right (41.0%) lung transplantation. Average patient age was similar between BOS and non-BOS patients (58.3±3.9 vs. 60.3±2.0 years, p=0.67). Males accounted for 61.5% of all patients. Chronic obstructive lung disease was the most common indication for lung transplantation (41.0%). Median FEV1 was lower among BOS patients compared to non-BOS patients (1.08 vs. 2.18 L/sec, p=0.001). Importantly, circulating fibrocyte number was increased in BOS patients compared to non-BOS patients (8.91×105 vs. 2.96×105 cells/ml, p=0.03) by flow cytometry and incrementally increased with advancing BOS stage (P=0.02). Conclusions Increased circulating fibrocyte levels correlate with the development of bronchiolitis obliterans syndrome following lung transplantation. Increasing fibrocyte levels positively correlates with advancing BOS stage. Quantification of circulating fibrocytes could serve as a novel biomarker and possible therapeutic target for BOS development in lung transplant patients. PMID:21801908

  12. Facial phenotypes in subgroups of prepubertal boys with autism spectrum disorders are correlated with clinical phenotypes

    PubMed Central

    2011-01-01

    Background The brain develops in concert and in coordination with the developing facial tissues, with each influencing the development of the other and sharing genetic signaling pathways. Autism spectrum disorders (ASDs) result from alterations in the embryological brain, suggesting that the development of the faces of children with ASD may result in subtle facial differences compared to typically developing children. In this study, we tested two hypotheses. First, we asked whether children with ASD display a subtle but distinct facial phenotype compared to typically developing children. Second, we sought to determine whether there are subgroups of facial phenotypes within the population of children with ASD that denote biologically discrete subgroups. Methods The 3dMD cranial System was used to acquire three-dimensional stereophotogrammetric images for our study sample of 8- to 12-year-old boys diagnosed with essential ASD (n = 65) and typically developing boys (n = 41) following approved Institutional Review Board protocols. Three-dimensional coordinates were recorded for 17 facial anthropometric landmarks using the 3dMD Patient software. Statistical comparisons of facial phenotypes were completed using Euclidean Distance Matrix Analysis and Principal Coordinates Analysis. Data representing clinical and behavioral traits were statistically compared among groups by using ?2 tests, Fisher's exact tests, Kolmogorov-Smirnov tests and Student's t-tests where appropriate. Results First, we found that there are significant differences in facial morphology in boys with ASD compared to typically developing boys. Second, we also found two subgroups of boys with ASD with facial morphology that differed from the majority of the boys with ASD and the typically developing boys. Furthermore, membership in each of these distinct subgroups was correlated with particular clinical and behavioral traits. Conclusions Boys with ASD display a facial phenotype distinct from that of typically developing boys, which may reflect alterations in the prenatal development of the brain. Subgroups of boys with ASD defined by distinct facial morphologies correlated with clinical and behavioral traits, suggesting potentially different etiologies and genetic differences compared to the larger group of boys with ASD. Further investigations into genes involved in neurodevelopment and craniofacial development of these subgroups will help to elucidate the causes and significance of these subtle facial differences. PMID:21999758

  13. Correlation

    NSDL National Science Digital Library

    Edwin P. Christmann

    2008-11-01

    This chapter will discuss the concept of correlation , which is used in later chapters that will explain the concepts of validity and reliability. Here, the authors introduce the Pearson correlation coefficient, a statistic that is used with ratio

  14. Questioning Strategies

    NSDL National Science Digital Library

    2012-01-01

    In this brief article from the Charles A. Dana Center at the University of Texas at Austin the best practices of questioning strategies are explained. The author illustrates the difference between an open and a closed question and provides examples of the five categories of questions that teachers should be asking. A bibliography of additional resources is included for further study.

  15. Four Questions

    ERIC Educational Resources Information Center

    Hark-Weber, Amara G., Ed.

    2013-01-01

    The author is pleased to introduce a new section in "TAJ," Four Questions. The structure is simple: four questions are asked to teaching artists working in various media and locations. The questions are always the same, but because each teaching artist's approach is unique, their answers will provide an insight into particular methodologies that…

  16. Detection of Merkel cell polyomavirus DNA in atypical fibroxanthoma in correlation to clinical features.

    PubMed

    Andres, C; Puchta, U; Flaig, M J

    2010-12-01

    A clear etiopathogenetic concept for atypical fibroxanthoma (AFX) is not established yet. Nevertheless, AFX is known as a pleomorphic but indolent tumor primarily of the elderly and/or immunosuppressed patient occurring in severely sun- or radiation-damaged skin. These risk factors are almost identical to those of Merkel cell carcinoma (MCC), a highly malignant skin tumor being thought to be pathogenetically associated with the recently discovered Merkel cell polyomavirus (MCPyV). Because AFX and MCC share risk factors, the aim of this study was to evaluate presence of MCPyV DNA in 23 cases of AFX by PCR and direct DNA sequencing. Subsequently, we correlated clinical features with MCPyV DNA status in AFX. We detected MCPyV DNA in 4 of 23 AFX. All patients with MCPyV DNA-positive tumors were men. The mean age of patients with MCPyV DNA-positive AFX was 84.8 ± 8.7 years (vs. 75.2 ± 7.8 years of MCPyV DNA-negative AFX), the mean duration of tumor growth was 4.5 ± 2.3 months (vs. 5.1 ± 2.8 months) and the mean tumor diameter was 1.2 ± 0.3 cm (vs. 1.3 ± 0.7 cm). Ulceration was present in 75% of MCPyV DNA-positive tumors (vs. 65.2%). In conclusion, MCPyV DNA is present in 17% of AFX, in this cohort affecting predominantly male patients with higher age (>80 years). Clinical features seem to be independent of MCPyV DNA status. Although the role of MCPyV is unclear in this setting, it may act as a cofactor in the tumorigenesis of AFX in a subset of cases. PMID:20861707

  17. Clinical correlates of enlarged prostate size in subjects with sexual dysfunction.

    PubMed

    Corona, Giovanni; Gacci, Mauro; Maseroli, Elisa; Rastrelli, Giulia; Vignozzi, Linda; Sforza, Alessandra; Forti, Gianni; Mannucci, Edoardo; Maggi, Mario

    2014-01-01

    Digito-rectal examination (DRE) of the prostate provides useful information on the state of prostate growth and on the presence of suspected peripheral nodules. The aim of this study is to describe the clinical and biochemical correlates of finding an enlarged prostate size at DRE in subjects with sexual dysfunction (SD). A consecutive series of 2379 patients was retrospectively studied. The analysis was focused on a subset of subjects (n = 1823; mean age 54.7 ± 11.4) selected for being free from overt prostatic diseases. Several parameters were investigated. After adjusting for confounders, the presence of an enlarged prostate size at DRE was associated with a higher risk of metabolic syndrome (HR = 1.346 (1.129-1.759); P = 0.030), type 2 diabetes mellitus (HR = 1.489 (1.120-1.980); P = 0.006), increased LDL cholesterol (>100 mg dl-1 ; HR = 1.354 (1.018-1.801); P = 0.037) and increased mean blood pressure (BP) values (HR = 1.017 (1.007-1.027) for each mmHg increment; P = 0.001). Accordingly, enlarged prostate size was also associated with a higher risk of arteriogenic erectile dysfunction (ED), as well as with other andrological conditions, such as varicocele and premature ejaculation (PE). PSA levels were significantly higher in subjects with enlarged prostate size when compared to the rest of the sample (HR = 3.318 (2.304; 4.799) for each log unit increment in PSA levels; P < 0.0001). Arteriogenic ED, according to different criteria, was also associated with increased PSA levels. In conclusion, our data support the need to examine prostate size either by clinical (DRE) or biochemical (PSA) inspection in subjects with SD, in order to have insights into the nature of the SD and the metabolic and cardiovascular (CV) background of the patient. PMID:24830688

  18. Correlation of thermal and mechanical effects of the holmium laser for various clinical applications

    NASA Astrophysics Data System (ADS)

    Grimbergen, Matthijs C. M.; Verdaasdonck, Rudolf M.; van Swol, Christiaan F. P.

    1998-05-01

    The Holmium laser has become established in orthopedic surgery and urology due to its unique combination of mechanical and thermal properties induced by explosive vapor bubbles. In a specialized setup, real-time high-speed and thermal images of dynamic vapor bubbles and thermal relaxation at a water tissue interface were obtained simultaneously. The thermal effects in the tissue model were correlated to the characteristics of the bubbles dependent on pulse energy (0.2 - 4 J), pulse repetition frequency (5 - 40 Hz), distance and angle of fiber delivery system (diameter 365 micrometer) to the tissue surface. Up to a fiber-to-tissue distance of 50% of the radius of the bubble, only a superficial tissue layer was heated. During bubble implosion, the tissue surface was attracted to the fiber, ripping of irregularities, and was effectively cooled by turbulence. In case of hard tissues, the bubble detached from the fiber imploding towards the hard surface. At closer distances (less than 50% of bubble radius), the tissue itself was vaporized resulting in mechanical damage and thermal relaxation into the tissue, especially above repetition rates of 5 Hz. There is a strong correlation between the path length of the free beam within the bubble and the degree of mechanical and thermal damage in the tissue directly irradiated by this beam. During clinical applications the surgeon should be aware of the size of the vapor bubble in relation to the distance and angle with the tissue for safe optimal use of the mechanical and thermal properties of the Holmium laser.

  19. Complexity, temporal stability, and clinical correlates of airway bacterial community composition in primary ciliary dyskinesia.

    PubMed

    Rogers, Geraint B; Carroll, Mary P; Zain, Nur Masirah M; Bruce, Kenneth D; Lock, Karen; Walker, Woolf; Jones, Graeme; Daniels, Thomas W V; Lucas, Jane S

    2013-12-01

    Primary ciliary dyskinesia (PCD) is a genetic disease characterized by abnormalities in ciliary function, leading to compromised airway clearance and chronic bacterial infection of the upper and lower airways. The compositions of these infections and the relationships between their characteristics and disease presentation are poorly defined. We describe here the first systematic culture-independent evaluation of lower airway bacteriology in PCD. Thirty-three airway samples (26 from sputum, 7 from bronchoalveolar lavage [BAL] fluid) were collected from 24 PCD patients aged 4 to 73 years. 16S rRNA quantitative PCR and pyrosequencing were used to determine the bacterial loads and community compositions of the samples. Bacterial loads, which ranged from 1.3 × 10(4) to 5.2 × 10(9) CFU/ml, were positively correlated with age (P = 0.002) but not lung function. An analysis of ?7,000 16S rRNA sequences per sample identified bacterial species belonging to 128 genera. The concurrently collected paired samples showed high bacterial community similarity. The mean relative abundance of the dominant genera was 64.5% (standard deviation [SD], 24.5), including taxa reported through standard diagnostic microbiology (members of the genera Pseudomonas, Haemophilus, and Streptococcus) and those requiring specific ex vivo growth conditions (members of the genera Prevotella and Porphyromonas). The significant correlations observed included a positive relationship between Pseudomonas aeruginosa relative abundance and age and a negative relationship between P. aeruginosa relative abundance and lung function. Members of the genus Ralstonia were also found to contribute substantially to the bacterial communities in a number of patients. Follow-up samples from a subset of patients revealed high levels of bacterial community temporal stability. The detailed microbiological characterization presented here provides a basis for the reassessment of the clinical management of PCD airway infections. PMID:24068019

  20. Correlation of HOXD3 promoter hypermethylation with clinical and pathologic features in screening prostate biopsies

    PubMed Central

    Chen, Leonard N; Rubin, Rachel S; Othepa, Eugide; Cer, Caroline; Yun, Elizabeth; Agarwal, Raghunath P; Collins, Brian T; McGeagh, Kevin; Pahira, John; Bandi, Guarav; Kowalczyk, Keith; Kumar, Deepak; Dritschilo, Anatoly; Collins, Sean P; Bostwick, David G; Lynch, John H; Suy, Simeng

    2014-01-01

    BACKGROUND Molecular markers that can discriminate indolent cancers from aggressive ones may improve the management of prostate cancer and minimize unnecessary treatment. Aberrant DNA methylation is a common epigenetic event in cancers and HOXD3 promoter hypermethylation (H3PH) has been found in prostate cancer. Our objective was to evaluate the relationship between H3PH and clinicopathologic features in screening prostate biopsies. METHODS Ninety-two patients who underwent a prostate biopsy at our institution between October 2011 and May 2012 were included in this study. The core with the greatest percentage of the highest grade disease was analyzed for H3PH by methylation-specific PCR. Correlational analysis was used to analyze the relationship between H3PH and various clinical parameters. Chi-square analysis was used to compare H3PH status between benign and malignant disease. RESULTS Of the 80 biopsies with HOXD3 methylation status assessable, 66 sets were confirmed to have cancer. In the 14 biopsies with benign disease there was minimal H3PH with the mean percentage of methylation reference (PMR) of 0.7%. In contrast, the HOXD3 promoter was hypermethylated in 16.7% of all cancers and in 50% of high risk tumors with an average PMR of 4.3% (P?=?0.008). H3PH was significantly correlated with age (P?=?0.013), Gleason score (P?=?0.031) and the maximum involvement of the biopsy core (P?=?0.035). CONCLUSIONS H3PH is associated with clinicopathologic features. The data indicate that H3PH is more common in older higher risk patients. More research is needed to determine the role of this marker in optimizing management strategies in men with newly diagnosed prostate cancer. Prostate 74:714–721, 2014. © 2014 The Authors. The Prostate published by Wiley Periodicals, Inc. PMID:24847526

  1. Dermoscopic features of clinically inflammatory dermatoses and their correlation with histopathologic reaction patterns.

    PubMed

    Goncharova, Yana; Attia, Enas A S; Souid, Khawla; Protzenko, Oleg; Koktishev, Igor

    2015-01-01

    Dermoscopy can be used in diagnosis of some chronic inflammatory dermatoses. In this study, the single most recent, fully developed lesion in 74 patients with clinically inflammatory dermatoses was examined dermoscopically and correlated histopathologically with psoriasiform, lichenoid, or spongiotic reaction patterns. Vascular component (morphology and arrangement) was the most prominent feature in the studied patterns mostly in the shape of dots (45 specimens, 60.8%), globules (30 specimens, 40.5%), and lines (45 specimens, 60.8%). Psoriasiform pattern showed vascular dots (20 specimens, 76.92%), and/or red globules (15 specimen, 57.69%), regularly distributed (17 specimens, 65.38%), on intense red background (15 specimens, 57.69%), and diffuse (13 specimens, 50%) white scales (18 specimen, 69.23%), with probability of these features together 100%. Lichenoid pattern showed red lines (23 cases, 65.71%), on dull or light red background (14 cases, 40% for each), with discolored areas (15 cases, 42.86%), brown reticular pigmentation (21 cases, 60%), and white scales (13 cases, 37.14%). Spongiotic pattern was characterized by follicular component and diffuse or peripheral scale distribution, with probability of both features together 100%. The main histopathologic features of inflammatory dermatoses, which influenced their dermoscopic patterns, are depth and size of vessels, presence and shape of epidermal hyperplasia, presence of spongiosis, and degree of dermal inflammation and oedema. These features influenced vascular morphology and distribution, corneal component, and background color. Among the studied reaction patterns, psoriasiform pattern showed the most consistent correlation with dermoscopic features. Dermoscopic picture of lichenoid reaction was the most contradictory. Spongiotic reaction showed absent specific vascular component. PMID:25297393

  2. Comparison of adherence monitoring tools and correlation to virologic failure in a pediatric HIV clinical trial.

    PubMed

    Intasan, Jintana; Bunupuradah, Torsak; Vonthanak, Saphonn; Kosalaraksa, Pope; Hansudewechakul, Rawiwan; Kanjanavanit, Suparat; Ngampiyaskul, Chaiwat; Wongsawat, Jurai; Luesomboon, Wicharn; Apornpong, Tanakorn; Kerr, Stephen; Ananworanich, Jintanat; Puthanakit, Thanyawee

    2014-06-01

    There is no consensus on a gold standard for monitoring adherence to antiretroviral therapy (ART). We compared different adherence monitoring tools in predicting virologic failure as part of a clinical trial. HIV-infected Thai and Cambodian children aged 1-12 years (N=207) were randomized to immediate-ART or deferred-ART until CD4% <15%. Virologic failure (VF) was defined as HIV-RNA >1000 copies/mL after ?6 months of ART. Adherence monitoring tools were: (1) announced pill count, (2) PACTG adherence questionnaire (form completed by caregivers), and (3) child self-report (self-reporting from children or caregivers to direct questioning by investigators during the clinic visit) of any missed doses in the last 3 days and in the period since the last visit. The Kappa statistic was used to describe agreement between each tool. The median age at ART initiation was 7 years with median CD4% 17% and HIV-RNA 5.0?log(10)copies/mL and 92% received zidovudine/lamivudine/nevirapine. Over 144 weeks, 13% had VF. Mean adherence by announced pill count before VF in VF children was 92% compared to 98% in children without VF (p=0.03). Kappa statistics indicated slight to fair agreement between tools. In multivariate analysis adjusting for gender, treatment arm ethnicity and caregiver education, significant predictors of VF were poor adherence by announced pill count (OR 4.56; 95%CI 1.78-11.69), reporting any barrier to adherence in the PACTG adherence questionnaire (OR 7.08; 95%CI 2.42-20.73), and reporting a missed dose in the 24 weeks since the last HIV-RNA assessment (OR 8.64; 95%CI 1.96-38.04). In conclusion, we recommend the child self-report of any missed doses since last visit for use in HIV research and in routine care settings, because it is easy and quick to administer and a strong association with development of VF. PMID:24901463

  3. Clinical correlates and heritability of erythrocyte eicosapentaenoic and docosahexaenoic acid content in the Framingham Heart Study

    PubMed Central

    Harris, William S.; Pottala, James V.; Lacey, Sean M.; Vasan, Ramachandran S.; Larson, Martin G.; Robins, Sander J.

    2013-01-01

    Objectives Red blood cell (RBC) levels of eicosapentaenoic acid (EPA) plus docosahexaenoic acid (DHA, the omega-3 index, expressed as a percent of total fatty acids) are inversely related to risk for cardiovascular disease (CVD). Although several mechanisms underlying this relationship have been proposed, understanding the associations between the omega-3 index and markers of CVD in the community can shed additional light on this question. The objectives of this study were to define the relations between the omega-3 index and clinical factors and to determine the heritability of the omega-3 index. Methods RBC samples (n = 3196) drawn between 2005 and 2008 from participants in the Framingham Study [Examination 8 of the Offspring cohort plus Examination 3 of the Omni (minorities) cohort] were analyzed for fatty acid composition by gas chromatography. Results The mean (SD) omega-3 index was 5.6% (1.7%). In multivariable regression models, the factors significantly and directly associated with the omega-3 index were age, female sex, higher education, fish oil supplementation, dietary intake of EPA + DHA, aspirin use, lipid pharmacotherapy, and LDL-cholesterol. Factors inversely associated were Offspring cohort, heart rate, waist girth, triglycerides and smoking. The total explained variability in the omega-3 index for the fully adjusted model was 73%, which included major components due to heritability (24%), EPA + DHA intake (25%), and fish oil supplementation (15%). Conclusion The variability in the omega-3 index is determined primarily by dietary and genetic factors. An increased omega-3 index is associated with a generally cardioprotective risk factor milieu. PMID:22727409

  4. Comprehensive Analysis of MGMT Promoter Methylation: Correlation with MGMT Expression and Clinical Response in GBM

    PubMed Central

    Shah, Nameeta; Lin, Biaoyang; Sibenaller, Zita; Ryken, Timothy; Lee, Hwahyung; Yoon, Jae-Geun; Rostad, Steven; Foltz, Greg

    2011-01-01

    O6-methylguanine DNA-methyltransferase (MGMT) promoter methylation has been identified as a potential prognostic marker for glioblastoma patients. The relationship between the exact site of promoter methylation and its effect on gene silencing, and the patient's subsequent response to therapy, is still being defined. The aim of this study was to comprehensively characterize cytosine-guanine (CpG) dinucleotide methylation across the entire MGMT promoter and to correlate individual CpG site methylation patterns to mRNA expression, protein expression, and progression-free survival. To best identify the specific MGMT promoter region most predictive of gene silencing and response to therapy, we determined the methylation status of all 97 CpG sites in the MGMT promoter in tumor samples from 70 GBM patients using quantitative bisulfite sequencing. We next identified the CpG site specific and regional methylation patterns most predictive of gene silencing and improved progression-free survival. Using this data, we propose a new classification scheme utilizing methylation data from across the entire promoter and show that an analysis based on this approach, which we call 3R classification, is predictive of progression-free survival (HR ?=?5.23, 95% CI [2.089–13.097], p<0.0001). To adapt this approach to the clinical setting, we used a methylation-specific multiplex ligation-dependent probe amplification (MS-MLPA) test based on the 3R classification and show that this test is both feasible in the clinical setting and predictive of progression free survival (HR ?=?3.076, 95% CI [1.301–7.27], p?=?0.007). We discuss the potential advantages of a test based on this promoter-wide analysis and compare it to the commonly used methylation-specific PCR test. Further prospective validation of these two methods in a large independent patient cohort will be needed to confirm the added value of promoter wide analysis of MGMT methylation in the clinical setting. PMID:21249131

  5. Clinical Correlates to Laboratory Measures for use in Non-Contact Anterior Cruciate Ligament Injury Risk Prediction Algorithm

    PubMed Central

    Myer, Gregory D.; Ford, Kevin R.; Khoury, Jane; Succop, Paul; Hewett, Timothy E.

    2010-01-01

    Background Prospective measures of high knee abduction moment during landing identify female athletes at high risk for non-contact anterior cruciate ligament injury. Biomechanical laboratory measurements predict high knee abduction moment landing mechanics with high sensitivity (85%) and specificity (93%). The purpose of this study was to identify correlates to laboratory-based predictors of high knee abduction moment for use in a clinic-based anterior cruciate ligament injury risk prediction algorithm. The hypothesis was that clinically obtainable correlates derived from the highly predictive laboratory-based models would demonstrate high accuracy to determine high knee abduction moment status. Methods Female basketball and soccer players (N=744) were tested for anthropometrics, strength and landing biomechanics. Pearson correlation was used to identify clinically feasible correlates and logistic regression to obtain optimal models for high knee abduction moment prediction. Findings Clinical correlates to laboratory-based measures were identified and predicted high knee abduction moment status with 73% sensitivity and 70% specificity. The clinic-based prediction algorithm, including (Odds Ratio: 95% confidence interval) knee valgus motion (1.43:1.30–1.59 cm), knee flexion range of motion (.98:0.96–1.01 deg), body mass (1.04:1.02–1.06 kg), tibia length (1.38:1.25–1.52 cm) and quadriceps to hamstring ratio (1.70:1.06–2.70) predicted high knee abduction moment status with C statistic 0.81. Interpretation The combined correlates of increased knee valgus motion, knee flexion range of motion, body mass, tibia length and quadriceps to hamstrings ratio predict high knee abduction moment status in female athletes with high sensitivity and specificity. PMID:20554101

  6. Correlation between CAG repeat length and clinical features in Machado-Joseph disease

    SciTech Connect

    Maciel, P.; Gaspar, C.; Silveira, I. [Montreal General Hospital Research Institute (Canada)] [and others

    1995-07-01

    Machado-Joseph disease (MJD) is associated with the expansion of a CAG trinucleotide repeat in a novel gene on 14q32.1. We confirmed the presence of this expansion in 156 MJD patients from 33 families of different geographic origins: 15 Portuguese Azorean, 2 Brazilian, and 16 North American of Portuguese Azorean descent. Normal chromosomes contain between 12 and 37 CAG repeats in the MJD gene, whereas MJD gene carriers have alleles within the expanded range of 62-84 CAG units. The distribution of expanded alleles and the gap between normal and expanded allele sizes is either inconsistent with a premutation hypothesis or most (if not all) of the alleles we studied descend from a common ancestor. There is a strong correlation between the expanded repeat size and the age at onset of the disease as well as the clinical presentation. There is mild instability of the CAG tract length with transmission of the expanded alleles; both increase and decrease in size between parents and progeny occur, with larger variations in male than in female transmissions. Together, these effects can partly explain the variability of age at onset and of phenotypic features in MJD; however, other modifying factors must exist. 37 refs., 6 figs.

  7. Clinical imaging and neuropathological correlations in an unusual case of cerebrotendinous xanthomatosis.

    PubMed

    Wallon, D; Guyant-Maréchal, L; Laquerrière, A; Wevers, R A; Martinaud, O; Kluijtmans, L A J; Yntema, H G; Saugier-Veber, P; Hannequin, D

    2010-01-01

    Cerebrotendinous xanthomatosis (CTX) is a rare autosomal recessive lipid storage disorder due to a deficiency of the mitochondrial enzyme sterol 27-hydroxylase (CYP 27) with reduced or no chenodeoxycholic synthesis. This deficiency leads to an accumulation of cholestanol in different sites such as the eye lens, central nervous system or tendons. We report a 64-year-old female patient with a progressive gait disorder associated with cognitive decline since the age of 59. The patient had no mental retardation, cataract or chronic diarrhea. Her family reported increasing behavioral modifications 10 years previously. Clinical examination revealed a spastic paraplegia and bilateral xanthomas on the Achilles tendons. Cerebral magnetic resonance imaging (MRI) revealed diffuse hyperintense T2 abnormalities in the pyramidal tracts from the internal capsules to the cerebral peduncles also Technetium-99m-ECD brain SPECT showed a severe cerebellar hypoperfusion. Serum cholestanol analysis was 7 µmol/l (N). After 2 years, she was bedridden and died of aspiration pneumonia. The neuropathological study confirmed the CTX diagnosis and the sequencing analysis revealed that she was compound heterozygous for two mutations in the CYP27A1 gene: 1435 C > T (exon 7) on one allele and a new mutation, 1017 G > C (exon 5) on the other. The interest of the present case is to report neuropathology findings strongly correlated with the MRI and SPECT abnormalities. PMID:21073839

  8. Psychopathic traits in adolescent offenders: an evaluation of criminal history, clinical, and psychosocial correlates.

    PubMed

    Campbell, Mary Ann; Porter, Stephen; Santor, Darcy

    2004-01-01

    Although a large body of research has established the relevance of psychopathy to adult offenders, its relevance to adolescent offenders is far less clear. The current study evaluated the clinical, psychosocial and criminal correlates of psychopathic traits in a sample of 226 male and female incarcerated adolescent offenders. According to an 18-item version of the Psychopathy Checklist-Youth Version (PCL-YV; Forth, Kosson, & Hare, 2003), only 9.4% exhibited a high level of psychopathic traits (PCL-YV>/=25). Consistent with past research, higher PCL-YV scores were positively associated with self-reported delinquency and aggressive behavior and were unrelated to emotional difficulties. Although higher PCL-YV scores were associated with the experience of physical abuse, the only psychosocial factor to predict PCL-YV scores was a history of non-parental living arrangements (e.g. foster care). In terms of criminality, a violent/versatile criminal history was positively associated with psychopathic traits. However, PCL-YV scores were unrelated to participants' official criminal records for total, non-violent, violent, and technical violation convictions. In conclusion, the data partially support the construct validity of psychopathy with adolescent offenders, but some inconsistencies with prior adult and adolescent psychopathy research were evident. These issues are discussed. PMID:14963879

  9. Intraligamentous ganglion cysts of the anterior cruciate Ligament: MR findings with clinical and arthroscopic correlations

    SciTech Connect

    Do-Dai, D.D.; Youngberg, R.A.; Lanchbury, F.D.; Pitcher, J.D. Jr.; Garver, T.H. [Madigan Army Medical Center, Tacoma, WA (United States)] [Madigan Army Medical Center, Tacoma, WA (United States)

    1996-01-01

    Magnetic resonance findings with clinical and arthroscopic correlation of intraligamentous cysts of the anterior cruciate ligament (ACL) are presented. Three cases of intraligamentous cysts of the ACL were identified out of 681 knee MRI examinations over a 2-year period. Arthroscopy and postoperative MRI were performed in all three patients, each of whom experienced knee pain with extreme flexion and extension. In all three cases the intraligamentous cyst was homogeneously hypointense on T1-weighted imaging and hyperintense on T2-weighted imaging relative to the ACL. Two of the three ACL cysts required a 70{degrees} scope for adequate visualization and establishment of posteromedial and posterolateral portals for arthroscopic treatment. One cyst could not be visualized arthroscopically and probing of the ACL from the anterior portal resulted in drainage of the cyst. No patient had presence of ACL cyst on follow-up MRI or recurrence of symptoms at a mean of 24 months. Intraligamentous cyst of ACL is a rare cause of knee pain. It should be suspected in patients having chronic pain with extremes of motion. Magnetic resonance findings are diagnostic and help to guide arthroscopy. 14 refs., 3 figs.

  10. Mutational patterns in the breast cancer mitochondrial genome, with clinical correlates.

    PubMed

    McMahon, Sarah; LaFramboise, Thomas

    2014-05-01

    The presence of mitochondrial DNA (mtDNA) mutations in human cancer has long been recognized, but their functional significance has remained obscure. Debate persists as to whether the mutations help drive the tumor, or are bystander events. Here, we analyze next-generation mtDNA sequence data from 99 breast cancer patients. High depth coverage enables detection of even low-level heteroplasmic variants, and data from matched normal tissue allow us to distinguish between shifts in heteroplasmy and acquired mutations. Somatic mtDNA mutations are found in 73 (73.7%) of patient tumors, and dramatic shifts from the initial germline allele proportions are observed for many heteroplasmies. Clustering of somatic mutations in promoter and replication regions, and also in genes coding for electron transport chain complex I, suggest selection for mutations affecting critical mitochondrial processes. Furthermore, statistical tests for Darwinian selection reveal evidence for positive and relaxed negative selection for somatic missense mutations. We also observe a dramatic decrease in per-cell mtDNA content in tumor tissues, as well as a surprising positive correlation between somatic mtDNA mutational burden and patient survival. Taken together, our results support the view that somatic mtDNA mutations are not solely bystander events, but have significance in cancer from both biological and clinical perspectives. We also anticipate that the catalog of heteroplasmies and somatic mutations presented here will serve as a reference for future studies of cancer mitochondrial genomes. PMID:24442641

  11. Proposed Provocative Questions — Provocative Questions

    Cancer.gov

    View all of the questions that have been submitted and see how they have been evaluated by peers. Submit your own evaluation of a submitted question, or leave a comment about a question (commenting requires log in or creation of your own PQ account).

  12. Clinical Correlates of ADHD in Females: Findings From a Large Group of Girls Ascertained From Pediatric and Psychiatric Referral Sources

    Microsoft Academic Search

    JOSEPH BIEDERMAN; STEPHEN V. FARAONE; ERIC MICK; SARAH WILLIAMSON; TIMOTHY E. WILENS; THOMAS J. SPENCER; WENDY WEBER; JENNIFER JETTON; ILANA KRAUS; JIM PERT; BARRY ZALLEN

    1999-01-01

    ObjectiveThe scientific literature about attention-deficit hyperactivity disorder (ADHD) is based almost exclusively on male subjects, and girls with ADHD may be underidentified and undertreated. The aim of this study was to examine clinical correlates of ADHD in females using comprehensive assessments in multiple domains of functioning.

  13. Emotional Lability in Children and Adolescents with Attention Deficit/Hyperactivity Disorder (ADHD): Clinical Correlates and Familial Prevalence

    ERIC Educational Resources Information Center

    Sobanski, Esther; Banaschewski, Tobias; Asherson, Philip; Buitelaar, Jan; Chen, Wai; Franke, Barbara; Holtmann, Martin; Krumm, Bertram; Sergeant, Joseph; Sonuga-Barke, Edmund; Stringaris, Argyris; Taylor, Eric; Anney, Richard; Ebstein, Richard P.; Gill, Michael; Miranda, Ana; Mulas, Fernando; Oades, Robert D.; Roeyers, Herbert; Rothenberger, Aribert; Steinhausen, Hans-Christoph; Faraone, Stephen V.

    2010-01-01

    Background: The goal of this study was to investigate the occurrence, severity and clinical correlates of emotional lability (EL) in children with attention deficit/hyperactivity disorder (ADHD), and to examine factors contributing to EL and familiality of EL in youth with ADHD. Methods: One thousand, one hundred and eighty-six children with ADHD…

  14. A METHOD FOR EXTRACTING IMAGING CORRELATIONS WITH ALTERATIONS IN GLOBAL GENE EXPRESSION

    E-print Network

    De Micheli, Giovanni

    statistically significant correlation (p of the algorithms created to answer a wide range of clinical questions. We implement here an algorithm to evaluate the correlation of imaging features with global gene expression and their significance. METHOD AND MATERIALS

  15. Correlation between clinical findings and magnetic resonance imaging for the assessment of local response after standard treatment in cervical cancer?

    PubMed Central

    Valduvieco, Izaskun; Biete, Albert; Rios, Iván; Llorente, Ricardo; Rovirosa, Angels; Pahisa, Jaume; Vidal, Laura; Farrús, Blanca; Samper, Pilar

    2013-01-01

    Background The aim of our study is to evaluate the correlation between gynecological examination and magnetic resonance (MRI) findings for the assessment of local response in cervical cancer patients treated with radiotherapy/chemotherapy (RT/ChT). Patients and methods This study is a retrospective review of 75 consecutive cervical cancer patients from April 2004 to November 2009 treated with RT/ChT. Clinical and radiological data were subsequently analyzed. Patient's median age was 51 with a FIGO stage from Ib to IVb. Individualized RT/ChT was administered with a median dose of 45 Gy. Sixty-three patients received a complementary brachytherapy. Seventy-one patients received chemotherapy on a weekly basis. Gynecological exam was performed 3 months and 6 months after treatment and these findings were compared to MRI results at the same time. Statistic analysis We used the Spearman's Rho test to determine the correlation level between the clinical and radiological methods. Results A correlation of 0.68 (60%) was observed between the clinical and MRI findings at 3 months with a further increase of up to 0.86 (82.6%) at 6 months. In the few cases with a poor correlation, the subsequent assessment and the natural history of the disease showed a greater value of the clinical exam as compared with the MRI findings. Conclusions Physical exam remains an essential tool to evaluate the local response to RT/ChT for cervical cancer. The optimal clinical radiological correlation found at 6 months after treatment suggests that the combination of gynecological examination and MRI are probably adequate in patient monitoring. PMID:24416556

  16. Clinical and pathological correlates of severity classifications in trigger fingers based on computer-aided image analysis

    PubMed Central

    2014-01-01

    Background The treatment of trigger finger so far has heavily relied on clinicians’ evaluations for the severity of patients’ symptoms and the functionality of affected fingers. However, there is still a lack of pathological evidence supporting the criteria of clinical evaluations. This study’s aim was to correlate clinical classification and pathological changes for trigger finger based on the tissue abnormality observed from microscopic images. Methods Tissue samples were acquired, and microscopic images were randomly selected and then graded by three pathologists and two physicians, respectively. Moreover, the acquired images were automatically analyzed to derive two quantitative parameters, the size ratio of the abnormal tissue region and the number ratio of the abnormal nuclei, which can reflect tissue abnormality caused by trigger finger. A self-developed image analysis system was used to avoid human subjectivity during the quantification process. Finally, correlations between the quantitative image parameters, pathological grading, and clinical severity classification were assessed. Results One-way ANOVA tests revealed significant correlations between the image quantification and pathological grading as well as between the image quantification and clinical severity classification. The Cohen’s kappa coefficient test also depicted good consistency between pathological grading and clinical severity classification. Conclusions The criteria of clinical classification were found to be highly associated with the pathological changes of affected tissues. The correlations serve as explicit evidence supporting clinicians in making a treatment strategy of trigger finger. In addition, our proposed computer-aided image analysis system was considered to be a promising and objective approach to determining trigger finger severity at the microscopic level. PMID:25055721

  17. Deficient conditioned pain modulation after spinal cord injury correlates with clinical spontaneous pain measures.

    PubMed

    Albu, Sergiu; Gómez-Soriano, Julio; Avila-Martin, Gerardo; Taylor, Julian

    2015-02-01

    The contribution of endogenous pain modulation dysfunction to clinical and sensory measures of neuropathic pain (NP) has not been fully explored. Habituation, temporal summation, and heterotopic noxious conditioning stimulus-induced modulation of tonic heat pain intensity were examined in healthy noninjured subjects (n = 10), and above the level of spinal cord injury (SCI) in individuals without (SCI-noNP, n = 10) and with NP (SCI-NP, n = 10). Thermoalgesic thresholds, Cz/AFz contact heat evoked potentials (CHEPs), and phasic or tonic (30 seconds) heat pain intensity were assessed within the C6 dermatome. Although habituation to tonic heat pain intensity (0-10) was reported by the noninjured (10 s: 3.5 ± 0.3 vs 30 s: 2.2 ± 0.5 numerical rating scale; P = 0.003), loss of habituation was identified in both the SCI-noNP (3.8 ± 0.3 vs 3.6 ± 0.5) and SCI-NP group (4.2 ± 0.4 vs 4.9 ± 0.8). Significant temporal summation of tonic heat pain intensity was not observed in the 3 groups. Inhibition of tonic heat pain intensity induced by heterotopic noxious conditioning stimulus was identified in the noninjured (-29.7% ± 9.7%) and SCI-noNP groups (-19.6% ± 7.0%), but not in subjects with SCI-NP (+1.1% ± 8.0%; P < 0.05). Additionally, the mean conditioned pain modulation response correlated positively with Cz/AFz CHEP amplitude (? = 0.8; P = 0.015) and evoked heat pain intensity (? = 0.8; P = 0.007) in the SCI-NP group. Stepwise regression analysis revealed that the mean conditioned pain modulation (R = 0.72) correlated with pain severity and pressing spontaneous pain in the SCI-NP group. Comprehensive assessment of sensory dysfunction above the level of injury with tonic thermal test and conditioning stimuli revealed less-efficient endogenous pain modulation in subjects with SCI-NP. PMID:25599447

  18. Disease quantification in dermatology: in vivo near-infrared spectroscopy measures correlate strongly with the clinical assessment of psoriasis severity

    NASA Astrophysics Data System (ADS)

    Greve, Tanja Maria; Kamp, Søren; Jemec, Gregor B. E.

    2013-03-01

    Accurate documentation of disease severity is a prerequisite for clinical research and the practice of evidence-based medicine. The quantification of skin diseases such as psoriasis currently relies heavily on clinical scores. Although these clinical scoring methods are well established and very useful in quantifying disease severity, they require an extensive clinical experience and carry a risk of subjectivity. We explore the opportunity to use in vivo near-infrared (NIR) spectra as an objective and noninvasive method for local disease severity assessment in 31 psoriasis patients in whom selected plaques were scored clinically. A partial least squares (PLS) regression model was used to analyze and predict the severity scores on the NIR spectra of psoriatic and uninvolved skin. The correlation between predicted and clinically assigned scores was R=0.94 (RMSE=0.96), suggesting that in vivo NIR provides accurate clinical quantification of psoriatic plaques. Hence, NIR may be a practical solution to clinical severity assessment of psoriasis, providing a continuous, linear, numerical value of severity.

  19. Correlation of clinical findings, collision parameters, and psychological factors in the outcome of whiplash associated disorders

    PubMed Central

    Richter, M; Ferrari, R; Otte, D; Kuensebeck, H; Blauth, M; Krettek, C

    2004-01-01

    Objective: To determine prognostic factors for the duration and severity of acute symptoms in subjects with grade 1 or 2 whiplash injuries. Methods: Collision victims presenting to a trauma centre with spinal pain or stiffness were assessed clinically (including a visual analogue scale (VAS)), radiologically, and psychologically (short form 36 (SF36), everyday life quality (EDLQ), pain control questionnaire (FSR)). Collision type and estimated ?V (change in velocity of the occupant's vehicle) were also assessed. Assessment at six months involved VAS symptom rating, SF36, EDLQ, depression scale (CES-D), and impact of event scale (IES). Results: 43 consecutive collision victims (22 male, 21 female; mean age 29 years (range 19 to 72) with grade 1 or 2 whiplash associated disorders were assessed. Mean ?V, available for 36 of 43 collisions, was 13.9 (5 to 30) km/h. Thirty two (74%) of the subjects were available for follow up at six months. The mean duration of symptoms was 28 (1 to 180) days in this group. No correlation was found between severity and duration of symptoms and the ?V of collision or other collision parameters. Patients with initial pain VAS >5 or with duration of symptoms more than 28 days had significant changes in SF36, EDLQ, CES-D, and IES scores at six months, and had initial scores that were predictive of these outcomes. Conclusions: Psychological factors were found to be more relevant than collision severity in predicting the duration and severity of symptoms in collision victims with grade 1 or 2 whiplash associated disorders. PMID:15090574

  20. Oxidative Stress and Erythrocyte Membrane Alterations in Children with Autism: Correlation with Clinical Features

    PubMed Central

    Visconti, Paola; Bolotta, Alessandra; Ferreri, Carla; Gobbi, Giuseppe; Malisardi, Gemma; Manfredini, Stefano; Marini, Marina; Nanetti, Laura; Pipitone, Emanuela; Raffaelli, Francesca; Resca, Federica; Mazzanti, Laura

    2013-01-01

    It has been suggested that oxidative stress may play a role in the pathogenesis of Autism Spectrum Disorders (ASD), but the literature reports somewhat contradictory results. To further investigate the issue, we evaluated a high number of peripheral oxidative stress parameters, and some related issues such as erythrocyte membrane functional features and lipid composition. Twenty-one autistic children (Au) aged 5 to 12 years, were gender and age-matched with 20 typically developing children (TD). Erythrocyte thiobarbituric acid reactive substances, urinary isoprostane and hexanoyl-lysine adduct levels were elevated in Au, thus confirming the occurrence of an imbalance of the redox status of Au, whilst other oxidative stress markers or associated parameters (urinary 8-oxo-dG, plasma radical absorbance capacity and carbonyl groups, erythrocyte superoxide dismutase and catalase activities) were unchanged. A very significant reduction of Na+/K+-ATPase activity (?66%, p<0.0001), a reduction of erythrocyte membrane fluidity and alteration in erythrocyte fatty acid membrane profile (increase in monounsaturated fatty acids, decrease in EPA and DHA-?3 with a consequent increase in ?6/?3 ratio) were found in Au compared to TD, without change in membrane sialic acid content. Some Au clinical features appear to be correlated with these findings; in particular, hyperactivity score appears to be related with some parameters of the lipidomic profile and membrane fluidity. Oxidative stress and erythrocyte membrane alterations may play a role in the pathogenesis of ASD and prompt the development of palliative therapeutic protocols. Moreover, the marked decrease in NKA could be potentially utilized as a peripheral biomarker of ASD. PMID:23840462

  1. Paraoxonase-1 Enzyme Activity Assay for Clinical Samples: Validation and Correlation Studies

    PubMed Central

    Garelnabi, Mahdi; Younis, Abdelmoneim

    2015-01-01

    Background Paraoxonase-1 (PON1) enzyme is reported in various types of tissues and linked to numerous pathophysiological disorders. It is a potential biomarker in many pathological conditions such as cardiovascular diseases. Material/Methods We conducted several small-scale studies to evaluate PON1 performance as affected by sample types, storage, and interferences. We also carried out short-term studies to compare the performance of the widely used PON1 assay to the similar commercially available PON1 kit assay method; sample size for the method comparison was N=40, and the number varied for other validation experiments. Results Our studies using various types of anticoagulants show that samples collected in tubes with NaF, citrate, EDTA, clot activator, and sodium heparin have increased PON1 levels that are 49%, 24.5%, 19.8%, 11.4%, and 8%, respectively, higher compared to serum samples collected in plain tubes. However, samples collected in lithium heparin tubes demonstrated 10.4% lower PON1 levels compared to serum collected in plain tubes. Biological interference such as hemolysis has little effect on PON1 levels; however, samples spiked with lipids have shown 13% lower PON 1 levels. Our studies comparing the PON1 method commonly available for PON1 assay and a similar non-ELISA commercially available PON1 kit method showed a weak Spearman correlation coefficient of R2=0.40 for the range of 104.9–245.6 U/L. Conclusions The current study provides new validation data on enzyme PON1 performance. While no appreciable change was seen with storage, samples type affects the enzyme performance. Our results should encourage additional clinical studies to investigate other aspects of factors known to affect PON1 enzyme function and performance. PMID:25814092

  2. Meta-analysis of clinical correlates of acute mortality in takotsubo cardiomyopathy.

    PubMed

    Singh, Kuljit; Carson, Kristin; Shah, Ranjit; Sawhney, Gagandeep; Singh, Balwinder; Parsaik, Ajay; Gilutz, Harel; Usmani, Zafar; Horowitz, John

    2014-04-15

    The incidence and clinical correlates of acute in-hospital mortality of takotsubo cardiomyopathy (TTC) are not clear. We performed a systematic review and meta-analysis to consolidate the current evidence on acute mortality in TTC. We then assessed the impact of "secondary" TTC, male gender, advancing age, and catecholamine use on mortality. A comprehensive search of 4 major databases (EMBASE, Ovid MEDLINE, PubMed, and Google Scholar) was performed from their inception to the first week of July 2013. We included original research studies, recruiting ?10 participants, published in English language, and those that reported data on mortality and cause of death in patients with TTC. Of 382 citations, 37 studies (2,120 patients with TTC) from 11 different countries were included in the analyses. The mean age of the cohort was 68 years (95% confidence interval [CI] 67 to 69) with female predominance (87%). The in-hospital mortality rate among patients with TTC was 4.5% (95% CI 3.1 to 6.2, I2=60.8%). Among all deaths, 38% were directly related to TTC complications and rest to underlying noncardiac conditions. Male gender was associated with higher TTC mortality rate (odds ratio 2.6, 95% CI 1.5 to 4.6, p=0.0008, I2=0%) so was "secondary" TTC (risk difference -0.11, 95% CI -0.18 to -0.04, p=0.003, I2=84%). The mean age of patients dying tended to be greater than that in the whole cohort (72±7 vs 65±7 years). In conclusion, TTC is not as benign as once thought. To reduce the mortality rate, greater efforts need to be directed to the diagnosis, treatment, and ultimately prevention of "secondary" TTC. PMID:24685327

  3. Correlation of Clinical and Dosimetric Factors With Adverse Pulmonary Outcomes in Children After Lung Irradiation

    SciTech Connect

    Venkatramani, Rajkumar, E-mail: rvenkatramani@chla.usc.edu [Division of Hematology/Oncology, Children's Hospital Los Angeles, Los Angeles, California (United States); Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, California (United States); Kamath, Sunil [Department of Pulmonology, Children's Hospital Los Angeles, Los Angeles, California (United States); Wong, Kenneth [Division of Hematology/Oncology, Children's Hospital Los Angeles, Los Angeles, California (United States); Olch, Arthur J. [Division of Hematology/Oncology, Children's Hospital Los Angeles, Los Angeles, California (United States); Department of Radiation Oncology, University of Southern California, Los Angeles, California (United States); Malvar, Jemily [Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California (United States); Sposto, Richard [Division of Hematology/Oncology, Children's Hospital Los Angeles, Los Angeles, California (United States); Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California (United States); Goodarzian, Fariba [Department of Radiology, Children's Hospital Los Angeles, Los Angeles, California (United States); Freyer, David R. [Division of Hematology/Oncology, Children's Hospital Los Angeles, Los Angeles, California (United States); Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, California (United States); Keens, Thomas G. [Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, California (United States); Department of Pulmonology, Children's Hospital Los Angeles, Los Angeles, California (United States); and others

    2013-08-01

    Purpose: To identify the incidence and the risk factors for pulmonary toxicity in children treated for cancer with contemporary lung irradiation. Methods and Materials: We analyzed clinical features, radiographic findings, pulmonary function tests, and dosimetric parameters of children receiving irradiation to the lung fields over a 10-year period. Results: We identified 109 patients (75 male patients). The median age at irradiation was 13.8 years (range, 0.04-20.9 years). The median follow-up period was 3.4 years. The median prescribed radiation dose was 21 Gy (range, 0.4-64.8 Gy). Pulmonary toxic chemotherapy included bleomycin in 58.7% of patients and cyclophosphamide in 83.5%. The following pulmonary outcomes were identified and the 5-year cumulative incidence after irradiation was determined: pneumonitis, 6%; chronic cough, 10%; pneumonia, 35%; dyspnea, 11%; supplemental oxygen requirement, 2%; radiographic interstitial lung disease, 40%; and chest wall deformity, 12%. One patient died of progressive respiratory failure. Post-irradiation pulmonary function tests available from 44 patients showed evidence of obstructive lung disease (25%), restrictive disease (11%), hyperinflation (32%), and abnormal diffusion capacity (12%). Thoracic surgery, bleomycin, age, mean lung irradiation dose (MLD), maximum lung dose, prescribed dose, and dosimetric parameters between V{sub 22} (volume of lung exposed to a radiation dose ?22 Gy) and V{sub 30} (volume of lung exposed to a radiation dose ?30 Gy) were significant for the development of adverse pulmonary outcomes on univariate analysis. MLD, maximum lung dose, and V{sub dose} (percentage of volume of lung receiving the threshold dose or greater) were highly correlated. On multivariate analysis, MLD was the sole significant predictor of adverse pulmonary outcome (P=.01). Conclusions: Significant pulmonary dysfunction occurs in children receiving lung irradiation by contemporary techniques. MLD rather than prescribed dose should be used to perform risk stratification of patients receiving lung irradiation.

  4. Phosphoinositide system-linked serotonin receptor subtypes and their pharmacological properties and clinical correlates.

    PubMed Central

    Pandey, S C; Davis, J M; Pandey, G N

    1995-01-01

    Serotonergic neurotransmission represents a complex mechanism involving pre- and post-synaptic events and distinct 5-HT receptor subtypes. Serotonin (5-HT) receptors have been classified into several categories, and they are termed as 5-HT1, 5-HT2, 5-HT3, 5-HT4, 5-HT5, 5-HT6 and 5-HT7 type receptors. 5-HT1 receptors have been further subdivided into 5-HT1A, 5-HT1B, 5-HT1D, 5-HT1E and 5-HT1F. 5-HT2 receptors have been divided into 5-HT2A, 5-HT2B and 5-HT2C receptors. All 5-HT2 receptor subtypes are linked to the multifunctional phosphoinositide (PI) signalling system. 5-HT3 receptors are considered ion-gated receptors and are also linked to the PI signalling system by an unknown mechanism. The 5-HT2A receptor subtype is the most widely studied of the 5-HT receptors in psychiatric disorders (for example, suicide, depression and schizophrenia) as well as in relation to the mechanism of action of antidepressant drugs. The roles of 5-HT2C and 5-HT3 receptors in psychiatric disorders are less clear. These 5-HT receptors also play an important role in alcoholism. It has been shown that 5-HT2A, 5-HT2C and 5-HT3 antagonists cause attenuation of alcohol intake in animals and humans. However, the exact mechanisms are unknown. The recent cloning of the cDNAs for 5-HT2A, 5-HT2C and 5-HT3 receptors provides the opportunity to explore the molecular mechanisms responsible for the alterations in these receptors during illness as well as pharmacotherapy. This review article will focus on the current research into the pharmacological properties, molecular biology, and clinical correlates of 5-HT2A, 5-HT2C and 5-HT3 receptors. PMID:7786883

  5. Genetic spectrum and clinical correlates of somatic mutations in aldosterone-producing adenoma.

    PubMed

    Fernandes-Rosa, Fabio Luiz; Williams, Tracy Ann; Riester, Anna; Steichen, Olivier; Beuschlein, Felix; Boulkroun, Sheerazed; Strom, Tim M; Monticone, Silvia; Amar, Laurence; Meatchi, Tchao; Mantero, Franco; Cicala, Maria-Verena; Quinkler, Marcus; Fallo, Francesco; Allolio, Bruno; Bernini, Giampaolo; Maccario, Mauro; Giacchetti, Gilberta; Jeunemaitre, Xavier; Mulatero, Paolo; Reincke, Martin; Zennaro, Maria-Christina

    2014-08-01

    Primary aldosteronism is the most common form of secondary hypertension. Somatic mutations in KCNJ5, ATP1A1, ATP2B3, and CACNA1D have been described in aldosterone-producing adenomas (APAs). Our aim was to investigate the prevalence of somatic mutations in these genes in unselected patients with APA (n=474), collected through the European Network for the Study of Adrenal Tumors. Correlations with clinical and biochemical parameters were first analyzed in a subset of 199 patients from a single center and then replicated in 2 additional centers. Somatic heterozygous KCNJ5 mutations were present in 38% (180/474) of APAs, whereas ATP1A1 mutations were found in 5.3% (25/474) and ATP2B3 mutations in 1.7% (8/474) of APAs. Previously reported somatic CACNA1D mutations as well as 10 novel CACNA1D mutations were identified in 44 of 474 (9.3%) APAs. There was no difference in the cellular composition of APAs or in CYP11B2, CYP11B1, KCNJ5, CACNA1D, or ATP1A1 gene expression in APAs across genotypes. Patients with KCNJ5 mutations were more frequently female, diagnosed younger, and with higher minimal plasma potassium concentrations compared with CACNA1D mutation carriers or noncarriers. CACNA1D mutations were associated with smaller adenomas. These associations were largely dependent on the population structure of the different centers. In conclusion, recurrent somatic mutations were identified in 54% of APAs. Young women with APAs are more likely to be KCNJ5 mutation carriers; identification of specific characteristics or surrogate biomarkers of mutation status may lead to targeted treatment options. PMID:24866132

  6. Essential Questions

    ERIC Educational Resources Information Center

    Wilhelm, Jeffrey D.

    2012-01-01

    The secret to teaching may be as simple as asking students good questions--and then giving them the opportunity to find the answers. The author shares how he uses essential questions that set the class off on an inquiry. Rather than consuming information that he distributes and then repeating it on a test, students carry out their own…

  7. Curiosity Questions

    ERIC Educational Resources Information Center

    Nelsen, Jane; DeLorenzo, Chip

    2010-01-01

    Have you ever found yourself lecturing a child, with the best of intentions, in an attempt to help him or her learn a lesson or process a situation in a manner that you feel will be productive? Curiosity questions, which the authors also call What and How questions, help children process an experience, event, or natural consequence so that they…

  8. Question Mars

    NSDL National Science Digital Library

    This is a lesson about generating hypotheses and testable questions. Learners will use critical thinking and a collaborative approach to pose questions related to the study of Mars and evaluate the quality of their questions. They will explore remote-sensing data collected by a camera orbiting Mars - the Thermal Emission Imaging System (THEMIS) and develop a team science question. Students will practice critical thinking skills, use a collaborative approach to this first critical step of the scientific process. Exploring the images of the surface of Mars in Visible (VIS) images, students will come up with a topic of study, their team science question and hypotheses. The lesson models scientific inquiry using the 5E instructional model and includes teacher notes and vocabulary.

  9. Assessment of cerebral visual impairment with the L94 visual perceptual battery: clinical value and correlation with MRI findings.

    PubMed

    Ortibus, E; Lagae, L; Casteels, I; Demaerel, P; Stiers, P

    2009-03-01

    In this article we describe visual perceptual abilities of a clinical population, referred for visual problems to our multidisciplinary team and assessed with the five computer tasks from the L94 visual perceptual battery. Clinical and neuroimaging findings were correlated with the findings on this task battery. Seventy children (35 males, 35 females) constituted our cohort. Age ranged from 4 to 20 years (mean 7y [SD 3y]). Forty children were born before 37 weeks gestational age. Thirty-six children had cerebral palsy (CP), of whom 24 had spastic diplegia, five had spastic hemiplegia, and four had spastic quadriplegia. Three children had ataxic CP. Perceptual visual impairment (PVI) was established in comparison to the performance age obtained on non-verbal intelligence subtests, instead of chronological age. Our results suggest that children with a history of preterm birth and a clinical CP picture are most at risk for a specific PVI. Correlations among other clinical variables did not define a clinical subgroup more at risk. Children with periventricular leucomalacia were almost equally represented in both PVI and non-PVI groups. Normal magnetic resonance imaging did not exclude the presence of PVI. In these children, however, we found another impairment profile, more in favour of dorsal stream impairment. PMID:19260932

  10. Myocardial uptake of indium-111-labeled antimyosin in acute subendocardial infarction: Clinical, histochemical, and autoradiographic correlation of myocardial necrosis

    SciTech Connect

    Hendel, R.C.; McSherry, B.A.; Leppo, J.A. (Univ. of Massachusetts Medical Center, Worcester (USA))

    1990-11-01

    Indium-111-labeled antimyosin has been utilized in the diagnosis and localization of acute transmural myocardial infarction. The present report describes a patient who presented with a massive subendocardial infarction. Two days after the injection of antimyosin, the patient's clinical status markedly deteriorated and he expired. Postmortem examination demonstrated severe three-vessel coronary artery disease with extensive myocyte death in the endocardium. Autoradiography and histochemical staining of the prosected heart demonstrated high correlation for myocardial necrosis and corresponded to clinical evidence for diffuse subendocardial infarction.

  11. Clinical and clinical laboratory correlates in sea otters dying unexpectedly in rehabilitation centers following the Exxon Valdez oil spill.

    PubMed

    Rebar, A H; Lipscomb, T P; Harris, R K; Ballachey, B E

    1995-07-01

    Following the Exxon Valdez oil spill, 347 oiled sea otters (Enhydra lutris) were treated in rehabilitation centers. Of these, 116 died, 94 within 10 days of presentation. Clinical records of 21 otters dying during the first 10 days of rehabilitation were reviewed to define the laboratory abnormalities and clinical syndromes associated with these unexpected deaths. The most common terminal syndrome was shock characterized by hypothermia, lethargy, and often hemorrhagic diarrhea. In heavily and moderately oiled otters, shock developed within 48 hours of initial presentation, whereas in lightly oiled otters shock generally occurred during the second week of captivity. Accompanying laboratory abnormalities included leukopenia with increased numbers of immature neutrophils (degenerative left shift), lymphopenia, anemia, azotemia (primarily prerenal), hyperkalemia, hypoproteinemia/hypoalbuminemia, elevations of serum transaminases, and hypoglycemia. Shock associated with hemorrhagic diarrhea probably occurred either as a direct primary effect of oiling or as an indirect effect secondary to confinement and handling in the rehabilitation centers. Lightly oiled otters were less likely to die from shock than were heavily oiled otters (22% vs. 72%, respectively). Heavily oiled otters developed shock more rapidly and had greater numbers of laboratory abnormalities, suggesting that exposure to oil was an important contributing factor. PMID:7483208

  12. Early-stage pulmonary adenocarcinoma (T1N0M0): a clinical, radiological, surgical, and pathological correlation of 104 cases. The MD Anderson Cancer Center Experience.

    PubMed

    Weissferdt, Annikka; Kalhor, Neda; Marom, Edith M; Benveniste, Marcelo F; Godoy, Myrna C; Correa, Arlene M; Swisher, Stephen G; Moran, Cesar A

    2013-08-01

    The recent proposal for histological subtyping of pulmonary adenocarcinoma by predominant pattern and introduction of the terms adenocarcinoma in situ and minimally invasive adenocarcinoma to replace the term bronchioloalveolar carcinoma by the International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society has led us to conduct a study of 104 patients with early-stage primary pulmonary adenocarcinoma (T1N0M0), with a view to histological subtype as defined by the new proposal and clinical outcome. None of the clinical parameters of our patient population (type of surgery, age, gender, tumor size, and comorbidities) showed any statistically significant correlation with outcome, except for associated malignancies, which not surprisingly appeared to have a negative impact on survival. In addition, statistical analyses of the histological characteristics to include tumor differentiation and the percentage of a lepidic or bronchioloalveolar component did not show any statistically significant values in terms of survival. Our results failed to show any statistically significant difference of survival between those T1N0M0 adenocarcinomas with a lepidic component and those without, thus questioning the use of terms such as in situ or minimally invasive adenocarcinoma. On the basis of our results, we consider that the outcome for patients with T1N0M0 disease is still best determined by appropriate staging rather than by changes in the pathology nomenclature of adenocarcinoma. PMID:23542459

  13. Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  14. Composing questions

    E-print Network

    Kotek, Hadas

    2014-01-01

    This dissertation motivates a new syntax and semantics for simplex and multiple wh-questions, concentrating on English and German data. The proposed theory combines Cable's (2007; 2010) Q-based syntax for wh-movement and ...

  15. Fragile X Premutation Tremor\\/Ataxia Syndrome: Molecular, Clinical, and Neuroimaging Correlates

    Microsoft Academic Search

    Sébastien Jacquemont; Randi J. Hagerman; Maureen Leehey; Jim Grigsby; Lin Zhang; James A. Brunberg; Claudia Greco; Vincent Des Portes; Tristan Jardini; Richard Levine; Elizabeth Berry-Kravis; W. Ted Brown; Stephane Schaeffer; John Kissel; Flora Tassone; Paul J. Hagerman

    2003-01-01

    We present a series of 26 patients, all 150 years of age, who are carriers of the fragile X premutation and are affected by a multisystem, progressive neurological disorder. The two main clinical features of this new syndrome are cerebellar ataxia and\\/or intention tremor, which were chosen as clinical inclusion criteria for this series. Other documented symptoms were short-term memory

  16. Examining the Clinical Correlates of Autism Spectrum Disorder in Youth by Ascertainment Source

    ERIC Educational Resources Information Center

    Joshi, Gagan; Faraone, Stephen V.; Wozniak, Janet; Petty, Carter; Fried, Ronna; Galdo, Maribel; Furtak, Stephannie L.; McDermott, Katie; Epstien, Cecily; Walker, Rosemary; Caron, Ashley; Feinberg, Leah; Biederman, Joseph

    2014-01-01

    To examine whether presentation of autism spectrum disorder (ASD) and associated patterns of psychiatric comorbidity and dysfunction vary by referral source. ASD youth referred to a specialized ambulatory program for ASD (N = 143) were compared to ASD youth referred to a general child psychiatry clinic (N = 217). More ASD clinic youth met criteria…

  17. Correlation between microRNA expression levels and clinical parameters associated with chronic hepatitis C viral infection in humans

    Microsoft Academic Search

    Rebecca T Marquez; Sarmistha Bandyopadhyay; Erik B Wendlandt; Kathy Keck; Brandon A Hoffer; Michael S Icardi; Randolph N Christensen; Warren N Schmidt; Anton P McCaffrey

    2010-01-01

    MicroRNAs (miRNAs) are small RNAs that regulate gene expression pathways. Previous studies have shown interactions between hepatitis C virus (HCV) and host miRNAs. We measured miR-122 and miR-21 levels in HCV-infected human liver biopsies relative to uninfected human livers and correlated these with clinical patient data. miR-122 is required for HCV replication in vitro, and miR-21 is involved in cellular

  18. Correlation of Cutaneous Lesions with Clinical Radiological and Urodynamic Findings in the Prognosis of Underlying Spinal Dysraphism Disorders

    Microsoft Academic Search

    Mehdi Sasani; Bahloul Asghari; Yalda Asghari; Ruya Afsharian; Ali Fahir Ozer

    2008-01-01

    Spinal dysraphism is characterized by a lack of fusion of the vertebral arches that occurs in the absence of spinous processes with variable amounts of lamina. Here, we retrospectively present the importance of cutaneous lesions and their correlation with clinical presentation, radiological examination and urodynamic assessment. We retrospectively reviewed 612 (6.12%) cases with skin lesions from 10,000 consecutive live-born children

  19. Examining the Clinical Correlates of Autism Spectrum Disorder in Youth by Ascertainment Source

    PubMed Central

    Joshi, Gagan; Faraone, Stephen V; Wozniak, Janet; Petty, Carter; Fried, Ronna; Galdo, Maribel; Furtak, Stephannie L.; McDermott, Katie; Epstien, Cecily; Walker, Rosemary; Caron, Ashley; Feinberg, Leah; Biederman, Joseph

    2014-01-01

    Objective To examine whether presentation of autism spectrum disorder (ASD) and associated patterns of psychiatric comorbidity and dysfunction vary by referral source. Methods ASD youth referred to a specialized ambulatory program for ASD (N=143) were compared to ASD youth referred to a general child psychiatry clinic (N=217). Results More ASD clinic youth met criteria for a more robust form of ASD (autistic disorder); more youth referred to the psychiatry clinic met criteria for broader spectrum ASD (PDD-NOS). General psychiatry clinic youth with ASD suffered from a greater burden of psychopathologies and higher levels of dysfunction. Conclusion The presentation of ASD in psychiatrically referred youth differs between general and ASD-specialized clinics, though both referral populations have high levels of comorbidity and dysfunction. PMID:24566937

  20. Provocative Questions feedback — Provocative Questions

    Cancer.gov

    Provocative Questions Skip to content. | Skip to navigation Personal tools Sign Up Log in Sections Home Home Current RFAs and PQs Cancer Prevention and Risk Mechanisms of Tumor Development or Recurrence Tumor Detection, Diagnosis, and Prognosis Cancer

  1. Primary uterine cervical cancer: correlation of preoperative magnetic resonance imaging and clinical staging (FIGO) with histopathology findings.

    PubMed

    Kraljevi?, Zdenko; Viskovi?, Klaudija; Ledinsky, Mario; Zadravec, Dijana; Grbavac, Ivan; Bilandzija, Marijana; Soljaci?-Vranes, Hrvojka; Kuna, Krunoslav; Klasni?, Ksenija; Krolo, Ivan

    2013-06-01

    The most commonly used staging system for cervical cancer is based on the International Federation of Gynaecology and Obstetrics (FIGO) staging system. Magnetic resonance imaging (MRI) has been accepted as the optimal tool for evaluation of the main prognostic factors and selection of therapeutic strategy. The purpose of this study was to compare the preoperative clinical examination FIGO staging findings with MRI and postoperative pathology report in females with primary cancer of the cervix. The study prospectively included 46 females consecutively hospitalized at the Department of Gynaecology and Obstetrics at the "Sestre milosrdnice" University Hospital Center in Zagreb. Interviews, clinical examination, transvaginal ultrasound and MRI were performed in all patients. In selected patients the surgical procedure was done and the correlation of clinical findings according to FIGO classifications, MRI and histopathological findings was completed. According to FIGO classification, positive clinical findings for stage IIA were found in 26/46 (55.5%) and stage IIB in 20/46 (44.5%)patients. FIGO MR modified classification confirmed stage IIA in 30/46 (66.6%) and stage IIB in 16/46 (33.4%) patients. Surgery (Wertheim radical hysterectomy with bilateral pelvic and selective para-aortic lymphadenectomy) was performed in 33/46 (71%) patients with clinically, MR, cytologically and pathohistologically confirmed findings of cervical cancer: 26 patients with IIA clinically FIGO stage and 7 with IIB stage. MRI examination proved better than clinical examination in staging of cervical carcinoma with 90.9% versus 79.0% accuracy rate. We suggest the application of the following MR protocol in all clinically staged FIGO IIA and IIB patients: T1W, T2WI and postcontrast dynamic T1WI after 3 and 60 seconds and after 5 minutes, performed on 1.5T MR machine. PMID:23941005

  2. Meniscal allograft transplantation: long-term clinical results with radiological and magnetic resonance imaging correlations

    Microsoft Academic Search

    Peter C. M. Verdonk; Koenraad L. Verstraete; Karl F. Almqvist; Kristof De Cuyper; Eric M. Veys; Gust Verbruggen; René Verdonk

    2006-01-01

    Long-term data on the clinical outcome and the fate of the meniscus allograft after transplantation are scarce. In this study we present the clinical, radiological and MRI outcome of the meniscus graft and the articular cartilage after 42 meniscus allograft transplantations in 41 patients with a minimum follow-up of 10 years. A total of 27 medial and 15 lateral meniscal allografts

  3. Correlated time to event data: Modeling repeated clinical mastitis data from dairy cattle in New York State.

    PubMed

    Schukken, Ynte H; Bar, Doron; Hertl, Julia; Gröhn, Yrjo T

    2010-12-01

    Mastitis is the most prevalent production disease in dairy herds worldwide and is considered to be the most economically important disease of dairy cattle. Modeling the risk of cows contracting mastitis is therefore of great interest for both targeting prevention programs and evaluating treatment protocols. Clinical mastitis (CM) is a disease of recurrent nature, thus correlation between the subsequent events within one cow may be present. This would violate the assumption behind most statistical time-to-event models. In the case of time to event models, the semi-parametric Cox regression models have become the default tool in modeling the time to an event. Limited methods are currently available to evaluate marginal and random (frailty) effects to account for multiple correlation sources. The objective of this study was to explore the implications of using several Cox or related semi-parametric or parametric models to estimate the hazard for CM in the presence of correlation between events. We evaluated the Andersen-Gill model which uses robust standard errors to account for the correlation, the Conditional Anderson-Gill model that uses stratification to account for event dependence, the Frailty model that introduces a random term to account for unobserved (cow level) heterogeneity, and a related generalized linear mixed model that uses Poisson regression to allow multi-level modeling of time-to-event data. We analyzed data on the occurrence of CM from five dairy farms in New York State. Data were from 8206 cows with 721, 275, 119, and 57 first, second, third, and fourth occurrences of CM, respectively, in the same lactation. The analysis of our sample dataset demonstrated that both cow- and farm-level correlation are present in the case of CM. The Conditional Frailty model was able to model one source of correlation in a random effect and one in a fixed effect. Poisson modeling allowed for simultaneous estimation of within cow correlation and within herd correlation. PMID:21035216

  4. Correlation

    NSDL National Science Digital Library

    Pennilyn Higgins

    Three hypothetical rock sections along an East-West transect are provided. Students correlate the three sections using the biostratigraphy of planktic forams (as a proxy for age), benthic forams (as a proxy of depth), and lithology (as a proxy of environment). Students are asked to provide an interpretation of the history of this depositional basin. An ash bed of known age is added and students are asked to determine if this new information affects their interpretation. Finally, an interesting lithologic feature is added, and students are asked to provide a geological explanation.

  5. Questionable Exercises.

    ERIC Educational Resources Information Center

    Liemohn, Wendell; Haydu, Traci; Phillips, Dawn

    1999-01-01

    This publication presents general guidelines for exercise prescription that have an anatomical basis but also consider the exerciser's ability to do the exercise correctly. It reviews various common questionable exercises, explaining how some exercises, especially those designed for flexibility and muscle fitness, can cause harm. Safer…

  6. Questor's Question

    ERIC Educational Resources Information Center

    Erickson, Mary; Dock, Michelle Nichols; Eldridge, Laurie

    2009-01-01

    Questor is a curious little bird whose four broad questions are helpful to anyone interested in making art or understanding the art of others. He was designed as a character in an online video for children, "Building on a River: Questor's Tale." The video is narrated by Questor, who relates the 2000 year history of architecture along the Salt…

  7. Four Questions

    ERIC Educational Resources Information Center

    Hark-Weber, Amara G., Ed.

    2013-01-01

    Teaching artists often find themselves working in schools and communities that are new to them, whether these are situations close to home or farther afield. This issue of Four Questions highlights teaching artists who travel extensively as part of their teaching and artistic practices and bring their expertise, energy, and creativity to…

  8. Benign soft-tissue lesions of the fingers: radiopathological correlation and clinical considerations.

    PubMed

    Oca Pernas, Roque; Prada González, Raquel; Santos Armentia, Eloísa; Hormaza Aguirre, Nerea; Tardáguila de la Fuente, Gonzalo; Trinidad López, Carmen; Delgado Sánchez-Gracián, Carlos

    2015-04-01

    Soft-tissue lesions of the fingers are commonly found in daily clinical practice. A wide range of tumors and pseudotumors have been described in this location, and the majority of them are benign. Ganglion cysts are the most common entity, and the localized type of tenosynovial giant cell tumors are the most frequent solid condition. Both may be easily recognized owing to their typical clinical and radiological characteristics. However, categorization of the spectrum of soft-tissue lesions of the fingers remains limited, despite imaging development, and many patients undergo surgery before radiological or histological diagnosis. Clinical history, radiographic features, and ultrasound and magnetic resonance patterns may help in obtaining the correct diagnosis or reducing the list of differential diagnoses. Radiologists should be familiar with imaging findings so that they can determine the size, extension, and affected neighboring anatomical structures, and provide information that allows adequate presurgical counseling. PMID:25367671

  9. Alcohol use disorders in opioid maintenance therapy: prevalence, clinical correlates and treatment.

    PubMed

    Soyka, Michael

    2015-01-01

    Maintenance therapy with methadone or buprenorphine is an established and first-line treatment for opioid dependence. Clinical studies indicate that about a third of patients in opioid maintenance therapy show increased alcohol consumption and alcohol use disorders. Comorbid alcohol use disorders have been identified as a risk factor for clinical outcome and can cause poor physical and mental health, including liver disorders, noncompliance, social deterioration and increased mortality risk. The effects of opioid maintenance therapy on alcohol consumption are controversial and no clear pattern has emerged. Most studies have not found a change in alcohol use after initiation of maintenance therapy. Methadone and buprenorphine appear to carry little risk of liver toxicity, but further research on this topic is required. Recent data indicate that brief intervention strategies may help reduce alcohol intake, but the existing evidence is still limited. This review discusses further clinical implications of alcohol use disorders in opioid dependence. PMID:25413371

  10. Monitoring the response of lymphoma patients to therapy: correlation of abdominal CT findings with clinical course and histologic cell type

    SciTech Connect

    Oliver, T.W. Jr.; Bernardino, M.E.; Sones, P.J. Jr.

    1983-10-01

    A review was made of 365 abdominal computed tomographic (CT) examinations in 125 patients with a histologic diagnosis of lymphoma who had undergone CT before and after therapy. Clinical correlation immediately preceding the follow-up CT examination was obtained in 100 patients. In these 100 patients, five distinct subgroups emerged: (a) reduction in extent of disease without changes in internal nodal characteristics; (b) reduction in extent of disease with change in internal nodal characteristics; (c) no change in extent of disease and no change in internal nodal characteristics; (d) no change in extent of disease but change in internal nodal charateristics; and (e) disease progression. Changes in internal nodal architecture consisted of diminished attenuation or mesenteric stranding. A 91% correlation existed between the CT findings and the clinical course. Of those patients with a worsening clinical course, and follow-up CT studies suggesting a stable or improved response to therapy, relapse in the majority (57%) involved the central nervous system. The authors conclude that limited abdominal CT examination is satisfactory in the posttherapy follow-up of lymphoma patients.

  11. Retrospective analysis of necropsy findings in patients of H1N1 and their correlation to clinical features.

    PubMed

    Prasad, H B; Puranik, S C; Kadam, D B; Sangle, S A; Borse, R T; Basavraj, A; Umarji, P B; Mave, Vidya; Ghorpade, S V; Bharadwaj, R; Jamkar, A V; Mishra, A C

    2011-08-01

    India reported its first case of H1N1 in July 2009 in Pune and since then, the number of reported cases and deaths exploded in India. Since very little data is available about histopathological findings in patients of H1N1 fatal cases in India, a retrospective chart analysis of necropsy findings of 15 cases of 2009 H1N1 fatal cases was performed. Common clinical features were fever, cough, and breathlessness followed by sore throat and rhinorrhea. Common lung findings were mononuclear cell infiltration, thick alveolar septae, intraalveolar hemorrhage. The other findings were congested pulmonary blood vessels, pulmonary edema, cytomegaly, fibrin accumulation and formation of eosinophilic membrane. These findings are suggestive of diffuse alveolar damage (DAD) and DAD with hemorrhage. All patients who underwent necropsy had radiographic findings suggestive of unilobar or multilobar pneumonia. This clinical finding can be correlated pathologically in these patients as all of them had either polymorphonuclear or mononuclear infiltrate. Furthermore, necrotizing pneumonitis pattern seen on these patients is the likely cause of mortality in these patients. Although clinical ARDS pattern was noted in all these patients, it was well correlated in lung pathology in all these cases. PMID:21887906

  12. Correlation of serum IL-13 and IL-5 levels with clinical response to Glatiramer acetate in patients with multiple sclerosis

    PubMed Central

    WIESEMANN, E; KLATT, J; WENZEL, C; HEIDENREICH, F; WINDHAGEN, A

    2003-01-01

    Glatiramer acetate (GA) is effective in the treatment of Multiple Sclerosis (MS) presumably by the induction of an immunoregulatory T-cell response. We have previously shown that GA directly induces the Th2 cytokines IL-13 and IL-5 in T-cells in vitro. In the present study we compared the in vitro response to GA in healthy controls, untreated and GA-treated MS patients and tested whether the induction of IL-13 and IL-5 secretion is also detectable in the serum of 25 MS patients treated with GA. Patients were grouped into clinical responders and nonresponders in order to determine a possible correlation with the immunological response. As a result we found a significant increase of IL-13 in the serum of clinical GA-responders whereas IL-13 was not detectable in controls, untreated MS (P < 0·001) and nonresponders (P = 0·015). Similarly, GA-treatment increased serum levels of IL-5 (P = 0·001). The correlation of serum IL-5 and clinical response was also significant (P = 0·039), however, there was an overlap between the different groups. The selective induction of IL-13 and IL-5 but not IL-4 by GA treatment suggests that the specific biological functions of these cytokines might be important for the therapeutic mechanism of GA. Measurement of serum IL-13 and IL-5 levels is a simple and inexpensive tool for monitoring the response to GA in MS patients. PMID:12930374

  13. The quantification of dynamic FET PET imaging and correlation with the clinical outcome in patients with glioblastoma

    NASA Astrophysics Data System (ADS)

    Thiele, Frank; Ehmer, Julia; Piroth, Marc D.; Eble, Michael J.; Coenen, Heinz H.; Kaiser, Hans-Juergen; Schaefer, Wolfgang M.; Buell, Ulrich; Boy, Christian

    2009-09-01

    The PET tracer O-(2-[18F]Fluoroethyl)-l-tyrosine (FET) has been shown to be valuable for different roles in the management of brain tumours. The aim of this study was to evaluate several quantitative measures of dynamic FET PET imaging in patients with resected glioblastoma. We evaluated dynamic FET PET in nine patients with histologically confirmed glioblastoma. Following FET PET, all subjects had radiation and chemotherapy. Tumour ROIs were defined by a threshold-based region-growing algorithm. We compared several standard measures of tumour uptake and uptake kinetics: SUV, SUV/background, distribution volume ratio (DVR), weighted frame differences and compartment model parameters. These measures were correlated with disease-free and overall survival, and analysed for statistical significance. We found that several measures allowed robust quantification. SUV and distribution volume did not correlate with clinical outcome. Measures that are based on a background region (SUV/BG, Logan-DVR) highly correlated with disease-free survival (r = -0.95, p < 0.0001), but not overall survival. Some advanced measures also showed a prognostic value but no improvement over the simpler methods. We conclude that FET PET probably has a prognostic value in patients with resected glioblastoma. The ratio of SUV to background may provide a simple and valuable predictive measure of the clinical outcome. Further studies are needed to confirm these explorative results.

  14. YKL-40 in Asthma and its correlation with different clinical parameters.

    PubMed

    Saba, Mohammadali; Sharif, Mohammad Reza; Akbari, Hossein; Nikoueinejad, Hassan; Ramazani Jolfaii, Maryam

    2014-08-01

    It has been suggested that elevated serum level of YKL-40 could be a marker for asthma and its severity. Along with few published studies, we investigated its correlation with asthma and its severity as well as spirometric indices.114 patients with asthma and 114 healthy controls underwent the assessment of serum level of YKL-40 (by ELISA) and spirometric indices. Pearson's coefficient determined the correlation between the variables and multivariate linear regression analysis was used for adjusting the effect of different probable confounding factors.Serum levels of YKL-40 were significantly higher in the asthmatic patients compared to those in healthy people (p<0.001). We also found a significant correlation between YKL-40 serum level and spirometric indices even after adjusting the effects of other variables.We report for the first time in an Iranian population that YKL-40 may be a good diagnostic marker of asthma in serum. PMID:24659163

  15. Correlation of In Vitro Itraconazole and Fluconazole Susceptibility with Clinical Outcome for Patients with Vulvovaginal Candidiasis

    Microsoft Academic Search

    Milce Costa; XistoSena Passos; AndréThiagoBorges Miranda; RosaneSilvaCarneiro de Araújo; Claudete Rodrigues Paula; MariadoRosário Rodrigues Silva

    2004-01-01

    Between April 2001 and April 2002 were studied 106 women with a clinical diagnosis of vaginal candidiasis seen at the Gynecology and Obstetrics Ambulatory of the Hospital das Clínicas da Universidade Federal de Goiás. The patients were assessed on two occasions, before starting treatment with itraconazole or fluconazole (initial visit) and 14 days after treatment (return). At two visits the

  16. Annual Research Review: Attachment Disorders in Early Childhood--Clinical Presentation, Causes, Correlates, and Treatment

    ERIC Educational Resources Information Center

    Zeanah, Charles H.; Gleason, Mary Margaret

    2015-01-01

    Background: Though noted in the clinical literature for more than 50 years, attachment disorders have been studied systematically only recently. In part because of the ubiquity of attachments in humans, determining when aberrant behavior is best explained as an attachment disorder as opposed to insecure attachment has led to some confusion. In…

  17. An activity-withdrawal distinction in schizophrenia: Behavioral, clinical, brain damage, and neurophysiological correlates

    Microsoft Academic Search

    Richard A. Depue

    1976-01-01

    Although P. H. Venables introduced an activity-withdrawal distinction in schizophrenia in 1957, the activity variable has been virtually neglected in the research literature on this disorder. This is clearly unwarranted because, as this paper illustrates, this distinction is potentially related to a number of behavioral, clinical, brain damage, and neurophysiological variables. In addition to the presentation of new data, these

  18. A Comparative Study of Clinical Correlates in Schizophrenia with Onset in Childhood, Adolescence and Adulthood

    ERIC Educational Resources Information Center

    Biswas, Parthasarathy; Malhotra, Savita; Malhotra, Anil; Gupta, Nitin

    2006-01-01

    Background: Childhood onset schizophrenia (COS) is a rare disorder. Comparative data on the effect of differential age of onset on clinical profile in schizophrenia are very few. Method: Subjects with COS (n = 15), adolescence onset schizophrenia (AdOS, n = 20) and adulthood onset schizophrenia (AOS, n = 20) were compared on socio-demographic,…

  19. Toxoplasma encephalitis in Haitian adults with acquired immunodeficiency syndrome: a clinical-pathologic-CT correlation

    Microsoft Academic Search

    M. J. D. Post; J. C. Chan; G. T. Hensley; T. A. Hoffman; L. B. Moskowitz; S. Lippmann

    1983-01-01

    The clinical data, histologic findings, and computed tomographic (CT) abnormalities in eight adult Haitians with toxoplasma encephalitis were analyzed retrospectively. Diagnosis was established by identification of Toxoplasma gondii on autopsy in five and brain biopsy in three specimens and subsequently confirmed by the immunoperoxidase method. All these patiens, six of whom had been in the United States for 24 months

  20. Clinical and psychological correlates of quality-of-life in polycystic ovary syndrome

    Microsoft Academic Search

    Susanne Hahn; Onno E Janssen; Susanne Tan; Katja Pleger; Klaus Mann; Manfred Schedlowski; Rainer Kimmig; Sven Benson; Efthimia Balamitsa; Sigrid Elsenbruch

    2005-01-01

    Objective: Polycystic ovary syndrome (PCOS) has been shown to cause a reduction in quality of life. This study examines the extent of different PCOS symptoms on quality-of-life, psychosocial well- being and sexual satisfaction. Methods: Complete metabolic, hormonal, clinical and psychosocial data were obtained from a total of 120 women with PCOS. Patients were compared with 50 healthy women to establish

  1. Clinical and Cognitive Correlates of Depressive Symptoms among Youth with Obsessive Compulsive Disorder

    ERIC Educational Resources Information Center

    Peris, Tara S.; Bergman, R. Lindsey; Asarnow, Joan R.; Langley, Audra; McCracken, James T.; Piacentini, John

    2010-01-01

    Depression is the most common comorbidity among adults with obsessive compulsive disorder (OCD), yet little is known about depressive symptoms in childhood OCD. This study examined clinical and cognitive variables associated with depressive symptomatology in 71 youths (62% male, M age = 12.7 years) with primary OCD. Youths presented with a range…

  2. Neural correlates of clinical symptoms and cognitive dysfunctions in obsessive–compulsive disorder

    Microsoft Academic Search

    Jun Soo Kwon; Jae-Jin Kim; Dong Woo Lee; Jae Sung Lee; Dong Soo Lee; Myung-Sun Kim; In Kyoon Lyoo; Maeng Je Cho; Myung Chul Lee

    2003-01-01

    Although results from neuropsychological and neuroimaging studies have postulated the involvement of the frontal lobe and the subcortical brain regions in the pathophysiology of obsessive–compulsive disorder (OCD), neuroimaging studies have provided little evidence that cognitive abnormalities in patients with OCD are related to dysfunctions in these areas. This study was designed to determine whether the clinical features and cognitive deficits

  3. Spastic Cerebral Palsy: Clinical Magnetic Resonance Imaging Correlation of 129 Children

    Microsoft Academic Search

    Wojciech Ku?ak; Wojciech Sobaniec; Bozena Kubas; Jerzy Walecki; Joanna Smigielska-Kuzia; Leszek Bockowski; Barbara Artemowicz; Krzysztof Sendrowski

    2007-01-01

    A prospective study was undertaken of 129 children with spastic cerebral palsy to clarify the relationship between magnetic resonance imaging (MRI) findings and clinical features of cerebral palsy. Low birth weight, asphyxia, prematurity, seizures, mental development, Gross Motor Function Classification System, and MRI findings were analyzed. Significant abnormalities relevant to the cerebral palsy were evident on imaging in 123 (95.3%).

  4. AIDS risk behaviours and correlates in teenagers attending sexually transmitted diseases clinics in Los Angeles

    Microsoft Academic Search

    A E Maxwell; R Bastani; K X Yan

    1995-01-01

    OBJECTIVE--Of all age groups, teenagers have the highest rates of sexually transmitted diseases. Therefore, it is particularly important to target interventions at this group. Teenagers attending STD clinics are at particularly high risk since behaviours that lead to an STD can also result in the transmission of HIV. The goal of this study was to collect information concerning the prevalence

  5. Current Trends in Anterior Cruciate Ligament ReconstructionPart II. Operative Procedures and Clinical Correlations

    Microsoft Academic Search

    Freddie H. Fu; Craig H. Bennett; C. Benjamin Ma; Jacques Menetrey; Christian Lattermann

    2000-01-01

    Surgical management of the anterior cruciate ligament-deficient knee has evolved from primary repair to extracapsular augmentation to anterior cruciate ligament reconstruction using biologic tissue grafts. The technique of anterior cruciate ligament reconstruction has improved over the last few decades with the aid of knowledge gained from basic science and clinical research. The biology and biomechanics of anterior cruciate ligament reconstruction

  6. Oxidative Stress Correlates with Headache Symptoms in Fibromyalgia: Coenzyme Q10 Effect on Clinical Improvement

    Microsoft Academic Search

    Mario D. Cordero; Francisco Javier Cano-García; Elísabet Alcocer-Gómez; Manuel De Miguel; José Antonio Sánchez-Alcázar

    2012-01-01

    BackgroundFibromyalgia (FM) is a chronic pain syndrome with unknown etiology and a wide spectrum of symptoms such as allodynia, debilitating fatigue, joint stiffness and migraine. Recent studies have shown some evidences demonstrating that oxidative stress is associated to clinical symptoms in FM of fibromyalgia. We examined oxidative stress and bioenergetic status in blood mononuclear cells (BMCs) and its association to

  7. Spectrum of single and multiple corona radiata infarcts: Clinical\\/MRI correlations

    Microsoft Academic Search

    Emre Kumral; Gamze Bayülkem

    2003-01-01

    We sought to determine the clinical pictures, topography and pathogenesis of patients with unilateral single or multiple corona radiata infarcts. We defined corona radiata ischemic stroke if the patient had a focal neurological deficit and a relevant non-hemorrhagic infarction confined to the vascular territory of a long medullary artery proved by CT and MRI with contrast. We compared risk factors

  8. Clinical features and correlates of major depressive disorder in individuals with body dysmorphic disorder

    Microsoft Academic Search

    Katharine A. Phillips; Elizabeth R. Didie; William Menard

    2007-01-01

    Background: Body dysmorphic disorder (BDD) and major depressive disorder (MDD) appear highly comorbid. However, MDD in individuals with BDD has received little investigation. Methods: The prevalence and characteristics of comorbid MDD were assessed in 178 BDD subjects. BDD subjects with current comorbid MDD (n=68) were compared to BDD subjects without current comorbid MDD (n=96) on demographic and clinical characteristics. Predictors

  9. Clinical phenotype in congenital muscular dystrophy: correlation with expression of merosin in skeletal

    Microsoft Academic Search

    J. Philpot; C. Sewry; J. Pennock; V. Dubowitz

    1995-01-01

    It has recently been shown that merosin, an extracellular matrix protein linked to the dystrophin-associated glycoproteins, is deficient in a proportion of patients with classical congenital muscular dystrophy (CMD). We have undertaken a detailed study of the clinical features and brain imaging in 24 cases of CMD in relation to the merosin status.Immunocytochemistry showed that merosin was present in 13

  10. MR Imaging in Children with D ermatomyositis: Musculoskeletal Findings and Correlation with Clinical and Laboratory Findings

    Microsoft Academic Search

    Ramiro J. Hernandezi; Donita B. Sullivan; Thomas L. Chenevert; David R. Keim

    OBJECTIVE. The purpose of this study was to describe the musculoskeletal MR findings in childhood dermatornyositis and to correlate MR findings with indicators of disease activity such as muscle strength and serum levels of muscle enzymes. SUBJECTS AND METHODS. This prospective study included 24 children: 19 chil- dren with dermatomyositis and five control subjects. The diagnosis of dermatomyo- sitis was

  11. Early Onset Recurrent Subtype of Adolescent Depression: Clinical and Psychosocial Correlates

    ERIC Educational Resources Information Center

    Hammen, Constance; Brennan, Patricia A.; Keenan-Miller, Danielle; Herr, Nathaniel R.

    2008-01-01

    Background: Evaluated trajectories of adolescent depression and their correlates in a longitudinal study of a community sample: early onset (by age 15) with major depression (MDE) recurrence between 15 and 20; early onset with no recurrence; later onset of major depression after age 15 with and without recurrence by 20; and never-depressed.…

  12. Ranking the Clinical and Pathological Correlates of Ventricular Expansion Mapped in 804 Alzheimer's

    E-print Network

    Thompson, Paul

    alignment method, to automatically segment parametric 3D surface models of the lateral ventricles in brain MRI scans from 184 AD, 391 MCI, and 229 healthy elderly controls. Radial expansion of the ventricles to rank correlates by effect size. Methods: 804 subjects were scanned as part of the Alzheimer's Disease

  13. The inflammatory phenotype of the fibrous plate is distinct from the liver and correlates with clinical outcome in biliary atresia.

    PubMed

    Arva, Nicoleta C; Russo, Pierre A; Erlichman, Jessi; Hancock, Wayne W; Haber, Barbara A; Bhatti, Tricia R

    2015-03-01

    Biliary atresia is an inflammatory cholangiopathy of still undetermined etiology. Correlations between histologic findings and clinical outcome in this disease have largely been based on evaluation of liver parenchyma. This study aimed to characterize the pattern of inflammation within the biliary remnant and identify associations between the type and degree of inflammation and clinical outcome as reflected by the transplant-free interval. The inflammation within the fibrous plates and livers of 41 patients with biliary atresia was characterized using immunohistochemical markers and the cell populations were digitally quantified. The type and quantity of cells within the infiltrate were then correlated with length of time from Kasai portoenterostomy until transplant. Histologic and immunohistochemical features of the biliary remnant allowed stratification of patients into "inflammatory plate" and "fibrotic plate" groups. Overall there was no significant difference in transplant-free interval between the two cohorts; however, there was a trend towards a longer time to transplant among patients in the "fibrotic plate" group. In addition, the composition of the inflammatory infiltrate in the fibrous plate was distinctly different from that present in the liver and only the characteristics of the inflammation in the fibrous plate, in particular the number of Foxp3+ T regulatory lymphocytes correlated with clinical outcome. The results of this study support the view of the extra-hepatic biliary tree as the primary site of injury in BA with the changes seen in the liver as secondary manifestations of outflow obstruction. The association between specific inflammatory cell subtypes within the fibrous plate and the length of transplant-free interval also supports the role of the immune system in the initial process of bile duct damage in biliary atresia. PMID:25624184

  14. Correlating anterior insula gray matter volume changes in young people with clinical and neurocognitive outcomes: an MRI study

    PubMed Central

    2012-01-01

    Background The anterior insula cortex is considered to be both the structural and functional link between experience, affect, and behaviour. Magnetic resonance imaging (MRI) studies have shown changes in anterior insula gray matter volume (GMV) in psychosis, bipolar, depression and anxiety disorders in older patients, but few studies have investigated insula GMV changes in young people. This study examined the relationship between anterior insula GMV, clinical symptom severity and neuropsychological performance in a heterogeneous cohort of young people presenting for mental health care. Methods Participants with a primary diagnosis of depression (n?=?43), bipolar disorder (n?=?38), psychosis (n?=?32), anxiety disorder (n?=?12) or healthy controls (n?=?39) underwent structural MRI scanning, and volumetric segmentation of the bilateral anterior insula cortex was performed using the FreeSurfer application. Statistical analysis examined the linear and quadratic correlations between anterior insula GMV and participants’ performance in a battery of clinical and neuropsychological assessments. Results Compared to healthy participants, patients had significantly reduced GMV in the left anterior insula (t?=?2.05, p?=?.042) which correlated with reduced performance on a neuropsychological task of attentional set-shifting (??=?.32, p?=?.016). Changes in right anterior insula GMV was correlated with increased symptom severity (r?=?.29, p?=?.006) and more positive symptoms (r?=?.32, p?=?.002). Conclusions By using the novel approach of examining a heterogeneous cohort of young depression, anxiety, bipolar and psychosis patients together, this study has demonstrated that insula GMV changes are associated with neurocognitive deficits and clinical symptoms in such young patients. PMID:22607202

  15. The Ratio of Monocytes to Lymphocytes in Peripheral Blood Correlates with Increased Susceptibility to Clinical Malaria in Kenyan Children

    PubMed Central

    Warimwe, George M.; Murungi, Linda M.; Kamuyu, Gathoni; Nyangweso, George M.; Wambua, Juliana; Naranbhai, Vivek; Fletcher, Helen A.; Hill, Adrian V. S.; Bejon, Philip; Osier, Faith H. A.; Marsh, Kevin

    2013-01-01

    Background Plasmodium falciparum malaria remains a major cause of illness and death in sub-Saharan Africa. Young children bear the brunt of the disease and though older children and adults suffer relatively fewer clinical attacks, they remain susceptible to asymptomatic P. falciparum infection. A better understanding of the host factors associated with immunity to clinical malaria and the ability to sustain asymptomatic P. falciparum infection will aid the development of improved strategies for disease prevention. Methods and Findings Here we investigate whether full differential blood counts can predict susceptibility to clinical malaria among Kenyan children sampled at five annual cross-sectional surveys. We find that the ratio of monocytes to lymphocytes, measured in peripheral blood at the time of survey, directly correlates with risk of clinical malaria during follow-up. This association is evident among children with asymptomatic P. falciparum infection at the time the cell counts are measured (Hazard ratio (HR) ?=? 2.7 (95% CI 1.42, 5.01, P ?=? 0.002) but not in those without detectable parasitaemia (HR ?=? 1.0 (95% CI 0.74, 1.42, P ?=? 0.9). Conclusions We propose that the monocyte to lymphocyte ratio, which is easily derived from routine full differential blood counts, reflects an individual's capacity to mount an effective immune response to P. falciparum infection. PMID:23437368

  16. UT Southwestern study finds spread of human melanoma cells in mice correlates with clinical outcomes in patients

    Cancer.gov

    UT Southwestern Medical Center scientists have developed an innovative model for predicting the progression of skin cancer in patients. In a new study published today in Science Translational Medicine, Stage III human melanoma cells from 20 patients were implanted into specially selected mice with compromised immune systems. Using this xenograft model, in which tissue is transplanted from one species to another, the institute’s team observed reproducible differences in the rate at which the cancer spread in the mice, or metastasized, that correlated with clinical outcomes in patients. UT Southwestern is home to the Harold C. Simmons Cancer Center.

  17. Clinical and Cognitive Correlates of Depressive Symptoms among Youth with Obsessive Compulsive Disorder

    PubMed Central

    Peris, Tara S.; Bergman, R. Lindsey; Asarnow, Joan R.; Langley, Audra; McCracken, James T.; Piacentini, John

    2010-01-01

    Depression is the most common comorbidity among adults with obsessive compulsive disorder (OCD), yet little is known about depressive symptoms in childhood OCD. This study examined clinical and cognitive variables associated with depressive symptomatology in 71 youths (62% male, mean age= 12.7 years) with primary OCD. Youths presented with a range of depressive symptoms, with 21% scoring at or above the clinical cutoff on the self-report measure of depression. Higher levels of depressive symptoms were associated with higher levels of cognitive distortions assessed on measures of insight, perceived control, competence, and contingencies. Depressive symptoms were also linked to older age and more severe OCD. Low perceived control and self-competence and high OCD severity independently predicted depression scores. PMID:20706915

  18. Retrospective study of colorectal cancer in Zimbabwe: Colonoscopic and clinical correlates

    PubMed Central

    Katsidzira, Leolin; Gangaidzo, Innocent Tichaona; Mapingure, Munyaradzi Paul; Matenga, Jonathan Arthur

    2015-01-01

    AIM: To compare differences in the frequency of colorectal cancer at colonoscopy in Zimbabwe according to ethnicity. METHODS: All lower gastrointestinal endoscopic procedures performed between January 2006 and December 2011 at a gastroenterology clinic in Harare, Zimbabwe were reviewed. The demographic characteristics, clinical indications, differences in bowel preparation and the endoscopic and histological diagnoses were compared between different ethnic groups with emphasis on colorectal cancer. The clinical and demographic characteristics and the endoscopic findings were compared using the student t-test and the ?2 test, while the clinical indications associated with a diagnosis of colorectal cancer were determined by logistic regression. RESULTS: All colonoscopies and sigmoidoscopies performed in 1236 Caucasians, 460 black Africans and 109 Asians were analysed. Colorectal cancer was diagnosed more frequently in the black African patients compared to Caucasians or Asians (10% vs 3%, 10% vs 2%, P < 0.001). However, polyps were less common among black Africans (5%) compared to both Caucasians (8%) and Asians (9%) (P = 0.03). Among patients with colorectal cancer, black Africans tended to be younger than Caucasians, who were over-represented in the oldest age category; 32 % vs 2% were less than 50 years and 41% vs 78% were older than 60 years (P < 0.001). Anaemia and weight loss were associated with colorectal cancer in both black African [odds ratio (OR): 2.73 (95%CI: 1.33-5.61) and 3.09 (1.35-7.07)] and Caucasian patients [OR: 6.65 (95%CI: 2.93-15.09) and 3.47 (1.52-7.94)]. CONCLUSION: The likelihood of diagnosing colorectal cancer in patients referred for colonoscopy in Zimbabwe is at least as likely among black Africans as it is among Caucasians. PMID:25741144

  19. Correlation between tumor vascularity and clinical findings in patients with pituitary adenomas

    Microsoft Academic Search

    Koji Takada; Shozo Yamada; Akira Teramoto

    2004-01-01

    Angiogenesis generally plays an essential role in tumor growth and metastasis, and also influences the response to treatment\\u000a in human malignant solid tumors. Even in nonmalignant tumors, angiogenesis is essential for tumor growth and invasion. In\\u000a order to define the relationship between tumor vascularity and the clinical course in patients with pituitary adenomas, we\\u000a quantified the vascularity in 47 pituitary

  20. Comorbidity of adult attention-deficit hyperactivity disorder and bipolar disorder: prevalence and clinical correlates

    Microsoft Academic Search

    Lut Tamam; Gonca Karakus; Nurgul Ozpoyraz

    2008-01-01

    The aim of this study was to determine the frequency of adult attention deficit hyperactivity disorder (ADHD) comorbidity\\u000a with lifetime bipolar disorder, and the influence of this comorbidity on various demographic and clinical variables in patients.\\u000a Patients (n = 159) with a previous diagnosis of bipolar disorder (79 female, 80 male) were included in this study. All patients were\\u000a interviewed for the

  1. Hemophilus influenzae pneumonia in the adult: radiographic appearance with clinical correlation

    SciTech Connect

    Pearlberg, J.; Haggar, A.M.; Saravolatz, L.; Beute, G.H.; Popovich, J.

    1984-04-01

    Hemophilus influenzae septicemia is an important cause of life-threatening pneumonia in an immunocompromised patient. Eleven cases proved by blood culture were analyzed. Multilobar involvement with lobar or segmental consolidation pleural effusion were common radiographic findings, but there were no signs of lobar expansion, bulging fissures, or cavitation. In general, predisposing factors such as alcoholism and chemotherapy place patients at risk. Radiographic response to therapy is variable but often lags behind clinical improvement.

  2. Depressed Antioxidant Status in Pregnant Women on Iron Supplements: Pathologic and Clinical Correlates

    Microsoft Academic Search

    J. I. Anetor; O. A. Ajose; F. N. Adeleke; G. O. Olaniyan-Taylor; F. A. Fasola

    2010-01-01

    Iron (Fe) remains a commonly prescribed supplement in pregnancy. Its possible pathologic potential is either uncommonly considered\\u000a or ignored. We determined the antioxidant status in pregnant women with and without Fe supplements. Fifty-eight apparently\\u000a healthy pregnant women on Fe supplements were selected for the study from the antenatal clinic of the University College Hospital,\\u000a Ibadan, Nigeria. Fifty-five aged matched pregnant

  3. Correlation of magnetic resonance imaging parameters with clinical disability in multiple sclerosis: a preliminary study

    Microsoft Academic Search

    J. Grimaud; G. J. Barker; L. Wang; M. Lai; D. G. MacManus; S. L. Webb; A. J. Thompson; W. I. McDonald; P. S. Tofts; D. H. Miller

    1999-01-01

    Magnetic resonance imaging (MRI) is frequently used to monitor new treatments in multiple sclerosis (MS), but its role is\\u000a limited by the uncertain relationship between MRI parameters and clinical disability. A brain MRI study using nine MRI parameters\\u000a was undertaken in 15 MS patients with a wide spectrum of disability to evaluate the relationship between each parameter and\\u000a disability. A

  4. Age of Onset in Pathological Gambling: Clinical, Therapeutic and Personality Correlates

    Microsoft Academic Search

    Susana Jimenez-MurciaEva; Eva M. Álvarez-Moya; Randy Stinchfield; Fernando Fernández-Aranda; Roser Granero; Neus Aymamí; Mónica Gómez-Peña; Nuria Jaurrieta; Francesca Bove; José M. Menchón

    2010-01-01

    We aimed to explore the association between age of onset of gambling problems and current psychopathological and clinical\\u000a status, personality profile and therapeutic outcome in a sample of pathological gamblers. A total of 904 consecutive pathological\\u000a gambling patients were administered several instruments about gambling behavior, psychopathology and personality. They received\\u000a a 4-month cognitive-behavioral group treatment. Information of dropouts and relapses

  5. Clinical and Functional Correlates of Platelet Cyclic GMP in Essential Hypertensives

    Microsoft Academic Search

    Carla Sala; Marta Rescaldani; Erika Santin; Gianni Bolla; Cesare Cuspidi

    2009-01-01

    BackgroundPlatelets play a central role in atherothrombosis, which is responsible of major cardiovascular complications in human hypertension. Nitric oxide (NO) inhibits platelet aggregation via the second messenger cyclic guanosine monophosphate (cGMP). In essential hypertensives (EHs), we examined the relationship between platelet cGMP and clinical, hemodynamic, humoral variables as well as the responses to aggregating agents.MethodsIn untreated EHs (male\\/female 106\\/43, age

  6. Correlates of subjective and functional outcomes in outpatient clinic attendees with schizophrenia and schizoaffective disorder

    Microsoft Academic Search

    Alex Hofer; Maria A. Rettenbacher; Christian G. Widschwendter; Georg Kemmler; Martina Hummer; W. Wolfgang Fleischhacker

    2006-01-01

    Outcome in schizophrenia is multidimensional and, thus, consists of clinical,humanitarian, rehabilitative and cost domains.\\u000a Accordingly, recovery is conceptualized as the ability to function in the community, socially and vocationally, as well as\\u000a being relatively free of disease–related psychopathology. The present cross–sectional study examined the relationship of premorbid\\u000a functioning, psychopathology, insight, attitudes toward medication and side–effects, as well as sociodemographic factors

  7. EARLY ADVERSITY IN CHRONIC DEPRESSION: CLINICAL CORRELATES AND RESPONSE TO PHARMACOTHERAPY

    PubMed Central

    Klein, Daniel N.; Arnow, Bruce A.; Barkin, Jennifer L.; Dowling, Frank; Kocsis, James H.; Leon, Andrew C.; Manber, Rachel; Rothbaum, Barbara O.; Trivedi, Madhukar H.; Wisniewski, Stephen R.

    2012-01-01

    Background There is growing evidence suggesting that early adversity may be a marker for a distinct pathway to major depressive disorder (MDD). We examined associations between childhood adversity and a broad variety of clinical characteristics and response to pharmacotherapy in a large sample of patients with chronic forms of MDD. Methods Subjects included 808 patients with chronic forms of MDD (chronic MDD, double depression, or recurrent MDD with incomplete recovery between episodes and a total continuous duration of >2 years) who were enrolled in a 12-week open-label trial of algorithm-guided pharmacotherapy. Baseline assessments included a semi-structured diagnostic interview, and clinician- and self-rated measures of depressive symptoms, social functioning, depressotypic cognitions, and personality traits, and childhood adversity. Patients were re-evaluated every 2 weeks. Results A longer duration of illness; earlier onset; greater number of episodes, symptom severity, self-rated functional impairment, suicidality, and comorbid anxiety disorder; and higher levels of dysfunctional attitudes and self-criticism were each associated with multiple forms of childhood adversity. A history of maternal overcontrol, paternal abuse, paternal indifference, sexual abuse, and an index of clinically significant abuse each predicted a lower probability of remission. Among patients completing the 12-week trial, 32% with a history of clinically significant abuse, compared to 44% without such a history, achieved remission. Conclusions These findings indicate that a history of childhood adversity is associated with an especially chronic form of MDD that is less responsive to antidepressant pharmacotherapy. PMID:19434623

  8. Clinical-physiologic correlates of Alzheimer's disease and frontal lobe dementia

    SciTech Connect

    Jagust, W.J.; Reed, B.R.; Seab, J.P.; Kramer, J.H.; Budinger, T.F. (Martinez Veterans Administration Medical Center, CA (USA))

    1989-01-01

    Thirty patients with degenerative dementia underwent clinical evaluation, neuropsychological testing, and single photon emission computed tomography (SPECT) with the blood flow tracer ({sup 123}I)-N-isopropyl-p-iodoamphetamine. Five of these patients were clinically and psychologically different from the others, demonstrating predominant behavioral disturbances with relative preservation of memory function. These five patients, who were felt to have a frontal lobe dementia (FLD), showed SPECT perfusion patterns which differed from the remaining 25 patients, who were diagnosed as having Alzheimer's disease (AD), and from 16 healthy control subjects. The FLD patients showed diminished perfusion in orbitofrontal, dorsolateral frontal, and temporal cortex relative to controls, while the AD patients showed lower perfusion in temporal and parietal cortex than controls. The FLD patients also showed hypoperfusion in both frontal cortical regions relative to AD patients. The pattern of performance on neuropsychological testing paralleled these differences in regional perfusion. These results suggest that clinical evaluation and physiological imaging may enable the differentiation of groups of degenerative dementia patients during life.

  9. PCNA and Ki67 expression in breast carcinoma: correlations with clinical and biological variables

    Microsoft Academic Search

    E Leonardi; S Girlando; G Serio; F A Mauri; G Perrone; S Scampini; P Dalla Palma; M Barbareschi

    1992-01-01

    AIMS: To investigate the expression of two cell cycle related antigens (proliferating cell nuclear antigen (PCNA) and Ki67 related antigen) in a series of breast cancers; and the possible correlations between the PCNA and Ki67 labelling indexes (PCNA-LI and Ki67-LI) and their associations with other biological and clinicopathological variables. METHODS: Ninety six ductal and 10 lobular carcinoma specimens were investigated.

  10. Clinical and ultrasonographic correlation between scapular dyskinesia and subacromial space measurement among junior elite tennis players

    Microsoft Academic Search

    R. T. Silva; L. G. Hartmann; C F de Souza Laurino; J P Rocha Biló

    2010-01-01

    ObjectivesIn this study, the hypothesis that tennis players with scapular dyskinesia present a smaller subacromial space than non-athletes was investigated. Additionally, the correlation between the size of the subacromial space and abnormalities in scapular movement during arm abduction was studied.DesignCross-sectional study.ParticipantsA total of 53 elite tennis players and 20 control participants were enrolled in the study. Participation was restricted to

  11. CYP24A1 Expression Inversely Correlates with Melanoma Progression: Clinic-Pathological Studies

    PubMed Central

    Bro?yna, Anna A.; Jochymski, Cezary; Janjetovic, Zorica; Jó?wicki, Wojciech; Tuckey, Robert C.; Slominski, Andrzej T.

    2014-01-01

    The major role of 24-hydroxylase (CYP24A1) is to maintain 1,25-dihydroxyvitamin D3 (1,25(OH)2D3) homeostasis. Recently, it has been discovered that CYP24A1 also catalyses the hydroxylation of 20(OH)D3, producing dihydroxy-derivatives that show very effective antitumorigenic activities. Previously we showed a negative correlation of vitamin D receptor (VDR) and CYP27B1 expression with progression, aggressiveness and overall or disease-free survivals of skin melanomas. Therefore, we analyzed CYP24A1 expression in relation to clinicopathomorphological features of nevi, skin melanomas and metastases. In melanocytic tumors, the level of CYP24A1 was higher than in the normal epidermis. The statistically highest mean CYP24A1 level was found in nevi and early stage melanomas. With melanoma progression, CYP24A1 levels decreased and in advanced stages were comparable to the normal epidermis and metastases. Furthermore, the CYP24A1 expression positively correlated with VDR and CYP27B1, and negatively correlated with mitotic activity. Lower CYP24A1 levels correlated with the presence of ulceration, necrosis, nodular type and amelanotic phenotypes. Moreover, a lack of detectable CYP24A1 expression was related to shorter overall and disease-free survival. In conclusion, the local vitamin D endocrine system affects melanoma behavior and an elevated level of CYP24A1 appears to have an important impact on the formation of melanocytic nevi and melanomagenesis, or progression, at early stages of tumor development. PMID:25334067

  12. Questions Submitted Online — Provocative Questions

    Cancer.gov

    Sequencing of natural human tumors is teaching us invaluable lessons. It is becoming clear that the new dogmas created in the post genome era are being questioned. The previously suspected genetic heterogeneity of tumors is now proven on the sequence level. The extreme genetic heterogeneity of individual tumors and the existence of multiple tumors (not metastases) pose fundamental doubt on the prevailing dogma of targeted drug(s) and personalized treatments.

  13. Neuropathologic Correlates of Hippocampal Atrophy in the Elderly: A Clinical, Pathologic, Postmortem MRI Study

    PubMed Central

    Dawe, Robert J.; Bennett, David A.; Schneider, Julie A.; Arfanakis, Konstantinos

    2011-01-01

    The volume of the hippocampus measured with structural magnetic resonance imaging (MRI) is increasingly used as a biomarker for Alzheimer's disease (AD). However, the neuropathologic basis of structural MRI changes in the hippocampus in the elderly has not been directly assessed. Postmortem MRI of the aging human brain, combined with histopathology, could be an important tool to address this issue. Therefore, this study combined postmortem MRI and histopathology in 100 elderly subjects from the Rush Memory and Aging Project and the Religious Orders Study. First, to validate the information contained in postmortem MRI data, we tested the hypothesis that postmortem hippocampal volume is smaller in subjects with clinically diagnosed Alzheimer's disease compared to subjects with mild or no cognitive impairment, as observed in antemortem imaging studies. Subsequently, the relations of postmortem hippocampal volume to AD pathology, Lewy bodies, amyloid angiopathy, gross infarcts, microscopic infarcts, and hippocampal sclerosis were examined. It was demonstrated that hippocampal volume was smaller in persons with a clinical diagnosis of AD compared to those with no cognitive impairment (P?=?2.6×10?7) or mild cognitive impairment (P?=?9.6×10?7). Additionally, hippocampal volume was related to multiple cognitive abilities assessed proximate to death, with its strongest association with episodic memory. Among all pathologies investigated, the most significant factors related to lower hippocampal volume were shown to be AD pathology (P?=?0.0018) and hippocampal sclerosis (P?=?4.2×10?7). Shape analysis allowed for visualization of the hippocampal regions most associated with volume loss for each of these two pathologies. Overall, this investigation confirmed the relation of hippocampal volume measured postmortem to clinical diagnosis of AD and measures of cognition, and concluded that both AD pathology and hippocampal sclerosis affect hippocampal volume in old age, though the impacts of each pathology on the shape of the hippocampus may differ. PMID:22043314

  14. Clinical Correlates of Initial Treatment Disengagement in First-Episode Psychosis.

    PubMed

    Myers, Neely; Bhatty, Sanaa; Broussard, Beth; Compton, Michael

    2014-11-01

    Aim: Early engagement in care is thought to reduce disabling social losses related to the duration of untreated psychosis (DUP), such as school dropout, homelessness, and incarceration, which contribute to chronic disability. Early intervention services that promote recovery will not be effective if eligible persons drop out of treatment after an initial hospitalization for a psychotic disorder. We had the unique opportunity to examine the treatment disengagement rate of patients with early psychosis after an initial hospitalization.Methods: In a predominantly male, African American, and socioeconomically disadvantaged group of 33 participants with first-episode psychosis assessed at initial hospitalization and six months after discharge, we compared clinical characteristics (medication adherence attitudes and behaviors, knowledge about schizophrenia, insight, symptom severity, and persistence ofalcohol and drug use) among those who disengaged and people who engaged in care.Results: More than half (18, 54.5%) attended <3 outpatient appointments in the six months after hospital discharge, and of those, nearly all (15, 83.3%) attended no outpatient appointments. Disengaged people were much less adherent to medications in the past month and six months, and scored lower on medication adherence attitudes, knowledge about psychosis, and insight. They had greater positive symptom severity and a higher likelihood of continuing drug use.Clinical Relevancy: Initial treatment disengagement is very common among young people with first-episode psychosis and associated with poorer clinical status. More research is needed onthe causes of disengagement during this critical period, and ways to improve initial treatment engagement among people with first-episode psychosis. PMID:25367162

  15. Clinical and sociodemographic correlates of suicidality in patients with major depressive disorder from six Asian countries

    PubMed Central

    2014-01-01

    Background East Asian countries have high suicide rates. However, little is known about clinical and sociodemographic factors associated with suicidality in Asian populations. The aim of this study was to evaluate the factors associated with suicidality in patients with major depressive disorder (MDD) from six Asian countries. Methods The study cohort consisted of 547 outpatients with MDD. Patients presented to study sites in China (n?=?114), South Korea (n?=?101), Malaysia (n?=?90), Singapore (n?=?40), Thailand (n?=?103), and Taiwan (n?=?99). All patients completed the Mini-International Neuropsychiatric Interview (MINI), the Montgomery–Asberg Depression Rating Scale (MADRS), the Global Severity Index(SCL-90R), the Fatigue Severity Scale, the 36-item short-form health survey, the Sheehan Disability Scale, and the Multidimensional Scale of Perceived Social Support (MSPSS). Patients were classified as showing high suicidality if they scored ?6 on the MINI suicidality module. Multivariate logistic regression analysis was used to examine sociodemographic and clinical factors related to high suicidality. Results One hundred and twenty-five patients were classed as high suicidality. Unemployed status (adjusted odds ratio [OR] 2.43, p?clinical factors were associated with high suicidality in Asian patients with MDD. These factors may facilitate the identification of MDD patients at risk of suicide. PMID:24524225

  16. Lymphomatoid granulomatosis--a single institute experience: pathologic findings and clinical correlations.

    PubMed

    Song, Joo Y; Pittaluga, Stefania; Dunleavy, Kieron; Grant, Nicole; White, Therese; Jiang, Liuyan; Davies-Hill, Theresa; Raffeld, Mark; Wilson, Wyndham H; Jaffe, Elaine S

    2015-02-01

    Lymphomatoid granulomatosis (LYG) is a rare angiocentric and angiodestructive Epstein-Barr virus (EBV)-associated B-cell lymphoproliferative disorder. It is hypothesized that these patients have dysregulated immune surveillance of EBV. We reviewed the biopsies of 55 patients with LYG who were referred for a prospective trial at the National Cancer Institute (1995 to 2010) and evaluated the histologic, immunohistochemical, in situ hybridization, and molecular findings of these biopsies in conjunction with clinical information. Grading of the lesions was based on morphologic features and the number of EBV-positive B cells. The median age was 46 years (M:F 2.2:1). Clinically, all patients had lung involvement (100%), with the next most common site being the central nervous system (38%). No patient had nodal or bone marrow disease. All patients had past EBV exposure by serology but with a low median EBV viral load. We reviewed 122 biopsies; the most common site was lung (73%), followed by skin/subcutaneous tissue (17%); other sites included kidney, nasal cavity, gastrointestinal tract, conjunctiva, liver, and adrenal gland. Histologically, the lesions showed angiocentricity, were rich in T cells, had large atypical B cells, and were positive for EBV. Grading was performed predominantly on the lung biopsy at diagnosis; they were distributed as follows: LYG grade 1 (30%), grade 2 (22%), and grade 3 (48%). Necrosis was seen in all grades, with a greater degree in high-grade lesions. Immunoglobulin gene rearrangement studies were performed, and a higher percentage of clonal rearrangements were seen in LYG grade 2 (50%) and grade 3 (69%) as compared with grade 1 (8%). LYG is a distinct entity that can usually be differentiated from other EBV-associated B-cell lymphoproliferative disorders on the basis of the combination of clinical presentation, histology, and EBV studies. Grading of these lesions is important because it dictates the treatment choice. PMID:25321327

  17. [Study on correlation of valvular function of deep vein and clinical symptoms].

    PubMed

    Yang, Z H; Gu, X P; Zhang, J W

    1994-03-01

    The material consists of 291 cases (299 limbs) in which all limbs have varicosity of superficial vein. Routine conventional venographic examinations were performed. Valsalva's test was adauted to observe the valvular function of the deep vein. The statistics showed close corelationship between valvular functional state and clinic manifestations (P < 0.005). In maintenance of the normal function of the vein in lower extremities, the valvular function of femoral vein together with that of the popliteal vein is better than each alone. The valvular function of the femoral vein is more efficient than that of popliteal vein. PMID:7842900

  18. CT findings of breast cancer with clinically complete response following neoadjuvant chemotherapy--histological correlation.

    PubMed

    Ogawa, Yasuhiro; Nishioka, Akihito; Kubota, Kei; Kariya, Shinji; Yoshida, Shoji; Maeda, Hironori; Tanaka, Yosuke; Moriki, Toshiaki; Tochika, Naoshige

    2003-01-01

    In breast cancer patients, several regimens of neoadjuvant chemotherapy have been developed in order to achieve prognostic advantages for individual patients. Though some percentages of breast cancer patients show clinically complete response to neoadjuvant chemotherapy, the histopathological specimens of these patients demonstrate a considerably high frequency of the existence of residual disease. In this study, we aimed to evaluate the therapeutic effect of neoadjuvant chemotherapy for breast cancer patients showing clinically complete response (cCR) to neoadjuvant chemotherapy, using thin-section (5 mm) helical CT (prone position) with bolus injection of contrast agent. Between April 1994 and March 2002, 9 patients with breast cancer showing cCR to the neoadjuvant chemotherapy, who had undergone thin-section CT study both before and following neoadjuvant chemotherapy, enrolled in the study. The mean age of the patients was 46.2 years and all of them were female. The clinical stages were, 8 patients in stage II, and one in stage IIIA. In the CT evaluation, residual disease was visualized in 5 out of the 9 patients. Histopathological examination disclosed the existence of residual cancers in 6 out of the 9 patients, but only non-invasive cancer was revealed in 1 out of the 6. As patients having residual disease composed only of non-invasive cancer are classified into the pathologically complete response group according to the WHO classification, 4 out of these 9 patients showing clinically complete response to the neoadjuvant chemotherapy were classified into pCR (pathologically complete response) group, and another 5 were classified into the pPR (pathologically partial response) group. As a result, the diagnostic accuracy of the second CT study performed after neoadjuvant chemotherapy was evaluated as 77.8%, with a sensitivity of 80.0%, a specificity of 75.0%, a positive predictive value (PPV) of 80.0%, and a negative predictive value (NPV) of 75.0%. Therefore, for precise evaluation of the neoadjuvant chemotherapeutic effect for breast cancer, thin-section CT studies are considered to be essential. PMID:12883716

  19. Expression of Wip1 in kidney carcinoma and its correlation with tumor metastasis and clinical significance.

    PubMed

    Sun, G G; Wang, Y D; Liu, Q; Hu, W N

    2015-01-01

    This study aimed to analyze the expression, clinical significance of proto-oncogene in kidney carcinoma and the biological effect in its cell line by siRNA targeting wild-type p53-induced phosphatase 1 (Wip1). Immunohistochemistry and western blot were respectively used to analyze Wip1 protein expression in 78 cases of kidney cancer and normal tissues to study the relationship between Wip1 expression and clinical factors. Wip1 siRNA was transiently transfected into papillary kidney carcinoma cell by liposome-mediated method and was detected by Quantitative real-time RT-PCR (qRT-PCR) and western blot. MTT assay, cell apoptosis, cell migration and invasion were also conducted as to the influence of the down-regulated expression of Wip1 that might be found on ACHN cells biological effect. The level of Wip1 protein expression was found to be significantly higher in kidney cancer tissue than normal tissues (P < 0.05). There were significant differences between Wip1 expression and lymph node metastasis, clinical stages and tumor differentiation (P < 0.05). Meanwhile, Increased expression of Wip1 was significantly with poor overall survival time by Kaplan-Meier analysis (P < 0.05). qRT-PCR and Western blot showed that ACHN cell transfected Wip1 siRNA had a lower relative expressive content than normal cell (P < 0.05). MTT assay, cell apoptosis, cell cycles demonstrated that ACHN cell transfected Wip1 siRNA had a lower survival fraction, higher cell apoptosis, more percentage of the G0/G1 phases, significant decrease in migration and invasion, and higher P53 and P16 protein expression compared with ACHN cell untransfected Wip1 siRNA (P < 0.05). Wip1 protein was increased in kidney carcinoma, specifically in T stages, lymph node metastasis, clinical stages and tumor differentiation. Wip1 may involved in the biological processes of kidney cancer cell proliferation, apoptosis, and migration and invasion by regulation P53 and P16 protein expression. PMID:24970693

  20. Testing homogeneity of proportion ratios for stratified correlated bilateral data in two-arm randomized clinical trials.

    PubMed

    Pei, Yanbo; Tian, Guo-Liang; Tang, Man-Lai

    2014-11-10

    Stratified data analysis is an important research topic in many biomedical studies and clinical trials. In this article, we develop five test statistics for testing the homogeneity of proportion ratios for stratified correlated bilateral binary data based on an equal correlation model assumption. Bootstrap procedures based on these test statistics are also considered. To evaluate the performance of these statistics and procedures, we conduct Monte Carlo simulations to study their empirical sizes and powers under various scenarios. Our results suggest that the procedure based on score statistic performs well generally and is highly recommended. When the sample size is large, procedures based on the commonly used weighted least square estimate and logarithmic transformation with Mantel-Haenszel estimate are recommended as they do not involve any computation of maximum likelihood estimates requiring iterative algorithms. We also derive approximate sample size formulas based on the recommended test procedures. Finally, we apply the proposed methods to analyze a multi-center randomized clinical trial for scleroderma patients. PMID:24974954

  1. Expression of Gli1 and Wnt2B correlates with progression and clinical outcome of pancreatic cancer

    PubMed Central

    Jiang, Hua; Li, Fengru; He, Chengzhi; Wang, Xuebin; Li, Qingqing; Gao, Hengjun

    2014-01-01

    Objective: The aim of this study was to investigate the expression and clinical significance of Gli1 and Wnt2B in pancreatic cancer. Methods: We have constructed a formalin-fixed paraffin embedded pancreatic tissue microarrays 180cylindrical tissue cores of human pancreatic cancer and its paracancerous nonmalignant pancreatic specimens (NMPs) from 90 patients. Levels of Gli1 and Wnt2B were measured by immunohistochemistry. We analyzed the correlations between the expression of these factors and clinicopathological parameters including prognosis. Results: The expressions of both Gli1 and Wnt2B in human pancreatic cancer tissues were significantly higher than those of normal pancreatic tissues (P=0.000, P=0.004 respectively). The analysis showed that the high cytoplasmic expression levels of Gli1 in pancreatic cancer tissues had significant correlation with lymph node metastasis (P=0.036) and Wnt2B had significant correlation with perineural invasion (P=0.045). Gli1 and Wnt2B have no positive correlation. Survival analysis by Kaplan-Meier demonstrated that elevated Wnt2B expression in cancer tissue predicted worse overall survival (OS) compared with group in lower expression (P=0.024). No correlation was found between the expression of Gli1 and overall survival of pancreatic cancer patients (P>0.05). Conclusions: In conclusion, these results indicate that the high-expression levels of Gli1 and Wnt2B might play a pivotal role during tumorigenesis of pancreatic cancer, and the high expression of Wnt2B might be associated with poor prognosis. PMID:25120849

  2. Molecular correlations in phenylketonuria: mutation patterns and corresponding biochemical and clinical phenotypes in a heterogeneous California population.

    PubMed

    Enns, G M; Martinez, D R; Kuzmin, A I; Koch, R; Wakeem, C K; Woo, S L; Eisensmith, R C; Packman, S

    1999-11-01

    We studied 133 California phenylketonuria (PKU) patients and one obligate heterozygote to delineate the molecular basis of PKU in a population with greater ethnic diversity than in previous studies, and to determine whether a correlation exists between genotype and clinical phenotype, with the latter defined by both the diagnostic pretreatment blood phenylalanine (PHE) level and cognitive (IQ) test scores. To determine PAH genotypes, we used PCR-mediated amplification, denaturing gradient gel electrophoresis, and direct sequencing on dried whole blood samples. Where possible, mutation severity was defined according to predicted in vitro PAH enzyme activity estimated by using Cos cell expression analysis for a given mutation. We then asked whether mutation severity, as defined by such expression analysis, correlated with pretreatment PHE levels or with IQ test results. A mutation was identified in 236 (88%) of 267 mutant alleles. Seventeen new mutant alleles were found; A47E, T81P, I102T, E182G, T328D, Y343P, K371R, Y387H, A389E, E422K, IVS9nt5, IVS11nt20, delS70, del364-368/del198-220, delF299, delT323, and -1C/T. In striking contrast to a number of studies in other populations, in this study, based on predicted PAH activity, we observed no correlation between mutation severity and pretreatment PHE levels. There was also no correlation between genotype and IQ. We conclude that in samples collected from an ethnically heterogeneous population, there is no correlation of mutation severity with either pretreatment PHE levels or IQ measurement in treated patients. We caution that genetic counseling in PKU should incorporate the notion that prognosis may not be predicted with precision based on mutation analysis in a given patient. PMID:10541324

  3. A comparison of nerve conduction velocities and current perception thresholds as correlates of clinical severity of diabetic sensory neuropathy.

    PubMed Central

    Rendell, M S; Katims, J J; Richter, R; Rowland, F

    1989-01-01

    Nerve conduction velocities (NCVs) are the standard measurements used to confirm the presence or absence of diabetic neuropathy. NCVs were contrasted with the newer technique of measurement of alternating current perception thresholds (CPTs) in assessing the quantitative level of correlation with severity of diabetic sensory neuropathy. A very detailed, scored neurological history (symptoms) and physical examination, emphasising sensory assessment, was conducted on 71 individuals with diabetic neuropathy of varying degrees of severity. Sensory and motor NCVs and CPTs at 5, 250, and 2000 Hz of the upper and lower extremities were determined for these individuals. In addition, vibration thresholds (VTs) were measured as a third modality. Twenty eight individuals underwent repeated evaluations at 2, 6, 10 and 12 months after the initial procedures. Using the results of 169 complete evaluations, correlations were determined between physical scores (PS) and symptoms scores (SS) and NCVs. NCV correlations with the SS were weaker than with the PS. The strongest of the correlations were found between the PS and motor NCVs of the median nerve (rho = 0.29) and the tibial nerve (rho = 0.38). Normal NCVs were present in the face of very significant historical and physical abnormality. Correlations of the SS and PS with both VTs and CPTs were higher than with the NCVs. CPTs proved the more effective as predictors of both symptomatic and physical impairment. NCVs appear to lack the resolving power necessary to evaluate subtle differences in clinical state of diabetic sensory neuropathy. The supplementary use of current perception testing may improve the quantitative assessment of this condition. PMID:2738593

  4. Clinical and quality of life data correlation with a single-optic accommodating intraocular lens

    PubMed Central

    Ramón, María L.; Piñero, David P.; Blanes-Mompó, Francisco J.; Pérez-Cambrodí, Rafael J.

    2012-01-01

    Purpose To examine a single-optic accommodating intraocular lens (IOL) visual performance by correlating IOL implanted eyes’ defocus curve with the intraocular aberrometric profile and the impact on the quality of life (QOL). Methods Prospective consecutive case series study including a total of 25 eyes of 14 patients with ages ranging between 52 and 79 years old. All cases underwent cataract surgery with implantation of the single-optic accommodating IOL Crystalens HD (Bausch & Lomb). Distance and near visual acuity outcomes, intraocular aberrations, the defocus curve and QOL (NEI VFQ-25) were evaluated 3 months after surgery. Results A significant improvement in distance visual acuity was found postoperatively (p = 0.02). Mean postoperative LogMAR uncorrected near visual acuity was 0.44 ± 0.23 (20/30). 60% of eyes had a postoperative addition between 0 and 1.5 diopters (D). The defocus curve showed an area of maximum visual acuity for the levels of defocus corresponding to distance and intermediate vision (?1 to +0.5 D). Postoperative intermediate visual acuity correlated significantly some QOL indices (r ? 0.51, p ? 0.03; difficulty in going down steps or seeing how people react to things that patient says) as well as with J0 component of manifest cylinder. Postoperative distance-corrected near visual acuity correlated significantly with age (r = 0.65, p < 0.01). Conclusions This accommodating IOL seems to be able to restore the distance visual function as well as to provide an improvement in intermediate and near vision with a significant impact on patient's QOL, although limited by age and astigmatism. Future studies with larger sample sizes should confirm all these trends.

  5. Thermographic and clinical correlation of myofascial trigger points in the masticatory muscles

    PubMed Central

    Haddad, D S; Brioschi, M L; Arita, E S

    2012-01-01

    Objectives The aim of the study was to identify and correlate myofascial trigger points (MTPs) in the masticatory muscles, using thermography and algometry. Methods 26 female volunteers were recruited. The surface facial area over the masseter and anterior temporalis muscles was divided into 15 subareas on each side (n = 780). This investigation consisted of three steps. The first step involved thermographic facial examination, using lateral views. The second step involved the pressure pain threshold (PPT), marking the MTP pattern areas for referred pain (n = 131) and local pain (n = 282) with a coloured pencil, and a photograph of the lateral face with the head in the same position as the infrared imaging. The last step was the fusion of these two images, using dedicated software (Reporter® 8.5—SP3 Professional Edition and QuickReport® 1.2, FLIR Systems, Wilsonville, OR); and the calculation of the temperature of each point. Results PPT levels measured at the points of referred pain in MTPs (1.28 ± 0.45 kgf) were significantly lower than the points of local pain in MTPs (1.73 ± 0.59 kgf; p < 0.05). Infrared imaging indicated differences between referred and local pain in MTPs of 0.5 °C (p < 0.05). Analysis of the correlation between the PPT and infrared imaging was done using the Spearman non-parametric method, in which the correlations were positive and moderate (0.4 ? r < 0.7). The sensitivity and specificity in MTPs were 62.5% and 71.3%, respectively, for referred pain, and 43.6% and 60.6%, respectively, for local pain. Conclusion Infrared imaging measurements can provide a useful, non-invasive and non-ionizing examination for diagnosis of MTPs in masticatory muscles. PMID:23166359

  6. RMI study and clinical correlations of ankle retinacula damage and outcomes of ankle sprain.

    PubMed

    Stecco, Antonio; Stecco, Carla; Macchi, Veronica; Porzionato, Andrea; Ferraro, Claudio; Masiero, Stefano; De Caro, Raffaele

    2011-12-01

    Recent studies reveal the role of the ankle retinacula in proprioception and functional stability of the ankle, but there is no clear evidence of their role in the outcomes of ankle sprain. 25 patients with outcomes of ankle sprain were evaluated by MRI to analyze possible damage to the ankle retinacula. Patients with damage were subdivided into two groups: group A comprised cases with ankle retinacula damage only, and group B those also with anterior talofibular ligament rupture or bone marrow edema. Both groups were examined by VAS, CRTA and static posturography and underwent three treatments of deep connective tissue massage (Fascial Manipulation technique). All evaluations were repeated after the end of treatment and at 1, 3 and 6 months. At MRI, alteration of at least one of the ankle retinacula was evident in 21 subjects, and a further lesion was also identified in 7 subjects. After treatment, VAS and CRTA evaluations showed a statistically significant decrease in values with respect to those before treatment (p < 0.0001). There were also significant improvements (p < 0.05) in stabilometric platform results. No significant difference was found between groups A and B. The initial benefit was generally maintained at follow-up. The alteration of retinacula at MRI clearly corresponds to the proprioceptive damage revealed by static posturography and clinical examination. Treatment focused on the retinacula may improve clinical outcomes and stabilometric data. PMID:21305286

  7. Toxoplasma encephalitis in Haitian adults with acquired immunodeficiency syndrome: a clinical-pathologic-CT correlation

    SciTech Connect

    Post, M.J.D.; Chan, J.C.; Hensley, G.T.; Hoffman, T.A.; Moskowitz, L.B.; Lippmann, S.

    1983-05-01

    The clinical data, histologic findings, and computed tomographic (CT) abnormalities in eight adult Haitians with toxoplasma encephalitis were analyzed retrospectively. Diagnosis was established by identification of Toxoplasma gondii on autopsy in five and brain biopsy in three specimens and subsequently confirmed by the immunoperoxidase method. All these patiens, six of whom had been in the United States for 24 months or less, had severe idiopathic immunodeficiency syndrome. All were lymphopenic and six were on treatment for tuberculosis when the toxoplasma encephalitis developed. All patients were studied with CT when they developed an altered mental status and fever associated with seizures and/or focal neurologic deficits. Scans before treatment showed multiple intraparenchymal lesions in seven and a single lesion in the thalamus in one. Ring and/or nodular enhancement of the lesions was found in six and hypodense areas in two. Progressions of abnormalities occurred on serial studies. These CT findings that were best shown on axial and coronal thin-section double-dose contrast studies were useful but not diagnostically pathognomonic. In patients with similar clinical presentation CT is recommended to identify focal areas of involvement and to guide brain biopsy or excision so that prompt medical thereapy of this often lethal infection can be instituted.

  8. Lifetime Obesity in Patients with Eating Disorders: Increasing Prevalence, Clinical and Personality Correlates

    PubMed Central

    Villarejo, Cynthia; Fernández-Aranda, Fernando; Jiménez-Murcia, Susana; Peñas-Lledó, Eva; Granero, Roser; Penelo, Eva; Tinahones, Francisco J; Sancho, Carolina; Vilarrasa, Nuria; Montserrat-Gil de Bernabé, Mónica; Casanueva, Felipe F; Fernández-Real, Jose Manuel; Frühbeck, Gema; De la Torre, Rafael; Treasure, Janet; Botella, Cristina; Menchón, José Manuel

    2012-01-01

    Objectives : The aims of our study were to examine the lifetime prevalence of obesity rate in eating disorders (ED) subtypes and to examine whether there have been temporal changes among the last 10 years and to explore clinical differences between ED with and without lifetime obesity. Methods : Participants were 1383 ED female patients (DSM-IV criteria) consecutively admitted, between 2001 and 2010, to Bellvitge University Hospital. They were assessed by means of the Eating Disorders Inventory-2, the Symptom Checklist-90—Revised, the Bulimic Investigatory Test Edinburgh and the Temperament and Character Inventory—Revised. Results : The prevalence of lifetime obesity in ED cases was 28.8% (ranging from 5% in anorexia nervosa to 87% in binge-eating disorders). Over the last 10 years, there has been a threefold increase in lifetime obesity in ED patients (p < .001). People with an ED and obesity had higher levels of childhood and family obesity (p < .001), a later age of onset and longer ED duration; and had higher levels of eating, general and personality symptomatology. Conclusions : Over the last 10 years, the prevalence of obesity associated with disorders characterized by the presence of binge episodes, namely bulimic disorders, is increasing, and this is linked with greater clinical severity and a poorer prognosis. Copyright © 2012 John Wiley & Sons, Ltd and Eating Disorders Association. PMID:22383308

  9. Distinct lymphocytes subsets in IgM-related neuropathy: clinical-immunological correlations.

    PubMed

    Iorio, Raffaele; Sabatelli, Mario; Del Grande, Alessandra; Bisogni, Giulia; Damato, Valentina; Plantone, Domenico; Marti, Alessandro; Frisullo, Giovanni; Romano, Angela; Rossini, Paolo Maria; Luigetti, Marco

    2015-02-01

    IgM-related neuropathy generally presents as a late-onset demyelinating polyneuropathy with predominant sensory loss and ataxia. However, we recently reported the clinical, neurophysiological and pathological findings from our cohort and identified in about a third of patients an atypical phenotype. We analyzed by flow cytometry the different lymphocytes subsets in the peripheral blood of patients affected by IgM-related neuropathy, chronic inflammatory demyelinating polyneuropathy (CIDP), monoclonal gammopathy of undetermined significance and healthy subjects, to investigate whether different immunological patterns may differentiate the classical phenotype from atypical forms. IFN-gamma producing CD4+ and CD8+ T lymphocytes, as well as CD4+ and CD8+ T cells expressing T-bet (T-helper type 1, Th1) were increased in CIDP patients. The percentage of circulating CD4+ and CD8+ T cells producing IL-10 as well as the percentage of CD19+ cells expressing Blimp-1 were higher in patients with IgM-neuropathy. We did not find any significant differences in the different lymphocytes subsets in the IgM-related neuropathy between patients with classical and atypical phenotype. Th1 cells are increased in CIDP patients while a T helper type 2-phenotype seems to prevail in patients with IgM-neuropathy. Further studies involving a larger patient population are needed to evaluate if different lymphocytes subset may be involved in different clinical phenotypes of IgM-related neuropathy. PMID:25192662

  10. Pro-inflammatory cytokine levels in human apical periodontitis: Correlation with clinical and histological findings.

    PubMed

    Jakovljevic, Aleksandar; Knezevic, Aleksandra; Karalic, Danijela; Soldatovic, Ivan; Popovic, Branka; Milasin, Jelena; Andric, Miroslav

    2014-08-27

    This study aimed to compare the levels of tumour necrosis factor-alpha (TNF-?), interleukin-1 beta (IL-1?) and interleukin-6 (IL-6) between apical periodontitis lesions with different clinical and histological features. Based on clinical data and history of disease, 100 human apical periodontitis lesions were categorised as either asymptomatic or symptomatic lesions. According to histological examination, lesions were divided into periapical granulomas and radicular cysts. Pulp tissues of 25 impacted wisdom teeth were used as controls. Homogenised tissue samples were centrifuged and supernatants were used for the determination of cytokine levels by enzyme-linked immunosorbent assay. Significantly higher levels of IL-1? and IL-6 were found in symptomatic lesions compared with asymptomatic lesions and control tissues (P?

  11. Correlation of Giardia duodenalis assemblages with clinical and epidemiological data in Cuban children.

    PubMed

    Puebla, Luis Jerez; Núñez, Fidel A; Fernández, Yenisey Alfonso; Fraga, Jorge; Rivero, Lázara Rojas; Millán, Iraís Atencio; Valdés, Lucía Ayllón; Silva, Isabel Martínez

    2014-04-01

    Giardia duodenalis is one of the most frequent intestinal parasitic infections in children worldwide. To date, eight main assemblages of G. duodenalis have been described, but only A and B genetic groups are known to infect humans. In Cuba, this parasite has most clinical impact on children. The aim of this investigation was genetic characterization of G. duodenalis isolated from children with giardiasis diagnosed at the Paediatric Hospital "William Soler" between 2010 and 2011, and to compare the genetic results with clinical and epidemiological data. A total of 103 stool samples from 452 children were positive for G. duodenalis and co-infections with other parasites were noted in 5 cases. Assemblage identification was carried out by the amplification of a fragment of the triosephosphate isomerase (tpi) gene. Sub-assemblages of assemblage A (AI and AII) were identified by a nested PCR using the intergenic spacer (IGS) region of ribosomal deoxyribonucleic acid gene as a target. DNA from 90 of 103 (87.4%) samples was successfully amplified by PCR-tpi. The prevalence of assemblages A and B was 40% and 42%, respectively. Infections with both assemblages were reported in 16 cases. No associations between epidemiological information and assemblage was detected, but assemblage B was significantly (P<0.01) more frequently found in children with diarrhea, flatulence or abdominal pain than assemblage A. Sub-assemblage AII accounted for the majority of cases (86.5%). PMID:24462623

  12. Surgically Repaired Massive Rotator Cuff Tears: MRI of Tendon Integrity, Muscle Fatty Degeneration, and Muscle Atrophy Correlated with Intraoperative and Clinical Findings

    Microsoft Academic Search

    J. M. Mellado; J. Calmet; M. Olona; C. Esteve; A. Camins; L. Pérez del Palomar; J. Giné; A. Saurí

    OBJECTIVE. Our goal in this study was to evaluate by means of MRI the clinical signif- icance of tendon integrity, muscle fatty degeneration, and muscle atrophy in surgically repaired massive rotator cuff tears and to correlate these and other prognostic factors with intraoperative and clinical findings. MATERIALS AND METHODS. Twenty-eight surgically proven massive rotator cuff tears were retrospectively included in

  13. Correlation of clinical neuromusculoskeletal and central somatosensory performance: variability in controls and patients with severe and mild focal hand dystonia.

    PubMed

    Byl, Nancy N; Nagarajan, Srikantan S; Merzenich, Michael M; Roberts, Tim; McKenzie, Alison

    2002-01-01

    Focal hand dystonia (FHd) is a recalcitrant, disabling movement disorder, characterized by involuntary co-contractions of agonists and antagonists, that can develop in patients who overuse or misuse their hands. The aim of this study was to document clinical neuromusculoskeletal performance and somatosensory responses (magnetoencephalography) in healthy controls and in FHd subjects with mild versus severe hand dystonia. The performance of healthy subjects (n = 17) was significantly better than that of FHd subjects (n =17) on all clinical parameters. Those with mild dystonia (n = 10) demonstrated better musculoskeletal skills, task-specific motor performance, and sensory discrimination, but the performance of sensory and fine motor tasks was slower than that of patients with severe dystonia. In terms of somatosensory evoked field responses (SEFs), FHd subjects demonstrated a significant difference in the location of the hand representation on the x and y axes, lower amplitude of SEFs integrated across latency, and a higher ratio of mean SEF amplitude to latency than the controls. Bilaterally, those with FHd (mild and severe) lacked progressive sequencing of the digits from inferior to superior. On the affected digits, subjects with severe dystonia had a significantly higher ratio of SEF amplitude to latency and a significantly smaller mean volume of the cortical hand representation than those with mild dystonia. Severity of dystonia positively correlated with the ratio of SEF mean amplitude to latency (0.9029 affected, 0.8477 unaffected; p < 0.01). The results of the present study strengthen the evidence that patients with FHd demonstrate signs of somatosensory degradation of the hand that correlates with clinical sensorimotor dysfunction, with characteristics of the de-differentiation varying by the severity of hand dystonia. If these findings represent aberrant learning, then effective rehabilitation must incorporate the principles of neuroplasticity. Training must be individualized to each patient to rebalance the sensorimotor feedback loop and to restore normal fine motor control. PMID:12757370

  14. Subcellular Spatial Correlation of Particle Traversal and Biological Response in Clinical Ion Beams

    SciTech Connect

    Niklas, Martin, E-mail: m.niklas@dkfz.de [Division of Medical Physics in Radiation Oncology, German Cancer Research Center, Heidelberg (Germany); German Cancer Consortium, National Center for Radiation Research in Oncology, Heidelberg Institute of Radiation Oncology, Heidelberg (Germany); Abdollahi, Amir [German Cancer Consortium, National Center for Radiation Research in Oncology, Heidelberg Institute of Radiation Oncology, Heidelberg (Germany); Molecular and Translational Radiation Oncology, Heidelberg Ion-Beam Therapy Center, University of Heidelberg Medical School and National Center for Tumor Diseases, German Cancer Research Center, Heidelberg (Germany); Department of Radiation Oncology and Radiation Therapy, University Hospital Heidelberg, Heidelberg (Germany); Heidelberg Ion-Beam Therapy Center, Heidelberg (Germany); Akselrod, Mark S. [Stillwater Crystal Growth Division, Landauer Inc, Stillwater, Oklahoma (United States); Debus, Jürgen [German Cancer Consortium, National Center for Radiation Research in Oncology, Heidelberg Institute of Radiation Oncology, Heidelberg (Germany); Molecular and Translational Radiation Oncology, Heidelberg Ion-Beam Therapy Center, University of Heidelberg Medical School and National Center for Tumor Diseases, German Cancer Research Center, Heidelberg (Germany); Department of Radiation Oncology and Radiation Therapy, University Hospital Heidelberg, Heidelberg (Germany); Heidelberg Ion-Beam Therapy Center, Heidelberg (Germany); Jäkel, Oliver [Division of Medical Physics in Radiation Oncology, German Cancer Research Center, Heidelberg (Germany); German Cancer Consortium, National Center for Radiation Research in Oncology, Heidelberg Institute of Radiation Oncology, Heidelberg (Germany); Department of Radiation Oncology and Radiation Therapy, University Hospital Heidelberg, Heidelberg (Germany); Heidelberg Ion-Beam Therapy Center, Heidelberg (Germany); and others

    2013-12-01

    Purpose: To report on the spatial correlation of physical track information (fluorescent nuclear track detectors, FNTDs) and cellular DNA damage response by using a novel hybrid detector (Cell-Fit-HD). Methods and Materials: The FNTDs were coated with a monolayer of human non-small cell lung carcinoma (A549) cells and irradiated with carbon ions (270.55 MeV u{sup ?1}, rising flank of the Bragg peak). Phosphorylated histone variant H2AX accumulating at the irradiation-induced double-strand break site was labeled (RIF). The position and direction of ion tracks in the FNTD were registered with the location of the RIF sequence as an ion track surrogate in the cell layer. Results: All RIF sequences could be related to their corresponding ion tracks, with mean deviations of 1.09 ?m and ?1.72 ?m in position and of 2.38° in slope. The mean perpendicular between ion track and RIF sequence was 1.58 ?m. The mean spacing of neighboring RIFs exhibited a regular rather than random spacing. Conclusions: Cell-Fit-HD allows for unambiguous spatial correlation studies of cell damage with respect to the intracellular ion traversal under therapeutic beam conditions.

  15. Sclerosis in bisphosphonate-related osteonecrosis of the jaws and its correlation with the clinical stages: study of 43 cases.

    PubMed

    Bagan, J V; Cibrian, R M; Lopez, J; Leopoldo-Rodado, M; Carbonell, E; Bagán, L; Utrilla, J; Scully, C

    2015-03-01

    We analysed the degree of sclerosis in the different stages of bisphosphonate-related osteonecrosis of the jaws (BRONJ) and studied the relation between the grade of sclerosis, the clinical symptoms, and the depth of lucency. We compared 43 patients with mandibular BRONJ with a control group of 40 cases with no bony lesions. The presence of sclerotic bone, cortical irregularities, radiolucency, fragmentation or sequestration, periostitis, and narrowing of the mandibular canal were studied from computed tomographic (CT) scans using the program ImageJ 1.47v (National Institute of Health, Bethesda, USA) to measure the radiolucency, width of the cortices, and degree of sclerosis. Patients with BRONJ had more severe sclerosis than controls (p<0.01). There was also a significant difference among the different stages of BRONJ, with the highest values found in stage III (p=0.02). The degree of sclerosis differed according to sex, type of bisphosphonate, and the clinical characteristics such as pain, or suppuration, but not significantly so (p>0.05). We conclude that the degree of sclerosis increases with the clinical stage of BRONJ, and is correlated with the depth of lucency. PMID:25560326

  16. Clinical and echocardiographic correlates of elevated troponin in amyloid light-chain cardiac amyloidosis.

    PubMed

    Apridonidze, Teimuraz; Steingart, Richard M; Comenzo, Raymond L; Hoffman, James; Goldsmith, Yuliya; Bella, Jonathan N; Landau, Heather; Liu, Jennifer E

    2012-10-15

    Increased troponin is associated with poor survival in patients with amyloid light-chain (AL) amyloidosis with cardiac involvement (CAL). The purpose of this investigation was to define the relation between increased troponin and clinical, morphologic, and functional features. The comparative utility of clinical, echocardiographic, and biochemical measurements in predicting survival in CAL was also investigated. One hundred seventeen patients with CAL were divided into 2 groups: normal troponin I (<0.06 ng/ml, n = 42) or increased troponin I (?0.06 ng/ml, n = 75). Patients in the high troponin I group were older (63 vs 58 years, p = 0.04), with higher B-type natriuretic peptide levels (1,417 vs 936 pg/ml, p = 0.0004). The high troponin I group also had higher echocardiography-determined early/late mitral inflow velocity ratio (2.2 vs 1.4, p = 0.005) and myocardial performance index (0.59 vs 0.45, p = 0.04) and lower stroke index (28 vs 38 ml/beat/m(2), p <0.0001) and left atrial systolic force (5.9 vs 8.4 k-dynes, p = 0.037) than the normal troponin group. Median survival was significantly shorter in the high troponin group (11 vs 45 months, p <0.001). At time of CAL diagnosis, univariate predictors of all-cause mortality included increased troponin, older age, male gender, New York Heart Association class III to IV, >2 organs involved, higher B-type natriuretic peptide, lower creatinine clearance, greater ventricular septal thickness, and higher myocardial performance index. However, by multivariate Cox survival analysis, only increased troponin was a significant predictor for all-cause mortality (hazard ratio 3.1, p = 0.002). In conclusion, increased troponin is associated with worse left ventricular and left atrial functions by echocardiography in patients with CAL. Among baseline variables, it is the strongest predictor of all-cause mortality in multivariate analysis. Troponin is a powerful tool in clinical and prognostic assessments of patients with CAL. PMID:22770934

  17. Correlation of general anxiety and dental anxiety in children aged 3 to 5 years: A clinical survey

    PubMed Central

    Nigam, Anant Gopal; Marwah, Nikhil; Goenka, Puneet; Chaudhry, Ajay

    2013-01-01

    Background: The aim of this study was to determine the prevalence of dental anxiety in a group of children aged 3 to 5 years and to explore the relationships between dental anxiety and general fearful nature of the child. Materials & Methods: A total of 250 children were selected for the study after due selection via inclusion criteria. Pre-school anxiety scale by Spence and Rapee (1999) was used to assess the general fear of the child and was filled by the parent during the first visit. Venham’s anxiety scale was used to assess the dental anxiety which was seen during routine dental examination of the child on his first visit. Results: The results were statistically analyzed using Chi square test and Karl Pearson coefficient of correlation. Conclusion: It was concluded that 24% of children showed association between high level of dental anxiety and high level of general fear; 56% of children also exhibited high level of dental anxiety with moderate score of general fear and 20% of children exhibited positive correlation between low level of dental anxiety and fear. How to cite this article: Nigam AG, Marwah N, Goenka P, Chaudhry A. Correlation of general anxiety and dental anxiety in children aged 3 to 5 years: A clinical survey. J Int Oral Health 2013;5(6):18-24 . PMID:24453440

  18. Alpha-adrenoceptors and vascular regulation: molecular, pharmacologic and clinical correlates.

    PubMed

    Piascik, M T; Soltis, E E; Piascik, M M; Macmillan, L B

    1996-01-01

    This manuscript is intended to provide a comprehensive review of the alpha-adrenoceptors (ARs) and their role in vascular regulation. The historical development of the concept of receptors and the division of the alpha-ARs into alpha 1 and alpha 2 subtypes is traced. Emphasis will be placed on current understanding of the specific contribution of discrete alpha 1- and alpha 2-AR subtypes in the regulation of the vasculature, selective agonists and antagonists for these receptors, the second messengers utilized by these receptors, the myoplasmic calcium pathways activated to initiate smooth muscle contraction, as well as the clinical uses of agonists and antagonists that work at these receptors. New information is presented that deals with the molecular aspects of ligand interactions with specific subdomains of these receptors, as well as mRNA distribution and the regulation of alpha 1- and alpha 2-AR gene transcription and translation. PMID:9364576

  19. [Clinical study of the correlation between bad breath and subgingival microflora].

    PubMed

    Moriyama, T

    1989-09-01

    A dark field microscopic examination of subgingival microorganisms and gas chromatographic analysis of volatile sulphur compounds were employed to investigate the role of subgingival microflora in the production of bad breath. Subjects (11 female, 13 male; aged 24 to 61) were divided into the following 2 groups on the basis of apparent bad breath by the olfactory judgement; bad breath group (group B, n = 13), and no bad breath group (group N, n = 11). A gas tight syringe was employed to withdraw 5 ml mouth air samples, which were injected directly into the gas chromatograph. Volatile sulphur compounds produced in mouth air were analyzed by gas chromatograph to determine volumes of CH3SH. Subgingival plaque samples were taken with sterilized paper points from the deepest site of probing depth in each subjects. The samples were examined by means of dark field microscopy and 100 bacteria in randomly selected fields were classified on a percentage basis into one of the following morphological categories: (1) spirochetes, (2) motile rods, (3) filaments, (4) fusiforms, (5) straight rods, and (6) coccoid cells. Total cell counts per 1 ml were calculated from bacterial counts of each categories. Comparison of 2 independent means from each groups were carried out by Wilcoxon's rank sum test for nonparametric values. Correlations of bacterial data with CH3SH values in mouth air were determined by means of Spearman rank correlation cofficient. Results were as follows; 1. Significant differences existed in the microbial flora between the 2 groups: percentage of spirochetes and motile rods in group B were significantly higher than those in group N (p less than 0.01). Total cell counts of group B were significantly greater than group N, and there were statistically significant differences (p less than 0.01). 2. CH3SH values in mouth air had positive correlations with the percentage of spirochetes, the percentage of motile rods, and total cell counts. These results are consistent with the view that subgingival microorganisms play a certain role in the production of bad breath. Moreover, it was suggested that spirochetes and motile rods are related to the mechanism of bad breath production. PMID:2641198

  20. Clinical Features and Virological Correlates of Neurocognitive Impairment among HIV-Infected Individuals in Nigeria

    PubMed Central

    Royal, Walter; Cherner, Mariana; Carr, Jean; Habib, Abdulrazaq G.; Akomolafe, Abimbola; Abimiku, Alashl'e.; Chaurat, Manhattan; Farley, John; Oluyemisi, Akinwande; Mamadu, Ibrahim; Johnson, Joyce; Ellis, Ronald; McCutchen, Allen; Grant, Igor; Blattner, William A.

    2013-01-01

    In Nigeria the incidence and prevalence of HIV related neurocognitive impairment (NCI) are unknown and there currently exists little information related to the viral correlates rates of NCI. Therefore studies were performed to examine the potential utility of applying an established neuropsychological (NP) screening battery and detailed NP testing to detect NCI and correlations with functional impairment and the presence of specific viral signatures among infected subjects. 60 HIV-1 seropositive antiretroviral-naive individuals and 56 seronegative control subjects were administered the International HIV Dementia Scale (IHDS) and assessed for functional impairment using the Karnofsky Performance Status Scale. 15 HIV infected patients and 11 controls were also administered a detailed NP battery. Blood samples from 8 infected subjects, 3 with evidence of NCI, were obtained for molecular analysis of HIV-1 strain. Unadjusted scores on the IHDS showed that, using a recommended total score cutoff of 10, 28.8% of the HIV-1 seropositive and 16.0% of seropositive individuals scored abnormally. The mean Karnofsky score for the HIV seropositive and seronegative groups were, respectively, 90.7 +12.2 and 98.8 +3.8 (p<0.0001). Results from testing using the full NP battery showed that overall the HIV seropositive group performed worse than the seronegative group, with effect sizes spanning from small (0.25 on the Trail Making Test A) to large (0.82 on Action Fluency), with an average effect size across the battery of 0.45, which approaches that which has been recorded in other international settings. Finally, sequencing of partial pol amplicons from viral isolates revealed that 2 of 3 patients with NCI were infected with subtype G virus and 1 with the circulating recombinant form (CRF) 02_AG; all 4 individuals without NCI were infected with CRF_02AG. These studies demonstrate the utility of conducting these studies for establishing the burden of NCI in the population of individuals with HIV-1 infection in Nigeria and for assessing the functional consequences and the virologic correlates of NCI. PMID:22528480

  1. Plasma biomarkers correlating with clinical outcome in a phase II study of sorafenib in advanced NSCLC.

    PubMed

    Blumenschein, George R; Reck, Martin; Fossella, Frank; Stewart, David J; Lathia, Chetan; Peña, Carol

    We investigated the relationship between plasma protein biomarker concentrations and clinical outcomes in 52 patients with relapsed/refractory advanced non-small cell lung cancer (NSCLC) treated with 400~mg bid sorafenib in a phase II trial. Blood samples were collected at baseline, on day 15 of cycle 1 (C1D15), and on day 1 of cycle 3 (C3D1), and plasma concentrations of total VEGF, VEGF-165, soluble (s) VEGFR-2, PDGF-BB, sPDGFR-?, sEGFR, sHER-2, uPA, PAI-1, uPAR, TIMP-1, and circulating Ras p21 were assayed by ELISA. Elevated baseline VEGF, VEGF-165, PDGF-BB, Ras p21, and TIMP-1 concentrations were associated with poorer patient outcomes (shorter overall survival [OS] and/or progression-free survival [PFS]). During treatment, the mean concentrations of sVEGFR-2, PDGF-BB, sPDGFR-?, TIMP-1, uPAR, and PAI-1 decreased, while the mean sEGFR concentration increased. Increases in VEGF, VEGF-165, PDGF-BB, and TIMP-1 during treatment were associated with better outcomes (longer OS and/or PFS), whereas increases in plasma Ras p21 during treatment were associated with shorter PFS. The associations between baseline concentrations and/or pharmacodynamic changes in plasma proteins and clinical outcomes in NSCLC patients treated with sorafenib suggest that these biomarkers may have a prognostic role and/or predict the efficacy of sorafenib in patients with NSCLC. PMID:22820084

  2. Frequency and distribution of uropathogenic Escherichia coli adhesins: a clinical correlation over 2,000 cases.

    PubMed

    Dalet, F; Segovia, T; Del Río, G

    1991-01-01

    In order to determine the pathogenic responsibility of Escherichia coli adhesins (ADHs) in urinary infections (UI), 2,000 different patients suffering different clinical urinary and male sexual gland infections were monitored. The ADHs were determined by agglutination techniques with human and guinea-pig red blood cells, Candida albicans and Saccharomyces cerevisiae cells and latex sensitized with GAL-GAL. In uncomplicated UIs, the possession of ADH is the main invasion mechanism for E. coli. The rate of E. coli ADH strains is very high (89%) in acute cases (727 of 818 cases: 310 of 362 cystitis; 104 of 113 recidivant cystitis; 120 of 126 pyelonephritis; 158 of 173 prostatitis, and 34 of 43 orchiepididymitis) and rare (10%) in asymptomatic or chronic cases (24 of 235 cases: 14 of 148 bacteriurias; 8 of 74 prostatitis, and 2 of 13 orchiepididymitis). A close relation is established between the presence of ADH and clinical symptoms. 90% (218 of 242) of acute cases with systemic symptoms are due to MR-type ADH strains, especially the P subtype. 71% (409 of 576) of acute cases with local symptoms are due to MS-type ADH strains. In complicated UIs the expression of ADH is not an essential condition for the invasion of the urinary apparatus. It has been strongly suggested that males are significantly more resistant to UI, both in the tract and parenchyma, than women. It can be deduced that the underlying disease is more liable to UI the lower the adherence level shown by isolated strains. Thus catheters, reflux and neurogenic bladder are, by far, more aggressive alterations than the prostatic adenoma, vesical tumor or lithiasis. PMID:1680692

  3. Heterogeneous pattern of bone disease in adult type 1 Gaucher disease: clinical and pathological correlates.

    PubMed

    van Dussen, L; Lips, P; van Essen, H W; Hollak, C E M; Bravenboer, N

    2014-09-01

    Gaucher disease (GD) is a lysosomal storage disorder characterized by accumulation of glucosylceramide in macrophages, so-called Gaucher cells, as a result of a deficiency of the lysosomal enzyme glucocerebrosidase. Bone complications are an important cause of morbidity of GD and are thought to result from imbalance in bone remodeling. Bone manifestations among GD patients demonstrate a large variation including increased osteoclastic bone resorption, low bone formation and osteonecrosis. The purpose of the current case series is to describe the histological features observed in undecalcified bone samples, obtained from three GD patients, and evaluate the relationship with clinical features in these patients. Bone fragments were obtained from three adult type 1 GD patients with variable degrees of bone disease during orthopedic surgery. Specimens were embedded without prior decalcification in methylmethacrylate and prepared for histology according to standardized laboratory procedures. Histology revealed a heterogeneous pattern of bone involvement. High cellularity of bone marrow, abundant presence of Gaucher cells (GCs) and high turnover were observed in a patient with a history of multiple bone complications, while minimal bone turnover and few GCs were detected in the mildest affected patient in this series. An intermediate picture with relatively low bone turnover and a substantial amount of Gaucher cells was demonstrated in the third, moderately affected patient. No gross abnormalities in three biochemical markers of bone turnover (osteocalcin, N-terminal propeptide of type 1 procollagen and type 1 collagen C-terminal telopeptide) were noted. Plastic embedding and subsequent Goldner and TRAP staining offered a unique possibility to study bone histological findings in GD. Our data show that bone manifestations in GD may vary both clinically as well as histologically and bone disease in GD will likely require a personalized approach. PMID:24947205

  4. The clinical stage of allergic rhinitis is correlated to inflammation as detected by nasal cytology.

    PubMed

    Gelardi, Matteo; Incorvaia, Cristoforo; Fiorella, Maria Luisa; Petrone, Paolo; Quaranta, Nicola; Russo, Cosimo; Puccinelli, Paola; Dell'Albani, Ilaria; Riario-Sforza, Gian Galeazzo; Cattaneo, Eleonora; Passalacqua, Gianni; Frati, Franco

    2011-12-01

    Allergic rhinitis (AR) is the most common allergic disease. The Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines classify AR according to its duration and severity and suggest recommended treatments, but there is evidence that these guidelines are insufficiently followed. Considering the validity of histopathological data, physicians are more likely to be persuaded by such information on AR. Thus, we attempted to define the severity of AR by nasal cytology on the basis of the ARIA classification. We examined 64 patients with AR caused by sensitization to grass pollen. We clinically defined AR according to the ARIA classification and performed nasal cytology by Rhino-probe sampling, staining and reading by optical microscopic observation. Clinically, 22 (34.4%), 21 (32.8%), 10 (15.6%), and 11 (17.2%) patients had mild intermittent, moderate-to-severe intermittent, mild persistent, and moderate-to-severe persistent AR, respectively. Nasal cytology detected neutrophils in 49 patients, eosinophils in 41 patients, mast cells in 21 patients, and lymphocytes or plasma cells in 28 patients. The patients with moderate-to-severe AR had significantly more mast cells and lymphocytes/ plasma cells than those with mild AR. Our findings demonstrate that the ARIA classification of AR severity is associated with different cell counts in nasal cytology; especially, moderate-to-severe AR shows significantly increased counts of mast cells and lymphocyte or plasma cells. The ease of performing nasal cytology ensures is feasibility as an office AR diagnostic procedure for primary care physicians, able to indicate when anti-inflammatory treatments, such as intranasal corticosteroids and subcutaneous or sublingual allergen immunotherapy, are needed. PMID:21999180

  5. Contrast-enhanced [18?F] fluorodeoxyglucose-positron emission tomography/computed tomography in clinical oncology: tumor-, site-, and question-based comparison with standard positron emission tomography/computed tomography

    PubMed Central

    2014-01-01

    Background The present study aimed to evaluate the added value of contrast-enhanced computed tomography (ceCT) in comparison to standard, non-enhanced CT in the context of a combined positron emission tomography (PET)/CT examination by means of a tumor-, site-, and clinical question-based approach. Methods Analysis was performed in 202 patients undergoing PET/CT consisting of a multiphase CT protocol followed by a whole-body PET. The Cochran Q test was performed, followed by a multiple comparisons correction (McNemar test and Bonferroni adjustment), to compare standard and contrast-enhanced PET (cePET/CT). Histopathology or clinical-radiologic follow-up greater than 1 year was used as a reference. Results cePET/CT showed significantly different results with respect to standard PET/CT in head and neck and gastrointestinal cancer (P?=?0.02 and 0.0002, respectively), in the evaluation of lesions located in the abdomen (P?=?0.009), and in the context of disease restaging (P?=?0.003). In all these clinical scenarios, adding ceCT resulted in a distinct benefit, by yielding a higher percentage of change in patient management. Conclusion These data strongly underline the importance of strictly selecting patients for the combined exam. In particular, patient selection should not be driven solely by mere tumor classification, but should also account for the clinical question and the anatomical location of the neoplastic disease, which can significantly impact patient management. PMID:25609564

  6. Prediction scores do not correlate with clinically adjudicated categories of pulmonary embolism in critically ill patients

    PubMed Central

    Katsios, CM; Donadini, M; Meade, M; Mehta, S; Hall, R; Granton, J; Kutsiogiannis, J; Dodek, P; Heels-Ansdell, D; McIntyre, L; Vlahakis, N; Muscedere, J; Friedrich, J; Fowler, R; Skrobik, Y; Albert, M; Cox, M; Klinger, J; Nates, J; Bersten, A; Doig, C; Zytaruk, N; Crowther, M; Cook, DJ

    2014-01-01

    BACKGROUND: Prediction scores for pretest probability of pulmonary embolism (PE) validated in outpatient settings are occasionally used in the intensive care unit (ICU). OBJECTIVE: To evaluate the correlation of Geneva and Wells scores with adjudicated categories of PE in ICU patients. METHODS: In a randomized trial of thromboprophylaxis, patients with suspected PE were adjudicated as possible, probable or definite PE. Data were then retrospectively abstracted for the Geneva Diagnostic PE score, Wells, Modified Wells and Simplified Wells Diagnostic scores. The chance-corrected agreement between adjudicated categories and each score was calculated. ANOVA was used to compare values across the three adjudicated PE categories. RESULTS: Among 70 patients with suspected PE, agreement was poor between adjudicated categories and Geneva pretest probabilities (kappa 0.01 [95% CI ?0.0643 to 0.0941]) or Wells pretest probabilities (kappa ?0.03 [95% CI ?0.1462 to 0.0914]). Among four possible, 16 probable and 50 definite PEs, there were no significant differences in Geneva scores (possible = 4.0, probable = 4.7, definite = 4.5; P=0.90), Wells scores (possible = 2.8, probable = 4.9, definite = 4.1; P=0.37), Modified Wells (possible = 2.0, probable = 3.4, definite = 2.9; P=0.34) or Simplified Wells (possible = 1.8, probable = 2.8, definite = 2.4; P=0.30). CONCLUSIONS: Pretest probability scores developed outside the ICU do not correlate with adjudicated PE categories in critically ill patients. Research is needed to develop prediction scores for this population. PMID:24083302

  7. Prevalence and clinical correlates of right ventricular dysfunction in patients with hypertrophic cardiomyopathy.

    PubMed

    Finocchiaro, Gherardo; Knowles, Joshua W; Pavlovic, Aleksandra; Perez, Marco; Magavern, Emma; Sinagra, Gianfranco; Haddad, Francois; Ashley, Euan A

    2014-01-15

    Hypertrophic cardiomyopathy (HC) is a disease that mainly affects the left ventricle (LV), however recent studies have suggested that it can also be associated with right ventricular (RV) dysfunction. The objective of this study was to determine the prevalence of RV dysfunction in patients with HC and its relation with LV function and outcome. A total of 324 consecutive patients with HC who received care at Stanford Hospital from 1999 to 2012 were included in the study. A group of 99 prospectively recruited age- and gender-matched healthy volunteers were used as controls. RV function was quantified using the RV fractional area change, tricuspid annular plane systolic excursion (TAPSE), and RV myocardial performance index (RVMPI). Compared with the controls, the patients with HC had a higher RVMPI (0.51 ± 0.18 vs 0.25 ± 0.06, p <0.001) and lower TAPSE (20 ± 3 vs 24 ± 4, p <0.001). RV dysfunction based on an RVMPI >0.4 and TAPSE <16 mm was found in 71% and 11% of the HC and control groups, respectively. Worst LV function and greater pulmonary pressures were independent correlates of RV dysfunction. At an average follow-up of 3.7 ± 2.3 years, 17 patients had died and 4 had undergone heart transplantation. LV ejection fraction <50% and TAPSE <16 mm were independent correlates of outcome (hazard ratio 3.98, 95% confidence interval 1.22 to 13.04, p = 0.02; and hazard ratio 3.66, 95% confidence interval 1.38 to 9.69, p = 0.009, respectively). In conclusion, RV dysfunction based on the RVMPI is common in patients with HC and more frequently observed in patients with LV dysfunction and pulmonary hypertension. RV dysfunction based on the TAPSE was independently associated with an increased likelihood of death or transplantation. PMID:24230980

  8. Comparative genome analysis of a large Dutch Legionella pneumophila strain collection identifies five markers highly correlated with clinical strains

    PubMed Central

    2010-01-01

    Background Discrimination between clinical and environmental strains within many bacterial species is currently underexplored. Genomic analyses have clearly shown the enormous variability in genome composition between different strains of a bacterial species. In this study we have used Legionella pneumophila, the causative agent of Legionnaire's disease, to search for genomic markers related to pathogenicity. During a large surveillance study in The Netherlands well-characterized patient-derived strains and environmental strains were collected. We have used a mixed-genome microarray to perform comparative-genome analysis of 257 strains from this collection. Results Microarray analysis indicated that 480 DNA markers (out of in total 3360 markers) showed clear variation in presence between individual strains and these were therefore selected for further analysis. Unsupervised statistical analysis of these markers showed the enormous genomic variation within the species but did not show any correlation with a pathogenic phenotype. We therefore used supervised statistical analysis to identify discriminating markers. Genetic programming was used both to identify predictive markers and to define their interrelationships. A model consisting of five markers was developed that together correctly predicted 100% of the clinical strains and 69% of the environmental strains. Conclusions A novel approach for identifying predictive markers enabling discrimination between clinical and environmental isolates of L. pneumophila is presented. Out of over 3000 possible markers, five were selected that together enabled correct prediction of all the clinical strains included in this study. This novel approach for identifying predictive markers can be applied to all bacterial species, allowing for better discrimination between strains well equipped to cause human disease and relatively harmless strains. PMID:20630115

  9. Sexual dysfunction in pre-menopausal diabetic women: clinical, metabolic, psychological, cardiovascular, and neurophysiologic correlates.

    PubMed

    Cortelazzi, Donatella; Marconi, Annamaria; Guazzi, Marco; Cristina, Maurizio; Zecchini, Barbara; Veronelli, Annamaria; Cattalini, Claudio; Innocenti, Alessandro; Bosco, Giovanna; Pontiroli, Antonio E

    2013-12-01

    An increased prevalence of female sexual dysfunction (FSD) has been reported in women with diabetes mellitus (DM). Our aim was to evaluate correlates (psychological, cardiovascular, and neurophysiologic) of FSD in DM women without chronic diabetic complications. Female Sexual Function Index (FSFI), Beck Depression Inventory (BDI), Michigan Diabetic Neuropathy Index (DNI), and the symptoms of diabetic neuropathy (SDN) questionnaires, metabolic variables, endothelial vascular function (flow-mediated dilation, FMD), echocardiography, and electromyography were studied. 109 pre-menopausal women (18-50 years) [48 with DM (14 type 1 DM, 34 type 2 DM, duration 12.6 ± 1.91 years), and 61 healthy women] received the above questionnaires; physical activity, smoking habits, parity, BMI, waist circumference, HOMA-IR index, fibrinogen, cholesterol (total, HDL, LDL), triglycerides, HbA1c, high-sensitivity C-reactive protein, total testosterone, and estradiol were measured; echocardiography, assessment of intima-media thickness (IMT), FMD, ECG (heart rate and Qtc, indexes of sympathetic activity), and electromyography were performed. FSFI total score and score for arousal, lubrication, and orgasm domains were lower in DM women than in controls (P < 0.05); DM women had higher BDI, Doppler A wave peak velocity, DNI, and SDN score (P < 0.001 to P < 0.04). Doppler E wave peak velocity, peroneal, posterior tibial and sural nerves conduction velocity and amplitude were lower in diabetic women than in controls (P < 0.05 to P < 0.001). FSFI score was positively correlated with physical activity, Doppler E wave peak velocity, and peroneal nerve amplitude and negatively with BDI, parity, IMT, SDN, and HbA1c (P < 0.05 to P < 0.001). At stepwise regression, SDN score (negatively) and Doppler E wave peak velocity (positively) predicted FSFI score (r = 507, P < 0.001). In conclusion, cardiovascular and neurological impairments are associated with FSD in diabetic women. Follow-up studies are required to evaluate sexual dysfunction as a risk factor for future cardiovascular or neurological events. PMID:23677545

  10. Vascular rejection in heart transplantation: clinical correlation, treatment options, and future considerations.

    PubMed

    Olsen, S L; Wagoner, L E; Hammond, E H; Taylor, D O; Yowell, R L; Ensley, R D; Bristow, M R; O'Connell, J B; Renlund, D G

    1993-01-01

    Vascular rejection injures the vascular endothelium in cardiac allografts in the absence of significant intramyocardial lymphocytic infiltration. When compared with cellular rejection, vascular rejection occurs earlier after transplantation, is more resistant to immunosuppressive augmentation, causes more allograft dysfunction, and is associated with a higher frequency of allograft loss. Between January 1990 and October 1992, acute hemodynamically significant vascular rejection developed in 13 of 170 patients (8%). Endomyocardial biopsy specimens revealed the typical findings of endothelial cell activation, immune complex deposition, and interstitial fibrin deposition in the absence of significant lymphocytic infiltration. All patients had clinical evidence of allograft dysfunction. In addition to high-dose corticosteroids, all patients received cyclophosphamide as an oral pulse for 4 days and underwent plasmapheresis for 3 consecutive days. Eight patients received OKT3 (n = 6) or antilymphoblast globulin (n = 2), and nine patients underwent systemic anticoagulation. Six patients required inotropic therapy for hemodynamic instability. Although one patient died during the initial episode, rejection resolved and left ventricular function returned to normal in 12 of 13 patients. However, vascular rejection recurred in three patients, two of whom subsequently died. Two other patients died during late follow-up because of noncompliance. Eight patients remain alive with normal allograft function and angiographically normal coronary arteries. Whereas the addition of cyclophosphamide and plasmapheresis may improve the outcome of vascular rejection, the results of treatment with currently available treatment modalities remain unacceptably poor. PMID:8476883

  11. Clonal evolution and clinical correlates of somatic mutations in myeloproliferative neoplasms.

    PubMed

    Lundberg, Pontus; Karow, Axel; Nienhold, Ronny; Looser, Renate; Hao-Shen, Hui; Nissen, Ina; Girsberger, Sabine; Lehmann, Thomas; Passweg, Jakob; Stern, Martin; Beisel, Christian; Kralovics, Robert; Skoda, Radek C

    2014-04-01

    Myeloproliferative neoplasms (MPNs) are a group of clonal disorders characterized by aberrant hematopoietic proliferation and an increased tendency toward leukemic transformation. We used targeted next-generation sequencing (NGS) of 104 genes to detect somatic mutations in a cohort of 197 MPN patients and followed clonal evolution and the impact on clinical outcome. Mutations in calreticulin (CALR) were detected using a sensitive allele-specific polymerase chain reaction. We observed somatic mutations in 90% of patients, and 37% carried somatic mutations other than JAK2 V617F and CALR. The presence of 2 or more somatic mutations significantly reduced overall survival and increased the risk of transformation into acute myeloid leukemia. In particular, somatic mutations with loss of heterozygosity in TP53 were strongly associated with leukemic transformation. We used NGS to follow and quantitate somatic mutations in serial samples from MPN patients. Surprisingly, the number of mutations between early and late patient samples did not significantly change, and during a total follow-up of 133 patient years, only 2 new mutations appeared, suggesting that the mutation rate in MPN is rather low. Our data show that comprehensive mutational screening at diagnosis and during follow-up has considerable potential to identify patients at high risk of disease progression. PMID:24478400

  12. [Clinical, structural-functional and haemodynamic correlates of cerebral venous blood circulation disturbances].

    PubMed

    Todua, F I; Verulashvili, I V; Kortushvili, M G; Gachechiladze, D G

    2006-01-01

    Difficulties of liquor circulation as a result of cerebrospinal fluid absorption and venous drainage of the entire intracranial space, in particular in the presence of venous system abnormalities in the forms of hypoplasia or aplasia of venous sinuses, play an essentiale role in cerebral venous dyscirculation. The symmetric character of hydrocephaly in chronic insufficiency of cerebral blood circulation and strong dependence of chronic cerebrovascular insufficiency on passive congestion suggest that the latter is characteristic of the blood supply system in whole. The MPI analysis of 120 patients revealed signs of cerebral ischemic lesions in 72% of cases, i.e. dilatation of liquor-containing spaces, multiple lacunar infarctions, especially in deep brain regions, diffusive changes of the periventricular white matter etc. Low indices of the blood flow increase during antiorthostatic loading, a trend towards decreasing of PI parameters and difficulty of blood flow in conditional insonation of intracranial veins in cases of "pseudotumorous syndrome" in patients with clinical signs of passive congestion. Venous dilatation of convexital brain areas and intensification of contrasting of direct sinus and vein of Galen were observed in venous infarctions. PMID:18193577

  13. Clinical Correlates of Non-Suicidal Self-Injury (NSSI) in an Outpatient Sample of Adolescents.

    PubMed

    García-Nieto, Rebeca; Carballo, Juan J; Hernando, Mónica Díaz de Neira; de León-Martinez, Victoria; Baca-García, Enrique

    2014-09-25

    Background: Non-suicidal self-injury (NSSI) in adolescents is a major public health concern. The first goal of our study was to describe the characteristics and functions of NSSI and NSSI thoughts in an adolescent outpatient sample. The second goal was to examine which clinical factors discriminate between these two groups of patients. Methods: 267 subjects were recruited from the Adolescent Outpatient Psychiatric Services, Jiménez Díaz Foundation (Madrid, Spain) from November 2011 to October 2012. All participants were administered the Spanish version of the Self-Injurious Thoughts and Behaviors Interview (SITBI). Results: 21.7% of patients reported having engaged in NSSI at least once in their lifetime. The most strongly endorsed function for NSSI was automatic negative reinforcement. In comparison with patients in the NSSI Thought group and the control group, patients in the NSSI group scored higher in Internalization of Anger and in all the scales comprising the Children's Depression Inventory. Conclusions: Our findings on the prevalence and functions of NSSI are consistent with the literature. NSSI was mainly performed for emotion regulation purposes; specifically, NSSI seems to be used to cope with anger and depression. In addition, internalization of anger might play a significant role in the maintenances of this behavior. PMID:25257184

  14. Clinical utility of residual latency in ulnar neuropathy at elbow: Is there any correlation?

    PubMed Central

    Khosrawi, Saeid; Dehghan, Farnaz; Shaygannejad, Vahid

    2015-01-01

    Background: Residual latency is the time difference between measured and predicted distal conduction time. We investigated ulnar nerve residual latency in patients with ulnar neuropathy at elbow for the possibility of its clinical utility. Materials and Methods: In a cross-sectional study and based on the inclusion and exclusion criteria, ulnar nerve residual latency was calculated by using standard settings in 63 hands of patients who had signs and symptoms suggesting ulnar neuropathy at elbow and 94 healthy hands as the control group. Results: Mean ulnar nerve residual latency for case and control groups were 1.82 ± 0.45 and 1.59 ± 0.54 ms, respectively, which showed a statistically significant difference (P = 0.01). There was no significant difference in mean ulnar nerve residual latency between males and females and also between right and left hands (P > 0.05). By considering different cut-off points, the sensitivity and specificity of a residual latency of 2.86 ms were 70% and 56%, respectively. Conclusion: Ulnar nerve residual latency may reflect the effects of an axonal injury at elbow on distal ulnar motor fibers. So, its measurement may help in the diagnosis of ulnar neuropathy at elbow. PMID:25709986

  15. Platelet-derived CD154: ultrastructural localization and clinical correlation in organ transplantation

    PubMed Central

    Charafeddine, Ali H.; Kim, Eugenia J.; Maynard, Dawn M.; Yi, Hong; Weaver, Timothy A.; Gunay-Aygun, Meral; Russell, Maria; Gahl, William A.; Kirk, Allan D.

    2012-01-01

    CD154 is an immunostimulatory ligand for CD40 that markedly influences alloimmunity. Its presence in platelets suggests that its release and subsequent immune effects are driven by trauma and thus could be relevant following organ transplantation. However, the release of platelet derived CD154 and its consequences have not been investigated in a clinical transplant setting. To better characterize the relationship between platelet activation and CD154 release, we investigated CD154 release by platelets obtained from normal individuals, and patients with two genetic defects that influence platelet granule development. Using these unique patient populations and immune-electron microscopy, we confirmed that CD154 was an alpha granule and not a cell surface protein, and thereafter optimized the methods for its in vivo measurement in humans. We then investigated plasma CD154 levels in kidney and liver transplant recipients and found no evidence that CD154 levels fluctuated systemically as a result of kidney or liver transplant procedures. Paradoxically, we found that kidney transplant patients had significantly lower systemic CD154 levels during episodes of rejection. These data suggest that the immune effects of CD154 are likely mediated through local and not systemic mechanisms, and discourage the use of CD154 as a peripheral biomarker in organ transplantation. PMID:22947105

  16. The Clinical Correlation of Regulatory T Cells and Cyclic Adenosine Monophosphate in Enterovirus 71 Infection

    PubMed Central

    Wang, Shih-Min; Chen, I-Chun; Liao, Yu-Ting; Liu, Ching-Chuan

    2014-01-01

    Background Brainstem encephalitis (BE) and pulmonary edema (PE) are notable complications of enterovirus 71 (EV71) infection. Objective This study investigated the immunoregulatory characterizations of EV71 neurological complications by disease severity and milrinone treatment. Study Design Patients <18 years with virologically confirmed EV71 infections were enrolled and divided into 2 groups: the hand, foot, and mouth disease (HFMD) or BE group, and the autonomic nervous system (ANS) dysregulation or PE group. Cytokine and cyclic adenosine monophosphate (cAMP) levels, and the regulatory T cell (Tregs) profiles of the patients were determined. Results Patients with ANS dysregulation or PE exhibited significantly low frequency of CD4+CD25+Foxp3+ and CD4+Foxp3+ T cells compared with patients with HFMD or BE. The expression frequency of CD4?CD8? was also significantly decreased in patients with ANS dysregulation or PE. Among patients with ANS dysregulation or PE, the expression frequency of CD4+Foxp3+ increased markedly after milrinone treatment, and was associated with reduction of plasma levels IL-6, IL-8 and IL-10. Plasma concentrations of cAMP were significantly decreased in patients with ANS dysregulation or PE compared with patients with HFMD or BE; however, cAMP levels increased after milrinone treatment. Conclusions These findings suggested decreased different regulatory T populations and cAMP expression correlate with increased EV71 disease severity. Improved outcome after milrinone treatment may associate with increased regulatory T populations, cAMP expression and modulation of cytokines levels. PMID:25010330

  17. Correlation of Ciprofloxacin Resistance with the AdeABC Efflux System in Acinetobacter baumannii Clinical Isolates

    PubMed Central

    Ardebili, Abdollah; Talebi, Malihe

    2014-01-01

    Background Acinetobacter baumannii is one of the most important pathogens capable of colonization in burn patients, leading to drug-resistant wound infections. This study evaluated the distribution of the AdeABC efflux system genes and their relationship to ciprofloxacin resistance in A. baumannii isolates collected from burn patients. Methods A total of 68 A. baumannii clinical strains were isolated from patients hospitalized in Motahari Burns Center in Tehran, Iran. Ciprofloxacin susceptibility was tested by the disk diffusion and agar dilution methods. PCR amplification of the adeRS-adeB drug efflux genes was performed for all resistant and susceptible isolates. To assess the role of the drug efflux pump in ciprofloxacin susceptibility, carbonyl cyanide 3-chlorophenylhydrazone (CCCP) was used as an efflux pump inhibitor (EPI). Results Approximately 95.6% of the Acinetobacter isolates were resistant to ciprofloxacin, with minimum inhibitory concentration (MIC) values ranging from 4 to ?128 µg/mL. The susceptibility of 86.1% of the resistant isolates increased by factors of 2 to 64 in the presence of CCCP. All resistant isolates were positive for the adeRS-adeB genes, and 73.2% of them had mutations in the AdeRS regulatory system. Conclusions The results showed that AdeABC genes are common in A. baumannii, which might be associated with ciprofloxacin non-susceptibility, as indicated by the observed linkage to the presence of the genes essential for the activity of the AdeABC, several single mutations occurring in the adeRS regulatory system, and an increase of ciprofloxacin susceptibility in the presence of a CCCP EPI. PMID:25368818

  18. Correlation of SRSF1 and PRMT1 expression with clinical status of pediatric acute lymphoblastic leukemia

    PubMed Central

    2012-01-01

    Background Acute lymphoblastic leukemia (ALL) is the most frequently-occurring malignant neoplasm in children, but the pathogenesis of the disease remains unclear. In a microarray assay using samples from 100 children with ALL, SFRS1 was found to be up-regulated. Serine/arginine-rich splicing factor 1 (SRSF1, also termed SF2/ASF), encoded by the SFRS1 gene, had been shown to be a pro-oncoprotein. Our previous study indicated that SRSF1 can be methylated by protein arginine methyltransferase 1 (PRMT1) in vitro; however, the biological function of SRSF1 and PRMT1 in pediatric ALL are presently unknown. Methods Matched, newly diagnosed (ND), complete remission (CR) and relapse (RE) bone marrow samples from 57 patients were collected in order to evaluate the expression patterns of SRSF1 and PRMT1. The potential oncogenic mechanism of SRSF1 and PRMT1 in leukemogenesis was also investigated. Results We identified significant up-regulation of SRSF1 and PRMT1 in the ND samples. Importantly, the expression of SRSF1 and PRMT1 returned to normal levels after CR, but rebounded in the RE samples. Our observation that SRSF1 could predict disease relapse was of particular interest, although the expression patterns of SRSF1 and PRMT1 were independent of the cytogenetic subtypes. In pre-B-cell lines, both SRSF1 and PRMT1 expression could be efficiently attenuated by the clinical chemotherapy agents arabinoside cytosine (Ara-c) or vincristine (VCR). Moreover, SRSF1 and PRMT1 were associated with each other in leukemia cells in vivo. Knock-down of SRSF1 resulted in an increase in early apoptosis, which could be further induced by chemotherapeutics. Conclusions Our results indicate that SRSF1 serves as an anti-apoptotic factor and potentially contributes to leukemogenesis in pediatric ALL patients by cooperating with PRMT1. PMID:22839530

  19. Correlation between clinical findings and eosinophil/neutrophil ratio in patients with nasal polyps.

    PubMed

    Tecimer, S Hancer; Kasapoglu, F; Demir, U L; Ozmen, O A; Coskun, H; Basut, O

    2015-04-01

    Chronic rhinosinusitis with nasal polyps (CRSwNP) is a frequent disease which can be classified as eosinophilic or neutrophilic based on dominant inflammatory cell type at tissue. The aim of this study was to evaluate the clinical relevance of classifying nasal polyps as eosinophilic or neutrophilic on treatment outcomes. The study was conducted with 40 patients who underwent either surgical or medical treatment with the diagnosis of CRSwNP. The patients were classified into two groups for further assessment up to eosinophil intensity at polyp tissue. All patients were examined by nasal endoscopy and paranasal computed tomography (CT). Before treatment, subjective symptom score, nasal endoscopy score, and CT score were measured. Subsequently, they were reevaluated by similar diagnostic tests after either medical or surgical treatment at sixth month. The preoperative subjective symptom score, endoscopy score, and paranasal CT score were compared between chronic rhinosinusitis (CRS) with eosinophilic nasal polyps (E-NP) (CRSwE-NP) group and CRS with neutrophilic nasal polyps group and there was no difference between the two groups (p = 0.369, p = 0.310 and p = 0.494 respectively). Although after treatment in both groups symptom score and endoscopy score were significantly improved but not the CT score, we found no difference in between the groups at sixth month. In most of the previous studies, patients with CRSwE-NP were assumed to have poor prognosis and high recurrence rate despite surgical or medical treatment. However, we did not find any association between eosinophilic or neutrophilic nature of nasal polyp tissue and disease severity. PMID:25007735

  20. Analysis of EHMT1 expression and its correlations with clinical significance in esophageal squamous cell cancer

    PubMed Central

    GUAN, XIAOJIAO; ZHONG, XINWEN; MEN, WANFU; GONG, SHULEI; ZHANG, LIN; HAN, YUCHEN

    2014-01-01

    Esophageal squamous cell carcinoma (ESCC) is a highly aggressive malignancy, requiring effective biomarkers for prognosis and therapeutic responsiveness. Histone H3K9 methyltransferases (EHMT1 and EHMT2) are global genome organizers, which are crucial for maintaining the balance state of cells in a tissue-specific manner. It was previously suggested that EHMT1 expression is a predictor of prognosis in several malignant tumors; however, the prognostic significance of EHMT1 expression in ESCC has not been determined. A cohort of 50 ESCC cases and 46 paired normal esophageal tissue samples were evaluated to assess the levels of EHMT1 expression by immunohistochemistry and reverse transcription-polymerase chain reaction. The SPSS software package was used for statistical data analysis. A significantly upregulated EHMT1 expression was observed in squamous preinvasive lesions and ESCC compared to the matched normal esophageal epithelia (52.0 vs. 21.7%, respectively). The expression of EHMT1 was correlated with tumor grade (G), depth of invasion (T) and lymph node metastasis (N) in ESCC. EHMT1 overexpression was found to be associated with poor cancer-specific survival in squamous cell carcinomas (?2=3.922, P=0.048). The expression of EHMT1 was identified as an independent prognostic factor for overall survival in ESCC patients. In conclusion, EHMT1 expression is upregulated in ESCC and early preinvasive esophageal squamous lesions and the overexpression of EHMT1 is associated with poor prognosis in ESCC. Therefore, the expression of EHMT1 may be an effective prognostic biomarker for ESCC. PMID:24649311

  1. Shrink pattern of breast cancer after neoadjuvant chemotherapy and its correlation with clinical pathological factors

    PubMed Central

    2013-01-01

    Background Breast conservation therapy (BCS) after neoadjuvant chemotherapy (NCT) can improve patients’ quality of life. Currently used intraoperative examination for negative margins may not be sufficient to detect microresidual foci, which are a risk factor for local recurrence. This study was conducted to investigate the shrinking pattern of breast cancer and residual tumors as a risk factor for BCS after NCT. Methods Ninety women with stage II or III invasive ductal carcinoma who achieved partial response after NCT with paclitaxel and epirubicin were enrolled. All patients had undergone modified radical mastectomy. One-half of the surgical specimens were subjected to subserial sectioning. Pathological changes of tumor bed and pericancerous tissues were examined with an optical microscope. The levels of estrogen receptors, progesterone receptors and HER2 were analyzed by immnohistochemical staining. Results The residual tumors were classified into three types according to their microscopic morphology: solitary lesion, multifocal and patchlike lesions, and main residual tumor with satellite lesions. Type I residual tumors were found in 55 patients (61%), type II in 30 patients (33%) and type III in 5 patients (6%). Types II and III were often associated with larger primary tumors. The types of residual tumors were not correlated with the status of hormone receptors or HER2. Conclusion Three types of residual tumors were observed after NCT. The solitary residual tumor is most common, but main residual tumors with satellite lesions are most likely to cause local recurrence after BCS. Subserial sectioning would improve the identification of microfoci and patient survival after BCS. PMID:23883300

  2. Comparison of medial and lateral meniscal transplantation with regard to extrusion of the allograft, and its correlation with clinical outcome.

    PubMed

    Koh, Y-G; Moon, H-K; Kim, Y-C; Park, Y-S; Jo, S-B; Kwon, S-K

    2012-02-01

    We compared extrusion of the allograft after medial and lateral meniscal allograft transplantation and examined the correlation between the extent of extrusion and the clinical outcome. A total of 73 lateral and 26 medial meniscus allografts were evaluated by MRI at a mean of 32 months (24 to 59) in 99 patients (67 men, 32 women) with a mean age of 35 years (21 to 52). The absolute values and the proportional widths of extruded menisci as a percentage were measured in coronal images that showed maximum extrusion. Functional assessments were performed using Lysholm scores. The mean extrusion was 4.7 mm (1.8 to 7.7) for lateral menisci and 2.9 mm (1.2 to 6.5) for medial menisci (p < 0.001), and the mean percentage extrusions were 52.0% (23.8% to 81.8%) and 31.2% (11.6% to 63.4%), respectively (p < 0.001). Mean Lysholm scores increased significantly from 49.0 (10 to 83) pre-operatively to 86.6 (33 to 99) at final follow-up for lateral menisci (p = 0.001) and from 50.9 (15 to 88) to 88.3 (32 to 100) for medial menisci (p < 0.001). The final mean Lysholm scores were similar in the two groups (p = 0.312). Furthermore, Lysholm scores were not found to be correlated with degree of extrusion (p = 0.242). Thus, transplanted lateral menisci extrude more significantly than transplanted medial menisci. However, the clinical outcome after meniscal transplantation was not found to be adversely affected by extrusion of the allograft. PMID:22323684

  3. Precordial ST-segment depression during acute inferior myocardial infarction: clinical, scintigraphic and angiographic correlations

    SciTech Connect

    Gibson, R.S.; Crampton, R.S.; Watson, D.D.; Taylor, G.J.; Carabello, B.A.; Holt, N.D.; Beller, G.A.

    1982-10-01

    The cause and associated pathophysiology of precordial ST-segment depression during acute inferior myocardial infarction (IMI) are controversial. To investigate this problem, electrocardiographic findings in 48 consecutive patients with acute IMI were prospectively compared with results of coronary angiography, submaximal exercise thallium-201 (/sup 201/Tl) scintigraphy and multigated blood pool imaging, all obtained 2 weeks after IMI, and with clinical follow-up at 3 months. Patients were classified according to the admission ECG obtained 3.3 +/- 3.1 hours after the onset of chest pain. Twenty-one patients (group A) had no or <1.0 mm ST-segment depression, and 27 (group B) had greater than or equal to1.0 mm ST-segment depression in two or more precordial (V/sub 1-6/) leads. Patients in group B had more prolonged chest pain after admission to the coronary care unit than those in group A (2.8 +/- 3.0 vs 1.2 +/- 1.1 hours, p<0.03), greater summed ST-segment elevation in leads II, III, aV/sub F/ (6.7 +/- 4.7 vs 3.3 +/- 4.5 mm, p<0.02), higher plasma peak creatine kinase levels (1133 +/- 781 vs 653 +/- 482 IU/l, p<0.01), a higher prevalence of ''true posterior'' infarction by ECG criteria (26% vs 5%, p<0.05), a lower radionuclide ejection fraction (46 +/- 9% vs 54 +/- 6%, p<0.001), more extensive infarct-related asynergy (p<0.001) and /sup 201/Tl perfusion abnormalities (p<0.01), more complications during hospitalization (p<0.03), and more cardiac events at 3 months (p<0.02). There were no significant differences between group A and group B in the extent of underlying coronary disease, prevalence of left anterior descending coronary artery disease, exercise-induced ST-segment depression or angina, /sup 201/Tl defects or wall motion abnormalities in anterior or septal segments.

  4. Psychiatric disorders and clinical correlates of suicidal patients admitted to a psychiatric hospital in Tokyo

    PubMed Central

    2010-01-01

    Background Patients admitted to a psychiatric hospital with suicidal behavior (SB) are considered to be especially at high risk of suicide. However, the number of studies that have addressed this patient population remains insufficient compared to that of studies on suicidal patients in emergency or medical settings. The purpose of this study is to seek features of a sample of newly admitted suicidal psychiatric patients in a metropolitan area of Japan. Method 155 suicidal patients consecutively admitted to a large psychiatric center during a 20-month period, admission styles of whom were mostly involuntary, were assessed using Structured Clinical Interviews for DSM-IV Axis I and II Disorders (SCID-I CV and SCID-II) and SB-related psychiatric measures. Associations of the psychiatric diagnoses and SB-related characteristics with gender and age were examined. Results The common DSM-IV axis I diagnoses were affective disorders 62%, anxiety disorders 56% and substance-related disorders 38%. 56% of the subjects were diagnosed as having borderline PD, and 87% of them, at least one type of personality disorder (PD). SB methods used prior to admission were self-cutting 41%, overdosing 32%, self-strangulation 15%, jumping from a height 12% and attempting traffic death 10%, the first two of which were frequent among young females. The median (range) of the total number of SBs in the lifetime history was 7 (1-141). Severity of depressive symptomatology, suicidal intent and other symptoms, proportions of the subjects who reported SB-preceding life events and life problems, and childhood and adolescent abuse were comparable to those of the previous studies conducted in medical or emergency service settings. Gender and age-relevant life-problems and life events were identified. Conclusions Features of the studied sample were the high prevalence of affective disorders, anxiety disorders and borderline PD, a variety of SB methods used prior to admission and frequent SB repetition in the lifetime history. Gender and age appeared to have an influence on SB method selection and SB-preceding processes. The findings have important implications for assessment and treatment of psychiatric suicidal patients. PMID:21144041

  5. Pregnancy Incidence and Correlates in a Clinical Trial Preparedness Study, North West Province South Africa

    PubMed Central

    Chetty-Makkan, Candice M.; Fielding, Katherine; Feldblum, Paul J.; Price, Matt A.; Kruger, Petra; Makkan, Heeran; Charalambous, Salome; Latka, Mary H.

    2014-01-01

    Introduction Women in HIV prevention trials often must typically agree to avoid pregnancy. Regardless, some become pregnant. Screening tools predicting pregnancy risk could maximize trial safety and efficiency. Objectives We assessed incidence and correlates of pregnancy among women at high HIV risk. Methods We enrolled sexually-active, HIV-negative women into an observational cohort (2008–2011). At enrolment demographic, contraceptive, reproductive, pregnancy intention and behavioural data were collected. Women reported if one or both partners wanted or intended for the couple to become pregnant. We measured gender role beliefs using a locally validated eight-point index. We tested HIV and pregnancy, and inquired about sexually transmitted infection symptoms (STIs) at enrollment and monthly. HIV testing included behavioural counselling and condom provision, but did not specifically counsel women to avoid pregnancy. Cox proportional hazard modelling evaluated the associations with pregnancy. The multivariate model included the following variables “Recent pregnancy attempts”, “Gender Roles Beliefs”, ”Self-reported STIs” and “Age”. Results We screened 1068 women and excluded (24.6%, 263/1068) who did not report risk behaviour. Non-pregnant, non-sterilized women aged 18–35 (median?=?21 years) enrolled (n?=?438). Most women reported one partner (74.7%) and a prior live birth (84.6%). Median follow-up time was 6 months (range 0.7–15.5). Pregnancy incidence was 25.1 per 100 women-years (n?=?57 pregnancies). Conservative beliefs on gender roles (Adjusted Hazard Ratio (aHR) 1.8; 95% confidence interval [CI] 1.1–2.9), recent pregnancy attempts (aHR 1.9; 95% CI 1.1–3.4) and baseline self-reported STI (aHR 2.5; 95% CI 1.4–4.4) were associated with increased incident pregnancy. Report of no pregnancy intention was associated with lowered pregnancy risk (aHR 0.3; 95% CI 0.1–0.7). Conclusions We identified new and confirmed existing factors that can facilitate screening for pregnancy risk. PMID:24802651

  6. Aggressive Behavior Problems in Children with Autism Spectrum Disorders: Prevalence and Correlates in a Large Clinical Sample.

    PubMed

    Hill, Alison Presmanes; Zuckerman, Katharine E; Hagen, Arlene D; Kriz, Daniel J; Duvall, Susanne W; van Santen, Jan; Nigg, Joel; Fair, Damien; Fombonne, Eric

    2014-09-01

    Aggressive behavior problems (ABP) are frequent yet poorly understood in children with Autism Spectrum Disorders (ASD) and are likely to co-vary significantly with comorbid problems. We examined the prevalence and sociodemographic correlates of ABP in a clinical sample of children with ASD (N = 400; 2-16.9 years). We also investigated whether children with ABP experience more intensive medical interventions, greater impairments in behavioral functioning, and more severe comorbid problems than children with ASD who do not have ABP. One in four children with ASD had Child Behavior Checklist scores on the Aggressive Behavior scale in the clinical range (T-scores ? 70). Sociodemographic factors (age, gender, parent education, race, ethnicity) were unrelated to ABP status. The presence of ABP was significantly associated with increased use of psychotropic drugs and melatonin, lower cognitive functioning, lower ASD severity, and greater comorbid sleep, internalizing, and attention problems. In multivariate models, sleep, internalizing, and attention problems were most strongly associated with ABP. These comorbid problems may hold promise as targets for treatment to decrease aggressive behavior and proactively identify high-risk profiles for prevention. PMID:25221619

  7. WHO-histological criteria for myeloproliferative neoplasms: reproducibility, diagnostic accuracy and correlation with gene mutations and clinical outcomes.

    PubMed

    Alvarez-Larrán, Alberto; Ancochea, Agueda; García, Mar; Climent, Fina; García-Pallarols, Francesc; Angona, Anna; Senín, Alicia; Barranco, Carlos; Martínez-Avilés, Luz; Serrano, Sergio; Bellosillo, Beatriz; Besses, Carlos

    2014-09-01

    Bone marrow histology is included in the diagnostic criteria of myeloproliferative neoplasms (MPNs). However, some concerns have emerged about its reproducibility. To evaluate the diagnostic accuracy of histology and to assess its correlation with presence of mutations and clinical outcomes, two pathologists reviewed the bone marrow biopsies corresponding to 211 patients with MPN. Despite the low agreement in the evaluation of individual histopathological characteristics, the concordance among pathologists when establishing the diagnosis was good (Kappa index 0·67). The specificity of histology was 100%, 98·5% and 98% in polycythaemia vera (PV), essential thrombocythaemia (ET) and primary myelofibrosis (PMF), respectively, whereas the sensitivity of histological diagnosis was low in PV and ET (32·5% and 54% respectively) and acceptable in PMF (75%). Thirteen out of 146 (9%) patients with clinical ET were diagnosed as prefibrotic PMF. No histological agreement or MPN otherwise unspecified was more frequently observed in JAK2 V617F-positive ET than in CALR-mutated cases, whereas megakaryocytic abnormalities and prefibrotic PMF were more frequently observed in CALR-mutated ET. In conclusion, histological criteria of MPN have a limited diagnostic accuracy due to low sensitivity. Patients with JAK2 V617F-positive MPN have a heterogeneous histology while CALR-positive ET is associated with megakaryocyte abnormalities and prefibrotic PMF. PMID:24957246

  8. Fibroid-associated heavy menstrual bleeding: correlation between clinical features, Doppler ultrasound assessment of vasculature, and tissue gene expression profiles.

    PubMed

    Tsiligiannis, Sophia E; Zaitseva, Marina; Coombs, Peter R; Shekleton, Paul; Olshansky, Moshe; Hickey, Martha; Vollenhoven, Beverley; Rogers, Peter A W

    2013-04-01

    Despite the prevalence of uterine fibroids (Fs), few studies have investigated the links between clinical features and the cellular or molecular mechanisms that drive F growth and development. Such knowledge will ultimately help to differentiate symptomatic from asymptomatic Fs and could result in the development of more effective and individualized treatments. The aim of this study was to investigate the relationship between ultrasound appearance, blood flow, and angiogenic gene expression in F, perifibroid (PM), and distant myometrial (DM) tissues. We hypothesized that angiogenic gene expression would be increased in tissues and participants that showed increased blood flow by Doppler ultrasound. The study was performed using Doppler ultrasound to measure blood flow prior to hysterectomy, with subsequent tissue samples from the F, PM, and DM being investigated for angiogenic gene expression. Overall, PM blood flow (measured as peak systolic velocity [PSV]) was higher than F blood flow, although significant heterogeneity was seen in vascularity and blood flow between different Fs and their surrounding myometrium. We did not find any correlation between PSV and any other clinical or molecular parameter in this study. We identified 19 angiogenesis pathway-related genes with significant differences in expression between F and DM, and 2 genes, matrix metalloproteinase 9 (MMP9) and Neuropilin 2 (NRP2), that were significantly different between F and PM. These results are consistent with subtle differences between PM and DM. Understanding the differences between symptomatic versus asymptomatic Fs may eventually lead to more effective treatments that directly target the source of heavy menstrual bleeding. PMID:22995988

  9. The expression of Wnt-1 inducible signaling pathway protein-2 in astrocytoma: Correlation between pathological grade and clinical outcome

    PubMed Central

    XIAO, GELEI; TANG, ZHI; YUAN, XIANRUI; YUAN, JIAN; ZHAO, JIE; ZHANG, ZHIPING; HE, ZHENGWEN; LIU, JINGPING

    2015-01-01

    Wnt-1 inducible signaling pathway protein-2 (WISP-2) is a member of the CCN family, which is critical for the control of cell morphology, motion, adhesion and other processes involved in tumorigenesis. The expression pattern and clinical significance of WISP-2 in astrocytomas remains unclear. In this study, reverse transcription-polymerase chain reaction was performed to systematically investigate the expression of WISP-2 in 47 astrocytoma tissues of different pathological grades and 10 normal brain tissues. The mRNA expression levels of WISP-2 in the astrocytoma tissues were observed to be significantly higher than those in the normal brain tissues. Furthermore, the upregulation of WISP-2 was found to be associated with astrocytomas of higher pathological grades. Subsequently, 154 astrocytoma and 15 normal brain tissues were analyzed using immunohistochemistry and similar results were obtained. Univariate and multivariate survival analyses were used to determine the correlations between WISP-2 expression and overall survival (OS) and progression-free survival (PFS). The results indicated that the expression of WISP-2 was found to negatively correlate with patient PFS and OS. These results demonstrated that the WISP-2 protein is involved in the pathogenesis and progression of human astrocytomas and may serve as a malignant biomarker of this disease. PMID:25435966

  10. Developing cross-correlation as a method for microvessel imaging using clinical intravascular optical coherence tomography systems

    PubMed Central

    Joseph, Shiju; Adnan, Asif; Subhash, Hrebesh M.; Leahy, Martin; Adlam, David

    2015-01-01

    Current clinical intravascular optical coherence tomography (IV-OCT) imaging systems have limited in-vivo flow imaging capability because of non-uniform catheter rotation and inadequate A-line scan density. Thus any flow-localisation method that seeks to identify sites of variation within the OCT image data-sets, whether that is in amplitude or phase, produces non-representative correlation (or variance) maps. In this study, both mean and the variation within a set of cross-correlation maps, for static OCT imaging was used to differentiate flow from nonflow regions. Variation was quantified by use of standard deviation. The advantage of this approach is its ability to image flow, even in the presence of motion artifacts. The ability of this technique to suppress noise and capture flow maps was demonstrated by imaging microflow in an ex-vivo porcine coronary artery model, by nailfold capillary imaging and in-vivo microvessel imaging from within the human coronary sinus. PMID:25798295

  11. Is there a group effect? It depends on how you ask the question: intraclass correlations for California Psychotherapy Alliance Scale-Group items.

    PubMed

    Kivlighan, Dennis M; Lo Coco, Gianluca; Gullo, Salvatore

    2015-01-01

    California Psychotherapy Alliance Scale-Group (CALPAS-G) data were collected from 1,138 group sessions attended by 248 group members in 16 counseling groups. Hierarchical linear modeling (HLM) was used to derive between-groups, between-member, and between-session variance components and intraclass correlation coefficients (ICCs) for the 12 CALPAS-G items. Using Ledermann and Kenny's (2012) descriptions of variable types, we examined differences in between-groups variance for the 6 CALPAS-G items classified as "Individual" items and the 6 CALPAS-G items classified as "Group" items. A Related-Samples Wilcoxon's Signed Ranked Test showed that the ICCs for the Group items were significantly larger than the ICCs for the Individual items. The results show the importance of how items are worded. If researchers want to accurately examine the between-groups component of the group therapy relationship they should develop measures that ask clients to describe their perceptions of the group, not the members own experience of the group. PMID:25364982

  12. Marchetti, Dario — Provocative Questions

    Cancer.gov

    This is an outstanding and intellectually-stimulating question which introduces a new way to translate more effectively metastasis research to the clinic. It is certainly worth exploring and badly needed. because, if positive, drugs could be immediately useful to help defined populations of patients. Per points, we agree that these are limited metastasis groups; however, results could at minimum justify moving forward to full adjuvant trials. Worthy cause given the "bottleneck" we experience nowadays since drugs are mostly not tested in metastasis prevention.

  13. Traditional eye medicine use by newly presenting ophthalmic patients to a teaching hospital in south-eastern Nigeria: socio-demographic and clinical correlates

    Microsoft Academic Search

    Boniface Ikenna Eze; Chimdi Memnofu Chuka-Okosa; Judith Nkechi Uche

    2009-01-01

    BACKGROUND: This study set out to determine the incidence, socio-demographic, and clinical correlates of Traditional Eye Medicine (TEM) use in a population of newly presenting ophthalmic outpatients attending a tertiary eye care centre in south-eastern Nigeria. METHODS: In a comparative cross-sectional survey at the eye clinic of the University of Nigeria Teaching Hospital (UNTH), Enugu, between August 2004 - July

  14. Correlation between phq-9 score and physical activity level, risk factors and non-communicable diseases in patients in family medicine clinic

    Microsoft Academic Search

    Zivana Gavric; Anna Culafic; Brankica Markovic

    2011-01-01

    The work of physicians in primary health care is essential in prevention and early detection of health risk factors. To determine\\u000a the incidence of depression among patients in family medicine clinics, as well as the correlation between depression, risk\\u000a factors and NCDs, and to determine correlation between depression (PHQ-9 score) and the level of physical activity. The pilot\\u000a study was

  15. Exhaled nitric oxide fractions are well correlated with clinical control in recurrent infantile wheeze treated with inhaled corticosteroids.

    PubMed

    Ghdifan, Sufian; Verin, Eric; Couderc, Laure; Lubrano, Marc; Michelet, Isabelle; Marguet, Christophe

    2010-11-01

    Fractional exhaled nitric oxide (FeNO) is a non-invasive marker of bronchial inflammation in asthma. However, the interest of FeNO measurement remained limited in infantile wheeze. The aim of this prospective study was to evaluate the feasibility and reproducibility of FeNO off-line measurement in very young children with recurrent wheeze and to assess whether clinical control of infantile wheeze correlates with FeNO levels. Two exhalation samples were collected in mylar balloon during quite tidal breathing. FeNO measurements were performed off-line by a NO analyzer. The participating patients were aged ?36 months, wheezes had started before the age of 24 months, and they were receiving maintenance treatment with inhaled corticosteroids for at least 3 months duration. The studied population comprised of 40 uncontrolled infants with persistent wheezy respiratory symptoms, median age 14.5 months, and 40 with optimal controlled infantile wheeze, median age 14 months. The reproducibility was excellent (r = 0.95; p < 0.0001). There was a significant difference in FeNO levels between the groups of persistent wheeze and well-controlled infants: 19.8 (2.5-99.3) ppb vs. 7.7 (0.6-29.5) ppb, p < 0.0001. At a FeNO level >15 ppb, the predictive values for uncontrolled disease were as follows: positive predictive value = 65%, negative predictive value = 90%. FeN0 levels were not increased by atopy or passive tobacco. Off-line assessment of FeNO is feasible, reproducible, and well accepted in wheezy very young children. Optimal clinical control of infantile wheeze appeared to be associated with the control of bronchial inflammation when evaluated by FeNO measurements. PMID:20977500

  16. Analysis of Serum Total and Free PSA Using Immunoaffinity Depletion Coupled to SRM: Correlation with Clinical Immunoassay Tests

    SciTech Connect

    Liu, Tao; Hossain, Mahmud; Schepmoes, Athena A.; Fillmore, Thomas L.; Sokoll, Lori J.; Kronewitter, Scott R.; Izmirlian, Grant; Shi, Tujin; Qian, Weijun; Leach, Robin; Thompson, Ian M.; Chan, Daniel W.; Smith, Richard D.; Kagan, Jacob; Srinivastava, Sudhir; Rodland, Karin D.; Camp, David G.

    2012-08-03

    Sandwich immunoassay is the standard technique used in clinical labs for quantifying protein biomarkers for disease detection, monitoring and therapeutic intervention. Albeit highly sensitive, the development of a specific immunoassay is rather time-consuming and associated with extremely high cost due to the requirement for paired immunoaffinity reagents of high specificity. Recently, mass spectrometry-based methods, specifically selected reaction monitoring mass spectrometry (SRM-MS), have been increasingly applied to measure low abundance biomarker candidates in tissue and biofluids, owing to high sensitivity and specificity, simplicity of assay configuration, and great multiplexing capability. In this study, we report for the first time the development of immunoaffinity depletion-based workflows and SRM-MS assays that enable sensitive and accurate quantification of total and free prostate-specific antigen (PSA) in serum without the requirement for specific PSA antibodies. With stable isotope dilution and external calibration, low ng/mL level detection of both total and free PSA was consistently achieved in both PSA-spiked female serum samples and actual patient serum samples. Moreover, comparison of the results obtained when SRM PSA assays and conventional immunoassays were applied to the same samples showed very good correlation (R2 values ranging from 0.90 to 0.99) in several independent clinical serum sample sets, including a set of 33 samples assayed in a blinded test. These results demonstrate that the workflows and SRM assays developed here provide an attractive alternative for reliably measuring total and free PSA in human blood. Furthermore, simultaneous measurement of free and total PSA and many other biomarkers can be performed in a single analysis using high-resolution liquid chromatographic separation coupled with SRM-MS.

  17. Promoter hypermethylation of CDH13 is a common, early event in human esophageal adenocarcinogenesis and correlates with clinical risk factors.

    PubMed

    Jin, Zhe; Cheng, Yulan; Olaru, Alexandru; Kan, Takatsugu; Yang, Jian; Paun, Bogdan; Ito, Tetsuo; Hamilton, James P; David, Stefan; Agarwal, Rachana; Selaru, Florin M; Sato, Fumiaki; Abraham, John M; Beer, David G; Mori, Yuriko; Shimada, Yutaka; Meltzer, Stephen J

    2008-11-15

    Although the CDH13 gene has been shown to undergo epigenetic silencing by promoter methylation in many types of tumors, hypermethylation of this gene in Barrett's-associated esophageal adenocarcinogenesis has not been studied. Two hundred fifty-nine human esophageal tissues were therefore examined for CDH13 promoter hypermethylation by real-time methylation-specific PCR. CDH13 hypermethylation showed discriminative receiver-operator characteristic curve profiles, sharply demarcating esophageal adenocarcinoma (EAC) from esophageal squamous cell carcinoma (ESCC) and normal esophagus (NE) (p < 0.0001). CDH13 normalized methylation values (NMV) were significantly higher in Barrett's esophagus (BE), dysplastic BE (D) and EAC than in NE (p < 0.0000001). CDH13 hypermethylation frequency was 0% in NE but increased early during neoplastic progression, rising to 70% in BE, 77.5% in D and 76.1% in EAC. Both CDH13 hypermethylation frequency and its mean NMV were significantly higher in BE with than without accompanying EAC. In contrast, only 5 (19.2%) of 26 ESCCs exhibited CDH13 hypermethylation. Furthermore, both CDH13 hypermethylation frequency and its mean NMV were significantly higher in EAC than in ESCC, as well as in BE or D vs. ESCC. Interestingly, mean CDH13 NMV was significantly lower in short-segment than in long-segment BE, a known clinical risk factor for neoplastic progression. Similarly, BE segment length was significantly lower in specimens with unmethylated than with methylated CDH13 promoters. 5-aza-2'-deoxycytidine treatment of OE33 EAC and KYSE220 ESCC cells reduced CDH13 methylation and increased CDH13 mRNA expression. These findings suggest that hypermethylation of CDH13 is a common, tissue-specific event in human EAC, occurs early during BE-associated neoplastic progression, and correlates with known clinical neoplastic progression risk factors. PMID:18729198

  18. Parvovirus B19 antibodies and correlates of infection in pregnant women attending an antenatal clinic in central Nigeria.

    PubMed

    Emiasegen, Samuel E; Nimzing, Lohya; Adoga, Moses P; Ohagenyi, Adamu Y; Lekan, Rufai

    2011-03-01

    Human parvovirus B19 infection is associated with spontaneous abortion, hydrops foetalis, intrauterine foetal death, erythema infectiosum (5th disease), aplastic crisis and acute symmetric polyarthropathy. However, data concerning Nigerian patients with B19 infection have not been published yet. The purpose of this study was to establish the prevalence of B19 IgG and IgM antibodies, including correlates of infection, among pregnant women attending an antenatal clinic in Nigeria. Subsequent to clearance from an ethical committee, blood samples were collected between August-November 2008 from 273 pregnant women between the ages of 15-40 years who have given their informed consent and completed self-administered questionnaires. Recombinant IgG and IgM enzyme linked immunosorbent assay kits (Demeditec Diagnostics, Germany) were used for the assays. Out of the 273 participants, 111 (40.7%) had either IgG or IgM antibodies. Out of these, 75 (27.5%) had IgG antibodies whereas 36 (13.2%) had IgM antibodies, and those aged 36-40 years had the highest prevalence of IgG antibodies. Significant determinants of infection (p < 0.05) included the receipt of a blood transfusion, occupation and the presence of a large number of children in the household. Our findings have important implications for transfusion and foeto-maternal health policy in Nigeria. Routine screening for B19 IgM antibodies and accompanying clinical management of positive cases should be made mandatory for all Nigerian blood donors and women of childbearing age. PMID:21537685

  19. Atrial Fibrillation in Hypertrophic Cardiomyopathy: Prevalence, Clinical Correlations, and Mortality in a Large High?Risk Population

    PubMed Central

    Siontis, Konstantinos C.; Geske, Jeffrey B.; Ong, Kevin; Nishimura, Rick A.; Ommen, Steve R.; Gersh, Bernard J.

    2014-01-01

    Background Atrial fibrillation (AF) is a common sequela of hypertrophic cardiomyopathy (HCM), but evidence on its prevalence, risk factors, and effect on mortality is sparse. We sought to evaluate the prevalence of AF, identify clinical and echocardiographic correlates, and assess its effect on mortality in a large high?risk HCM population. Methods and Results We identified HCM patients who underwent evaluation at our institution from 1975 to 2012. AF was defined by known history (either chronic or paroxysmal), electrocardiogram, or Holter monitoring at index visit. We examined clinical and echocardiographic variables in association with AF. The effect of AF on overall and cause?specific mortality was evaluated with multivariate Cox proportional hazards models. Of 3673 patients with HCM, 650 (18%) had AF. Patients with AF were older and more symptomatic (P<0.001). AF was less common among patients with obstructive HCM phenotype and was associated with larger left atria, higher E/e’ ratios, and worse cardiopulmonary exercise tolerance (all P values<0.001). During median (interquartile range) follow?up of 4.1 (0.2 to 10) years, 1069 (29%) patients died. Patients with AF had worse survival compared to those without AF (P<0.001). In multivariate analysis adjusted for established risk factors of mortality in HCM, the hazard ratio (95% confidence interval) for the effect of AF on overall mortality was 1.48 (1.27 to 1.71). AF did not have an effect on sudden or nonsudden cardiac death. Conclusions In this large referral HCM population, approximately 1 in 5 patients had AF. AF was a strong predictor of mortality, even after adjustment for established risk factors. PMID:24965028

  20. Prevalence and Clinical Correlates of Sarcopenia in Community-Dwelling Older People: Application of the EWGSOP Definition and Diagnostic Algorithm

    PubMed Central

    2014-01-01

    Background. Muscle impairment is a common condition in older people and a powerful risk factor for disability and mortality. The aim of this study was to apply the European Working Group on Sarcopenia in Older People criteria to estimate the prevalence and investigate the clinical correlates of sarcopenia, in a sample of Italian community-dwelling older people. Methods. Cross-sectional analysis of 730 participants (74% aged 65 years and older) enrolled in the InCHIANTI study. Sarcopenia was defined according to the European Working Group on Sarcopenia in Older People criteria using bioimpedance analysis for muscle mass assessment. Logistic regression analysis was used to identify the factors independently associated with sarcopenia. Results. Sarcopenia defined by the European Working Group on Sarcopenia in Older People criteria increased steeply with age (p < .001), with 31.6% of women and 17.4% of men aged 80 years or older being affected by this condition. Higher education (odds ratio: 0.85; 95% CI: 0.74–0.98), lower insulin-like growth factor I (lowest vs highest tertile, odds ratio: 3.89; 95% CI: 1.03–14.1), and low bioavailable testosterone (odds ratio: 2.67; 95% CI: 1.31–5.44) were independently associated with the likelihood of being sarcopenic. Nutritional intake, physical activity, and level of comorbidity were not associated with sarcopenia. Conclusions. Sarcopenia identified by the European Working Group on Sarcopenia in Older People criteria is a relatively common condition in Italian octogenarians, and its prevalence increases with aging. Correlates of sarcopenia identified in this study might suggest new approaches for prevention and treatment of sarcopenia. PMID:24085400

  1. Correlation of the Vesicular Acetylcholine Transporter Densities in the Striata to the Clinical Abilities of Women with Rett Syndrome (RTT)

    PubMed Central

    BRAŠI?, JAMES ROBERT; BIBAT, GENILA; KUMAR, ANIL; ZHOU, YUN; HILTON, JOHN; YABLONSKI, MARYBETH E.; DOGAN, AHMET SEMIH; GUEVARA, MARIA RITA; STEPHANE, MASSOUD; JOHNSTON, MICHAEL; WONG, DEAN FOSTER; NAIDU, SAKKUBAI

    2012-01-01

    Rett syndrome (RTT) is a neurodevelopmental disability characterized by mutations in the X-linked methyl-CpG-binding protein 2 (MeCP2) located at the Xq28 region. The severity is modified in part by X chromosomal inactivation resulting in wide clinical variability. We hypothesized that the ability to perform the activities of daily living (ADL) is correlated with the density of vesicular acetylcholine transporters in the striata of women with RTT. The density of the vesicular acetylcholine transporters in the living human brain can be estimated by single-photon emission-computed tomography (SPECT) after the administration of (?)-5-[123I]iodobenzovesamicol ([123I]IBVM). Twenty-four (24) hours following the intravenous injection of approximately 333 MBq (9 mCi) [123I]IBVM, four women with RTT and nine healthy adult volunteer control participants underwent SPECT brain scans for sixty (60) minutes. The Vesicular Acetylcholine Transporter Binding Site Index (VATBSI) (Kuhl et al., 1994), a measurement of the density of vesicular acetylcholine transporters, was estimated in the striatum and the reference structure, the cerebellum. The women with RTT were assessed for certain activities of daily living (ADL). Although striatal VATSBI was not significantly lower in RTT (5.2 ± 0.9) than in healthy adults (5.7 ± 1.6), RTT striatal VATSBI and ADL scores were linearly associated (ADL = 0.89*VATSBI + 4.5; R2=0.93; p<0.01), suggesting a correlation between the ability to perform ADL and the density of vesicular acetylcholine transporters in the striata of women with RTT. [123I]IBVM is a promising tool to characterize the pathophysiological mechanisms of RTT and other neurodevelopmental disabilities. PMID:22223404

  2. Correlates of abortions and condom use among high risk women attending an std clinic in st Petersburg, Russia

    PubMed Central

    2011-01-01

    Background Many women in Russia rely on abortion as a primary birth control method. Although refusal to use contraceptives, including condoms, may undermine public health efforts to decrease HIV sexual risk behaviors, few studies have investigated the risk factors associated with abortion among women at high risk for HIV. This study sought to identify the correlates of abortions and of lack of condom use among high risk STD clinic patients in St Petersburg Russia. Methods Cross-sectional analysis of data collected between 2009 and 2010 from women who had casual or multiple sexual partners in the previous three months was analyzed. Multivariate logistic regression assessed the independent correlates of abortion(s) and no condom use in the prior three months. Independent variables included socio-demographics, at risk drinking per alcohol use disorder identification test (AUDIT-C) criteria, having sex after drinking alcohol, having a sexual partner who injects illicit drugs, and parity. Results Of 87 participants, 45% had an abortion in their lifetime and 26% did not use condoms in the prior three months. Abortion was independently associated with low income (OR, 3.33, 95%CI, 1.13-9.78) and at risk drinking (OR, 3.52, 95%CI, 1.24-10.05). Lack of condom use was independently associated with being more likely to have sex after drinking (OR, 3.37, 95%CI, 1.10-10.28) and parity (OR, 3.69, 95%CI, 1.25-10.89). Conclusions Programs to increase contraceptive use including condom use among women at high risk for STD/HIV in Russia are needed. Programs to reduce sexual HIV risk and abortion rates must address alcohol misuse and target women with limited income. PMID:21992690

  3. Viral Load Detection Using Dried Blood Spots in a Cohort of HIV-1-Infected Children in Uganda: Correlations with Clinical and Immunological Criteria for Treatment Failure

    PubMed Central

    Lundin, Rebecca; Petrara, Maria Raffaella; Penazzato, Martina; Massavon, William; Kizito, Susan; Nabachwa, Sandra Monica; Nannyonga Musoke, Maria; Namisi, Charles; Morelli, Erika; Bilardi, Davide; Mazza, Antonio; Zanchetta, Marisa; Giaquinto, Carlo; De Rossi, Anita

    2014-01-01

    Correlations between clinical/immunological treatment failure and viral load (VL) detected by dried blood spot (DBS) sampling were explored in HIV-1-infected children in Uganda. Of 104 children on combined antiretroviral treatment (cART), 12.5% experienced clinical and/or immunological failure, while 28.8%, 44.2%, and 26.9% had VLs of <1,000, 1,000 to 5,000, and >5,000 copies/ml, respectively. Clinical/immunological failure poorly predicted virological failure. PMID:24789197

  4. Menopause Analytical Hormonal Correlate Outcome Study (MAHCOS) and the Association to Brain Electrophysiology (P300) in a Clinical Setting

    PubMed Central

    Braverman, Eric R.; Han, David; Oscar-Berman, Marlene; Karikh, Tatiana; Truesdell, Courtney; Dushaj, Kristina; Kreuk, Florian; Li, Mona; Stratton, Danielle; Blum, Kenneth

    2014-01-01

    Various studies have demonstrated that increased leptin levels and obesity are inversely related to cognitive decline in menopausal women. It is hypothesized that adiposity is inversely correlated with cognitive decline, as women with increased weight are less vulnerable to diminishing cognition. However, it is increasingly observed that menopausal women, even with increased adiposity, experience significant cognitive decline. Positron emission tomography (PET) has been used to analyze cognitive function and processing in menopausal women. Evoked potentials (P300) and neurophysiologic tests have validated brain metabolism in cognitively impaired patients. Post-hoc analyses of 796 female patients entering PATH Medical Clinic, between January 4, 2009 and February 24, 2013, were performed as part of the “Menopause Analytical Hormonal Correlate Outcome Study” (MAHCOS). Patient age range was 39–76 years (46.7±0.2). P300 latency and amplitude correlated with a number of hormones: follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol, estrone, estriol, DHEA, pregnenolone, progesterone, free and total testosterone, thyroid stimulating hormone (TSH), Vitamins D 1.25 and D 25OH, leptin, and insulin-like growth factor-binding protein 3 (IGF-BP3). Corrected statistics did not reveal significant associations with P300 latency or amplitude for these hormones except for leptin plasma levels. However, factor analysis showed that FSH and LH clustered together with Vitamin D1.25 and Vitamin D25OH, P300 latency (not amplitude), and log leptin were found to be associated in the same cluster. Utilizing regression analysis, once age adjusted, leptin was the only significant predictor for latency or speed (p?=?0.03) with an effect size of 0.23. Higher plasma leptin levels were associated with abnormal P300 speed (OR?=?0.98). Our findings show a significant relationship of higher plasma leptin levels, potentially due to leptin resistance, and prolonged P300 latency. This suggests leptin resistance may delay electrophysiological processing of memory and attention, which appears to be the first of such an association. PMID:25251414

  5. Question, Problem, Purpose

    NSDL National Science Digital Library

    Michael P. Klentschy

    2008-04-01

    Questions and question-formulating strategies are central to science. In many ways the formulation of a question forms the basis for high-quality instruction in science. Effective questioning has a strong connection to cognitive theory. The sentence start

  6. Serum immunoglobulin free light-chain measurement in primary amyloidosis: prognostic value and correlations with clinical features

    PubMed Central

    Dispenzieri, Angela; Katzmann, Jerry A.; Larson, Dirk R.; Colby, Colin L.; Lacy, Martha Q.; Hayman, Suzanne R.; Buadi, Francis K.; Leung, Nelson; Zeldenrust, Steve R.; Ramirez-Alvarado, Marina; Clark, Raynell J.; Kyle, Robert A.; Rajkumar, S. Vincent; Gertz, Morie A.

    2010-01-01

    Immunoglobulin free light chains (FLCs) are the precursors of amyloid fibrils in primary amyloidosis (AL). We studied the relationship between FLC levels and clinical features in 730 patients with newly diagnosed AL. The plasma cell clone was ? in 72% patients, and ? in 28% patients. ?-AL had more GI tract and liver involvement, where as renal involvement was more with ?-AL. While the overall survival (OS) was similar for ? and ?-AL, the median OS for those without an identifiable serum heavy chain was significantly shorter (12.6 vs 29.9 months; P = .02). The OS was shorter among those with a higher dFLC (involved FLC?uninvolved FLC; ? > 29.4 mg/dL or ? > 18.2 mg/dL using median for cutoff); 10.9 vs 37.1 months; P < .001. In multivariate analysis, dFLC was independent of other prognostic factors. The type of light chain impacts the spectrum of organ involvement and the FLC burden correlates with survival in AL. PMID:20798235

  7. Correlation of long non-coding RNA expression with metastasis, drug resistance and clinical outcome in cancer

    PubMed Central

    Malek, Ehsan; Jagannathan, Sajjeev; Driscoll, James J.

    2014-01-01

    The therapeutic response and clinical outcome of patients diagnosed with the same cancer type and that receive identical treatment is highly variable to reflect the genetic heterogeneity within tumor cells. Non-coding RNAs (ncRNAs) are recently discovered molecules that regulate eukaryotic gene expression and represent a significant advance towards a better understanding of the mechanisms that govern cellular growth. NcRNAs are essential for the proper regulation of cell proliferation and survival under physiologic conditions and are deregulated in many pathologies, e.g., human cancers. NcRNAs have been associated with cancer diagnosis, staging, treatment response, metastasis and survival and include distinct subtypes, e.g., long ncRNAs (lncRNAs) and microRNAs (miRNAs). LncRNAs have been linked to essential growth-promoting activities and their deregulation contributes to tumor cell survival. A prominent example is the Hox transcript antisense intergenic lncRNA, HOTAIR, that cooperates with the polycomb repressive complex to reprogram chromatin organization. HOTAIR expression is deregulated in a spectrum of cancers and HOTAIR expression correlates with patient survival. Here, we highlight emerging evidence that supports a role for lncRNAs in cancer with implications for the development of novel diagnostics and therapeutics. PMID:25275300

  8. Molecular and clinical correlations in spinocerebellar ataxia type I: Evidence for familial effects on the age at onset

    SciTech Connect

    Ranum, L.P.W.; Chung, M.; Schut, L.J.; Duvick, L.A. (Univ. of Minnesota, Minneapolis, MN (United States)); Banfi, S.; McCall, A. (Baylor College of Medicine, Houston, TX (United States)); Bryer, A.; Ramesar, R.; Subramony, S.H.; Goldfarb, L. (and others)

    1994-08-01

    The spinocerebellar ataxias are a group of debilitating neurodegenerative diseases for which a clinical classification system has proved unreliable. The authors have recently isolated the gene for spinocerebellar ataxia type 1 (SCA1) and have shown that the disease is caused by an expanded, unstable, CAG trinucleotide repeat within an expressed gene. Normal alleles have a size range of 19-36 repeats, while SCA1 alleles have 42-81 repeats. In this study, they examined the frequency and variability of the SCA1 repeat expansion in 87 kindreds with diverse ethnic backgrounds and dominantly inherited ataxia. All nine families for which linkage to the SCA1 region of 6p had previously been established showed repeat expansion, while 3 of the remaining 78 showed a similar abnormality. For 113 patients from the families with repeat expansion, inverse correlations between CAG repeat size and both age at onset and disease duration were observed. Repeat size accounted for 66% of the variation in age at onset in these patients. After correction for repeat size, interfamilial differences in age at onset remained significant, suggesting that additional genetic factors affect the expression of the SCA1 gene product. 48 refs., 4 figs.

  9. miR-375 inhibits cell growth and correlates with clinical outcomes in tongue squamous cell carcinoma.

    PubMed

    Jia, Lingfei; Huang, Yiping; Zheng, Yunfei; Lyu, Mingyue; Zhang, Chunan; Meng, Zhen; Gan, Yehua; Yu, Guangyan

    2015-04-01

    miR-375 has been implicated in various types of cancers. However, its role in tongue squamous cell carcinoma (TSCC) remains unclear. This study aimed to investigate the effects of miR-375 on cell growth and the prognosis of TSCC patients. Using quantitative reverse transcription-polymerase chain reaction, we evaluated miR-375 expression in TSCC samples and TSCC cell lines. The results showed that miR-375 expression was significantly reduced in the TSCC tissues and cell lines. A low level expression of miR-375 in TSCC patients was related to poor of prognosis. Moreover, the effects of miR-375 overexpression on cell proliferation, the cell cycle and the expression of Sp1 and cyclin D1 were examined in TSCC cells. We demonstrated that overexpression of miR-375 significantly inhibited the cell proliferation and cell cycle progression in TSCC cell lines. Overexpression of miR-375 inhibited Sp1 expression by targeting the 3' untranslated region of the Sp1 transcript. The knockdown of Sp1 expression resulted in the subsequent downregulation of cyclin D1. Taken together, our study suggests that miR-375 inhibits the cell growth, and its expression is correlated with clinical outcomes in TSCC. PMID:25633534

  10. Child behaviour checklist emotional dysregulation profiles in youth with disruptive behaviour disorders: clinical correlates and treatment implications.

    PubMed

    Gabriele, Masi; Pietro, Muratori; Azzurra, Manfredi; Simone, Pisano; Annarita, Milone

    2015-01-30

    Two Child Behaviour Checklist (CBCL) profiles were correlated to poor self-regulation, Deficient Emotional Self-Regulation (DESR) (elevation between 1 and 2 Standard Deviations (SD) in Anxiety/Depression, Aggression, Attention subscales), and Dysregulation Profile (DP) (elevation of 2 Standard Deviations or more). We explored youths with Oppositional Defiant Disorder (ODD) and Conduct Disorder (CD) whether these profiles are associated with specific clinical features. The sample included 57 patients with DESR profile and 41 with DP profile, ages 9 to 15 years, all assigned to a non-pharmacological Multimodal Treatment Program. No differences resulted between groups in demographic features, diagnosis ratio, and comorbidities with Attention Deficit Hyperactivity Disorder (ADHD), Bipolar Disorder (BD), and Anxiety Disorder. The DP group was associated with higher scores in Withdrawn, Social Problem, Thought, Rule Breaking, and Somatic CBCL subscales, and higher scores in Narcissism and Impulsivity (but not Callous-Unemotional (CU)), according to the Antisocial Process Screening Device (APSD). After treatment, patients with DESR improved their personality traits (Narcissistic and Callous-Unemotional, but not Impulsivity), while changes in CBCL scales were modest. Patients with DP improved scales of Attention, Aggression, Anxiety-Depression, Rule Breaking, Withdrawal, Social Problem and Thought, while personality features did not change. These results suggest diagnostic implications of CBCL profiles, and indications for targeted treatment strategies. PMID:25480545

  11. Mutation Spectrum of RB1 Gene in Unilateral Retinoblastoma Cases from Tunisia and Correlations with Clinical Features

    PubMed Central

    Ayari-Jeridi, Hajer; Moran, Kimberly; Chebbi, Amel; Bouguila, Hédi; Abbes, Imen; Charradi, Khaoula; Benammar-Elgaaïed, Amel; Ganguly, Arupa

    2015-01-01

    Retinoblastoma, an embryonic neoplasm of retinal origin, is the most common primary intraocular malignancy in children. Somatic inactivation of both alleles of the RB1 tumor suppressor gene in a retinal progenitor cell through diverse mechanisms including genetic and epigenetic modifications, is the crucial event in initiation of tumorigenesis in most cases of isolated unilateral retinoblastoma. We analyzed DNA from tumor tissue and from peripheral blood to determine the RB1 mutation status and seek correlations with clinical features of 37 unrelated cases of Tunisian origin with sporadic retinoblastoma. All cases were unilateral except one who presented with bilateral disease, in whom no germline coding sequence alteration was identified. A multi-step mutation scanning protocol identified bi-allelic inactivation of RB1 gene in 30 (81%) of the samples tested. A total of 7 novel mutations were identified. There were three tumors without any detectable mutation while a subset contained multiple mutations in RB1 gene. The latter group included tumors collected after treatment with chemotherapy. There were seven individuals with germline mutations and all presented with advanced stage of tumor. There was no difference in age of onset of RB based on the germline mutation status. Thus 20% of the individuals with sporadic unilateral RB in this series carried germline mutations and indicate the importance of genetic testing all children with sporadic retinoblastoma. These findings help to characterize the spectrum of mutations present in the Tunisian population and can improve genetic diagnosis of retinoblastoma. PMID:25602518

  12. Clinical observations on the effect of carotid artery occlusion on cerebral blood flow mapped by xenon computed tomography and its correlation with carotid artery back pressure

    Microsoft Academic Search

    David L. Steed; Marshall W. Webster; Egbert J DeVries; Charles A. Jungreis; Joseph A. Horton; Laligam Sehkar; Howard Yonas

    1990-01-01

    Xenon computed tomographic cerebral blood flow mapping was correlated with internal carotid artery stump pressures and clinical neurologic assessment during temporary internal carotid artery occlusion. One hundred fourteen patients with skull base tumors or intracranial aneurysms potentially requiring carotid resection or ligation underwent angiography, xenon CT cerebral blood flow mapping, and internal carotid artery blood pressure monitoring. The internal carotid

  13. Why "Who Is the Client?" Is the Wrong Ethical Question

    ERIC Educational Resources Information Center

    Fisher, Mary Alice

    2014-01-01

    The familiar question "Who is the client?" elicits a singular answer. This may be appropriate as a clinical question, and it is sometimes necessary as a legal question or reimbursement question, but on ethical questions, the National Association of School Psychologists Ethics Code requires school psychologists to "think plural"…

  14. Seminal, clinical and colour-Doppler ultrasound correlations of prostatitis-like symptoms in males of infertile couples.

    PubMed

    Lotti, F; Corona, G; Mondaini, N; Maseroli, E; Rossi, M; Filimberti, E; Noci, I; Forti, G; Maggi, M

    2014-01-01

    'Prostatitis-like symptoms' (PLS) are a cluster of bothersome conditions defined as 'perineal and/or ejaculatory pain or discomfort and National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI) pain subdomain score ?4' (Nickel's criteria). PLS may originate from the prostate or from other portions of the male genital tract. Although PLS could be associated with 'prostatitis', they should not be confused. The NIH-CPSI is considered the gold-standard for assessing PLS severity. Although previous studies investigated the impact of prostatitis, vesiculitis or epididymitis on semen parameters, correlations between their related symptoms and seminal or scrotal/transrectal colour-Doppler ultrasound (CDU) characteristics have not been carefully determined. And no previous study evaluated the CDU features of PLS in infertile men. This study was aimed at investigating possible associations among NIH-CPSI (total and subdomain) scores and PLS, with seminal, clinical and scrotal/transrectal CDU parameters in a cohort of males of infertile couples. PLS of 400 men (35.8 ± 7.2 years) with a suspected male factor were assessed by the NIH-CPSI. All patients underwent, during the same day, semen analysis, seminal plasma interleukin 8 (sIL-8, a marker of male genital tract inflammation), biochemical evaluation, urine/seminal cultures, scrotal/transrectal CDU. PLS was detected in 39 (9.8%) subjects. After adjusting for age, waist and total testosterone (TT), no association among NIH-CPSI (total or subdomain) scores or PLS and sperm parameters was observed. However, we found a positive association with current positive urine and/or seminal cultures, sIL-8 levels and CDU features suggestive of inflammation of the epididymis, seminal vesicles, prostate, but not of the testis. The aforementioned significant associations of PLS were further confirmed by comparing PLS patients with age-, waist- and TT-matched PLS-free patients (1 : 3 ratio). In conclusion, NIH-CPSI scores and PLS evaluated in males of infertile couples, are not related to sperm parameters, but mainly to clinical and CDU signs of infection/inflammation. PMID:24288243

  15. Use of 4-Dimensional Computed Tomography-Based Ventilation Imaging to Correlate Lung Dose and Function With Clinical Outcomes

    SciTech Connect

    Vinogradskiy, Yevgeniy, E-mail: yevgeniy.vinogradskiy@ucdenver.edu [Department of Radiation Oncology, University of Colorado School of Medicine, Aurora, Colorado (United States)] [Department of Radiation Oncology, University of Colorado School of Medicine, Aurora, Colorado (United States); Castillo, Richard [Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States)] [Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Castillo, Edward [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States) [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Department of Computational and Applied Mathematics, Rice University, Houston, Texas (United States); Tucker, Susan L. [Departments of Bioinformatics and Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States)] [Departments of Bioinformatics and Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Liao, Zhongxing [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States)] [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Guerrero, Thomas [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States) [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Department of Computational and Applied Mathematics, Rice University, Houston, Texas (United States); Martel, Mary K. [Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States)] [Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States)

    2013-06-01

    Purpose: Four-dimensional computed tomography (4DCT)-based ventilation is an emerging imaging modality that can be used in the thoracic treatment planning process. The clinical benefit of using ventilation images in radiation treatment plans remains to be tested. The purpose of the current work was to test the potential benefit of using ventilation in treatment planning by evaluating whether dose to highly ventilated regions of the lung resulted in increased incidence of clinical toxicity. Methods and Materials: Pretreatment 4DCT data were used to compute pretreatment ventilation images for 96 lung cancer patients. Ventilation images were calculated using 4DCT data, deformable image registration, and a density-change based algorithm. Dose–volume and ventilation-based dose function metrics were computed for each patient. The ability of the dose–volume and ventilation-based dose–function metrics to predict for severe (grade 3+) radiation pneumonitis was assessed using logistic regression analysis, area under the curve (AUC) metrics, and bootstrap methods. Results: A specific patient example is presented that demonstrates how incorporating ventilation-based functional information can help separate patients with and without toxicity. The logistic regression significance values were all lower for the dose–function metrics (range P=.093-.250) than for their dose–volume equivalents (range, P=.331-.580). The AUC values were all greater for the dose–function metrics (range, 0.569-0.620) than for their dose–volume equivalents (range, 0.500-0.544). Bootstrap results revealed an improvement in model fit using dose–function metrics compared to dose–volume metrics that approached significance (range, P=.118-.155). Conclusions: To our knowledge, this is the first study that attempts to correlate lung dose and 4DCT ventilation-based function to thoracic toxicity after radiation therapy. Although the results were not significant at the .05 level, our data suggests that incorporating ventilation-based functional imaging can improve prediction for radiation pneumonitis. We present an important first step toward validating the use of 4DCT-based ventilation imaging in thoracic treatment planning.

  16. Extent of collateralization predicting symptomatic cerebral vasospasm among pediatric patients: correlations among angiography, transcranial Doppler ultrasonography, and clinical findings.

    PubMed

    Moftakhar, Parham; Cooke, Daniel L; Fullerton, Heather J; Ko, Nerissa U; Amans, Matthew R; Narvid, Jared A; Dowd, Christopher F; Higashida, Randall T; Halbach, Van V; Hetts, Steven W

    2015-03-01

    OBJECT Although the development and prevalence of cerebral vasospasm (CV) has been extensively investigated in adults, little data exist on the development of CV in children. The authors hypothesized that even though children have highly vasoreactive arteries, because of a robust cerebral collateral blood flow, they rarely develop symptomatic CV. METHODS The authors retrospectively reviewed their university hospital's neurointerventional database for children (that is, patients ? 18 years) who were examined or treated for aneurysmal or traumatic subarachnoid hemorrhage (SAH) during the period 1990-2013. Images from digital subtraction angiography (DSA) were analyzed for the extent of CV and collateralization of the cerebral circulation. Results from transcranial Doppler (TCD) ultrasonography were correlated with those from DSA. Cerebral vasospasm on TCD ultrasonography was defined according to criteria developed for adults. Clinical outcomes of CV were assessed with the pediatric modified Rankin Scale (mRS). RESULTS Among 37 children (21 boys and 16 girls ranging in age from 8 months to 18 years) showing symptoms of an aneurysmal SAH (comprising 32 aneurysms and 5 traumatic pseudoaneurysms), 17 (46%) had CV confirmed by DSA; CV was mild in 21% of these children, moderate in 50%, and severe in 29%. Only 3 children exhibited symptomatic CV, all of whom had poor collateralization of cerebral vessels. Among the 14 asymptomatic children, 10 (71%) showed some degree of vessel collateralization. Among 16 children for whom TCD data were available that could be correlated with the DSA findings, 13 (81%) had CV according to TCD criteria. The sensitivity and specificity of TCD ultrasonography for diagnosing CV were 95% and 59%, respectively. The time to CV onset detected by TCD ultrasonography was 5 ± 3 days (range 2-10 days). Twenty-five (68%) of the children had good long-term outcomes (that is, had mRS scores of 0-2). CONCLUSIONS Children have a relatively high incidence of angiographically detectable, moderate-to-severe CV. Children rarely develop symptomatic CV and have good long-term outcomes, perhaps due to robust cerebral collateral blood flow. Criteria developed for detecting CV with TCD ultrasonography in adults overestimate the prevalence of CV in children. Larger studies are needed to define TCD ultrasonography-based CV criteria for children. PMID:25555113

  17. The Utilization of a Clinical Decision Support System to Manage Adult Type 2 Diabetes: A Correlational Study

    ERIC Educational Resources Information Center

    Faught, I. Charie

    2012-01-01

    While the Institute of Medicine (2001) has promoted health information technology to improve the process of care such as compliance with clinical practice guidelines and quicker access to clinical information, diagnostic tests, and treatment results, very little was known about how a clinical decision support system can contribute to diabetes…

  18. Anti-HCV and HCV-RNA prevalence and clinical correlations in cases with non-Hodgkin's lymphoma.

    PubMed

    Paydas, Semra; Kilic, Banu; Yavuz, Sinan; Disel, Umut; Tanriverdi, Kahraman; Sahin, Berksoy; Burgut, Refik

    2003-10-01

    Hepatitis C virus (HCV) is an RNA virus in the Flaviviridae family. It displays lymphotropism in addition to hepatotropism and extrahepatic manifestations are very well known. There are many studies showing an association between HCV infection and non-Hodgkin's lymphomas (NHL). In this study the evidence for HCV infection was studied in cases with NHL. To this end, anti-HCV antibody and HCV-RNA were screened in serum samples of cases with NHL using third-generation ELISA and RT-PCR. Anti-HCV antibody was studied in 223 patients and was found to be positive in 18 cases (8.1%). Anti-HCV antibody positivity was compared with our blood bank/blood donor population. There was an important increased risk of HCV infection--the common odds ratio was 34.56 and corrected odds ratio was 19.07. HCV-RNA was studied in 67 of 223 serum samples. HCV-RNA was found to be positive in 21 of 67 samples (31.3%). When compared with clinico-demographic parameters for anti-HCV and HCV-RNA, including age, nodal status, and grade (in evaluable cases), except age in cases with or without HCV-RNA, we did not find an important correlation with HCV status and clinical findings (P=0.155; 0.442; 0.288 for anti-HCV and 0.027; 0,558; 0.126, respectively). These results suggest that HCV infection may be an important risk factor for lymphomagenesis and HCV-RNA is more useful for the detection of HCV infection in these immunosuppressed cases. Simultaneous detection of anti-HCV and HCV-RNA will be more informative in this population. PMID:14508793

  19. Overexpression of E2F-5 correlates with a pathological basal phenotype and a worse clinical outcome

    PubMed Central

    Umemura, S; Shirane, M; Takekoshi, S; Kusakabe, T; Itoh, J; Egashira, N; Tokuda, Y; Mori, K; Osamura, Y R

    2009-01-01

    The purpose of the present study is to identify genes that contribute to cell proliferation or differentiation of breast cancers independent of signalling through the oestrogen receptor (ER) or human epidermal growth factor receptor 2 (HER2). An oligonucleotide microarray assayed 40 tumour samples from ER(+)/HER2(?), ER(+)/HER2(+), ER(?)/HER2(+), and ER(?)/HER2(?) breast cancer tissues. Quantitative reverse transcriptase PCR detected overexpression of a cell cycle-related transcription factor, E2F-5, in ER-negative breast cancers, and fluorescence in situ hybridisation detected gene amplification of E2F-5 in 5 out of 57 (8.8%) breast cancer samples. No point mutations were found in the DNA-binding or DNA-dimerisation domain of E2F-5. Immunohistochemically, E2F-5-positive cancers correlated with a higher Ki-67 labelling index (59.5%, P=0.001) and higher histological grades (P=0.049). E2F-5-positive cancers were found more frequently in ER(?)/progesterone receptor (PgR)(?)/HER2(?) cancer samples (51.9%, P=0.0049) and in breast cancer samples exhibiting a basal phenotype (56.0%, P=0.0012). Disease-free survival in node-negative patients with E2F-5-positive cancers was shorter than for patients with E2F-5-negative cancers. In conclusion, we identify, for the first time, a population of breast cancer cells that overexpress the cell cycle-related transcription factor, E2F-5. This E2F-5-positive breast cancer subtype was associated with an ER(?)/PgR(?)/HER2(?) status, a basal phenotype, and a worse clinical outcome. PMID:19259095

  20. Lectin-reactive Anti-?-Gal in Patients with Crohn’s Disease: Correlation with Clinical Phenotypes

    PubMed Central

    Safaie, Parham; Ham, Maggie; Kuang, Peter; Mehta, Anand S.; Wang, Mengjun; Cheifetz, Adam S.; Robson, Simon; Lau, Daryl; Block, Timothy M.; Moss, Alan C.

    2014-01-01

    Background Patients with inflammatory bowel disease have higher proportions of immunoglobulin G (IgG) antibodies lacking N-galactose, also called agalactosyl IgG, in their serum. Such agalactosyl IgGs have been associated with disease activity and the immunogenicity of biologics. The aim was to describe the relationship between circulating levels of a subset of agalactosyl IgGs (anti-?-Gal) and Crohn’s disease (CD) phenotypes. Methods Prospectively collected serum samples of a well-characterized cohort of patients with inflammatory bowel disease and controls were used. Serum anti-?-Gal levels were measured by a high-affinity enzyme-linked immunosorbent assay and referenced to a standard control. Results Serum samples from 167 subjects were tested; 62 with CD, 76 with ulcerative colitis, and 29 controls. Agalactosyl anti-?-Gal levels were significantly higher in active CD than in active ulcerative colitis (P = 0.0043) or healthy controls (P < 0.0001). Among patients with CD, agalactosyl anti-?-Gal levels were significantly higher in those with a history of arthritis, than those without (P = 0.0002), but lower in those taking immunomodulators (P = 0.03). There was no correlation between agalactosyl anti-?-Gal levels and indices of Crohn’s severity, including C-reactive protein levels or Harvey– Bradshaw index. Patients who were primary or secondary nonresponders to infliximab had similar agalactosyl anti-?-Gal levels to clinical responders. Conclusions Patients with CD have greater amounts of agalactosylated anti-?-Gal antibodies in their serum, particularly in those with associated joint disease. This increase seems to be independent of indices of disease activity, but is influenced by immunomodulator use. PMID:24185312