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Sample records for anti-hbc positive result

  1. [Hepatitis B infection transmission by anti-HBc-positive grafts].

    PubMed

    Bárcena, Rafael

    2014-07-01

    In Spain, the rate of anti-HBc positive, HBsAg-negative carriers is approximately 10% of adults between the ages of 26 and 65 years. It is therefore impossible to exclude these donors without increasing the mortality of recipients on waiting lists. The incidence of de novo hepatitis B infection in HBsAg-negative recipients of anti-HBc-positive donors is high without prophylaxis and is related to the serological state of the recipient against HBV. Anti-HBc and anti-HBs-positive recipients have low risk, with or without prophylaxis. This patient group therefore does not require prophylaxis but rather periodic posttransplantation checkups. For the other recipient groups (naïve, anti-Hbc and anti-HBs isolates), prophylaxis with IgG HB, lamivudine or combined therapy decreases the incidence of infection. These patients should be treated with prophylaxis immediately after transplantation. Depending on the risk, cost and benefit, patients should currently be treated with lamivudine 100mg/d indefinitely or for longer periods (>10 years). Periodic checkups of HBsAg should be conducted, and if there is graft dysfunction then HBV DNA should be checked. IF HBV DNA is discovered in the donor and found to be positive in serum or in the biopsy, the prophylaxis should be an analogue with a high barrier to resistance from the start. Grafts from anti-HBc-positive donors are not considered at-risk grafts and are used according to donor severity, without being determined by the recipient's serological profile. Copyright © 2014 Elsevier España, S.L. All rights reserved.

  2. Clinical significance of “anti-HBc alone” in human immunodeficiency virus-positive patients

    PubMed Central

    Pérez-Rodríguez, Mª Teresa; Sopeña, Bernardo; Crespo, Manuel; Rivera, Alberto; del Blanco, Teresa González; Ocampo, Antonio; Martínez-Vázquez, César

    2009-01-01

    AIM: To determine the prevalence and clinical relevance of isolated antibodies to hepatitis B core antigen as the only marker of infection (“anti-HBc alone”) among human immunodeficiency virus (HIV) type-1 infected patients. Occult hepatitis B infection frequency was also evaluated. METHODS: Three hundred and forty eight histories from 2388 HIV-positive patients were randomly reviewed. Patients with serological markers of hepatitis B virus (HBV) infection were classified into three groups: past hepatitis, “anti-HBc alone” and chronic hepatitis. Determination of DNA from HBV, and RNA and genotype from hepatitis C virus (HCV) were performed on “anti-HBc alone” patients. RESULTS: One hundred and eighty seven (53.7%) HIV-positive patients had markers of HBV infection: 118 past infection (63.1%), 14 chronic hepatitis (7.5%) and 55 “anti-HBc alone” (29.4%). Younger age [2.3-fold higher per every 10 years younger; 95% confidence intervals (CI) 1.33-4.00] and antibodies to HCV infection [odds ratio (OR) 2.87; 95% CI 1.10-7.48] were factors independently associated with the “anti-HBc alone” pattern. No differences in liver disease frequency were detected between both groups. Serum levels of anti-HBs were not associated with HCV infection (nor viral replication or HCV genotype), or with HIV replication or CD4 level. No “anti-HBc alone” patient tested positive for HBV DNA. CONCLUSION: “Anti-HBc alone” prevalence in HIV-positive patients was similar to previously reported data and was associated with a younger age and with antibodies to HCV infection. In clinical practice, HBV DNA determination should be performed only in those patients with clinical or analytical signs of liver injury. PMID:19291824

  3. Comparison of Two Test Strategies for Clarification of Reactive Results for Anti-HBc in Blood Donors.

    PubMed

    Juhl, David; Knobloch, Johannes K-M; Görg, Siegfried; Hennig, Holger

    2016-01-01

    Testing for antibodies against hepatitis B core antigen (anti-HBc) was introduced to detect blood donors suffering from occult hepatitis B infection. Confirmation of specification of reactive results in the anti-HBc screening assay is still a challenge for blood donation services. Two different test strategies for confirmation of specification of reactive anti-HBc tests, one performed in our institute and one suggested by the German authority (Paul-Ehrlich-Institut (PEI)), were compared. The first strategy is based on one supplemental anti-HBc test, the other requires two supplemental anti-HBc tests. 389 samples from 242 donors were considered. Both test strategies yielded concordant results in 117 reactive samples termed 'true-positive' or 'specificity confirmed', in 156 reactive samples termed 'false-positive' or 'specificity not confirmed', and in 99 negative samples. In 17 samples obtained from 11 donors, both test strategies gave discrepant results ('false-positive' but 'specificity confirmed'). In 10 of 11 donors, a real HBV infection was very unlikely, one remained unclear. 30 donors considered 'false-positive' became negative in all anti-HBc tests after follow-up testing and thus eligible for donor re-entry. The test strategy suggested by the PEI yielded no additional information but induced an overestimation of HBV infections and unnecessary look-back procedures. Many anti-HBc-reactive donors can be regained after follow-up testing.

  4. Association between anti-HBc positivity and hepatocellular carcinoma in HBsAg-negative subjects with chronic liver disease

    PubMed Central

    Coppola, Nicola; Onorato, Lorenzo; Sagnelli, Caterina; Sagnelli, Evangelista; Angelillo, Italo F.

    2016-01-01

    Abstract A meta-analysis was performed to ascertain to what extent hepatitis B surface antigen (HBsAg)-negative/anti-hepatitis B core (anti-HBc)-positive subjects with chronic liver disease are at a higher risk of developing hepatocellular carcinoma (HCC) than the anti-HBc-negative. All studies included had to fulfill the following characteristics and inclusion criteria: they investigated the relationship between HBsAg-negative/anti-HBc-positive serology and the occurrence of HCC, whether a case–control or cohort study, they provided relative risk (RR) or odds ratios (ORs) and 95% confidence intervals (CIs), were available as a full text written in English, and were published and indexed up to April 2015. Twenty-six original studies met the inclusion criteria, allowing a meta-analysis on 44,553 patients. The risk of HCC among the 9986 anti-HBc-positive subjects was 67% higher than in the 34,567 anti-HBc-negative (95% CI = 1.44–1.95, P < 0.0001). The results were similar when groups of patients with a different stage of liver disease (patients with chronic liver disease, patients with cirrhosis), with different ethnicity (Asian and non-Asian) and etiology (HCV and non-HCV) were considered. The risk of HCC was significantly higher in the 651 anti-HBs/anti-HBc-positive patients (RR = 1.36; 95% CI = 1.17–1.58, P = 0.03) and in the 595 anti-HBs-negative/anti-HBc-positive subjects (RR = 2.15; 95% CI = 1.58–2.92, P < 0.0001) than in the 1242 anti-HBs/anti-HBc negative. However, the RR from 8 studies indicated that the risk of HCC was 35% lower among the anti-HBs/anti-HBc-positive subjects compared to the anti-HBs-negative/anti-HBc-positive (RR = 0.65; 95% CI = 0.52–0.8, P < 0.0001). This meta-analysis shows that in HBsAg-negative subjects with chronic liver disease, anti-HBc positivity is strongly associated with the presence of HCC, an association observed in all subgroups according to the stage of the disease

  5. Responses to hepatitis B vaccine in isolated anti-HBc positive adults.

    PubMed

    Yao, Jun; Ren, Wen; Chen, Yongdi; Jiang, Zhenggang; Shen, Lingzhi; Shan, Huan; Dai, Xuewei; Li, Jing; Liu, Ying; Qiu, Yan; Ren, Jingjing

    2016-07-02

    Immune responses of isolated anti-HBc subjects are not well characterized in populations in China. This study aimed to evaluate immune responses to hepatitis B vaccination in isolated anti-HBc positive subjects. A cohort of 608 subjects were selected and separated into isolated anti-HBc (negative for HBsAg and anti-HBs, positive for anti-HBc) and control (negative for HBsAg, anti-HBs, and anti-HBc) groups, who were matched by age and sex. All subjects received 3 doses of hepatitis B vaccine (20μg) at months 0, 1, and 3, followed by testing for serological responses 1 month after the third vaccination. The positive seroprotection rate and geometric mean titer (GMT) for hepatitis B surface antibody (anti-HBs) of isolated anti-HBc subjects were significantly lower than those in the control group(86.2% vs.92.1%, P = 0.02; 47.26 vs.97.81 mIU/mL, P < 0.001). When stratified by age, positive seroprotection rate in the isolated anti-HBc group were 92%, 88.5% and 79.4% in the 20-34, 35-49, and 50-60 y old subgroups, respectively (χ2 = 5.919, P = 0.04). Additionally, the GMT level for anti-HBs in the isolated anti-HBc group for different age subgroups were 104.43, 47.87 and 31.79 mIU/mL respectively (χ2 = 19.44, P < 0.001). The GMT level for anti-HBc before vaccination were negatively correlated with GMT for anti-HBs after 3 doses of hepatitis B vaccine (r = -0.165, P < 0.001). In conclusion, isolated anti-HBc positive subjects can achieve good immune responses after hepatitis B vaccination, and the positive seroprotection rate and GMT level for anti-HBs were lower than the control group. Better responses could be observed in young adults, and significant negative correlations were found between GMT of anti-HBc before vaccination and GMT of anti-HBs after vaccination.

  6. Characterisation and follow-up study of occult hepatitis B virus infection in anti-HBc-positive qualified blood donors in southern China

    PubMed Central

    Ye, Xianlin; Li, Tong; Xu, Xiaoxuan; Du, Peng; Zeng, Jinfeng; Zhu, Weigang; Yang, Baocheng; Li, Chengyao; Allain, Jean-Pierre

    2017-01-01

    Background Most major Chinese blood centres look for hepatitis B surface antigen (HBsAg) and perform nucleic acid testing to screen blood for hepatitis B virus infection. The search for antibodies to the core of hepatitis B virus (anti-HBc) has not been implemented because it would lead to a high rate of discarded blood units. The aim of this study was to evaluate the prevalence of occult HBV infection among anti-HBc-positive qualified blood donors in southern China. Materials and methods We tested anti-HBc-positive blood donations negative for HBsAg and HBV DNA by standard NAT from Shenzhen for the presence of HBV DNA by sensitive nested and quantitative polymerase chain reactions. Anti-HBs titres were quantified. HBV DNA-positive donors were traced and followed-up. Results Of the 1,033 qualified donors, 47.4% (95% CI: 44.4 to 50.5%) carried anti-HBc as evidence of exposure to HBV. The rate of anti-HBc positivity increased steadily with age, ranging from 32.6% in the age group <30 years to 69.8% in the age group <50 years (p<0.001). Of the 1,033 donors, 777 (75.2%; 95% CI: 72.4 to 77.8%) carried anti-HBs (>10 IU/L). HBV DNA was detected in 14 donors who were anti-HBc-positive, HBsAg-negative and negative by routine NAT. Seven of those 14 specimens had an anti-HBs titre above 100 mIU/mL. The prevalence of OBI in anti-HBc-positive qualified blood donors was 2.86% (95% CI: 1.57 to 4.75%). Eight of the 14 OBI cases were genotype B and one was genotype C; 7/14 cases were followed-up, one case converted to anti-HBe. HBV DNA became undetectable in all follow-up samples. Discussion A small proportion of anti-HBc-positive qualified donors carry HBV DNA after HBsAg and NAT screening. This finding suggests the possibility of HBV transmission from asymptomatic donors, especially in areas of high HBV prevalence. More sensitive NAT rather than anti-HBc testing should be considered to improve blood safety. PMID:27416568

  7. Persistent risk of HBV reactivation despite extensive lamivudine prophylaxis in haematopoietic stem cell transplant recipients who are anti-HBc-positive or HBV-negative recipients with an anti-HBc-positive donor.

    PubMed

    Cerva, C; Colagrossi, L; Maffongelli, G; Salpini, R; Di Carlo, D; Malagnino, V; Battisti, A; Ricciardi, A; Pollicita, M; Bianchi, A; Picardi, A; Cudillo, L; Cerretti, R; De Angelis, G; Cantonetti, M; Andreoni, M; Perno, C F; Arcese, W; Svicher, V; Sarmati, L

    2016-11-01

    The overall rate of hepatitis B virus (HBV) reactivation was evaluated in a population of 373 haematological stem cell transplant (HSCT) patients treated with lamivudine (LMV) if they were anti-HBc-positive/HBV-DNA-negative recipients or if they were HBV-negative recipients with an anti-HBc-positive donor. The incidence of HBV reactivation was calculated in two groups of autologous (auto) or allogeneic (allo) HSCT patients who were stratified according to their HBV serostatus. The former group included 57 cases: 10 auto-HSCT and 27 allo-HSCT anti-HBc-positive recipients, two auto-HSCT and three allo-HSCT inactive carriers, and 15 allo-HSCT recipients with an anti-HBc-positive donor. Forty-seven (82.4%) patients in this group received LMV prophylaxis (the median (interquartile range, IQR) of LMV treatment was 30 (20-38) months). The second group consisted of 320 anti-HBc-negative auto-HSCT and allo-HSCT recipients with anti-HBc-negative donors. None of these patients received any prophylaxis. Two patients in the first group and two in the second group experienced reactivation of HBV infection, with an incidence of 3.5% (95% CI 0.4-12.1%) and 0.6% (95% CI 0.1-2.2%), respectively. Only one out of four reactivated patients was LMV-treated. The cumulative probability of HBV reactivation at 6 years from HSCT was 15.8% (95% CI 15.2-16.4%). Three of four viral isolates obtained from the HBV-reactivated patients harboured mutations in the immune-active HBsAg-region. In a HSCT population carefully evaluated for HBV prophylaxis, a risk of HBV reactivation persisted in the group of patients who were not LMV-treated. Only one LMV-treated patient experienced reactivation of HBV with a resistant HBV isolate.

  8. Can HB vaccine yield a booster effect on individuals with positive serum anti-HBs and anti-HBc markers ?

    PubMed Central

    Wang, Ru-Xiang; Guo, Ying; Yang, Chang-Hong; Song, Yu; Chen, Juan; Pang, Fu-Sheng; Lei, Shao-Ping; Jia, Xiao-Ming; Wen, Jin-Ying; Shi, Christina Y.

    2004-01-01

    AIM: To evaluate if HB vaccination can yield a booster effect on the anti-HBs level of those naturally acquired HBV positive markers. METHODS: Sera were collected from 1399 newly enrolled university students aged between 18-20 years at the entrance medical examination in 2001. Forty-four students (28 males and 16 females) with positive serum anti-HBs and anti-HBc markers served as an observation group and another 44 students (24 males and 20 females) without any HBV markers as the control. HB vaccination was given to all the students without positive serum HBsAg according to 0, 1, 6 month regimen and the peripheral venous blood was sampled from those of both observation and control groups for anti-HBs detection one month after the second and third doses. Anti-HBs levels were measured by ELISA. RESULTS: The seroconversion rate of anti-HBs in the control group was 100% after the second dose, but the geometric mean titers (GMTs) were low. The tendency of serum anti-HBs changes after the 3rd dose was completely different between the two groups. Although more than half of those with positive anti-HBs and anti-HBc showed a mild increase of anti-HBs levels after the 2nd boosting dose (mean anti-HBs level was 320:198 mIU), but the increase of serum anti-HBs titer was much smaller than that in the control group. The averages of their initial serum anti-HBs levels and the levels after the 2nd and 3rd doses were 198, 320 and 275 mIU respectively. All the subjects from the control group had an obvious increase in their serum anti-HBs levels which was nearly 4 times the baseline level (302:78 mIU). CONCLUSION: HB vaccination can not enhance anti-HBs levels in those with positive serum anti-HBs and anti-HBc markers. PMID:14716846

  9. No evidence of hepatitis B virus activity in patients with anti-HBc antibody positivity with or without anti-hepatitis C virus antibody positivity.

    PubMed

    Haushofer, Alexander C; Hauer, René; Brunner, Harald; Köller, Ursula; Trubert-Exinger, Doris; Halbmayer, Walter-Michael; Koidl, Christoph; Kessler, Harald H

    2004-04-01

    The serological pattern of anti-HBc antibody positivity without both, HBsAg and anti-HBs antibody positivity may be present in up to 4% of the population of Europe and the United States. The aim of the present study was to determine the hepatitis B virus (HBV) activity by detection of serum HBV DNA in patients with anti-HBc antibody positivity only and with confirmed anti-hepatitis C virus (anti-HCV) antibody positivity or without anti-HCV antibody positivity. A total of 141 patients positive for anti-HBc antibodies only, were investigated on serum HBV DNA load. Patients were classified into two groups: patients with confirmed positive anti-HCV antibodies (group 1) and patients without anti-HCV antibodies (group 2). Demographic data of patient groups were similar. In 66 of 70 patients with anti-HBc antibodies and anti-HCV antibodies (group 1), serum HCV RNA was detected; the remaining 4 patients were HCV RNA negative but the presence of anti-HCV antibodies was confirmed by the line probe assay. In none of the patients, with anti-HBc antibodies and without anti-HCV antibodies (group 2), serum HCV RNA was detected. In none of the patients, serum HBV DNA was detected. In this study, serum HBV DNA could not be detected in patients with anti-HBc antibodies only. There seems to be no need for determination of serum HBV DNA in patients without clinical evidence of chronic liver disease. Nevertheless, it would be useful to test patients with progressive liver disease and those, which belong to high-risk groups such as hemophiliacs, intravenous drug abusers, patients on hemodialysis, and immunocompromised patients.

  10. Clinical course and core variability in HBV infected patients without detectable anti-HBc antibodies.

    PubMed

    Anastasiou, Olympia E; Widera, Marek; Verheyen, Jens; Korth, Johannes; Gerken, Guido; Helfritz, Fabian A; Canbay, Ali; Wedemeyer, Heiner; Ciesek, Sandra

    2017-08-01

    The presence of anti-HBc antibodies indicates direct encounter of the immune system with hepatitis B virus (HBV). Aim of our study was to seek for anti-HBc negative but HBV replicating patients and analyze their clinical course and preconditions. From 1568 HBV-DNA positive patients, 29 patients (1.85%) tested negative for anti-HBc. The absence of anti-HBc could be confirmed in 19 patients using an alternative assay. In 16 of 19 cases, a partial or full HBV genome analysis was performed with NGS sequencing to evaluate if specific mutations were associated with anti-HBc absence. As a control group samples from 32 matched HBV infected patients with detectable anti-HBc were sequenced. Patients with detectable HBV-DNA and sequenced HBV core region in the confirmed absence of anti-HBc were diagnosed with acute HBV infection (n=3), HBV reactivation (n=9) and chronic hepatitis B (n=4). Most patients (12/16) were immunosuppressed: 3/16 patients had an HIV coinfection, 7/16 patients suffered from a malignant disease and 4/16 patients underwent solid organ transplantation (from which 2/4 had a malignant disease). Compared to the control cohort, HBV variants from anti-HBc negative patients showed less variability in the core region. In the absence of anti-HBc, HBV-DNA was most often found in immunocompromised hosts. Distinct mutations or deletions in the core region did not explain anti-HBc negativity. It would be advisable not to rely only on a single result of anti-HBc negativity to exclude HBV infection in immunocompromised hosts, but to measure anti-HBc repeatedly or with different methods. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. Frequency of HBV DNA detection in US blood donors testing positive for the presence of anti-HBc: implications for transfusion transmission and donor screening.

    PubMed

    Kleinman, Steven H; Kuhns, Mary C; Todd, Deborah S; Glynn, Simone A; McNamara, Anne; DiMarco, Anthony; Busch, Michael P

    2003-06-01

    An estimate of the rate of HBV DNA-positive, anti-HBc-positive units is important for evaluating the need for anti-HBc donor screening, especially in the context of HBV NAT. HBsAg EIA-nonreactive, anti-HBc-reactive (Corzyme, Abbott Laboratories) specimens were retrieved from a repository and were retested for anti-HBc (with PRISM HBcore, Abbott Laboratories, currently under FDA review) and anti-HBs (with PRISM Ausab, Abbott Laboratories, research assay). HBV DNA testing using a PCR assay with a greater than 95 percent detection rate of less than 50 copies per mL was performed on a subset of specimens that were PRISM HBcore-reactive and were anti-HBs- negative or reactive at less than 100 IU per L. A total of 395 of 1231 specimens eligible by our serologic criteria were tested by PCR. Four anti-HBs-negative specimens were PCR-positive with estimated HBV DNA copy numbers of 10 per 30 copies per mL in two specimens and 50 to 100 copies per mL in two others. The HBV DNA detection rate in anti-HBs-negative specimens was 3.7 percent, and the projected rate among all Corzyme-reactive specimens was 0.24 percent, leading to an estimated yield of 1 HBV DNA-positive, anti-HBc-positive unit in 49,000 units that were otherwise eligible for transfusion (95% CI, 1 in 16,600-1 in 152,600). Anti-HBc screening detects HBsAg EIA-negative, HBV-infected donors at a rate comparable to the estimated residual risk for HBV window-period infections. The low viral load in the HBV DNA-positive samples suggests that minipool NAT will not detect most potentially infectious units from anti-HBc-positive donors.

  12. HBV vaccination of HCV-infected patients with occult HBV infection and anti-HBc-positive blood donors.

    PubMed

    Pereira, J S F; Gonçales, N S L; Silva, C; Lazarini, M S K; Pavan, M H P; Fais, V C; Gonçales Júnior, F L

    2006-04-01

    Anti-HBc positivity is a frequent cause of donation rejection at blood banks. Hepatitis B virus (HBV) infection may also occur in HBsAg-negative patients, a situation denoted occult infection. Similarly, very low levels of HBV-DNA have also been found in the sera of patients with chronic hepatitis C virus (HCV) infection, even in the absence of serum HBsAg. Initially we searched for HBV-DNA in serum of 100 blood donors and 50 HCV-infected patients who were HBsAg negative/anti-HBc positive by nested-PCR and by an HBV monitor commercial test for HBV-DNA. Anti-HBs seroconversion rates were measured in 100 blood donors and in 22 patients with chronic HCV infection after HBV vaccination to determine if the HBV vaccination could eliminate an occult HBV infection in these individuals. Occult HBV infection was detected in proportionally fewer blood donors (6/100 = 6%) than chronic hepatitis C patients (12/50 = 24%) (P < 0.05). We noted seroconversion in 6/6 (100%) HBV-DNA(+) and in 84/94 (89.4%) HBV-DNA(-) blood donors (P > 0.05). All subjects who were HBV-DNA(+) before the first dose of HBV vaccine (D1), became HBV-DNA(-) after D1, D2, and D3. Among 22 HCV-positive patients, 10 HBV-DNA(+) and 12 HBV-DNA(-), seroconversion was observed in 9/10 (90%) HBV-DNA(+) and in 9/12 (75%) HBV-DNA(-) subjects (P > 0.05). The disappearance of HBV-DNA in the majority of vaccinated patients suggests that residual HBV can be eliminated in patients with occult infection.

  13. The underlying mechanisms for the 'anti-HBc alone' serological profile.

    PubMed

    Pondé, R A A; Cardoso, D D P; Ferro, M O

    2010-02-01

    The serological pattern, "anti-HBc alone", characterized by the presence of antibodies against the core antigen of hepatitis B virus (anti-HBc) as the only marker of hepatitis B, is not rare in a diagnostic setting. Depending on the prevalence of HBV infection and the patient group investigated, 1-31% of positive anti-HBc results are isolated positive findings. Anti-HBc alone is frequently observed in intravenous drug addicts, HIV-infected individuals, patients who are coinfected with HBV and hepatitis C virus, and pregnant women. However, it is not clear how this profile should be interpreted. Several studies have shown that anti-HBc alone is not only compatible with acute and resolved HBV infection but also with chronic infection. The reasons for the lack of HBsAg and anti-HBs in anti-HBc-alone individuals are not clear, but several mechanisms and possibilities have been suggested that could explain this phenomenon, some of which are delineated in this article.

  14. Randomized prospective study evaluating tenofovir disoproxil fumarate prophylaxis against hepatitis B virus reactivation in anti-HBc-positive patients with rituximab-based regimens to treat hematologic malignancies: The Preblin study

    PubMed Central

    Buti, María; Manzano, María L.; Morillas, Rosa M.; García-Retortillo, Montserrat; Martín, Leticia; Prieto, Martín; Gutiérrez, María L.; Suárez, Emilio; Gómez Rubio, Mariano; López, Javier; Castillo, Pilar; Rodríguez, Manuel; Zozaya, José M.; Simón, Miguel A.; Morano, Luis E.; Calleja, José L.; Esteban, Rafael

    2017-01-01

    Background Hepatitis B virus (HBV) reactivation in patients with resolved HBV infection (HBsAg negative, antiHBc positive) is uncommon, but potentially fatal. The role of HBV prophylaxis in this setting is uncertain. The aim of this study was to compare the efficacy of tenofovir disoproxil fumarate (TDF) prophylaxis versus close monitoring in antiHBc-positive, HBsAg-negative patients under treatment with rituximab (RTX)-based regimens for hematologic malignancy. Methods PREBLIN is a phase IV, randomized, prospective, open-label, multicenter, parallel-group trial conducted in 17 hospitals throughout Spain. Anti-HBc-positive, HBsAg-negative patients with undetectable HBV DNA were randomized to receive TDF 300 mg once daily (Group I) or observation (Group II). The primary endpoint was the percentage of patients showing HBV reactivation during 18 months following initiation of RTX treatment. Patients with detectable HBV DNA (Group III) received the same dose of TDF and were analyzed together with Group I to investigate TDF safety. Results Sixty-one patients were enrolled in the study, 33 in the TDF treatment group and 28 in the observation group. By ITT analysis, HBV reactivation was 0% (0/33) in the study group and 10.7% (3/28) in the observation group (p = 0.091). None of the patients in either group showed significant differences in liver function parameters between baseline and the last follow-up sample. TDF was generally well tolerated and there were no severe treatment-related adverse events. Conclusion In patients with hematological malignancy and resolved hepatitis B infection receiving RTX-based regimens, HBV reactivation did not occur in patients given TDF prophylaxis. PMID:28898281

  15. The influence of anti-HBc status on the sustained virological response rate in HCV-infected patients treated with pegylated interferon alfa 2 and ribavirin

    PubMed Central

    Simon, Krzysztof A; Serafińska, Sylwia; Janocha-Litwin, Justyna; Pazgan-Simon, Monika; Madej, Grzegorz

    2016-01-01

    Aim of the study To determine the influence of HBsAg and HBeAg negative but anti-HBc positive status on the sustained virological response (SVR) rate in HCV-infected patients treated with pegylated interferon alfa 2 (Peg-IFNα-2) and ribavirin (RBV). Material and methods The study was based on the retrospective analysis of medical records of HCV-infected patients who started Peg-IFNα and RBV treatment between 1 January 2011 and 31 December 2013 at the 1st and 2nd Department of Infectious Diseases of the Regional Hospital in Wrocław, Poland. Results Among 240 patients included in the analysis 99 were anti-HBc positive and 141 anti-HBc negative. In the genotype 1, anti-HBc positive group the SVR rate was 47% and in the anti-HBc negative group it was 42.7% (p = 0.591). In the genotype 3, anti-HBc positive group the SVR rate was 60% and in anti-HBc negative patients it was 63.2% (p = 0.79). Differences in SVR rates between anti-HBc positive and negative groups were not statistically significant. None of the anti-HBc positive patients developed reactivation of HBV infection during or in the 24 weeks following the end of treatment. Conclusions Anti-HBc determination does not seem to be useful in predicting treatment outcome of conventional Peg-IFNα/RBV therapy in patients infected with HCV genotypes 1 and 3. PMID:28856281

  16. Detection of antibodies to hepatitis B core antigen using the Abbott ARCHITECT anti-HBc assay: analysis of borderline reactive sera.

    PubMed

    Ollier, Laurence; Laffont, Catherine; Kechkekian, Aurore; Doglio, Alain; Giordanengo, Valérie

    2008-12-01

    Routine use of the automated chemiluminescent microparticle immunoassay Abbott ARCHITECT anti-HBc for diagnosis of hepatitis B is limited in case of borderline reactive sera with low signal close to the cut-off index. In order to determine the significance of anti-HBc detection when borderline reactivity occurs using the ARCHITECT anti-HBc assay, a comparative study was designed. 3540 serum samples collected over a 2-month period in the hospital of Nice were examined for markers of HBV infection (HBsAg, anti-HBs and anti-HBc). One hundred seven samples with sufficient volume and with borderline reactivity by the ARCHITECT assay were tested by two other anti-HBc assays, a microparticle enzyme immunoassay (MEIA, AxSYM Core, Abbott Laboratories, IL, USA) and an enzyme linked fluorescent assay (ELFA, VIDAS Anti-HBc Total II, bioMérieux, Lyon, France). Only 46 samples were confirmed by the AxSYM and the VIDAS assays. Additional serological information linked to patient history showed that the remaining samples (61) were false positives (11), had low titer of anti-HBc antibodies (13), or were inconclusive (37). This comparative study highlighted the existence of a grey zone around the cut-off index. Confirmative results through a different immunoassay are needed to confirm the diagnosis of HBV on borderline reactive sera using the ARCHITECT anti-HBc assay.

  17. Late hepatitis B virus reactivation after lamivudine prophylaxis interruption in an anti-HBs-positive and anti-HBc-negative patient treated with rituximab-containing therapy.

    PubMed

    Ceccarelli, Laura; Salpini, Romina; Sarmati, Loredana; Svicher, Valentina; Bertoli, Ada; Sordillo, Pasquale; Ricciardi, Alessandra; Perno, Carlo Federico; Andreoni, Massimo; Sarrecchia, Cesare

    2012-08-01

    We describe a case of an anti-HBs-positive patient who experienced hepatitis B reactivation 18 months after the discontinuation of rituximab and after 12 months of lamivudine prophylaxis. The patient carried a hepatitis B genotype D virus harbouring a single immune escape mutation, sT118K. No consensus guidelines regarding the optimal length of treatment or the best elective drug have been defined for antiviral prophylaxis for HBsAg-negative, anti-HBc- and/or anti-HBs-positive patients undergoing immunosuppressive treatment. Screening based on HBV serological markers and HBV DNA testing is a critical issue to recognise hepatitis B reactivation as early as possible. Furthermore, it is of outstanding importance to identify alternative markers (e.g. cccDNA, HBV core related antigen, etc.), that could be predictive of HBV reactivation.

  18. Presence of anti-HBc is associated to high rates of HBV resolved infection and low threshold for Occult HBV Infection in HIV patients with negative HBsAg in Chile.

    PubMed

    Vargas, Jose Ignacio; Jensen, Daniela; Sarmiento, Valeska; Peirano, Felipe; Acuña, Pedro; Fuster, Felipe; Soto, Sabrina; Ahumada, Rodrigo; Huilcaman, Marco; Bruna, Mario; Jensen, Werner; Fuster, Francisco

    2016-04-01

    HBV-HIV coinfection is prevalent. Frequently, anti-HBc is the only serological marker of HBV, which can be indicative of HBV resolved infection, when found together with anti-HBs reactivity; or present as "isolated anti-HBc," related to HBV occult infection with presence of detectable DNA HBV, more prevalent in HIV-positive individuals. Regional data about this condition are scarce. Anti-HBc rapid test has been used as screening, but its performance has not been described in HIV-positive patients. The aim of this study was determine prevalence of anti-HBc in HIV-positive patients, serological pattern of HBV resolved infection and isolated anti-HBc, evaluating presence of HBV occult infection. Assess anti-HBc rapid test compared to ECLIA. Methods included measurement of anti-HBc and anti-HBs in HIV-positive patients with negative HBsAg. Serum HBV DNA quantification and HBV booster vaccination to "isolated anti-HBc" individuals. Detection of anti-HBc by rapid test and ECLIA. In 192 patients, prevalence of anti-HBc was 42.7% (82/192); associated to male gender, drug use, men-sex-men, positive-VDRL, and longer time HIV diagnosis. 34.4% (66/192) had presence of anti-HBs, mean titers of 637 ui/ml. Isolated anti-HBc in 8.3% (16/192), associated to detectable HIV viral load and no-use of HAART; in them, HBV DNA was undetectable, and 60% responded to HBV vaccination booster. Anti-HBc rapid test showed low sensibility (32.9%) compared to ECLIA. These results show that prevalence of anti-HBc in HIV-positive individuals is high, in most cases accompanied with anti-HBs as HBV resolved infection. Low prevalence of "isolated anti-HBc," with undetectable HBV DNA, and most had anamnestic response to HBV vaccination; suggest low possibility of occult HBV infection. Anti-HBc rapid test cannot be recommended as screening method for anti-HBc.

  19. [Investigation of HBV-DNA using the polymerase chain reaction (PCR) in HBsAg-negative, anti-HBc-positive Venezuelan donors].

    PubMed

    León, G; López, J L; Maio, A; García, L; Quiroz, A M

    1999-10-01

    In our Center the disposal of blood with HBV positive markers is approximately 6%, being 90% AgsHB negative and anti HBc positive. With the purpose of knowing the infected capacities of these donations and to consider the possibility of using them for transfusion, the presence of the viral genoma was investigated by PCR, in a group of samples with these characteristics that were also anti sHB positive. They were correlated with the readings of the anti cHB total, with the anti cHB-IgM and with the titration of the anti sHB. 87/100 random samples, from February to June 1996, were frozen at -30 degrees C for their later evaluation. In the serological screening were used Auszyme Monoclonal of Abbott and the Heprofile anti cHB, ADI-Diagnostic. The readings of the anti cHB was considered strong, moderate or weak according to its distance to the cut off. For the determination of the anti sHB, Hepanostika anti sHB, Organon Technika was used. They were considered with low titers (< 10 UI/L), high (> or = 10 UI/L) and very high (> or = 100 UI/L). In the determination of the anti cHB-IgM, Heprofile ADI-Diagnostic was used. For the investigation of the viral genoma, it was carried out with double PCR-ADN, using two internal and two external primers for the core-precore region. 70/87 (80.45%) of the samples presented high readings of anti cHB with high titers of anti sHB, being positive for anti cHB-IgM seven of them and one was HBV-ADN positive (1.42%) suggesting the possibility to be cronic carrier. In the remaining 19.55% of the samples we didn't detect positive results in the amplification assays. 1. The donors showed high levels of immunocompetence. 2. High titer of anti sHB doesn't guarantee the absence of viral genoma and therefore the absence of infectivity can not be sure. This doesn't allow us to come in like donors neither to use their blood in the transfusional therapy.

  20. Anti-HBc & HBV-DNA detection in blood donors negative for hepatitis B virus surface antigen in reducing risk of transfusion associated HBV infection.

    PubMed

    Behzad-Behbahani, A; Mafi-Nejad, A; Tabei, S Z; Lankarani, K B; Torab, A; Moaddeb, A

    2006-01-01

    Though sensitive screening assays for detection of hepatitis B virus surface antigen (HBsAg) are available, occasional cases of post-transfusion hepatitis B virus infection (PTH) still occur. The present study was undertaken to assess the prevalence of anti-hepatitis B core (anti-HBc) positivity and presence of HBV-DNA in serum sample of healthy blood donors negative for both HBsAg and anti-HCV antibody in Shiraz, Iran. Since anti-HBc detection is not mandatory in Iran, we evaluated whether anti-HBc detection could be adopted as a screening assay for safety of donated blood. Two thousands serum samples negative for both HBsAg and anti-HCV collected from healthy blood donors were tested for the presence of anti HBc antibody. All samples positive for anti-HBc antibody were then investigated for determination of anti-HBc titre, anti-HBs titre, HbeAg and anti-HBe antibody by enzyme immunoassay (EIA). Every sample that tested negative for HBsAg but positive for anti-HBc alone or in combination with other serological markers was also examined for the presence of HBV-DNA by polymerase chain reaction (PCR). Of the 2000 samples tested, 131 (6.55%) blood samples were found to be positive for anti- HBc. HBV DNA was detected among 16 of 131(12.2%) anti-HBc positive specimens. Further, there was an association between the titration of anti-HBc antibody and the intensity of expected PCR product band. The liver function test results were all in normal range except in 4 of 16 HBV-DNA positive subjects. The mean levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in HBV-PCR positive subjects were 14 IU/l and 23.7 IU/l respectively. Anti-HBc antibody should be tested routinely on blood donors volunteers and if the sample found positive regardless of anti-HBs titre, the blood should be discarded. Further testing for HBV-DNA would be appropriate to follow up the donor for HBV infection.

  1. Clinical and virological factors associated with hepatitis B virus reactivation in HBsAg-negative and anti-HBc antibodies-positive patients undergoing chemotherapy and/or autologous stem cell transplantation for cancer.

    PubMed

    Borentain, P; Colson, P; Coso, D; Bories, E; Charbonnier, A; Stoppa, A M; Auran, T; Loundou, A; Motte, A; Ressiot, E; Norguet, E; Chabannon, C; Bouabdallah, R; Tamalet, C; Gérolami, R

    2010-11-01

    We studied clinical outcome and clinico-virological factors associated with hepatitis B virus reactivation (HBV-R) following cancer treatment in hepatitis B virus surface antigen (HBsAg)-negative/anti-hepatitis B core antibodies (anti-HBcAb)-positive patients. Between 11/2003 and 12/2005, HBV-R occurred in 7/84 HBsAg-negative/anti-HBcAb-positive patients treated for haematological or solid cancer. Virological factors including HBV genotype, core promoter, precore, and HBsAg genotypic and amino acid (aa) patterns were studied. Patients presenting with reactivation were men, had an hepatitis B virus surface antibody (HBsAb) titre <100 IU/L and underwent >1 line of chemotherapy (CT) significantly more frequently than controls. All were treated for haematological cancer, 3/7 received haematopoietic stem cell transplantation (HSCT), and 4/7 received rituximab. Using multivariate analysis, receiving >1 line of CT was an independent risk factor for HBV-R. Fatal outcome occurred in 3/7 patients (despite lamivudine therapy in two), whereas 2/4 survivors had an HBsAg seroconversion. HBV-R involved non-A HBV genotypes and core promoter and/or precore HBV mutants in all cases. Mutations known to impair HBsAg antigenicity were detected in HBV DNA from all seven patients. HBV DNA could be retrospectively detected in two patients prior cancer treatment and despite HBsAg negativity. HBV-R is a concern in HBsAg-negative/anti-HBcAb-positive patients undergoing cancer therapy, especially in males presenting with haematological cancer, a low anti-HBsAb titre and more than one chemotherapeutic agent. HBV DNA testing is mandatory to improve diagnosis and management of HBV-R in these patients. The role of specific therapies such as rituximab or HSCT as well as of HBV aa variability deserves further studies. © 2009 Blackwell Publishing Ltd.

  2. Lack of correlation between HBsAg and HBV DNA levels in blood donors who test positive for HBsAg and anti-HBc: implications for future HBV screening policy.

    PubMed

    Kuhns, Mary C; Kleinman, Steven H; McNamara, Anne L; Rawal, Bhupat; Glynn, Simone; Busch, Michael P

    2004-09-01

    Studies showing a significant correlation between hepatitis B surface antigen (HBsAg) and hepatitis B virus (HBV) deoxyribonucleic acid (DNA) levels have focused on the HBV seroconversion window period. HBsAg levels relative to HBV DNA results in 200 HBsAg-positive, anti-hepatitis B core antigen (HBc)-reactive blood donations were analyzed using quantitative polymerase chain reaction (PCR) (detection limit 400 copies/mL), two research PCR assays with increasing sensitivities (65 copies/mL and 1.3 copies/mL, respectively), and a quantitative HBsAg assay; HBsAg and HBV DNA levels were correlated with HBV serologic profiles; and the potential for replacing HBsAg screening with nucleic acid testing (NAT) was analyzed. Serologic profiles for over 90 percent of the donor samples were consistent with chronic HBV infection. Correlation between HBsAg and HBV DNA concentrations was weak (correlation coefficient = 0.33). Thirty-six percent (72/200) of donor samples had DNA levels under 400 copies per mL. Retesting of the 72 samples by more sensitive PCR assays showed that 60 out of 200 (30%) were positive by PCR with sensitivity of 65 copies per mL, whereas 6 out of 200 (3%) required PCR sensitivity of 1.3 copies per mL for positivity. Three percent (6/200) were negative by all three NAT assays. HBV DNA levels in HBsAg-positive, anti-HBc-reactive blood donations can be extremely low. About 6 percent of donations would be negative by current minipool HBV NAT methods. About 3 percent of donations would remain undetected by sensitive single-donor NAT. These results indicate caution in any consideration of dropping HBsAg screening.

  3. Risks and treatment strategies for de novo hepatitis B virus infection from anti-HBc-positive donors in pediatric living donor liver transplantation.

    PubMed

    Dong, Chong; Gao, Wei; Ma, Nan; Sun, Chao; Zheng, Wei-Ping; Wang, Kai; Shen, Zhong-Yang

    2017-03-01

    The aim of this study was to analyze the incidence and risk factors of de novo HBV infection in pediatric patients receiving living donor liver transplants (LDLT) from HBcAb-positive donors, and to explore its treatment strategies. The data of 101 pediatric recipients receiving LDLT in Tianjin First Central Hospital between September 2006 and December 2012 were retrospectively analyzed. The HBV markers were regularly tested before and after the surgery, including HBsAb, HBsAg, HBeAg, HBeAb, and HBcAb. The median follow-up period was 25.6 months, during which eight cases (7.92%) were diagnosed with de novo HBV infection. Forty-four (43.6%) of the children received HBcAb-positive allografts. The rate of de novo HBV in the children that received HBcAb+ livers vs those received HBcAb- livers was 15.9% (7/44) vs 1.7% (1/57) (P=.037). The rates of de novo HBV in the children who received HBcAb-positive allografts were significantly less than in those that received preventative therapy with HBIG and lamivudine treatment (2/31, 6.4%) vs those that did not (5/13, 38.5%) (P<.01). HBcAb-positive liver donors are strongly associated with de novo HBV in HBsAg-negative pediatric patients receiving LDLT. However, the incidence of de novo HBV infection is significantly less with the use of prophylactic treatment strategies. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  4. Reactivation of occult hepatitis B virus infection following cytotoxic lymphoma therapy in an anti-HBc negative patient.

    PubMed

    Feeney, Susan A; McCaughey, Conall; Watt, Alison P; Agnaf, Moulod R El; McDougall, Neil; Wend, Ulrike C; Gerlich, Wolfram H; Coyle, Peter V

    2013-04-01

    Screening hepatitis B virus (HBV) surface antigen (HBsAg) and HBV core antibody (anti-HBc) is recommended prior to cytotoxic or immunosuppressive therapy. This case describes an anti-HBc negative, DNA positive occult HBV infection in a 71-year-old Caucasian male following rituximab-based treatment for follicular lymphoma. Pre-screening serology indicated negative HBsAg and anti-HBc. However, following sequential treatment cycles the patient developed weak HBsAg with a low HBV DNA load (<1,000 IU/ml), but remained anti-HBc negative. The DNA load peaked 5 months later (>1 × 10(6)  IU/ml) and he was subsequently treated with Tenofovir. Currently the patient remains anti-HBc negative, and is anti-HBe negative, anti-HBs negative, HBeAg positive. No clinical or biochemical evidence of hepatitis has occurred. Sequencing and phylogenetic analysis identified the HBV genosubtype as D4, most probably acquired some years ago during a stay in Papua New Guinea, in spite of prior hepatitis B vaccination. Four amino acid substitutions were detected within the HBsAg loop yet none in the core protein. This case questions the dependability of anti-HBc testing and highlights the role of HBV DNA testing prior to and throughout cytotoxic or immunosuppressive regimes. As this case exemplifies, vaccination protects against clinical infection but may not exclude seronegative occult infection with the possibility of reactivation. Copyright © 2013 Wiley Periodicals, Inc.

  5. Positive hepatitis B virus core antibody in HIV infection--false positive or evidence of previous infection?

    PubMed

    Pallawela, S N S; Sonnex, C; Mabayoje, D; Bloch, E; Chaytor, S; Johnson, M A; Carne, C; Webster, D P

    2015-02-01

    Isolated HBV core antibody (anti-HBc) is defined as the presence of anti-HBc with a negative HBV surface antigen (HBsAg) and HBV surface antibody (anti-HBs <10 IU/l). In patients infected with HIV with isolated anti-HBc, the aim was to determine: The prevalence of isolated positive anti-HBc; The most effective method of identifying which patients have had previous Hepatitis B Virus (HBV) infection; The prevalence of false positive anti-HBc. HBV serology results were identified from 539 patients infected with HIV sampled between January 2010 and December 2012. In those with an isolated anti-HBc and negative anti-HBe, a second anti-HBc test was carried out using a different assay. Samples were also screened for HBV DNA. The anti-retroviral regimens at time of screening were documented. 101/539 had an isolated anti-HBc. Of these, 32 (32%) had a positive anti-HBe (including 1 equivocal) and 69(68%) were anti-HBe negative. Of those negative for anti-HBe, 32 were tested for both DNA and a second anti-HBc. Of these 26 (81%) were on cART at time of HBV testing, with 25 (78%) on ART with anti-HBV activity. The prevalence of isolated anti-HBc was 19%. Only 32% were also anti-HBe positive, whereas 97% of those anti-HBe negative were positive on a second anti-HBc assay suggesting lack of utility of anti-HBe in resolving serological quandaries. One subject (3%) had a false positive anti-HBc. There was no evidence of chronic HBV but 78% patients were on HBV-suppressive combination anti-retroviral therapy.

  6. Hepatitis B Virus DNA in Blood Samples Positive for Antibodies to Core Antigen and Negative for Surface Antigen

    PubMed Central

    Gutiérrez, C.; León, G.; Loureiro, C. L.; Uzcátegui, N.; Liprandi, F.; Pujol, F. H.

    1999-01-01

    Anti-hepatitis B core antigen (HBcAg)-positive hepatitis B surface antigen (HBsAg)-negative plasma samples from blood donors were tested by nested PCR. DNA positivity was more significantly associated with high levels of anti-HBcAg than with low levels of anti-HBsAg antibodies. Analysis of a dilution of anti-HBcAg antibodies might result in a more rational exclusion of anti-HBcAg-positive HBsAg-negative samples, reducing the number of donations discarded and enabling more countries to incorporate anti-HBcAg testing. PMID:10473534

  7. Low hepatitis B prevalence among pre-school children in Denmark: saliva anti-HBc screening in day care centres.

    PubMed

    Fisker, Niels; Georgsen, Jørgen; Stolborg, Torsten; Khalil, Mohammed Rohi; Christensen, Peer Brehm

    2002-12-01

    Although Denmark has a low hepatitis B virus (HBV) prevalence, HBV transmission has been reported in Danish day-care centres. The aim of this study was to validate saliva anti-HBc testing as a method for HBV screening, the applicability of saliva sampling to pre-school children, and to determine the HBV prevalence in Danish day-care centres with a high proportion of immigrants. For validation, paired saliva and plasma samples were obtained from blood donors and injecting drug users. Employees and children in day-care centres with a high proportion of immigrant children were offered saliva screening followed by blood test if positive. The specificity and sensitivity of anti-HBc tests on saliva was 100% (102 blood donors and four injecting drug users) and 85.9% (61 of 71 anti-HBc-positive injecting drug users), respectively. In all samples from HBsAg (n = 7) or anti-HBc IgM-positives (n = 9), anti-HBc was detected in saliva. Adequate saliva samples were obtained from 93% (588/634) of children and 100% (166/166) of employees participating in the day-care centre survey. Among children 55% were of non-Scandinavian origin and only one (0.2%, 95% CI [0.0; 1.0]) was HBV positive. Among employees the corresponding values were 22% and 7 (4.2%). The positive predictive value of the saliva test was 25% (1/4) among children and 88% (7/8) among adults. In conclusion, saliva testing is feasible for HBV screening among children in low prevalence populations, but any anti-HBc reactivity should be confirmed by plasma analysis. The HBV prevalence in pre-school children in Denmark is low even among immigrants from endemic areas.

  8. [Prevalence of antibody against the hepatitis B core antigen (anti-HBc)among hospital personnel in Buenos Aires].

    PubMed

    Choc de Zanalda, B; Manterola, A C; Díaz Lestrem, M; Frider, B; Zocchi, G A; Fainboim, H; Clua, G I; Amor, E

    1990-01-01

    A group of 1,479 employees in 19 Buenos Aires hospitals were tested for antibody to hepatitis B core antigen (anti-HBc) to identify those who should be vaccinated against this infection. The average age of the subjects was 38.22 years; 70.86% of them were women and 85.5% were working in services where the risk of infection was high. The enzyme-linked immunosorbent assay (ELISA) was used, and the data were analyzed by the chi-square test. The results showed that 1,257 subjects (85.0%) did not have anti-HBc and thus were considered candidates for vaccination. The antibody was present in 222 individuals (15.0%). The prevalence of anti-HBc increased with age and with length of service, and it was greater in laboratory technicians, nurses, and those in high-risk services. These differences were statistically significant (P less than 0.01). A total of 23 carriers of hepatitis B surface antigen (AgHBs) were identified. In high-risk groups, vaccination against hepatitis B should be preceded by serological screening of susceptible individuals; the use of anti-HBc for this purpose allows carriers of AgHBs to be identified. The high prevalence of anti-HBc in laboratory technicians, nurses, and nurses' aides might justify their systematic vaccination.

  9. Anti-HBc Screening of Blood Donors in Bangladesh: Relevance to Containment of HBV Propagation.

    PubMed

    Jahan, Munira; Islam, Md Asadul; Akbar, Sheikh Mohammad Fazle; Takahashi, Kazuaki; Tabassum, Shahina; Rahman, Atiar; Haque, Md Atiqul; Biswas, Joly; Mishiro, Shunji; Al-Mahtab, Mamun

    2016-06-01

    To avoid further transmission of hepatitis B virus (HBV) infection, blood is tested for hepatitis B surface antigen (HBsAg) before transfusion. However, post-transfusion hepatitis B has been detected in clinics after transfusion of HBsAg-negative blood. The study presented here was undertaken to assess if HBsAg-negative blood is free from HBV or not. Sera were collected from 398 blood donors who were negative for HBsAg. Out of 398 blood samples, antibody to hepatitis B core antigen (ant-HBc) was detected in 82 sera samples. HBV DNA was evaluated in HBsAg-negative, anti-HBc-positive sera. HBsAg, hepatitis B e antigen (HBeAg), antibody to HBeAg (anti-HBe), and anti-HBc in the sera were measured by an enzyme-linked immunosorbent assay (ELISA). HBV DNA was quantified by a real time polymerase chain reaction (PCR). Out of 82 HBsAg-negative, anti-HBc-positive sera samples, HBV DNA were detected in the sera of 7 voluntary blood donors. Out of these 7 subjects, all were negative for HBeAg. The levels of ALT were more than 30 IU/L in 6 of 7 HBVDNA-positive subjects and it was above upper limit of normal (>42 IU/ml) in one subject. The present recommendation about blood transfusion of HBsAg-negative blood system is not capable of blocking HBV transmission to blood recipients. Although advanced countries have adopted nucleic acid testing (NAT) for preventing HBV transmission, developing countries may apply anti-HBc testing and ALT estimation before blood transmission.

  10. Frequency and significance of antibodies against hepatitis B core (anti-HBc) antigen as the only serological marker for hepatitis B infection in Lebanese blood donors.

    PubMed

    Ramia, S; Ramlawi, F; Kanaan, M; Klayme, S; Naman, R

    2005-08-01

    During a 2-year period, blood samples from 2505 Lebanese blood donors were chosen at random, at various periods of time at one blood donation centre (Hotel Dieu de France, Beirut, Lebanon) and were screened for markers of HBV infection (HBsAg, anti-HBc and anti-HBs). The study showed HBsAg positivity of 0.6% and an overall exposure rate to HBV of 10.0%. Out of the 2505 blood donors screened, 56 (22%) were found to be 'anti-HBc alone' positive which is almost four times the HBsAg positivity. The 56 'anti-HBc alone' samples were retested by another ELISA kit commercially available and 54 samples were 'anti-HBc alone' positive by both assays. The 54 samples had no serological markers as evidence of infection with human immunodeficiency virus (HIV) or hepatitis C virus (HCV). Only seven (13%) out of the 54 samples were HBV DNA positive by PCR and all were HBV genotype D. All seven HBV DNA-positive samples had HBV DNA levels below 400 copies/ml. Although any circulating HBV DNA among our 'anti-HBc alone' blood donors was below the detection limit of our Amplicor Monitor assay, some of these samples had circulating virus. A national study, where a larger number of blood donors from different blood donation centres across the country will perhaps determine whether screening for anti-HBc in addition to HBsAg detection is needed in Lebanese blood donors.

  11. Significance of anti-HBc only in blood donors: a serological and virological study after hepatitis B vaccination.

    PubMed

    Gessoni, Gianluca; Beggio, Samanta; Barin, Paolo; Favarato, Mosè; Galli, Claudio; Valverde, Sara; Nata, Massimo Boscolo; Salvadego, Maria Monica; Marchiori, Giorgio

    2014-01-01

    Blood donors positive only for anti-HBc may have a resolved hepatitis B virus (HBV) infection, low grade chronic infection or infection with variant strains of HBV. We aimed to assess the significance of this serological pattern after hepatitis B vaccination in such cases. Twenty-four anti-HBc only blood donors were vaccinated with the Engerix HBV vaccine and a serological and virological evaluation was performed before HBV vaccination and 7-10 days after each dose. Subjects were classified as non-responders if their anti-HBs levels stayed below 10 IU/L after full vaccination, while the response was considered secondary (anamnestic) if anti-HBs levels rose over 10 IU/L after the first vaccine dose, and primary if anti-HBs levels rose over 10 IU/L only after the second or third vaccine dose. Of the 21 fully evaluable donors, six had no response, eight showed a primary response and seven had an anamnestic response. One non-responder had transient positivity for HBV-DNA at low levels (12 IU/mL) with persistent negativity for HBsAg. Anti-HBc-only positive blood donors are a heterogeneous population including HBV naïve subjects with a likely false-positive anti-HBc reactivity, subjects with a resolved HBV infection, and subjects with persistent low-level HBV replication. The analysis of the anti-HBs response after a dose of HBV vaccine may help to distinguish among the different causes of the isolated anti-HBc positivity, thereby enabling proper counselling and potential readmission to blood donation.

  12. Hepatitis B virus DNA in blood donors with anti-HBc as a possible indicator of active hepatitis B virus infection in Yucatan, Mexico.

    PubMed

    García-Montalvo, B M; Farfán-Ale, J A; Acosta-Viana, K Y; Puerto-Manzano, F I

    2005-10-01

    Hepatitis B virus (HBV) may be present in serum even when negative for HBV surface antigen (HBsAg). If routine screening of sera for anti-HBV core antigen (anti-HBc) is not done, low-level HBV viraemia may not be identified. A study was done on the presence of HBV DNA in serum samples from Mexican blood donors negative for HBsAg. Sera from 158 volunteer blood donors, negative for HBsAg and anti-HBs, but positive for anti-HBc, were analysed using nested polymerase chain reaction (PCR). HBV DNA was detected in sera from 13 (8.23%) of the 158. Specificity of the PCR-amplified products was corroborated using Southern blot. Single strand conformation polymorphism (SSCP) analysis showed identical SSCP-banding patterns for all 13 PCR products, suggesting similar cDNA sequences. Occult HBV infection was observed in approximately 8% of anti-HBc only donors. The absence of HBsAg in the blood of apparently healthy individuals may not be sufficient to ensure lack of circulating HBV, and blood containing anti-HBc only may be infectious until proven otherwise.

  13. [Vaccination against hepatitis B on the Ivory Coast: study of the anti-HBs response in healthy adult subjects carrying only anti-HBc antibodies before vaccination].

    PubMed

    Ouattara, S A; Meite, M; Aron, Y

    1986-01-01

    A total of 103 volunteers, from 18 to 55 years of age, have received the hevac B Pasteur 5 micrograms vaccine subcutane on sly; one injection a month during three months and one booster injection after one year. The study of the anti-HBs reaction of the subjects, with regard to the serological status to the hepatite B virus before inoculation, has shown that only 78.8% of the subjects, who are only positive towards the anti-HBc antibody, will develop an anti-HBs response of primary type with a relatively low value. In contrast, all anti-HBc and/or anti-HBs subjects, who are positive before inoculation, react with relatively high anti-HBs values right after the first injection, of the seronegative subjects before inoculation. 93.3% will develop an anti-HBs seroconversion after the complete inoculation procedure.

  14. Hepatitis B Core IgM antibody (anti-HBcIgM) among hepatitis B Surface antigen (HBsAg) negative blood donors in Nigeria

    PubMed Central

    2011-01-01

    Background Transfusion associated Hepatitis B virus (TAHBV) continues to be a major problem despite mandatory screening for Hepatitis B surface Antigen (HBsAg). Presence of HBsAg is the common method for detecting hepatitis B infection. Unfortunately, this marker is not detected during the window period of the infection. Nigeria being a developing country cannot afford DNA testing of all collected units of blood which serve as the only possibility of achieving zero risk of transfusion associated HBV. Five different serological makers of hepatitis B virus (HBV) infection were therefore assessed to evaluate the reliability of using HBsAg marker alone in diagnosis of HBV infection among blood donors and to detect the serological evidence of the infection at the window period. This will preclude the possibility of transmitting hepatitis B through transfusion of Hepatitis B surface antigen (HBsAg) negative blood in Nigeria. Methods Between July and August 2009, 92 blood donors were enrolled for the study. The prevalence of 5 different markers of Hepatitis B virus infection was detected using Enzyme Linked Immunosorbent Assay (ELISA). Demographic factors were assessed during the study. Results HBsAg and its antibody (anti-HBs) was detected in 18 (19.6%) and 14(15.2%) of the 92 blood donors respectively. Anti-HBc IgM was found in 12(13.0%) of the 92 blood donors while Hepatitis B envelope antigen (HBeAg) and its antibody (anti-HBe) were detected in 4(8.9%) and 12(26.7%) respectively from 45 donors sampled. HBeAg is a marker of high infectivity and appears after HBsAg. At least one serological marker was detected in 30(32.6%) of the blood donors. Five (5.4%) of the 92 donors had anti-HBc IgM as the only serological evidence of hepatitis B virus infection. Conclusions The result of this study shows that five donors have anti-HBcIgM as the only serological evidence of HBV infection. Inclusion of anti-HBcIgM in routine screening of blood donors in Nigeria should be encouraged

  15. Occult HBV among Anti-HBc Alone: Mutation Analysis of an HBV Surface Gene and Pre-S Gene.

    PubMed

    Kim, Myeong Hee; Kang, So Young; Lee, Woo In

    2017-05-01

    The aim of this study is to investigate the molecular characteristics of occult hepatitis B virus (HBV) infection in 'anti-HBc alone' subjects. Twenty-four patients with 'anti-HBc alone' and 20 control patients diagnosed with HBV were analyzed regarding S and pre-S gene mutations. All specimens were analyzed for HBs Ag, anti-HBc, and anti-HBs. For specimens with an anti-HBc alone, quantitative analysis of HBV DNA, as well as sequencing and mutation analysis of S and pre-S genes, were performed. A total 24 were analyzed for the S gene, and 14 were analyzed for the pre-S gene through sequencing. A total of 20 control patients were analyzed for S and pre-S gene simultaneously. Nineteen point mutations of the major hydrophilic region were found in six of 24 patients. Among them, three mutations, S114T, P127S/T, M133T, were detected in common. Only one mutation was found in five subjects of the control group; this mutation was not found in the occult HBV infection group, however. Pre-S mutations were detected in 10 patients, and mutations of site aa58-aa100 were detected in 9 patients. A mutation on D114E was simultaneously detected. Although five mutations from the control group were found at the same location (aa58-aa100), no mutations of occult HBV infection were detected. The prevalence of occult HBV infection is not low among 'anti-HBc alone' subjects. Variable mutations in the S gene and pre-S gene were associated with the occurrence of occult HBV infection. Further larger scale studies are required to determine the significance of newly detected mutations.

  16. Application of hepatitis B core particles produced by human primary hepatocellular carcinoma (PLC/342) propagated in nude mice to the determination of anti-HBc by passive hemagglutination.

    PubMed

    Miyamoto, K; Itoh, Y; Tsuda, F; Matsui, T; Tanaka, T; Miyamoto, H; Naitoh, S; Imai, M; Usuda, S; Nakamura, T

    1986-05-22

    Human primary hepatocellular carcinoma (PLC/342), carried by nude mice, produces hepatitis B core particles as well as hepatitis B surface antigen particles. Core particles purified form PLC/342 tumors displayed epitopes of hepatitis B core antigen (HBcAg) but not epitopes of hepatitis B e antigen (HBeAg) on their surface, unlike core particles prepared from Dane particles, derived from plasma of asymptomatic carriers, that expressed epitopes of both HBcAg and HBeAg. Core particles obtained from PLC/342 tumors were applied to the determination of antibody to HBcAg (anti-HBc) by passive hemagglutination. The assay detected anti-HBc not only in individuals with persistent infection with hepatitis B virus and in those who had recovered from transient infection, but also in patients with acute type B hepatitis, indicating that it can detect anti-HBc of either IgG or IgM class. A liberal availability of core particles from tumors carried by nude mice, taken together with an easy applicability of the method, would make the passive hemagglutination for anti-HBc a valuable tool in clinical and epidemiological studies, especially in places where sophisticated methods are not feasible.

  17. Characterization of overt and occult hepatitis B virus infection among HTLV-1 positive healthy carriers in the Northeast of Iran; AN HTLV-I endemic area.

    PubMed

    Chenari, Maryam; Norouzi, Mehdy; Ghalichi, Leila; Rezaee, Abdolrahim; Yari, Atefe; Alavian, Seyed Moayed; Jazayeri, Seyed Mohammad

    2014-11-01

    To date, no studies have provided data on hepatitis B virus (HBV) prevalence among asymptomatic, healthy human T-lymphotropic virus (HTLV-I) positive carriers. This sero- and molecular epidemiology study was performed on patients in the Northeast of Iran, which is an endemic area for HTLV-I infection. A total of 109 sera were collected from HTLV-I positive healthy carriers who were admitted to Ghaem Hospital, Mashhad City. All were tested for HBV serology and subsequently, real time PCR was carried out on the samples, regardless of the results of the serology. Standard PCR and direct sequencing were applied on positive samples. All cases were negative for HBsAg, Anti-HBc, and anti-HBs were positive in 34 (31.1%), and 35 (32%) individuals, respectively. There were 19 (17.4%) cases that were positive only for anti-HBs, and they had already received HBV vaccine. 16 (15%) were positive for both anti-HBs and anti-HBc, indicating a past-resolved HBV infection. 18 (16.5%) were isolated as anti-HBc, and 56 (51.3%) were negative for all HBV serological markers. Only one subject (0.9%) had detectable HBV DNA (2153 copy/ml), and assigned as being an occult HBV infection. The low prevalence of HBsAg, despite the high percentage of anti-HBc positive cases, might be related to the suppression effect of HTLV-I on surface protein expression. The low prevalence of HBV infection among HTLV-I positive healthy carriers from an endemic region, indicates that the epidemiology of HTLV-I and HBV coinfection is related to the endemicity of HBV in that region, rather than HTLV-I endemicity.

  18. Quantitative Hepatitis B Core Antibody Level Is a New Predictor for Treatment Response In HBeAg-positive Chronic Hepatitis B Patients Receiving Peginterferon

    PubMed Central

    Hou, Feng-Qin; Song, Liu-Wei; Yuan, Quan; Fang, Lin-Lin; Ge, Sheng-Xiang; Zhang, Jun; Sheng, Ji-Fang; Xie, Dong-Ying; Shang, Jia; Wu, Shu-Huan; Sun, Yong-Tao; Wei, Shao-Feng; Wang, Mao-Rong; Wan, Mo-Bin; Jia, Ji-Dong; Luo, Guang-Han; Tang, Hong; Li, Shu-Chen; Niu, Jun-Qi; Zhou, Wei-dong; Sun, Li; Xia, Ning-Shao; Wang, Gui-Qiang

    2015-01-01

    A recent study revealed that quantitative hepatitis B core antibody (qAnti-HBc) level could serve as a novel marker for predicting treatment response. In the present study, we further investigated the predictive value of qAnti-HBc level in HBeAg-positive patients undergoing PEG-IFN therapy. A total of 140 HBeAg-positive patients who underwent PEG-IFN therapy for 48 weeks and follow-up for 24 weeks were enrolled in this study. Serum samples were taken every 12 weeks post-treatment. The predictive value of the baseline qAnti-HBc level for treatment response was evaluated. Patients were further divided into 2 groups according to the baseline qAnti-HBc level, and the response rate was compared. Additionally, the kinetics of the virological and biochemical parameters were analyzed. Patients who achieved response had a significantly higher baseline qAnti-HBc level (serological response [SR], 4.52±0.36 vs. 4.19±0.58, p=0.001; virological response [VR], 4.53±0.35 vs. 4.22±0.57, p=0.005; combined response [CR], 4.50±0.36 vs. 4.22±0.58, p=0.009)). Baseline qAnti-HBc was the only parameter that was independently correlated with SR (p=0.008), VR (p=0.010) and CR(p=0.019). Patients with baseline qAnti-HBc levels ≥30,000 IU/mL had significantly higher response rates, more HBV DNA suppression, and better hepatitis control in PEG-IFN treatment. In conclusion, qAnti-HBc level may be a novel biomarker for predicting treatment response in HBeAg-positive patients receiving PEG-IFN therapy. PMID:25553110

  19. Characterization of occult hepatitis B virus infection among HIV positive patients in Cameroon.

    PubMed

    Gachara, George; Magoro, Tshifhiwa; Mavhandu, Lufuno; Lum, Emmaculate; Kimbi, Helen K; Ndip, Roland N; Bessong, Pascal O

    2017-03-08

    Occult hepatitis B infection (OBI) among HIV positive patients varies widely in different geographic regions. We undertook a study to determine the prevalence of occult hepatitis B infection among HIV infected individuals visiting a health facility in South West Cameroon and characterized occult HBV strains based on sequence analyses. Plasma samples (n = 337), which previously tested negative for hepatitis B surface antigen (HBsAg), were screened for antibodies against hepatitis B core (anti-HBc) and surface (anti-HBs) antigens followed by DNA extraction. A 366 bp region covering the overlapping surface/polymerase gene of HBV was then amplified in a nested PCR and the amplicons sequenced using Sanger sequencing. The resulting sequences were then analyzed for genotypes and for escape and drug resistance mutations. Twenty samples were HBV DNA positive and were classified as OBI giving a prevalence of 5.9%. Out of these, 9 (45%) were anti-HBs positive, while 10 (52.6%) were anti-HBc positive. Additionally, 2 had dual anti-HBs and anti-HBc reactivity, while 6 had no detectable HBV antibodies. Out of the ten samples that were successfully sequenced, nine were classified as genotype E and one as genotype A. Three sequences possessed mutations associated with lamivudine resistance. We detected a number of mutations within the major hydrophilic region of the surface gene where most immune escape mutations occur. Findings from this study show the presence of hepatitis B in patients without any of the HBV serological markers. Further prospective studies are required to determine the risk factors and markers of OBI.

  20. The European Sero-Epidemiology Network 2: standardization of assay results for hepatitis B virus.

    PubMed

    Kafatos, G; Anastassopoulou, C; Nardone, A; Andrews, N; Barbara, C; Boot, H J; Butur, D; Davidkin, I; Gelb, D; Griskevicius, A; Hesketh, L; Icardi, G; Jones, L; Kra-Oz, Z; Miller, E; Mossong, J; Nemecek, V; de Ory, F; Sobotová, Z; Thierfelder, W; Van Damme, P; Hatzakis, A

    2007-04-01

    The aim of the European Sero-Epidemiology Network 2 was to coordinate and standardize the serological surveillance of vaccine-preventable diseases in Europe. In this study, the standardization of hepatitis B virus (HBV) results is described. The 15 participating national laboratories tested a unique panel of 172 sera established by the Greek reference centre for HBV surface antigen (HBsAg), antibodies to HBsAg (anti-HBs) and/or to the HBV core antigen (anti-HBc) by assay methods of their choice. Country-specific quantitative measurements for anti-HBs and anti-HBc were transformed into common units using standardization equations derived by regressing each country's panel results against the reference centre's results, thus adjusting for interassay and interlaboratory variability. For HBsAg, a qualitative analysis (positive/negative) showed at least 99% agreement with the reference laboratory for all countries. By combining these standardized and qualitative results for the markers mentioned earlier, it was possible to achieve comparable estimates of the proportion of the population susceptible to HBV, vaccinated against HBV, with a past HBV infection, and with a current infection or chronic carrier state. Standardization is a very important tool that allows for international serological comparisons to assess the current vaccination policies and the progress of HBV control in Europe.

  1. Positive Classroom Environments = Positive Academic Results

    ERIC Educational Resources Information Center

    Wilson-Fleming, LaTerra; Wilson-Younger, Dylinda

    2012-01-01

    This article discusses the effects of a positive classroom environment and its impact on student behavior and achievement. It also provides strategies for developing expectations for student achievement and the importance of parental involvement. A positive classroom environment is essential in keeping behavior problems to a minimum. There are a…

  2. [Sero-epidemiological analysis on hepatitis B among children aged 1-14 years old born to HBsAg positive mother in China, 2014].

    PubMed

    Wang, F Z; Zheng, H; Zhang, G M; Miao, N; Sun, X J; Cui, F Q

    2017-04-10

    Objective: To analyze the sero-epidemiological features of hepatitis B among children aged 1-14 years old who were born to HBsAg positive mothers. Methods: Based on the results from the hepatitis B national sero-survey in 2014, children aged 1-14 years old born to HBsAg positive mother were involved in this study. Positive rates on HBsAg, anti-HBs, anti-HBc by gender, age, nationality, birth place, residency (urban/rural), region (eastern/central/western) and related factors of HBsAg and anti-HBs for children under research, were analyzed by SPSS 18.0 statistical software. Results: A total of 645 children aged 1-14 years old that born to HBsAg positive mothers were analyzed in the study. Positive rates on HBsAg, anti-HBs, anti-HBc among these children were 3.41% (22/645), 71.94% (464/645) and 7.60% (49/645), respectively. HBsAg positive rates for children aged 1-2 years, 3-4 years, 5-9 years, 10-14 years appeared 1.27% (3/236), 3.23% (6/186), 5.71% (8/140) and 6.02% (5/83), respectively. The anti-HBs positive rates were 85.17% (201/236), 69.35% (129/186), 56.43% (79/140), 66.27% (55/83) while the anti-HBc positive rates were 4.66% (11/236), 5.38% (10/186), 11.43% (16/140) and 14.46% (12/83), respectively. Results from the multifactor logistic analysis showed that birth place, time of the first dose of HepB inoculation were major influencing factors on the positive rates among children with HBsAg. HBsAg positive rate for the children born outside the hospital was higher than those born in the hospital (OR=7.47, 95%CI:1.50-37.25). HBsAg positive rate for children with the first dose of HepB inoculation>24 h after birth, was higher than that inoculation within 24 h after birth (OR=6.21, 95% CI: 2.15-17.99). Conclusions: Some achievements in preventing mother-to-child transmission of hepatitis B had been seen in China. Hospital delivery for pregnant women and timely HepB vaccination with birth-dose for the neonates, remained the key strategy on prevention of HBV

  3. Long-term efficacy of hepatitis B vaccination as post-transplant prophylaxis in hepatitis B surface antigen (HBsAg) positive recipients and HBsAg negative recipients of anti-hepatitis B core positive grafts.

    PubMed

    Yoshizawa, Atsushi; Yamashiki, Noriyo; Ueda, Yoshihide; Kaido, Toshimi; Okajima, Hideaki; Marusawa, Hiroyuki; Chiba, Tsutomu; Uemoto, Shinji

    2016-05-01

    Hepatitis B virus (HBV) reactivation after liver transplantation in HBV patients, or in HBV negative recipients of anti-hepatitis B core (HBc) positive grafts, has been prevented by prophylactic use of hepatitis B immunoglobulin (HBIG) and/or nucleoside/nucleotide analogs (NA). Vaccination against HBV is an alternative that may provide a chance to discontinue prophylaxis by producing anti-hepatitis B surface (HBs) antibodies. We retrospectively reviewed 40 HBV positive recipients (HBV+ group) and 27 HBV negative recipients of anti-HBc positive grafts (HBV-/anti-HBc+ graft group), who were administrated double-dose hepatitis B vaccination. Recipients were regarded as responders when anti-HBs greater than 100 IU/L was maintained for 6 months or more without HBIG. Response rates of vaccine and long-term outcomes were analyzed. Eighteen of the 40 patients in the HBV+ group (45%) and 18 of the 27 patients in the HBV-/anti-HBc+ graft group (67%) responded to vaccination after a median of four and three times, respectively. Younger age was the only independent factor associated with vaccine response in the HBV-/anti-HBc+ graft group (P = 0.03), whereas no factor was found to be an independent predictor for vaccine response in the HBV+ group. Among the 18 responders in the HBV+ group, 17 remained without NA or HBIG 8.2 years after the start of vaccination. Ten of those required periodic booster vaccination. All 18 responders in the HBV-/anti-HBc+ graft group remained free from HBV prophylaxis 6.2 years after the start of vaccination. Younger recipients have a greater chance to develop sufficient anti-HBs after double-dose HBV vaccination, leading to discontinue HBV prophylaxis. © 2015 The Japan Society of Hepatology.

  4. Correlates of HIV, HBV, and HCV infections in a prison inmate population: results from a multicentre study in Italy.

    PubMed

    Babudieri, S; Longo, B; Sarmati, L; Starnini, G; Dori, L; Suligoi, B; Carbonara, S; Monarca, R; Quercia, G; Florenzano, G; Novati, S; Sardu, A; Iovinella, V; Casti, A; Romano, A; Uccella, I; Maida, I; Brunetti, B; Mura, M S; Andreoni, M; Rezza, G

    2005-07-01

    A cross-sectional study was undertaken on the correlates of infection for the human immunodeficiency virus (HIV) and hepatitis viruses B and C (HBV and HCV) in a sample of inmates from eight Italian prisons. A total of 973 inmates were enrolled [87.0% males, median age of 36 years, 30.4% intravenous drug users (IDUs), 0.6% men who have sex with men (MSWM)]. In this sample, high seroprevalence rates were found (HIV: 7.5%; HCV: 38.0%; anti-HBc: 52.7%; HBsAg: 6.7%). HIV and HCV seropositivity were associated strongly with intravenous drug use (OR: 5.9 for HIV; 10.5 for HCV); after excluding IDUs and male homosexuals, the HIV prevalence remained nonetheless relatively high (2.6%). HIV prevalence was higher for persons from Northern Italy and Sardinia. The age effect was U-shaped for HIV and HCV infections; HBV prevalence increased with age. Tattoos were associated with HCV positivity (OR: 2.9). The number of imprisonments was associated with HIV infection, whereas the duration of imprisonment was only associated with anti-HBc. The probability of being HIV-seropositive was higher for HCV-seropositive individuals, especially if IDUs. In conclusion, a high prevalence of HIV, HCV, and HBV infections among inmates was observed: these high rates are in part attributable to the high proportion of IDUs. Frequency of imprisonment and tattoos were associated, respectively, with HIV and HCV positivity. Although it is possible that the study population is not representative of Italy's prison inmate population, the results stress the need to improve infection control measures users was prisons. Copyright (c) 2005 Wiley-Liss, Inc.

  5. Hepatitis B virus infection assessed 3 to 18 years after vaccination in Cuban children and adolescents born to HBsAg-positive mothers.

    PubMed

    Rodríguez Lay, Licel de Los Angeles; Bello Corredor, Marité; Montalvo Villalba, Maria Caridad; Chibás Ojeda, Annia Gertrudis; Sariego Frómeta, Susel; Diaz González, Manuel; Abad Lamoth, Yoandra; Sánchez Wong, Meilin; Sausy, Aurélie; Muller, Claude P; Hübschen, Judith M

    2017-08-01

    Thirty-two participants, aged between 3-18 years, born to hepatitis B surface antigen (HBsAg)-positive mothers and vaccinated at birth were analyzed for hepatitis B virus (HBV) infection. Overall, 56% had anti-HB titers ≥10 IU/L; five were positive for antibodies to the core antigen (anti-HBc), and two of these were also positive for HBsAg/DNA. One of the HBsAg/anti-HBc double-negative children presented with an unusual occult infection (HBV DNA-positive). No known vaccine escape mutations were detectable. Our data suggest that the vaccine protected 93.8% of children in this high-risk group against chronic HBV infection. Occult infections should be considered even in countries with low endemicity and high vaccination coverage.

  6. Prevalence of antibody to Hepatitis B core antigen and Hepatitis B virus DNA in HBsAg negative healthy blood donors.

    PubMed

    Karimi, Gharib; Zadsar, Maryam; Vafaei, Nasrin; Sharifi, Zohreh; FalahTafti, Mohammad

    2016-03-05

    Hepatitis B virus is one of the most important blood born viruses. Although the sensitivity of screening tests has been considerably increased, transmission may still occur due to window period or occult hepatitis B infections (OBIs). This study was aimed at evaluating the prevalence of the anti-HBc and identifying the HBV DNA in HBsAg negative blood donors. The Blood samples from 2031 HBsAg-negative blood donors were divided into three aliquots and tested for anti-HBc, anti-HBs and HBV DNA. Serologic screening including anti-HBc and anti-HBs was performed. As a confirmatory test, all positive results for anti-HBc were retested with another kit. Two positive results were considered for anti-HBc positivity. All HBsAg negative selected donations were tested by PCR assay on pooled specimens (five samples per pool), plasma samples found to be HBsAg negative but anti-HBc positive were selected for a single-unit specimen Real-Time assay. The study population had a mean age of 33.25 ± 10.09 years were mainly composed of males (94.8 %). The seroprevalance rate was 4.9 % for Anti-HBc and 31.9 % for HBsAb. The majority (58.6 %) of Anti-HBc positive cases were regular blood donors with 42-49 years being the largest age group (41.4 %). Neither individual NAT nor pooled NAT test detected any HBV DNA. However, Screening of anti-HBc Ab is proposed as a method to identify previous contact with HBV, but there is controversy in literature data regarding the cost-benefit of exclusion of positive anti-HBc Ab in blood donors. Our data does not suggest HBc-Ab test as a screening tool in the study setting.

  7. Occult HBV infection in anti-HBs-positive young adults after neonatal HB vaccination.

    PubMed

    Xu, Libin; Wei, Yong; Chen, Taoyang; Lu, Jianhua; Zhu, Chang-Lin; Ni, Zhengping; Huang, Fei; Du, Jun; Sun, Zongtang; Qu, Chunfeng

    2010-08-23

    Previous follow-up on our neonatal HB vaccination cohorts with 80,000 individuals in Qidong, China, showed significant protective efficacy of immunization against HBV infection in childhood. However, some vaccinees were found to be HBsAg negative, but anti-HBs positive and anti-HBc positive at age 10-11 years. To study this phenomenon, 2919 vaccinees at age 19-21 years were sampled from the cohort. HBsAg(-), anti-HBs(+) and anti-HBc(+) were found in 124/2919 (4.2%) of the vaccinees. HBV DNA was detectable in 81/106 sample sera by using nested PCR. The PreS-S regions of HBV were sequenced in 41 randomly sampled sera. All the HBV isolates were HBV genotype C. Twenty one isolates (21/41, 51.2%) were identical to an HBV isolated in this area (GU434374). Only 4/41 (9.8%) showed mutations at the "a" epitope and three of them were G145A. The other mutations were found outside of the "a" epitope. Most of the sera contained <10,000 HBV copies/ml. Occult HBV infection happened in the young adults with HBsAg(-), anti-HBs(+) and anti-HBc(+) status, who received neonatal vaccination in Qidong.

  8. Global Positioning System receiver evaluation results

    SciTech Connect

    Byrne, R.H.

    1993-09-01

    A Sandia project currently uses an outdated Magnavox 6400 Global Positioning System (GPS) receiver as the core of its navigation system. The goal of this study was to analyze the performance of the current GPS receiver compared to newer, less expensive models and to make recommendations on how to improve the performance of the overall navigation system. This paper discusses the test methodology used to experimentally analyze the performance of different GPS receivers, the test results, and recommendations on how an upgrade should proceed. Appendices contain detailed information regarding the raw data, test hardware, and test software.

  9. [Atypical serological profiles in hepatitis B infections: investigation of S gene mutations in cases with concurrently positive for HBsAg and anti-HBs].

    PubMed

    Aydın, Neriman; Kırdar, Sevin; Uzun, Nilgül; Eyigör, Mete; Sayan, Murat

    2016-10-01

    Hepatitis B virus (HBV) causes different clinical manifestations, ranging from asymptomatic carriage to fulminant or chronic hepatitis. Serological tests are widely used for the diagnosis of HBV infections to detect viral markers. However, facing with atypical serological profiles in some patients leads to problems in interpreting of the results and management of the patients. The aims of this study were to investigate the atypical serologic profiles seen in patients screened for HBV infection and the S gene mutations in patients with concurrent positivity of HBsAg and anti-HBs. A total of 592 sera from patients (332 male, 260 female; age range: 13-84 years, mean age: 43.9 years) prediagnosed as HBV infection between January to September 2013, and screened for HBV markers (HBsAg, anti-HBs, HBeAg, anti-HBe, anti-HBc-IgM, anti-HBc-total and HBV-DNA) were included in the study. Of those samples 364 were screened only for HBsAg and anti-HBs markers. S gene mutations were investigated by direct sequencing method in sera which were concurrent positive for HBsAg and anti-HBs. In our study, 5.2% (31/592) of the sera yielded atypical serologic profiles. Of these 13 cases were concurrently positive for HBsAg and anti-HBs; nine were HBeAg positive, anti-HBe and HBV-DNA negative; eight were HBeAg, anti-HBe and HBV-DNA positive; and one was HBsAg and anti-HBs negative, anti-HBe and HBV-DNA positive. The rate of concurrent positivity of HBsAg and anti-HBs was 3.6% (13/364), while 76.9% (10/13) of those cases were also positive for HBV-DNA. DNA sequencing was performed for seven out of 10 samples which were positive for HBsAg, anti-HBs and HBV-DNA, however three samples were not used because of the low amounts. Sequence analysis of seven samples showed S gene mutations in two samples, one was sS143L with sS193L, a HBV vaccine escape mutation, and the other was sP120R, a HBV immune escape mutation. Of the patients 2.7% (10/364) was negative for both HBsAg and anti-HBs; in which

  10. Clinical significance of antibody to hepatitis B core antigen in multitransfused hemodialysis patients

    PubMed Central

    Elghannam, Doaa M.; Aly, Rabab M.; Goda, Enas F.; Eltoraby, Ehab E.; Farag, Raghda E.

    2009-01-01

    Background: In spite of the progress made in the prevention of transfusion transmitted infections over the last few years, transmission of HBV infection through transfusion of HBsAg negative blood has been documented. Objectives: To assess the frequency and clinical significance of anti-HBc in multitransfused hemodialysis patients. Materials and Methods: One hundred and forty-three hemodialysis patients who had been receiving blood regularly with an average of 39.4 ± 7.579 months on hemodialysis were enrolled in this study. HBV markers (HBsAg, anti-HBc, anti-HBs) were measured in these patients and in 100 healthy controls by the ELISA technique. The following data were obtained for all patients: socio demographic data, number of blood transfusions and some laboratory investigations. Results: In our patients, anti-HBc was positive in 9%, anti HBs in 7%, coexistant HbsAg/anti-HBc in 2.8% and anti HBc/anti HBs in 18.9%, meanwhile no patients were positive for HBsAg alone. In patients with only positive anti-HBc, the levels of anti-HBc were significantly related to abnormal results of liver function. In patients with positive anti-HBs/anti-HBc (n = 27), 18 patients had abnormal liver function, and 9 patients had normal liver function with no significant difference between them. Conclusions: This study suggests that hepatitis B prevalence in our multitransfused hemodialysis patients is far in excess of that anticipated on the basis of HBsAg prevalence. Absence of HBsAg in the blood of hemodialyzed patients may not be sufficient to ensure lack of circulating HBV, and isolated positivity of anti-HBc may be a possible indicator of active hepatitis B infection. PMID:20041091

  11. Routine use of counter-immunoelectrophoresis test for detecting antibody to hepatitis B virus core antigen.

    PubMed Central

    Freeman, R; Hambling, M H

    1978-01-01

    Tests by counter-immunoelectrophoresis for antibody to hepatitis B core antigen (anti-HBc) were introduced into a routine testing programme for evidence of hepatitis B virus infection. Samples tested for anti-HBc were selected on the basis of the results of tests for HBsAg and clinical details. The sensitivity and specificity of the test were assessed and correlations made with the presence of HBsAg. The presence of anti-HBc was very useful in the interpretation of a doubtful positive result for HBsAg in the haemagglutination test. With very few exceptions the serum samples positive for HBsAg by routine tests also contained anti-HBc. It is concluded that the test is valuable and merits introduction into routine testing programmes. PMID:711911

  12. [Post-transfusion hepatitis iin Chile: the reference parameters].

    PubMed

    Ibarra, H; Riedemann, S; Gómez, J C; Reinhardt, G; Hochstein-Mintzel, V; Froesner, G

    1990-02-01

    Most cases of post-transfusion hepatitis correspond to infection by non-A non-B virus. Indirect test (ALT elevation, anti-HBc titers) have been used to detect the presence of this virus. We screened 692 blood donors and health personnel, measuring anti-HBc (n = 572), HBs antigen (340), and ALT serum levels (190). Positive results were obtained for anti-HBc in 1.7% and HBs in 0%. ALT levels were 25 +/- 12 u/l in males and 18 +/- 14 in females (p < 0.01). ALT levels above 45 u/l were found in 6% of subjects. ALT levels were not related to anti-HBc positiveness nor to alcohol intake. The possible risk of posttransfusion hepatitis related to increased ALT levels remains to be clarified by specific markers.

  13. Prediction of occult hepatitis B virus infection in liver transplant donors through hepatitis B virus blood markers.

    PubMed

    Tandoi, Francesco; Caviglia, Gian Paolo; Pittaluga, Fabrizia; Abate, Maria Lorena; Smedile, Antonina; Romagnoli, Renato; Salizzoni, Mauro

    2014-11-01

    Occult hepatitis B virus infection is defined as detectable HBV-DNA in liver of HBsAg-negative individuals, with or without detectable serum HBV-DNA. In deceased liver donors, results of tissue analysis cannot be obtained prior to allocation for liver transplantation. we investigated prevalence and predictability of occult hepatitis B using blood markers of viral exposure/infection in deceased liver donors. In 50 consecutive HBsAg-negative/anti-HBc-positive and 20 age-matched HBsAg-negative/anti-HBc-negative donors, a nested-PCR assay was employed in liver biopsies for diagnosis of occult hepatitis B according to Taormina criteria. All donors were characterized for plasma HBV-DNA and serum anti-HBs/anti-HBe. In liver tissue, occult hepatitis B was present in 30/50 anti-HBc-positive (60%) and in 0/20 anti-HBc-negative donors (p<0.0001). All anti-HBc-positive donors with detectable HBV-DNA in plasma (n=5) or anti-HBs>1,000 mIU/mL (n=5) eventually showed occult infection, i.e, 10/30 occult hepatitis B-positive donors which could have been identified prior to transplantation. In the remaining 40 anti-HBc-positive donors, probability of occult infection was 62% for anti-HBe-positive and/or anti-HBs ≥ 58 mIU/mL; 29% for anti-HBe-negative and anti-HBs<58 mIU/mL. In deceased donors, combining anti-HBc with other blood markers of hepatitis B exposure/infection allows to predict occult hepatitis B with certainty and speed in one third of cases. These findings might help refine the allocation of livers from anti-HBc-positive donors. Copyright © 2014 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  14. False positive test results for pheochromocytoma from 2000 to 2008.

    PubMed

    Yu, R; Wei, M

    2010-10-01

    Testing for pheochromocytoma becomes more frequent in clinical practice. False positive test results may cause patient anxiety and unnecessary imaging studies. The data on false positive results for pheochromocytoma in routine clinical practice are lacking. To examine the prevalence of false positive results and to reveal the clinical features and laboratory tests of patients with markedly elevated but false positive test results, a database of tests for pheochromocytoma at a large general hospital between 2000 and 2008 was reviewed. Of 1,896 patients tested, 417 (22.0%) had at least one abnormal test result and 66 (3.5%) had markedly elevated results. 24 patients with markedly elevated but false positive results received 65 imaging studies and 1 adrenalectomy. The causes of the misleading results included physiological variations (33%), laboratory errors (29%), and drug interference with measurement (21%). The false positive rate of a markedly elevated result was lowest for vanillylmandelic acid (9%) and highest for urine metanephrines (50%) (p = 0.03). Nearly half of all test results were normal and 79% of patients had at least one normal result. Therefore false positive test results for pheochromocytoma are rather common. Markedly elevated but false positive test results can potentially be avoided by judicious selection of patients and tests. Pretest risk, physiological variations of catecholamine levels, laboratory errors, and drug interference should be considered in interpreting abnormal test results. © J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York.

  15. [Characterization of hepatitis B virus strains from the Central African Republic: preliminary results].

    PubMed

    Bekondi, C; Olinger, C M; Boua, N; Talarmin, A; Venard, V; Muller, C P; Le Faou, A

    2008-07-01

    Genotyping of Hepatitis B virus (HBV) strains from patients in Central African Republic and comparison with results obtained in other African countries. Sera were collected from patients admitted with symptoms of acute or chronic hepatitis to the "Hôpital de l'Amitié de Bangui", Central African Republic (CAR). The complete sequence of preS2/S gene has been defined for determining genotypes. Hundred and ninety-six sera were collected from 112 men and 84 women. Ninety-two percent of patients had contact with HBV (anti-HBc postitive) and the HBsAg prevalence was about 62%. HBV DNA was detected in 66% of HBsAg positive sera. No HBV-DNA was evidenced among patients with negative HBsAg. Ninety-three percent of the HBV strains belonged to genotype E; one (3.4%) belonged to genotype A1, and one (3.4%) belonged to genotype D. The high prevalence of HBV infection in the studied population is due to their recruitment. The genotype E is predominant in CAR and the intragroup variability of HBV genotype E reached only 1.8%. Genotypes A and D were less common in CAR their presence may be explained by importation.

  16. The clinical utility of a positive antinuclear antibody test result.

    PubMed

    Abeles, Aryeh M; Abeles, Micha

    2013-04-01

    This retrospective study investigated the clinical utility of a positive antinuclear antibody (ANA) test performed outside of the rheumatology setting. Prior studies have investigated the frequency of ANA positivity within the general population. The purpose of this investigation was to evaluate the clinical utility of a positive ANA test result in a real-world setting by reviewing the final diagnoses of patients who were referred to a tertiary rheumatology clinic for evaluation of a positive ANA test result. We reviewed the records of patients presenting to the authors between July 2007 and July 2009. Patients were included in the evaluation if they were referred for a positive ANA test result. All relevant descriptive and laboratory data were collated, as were the initial reasons for ordering ANA testing and the ultimate diagnoses reached. Positive predictive values for a "positive ANA test result" were calculated for all antinuclear antibody-associated rheumatic diseases and for lupus specifically. A total of 232 patients were referred for a positive ANA test result. The positive predictive value of a positive ANA test result in this cohort was 2.1% for lupus and 9.1% for any antinuclear antibody-associated rheumatic disease. No antinuclear antibody-associated rheumatic disease was identified in patients with an ANA<1:160. The most common reason for ordering ANA testing was widespread pain (54/232, 23.2%). In this retrospective study, more than 90% of patients who were referred to a tertiary rheumatology clinic for a positive ANA test result had no evidence for an ANA-associated rheumatic disease. The poor predictive value of a positive ANA in this cohort was largely attributable to unnecessary testing in patients with low pretest probabilities for ANA-associated rheumatic disease. Copyright © 2013 Elsevier Inc. All rights reserved.

  17. 49 CFR 219.605 - Positive drug test results; procedures.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION CONTROL OF ALCOHOL AND DRUG USE Random Alcohol and Drug Testing Programs § 219.605 Positive drug test results; procedures. (a) [Reserved] (b) Procedures for administrative... 49 Transportation 4 2014-10-01 2014-10-01 false Positive drug test results; procedures. 219.605...

  18. 49 CFR 219.605 - Positive drug test results; procedures.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION CONTROL OF ALCOHOL AND DRUG USE Random Alcohol and Drug Testing Programs § 219.605 Positive drug test results; procedures. (a) (b) Procedures for administrative handling... 49 Transportation 4 2012-10-01 2012-10-01 false Positive drug test results; procedures. 219.605...

  19. 49 CFR 219.605 - Positive drug test results; procedures.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION CONTROL OF ALCOHOL AND DRUG USE Random Alcohol and Drug Testing Programs § 219.605 Positive drug test results; procedures. (a) (b) Procedures for administrative handling... 49 Transportation 4 2013-10-01 2013-10-01 false Positive drug test results; procedures. 219.605...

  20. 49 CFR 219.605 - Positive drug test results; procedures.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION CONTROL OF ALCOHOL AND DRUG USE Random Alcohol and Drug Testing Programs § 219.605 Positive drug test results; procedures. (a) [Reserved] (b) Procedures for administrative... 49 Transportation 4 2011-10-01 2011-10-01 false Positive drug test results; procedures. 219.605...

  1. Nasal deformities resulting from flow driver continuous positive airway pressure.

    PubMed Central

    Robertson, N J; McCarthy, L S; Hamilton, P A; Moss, A L

    1996-01-01

    Over a period of six months, seven cases were documented of trauma to the nose as a result of flow driver continuous positive airway pressure in babies of very low birthweight (VLBW). There was a complication rate of 20% in the babies who required it. Deformities consisted of columella nasi necrosis which can occur within three days, flaring of nostrils which worsens with duration of continuous positive airway pressure, and snubbing of the nose which persists after prolonged continuous positive airway pressure. These complications should be preventable by modifications to the mechanism and method of use. Images PMID:8976689

  2. Solid organ transplantation from hepatitis B virus-positive donors: consensus guidelines for recipient management.

    PubMed

    Huprikar, S; Danziger-Isakov, L; Ahn, J; Naugler, S; Blumberg, E; Avery, R K; Koval, C; Lease, E D; Pillai, A; Doucette, K E; Levitsky, J; Morris, M I; Lu, K; McDermott, J K; Mone, T; Orlowski, J P; Dadhania, D M; Abbott, K; Horslen, S; Laskin, B L; Mougdil, A; Venkat, V L; Korenblat, K; Kumar, V; Grossi, P; Bloom, R D; Brown, K; Kotton, C N; Kumar, D

    2015-05-01

    Use of organs from donors testing positive for hepatitis B virus (HBV) may safely expand the donor pool. The American Society of Transplantation convened a multidisciplinary expert panel that reviewed the existing literature and developed consensus recommendations for recipient management following the use of organs from HBV positive donors. Transmission risk is highest with liver donors and significantly lower with non-liver (kidney and thoracic) donors. Antiviral prophylaxis significantly reduces the rate of transmission to liver recipients from isolated HBV core antibody positive (anti-HBc+) donors. Organs from anti-HBc+ donors should be considered for all adult transplant candidates after an individualized assessment of the risks and benefits and appropriate patient consent. Indefinite antiviral prophylaxis is recommended in liver recipients with no immunity or vaccine immunity but not in liver recipients with natural immunity. Antiviral prophylaxis may be considered for up to 1 year in susceptible non-liver recipients but is not recommended in immune non-liver recipients. Although no longer the treatment of choice in patients with chronic HBV, lamivudine remains the most cost-effective choice for prophylaxis in this setting. Hepatitis B immunoglobulin is not recommended.

  3. Anti-hepatitis B core positivity as a risk factor for hepatocellular carcinoma in alcoholic cirrhosis: a case-control study.

    PubMed

    Kwon, Oh Sang; Jung, Young Kul; Bae, Kyoung Suk; Kim, Ju Hyun; Kim, Sang Gyune; Kim, Young Seok; Lee, Jung Il; Lee, Jin Woo; Kim, Yun Soo

    2012-09-01

    Hepatocellular carcinoma (HCC) is occasionally developed in patients with alcoholic cirrhosis. Old age, male gender, lifetime quantity of alcohol, and presence of hepatitis C virus (HCV) infection are risk factors for HCC in alcoholic cirrhosis. In this study, we investigated whether anti-hepatitis B core (HBc) positivity or occult hepatitis B virus (HBV) infection is a risk factor for HCC in patients with alcoholic cirrhosis. Between January 2006 and August 2008, a total of 72 cirrhotic male patients with an initial diagnosis of HCC, hospitalized in three major hospitals in the Incheon area, were enrolled as cases. Another 72 cirrhotic male patients without HCC, who matched the cases by age (±3 years), were enrolled as controls. All cases and controls were negative for hepatitis B surface antigen and anti-HCV, but had history of chronic alcohol intake over 80 g per day. The clinical characteristics including presence of anti-HBc or serum HBV DNA (identified by nested polymerase chain reaction) were investigated. The mean age of both the cases and controls was 62 ± 10 years. The basal laboratory data, Child-Pugh scores, total lifetime alcohol intake (1459 ± 1364 versus 1641 ± 1045 kg), and detection rates of serum HBV DNA [31.7% (20/63) versus 29.9% (20/67)] of the cases and controls were not significantly different. However, the anti-HBc positivity rate was higher among the cases [86.1% (62/72)] than in the controls [66.7% (48/72); p=0.005] and was the only significant risk factor for HCC (odds ratio; 3.1, 95% confidence interval; 1.354-7.098, p=0.007). Anti-HBc positivity was identified as a risk factor for the development of HCC in patients with alcoholic cirrhosis.

  4. Occult Hepatitis B Virus Infection among HIV Positive Patients in Nigeria

    PubMed Central

    Opaleye, Oluyinka Oladele; Oluremi, Adeolu Sunday; Atiba, Adetona Babatunde; Adewumi, Moses Olubusuyi; Mabayoje, Olatunji Victor; Donbraye, Emmanuel; Ojurongbe, Olusola; Olowe, O. Adekunle

    2014-01-01

    HIV has been known to interfere with the natural history of hepatitis B virus (HBV) infection. In this study we investigate the prevalence of occult hepatitis B virus infection (OBI) among HIV-infected individuals in Nigeria. Overall, 1200 archived HIV positive samples were screened for detectable HBsAg using rapid technique, in Ikole Ekiti Specialist Hospital. The HBsAg negative samples were tested for HBsAg, anti-HBc, and anti-HCV by ELISA. Polymerase chain reaction was used for HBV DNA amplification and CD4 counts were analyzed by cytometry. Nine hundred and eighty of the HIV samples were HBsAg negative. HBV DNA was detected in 21/188 (11.2%) of patients without detectable HBsAg. CD4 count for the patients ranged from 2 to 2,140 cells/μL of blood (mean = 490 cells/μL of blood). HCV coinfection was detected only in 3/188 (1.6%) of the HIV-infected patients (P > 0.05). Twenty-eight (29.2%) of the 96 HIV samples screened were positive for anti-HBc. Averagely the HBV viral load was <50 copies/mL in the OBI samples examined by quantitative PCR. The prevalence of OBI was significantly high among HIV-infected patients. These findings highlight the significance of nucleic acid testing in HBV diagnosis in HIV patients. PMID:24868208

  5. Dimethylamylamine: a drug causing positive immunoassay results for amphetamines.

    PubMed

    Vorce, Shawn P; Holler, Justin M; Cawrse, Brian M; Magluilo, Joseph

    2011-04-01

    The Department of Defense (DoD) operates six forensic urine drug-testing laboratories that screen close to 5 million urine samples for amphetamines yearly. Recently, the DoD laboratories have observed a significant decrease in the confirmation rates for amphetamines because of specimens screening positive by two separate immunoassays and confirming negative by gas chromatography-mass spectrometry (GC-MS). Previous studies conducted by the Division of Forensic Toxicology, Armed Force Institute of Pathology (AFIP) utilizing a GC-MS basic drug screen and a designer drug screen revealed no common compound or compound classes as to the cause of the immunoassay-positive results. Additional information obtained from an immunoassay vendor suggested the anorectic compound dimethylamylamine (DMAA) may be the cause of the false-positive screens. An additional 134 false-positive samples were received and analyzed using liquid chromatography-tandem mass spectrometry (LC-MS-MS) for DMAA. LC-MS-MS analysis revealed the presence of DMAA in 92.3% of the false-positive samples at a concentration of approximately 6.0 mg/L DMAA, causing a positive screen on both immunoassay kits.

  6. 49 CFR 219.605 - Positive drug test results; procedures.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Positive drug test results; procedures. 219.605 Section 219.605 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION, DEPARTMENT OF TRANSPORTATION CONTROL OF ALCOHOL AND DRUG USE Random Alcohol and Drug Testing...

  7. [Evaluation of the test results on hepatitis B pilot surveillance labortory in 9 provinces of China].

    PubMed

    Wang, Fu-zhen; Cui, Fu-qiang; Gong, Xiao-hong

    2010-06-01

    To assess the test quality of HBsAg, anti-HBc IgM and anti-HAV IgM in the laboratories of Hepatitis B pilot surveillance provinces. Blood serum from each of the Hepatitis B pilot surveillance provinces were collected to verify the test results. The Chemiluminescence Microparticle Immuno Assay (CMIA), ARCHITECT i2000 automatic light detector and test reagents produced by U.S.A. Abbott corporation were used in the retest. Using the Abbott reagent CMIA test results as the criteria, the domestic made ELISA reagents sensitivity, specificity, the total coincidence rate and Yoden index of HBsAg, anti-HBc IgM and anti-HAV IgM were evaluated in Hepatitis B pilot surveillance provinces. In the National Notifiable Diseases Reporting System (NNDRS) reported Hepatitis B cases, the proportion of detecting HBsAg and anti-HBc IgM was 98.53% and 39.49% respectively. Through the verification test to the reported cases in Hepatitis B pilot surveillance provinces, the original and veritication diagnosis 01 the reported eases was quite different. Among 197 acute Hepatitis B reported cases, 56 cases were agreeable with diagnosis cretirea, accounting for 28.42%. Among 1046 chronic Hepatitis B reported cases, the verification diagnosis of 602 cases was consistent with the original diagnosis, accounting for 57.55%. By using Abbott reagent and CMIA method to test again, it was found that the verification test results using domesticmade reagent and ELISA assay were low consistency compared with the test results of Abbott reagent CMIA method. The detection result of home-made reagents by ELISA compared with the Abbott reagents CMIA, the sensitivity and the total coincidence rate of HBsAg were over 95%, Kappa value was 0.439, and specificity was only 50.00%. The sensitivity, the total coincidence rate and the specificity of Anti-HBc IgM were moderate level, Kappa value was 0.516. The sensitivity of Anti-HAV IgM were 20%, and the total coincidence and specificity were higher, Kappa value was 0

  8. Prevalence of Serologic Hepatitis B Markers in Blood Donors From Puebla, Mexico: The Association of Relatively High Levels of Anti-Core Antibodies With the Detection of Surface Antigen and Genomic DNA

    PubMed Central

    Sosa-Jurado, Francisca; Hilda Rosas-Murrieta, Nora; Guzman-Flores, Belinda; Perez Zempoaltecalt, Cintia; Patricia Sanchez Torres, Ana; Ramirez Rosete, Leticia; Bernal-Soto, Maribel; Marquez-Dominguez, Luis; Melendez-Mena, Daniel; Angel Mendoza Torres, Miguel; Teresa Lopez Delgado, Maria; Reyes-Leyva, Julio; Vallejo-Ruiz, Veronica; Santos-Lopez, Gerardo

    2016-01-01

    Background The hepatitis B virus (HBV) causes chronic hepatitis, hepatic cirrhosis, and hepatocellular carcinoma. Surface antigen (HBsAg) detection is a definitive test that can confirm HBV infection, while the presence of antibodies against the core protein (anti-HBc) suggests either a previous or ongoing infection or occult hepatitis B infection (OBI). Objectives The aim of the present study was to determine the prevalence of anti-HBc and HBsAg in blood donors. Further, the study aimed to estimate the anti-HBc level at which HBV DNA is detected in putative OBI cases, as well as to search for mutations in the “a” determinant associated with the non-detection of HBsAg in serum. Patients and Methods We conducted a cross-sectional study from 2003–2009. The study included 120,552 blood donors from the state of Puebla, Mexico. Different commercial systems based on microparticles (enzymatic (MEIA) or chemiluminescent (CMIA)) were used to determine the HBsAg and anti-HBc levels. For the detection of HBV DNA, a nested polymerase chain reaction (nested PCR) was used and the genotypes were determined using Sanger sequencing. Results Of the 120,552 blood donors, 1437 (1.19%, 95% CI: 1.12 - 1.26) were reactive to anti-HBc, while 82 (0.066%, 95% CI: 0.053 - 0.079) were reactive to HBsAg. Some 156 plasma samples collected in 2009 from anti-HBc-positive/HBsAg-negative blood donors were submitted for HBV DNA detection in a search for probable OBI. Viral DNA was detected in 27/156 (17.3%, 95% CI: 11.5 - 23.1). Our results show an association between HBV DNA or HBsAg and anti-HBc S/CO levels ≥ 4.0. All DNA samples were identified as genotype H and some “a” determinant mutations were identified, although none corresponded to mutations previously reported to hinder the detection of HBsAg by commercial immunoassays. Conclusions We observed that as the anti-HBc levels increase, there is a higher prevalence of the viral protein HBsAg in blood donors. Samples testing positive

  9. Prevalence of Serologic Hepatitis B Markers in Blood Donors From Puebla, Mexico: The Association of Relatively High Levels of Anti-Core Antibodies With the Detection of Surface Antigen and Genomic DNA.

    PubMed

    Sosa-Jurado, Francisca; Hilda Rosas-Murrieta, Nora; Guzman-Flores, Belinda; Perez Zempoaltecalt, Cintia; Patricia Sanchez Torres, Ana; Ramirez Rosete, Leticia; Bernal-Soto, Maribel; Marquez-Dominguez, Luis; Melendez-Mena, Daniel; Angel Mendoza Torres, Miguel; Teresa Lopez Delgado, Maria; Reyes-Leyva, Julio; Vallejo-Ruiz, Veronica; Santos-Lopez, Gerardo

    2016-06-01

    The hepatitis B virus (HBV) causes chronic hepatitis, hepatic cirrhosis, and hepatocellular carcinoma. Surface antigen (HBsAg) detection is a definitive test that can confirm HBV infection, while the presence of antibodies against the core protein (anti-HBc) suggests either a previous or ongoing infection or occult hepatitis B infection (OBI). The aim of the present study was to determine the prevalence of anti-HBc and HBsAg in blood donors. Further, the study aimed to estimate the anti-HBc level at which HBV DNA is detected in putative OBI cases, as well as to search for mutations in the "a" determinant associated with the non-detection of HBsAg in serum. We conducted a cross-sectional study from 2003-2009. The study included 120,552 blood donors from the state of Puebla, Mexico. Different commercial systems based on microparticles (enzymatic (MEIA) or chemiluminescent (CMIA)) were used to determine the HBsAg and anti-HBc levels. For the detection of HBV DNA, a nested polymerase chain reaction (nested PCR) was used and the genotypes were determined using Sanger sequencing. Of the 120,552 blood donors, 1437 (1.19%, 95% CI: 1.12 - 1.26) were reactive to anti-HBc, while 82 (0.066%, 95% CI: 0.053 - 0.079) were reactive to HBsAg. Some 156 plasma samples collected in 2009 from anti-HBc-positive/HBsAg-negative blood donors were submitted for HBV DNA detection in a search for probable OBI. Viral DNA was detected in 27/156 (17.3%, 95% CI: 11.5 - 23.1). Our results show an association between HBV DNA or HBsAg and anti-HBc S/CO levels ≥ 4.0. All DNA samples were identified as genotype H and some "a" determinant mutations were identified, although none corresponded to mutations previously reported to hinder the detection of HBsAg by commercial immunoassays. We observed that as the anti-HBc levels increase, there is a higher prevalence of the viral protein HBsAg in blood donors. Samples testing positive for HBV-DNA were seen to exhibit a ten-fold higher presence of anti-HBc

  10. False-positive results with amylase testing of citrus fruits.

    PubMed

    Ricci, Ugo; Carboni, Ilaria; Torricelli, Francesca

    2014-09-01

    In a case of robbery in which the criminals passed through the garden adorned with calamondin trees (Citrus madurensis), the investigators found in the grass six calamondin fruits, some undamaged, while others apparently bitten. The fruits were collected and sent to the laboratory for DNA analysis to verify the presence of saliva and robbers' DNA profile. A specific immunochromatographic strip test for saliva confirmed the presence of human salivary α-amylase, but similar positive results were also observed for intact calamondin and other citrus fruits. Further analysis with a specific automated amylase test confirmed the absence of amylase activity. DNA quantification and typing using a specific forensic kit revealed no human DNA presence in any fruits. This case report demonstrates for the first time the occurrence of false positives when human saliva is sought on citrus fruits. © 2014 American Academy of Forensic Sciences.

  11. Infectivity of blood components from donors with occult hepatitis B infection - results from an Australian lookback programme.

    PubMed

    Seed, C R; Maloney, R; Kiely, P; Bell, B; Keller, A J; Pink, J

    2015-02-01

    Previous studies have demonstrated that transfused blood components from donors with occult hepatitis B virus infection (OBI) are potentially infectious. This study reports the results of an Australian lookback programme for the period subsequent to the commencement of individual donation HBV NAT in July 2010 and estimates the HBV transmission rate for components from two categories of donors, confirmed OBI and HBV inconclusive (anti-HBc reactive with non-discriminated NAT result). Using the results of lookback investigations, we estimated HBV transmission rates by donor category and type of component transfused based on the prevalence of antibodies to HBV core antigen (anti-HBc) in recipients adjusted for the estimated prevalence in the general population. After subtracting the background anti-HBc rate, we derived an adjusted transmission rate (all components) with lower and upper bounds as follows: 0·85% (0·00-2·35%) for OBI donors, 2·83% (1·23-4·33%) for inconclusive donors and 1·81% (0·21-3·31%) for total (OBI and inconclusive) donors. The median adjusted transmission rate for total donors was higher (but not statistically) for plasma (3·01%) than RCCs (2·86%), but there was no evidence of transmission for cryoprecipitate or platelets (0% for both components). Our lookback study suggests a low (0·2-3·3%) but measurable rate of HBV transmission in Australia associated with donors with OBI and supports published evidence that at least some blood component types from OBI donors, including a proportion undetectable by ID-NAT can transmit HBV by transfusion. © 2014 International Society of Blood Transfusion.

  12. "Positive" results increase down the Hierarchy of the Sciences.

    PubMed

    Fanelli, Daniele

    2010-04-07

    The hypothesis of a Hierarchy of the Sciences with physical sciences at the top, social sciences at the bottom, and biological sciences in-between is nearly 200 years old. This order is intuitive and reflected in many features of academic life, but whether it reflects the "hardness" of scientific research--i.e., the extent to which research questions and results are determined by data and theories as opposed to non-cognitive factors--is controversial. This study analysed 2434 papers published in all disciplines and that declared to have tested a hypothesis. It was determined how many papers reported a "positive" (full or partial) or "negative" support for the tested hypothesis. If the hierarchy hypothesis is correct, then researchers in "softer" sciences should have fewer constraints to their conscious and unconscious biases, and therefore report more positive outcomes. Results confirmed the predictions at all levels considered: discipline, domain and methodology broadly defined. Controlling for observed differences between pure and applied disciplines, and between papers testing one or several hypotheses, the odds of reporting a positive result were around 5 times higher among papers in the disciplines of Psychology and Psychiatry and Economics and Business compared to Space Science, 2.3 times higher in the domain of social sciences compared to the physical sciences, and 3.4 times higher in studies applying behavioural and social methodologies on people compared to physical and chemical studies on non-biological material. In all comparisons, biological studies had intermediate values. These results suggest that the nature of hypotheses tested and the logical and methodological rigour employed to test them vary systematically across disciplines and fields, depending on the complexity of the subject matter and possibly other factors (e.g., a field's level of historical and/or intellectual development). On the other hand, these results support the scientific status

  13. Occult hepatitis B virus infection among Egyptian blood donors

    PubMed Central

    Said, Zeinab N; El Sayed, Manal H; Salama, Iman I; Aboel-Magd, Enas K; Mahmoud, Magda H; El Setouhy, Maged; Mouftah, Faten; Azzab, Manal B; Goubran, Heidi; Bassili, Amal; Esmat, Gamal E

    2013-01-01

    AIM: To identify blood donors with occult hepatitis B virus (HBV) infection (OBI) to promote safe blood donation. METHODS: Descriptive cross sectional study was conducted on 3167 blood donors negative for hepatitis B surface antigen (HBsAg), hepatitis C antibody (HCV Ab) and human immunodeficiency virus Ab. They were subjected to the detection of alanine aminotransferase (ALT) and aspartate transaminase (AST) and screening for anti-HBV core antibodies (total) by two different techniques; [Monoliza antibodies to hepatitis B core (Anti-HBc) Plus-Bio-Rad] and (ARC-HBc total-ABBOT). Positive samples were subjected to quantitative detection of antibodies to hepatitis B surface (anti-HBs) (ETI-AB-AUK-3, Dia Sorin-Italy). Serum anti-HBs titers > 10 IU/L was considered positive. Quantitative HBV DNA by real time polymerase chain reaction (PCR) (QIAGEN-Germany) with 3.8 IU/mL detection limit was estimated for blood units with negative serum anti-HBs and also for 32 whose anti-HBs serum titers were > 1000 IU/L. Also, 265 recipients were included, 34 of whom were followed up for 3-6 mo. Recipients were investigated for ALT and AST, HBV serological markers: HBsAg (ETI-MAK-4, Dia Sorin-Italy), anti-HBc, quantitative detection of anti-HBs and HBV-DNA. RESULTS: 525/3167 (16.6%) of blood units were positive for total anti-HBc, 64% of those were anti-HBs positive. Confirmation by ARCHITECT anti-HBc assay were carried out for 498/525 anti-HBc positive samples, where 451 (90.6%) confirmed positive. Reactivity for anti-HBc was considered confirmed only if two positive results were obtained for each sample, giving an overall prevalence of 451/3167 (14.2%) for total anti-HBc. HBV DNA was quantified by real time PCR in 52/303 (17.2%) of anti-HBc positive blood donors (viral load range: 5 to 3.5 x 105 IU/mL) with a median of 200 IU/mL (mean: 1.8 x 104 ± 5.1 x 104 IU/mL). Anti-HBc was the only marker in 68.6% of donors. Univariate and multivariate logistic analysis for identifying risk

  14. Adding source positions to the IVS combination—First results

    NASA Astrophysics Data System (ADS)

    Bachmann, Sabine; Thaller, Daniela

    2017-07-01

    The consistent estimation of terrestrial reference frames (TRF), celestial reference frames (CRF) and Earth orientation parameters (EOP) is still an open subject and offers a large field of investigations. Until now, source positions resulting from Very Long Baseline Interferometry (VLBI) observations are not routinely combined on the level of normal equations in the same way as it is a common process for station coordinates and EOPs. The combination of source positions based on VLBI observations is now integrated in the IVS combination process. We present the studies carried out to evaluate the benefit of the combination compared to individual solutions. On the level of source time series, improved statistics regarding weighted root mean square have been found for the combination in comparison with the individual contributions. In total, 67 stations and 907 sources (including 291 ICRF2 defining sources) are included in the consistently generated CRF and TRF covering 30 years of VLBI contributions. The rotation angles A_1, A_2 and A_3 relative to ICRF2 are -12.7, 51.7 and 1.8 μas, the drifts D_α and D_δ are -67.2 and 19.1 μas/rad and the bias B_δ is 26.1 μas. The comparison of the TRF solution with the IVS routinely combined quarterly TRF solution shows no significant impact on the TRF, when the CRF is estimated consistently with the TRF. The root mean square value of the post-fit station coordinate residuals is 0.9 cm.

  15. Adding source positions to the IVS combination—First results

    NASA Astrophysics Data System (ADS)

    Bachmann, Sabine; Thaller, Daniela

    2016-12-01

    The consistent estimation of terrestrial reference frames (TRF), celestial reference frames (CRF) and Earth orientation parameters (EOP) is still an open subject and offers a large field of investigations. Until now, source positions resulting from Very Long Baseline Interferometry (VLBI) observations are not routinely combined on the level of normal equations in the same way as it is a common process for station coordinates and EOPs. The combination of source positions based on VLBI observations is now integrated in the IVS combination process. We present the studies carried out to evaluate the benefit of the combination compared to individual solutions. On the level of source time series, improved statistics regarding weighted root mean square have been found for the combination in comparison with the individual contributions. In total, 67 stations and 907 sources (including 291 ICRF2 defining sources) are included in the consistently generated CRF and TRF covering 30 years of VLBI contributions. The rotation angles A_1 , A_2 and A_3 relative to ICRF2 are -12.7, 51.7 and 1.8 {μ} as, the drifts D_α and D_δ are -67.2 and 19.1 μ as/rad and the bias B_δ is 26.1 μ as. The comparison of the TRF solution with the IVS routinely combined quarterly TRF solution shows no significant impact on the TRF, when the CRF is estimated consistently with the TRF. The root mean square value of the post-fit station coordinate residuals is 0.9 cm.

  16. EXPERIMENTAL RESULTS FROM A MICROWAVE CAVITY BEAM POSITION MONITOR.

    SciTech Connect

    BALAKIN,V.; BAZHAN,A.; LUNEV,P.; SOLYAK,N.; VOGEL,V.; ZHOGOLEV,P.; LISITSYN,A.; YAKIMENKO,V.

    1999-03-29

    Future Linear Colliders have hard requirements for the beam transverse position stability in the accelerator. A beam Position Monitor (BPM) with the resolution better than 0.1 micron in the single bunch regime is needed to control the stability of the beam position along the linac. Proposed BPM is based on the measurement of the asymmetrical mode excited by single bunch in the cavity. Four stages of signal processing (space-, time-, frequency- and phase-filtering providing the required signal-to-noise ratio) are used to obtain extremely high resolution. The measurement set-up was designed by BINP and installed at ATF/BNL to test experimentally this concept. The set-up includes three two-coordinates BPM's at the frequency of 13.566 GHz, and reference intensity/phase cavity. BPM's were mounted on support table. The two-coordinates movers allow to move and align BPM's along the straight line, using the signals from the beam. The position of each monitor is controlled by the sensors with the accuracy 0.03 micron. The information from three monitors allows to exclude angle and position jitter of the beam and measure BPM resolution. In the experiments the resolution of about 0.15 micron for 0.25 nC beam intensity was obtained, that is close to the value required.

  17. Distance between homologous chromosomes results from chromosome positioning constraints.

    PubMed

    Heride, Claire; Ricoul, Michelle; Kiêu, Kien; von Hase, Johann; Guillemot, Vincent; Cremer, Christoph; Dubrana, Karine; Sabatier, Laure

    2010-12-01

    The organization of chromosomes is important for various biological processes and is involved in the formation of rearrangements often observed in cancer. In mammals, chromosomes are organized in territories that are radially positioned in the nucleus. However, it remains unclear whether chromosomes are organized relative to each other. Here, we examine the nuclear arrangement of 10 chromosomes in human epithelial cancer cells by three-dimensional FISH analysis. We show that their radial position correlates with the ratio of their gene density to chromosome size. We also observe that inter-homologue distances are generally larger than inter-heterologue distances. Using numerical simulations taking radial position constraints into account, we demonstrate that, for some chromosomes, radial position is enough to justify the inter-homologue distance, whereas for others additional constraints are involved. Among these constraints, we propose that nucleolar organizer regions participate in the internal positioning of the acrocentric chromosome HSA21, possibly through interactions with nucleoli. Maintaining distance between homologous chromosomes in human cells could participate in regulating genome stability and gene expression, both mechanisms that are key players in tumorigenesis.

  18. The Development and Resulting Performance Impact of Positive Psychological Capital

    ERIC Educational Resources Information Center

    Luthans, Fred; Avey, James B.; Avolio, Bruce J.; Peterson, Suzanne J.

    2010-01-01

    Recently, theory and research have supported psychological capital (PsyCap) as an emerging core construct linked to positive outcomes at the individual and organizational level. However, to date, little attention has been given to PsyCap development through training interventions; nor have there been attempts to determine empirically if such…

  19. The Development and Resulting Performance Impact of Positive Psychological Capital

    ERIC Educational Resources Information Center

    Luthans, Fred; Avey, James B.; Avolio, Bruce J.; Peterson, Suzanne J.

    2010-01-01

    Recently, theory and research have supported psychological capital (PsyCap) as an emerging core construct linked to positive outcomes at the individual and organizational level. However, to date, little attention has been given to PsyCap development through training interventions; nor have there been attempts to determine empirically if such…

  20. Prone position results in enhanced pressor response to ephedrine compared with supine position during general anesthesia.

    PubMed

    Xia, Jiangyan; Yuan, Jing; Lu, Xinjian; Yin, Ning

    2016-06-01

    To elucidate and compare the pressor response to ephedrine in the prone or supine position during general anesthesia (GA). Prospective cohort study. Department of General Surgery or Spine Surgery, Zhongda Hospital, Southeast University, Nanjing, China. Fifty-six patients who were scheduled to undergo elective surgery in the supine or prone position (n = 28 each) and using a generic GA protocol. During surgery, the patients received intravenous (IV) ephedrine when their systolic blood pressure (SBP) decreased to 90 to 110 mm Hg. Hemodynamic changes were measured at 1-minute intervals for 10 minutes and were compared with baseline. Forty-nine patients (23 in the prone position and 26 in the supine position) completed the study. There were no significant differences between the groups with regard to demographic characteristics, hemodynamic parameters, end-tidal concentration of sevoflurane, and dose of propofol and remifentanil (all P> .05). After the bolus injection of ephedrine, a significant increase in SBP was observed in both groups compared to baseline, but the duration and magnitude of the increase in SBP were longer and greater in the prone position than in the supine position. The magnitude of increase of the mean blood pressure was significantly greater in the prone position compared to the supine position at 2 to 7 minutes after ephedrine injection. Ephedrine could cause significant increase in diastolic blood pressure 2 minutes after IV injection, which could last until at least 9 minutes in the prone position group compared to only for 5 minutes in the supine position group (all P< .05). Compared to the supine position, the prone position could augment the pressor response to IV ephedrine during GA. Further studies are recommended to identify its association with other confounding factors such as surgery type or duration, patient history of cardiovascular disease, or patient hydration status. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. FERMILAB SWITCHYARD RESONANT BEAM POSITION MONITOR ELECTRONICS UPGRADE RESULTS

    SciTech Connect

    Petersen, T.; Diamond, J.; Liu, N.; Prieto, P. S.; Slimmer, D.; Watts, A.

    2016-10-12

    The readout electronics for the resonant beam position monitors (BPMs) in the Fermilab Switchyard (SY) have been upgraded, utilizing a low noise amplifier transition board and Fermilab designed digitizer boards. The stripline BPMs are estimated to have an average signal output of between -110 dBm and -80 dBm, with an estimated peak output of -70 dBm. The external resonant circuit is tuned to the SY machine frequency of 53.10348 MHz. Both the digitizer and transition boards have variable gain in order to accommodate the large dynamic range and irregularity of the resonant extraction spill. These BPMs will aid in auto-tuning of the SY beamline as well as enabling operators to monitor beam position through the spill.

  2. Percutaneous peritoneovenous shunt positioning: technique and preliminary results.

    PubMed

    Orsi, Franco; Grasso, Rosario Francesco; Bonomo, Guido; Monti, Cinzia; Marinucci, Irene; Bellomi, Massimo

    2002-05-01

    Nine peritoneovenous shunts were positioned by percutaneous technique in seven patients with advanced malignancy causing severe refractory ascites, and in two patients with hepatic cirrhosis (one with hepatocarcinoma). In all patients the shunts were percutaneously placed through the subclavian vein in the angiographic suite under digital fluoroscopic guide. No complications directly related to the procedure occurred. The shunt was successfully positioned in all patients in 60 min average time. No patient showed symptoms related to pulmonary overload or to disseminated intravascular coagulation. All patients had a significant improvement of the objective symptoms related to ascites such as respiratory symptoms, dyspepsia, and functional impairment to evacuation describing an improvement of their quality of life. Maximum shunt patency was 273 days. Percutaneous placement of peritoneovenous shunt is a safe, fast, and inexpensive procedure, extremely useful in resolution of refractory ascites, reducing symptoms, and allowing effective palliation, with a great improvement in quality of life.

  3. Antibody to hepatitis B core antigen levels in the natural history of chronic hepatitis B: a prospective observational study.

    PubMed

    Jia, Wei; Song, Liu-Wei; Fang, Yu-Qing; Wu, Xiao-Feng; Liu, Dan-Yang; Xu, Chun; Wang, Xiao-Mei; Wang, Wen; Lv, Dong-Xia; Li, Jun; Deng, Yong-Qiong; Wang, Yan; Huo, Na; Yu, Min; Xi, Hong-Li; Liu, Dan; Zhou, Yi-Xing; Wang, Gui-Qiang; Xia, Ning-Shao; Zhang, Ming-Xiang

    2014-12-01

    Previous studies have revealed antibody to hepatitis B core antigen (anti-HBc) levels as a predictor of treatment response in hepatitis B early antigen (HBeAg)-positive chronic hepatitis B (CHB) patients in both interferon and nucleos(t)ide analog therapy cohorts. However, there is no information about anti-HBc levels in the natural history of CHB. This study aimed to define anti-HBc levels of different phases in the natural history of CHB. Two hundred eleven treatment-naive CHB patients were included in the study. They were classified into 4 phases: immune tolerance (IT) phase (n = 39), immune clearance (IC) phase (n = 48), low or no-replicative (LR) phase (n = 55), and HBeAg-negative hepatitis (ENH, n = 69). Fifty patients who were HBsAg negative and anti-HBc positive were also recruited as past HBV infection (PBI) control group. Anti-HBc levels were measured by a newly developed double-sandwich immunoassay. Correlation of anti-HBc levels with alanine aminotransferase (ALT) and other HBV-related markers within each phase was performed. Serum anti-HBc levels were statistically significant between patients in different phases of CHB (P < 0.001). The median anti-HBc levels were: IT (3.17 log 10 IU/mL), IC (4.39 log 10 IU/mL), LR (3.29 log 10 IU/mL), ENH (4.12 log 10 IU/mL), and PBI (0.61 log 10 IU/mL). There existed a strong correlation in IC (r = 0.489, P < 0.001), a poor correlation in ENH (r = 0.275, P = 0.042), and no correlation in patients with ALT reached 5 times upper limit of normal (r = 0.120, P = 0.616). Anti-HBc levels show significant differences during the natural course of CHB. These results may provide some potentially useful insights into hepatitis B pathogenesis and immune activation against hepatitis B virus.

  4. False-Positive Viability PCR Results: An Association with Microtubes.

    PubMed

    Agustí, Gemma; Fittipaldi, Mariana; Codony, Francesc

    2017-03-01

    Currently, one of the most challenged points to expand the use of viability PCR technique is achieving the complete exclusion of dead cells amplification signals, thus avoiding the overestimation of live cells population. Considering that, and based on the hypothesis that DNA may be retained by microtube walls, the impact of the microtube was addressed on signals from live and heat-killed cells. A double-dye reagent, PEMAX™, which comprises a mix of photo-reactive azide forms of phenanthridium, was used in this work. We found that if both the incubation and the photoactivation steps are carried out in different microtubes, the dead cell signal is greatly reduced than when those steps are done in the same tube. Therefore, the strategy depicted in this study presents a simple and efficient step in minimizing false-positive signal when employing viability PCR.

  5. Red Cross only positive result of horrifying 1859 bloodbath.

    PubMed Central

    Brooks, J

    1996-01-01

    Haunted by the suffering and human devastation he witnessed after the 1859 Battle of Solferino in Italy, Swiss banker Henry Dunant wrote a book that galvanized European governments and resulted in the first international agreement that established rules for the conduct of war. The Geneva Convention also resulted in the formation of the Red Cross. PMID:8873648

  6. Traumatic keratoplasty rupture resulting from continuous positive airway pressure mask.

    PubMed

    Fiorentzis, Miltiadis; Seitz, Berthold; Viestenz, Arne

    2015-06-01

    To report a rare case of traumatic wound dehiscence caused by the use of a continuous positive airway pressure (CPAP) mask in a patient with chronic obstructive pulmonary disease (COPD) after penetrating keratoplasty (PKP). Observational case report. A 55-year-old man who was treated with uncomplicated PKP due to pellucid marginal corneal degeneration in the right eye 9 months earlier presented to the emergency department after a globe rupture caused by dislocation of his CPAP mask during sleep. The best-corrected visual acuity (BCVA) was light perception in the right eye. The corneal graft was dehisced from 12 over 3 to 6 o'clock (180 degrees) with interruption of the double running corneal sutures and nasal iris as well as vitreous incarceration. The graft was resutured in place with 33 interrupted 10-0 monofilament nylon sutures. The BCVA improved to 20/100 three months after globe reconstruction. This case underlines the necessity of education for patients undergoing keratoplasty regarding the use of protective eyewear, to avoid predictable or accidental ocular injuries and graft dehiscence or its subsequent consequences. CPAP masks should be fitted (eyeball sparing) to the margins of the orbit after PKP.

  7. Decrease in the prevalence of hepatitis B and a low prevalence of hepatitis C virus infections in the general population of the Seychelles.

    PubMed Central

    Bovet, P.; Yersin, C.; Herminie, P.; Lavanchy, D.; Frei, P. C.

    1999-01-01

    A serological survey of hepatitis B virus (HBV) and hepatitis C virus (HCV) infections was carried out on a random sex- and age-stratified sample of 1006 individuals aged 25-64 years in the Seychelles islands. Anti-HBc and anti-HCV antibodies were detected using commercially available enzyme-linked immunosorbent assays (ELISA), followed by a Western blot assay in the case of a positive result for anti-HCV. The age-adjusted seroprevalence of anti-HBc antibodies was 8.0% (95% CI: 6.5-9.9%) and the percentage prevalence among males/females increased from 7.0/3.1 to 19.1/13.4 in the age groups 25-34 to 55-64 years, respectively. Two men and three women were positive for anti-HCV antibodies, with an age-adjusted seroprevalence of 0.34% (95% CI: 0.1-0.8%). Two out of these five subjects who were positive for anti-HCV also had anti-HBc antibodies. The seroprevalence of anti-HBc was significantly higher in unskilled workers, persons with low education, and heavy drinkers. The age-specific seroprevalence of anti-HBc in this population-based survey, which was conducted in 1994, was approximately three times lower than in a previous patient-based survey carried out in 1979. Although there are methodological differences between the two surveys, it is likely that the substantial decrease in anti-HBc prevalence during the last 15 years may be due to significant socioeconomic development and the systematic screening of blood donors since 1981. Because hepatitis C virus infections are serious and the cost of treatment is high, the fact that the prevalence of anti-HCV antibodies is at present low should not be an argument for not screening blood donors for anti-HCV and eliminating those who are positive. PMID:10612888

  8. Prevalence of occult hepatitis B virus infection in hemodialysis patients in Isfahan, Iran

    PubMed Central

    Kalantari, Hamid; Ferdowsi, Faezeh; Yaran, Majid

    2016-01-01

    Background: The absence of a detectable hepatitis B surface antigen (HBsAg) with or without hepatitis B core antibody (anti-HBc) or hepatitis B surface antibody (anti-HBs) in the presence of hepatitis B virus-DNA (HBV-DNA) is defined as occult HBV infection. This study was aimed to evaluate the prevalence of occult HBV infection in patients receiving hemodialysis (HD) in Isfahan, Iran. Materials and Methods: This cross sectional study was done on 400 patients without acute or chronic HBV infection with end-stage renal disease undergoing regular HD. Blood samples were collected prior to the HD session, and serological markers of viral hepatitis B included HBsAg, anti-HBs and anti-HBc were measured using standard third generation commercially available enzyme immunoassays kit, then samples of positive anti-HBc and negative anti-HBs were tested for HBV DNA using quantitative real-time polymerase chain reaction techniques. Data were analyzed by SPSS using t-test and Chi-square test. Results: The mean age of patients was 51.6 ± 11.2 years. Anti-HBc positive was observed in 32 (8%) of 400 studied patients with negative HBsAg. Of 32 patients with anti-HBc positive, 15 were males and 17 were females with mean age of 49.7 ± 12.6 years. Among 32 patients with anti-HBc positive, 10 patients were negative for anti-HBs. All of 10 patients were negative for HBV DNA. The prevalence of occult HBV infection was 0%. Conclusions: The prevalence of occult HBV infection in HBsAg negative patients undergoing HD was 0% and look to be among the lowest worldwide. So, occult HBV infection is not a significant health problem in HD patients in this region. PMID:27713872

  9. Donor screening for hepatitis B virus infection in a cell and tissue bank.

    PubMed

    Solves, P; Mirabet, V; Alvarez, M; Vila, E; Quiles, F; Villalba, J V; Montoro, J A; Soler, M A; Roig, R J

    2008-12-01

    Hepatitis B virus (HBV) has been transmitted by tissue transplantation. In order to reduce the risk of HBV transmission, testing for antibody to HBV core antigen (anti-HBc) is used in addition to testing for hepatitis B surface antigen (HBsAg) in many blood centers and tissue banks. We retrospectively analyzed the results of HBV assays in tissue donors. All tissue donors were tested for HBsAg and anti-HBc. All anti-HBc positive sera were tested for the antibody to HBsAg (anti-HBs). From July 2006, an HBV nucleic acid testing (NAT) assay was also performed. A total of 6855 tissue donors from January 1999 till July 2007 were tested for HBV assays: 4756 women and 2099 men. Positive HBsAg was found in 23 (0.36%) living donors, while no multiorgan or cord blood (CB) donor was found to be positive for HBsAg. Positive anti-HBc was found in 80 multiorgan donors (12.94%), 599 living donors (17.84%), and 103 CB donors (3.57%) (P<0.005), while isolated anti-HBc was found in 12 multiorgan (1.94%), in 126 living tissue donors (3.75%), and in 8 CB donors (0.28%). A total of 1310 donors were analyzed for single-sample DNA HBV NAT assay. We consider that anti-HBc and NAT assays must both still be performed in addition to HBsAg assay for HBV screening in tissue donors. All these tests will be useful in order to define an algorithm for safe and efficient management of the tissue bank.

  10. Occult hepatitis B virus infection among blood donors from the Brazilian Amazon: implications for transfusion policy

    PubMed Central

    Moresco, M. N. dos S.; Virgolino, H. de A.; de Morais, M. P. E.; da Motta-Passos, I.; Gomes-Gouvêa, M. S.; de Assis, L. M. S.; Aguiar, K. R. de L.; Lombardi, S. C. F.; Malheiro, A.; Cavalheiro, N. de P.; Levi, J. E.; Torres, K. L.

    2016-01-01

    Background Brazil requires the performance of both a test for hepatitis B surface antigen (HBsAg) and a test for antibodies to the core of hepatitis B for blood donor screening. Blood centres in regions of high HBV endemicity struggle to maintain adequate stocks in face of the high discard rates due to anti-HBc reactivity. We evaluated the potential infectivity of donations positive for anti-HBc in search of a rational approach for the handling of these collections. Study Design and Methods We tested anti-HBc reactive blood donations from the state of Amazonas for the presence of HBV DNA and for titres of anti-HBs. The study population consists of village-based donors from the interior of Amazonas state. Results Among 3600 donations, 799 were anti-HBc reactive (22·2%). We were able to perform real-time PCR for the HBV S gene on specimens from 291 of these donors. Eight of these samples were negative for HBsAg and positive for HBV DNA and were defined as occult B virus infections (2·7%). Six of those eight specimens had anti-HBs titres above 100 mIU/ml, indicating the concomitant presence of the virus with high antibody titres. Conclusion A small proportion of anti-HBc reactive donors carry HBV DNA and anti-HBs testing is not useful for predicting viremia on them. This finding indicates the possibility of HBV transmission from asymptomatic donors, especially in areas of high HBV prevalence. Sensitive HBV DNA nucleic acid testing may provide another level of safety, allowing eventual use of anti-HBc reactive units in critical situations. PMID:24697276

  11. Baseline quantitative hepatitis B core antibody titre alone strongly predicts HBeAg seroconversion across chronic hepatitis B patients treated with peginterferon or nucleos(t)ide analogues

    PubMed Central

    Fan, Rong; Sun, Jian; Yuan, Quan; Xie, Qing; Bai, Xuefan; Ning, Qin; Cheng, Jun; Yu, Yanyan; Niu, Junqi; Shi, Guangfeng; Wang, Hao; Tan, Deming; Wan, Mobin; Chen, Shijun; Xu, Min; Chen, Xinyue; Tang, Hong; Sheng, Jifang; Lu, Fengmin; Jia, Jidong; Zhuang, Hui; Xia, Ningshao; Hou, Jinlin

    2016-01-01

    Objective The investigation regarding the clinical significance of quantitative hepatitis B core antibody (anti-HBc) during chronic hepatitis B (CHB) treatment is limited. The aim of this study was to determine the performance of anti-HBc as a predictor for hepatitis B e antigen (HBeAg) seroconversion in HBeAg-positive CHB patients treated with peginterferon (Peg-IFN) or nucleos(t)ide analogues (NUCs), respectively. Design This was a retrospective cohort study consisting of 231 and 560 patients enrolled in two phase IV, multicentre, randomised, controlled trials treated with Peg-IFN or NUC-based therapy for up to 2 years, respectively. Quantitative anti-HBc evaluation was conducted for all the available samples in the two trials by using a newly developed double-sandwich anti-HBc immunoassay. Results At the end of trials, 99 (42.9%) and 137 (24.5%) patients achieved HBeAg seroconversion in the Peg-IFN and NUC cohorts, respectively. We defined 4.4 log10 IU/mL, with a maximum sum of sensitivity and specificity, as the optimal cut-off value of baseline anti-HBc level to predict HBeAg seroconversion for both Peg-IFN and NUC. Patients with baseline anti-HBc ≥4.4 log10 IU/mL and baseline HBV DNA <9 log10 copies/mL had 65.8% (50/76) and 37.1% (52/140) rates of HBeAg seroconversion in the Peg-IFN and NUC cohorts, respectively. In pooled analysis, other than treatment strategy, the baseline anti-HBc level was the best independent predictor for HBeAg seroconversion (OR 2.178; 95% CI 1.577 to 3.009; p<0.001). Conclusions Baseline anti-HBc titre is a useful predictor of Peg-IFN and NUC therapy efficacy in HBeAg-positive CHB patients, which could be used for optimising the antiviral therapy of CHB. PMID:25586058

  12. [The significance and place of HBsAg neutralization test in the diagnosis and algorithm of hepatitis B infection].

    PubMed

    Aytaç, Özlem; Toyran, Alparslan; Aksoy, Altan

    2017-04-01

    The diagnosis of hepatitis B virus infection is evaluated serologically, virologically, biochemically, and with histologic liver indicators. The aim of this study was to investigate the place and significance of the HBsAg neutralization test in the diagnostic algorithm for hepatitis Binfection. From the venous blood samples sent to Ankara Numune Education and Research Hospital Medical Microbiology Laboratory between September 2014 and May 2016 for HBsAg test, serum samples regarded each patient as reactive (≥ 0.9 S\\CO) , 9 ≤ S ≤ CO ≤ 30) were studied twice. A total of 105 samples which were reactive in both analyses were included in the study. After the evaluation of these samples by neutralization confirmation test, which is routinely performed in our laboratory, the samples were stored under optimal conditions and studied for HBV DNA with the real-time PCR and for HBeAg, anti-HBeAg, anti-HBc IgM, and anti-HBc total antibody assays by ELISA. The 105 samples, in which HBsAg was detected, were analyzed with the neutralization test. The presence of HBsAg was confirmed by neutralization test in 67 of 105 samples (63.8%), and of these patients, two patients (2.3%) had negative HBV DNA and anti-HBc total antibody test (false positive neutralization test). Of the 105 samples included in the study, the anti-HBc total antibody test was positive in 78 patients (74.3%). However, out of these 78 patients who were positive for the anti-HBc total antibody test, there were 13 patients (16.7%) with negative neutralization and HBV DNA test results (false positive anti-HBc total antibody test). The HBV DNA positivity was detected significantly lower in samples with HBsAg level ≤ 5 S/CO compared to the samples with HBsAg level > 5 S/CO (p= 0.020). Also, if the unit price of the neutralization test used in our study was considered, the cost was 17,00 TL while the unit price of HBV DNA test was 55,00 TL. Utilization of the neutralization test instead of HBV DNA test

  13. Occult HBV Infection in Immunized Neonates Born to HBsAg-Positive Mothers: A Prospective and Follow-Up Study

    PubMed Central

    Nie, Jing-Jing; Liang, Xiao-Feng; Yan, Ling; Wang, Fu-Zhen; Zhai, Xiang-Jun; Liu, Jian-Xun; Zhu, Feng-Cai; Chang, Zhan-Jun; Li, Jie

    2016-01-01

    Objective Occult HBV infection (OBI) has been reported in infants born to HBsAg-positive mothers despite immunization. This study aims to determine the maintenance of this status in a prospective birth cohort. Methods A total of 158 neonates born to HBsAg-positive mothers were enrolled. All received passive-active immunization against HBV according to a 0-1-6 schedule. Sera were collected at 7 months of age. Those diagnosed with OBI were serially followed up at 12, 24 and 36 months of age. HBV serological markers were determined by Abbott i2000 system. HBV DNA was quantitated by Abbott m2000 system. Standard PCR followed by direct sequencing were applied for mother-child HBV pairs. Homology and phylogenetic comparisons were done by BLAST and Mega 5. Results All the 158 neonates were HBsAg-negative and anti-HBs-positive at 7 months of age, and 32 (20.3%) of them were diagnosed with OBI, with a median HBV DNA level of 1.97 (1.20–3.71) log IU/mL. Of them, HBV DNA was positive in 25.0%, 21.9% and 7.7% at 12, 24 and 36 months of age, respectively. HBV DNA disappeared at one of the follow-up points in 31 neonates, however, rebounded to low levels in 6 of them thereafter. HBV DNA persisted at low levels during follow-ups in the other one neonate apart from the above 31. All remained negative for HBsAg. Only two (6.3%) neonates were positive for anti-HBc after 24 months of age. HBV showed close homology and phylogenetic relationships for mother-child pairs. S-escape mutant, G145R, was not discovered. The first vaccine dose within 6 hours of birth significantly reduced the occurrence of OBI (59.4% vs. 83.3%, p = 0.003). Conclusions HBV may be controlled in immunized neonates of HBsAg-positive mothers, after being diagnosed with OBI. Timely vaccination against HBV may provide the utmost protection. Long-term and close monitorings are needed. PMID:27835694

  14. The oblique supine decubitus position: technical description and comparison of results with the prone decubitus and dorsal supine decubitus positions.

    PubMed

    Arrabal-Martin, Miguel; Arrabal-Polo, Miguel A; Lopez-Leon, Victor; Merino-Salas, Sergio; Palao-Yago, Francisco; Cámara-Ortega, Manuel; Zuluaga-Gomez, Armando

    2012-10-01

    Our objective was to analyze the advantages of the percutaneous nephrolithotomy in oblique supine decubitus compared to the prone and dorsal supine position. In 87 patients diagnosed with urolithiasis (495.5-530.8 mm(2)), percutaneous nephrolithotomy (PNL) was performed from 2000 to 2011. The patients were divided into three groups: Group A, 32 patients, PNL in the prone decubitus position; Group B, 24 patients, PNL in the dorsal supine position; Group C, 31 patients, PNL in the oblique supine position. We analyzed intraoperative parameters, complications, and results among the three groups. The three procedures were performed with a single access, 24-30 Ch. No statistically significant differences were found among the three groups regarding the patients' characteristics, or the morphology or size of the kidney stone treated. The operation time was shorter in the cases of PNL in dorsal supine and oblique supine compared to the prone position. The complication rate was very similar in the three groups. The main advantage of the PNL in oblique supine compared to the dorsal supine was that the puncture could in all cases be directed by ultrasonography, with greater precision, more safety, and more control of the percutaneous renal access. The oblique supine decubitus position is a safe position for the percutaneous treatment of urolithiasis and it becomes easier when the puncture is guided by ultrasound.

  15. Impact of hepatitis B vaccination in children born to HBsAg-positive mothers: a 20-year retrospective study.

    PubMed

    Bracciale, L; Fabbiani, M; Sansoni, A; Luzzi, L; Bernini, L; Zanelli, G

    2009-08-01

    Preventive measures remain the best approach to control the spread of hepatitis B virus (HBV) infection. To evaluate the effectiveness of vaccination against HBV, we conducted a 20-year retrospective study on 100 subjects, born to hepatitis B surface antigen (HBsAg)-positive mothers, who had received postexposure prophylaxis at the Clinic of Infectious Diseases (Siena University, Italy) during 1984-2004. All patients were tested for the presence of HBsAg, anti-HBs and anti-HB core antigen (anti-HBc). Two subjects (2%) acquired the infection as shown by the presence of anti-HBc. Of the 98 patients who did not acquire the infection, 62 of these (63.3%) had an anti-HBs concentration considered protective (> or =10 mIU/ml). The percentage of protected subjects decreased in relation to time from vaccination with a significant reduction (p = 0.009) of anti-HBs geometric mean titre (GMT) after 5 years, which reached the level of 10 mIU/ml after about 15 years. No patients without protective concentration have acquired the infection as of today. Only 12% of the HBsAg-positive mothers were followed in specialized structures after pregnancy, reflecting the scarce knowledge of the problem in the general population. Our data, while confirming the effectiveness of anti hepatitis B vaccination, highlight the need for postvaccination follow-up, particularly in high-risk categories, to prolong protection, through booster doses if necessary. We show, moreover, the importance of maintaining active surveillance in the territory to improve follow-up to chronic carriers and to sensitize families.

  16. Green Positive Guidance and Green Positive Life Counseling for Decent Work and Decent Lives: Some Empirical Results

    PubMed Central

    Di Fabio, Annamaria; Bucci, Ornella

    2016-01-01

    This article discusses green positive guidance and green positive life counseling for decent work and decent lives. From a green guidance perspective, the connectedness to nature construct is important both in terms of the meaning of work and life construction. The study discussed in this article analyzed the relationship between empathy and connectedness to nature, controlling for the effects of fluid intelligence and personality traits. In this connection, the Advanced Progressive Matrices, the Big Five Questionnaire, and the Interpersonal Reactivity Index were administered to 144 Italian high school students. The study revealed that connecteness to nature was not associated with fluid intelligence and was only moderately associated with personality traits. It was empathy that showed the highest association with connectedness to nature. The results open new opportunities for future research and interventions in green positive guidance/life counseling and green positive decent work. PMID:26973563

  17. Green Positive Guidance and Green Positive Life Counseling for Decent Work and Decent Lives: Some Empirical Results.

    PubMed

    Di Fabio, Annamaria; Bucci, Ornella

    2016-01-01

    This article discusses green positive guidance and green positive life counseling for decent work and decent lives. From a green guidance perspective, the connectedness to nature construct is important both in terms of the meaning of work and life construction. The study discussed in this article analyzed the relationship between empathy and connectedness to nature, controlling for the effects of fluid intelligence and personality traits. In this connection, the Advanced Progressive Matrices, the Big Five Questionnaire, and the Interpersonal Reactivity Index were administered to 144 Italian high school students. The study revealed that connecteness to nature was not associated with fluid intelligence and was only moderately associated with personality traits. It was empathy that showed the highest association with connectedness to nature. The results open new opportunities for future research and interventions in green positive guidance/life counseling and green positive decent work.

  18. Hepatitis B virus prevalence and transmission risk factors in inflammatory bowel disease patients at Clementino Fraga Filho university hospital

    PubMed Central

    Tolentino, Yolanda Faia Manhães; Fogaça, Homero Soares; Zaltman, Cyrla; Ximenes, Lia Laura Lewis; Coelho, Henrique Sérgio Moraes

    2008-01-01

    AIM: To evaluate the prevalence of hepatitis B virus (HBV) infection in inflammatory bowel disease (IBD) patients that followed up in our hospital and try to identify the possible risk factors involved in this infection transmission. METHODS: This was a cross-sectional study for which 176 patients were selected according to their arrival for the medical interview. All these patients had already IBD diagnosis. The patient was interviewed and a questionnaire was filled out. RESULTS: In the group of 176 patients whom we examined, we found that 17% (30) were anti-HBc positive. Out of 30 patients with positive anti-HBc, 2.3% (4) had positive HBsAg and negative HBV-DNA. In an attempt to identify the possible HBV infection transmission risk factors in IBD patients, it was observed that 117 patients had been submitted to some kind of surgical procedure, but only 24 patients had positive anti-HBc (P = 0.085). It was also observed that surgery to treat IBD complications was not a risk factor for HBV infection transmission, since we did not get a statically significant P value. However, IBD patients that have been submitted to surgery to treat IBD complications received more blood transfusions then patients submitted to other surgical interventions (P = 0.015). CONCLUSION: There was a high incidence of positive anti-HBc (17%) and positive HBsAg (2.3%) in IBD patient when compared with the overall population (7.9%). PMID:18506926

  19. Xpert MTB/RIF Results in Patients With Previous Tuberculosis: Can We Distinguish True From False Positive Results?

    PubMed

    Theron, Grant; Venter, Rouxjeane; Calligaro, Greg; Smith, Liezel; Limberis, Jason; Meldau, Richard; Chanda, Duncan; Esmail, Aliasgar; Peter, Jonny; Dheda, Keertan

    2016-04-15

    Patients with previous tuberculosis may have residual DNA in sputum that confounds nucleic acid amplification tests such as Xpert MTB/RIF. Little is known about the frequency of Xpert-positive, culture-negative ("false positive") results in retreatment patients, whether these are distinguishable from true positives, and whether Xpert's automated filter-based wash step reduces false positivity by removing residual DNA associated with nonintact cells. Pretreatment patients (n = 2889) with symptoms of tuberculosis from Cape Town, South Africa, underwent a sputum-based liquid culture and Xpert. We also compared Xpert results from dilutions of intact or heat-lysed and mechanically lysed bacilli. Retreatment cases were more likely to be Xpert false-positive (45/321 Xpert-positive retreatment cases were false-positive) than new cases (40/461) (14% [95% confidence interval {CI}, 10%-18%] vs 8% [95% CI, 6%-12%];P= .018). Fewer years since treatment completion (adjusted odds ratio [aOR], 0.85 [95% CI, .73-.99]), less mycobacterial DNA (aOR, 1.14 [95% CI, 1.03-1.27] per cycle threshold [CT]), and a chest radiograph not suggestive of active tuberculosis (aOR, 0.22 [95% CI, .06-.82]) were associated with false positivity. CThad suboptimal accuracy for false positivity: 46% of Xpert-positives with CT> 30 would be false positive, although 70% of false positives would be missed. CT's predictive ability (area under the curve, 0.83 [95% CI, .76-.90]) was not improved by additional variables. Xpert detected nonviable, nonintact bacilli without a change in CTvs controls. One in 7 Xpert-positive retreatment patients were culture negative and potentially false positive. False positivity was associated with recent previous tuberculosis, high CT, and a chest radiograph not suggestive of active tuberculosis. Clinicians may consider awaiting confirmatory testing in retreatment patients with CT> 30; however, most false positives fall below this cut-point. Xpert can detect DNA from nonviable

  20. Seroprevalence of hepatitis B virus infection in individuals with clinical evidence of hepatitis in Goiânia, Goiás. Detection of viral DNA and determination of subtypes.

    PubMed

    Silva, Claudia de Oliveira e; Azevedo, Marli da Silva Pereira; Soares, Célia Maria de Almeida; Martins, Regina Maria Bringel; Ramos, Carmen Helena; Daher, Roberto Ruhman; Cardoso, Divina das Dôres de Paula

    2002-01-01

    The presence of serological markers for hepatitis B virus (HBsAg, anti-HBc IgM and Anti-HBc total) was investigated in the serum of 1,396 individuals who had clinical suspect of hepatitis. It was observed that 50.7% of the individuals were positive and, from the total of the studied individuals, 14.5% were positive for HBsAg. From these, 8.5% were also positive for anti-HBc IgM. The analysis in relation to gender showed a higher seroprevalence index among male individuals (p < 0.0001). It was observed the occurrence of subtypes adw2 (62.7%), ayw3 (23.5%), ayw2 (9.8%) and adw4 (3.9%). The viral DNA was detected in 61 (33.9%) HBsAg positive samples and in one sample positive only for anti-HBc total. These results indicate an important incidence of the HBV infection in this population, and reinforce previous studies regarding this virus in the central west region of Brazil.

  1. Xpert MTB/RIF Results in Patients With Previous Tuberculosis: Can We Distinguish True From False Positive Results?

    PubMed Central

    Theron, Grant; Venter, Rouxjeane; Calligaro, Greg; Smith, Liezel; Limberis, Jason; Meldau, Richard; Chanda, Duncan; Esmail, Aliasgar; Peter, Jonny; Dheda, Keertan

    2016-01-01

    Background. Patients with previous tuberculosis may have residual DNA in sputum that confounds nucleic acid amplification tests such as Xpert MTB/RIF. Little is known about the frequency of Xpert-positive, culture-negative (“false positive”) results in retreatment patients, whether these are distinguishable from true positives, and whether Xpert's automated filter-based wash step reduces false positivity by removing residual DNA associated with nonintact cells. Methods. Pretreatment patients (n = 2889) with symptoms of tuberculosis from Cape Town, South Africa, underwent a sputum-based liquid culture and Xpert. We also compared Xpert results from dilutions of intact or heat-lysed and mechanically lysed bacilli. Results. Retreatment cases were more likely to be Xpert false-positive (45/321 Xpert-positive retreatment cases were false-positive) than new cases (40/461) (14% [95% confidence interval {CI}, 10%-18%] vs 8% [95% CI, 6%–12%]; P = .018). Fewer years since treatment completion (adjusted odds ratio [aOR], 0.85 [95% CI, .73–.99]), less mycobacterial DNA (aOR, 1.14 [95% CI, 1.03–1.27] per cycle threshold [CT]), and a chest radiograph not suggestive of active tuberculosis (aOR, 0.22 [95% CI, .06–.82]) were associated with false positivity. CT had suboptimal accuracy for false positivity: 46% of Xpert-positives with CT > 30 would be false positive, although 70% of false positives would be missed. CT's predictive ability (area under the curve, 0.83 [95% CI, .76–.90]) was not improved by additional variables. Xpert detected nonviable, nonintact bacilli without a change in CT vs controls. Conclusions. One in 7 Xpert-positive retreatment patients were culture negative and potentially false positive. False positivity was associated with recent previous tuberculosis, high CT, and a chest radiograph not suggestive of active tuberculosis. Clinicians may consider awaiting confirmatory testing in retreatment patients with CT > 30; however, most false

  2. Prevalence, Risk Behaviors, and Virological Characteristics of Hepatitis B Virus Infection in a Group of Men Who Have Sex with Men in Brazil: Results from a Respondent-Driven Sampling Survey

    PubMed Central

    Oliveira, Marina P.; Matos, Márcia A. D.; Silva, Ágabo M. C.; Lopes, Carmen L. R.; Teles, Sheila A.; Matos, Marcos A.; Spitz, Natália; Araujo, Natalia M.; Mota, Rosa M. S.; Kerr, Ligia R. F. S.; Martins, Regina M. B.

    2016-01-01

    Background Men who have sex with men (MSM) are at increased risk of exposure to hepatitis B virus (HBV) compared with the general population. This study aims to assess the epidemiological and virological characteristics of HBV infection in a sample of MSM in Brazil, where data are scarce. Methods A cross-sectional study was conducted among MSM in the City of Goiânia, Central Brazil, from March to November 2014, using Respondent-Driven Sampling (RDS). After signing the consent form, participants were interviewed and a blood sample collected. All samples were tested for HBV serological markers and HBV DNA. HBV nucleotide sequence analysis was also performed. Results A total of 522 MSM were recruited in the study. The prevalence of HBV infection (current or past [presence of anti-HBc marker]) was 15.4% (95% CI: 8.7–25.8) and the rate of HBsAg carriers was 0.6% (95% CI: 0.2–1.6). About 40% (95% CI: 32.3–48.8) of the participants had serological evidence of previous HBV vaccination (reactive for isolated anti-HBs). In addition, 44.3% (95% CI: 36.1–52.9) were seronegative for all HBV markers. Age over 25 years old, receptive anal intercourse, previous sex with women, and history of sexually transmitted infections (STIs) were factors associated with HBV infection. HBV DNA was detected only in HBsAg-positive individuals. HBV isolates were classified into genotype A (subgenotypes A1 and A2), and some mutations were identified throughout the genome. Therefore, occult HBV infection was not observed in the study population. Conclusions Public health strategies should be improved for the MSM population in order to prevent HBV and other STIs, as well as to provide appropriate management of patients with active infections. PMID:27508385

  3. False-Positive Results of Enzyme Immunoassays for Human Immunodeficiency Virus in Patients with Uncomplicated Malaria

    PubMed Central

    Gasasira, Anne F.; Dorsey, Grant; Kamya, Moses R.; Havlir, Diane; Kiggundu, Moses; Rosenthal, Philip J.; Charlebois, Edwin D.

    2006-01-01

    Malaria may impact upon human immunodeficiency virus (HIV) test results. We evaluated two HIV enzyme immunoassays (EIAs) by testing 1,965 Ugandans with malaria. We found poor positive predictive values (53% and 76%), particularly with younger age. Combining EIAs eliminated false positives but missed 21% of true positives. Performance of HIV EIAs in malaria may be unsatisfactory. PMID:16891532

  4. CT Colonography with Computer-aided Detection: Recognizing the Causes of False-Positive Reader Results

    PubMed Central

    Dachman, Abraham H.; Wroblewski, Kristen; Vannier, Michael W.; Horne, John M.

    2014-01-01

    Computed tomography (CT) colonography is a screening modality used to detect colonic polyps before they progress to colorectal cancer. Computer-aided detection (CAD) is designed to decrease errors of detection by finding and displaying polyp candidates for evaluation by the reader. CT colonography CAD false-positive results are common and have numerous causes. The relative frequency of CAD false-positive results and their effect on reader performance on the basis of a 19-reader, 100-case trial shows that the vast majority of CAD false-positive results were dismissed by readers. Many CAD false-positive results are easily disregarded, including those that result from coarse mucosa, reconstruction, peristalsis, motion, streak artifacts, diverticulum, rectal tubes, and lipomas. CAD false-positive results caused by haustral folds, extracolonic candidates, diminutive lesions (<6 mm), anal papillae, internal hemorrhoids, varices, extrinsic compression, and flexural pseudotumors are almost always recognized and disregarded. The ileocecal valve and tagged stool are common sources of CAD false-positive results associated with reader false-positive results. Nondismissable CAD soft-tissue polyp candidates larger than 6 mm are another common cause of reader false-positive results that may lead to further evaluation with follow-up CT colonography or optical colonoscopy. Strategies for correctly evaluating CAD polyp candidates are important to avoid pitfalls from common sources of CAD false-positive results. ©RSNA, 2014 PMID:25384290

  5. Positioning.

    ERIC Educational Resources Information Center

    Conone, Ruth M.

    The key to positioning is the creation of a clear benefit image in the consumer's mind. One positioning strategy is creating in the prospect's mind a position that takes into consideration the company's or agency's strengths and weaknesses as well as those of its competitors. Another strategy is to gain entry into a position ladder owned by…

  6. A retrospective analysis of false-positive infectious screening results in blood donors

    PubMed Central

    Vo, Michelle T.; Bruhn, Roberta; Kaidarova, Zhanna; Custer, Brian S.; Murphy, Edward L.; Bloch, Evan M.

    2016-01-01

    BACKGROUND False-positive infectious transfusion screening results remain a challenge with continued loss of both donors and blood products. We sought to identify associations between donor demographic characteristics (age, race, sex, education, first-time donor status) and testing false positive for viruses during routine blood donation screening. In addition the study assessed the prevalence of high-risk behaviors in false-positive donors. STUDY DESIGN AND METHODS Blood Systems, Inc. donors with allogeneic donations between January 1, 2011, and December 31, 2012, were compared in a case-control study. Those with a false-positive donation for one of four viruses (human immunodeficiency virus [HIV], human T-lymphotropic virus [HTLV], hepatitis B virus [HBV], and hepatitis C virus [HCV]) were included as cases. Those with negative test results were controls. For a subset of cases, infectious risk factors were evaluated. RESULTS Black race and Hispanic ethnicity were associated with HCV and HTLV false-positive results. Male sex and lower education were associated with HCV false positivity, and age 25 to 44 was associated with HTLV false positivity. First-time donors were more likely to be HCV false positive although less likely to be HBV and HTLV false positive. No significant associations between donor demographics and HIV false positivity were observed. A questionnaire for false-positive donors showed low levels of high-risk behaviors. CONCLUSION Demographic associations with HCV and HTLV false-positive results overlap with those of true infection. While true infection is unlikely given current testing algorithms and risk factor evaluation, the findings suggest nonrandom association. Further investigation into biologic mechanisms is warranted. PMID:26509432

  7. Delays in antiretroviral therapy initiation among HIV-positive individuals: results of the positive living with HIV study

    PubMed Central

    Poudel, Krishna C.; Buchanan, David R.; Poudel-Tandukar, Kalpana

    2016-01-01

    Background Lack of early initiation of antiretroviral therapy (ART) remains a major health concern due to increased risk of premature mortality and further HIV transmission. This study explored CD4+ cell count monitoring in relation to delays in ART initiation among HIV-positive individuals in the Kathmandu Valley, Nepal, where ART coverage was only 23.7% in 2011. Design We recruited a total of 87 ART-naïve, HIV-positive individuals aged 18 to 60 years through the networks of five non-government organizations working with HIV-positive individuals. We collected data on the history of ART initiation, CD4+ cell count monitoring, socio-demographic variables, perceived family support (measured with 10-item Nepali Family Support and Difficulty Scale), depression, and HIV symptom burden. Correlates of ART eligibility were examined using multivariable logistic regression analysis. Results A total of 72 of the 87 ART-naïve participants (82.8%) had monitored their CD4+ cell count in the past 6 months. Of these, 36 (50%) participants were eligible for ART initiation with CD4+ cell count <350 cells/mm3. A total of 12 participants had CD4+ cell count <200 cells/mm3. Lower level of perceived family support was associated with 6.05-fold higher odds (95% confidence interval =1.95 to 18.73) of being ART eligible with a CD4+ cell count <350 cells/mm3. Conclusions High rate of delays in ART initiation and the strong association of low perceived family support with ART eligibility in our study participants suggest that HIV service providers should consider the role and impact of family support in influencing individual decisions to initiate ART among eligible HIV-positive individuals. PMID:27369221

  8. Aerosolized vaccine as an unexpected source of false-positive Bordetella pertussis PCR results.

    PubMed

    Salimnia, Hossein; Lephart, Paul R; Asmar, Basim I; Prebelich, Dawn; Paulson, Erin; Fairfax, Marilynn R

    2012-02-01

    When 13 of 13 nasal wash specimens from a single pediatrician's office tested positive for low quantities of Bordetella pertussis DNA, we suspected prelaboratory contamination. Investigation revealed that Pentacel and Adacel vaccines contain high copy numbers of B. pertussis DNA, which can be aerosolized, causing false-positive B. pertussis PCR results.

  9. Psychological impact of positive cervical cancer screening results among Japanese women.

    PubMed

    Isaka, Yukari; Inada, Haruhiko; Hiranuma, Yuri; Ichikawa, Masao

    2017-02-01

    While cervical cancer screening is useful for detecting and then treating the disease at an early stage, most women with screen-positive results are free from cervical cancer but nevertheless subject to the unnecessary worry entailed in receiving such results. The purpose of this study was to examine whether receiving a screen-positive result was actually related to psychological distress among Japanese women who underwent cervical cancer screening. We conducted a questionnaire survey at health facilities in a semiurban city of Ibaraki prefecture, involving 1744 women who underwent cervical cancer screening and 72 who received screen-positive results and then underwent further testing. We used the K6 scale to assess their psychological distress (K6 score ≥5) and performed multiple logistic regression analyses to estimate the relative effect of receiving screen-positive results on psychological distress. Psychological distress was more prevalent among women with screen-positive results (OR 2.22; 95 % CI 1.32-3.74), while it was also related to history of mental health consultation (OR 2.26; 95 % CI 1.69-3.01) and marital status (OR 1.32; 95 % CI 1.02-1.70). Receiving a positive cervical cancer screening result was associated with psychological distress. To alleviate this psychological impact, the current form of communicating the screening results should be reconsidered.

  10. Phosphatidylethanol: the potential role in further evaluating low positive urinary ethyl glucuronide and ethyl sulfate results.

    PubMed

    Skipper, Gregory E; Thon, Natasha; Dupont, Robert L; Baxter, Louis; Wurst, Friedrich M

    2013-09-01

    Whereas urinary ethyl glucuronide (EtG) levels above 1,000 ng/ml reflect with a high probability ethanol (EtOH) consumption, levels below this cutoff are difficult to interpret as both extraneous (nonbeverage) EtOH exposure, recent drinking, and more distant high EtOH intake (several days ago) might yield similar results. This might be of particular relevance in medico-legal cases. To overcome this dilemma, phosphatidylethanol (PEth) might be a promising marker, because blood PEth is only positive following significant alcohol use. The aim of our study was therefore to employ PEth as a marker to differentiate between the different conditions. Subjects included were 252 participants in monitoring with the Alabama Physician Health Program. All subjects testing positive for EtG and/or ethyl sulfate (EtS) who denied drinking after routine supportive confrontation were subject to information about PEth testing. If they still denied drinking, PEth testing was performed and the result communicated. EtG, EtS, and PEth testing was performed in a commercial laboratory using liquid chromatography tandem mass spectrometry methods. Of a total of 18 subjects who tested positive for EtG and/or EtS, 10 denied drinking. Of the 7 who denied drinking after PEth explanation, in 5 cases, their claim was supported by a negative PEth result. In 2 cases, a positive PEth result was in contrast to their claim. PEth results in combination with previous low positive EtG/EtS results allow differentiating between innocent/extraneous exposure and drinking. Negative PEth testing following low positive EtG/EtS results helps to further elucidate the findings and support the claim of the patient of recent alcohol abstinence. Positive PEth testing following positive EtG/EtS results confirms recent drinking. Copyright © 2013 by the Research Society on Alcoholism.

  11. False positive results for antibody to HIV in two men with systemic lupus erythematosus.

    PubMed Central

    Esteva, M H; Blasini, A M; Ogly, D; Rodríguez, M A

    1992-01-01

    False positive results were obtained for HIV tests in two men with active systemic lupus erythematosus (SLE) who were suspected of being infected with HIV because of fever, weight loss, lymphadenopathy, and inflammatory myopathy. Enzyme linked immunosorbent assays (ELISAs) for HIV were twice positive when tested three times over a period of six months. Western blot analysis showed reactivity against the gp41 band in patient 1. False positive results for HIV tests can occur in patients with SLE, potentially leading to an erroneous diagnosis of HIV infection. PMID:1417140

  12. Methods used by accredited dental specialty programs to advertise faculty positions: results of a national survey.

    PubMed

    Ballard, Richard W; Hagan, Joseph L; Armbruster, Paul C; Gallo, John R

    2011-01-01

    The various reasons for the current and projected shortages of dental faculty members in the United States have received much attention. Dental school deans have reported that the top three factors impacting their ability to fill faculty positions are meeting the requirements of the position, lack of response to position announcement, and salary/budget limitations. An electronic survey sent to program directors of specialty programs at all accredited U.S. dental schools inquired about the number of vacant positions, advertised vacant positions, reasons for not advertising, selection of advertising medium, results of advertising, and assistance from professional dental organizations. A total of seventy-three permanently funded full-time faculty positions were reported vacant, with 89.0 percent of these positions having been advertised in nationally recognized professional journals and newsletters. Networking or word-of-mouth was reported as the most successful method for advertising. The majority of those responding reported that professional dental organizations did not help with filling vacant faculty positions, but that they would utilize the American Dental Association's website or their specialty organization's website to post faculty positions if they were easy to use and update.

  13. Determining the Clinical Utility of an Absolute Procalcitonin Value for Predicting a Positive Culture Result.

    PubMed

    Caffarini, Erica M; DeMott, Joshua; Patel, Gourang; Lat, Ishaq

    2017-05-01

    Various procalcitonin ranges have been established to guide antimicrobial therapy; however, there are no data that establish whether the initial procalcitonin value can determine the likelihood of a positive culture result. This study aimed to establish if the initial procalcitonin value, on clinical presentation, has a positive predictive value for any positive culture result. This was a retrospective study of 813 medical intensive care unit patients. Data collected included patient demographics, procalcitonin assay results, sources of infection, culture results, and lengths of stay. Patients were excluded if they were immunocompromised. The primary outcome of this study was to determine a procalcitonin value that would predict any positive culture. Secondary outcomes included the sensitivity, specificity, positive predictive value, and negative predictive value for procalcitonin. After exclusions, a total of 519 patient charts were reviewed to determine the impact of the initial procalcitonin value on culture positivity. In our analyses, the receiver operating characteristic values were 0.62 for all cultures, 0.49 for pulmonary infections, 0.43 for urinary tract infections, and 0.78 for bacteremia. A procalcitonin value of 3.61 ng/ml was determined to be the threshold value for a positive blood culture result (prevalence, 4%). For bacteremia, the sensitivity of procalcitonin was 75%, the specificity was 72%, the positive predictive value was 20%, and the negative predictive value was 97%. Procalcitonin was a poor predictor of culture positivity. An initial procalcitonin value of less than 3.61 ng/ml may be useful in predicting whether bacteremia is absent. Procalcitonin should not be used as the only predictor for determining initiation of antibiotic therapy. Copyright © 2017 American Society for Microbiology.

  14. Hypertension is strongly associated with false-positive bicycle exercise stress echocardiography testing results.

    PubMed

    Keller, Karsten; Stelzer, Kathrin; Munzel, Thomas; Ostad, Mir Abolfazl

    2016-12-01

    Exercise echocardiography is a reliable routine test in patients with known or suspected coronary artery disease. However, in ∼15% of all patients, stress echocardiography leads to false-positive stress echocardiography results. We aimed to investigate the impact of hypertension on stress echocardiographic results. We performed a retrospective study of patients with suspected or known stable coronary artery disease who underwent a bicycle exercise stress echocardiography. Patients with false-positive stress results were compared with those with appropriate results. 126 patients with suspected or known coronary artery disease were included in this retrospective study. 23 patients showed false-positive stress echocardiography results. Beside comparable age, gender distribution and coronary artery status, hypertension was more prevalent in patients with false-positive stress results (95.7% vs. 67.0%, p = 0.0410). Exercise peak load revealed a borderline-significance with lower loads in patients with false-positive results (100.0 (IQR 75.0/137.5) vs. 125.0 (100.0/150.0) W, p = 0.0601). Patients with false-positive stress results showed higher systolic (2.05 ± 0.69 vs. 1.67 ± 0.39 mmHg/W, p = 0.0193) and diastolic (1.03 ± 0.38 vs. 0.80 ± 0.28 mmHg/W, p = 0.0165) peak blood pressure (BP) per wattage. In a multivariate logistic regression test, hypertension (OR 17.6 [CI 95% 1.9-162.2], p = 0.0115), and systolic (OR 4.12 [1.56-10.89], p = 0.00430) and diastolic (OR 13.74 [2.46-76.83], p = 0.00285) peak BP per wattage, were associated with false-positive exercise results. ROC analysis for systolic and diastolic peak BP levels per wattage showed optimal cut-off values of 1.935mmHg/W and 0.823mmHg/W, indicating false-positive exercise echocardiographic results with AUCs of 0.660 and 0.664, respectively. Hypertension is a risk factor for false-positive stress exercise echocardiographic results in patients with known or

  15. Risk of breast cancer after false-positive results in mammographic screening.

    PubMed

    Román, Marta; Castells, Xavier; Hofvind, Solveig; von Euler-Chelpin, My

    2016-06-01

    Women with false-positive results are commonly referred back to routine screening. Questions remain regarding their long-term outcome of breast cancer. We assessed the risk of screen-detected breast cancer in women with false-positive results. We conducted a joint analysis using individual level data from the population-based screening programs in Copenhagen and Funen in Denmark, Norway, and Spain. Overall, 150,383 screened women from Denmark (1991-2008), 612,138 from Norway (1996-2010), and 1,172,572 from Spain (1990-2006) were included. Poisson regression was used to estimate the relative risk (RR) of screen-detected cancer for women with false-positive versus negative results. We analyzed information from 1,935,093 women 50-69 years who underwent 6,094,515 screening exams. During an average 5.8 years of follow-up, 230,609 (11.9%) women received a false-positive result and 27,849 (1.4%) were diagnosed with screen-detected cancer. The adjusted RR of screen-detected cancer after a false-positive result was 2.01 (95% CI: 1.93-2.09). Women who tested false-positive at first screen had a RR of 1.86 (95% CI: 1.77-1.96), whereas those who tested false-positive at third screening had a RR of 2.42 (95% CI: 2.21-2.64). The RR of breast cancer at the screening test after the false-positive result was 3.95 (95% CI: 3.71-4.21), whereas it decreased to 1.25 (95% CI: 1.17-1.34) three or more screens after the false-positive result. Women with false-positive results had a twofold risk of screen-detected breast cancer compared to women with negative tests. The risk remained significantly higher three or more screens after the false-positive result. The increased risk should be considered when discussing stratified screening strategies. © 2016 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

  16. Consequences of a false-positive mammography result: drug consumption before and after screening.

    PubMed

    von Euler-Chelpin, My; Bæksted, Christina; Vejborg, Ilse; Lynge, Elsebeth

    2016-05-01

    Background Previous research showed women experiencing false-positive mammograms to have greater anxiety about breast cancer than women with normal mammograms. To elucidate psychological effects of false-positive mammograms, we studied impact on drug intake. Methods We calculated the ratio of drug use for women with false-positive versus women with normal mammograms, before and after the event, using population-based registers, 1997-2006. The ratio of the ratios (RRR) assessed the impact. Results Before the test, 40.3% of women from the false-positive group versus 36.2% from the normal group used anxiolytic and antidepressant drugs. There was no difference in use of beta blockers. Hormone therapy was used more frequently by the false-positive, 36.6% versus 28.7%. The proportion of women using anxiolytic and antidepressant drugs increased with 19% from the before to the after period in the false-positive group, and with 16% in the normal group, resulting in an RRR of 1.02 (95% CI 0.92-1.14). RRR was 1.03 for beta blockers, 0.97 for hormone therapy. Conclusion(s) Drugs used to mitigate mood disorders were used more frequently by women with false-positive than by women with normal mammograms already before the screening event, while the changes from before to after screening were similar for both groups. The results point to the importance of control for potential selection in studies of screening effects.

  17. Receipt of a false positive test result during routine screening for ovarian cancer: a teachable moment?

    PubMed

    Floyd, Andrea; Steffens, Rachel F; Pavlik, Edward; Andrykowski, Michael A

    2011-03-01

    The term "teachable moment" (TM) has been used to describe a life transition or event which motivates an individual to change a behavior or presents an opportunity to intervene to prompt behavior change. We examined whether receipt of a false positive ovarian cancer (OC) screening result may represent a TM. 403 women participating in an OC screening program completed questionnaires assessing demographic, clinical, behavioral, and psychosocial information. The TM was operationalized as expressed interest in receiving health-related information. We hypothesized that among women receiving a false positive screening test result, those women who had experienced greater personal perceived risk for OC as well as distress would be more interested in receiving health-related information than women receiving a normal result. Analyses revealed that women receiving a false positive screening result were less interested in receiving health-related information than women receiving a normal screening result. For women receiving a false positive result, expressed interest in receipt of health-related information was only modestly related to distress and related even less to perceptions of OC risk. Our data do not support viewing a false positive OC screening result as a TM. Potential explanations for the current findings as well as recommendations for future research investigating the TM are discussed.

  18. Image deblurring applied to infrared tongue position imaging: Initial simulation results

    NASA Astrophysics Data System (ADS)

    Poots, J. Kent

    2013-10-01

    Paper describes development work for a new biomedical application of image deblurring. Optical imaging is not currently used to assess tongue position during speech, nor is optical imaging the modality of choice for imaging tissue of moderate thickness. Tongue position assessment is important during rehabilitation. Optical imaging of biological tissue provides good contrast, but incident light is scattered, seriously restricting clinical usefulness. Paper describes simulation results for scattering correction and suggests possible directions for future work. Images are represented by sparse matrices.

  19. Precursor medications as a source of methamphetamine and/or amphetamine positive drug testing results.

    PubMed

    Cody, John T

    2002-05-01

    Medical Review Officer interpretation of laboratory results is an important component of drug testing programs. The clinical evaluation of laboratory results to assess the possibility of appropriate medical use of a drug is a task with many different facets, depending on the drug class considered. This intercession prevents the reporting of positive results unless it is apparent that drugs were used illicitly. In addition to the commonly encountered prescribed drugs that yield positive drug testing results, other sources of positive results must be considered. This review describes a series of compounds referred to as "precursor" drugs that are metabolized by the body to amphetamine and/or methamphetamine. These compounds lead to positive results for amphetamines even though neither amphetamine nor methamphetamine were used, a possibility that must be considered in the review of laboratory results. Description of the drugs, their clinical indications, and results seen following administration are provided. This information allows for the informed evaluation of results with regard to the potential involvement of these drugs.

  20. Estimated results analysis and application of the precise point positioning based high-accuracy ionosphere delay

    NASA Astrophysics Data System (ADS)

    Wang, Shi-tai; Peng, Jun-huan

    2015-12-01

    The characterization of ionosphere delay estimated with precise point positioning is analyzed in this paper. The estimation, interpolation and application of the ionosphere delay are studied based on the processing of 24-h data from 5 observation stations. The results show that the estimated ionosphere delay is affected by the hardware delay bias from receiver so that there is a difference between the estimated and interpolated results. The results also show that the RMSs (root mean squares) are bigger, while the STDs (standard deviations) are better than 0.11 m. When the satellite difference is used, the hardware delay bias can be canceled. The interpolated satellite-differenced ionosphere delay is better than 0.11 m. Although there is a difference between the between the estimated and interpolated ionosphere delay results it cannot affect its application in single-frequency positioning and the positioning accuracy can reach cm level.

  1. Copy-Number Variation and False Positive Prenatal Aneuploidy Screening Results

    PubMed Central

    Snyder, Matthew W.; Simmons, LaVone E.; Kitzman, Jacob O.; Coe, Bradley P.; Henson, Jessica M.; Daza, Riza M.; Eichler, Evan E.; Shendure, Jay; Gammill, Hilary S.

    2015-01-01

    SUMMARY Investigations of noninvasive prenatal screening for aneuploidy by analysis of circulating cell-free DNA (cfDNA) have shown high sensitivity and specificity in both high-risk and low-risk cohorts. However, the overall low incidence of aneuploidy limits the positive predictive value of these tests. Currently, the causes of false positive results are poorly understood. We investigated four pregnancies with discordant prenatal test results and found in two cases that maternal duplications on chromosome 18 were the likely cause of the discordant results. Modeling based on population-level copy-number variation supports the possibility that some false positive results of noninvasive prenatal screening may be attributable to large maternal copy-number variants. (Funded by the National Institutes of Health and others.) PMID:25830323

  2. Copy-number variation and false positive prenatal aneuploidy screening results.

    PubMed

    Snyder, Matthew W; Simmons, LaVone E; Kitzman, Jacob O; Coe, Bradley P; Henson, Jessica M; Daza, Riza M; Eichler, Evan E; Shendure, Jay; Gammill, Hilary S

    2015-04-23

    Investigations of noninvasive prenatal screening for aneuploidy by analysis of circulating cell-free DNA (cfDNA) have shown high sensitivity and specificity in both high-risk and low-risk cohorts. However, the overall low incidence of aneuploidy limits the positive predictive value of these tests. Currently, the causes of false positive results are poorly understood. We investigated four pregnancies with discordant prenatal test results and found in two cases that maternal duplications on chromosome 18 were the likely cause of the discordant results. Modeling based on population-level copy-number variation supports the possibility that some false positive results of noninvasive prenatal screening may be attributable to large maternal copy-number variants. (Funded by the National Institutes of Health and others.).

  3. Significance of a Positive Toxoplasma Immunoglobulin M Test Result in the United States.

    PubMed

    Dhakal, Reshika; Gajurel, Kiran; Pomares, Christelle; Talucod, Jeanne; Press, Cynthia J; Montoya, Jose G

    2015-11-01

    A positive Toxoplasma immunoglobulin M (IgM) result is often interpreted as a marker of an acute infection. However, IgM can persist for several years, and Toxoplasma commercial IgM diagnostic test kits can yield a number of false-positive results. For these reasons, a chronic Toxoplasma infection can be erroneously classified as an acute infection, resulting in serious adverse consequences, especially in pregnant women, leading to emotional distress and unnecessary interventions, including termination of pregnancy. Interpretation of Toxoplasma serology at a reference laboratory can help differentiate a recently acquired infection from a chronic infection. Serological test results for 451 patients with positive Toxoplasma IgM and IgG test results obtained at nonreference laboratories (NRLs) that were referred to Palo Alto Medical Foundation Toxoplasma Serology Laboratory (PAMF-TSL) to determine whether the patient was acutely or chronically infected were retrospectively reviewed. PAMF-TSL results established that of the 451 patients, 335 (74%) had a chronic infection, 100 (22%) had an acute infection, and 7 (2%) were not infected, and for 9 (2%), results were indeterminate. Positive Toxoplasma IgM and IgG test results obtained at NRLs cannot accurately distinguish between acute and chronic infections. To do so, testing at reference laboratories is required, as mandated in 1997 in a letter from the Food and Drug Administration (FDA) to clinicians and laboratories in the United States.

  4. Significance of a Positive Toxoplasma Immunoglobulin M Test Result in the United States

    PubMed Central

    Gajurel, Kiran; Pomares, Christelle; Talucod, Jeanne; Press, Cynthia J.

    2015-01-01

    A positive Toxoplasma immunoglobulin M (IgM) result is often interpreted as a marker of an acute infection. However, IgM can persist for several years, and Toxoplasma commercial IgM diagnostic test kits can yield a number of false-positive results. For these reasons, a chronic Toxoplasma infection can be erroneously classified as an acute infection, resulting in serious adverse consequences, especially in pregnant women, leading to emotional distress and unnecessary interventions, including termination of pregnancy. Interpretation of Toxoplasma serology at a reference laboratory can help differentiate a recently acquired infection from a chronic infection. Serological test results for 451 patients with positive Toxoplasma IgM and IgG test results obtained at nonreference laboratories (NRLs) that were referred to Palo Alto Medical Foundation Toxoplasma Serology Laboratory (PAMF-TSL) to determine whether the patient was acutely or chronically infected were retrospectively reviewed. PAMF-TSL results established that of the 451 patients, 335 (74%) had a chronic infection, 100 (22%) had an acute infection, and 7 (2%) were not infected, and for 9 (2%), results were indeterminate. Positive Toxoplasma IgM and IgG test results obtained at NRLs cannot accurately distinguish between acute and chronic infections. To do so, testing at reference laboratories is required, as mandated in 1997 in a letter from the Food and Drug Administration (FDA) to clinicians and laboratories in the United States. PMID:26354818

  5. Poppy seed ingestion as a contributing factor to opiate-positive urinalysis results: the Pacific perspective.

    PubMed

    Selavka, C M

    1991-05-01

    The possible contribution of poppy seed foods to positive opiate urinalysis results, especially from foods available in the Pacific Rim area, has recently become an issue for the U.S. Army Forensic Toxicology Drug Testing Laboratory in Hawaii. To assess the likelihood of this possible contribution, seven different poppy seed food products were consumed by male and female volunteers, and urine specimens were collected at time increments up to either 24 or 72 h. Specimens were evaluated for opiates using Roche Abuscreen radioimmunoassay (RIA), and all RIA positive specimens were analyzed for morphine and codeine using gas chromatography/mass spectrometry (GC-MS). Poppy seed cake, bagels, muffins, and rolls did not contain sufficient quantities of poppy seeds to give rise to opiate positive specimens by U.S. Department of Defense (DOD) GC-MS cutoff levels (morphine = 4000 ng/mL, codeine = 2000 ng/mL), although a number of specimens were positive by National Institute on Drug Abuse (NIDA) cutoff levels (morphine and codeine = 300 ng/mL). However, ingestion of poppy seed streusel or Danish pastry led to confirmed morphine and codeine positive specimens, irrespective of the use of DOD or NIDA confirmation cutoff values. In addition, significant amounts of codeine were observed in a number of these specimens. These findings argue against the unqualified application of previously published quantitative guidelines for eliminating poppy seed ingestion as a possible cause for a positive opiate urinalysis result.

  6. Low socioeconomic position and depression persistence: longitudinal results from the GAZEL cohort study.

    PubMed

    Melchior, Maria; Chastang, Jean-François; Leclerc, Annette; Ribet, Céline; Rouillon, Frédéric

    2010-05-15

    Research examining the association between socioeconomic position and depression course has yielded inconsistent results. We tested the association between low socioeconomic position and 7-year depression persistence among 298 community-based individuals with depression (subset of the GAZEL cohort study based in France). Data were analyzed using Generalized Estimating Equation (GEE models). Low socioeconomic position predicted depression persistence (men: low vs. intermediate/high income: OR: 2.52, 95% CI 1.28-4.95; women: low vs. intermediate/high occupational grade: OR: 2.25, 95% CI 1.06-4.80). These associations were reduced and became statistically nonsignificant after controlling for baseline sociodemographic characteristics and stressful life events (men and women), overall health (men), and the severity of mental health difficulties (men and women). Overall, depressed individuals with low socioeconomic position appear disproportionately likely to experience multiple risk factors of long-term depression.

  7. Multiple factors contribute to positive results for hepatitis A virus immunoglobulin M antibody.

    PubMed

    Alatoom, Adnan; Ansari, M Qasim; Cuthbert, Jennifer

    2013-01-01

    In the United States, a successful vaccination program for hepatitis A virus (HAV) infection has decreased both its incidence and the true positive rate for diagnostic immunoglobulin M (IgM) antibody to HAV in acute hepatitis. To survey positive results of HAV IgM tests and determine the effect of changing ordering options. We reviewed all positive results for IgM antibody to HAV between January 2007 and December 2010. Patient demographics, clinical history, and laboratory data were recorded and the encounter, order, and reason for test reviewed. Each result was categorized as indicating acute, recent, resolved, or indeterminate HAV infection. A total of 10,735 tests were performed; 35 patients had 49 positive results. Most positive test results were associated with outpatient visits and were ordered in the assessment of patients with liver disease, but not clinical acute hepatitis. In the final analysis, 4 patients had acute hepatitis A and 20 individual patients had recent and/or resolved hepatitis. All but 1 of the remaining 11 patients had another established cause of liver disease with a positive IgM HAV antibody test result; data to determine causality were insufficient. The total number of tests requested annually decreased more than 35% with the introduction of computerized physician order entry. Current assays for IgM HAV antibodies are overused in the absence of clinical acute hepatitis; future clinical decision support may improve patterns of order entry. Most patients have findings consistent with HAV exposure but not acute hepatitis; dormant viral infection may be a continuing source of antigen.

  8. Reducing False-Positive Pregnancy Test Results in Patients With Cancer.

    PubMed

    McCash, Samuel I; Goldfrank, Deborah J; Pessin, Melissa S; Ramanathan, Lakshmi V

    2017-09-05

    To assess whether the use of a laboratory test specific for intact human chorionic gonadotropin (hCG) would reduce the number of false-positive pregnancy test results. From October 21, 2014, to January 20, 2015, and April 1, 2015, to June 2, 2015, all serum samples sent for pregnancy screening at a large cancer center with a value of 5 milli-international units/mL or greater total β-hCG were frozen and stored and then retested using intact hCG reagent. We compared the accuracy of total β-hCG and intact hCG results for the diagnosis of clinically confirmed pregnancy. A negative test was defined as 14 milli-international units/mL or less, our current institutional cutoff. We also assessed a cutoff of less than 5 milli-international units/mL, a historical cutoff to rule out pregnancy. We performed intact hCG testing on 64 patient samples, of which 34 had originally resulted positive when tested for total β-hCG. These included 21 cases of clinically confirmed pregnancy and 13 false-positive cases. No women were pregnant when their intact hCG concentration was 14 milli-international units/mL or less, and all pregnancies were detected at and above this concentration. Intact hCG reduced the number of false-positive pregnancy test results from 13 to 1, a 92% reduction (95% CI 64-99%), corresponding to a reduction in the false-positive rate from 38% (95% CI 22-56%) to 3% (95% CI 1-15%). The use of intact hCG reagent in patients with cancer reduces the rate of false-positive pregnancy test results without increasing the rate of false-negative test results.

  9. Preliminary Results on Setup Precision of Prone-Lateral Patient Positioning for Whole Breast Irradiation

    SciTech Connect

    Veldeman, Liv; Speleers, Bruno; Bakker, Marlies; Jacobs, Filip; Coghe, Marc; De Gersem, Werner; Impens, Aline; Nechelput, Sarah; De Wagter, Carlos

    2010-09-01

    Purpose: The aim of this study was to develop a rapid and reproducible technique for prone positioning and to compare dose-volume indices in prone and supine positions. Methods and Materials: Eighteen patients underwent computed tomography imaging for radiotherapy planning in prone and supine position. Experience was gained in the first eight patients, which lead to modifications of the Horizon prone breast board (Civco Medical Solutions, Orange City, Iowa, USA) and the patient setup technique. A unilateral breast holder (U-BH) was developed (Van de Velde, Schellebelle, Belgium) to retract the contralateral breast away from the treated breast. The technique was then applied to an additional 10 patients. The setup precision was evaluated using daily cone-beam CT. Results: Modifications to the breast board were made to secure a prone-lateral rather then a pure prone position. We evolved from a classical setup using laser marks on the patients' body to a direct breast setup using marks on the breast only. The setup precision of the direct positioning procedure with the modified breast board and the U-BH is comparable to supine setup data in the literature. Dose-volume indices for heart and lung show significantly better results for prone than for supine position, and dose homogeneity within the treated breast did not differ according to the treatment position. Conclusions: The setup precision of our prone-lateral positioning technique is comparable to supine data in literature. Our data show the advantage of prone radiotherapy to spare the lung and heart. Further research is necessary to reduce the duration of prone setup.

  10. Fenofibric Acid Can Cause False-Positive Urine Methylenedioxymethamphetamine Immunoassay Results.

    PubMed

    Quesada, Loreto; Gomila, Isabel; Fe, Antonia; Servera, Miguel A; Yates, Christopher; Morell-Garcia, Daniel; Castanyer, Bartomeu; Barceló, Bernardino

    2015-01-01

    We present a false-positive result of ecstasy (3,4-methylenedioxy-NN-methylamphetamine) screening due to the therapeutic use of fenofibrate, an antihyperlipidemic drug. Our hypothesis was that the main metabolite of fenofibrate, fenofibric acid, was responsible for this cross-reactivity on a DRI(®) Ecstasy Assay, using a cut-off of 500 ng/mL. We estimated that the addition of 225 µg/mL pure fenofibric acid to blank urine would be sufficient to result in a positive DRI(®) Ecstasy Assay. The results obtained on the urine samples analyses of the patient show that the DRI(®) Ecstasy Assay resulted negative 2 days after discontinuing fenofibrate treatment, when the urine fenofibric acid concentration corrected by creatinine and determinated by gas chromatography-mass spectrometry was 20.3 µg/mg creatinine. The cross-reactivity data for fenofibric acid would seem to indicate that there was insufficient concentration of measured compound to account for the positive immunochemical results for ecstasy. This apparent discrepancy can be explained in several ways, one of them is that the β-glucuronidase-resistent fenofibric acid isomers are responsible. This process could explain the low recovery of free fenofibric acid when we use the developed method for its quantification in urine samples. Positive results on immunoassay screening must be considered presumptive until confirmation with another method based on a different principle, preferably gas chromatography-mass spectrometry or liquid chromatography-mass spectrometry.

  11. Definition of a positive test result in computed tomography screening for lung cancer: a cohort study.

    PubMed

    Henschke, Claudia I; Yip, Rowena; Yankelevitz, David F; Smith, James P

    2013-02-19

    Low-dose computed tomography screening for lung cancer can reduce mortality among high-risk persons, but "false-positive" findings may result in unnecessary evaluations with attendant risks. The effect of alternative thresholds for defining a positive result on the rates of positive results and cancer diagnoses is unknown. To assess the frequency of positive results and potential delays in diagnosis in the baseline round of screening by using more restrictive thresholds. Prospective cohort study. Multi-institutional International Early Lung Cancer Action Program. 21 136 participants with baseline computed tomography performed between 2006 and 2010. The frequency of solid and part-solid pulmonary nodules and the rate of lung cancer diagnosis by using current (5 mm) and more restrictive thresholds of nodule diameter. The frequency of positive results in the baseline round by using the current definition of positive result (any parenchymal, solid or part-solid, noncalcified nodule ≥5.0 mm) was 16% (3396/21 136). When alternative threshold values of 6.0, 7.0, 8.0 and 9.0 mm were used, the frequencies of positive results were 10.2% (95% CI, 9.8% to 10.6%), 7.1% (CI, 6.7% to 7.4%), 5.1% (CI, 4.8% to 5.4%), and 4.0% (CI, 3.7% to 4.2%), respectively. Use of these alternative definitions would have reduced the work-up by 36%, 56%, 68%, and 75%, respectively. Concomitantly, lung cancer diagnostics would have been delayed by at most 9 months for 0%, 5.0% (CI, 1.1% to 9.0%), 5.9% (CI, 1.7 to 10.1%), and 6.7% (CI, 2.2% to 11.2%) of the cases of cancer, respectively. This was a retrospective analysis and thus whether delays in diagnosis would have altered outcomes cannot be determined. These findings suggest that using a threshold of 7 or 8 mm to define positive results in the baseline round of computed tomography screening for lung cancer should be prospectively evaluated to determine whether the benefits of decreasing further work-up outweigh the consequent delay in

  12. The magnitude and challenge of false-positive newborn screening test results.

    PubMed

    Kwon, C; Farrell, P M

    2000-07-01

    This study examined for the first time to our knowledge the national data available from newborn screening programs in the United States and determined the salient characteristics of various screening tests for 3 hereditary metabolic disorders and 2 congenital endocrinopathies with emphasis on positive predictive values (PPVs) to delineate the magnitude of false-positive results. Reports published by the Council of Regional Networks for Genetic Services for 1990 through 1994 were examined carefully, paying particular attention to phenylketonuria, galactosemia, biotinidase deficiency, congenital hypothyroidism, and congenital adrenal hyperplasia (CAH). Because of recent improvements in data collecting, reporting, and tabulating, we used data from 1993 and 1994 to determine the apparent sensitivity, specificity, relative incidence rates, and PPVs for the 5 disorders. For biotinidase deficiency and CAH, we also calculated relative incidence rates and PPVs for 1991 and 1992. Our analyses revealed the following best estimates for the relative incidence rates of 5 disorders: phenylketonuria, 1:14,000; galactosemia, 1:59,000; biotinidase deficiency, 1:80,000; congenital hypothyroidism, 1:3,300; and CAH, 1:20,000. An apparent sensitivity of 100% has been reported by the various states for most of the disorders, and specificity levels are all above 99%. The PPVs, however, range from 0.5% to 6.0%. Consequently, on average, there are more than 50 false-positive results for every true-positive result identified through newborn screening in the United States. The magnitude of false-positive results generated in newborn screening programs, particularly for congenital endocrinopathies, presents a great challenge for future improvement of this important public health program. Attention must be given to improved laboratory tests, use of more specific markers, and better risk communication for families of patients with false-positive test results.

  13. Impact on HIV test providers of giving a positive test result.

    PubMed

    Myers, Ted; Worthington, Catherine; Aguinaldo, Jeffrey P; Haubrich, Dennis J; Ryder, Karen; Rawson, Brian

    2007-09-01

    The provision of a positive HIV antibody test result and the direction and support given to the test recipient are critical components of care and prevention. There has been little research that describes what happens in such interactions between recipient and provider. The impact on the test provider of delivering the HIV test result is an important issue to consider. The discomfort experienced by some health providers in giving a positive test result may have adverse effects on the client interaction or may carry over into subsequent client interactions. Utilizing a thematic analysis on interview data from 24 HIV test providers, we describe the impact of delivering a positive test result on HIV test providers, identify the factors that influence this impact, and describe strategies used to manage the impact. As with other health care professionals communicating "bad news,"HIV test providers experience a variety of impacts. While a small number of providers indicated little or no impact of delivering the HIV positive test result because the diagnosis is ''not the end of the world,'' most indicated it was difficult as it was anticipated that the test recipient would (or did) find the news distressing. Several coping strategies were identified.

  14. Extending positive CLASS results across multiple instructors and multiple classes of Modeling Instruction

    NASA Astrophysics Data System (ADS)

    Brewe, Eric; Traxler, Adrienne; de la Garza, Jorge; Kramer, Laird H.

    2013-12-01

    We report on a multiyear study of student attitudes measured with the Colorado Learning Attitudes about Science Survey in calculus-based introductory physics taught with the Modeling Instruction curriculum. We find that five of six instructors and eight of nine sections using Modeling Instruction showed significantly improved attitudes from pre- to postcourse. Cohen’s d effect sizes range from 0.08 to 0.95 for individual instructors. The average effect was d=0.45, with a 95% confidence interval of (0.26-0.64). These results build on previously published results showing positive shifts in attitudes from Modeling Instruction classes. We interpret these data in light of other published positive attitudinal shifts and explore mechanistic explanations for similarities and differences with other published positive shifts.

  15. Variations of blood pressure in stroke unit patients may result from alternating body positions.

    PubMed

    Aries, Marcel J H; Elting, Jan Willem; Stewart, Roy E; de Keyser, Jacques; Thien, Theo; Kremer, Berry P; Vroomen, Patrick C A J

    2012-08-01

    Blood pressure (BP) is one of the major vital parameters monitored in the stroke unit. The accuracy of indirect BP measurement is strongly influenced by the position of both patient and arm during the measurement. Acute stroke patients are often nursed in lateral decubitus positions. The effect of these alternating body positions in relation to affected body side on the outcome and reliability of BP readings in acute stroke patients is unknown. An automatic oscillometric BP device was used. BP was measured in both arms in the (back) supine and both lateral decubitus positions. In total, 54 consecutive acute stroke patients were included. Thirty-five patients had right-sided deficits and 19 patients had left-sided deficits. Supine BP readings were similar in the right and left arms regardless of side of deficit. Measurements of BP in the lateral decubitus positions resulted in significantly lower BP readings in the uppermost arm (around 12 mm Hg in both arms) and significantly higher readings in the right lowermost arm (around 6 mm Hg) compared to the supine position. This effect seemed less pronounced when the left lowermost arm was measured. There was no relation between change of BP readings in various lateral positions and side of stroke. Alternating lateral decubitus positions according to nursing standards in acute stroke patients lead to a mean 18 mm Hg BP fluctuation. This may largely be explained by hydrostatic pressure effects, partly by anatomic factors in the left lowermost arm, but not by the side of stroke. Copyright © 2012 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  16. Are Hemorrhoids Associated with False-Positive Fecal Immunochemical Test Results?

    PubMed Central

    Kim, Nam Hee; Park, Jung Ho; Park, Dong Il; Sohn, Chong Il; Choi, Kyuyong

    2017-01-01

    Purpose False-positive (FP) results of fecal immunochemical tests (FITs) conducted in colorectal cancer (CRC) screening could lead to performing unnecessary colonoscopies. Hemorrhoids are a possible cause of FP FIT results; however, studies on this topic are extremely rare. We investigated whether hemorrhoids are associated with FP FIT results. Materials and Methods A retrospective study was conducted at a university hospital in Korea from June 2013 to May 2015. Of the 34547 individuals who underwent FITs, 3946 aged ≥50 years who underwent colonoscopies were analyzed. Logistic regression analysis was performed to determine factors associated with FP FIT results. Results Among 3946 participants, 704 (17.8%) showed positive FIT results and 1303 (33.0%) had hemorrhoids. Of the 704 participants with positive FIT results, 165 had advanced colorectal neoplasia (ACRN) and 539 had no ACRN (FP results). Of the 1303 participants with hemorrhoids, 291 showed FP results, of whom 81 showed FP results because of hemorrhoids only. Participants with hemorrhoids had a higher rate of FP results than those without hemorrhoids (291/1176, 24.7% vs. 248/2361, 10.5%; p<0.001). Additionally, the participants with hemorrhoids as the only abnormality had a higher rate of FP results than those experiencing no such abnormalities (81/531, 15.3% vs. 38/1173, 3.2%; p<0.001). In multivariate analysis, the presence of hemorrhoids was identified as an independent predictor of FP results (adjusted odds ratio, 2.76; 95% confidence interval, 2.24–3.40; p<0.001). Conclusion Hemorrhoids are significantly associated with FP FIT results. Their presence seemed to be a non-negligible contributor of FP results in FIT-based CRC screening programs. PMID:27873508

  17. Follow-up actions from positive results of in vitro genetic toxicity testing

    EPA Science Inventory

    Appropriate follow-up actions and decisions are needed when evaluating and interpreting clear positive results obtained in the in vitro assays used in the initial genotoxicity screening battery (i.e., the battery of tests generally required by regulatory authorities) to assist in...

  18. Follow-up actions from positive results of in vitro genetic toxicity testing

    EPA Science Inventory

    Appropriate follow-up actions and decisions are needed when evaluating and interpreting clear positive results obtained in the in vitro assays used in the initial genotoxicity screening battery (i.e., the battery of tests generally required by regulatory authorities) to assist in...

  19. 10 CFR 26.103 - Determining a confirmed positive test result for alcohol.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 1 2012-01-01 2012-01-01 false Determining a confirmed positive test result for alcohol. 26.103 Section 26.103 Energy NUCLEAR REGULATORY COMMISSION FITNESS FOR DUTY PROGRAMS Collecting... fitness indicates that the donor is fit to safely and competently perform his or her duties. ...

  20. 10 CFR 26.103 - Determining a confirmed positive test result for alcohol.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 1 2013-01-01 2013-01-01 false Determining a confirmed positive test result for alcohol. 26.103 Section 26.103 Energy NUCLEAR REGULATORY COMMISSION FITNESS FOR DUTY PROGRAMS Collecting... fitness indicates that the donor is fit to safely and competently perform his or her duties. ...

  1. 10 CFR 26.103 - Determining a confirmed positive test result for alcohol.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 1 2010-01-01 2010-01-01 false Determining a confirmed positive test result for alcohol. 26.103 Section 26.103 Energy NUCLEAR REGULATORY COMMISSION FITNESS FOR DUTY PROGRAMS Collecting... fitness indicates that the donor is fit to safely and competently perform his or her duties. ...

  2. 10 CFR 26.103 - Determining a confirmed positive test result for alcohol.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 1 2011-01-01 2011-01-01 false Determining a confirmed positive test result for alcohol. 26.103 Section 26.103 Energy NUCLEAR REGULATORY COMMISSION FITNESS FOR DUTY PROGRAMS Collecting... fitness indicates that the donor is fit to safely and competently perform his or her duties. ...

  3. 10 CFR 26.103 - Determining a confirmed positive test result for alcohol.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 1 2014-01-01 2014-01-01 false Determining a confirmed positive test result for alcohol. 26.103 Section 26.103 Energy NUCLEAR REGULATORY COMMISSION FITNESS FOR DUTY PROGRAMS Collecting... fitness indicates that the donor is fit to safely and competently perform his or her duties. ...

  4. Responses to Positive Results from Suspicionless Random Drug Tests in US Public School Districts

    ERIC Educational Resources Information Center

    Ringwalt, Chris; Vincus, Amy A.; Ennett, Susan T.; Hanley, Sean; Bowling, J. Michael; Yacoubian, George S., Jr.; Rohrbach, Louise A.

    2009-01-01

    Background: Little is known about the context in which school-based suspicionless random drug testing (SRDT) occurs. The primary purpose of the current study was to describe school districts' responses to students' first positive result in districts with SRDT programs. Methods: Data were collected in spring 2005 from 1612 drug prevention…

  5. Are Hemorrhoids Associated with False-Positive Fecal Immunochemical Test Results?

    PubMed

    Kim, Nam Hee; Park, Jung Ho; Park, Dong Il; Sohn, Chong Il; Choi, Kyuyong; Jung, Yoon Suk

    2017-01-01

    False-positive (FP) results of fecal immunochemical tests (FITs) conducted in colorectal cancer (CRC) screening could lead to performing unnecessary colonoscopies. Hemorrhoids are a possible cause of FP FIT results; however, studies on this topic are extremely rare. We investigated whether hemorrhoids are associated with FP FIT results. A retrospective study was conducted at a university hospital in Korea from June 2013 to May 2015. Of the 34547 individuals who underwent FITs, 3946 aged ≥50 years who underwent colonoscopies were analyzed. Logistic regression analysis was performed to determine factors associated with FP FIT results. Among 3946 participants, 704 (17.8%) showed positive FIT results and 1303 (33.0%) had hemorrhoids. Of the 704 participants with positive FIT results, 165 had advanced colorectal neoplasia (ACRN) and 539 had no ACRN (FP results). Of the 1303 participants with hemorrhoids, 291 showed FP results, of whom 81 showed FP results because of hemorrhoids only. Participants with hemorrhoids had a higher rate of FP results than those without hemorrhoids (291/1176, 24.7% vs. 248/2361, 10.5%; p<0.001). Additionally, the participants with hemorrhoids as the only abnormality had a higher rate of FP results than those experiencing no such abnormalities (81/531, 15.3% vs. 38/1173, 3.2%; p<0.001). In multivariate analysis, the presence of hemorrhoids was identified as an independent predictor of FP results (adjusted odds ratio, 2.76; 95% confidence interval, 2.24-3.40; p<0.001). Hemorrhoids are significantly associated with FP FIT results. Their presence seemed to be a non-negligible contributor of FP results in FIT-based CRC screening programs.

  6. Preliminary Results From a Laboratory Study of Positive Streamer Discharges on Simulated Ice Hydrometeors

    NASA Astrophysics Data System (ADS)

    Petersen, D.; Bailey, M.; Hallett, J.; Beasley, W.

    2007-12-01

    The initiation of lightning remains an open question, due in large part to a deficit of in-situ observational evidence. Recent theoretical descriptions of lightning initiation have focused on runaway breakdown and related secondary processes, but have not convincingly explained the details of onset of the embryonic lightning leader channel. Among possible mechanisms contributing to the initial leader formation are positive streamer discharges from ice hydrometeors, themselves once favored as the primary explanation of lightning initiation. We present preliminary results from a new laboratory study of positive streamer discharges on simulated ice hydrometeors. Emphasis is given to precisely defining the minimum electric field strength required for onset of positive streamer generation, with variables of interest being ice crystal size, habit and environmental temperature.

  7. Marijuana-positive urine test results from consumption of hemp seeds in food products.

    PubMed

    Fortner, N; Fogerson, R; Lindman, D; Iversen, T; Armbruster, D

    1997-10-01

    Commercially available snack bars and other foodstuffs prepared from pressed hemp seeds were ingested by volunteers. Urine specimens were collected for 24 h after ingestion of the foodstuffs containing hemp seeds and tested for marijuana using an EMIT immunoassay and gas chromatography-mass spectrometry (GC-MS). Specimens from individuals who ate one hemp seed bar demonstrated little marijuana immunoreactivity, and only one specimen screened positive at a 20-ng/mL cutoff. Specimens from individuals who ate two hemp seed bars showed increased immunoreactivity, and five specimens screened positive at a 20-ng/mL cutoff. A single specimen yielded a quantitative GC-MS value (0.6 ng/mL), but it failed to meet reporting criteria. Several specimens from individuals who ate three cookies made from hemp seed flour and butter screened positive at both 50- and 20-ng/mL cutoffs. Two specimens produced quantitative GC-MS values (0.7 and 3.1 ng/mL), but they failed to meet reporting criteria. Several specimens also tested positive with an FDA-approved on-site marijuana-screening device. Hemp seeds similar to those used in the foodstuffs did not demonstrate the presence of marijuana when tested by GC-MS. In this study, ingestion of hemp seed food products resulted in urine specimens that screened positive for marijuana. No specimens gave a GC-MS quantitative value above the limit of detection for marijuana.

  8. False-Positive Results in Cancer Epidemiology: A Plea for Epistemological Modesty

    PubMed Central

    McLaughlin, Joseph K.; La Vecchia, Carlo; Tarone, Robert E.; Lipworth, Loren; Blot, William J.

    2008-01-01

    False-positive results are inherent in the scientific process of testing hypotheses concerning the determinants of cancer and other human illnesses. Although much of what is known about the etiology of human cancers has arisen from well-conducted epidemiological studies, epidemiology has been increasingly criticized for producing findings that are often sensationalized in the media and fail to be upheld in subsequent studies. Herein we describe examples from cancer epidemiology of likely false-positive findings and discuss conditions under which such results may occur. We suggest general guidelines or principles, including the endorsement of editorial policies requiring the prominent listing of study caveats, which may help reduce the reporting of misleading results. Increased epistemological humility regarding findings in epidemiology would go a long way to diminishing the detrimental effects of false-positive results on the allocation of limited research resources, on the advancement of knowledge of the causes and prevention of cancer, and on the scientific reputation of epidemiology and would help to prevent oversimplified interpretations of results by the media and the public. PMID:18612135

  9. The trazodone metabolite meta-chlorophenylpiperazine can cause false-positive urine amphetamine immunoassay results.

    PubMed

    Baron, Jason M; Griggs, David A; Nixon, Andrea L; Long, William H; Flood, James G

    2011-07-01

    Amphetamines and methamphetamines are part of an important class of drugs included in most urine drugs of abuse screening panels, and a common assay to detect these drugs is the Amphetamines II immunoassay (Roche Diagnostics). To demonstrate that meta-chlorophenylpiperazine (m-CPP), a trazodone metabolite, cross-reacts in the Amphetamines II assay, we tested reference standards of m-CPP at various concentrations (200 to 20,000 g/L). We also tested real patient urine samples containing m-CPP (detected and quantified by HPLC) with no detectable amphetamine, methamphetamine, or MDMA (demonstrated by GC MS). In both the m-CPP standards and the patient urine samples, we found a strong association between m-CPP concentration and Amphetamines II immunoreactivity (r = 0.990 for the urine samples). Further, we found that patients taking trazodone can produce urine with sufficient m-CPP to result in false-positive Amphetamines II results. At our institution, false-positive amphetamine results occur not infrequently in patients taking trazodone with at least 8 trazodone-associated false-positive results during a single 26-day period. Laboratories should remain cognizant of this interference when interpreting results of this assay.

  10. Accuracy and stability of positioning in radiosurgery: Long term results of the Gamma Knife system

    SciTech Connect

    Heck, Bernhard; Jess-Hempen, Anja; Kreiner, Hans Juerg; Schoepgens, Hans; Mack, Andreas

    2007-04-15

    The primary aim of this investigation was to determine the long term overall accuracy of an irradiation position of Gamma Knife systems. The mechanical accuracy of the system as well as the overall accuracy of an irradiation position was examined by irradiating radiosensitive films. To measure the mechanical accuracy, the GafChromic registered film was fixed by a special tool at the unit center point (UCP). For overall accuracy the film was mounted inside a phantom at a target position given by a two-dimensional cross. Its position was determined by CT or MRI scans, a treatment was planned to hit this target by use of the standard planning software and the radiation was finally delivered. This procedure is named ''system test'' according to DIN 6875-1 and is equivalent to a treatment simulation. The used GafChromic registered films were evaluated by high resolution densitometric measurements. The Munich Gamma Knife UCP coincided within x;y;z: -0.014{+-}0.09 mm; 0.013{+-}0.09 mm; -0.002{+-}0.06 mm (mean{+-}SD) to the center of dose distribution. There was no trend in the measured data observed over more than ten years. All measured data were within a sphere of 0.2 mm radius. When basing the target definition in the system test on MRI scans, we obtained an overall accuracy of an irradiation position in the x direction of 0.21{+-}0.32 mm and in the y direction 0.15{+-}0.26 mm (mean{+-}SD). When a CT-based target definition was used, we measured distances in x direction 0.06{+-}0.09 mm and in y direction 0.04{+-}0.09 mm (mean{+-}SD), respectively. These results were compared with those obtained with a Gamma Knife equipped with an automatic positioning system (APS) by use of a different phantom. This phantom was found to be slightly less accurate due to its mechanical construction and the soft fixation into the frame. The phantom related position deviation was found to be about {+-}0.2 mm, and therefore the measured accuracy of the APS Gamma Knife was evidently less

  11. Way forward in case of a false positive in vitro genotoxicity result for a cosmetic substance?

    PubMed

    Doktorova, Tatyana Y; Ates, Gamze; Vinken, Mathieu; Vanhaecke, Tamara; Rogiers, Vera

    2014-02-01

    The currently used regulatory in vitro mutagenicity/genotoxicity test battery has a high sensitivity for detecting genotoxicants, but it suffers from a large number of irrelevant positive results (i.e. low specificity) thereby imposing the need for additional follow-up by in vitro and/or in vivo genotoxicity tests. This could have a major impact on the cosmetic industry in Europe, seen the imposed animal testing and marketing bans on cosmetics and their ingredients. Afflicted, but safe substances could therefore be lost. Using the example of triclosan, a cosmetic preservative, we describe here the potential applicability of a human toxicogenomics-based in vitro assay as a potential mechanistically based follow-up test for positive in vitro genotoxicity results. Triclosan shows a positive in vitro chromosomal aberration test, but is negative during in vivo follow-up tests. Toxicogenomics analysis unequivocally shows that triclosan is identified as a compound acting through non-DNA reactive mechanisms. This proof-of-principle study illustrates the potential of genome-wide transcriptomics data in combination with in vitro experimentation as a possible weight-of-evidence follow-up approach for de-risking a positive outcome in a standard mutagenicity/genotoxicity battery. As such a substantial number of cosmetic compounds wrongly identified as genotoxicants could be saved for the future. Copyright © 2013 Elsevier Ltd. All rights reserved.

  12. Differentiating medicinal from illicit use in positive methamphetamine results in a pain population.

    PubMed

    West, Robert; Pesce, Amadeo; West, Cameron; Mikel, Charles; Velasco, Javier; Gonzales, Elizabeth; Dizon, Zenaida; Almazan, Perla; Latyshev, Sergey

    2013-03-01

    In addition to illicit methamphetamine, there are prescription and over-the-counter medications that, if ingested, may yield positive methamphetamine (MAMP) results on laboratory urine drug tests. The purpose of the study is to estimate the prevalence of medicinal and illicit MAMP in the pain population using chiral analysis to determine the relative amounts of the d and l-MAMP enantiomers. This retrospective analysis included the LC-MS/MS results and prescriber provided medication histories of 485,889 de-identified urine specimens from patients treated for pain. Two groups of 100 specimens each were subjected to chiral analysis. Group 1 contained specimens that were MAMP positive and amphetamine negative. Group 2 contained randomly selected MAMP positive specimens. The overall MAMP positivity rate of the 485,889 specimens tested was 1.6%. The prevalence of MAMP medications based on reported medications and detection of l-MAMP in Group 1 and Group 2 was 44% and 6%, respectively. These data indicate that the use of both illicit and medicinal MAMP is found in this patient population, and that medicinal use is underreported in clinical histories. Therefore, clinical laboratories should provide on request chiral analysis to aid in differentiating illicit and medicinal MAMP.

  13. [A pseudo-outbreak of pharyngeal gonorrhoea related to a false-positive PCR-result].

    PubMed

    Verzijl, A; Berretty, P J M; Erceg, A; Krekels, G A M; Van den Brule, A J C; Boel, C H E

    2007-03-24

    Nucleic acid amplification tests, including the polymerase chain reaction (PCR), are sensitive and specific tests that are often used for diagnosing sexually transmitted diseases (STDs). A pseudo-outbreak of pharyngeal gonorrhoea in a group of prostitutes turned out to have been caused by false-positive test results due to commensal oropharyngeal Neisseria species. Specific molecular tests may yield erroneous results. When the results of an STD study have major consequences at a legal or social level, it is advisable, in consultation with a medical microbiologist, to take a sample for culture or to carry out a second molecular test aimed at a different part of the bacterial genome.

  14. Risk of Breast Cancer in Women with False-Positive Results according to Mammographic Features.

    PubMed

    Castells, Xavier; Torá-Rocamora, Isabel; Posso, Margarita; Román, Marta; Vernet-Tomas, Maria; Rodríguez-Arana, Ana; Domingo, Laia; Vidal, Carmen; Baré, Marisa; Ferrer, Joana; Quintana, María Jesús; Sánchez, Mar; Natal, Carmen; Espinàs, Josep A; Saladié, Francina; Sala, María

    2016-08-01

    Purpose To assess the risk of breast cancer in women with false-positive screening results according to radiologic classification of mammographic features. Materials and Methods Review board approval was obtained, with waiver of informed consent. This retrospective cohort study included 521 200 women aged 50-69 years who underwent screening as part of the Spanish Breast Cancer Screening Program between 1994 and 2010 and who were observed until December 2012. Cox proportional hazards regression analysis was used to estimate the age-adjusted hazard ratio (HR) of breast cancer and the 95% confidence interval (CI) in women with false-positive mammograms as compared with women with negative mammograms. Separate models were adjusted for screen-detected and interval cancers and for screen-film and digital mammography. Time without a breast cancer diagnosis was plotted by using Kaplan-Meier curves. Results When compared with women with negative mammograms, the age-adjusted HR of cancer in women with false-positive results was 1.84 (95% CI: 1.73, 1.95; P < .001). The risk was higher in women who had calcifications, whether they were (HR, 2.73; 95% CI: 2.28, 3.28; P < .001) or were not (HR, 2.24; 95% CI: 2.02, 2.48; P < .001) associated with masses. Women in whom mammographic features showed changes in subsequent false-positive results were those who had the highest risk (HR, 9.13; 95% CI: 8.28, 10.07; P < .001). Conclusion Women with false-positive results had an increased risk of breast cancer, particularly women who had calcifications at mammography. Women who had more than one examination with false-positive findings and in whom the mammographic features changed over time had a highly increased risk of breast cancer. Previous mammographic features might yield useful information for further risk-prediction models and personalized follow-up screening protocols. (©) RSNA, 2016 Online supplemental material is available for this article.

  15. False-positive amphetamine toxicology screen results in three pregnant women using labetalol.

    PubMed

    Yee, Lynn M; Wu, Danny

    2011-02-01

    Labetalol is commonly used for control of hypertension in pregnancy. A component of the workup for new-onset hypertension in pregnancy often includes a urine drug screen. A labetalol metabolite is structurally similar to amphetamine and methamphetamine, thus causing potential cross-reactivity in drug immunoassays. We present one case of cocaine-induced hypertensive crisis superimposed on chronic hypertension and two cases of severe preeclampsia for which patients required escalating doses of labetalol for hypertension, with subsequent false-positive amphetamine urine drug screen results. In pregnant women requiring labetalol for treatment of hypertensive disease, a urine drug screen may be falsely positive for amphetamines and methamphetamines. Providers should be cognizant of this possibility when interpreting the results of urine drug screens.

  16. Reporting of Positive Results in Randomized Controlled Trials of Mindfulness-Based Mental Health Interventions

    PubMed Central

    Coronado-Montoya, Stephanie; Levis, Alexander W.; Kwakkenbos, Linda; Steele, Russell J.; Turner, Erick H.; Thombs, Brett D.

    2016-01-01

    Background A large proportion of mindfulness-based therapy trials report statistically significant results, even in the context of very low statistical power. The objective of the present study was to characterize the reporting of “positive” results in randomized controlled trials of mindfulness-based therapy. We also assessed mindfulness-based therapy trial registrations for indications of possible reporting bias and reviewed recent systematic reviews and meta-analyses to determine whether reporting biases were identified. Methods CINAHL, Cochrane CENTRAL, EMBASE, ISI, MEDLINE, PsycInfo, and SCOPUS databases were searched for randomized controlled trials of mindfulness-based therapy. The number of positive trials was described and compared to the number that might be expected if mindfulness-based therapy were similarly effective compared to individual therapy for depression. Trial registries were searched for mindfulness-based therapy registrations. CINAHL, Cochrane CENTRAL, EMBASE, ISI, MEDLINE, PsycInfo, and SCOPUS were also searched for mindfulness-based therapy systematic reviews and meta-analyses. Results 108 (87%) of 124 published trials reported ≥1 positive outcome in the abstract, and 109 (88%) concluded that mindfulness-based therapy was effective, 1.6 times greater than the expected number of positive trials based on effect size d = 0.55 (expected number positive trials = 65.7). Of 21 trial registrations, 13 (62%) remained unpublished 30 months post-trial completion. No trial registrations adequately specified a single primary outcome measure with time of assessment. None of 36 systematic reviews and meta-analyses concluded that effect estimates were overestimated due to reporting biases. Conclusions The proportion of mindfulness-based therapy trials with statistically significant results may overstate what would occur in practice. PMID:27058355

  17. Accuracy of relative positioning by interferometry with GPS Double-blind test results

    NASA Technical Reports Server (NTRS)

    Counselman, C. C., III; Gourevitch, S. A.; Herring, T. A.; King, B. W.; Shapiro, I. I.; Cappallo, R. J.; Rogers, A. E. E.; Whitney, A. R.; Greenspan, R. L.; Snyder, R. E.

    1983-01-01

    MITES (Miniature Interferometer Terminals for Earth Surveying) observations conducted on December 17 and 29, 1980, are analyzed. It is noted that the time span of the observations used on each day was 78 minutes, during which five satellites were always above 20 deg elevation. The observations are analyzed to determine the intersite position vectors by means of the algorithm described by Couselman and Gourevitch (1981). The average of the MITES results from the two days is presented. The rms differences between the two determinations of the components of the three vectors, which were about 65, 92, and 124 m long, were 8 mm for the north, 3 mm for the east, and 6 mm for the vertical. It is concluded that, at least for short distances, relative positioning by interferometry with GPS can be done reliably with subcentimeter accuracy.

  18. Does positive affect change in old age? Results from a 22-year longitudinal study.

    PubMed

    Gana, Kamel; Saada, Yaël; Amieva, Hélène

    2015-03-01

    The authors examined longitudinal change in positive affect (PA), a component of subjective well-being. Positive affect was assessed with the PA subscale of the Center for Epidemiologic Studies-Depression Scale (Radloff, 1977) in a sample of individuals from the PAQUID cohort (n = 3,777; age 62-101 years, M = 75.46, SD = 6.91 at Wave 1) over a period of 22 years (10 waves of data). Latent growth curve modeling was used to assess change in PA. A quadratic latent growth curve was found to characterize the latent growth pattern of PA in our sample, indicating linear change before a decline phase. These results were discussed with reference to the well-being paradox. (c) 2015 APA, all rights reserved).

  19. False-positive PCR results linked to administration of seasonal influenza vaccine.

    PubMed

    Curran, T; McCaughey, C; Ellis, J; Mitchell, S J; Feeney, S A; Watt, A P; Mitchell, F; Fairley, D; Crawford, L; McKenna, J; Coyle, P V

    2012-03-01

    False-positive PCR results usually occur as a consequence of specimen-to-specimen or amplicon-to-specimen contamination within the laboratory. Evidence of contamination at time of specimen collection linked to influenza vaccine administration in the same location as influenza sampling is described. Clinical, circumstantial and laboratory evidence was gathered for each of five cases of influenza-like illness (ILI) with unusual patterns of PCR reactivity for seasonal H1N1, H3N2, H1N1 (2009) and influenza B viruses. Two 2010 trivalent influenza vaccines and environmental swabs of a hospital influenza vaccination room were also tested for influenza RNA. Sequencing of influenza A matrix (M) gene amplicons from the five cases and vaccines was undertaken. Four 2009 general practitioner (GP) specimens were seasonal H1N1, H3N2 and influenza B PCR positive. One 2010 GP specimen was H1N1 (2009), H3N2 and influenza B positive. PCR of 2010 trivalent vaccines showed high loads of detectable influenza A and B RNA. Sequencing of the five specimens and vaccines showed greatest homology with the M gene sequence of Influenza A/Puerto Rico/8/1934 H1N1 virus (used in generation of influenza vaccine strains). Environmental swabs had detectable influenza A and B RNA. RNA detection studies demonstrated vaccine RNA still detectable for at least 66 days. Administration of influenza vaccines and clinical sampling in the same room resulted in the contamination with vaccine strains of surveillance swabs collected from patients with ILI. Vaccine contamination should therefore be considered, particularly where multiple influenza virus RNA PCR positive signals (e.g. H1N1, H3N2 and influenza B) are detected in the same specimen.

  20. Allelic Dropout Can Cause False-Positive Results for Prader-Willi and Angelman Syndrome Testing

    PubMed Central

    Hussain Askree, Syed; Hjelm, Lawrence N.; Ali Pervaiz, Muhammad; Adam, Margaret; Bean, Lora J.H.; Hedge, Madhuri; Coffee, Bradford

    2011-01-01

    The diagnosis of many genetic disorders relies on a combination of clinical suspicion and confirmatory genetic testing. Our laboratory uses a standard methylation-sensitive PCR (MSP) to target the differentially methylated SNRPN gene to test for Prader-Willi syndrome (PWS) and Angelman syndrome. One patient, a 27-month-old female, who lacked the classical clinical features of PWS, but had a molecular diagnosis of PWS by MSP by another laboratory, had repeat testing in our laboratory. Testing by MSP in our laboratory also identified an apparent loss of the unmethylated paternal allele, consistent with a diagnosis of PWS. Confirmatory testing using Southern blot analysis with a methylation-sensitive restriction enzyme showed a normal pattern of methylation, detecting both the methylated maternal and unmethylated paternal alleles. To investigate these discrepant results, we amplified and sequenced the SNRPN locus in this patient and identified a single nucleotide change within the binding site for the unmethylated DNA-specific primer. These results indicate this nucleotide change led to allelic dropout in the MSP analysis, yielding the false-positive result. Subsequently, MSP analysis using an alternate primer set that was developed by our laboratory detected both methylated and unmethylated alleles. These findings illustrate that allelic dropout due to the presence of rare polymorphisms can cause false-positive results in commonly used MSP assays and lead to molecular misdiagnosis. PMID:21227401

  1. False-Positive Results after Environmental Pinworm PCR Testing due to Rhabditid Nematodes in Corncob Bedding

    PubMed Central

    Leblanc, Mathias; Berry, Kristina; Graciano, Sandy; Becker, Brandon; Reuter, Jon D

    2014-01-01

    Modern rodent colonies are housed in individually ventilated cages to protect the animals from contamination with adventitious pathogens. Standard health monitoring through soiled-bedding sentinels does not always detect infections, especially in the context of low pathogen prevalence. Recently proposed alternatives include analyzing environmental samples from the cages or rack exhaust by PCR to improve the detection of rodent pathogens but optimal sampling strategies have not yet been established for different microorganisms. Although generally very sensitive and specific, these molecular assays are not foolproof and subject to false-positive and –negative results and should always be interpreted cautiously with an overall understanding of the intrinsic controls and all the variables that may affect the results. Here, we report a limited Aspiculuris tetraptera outbreak in a mouse barrier facility that was detected by fecal PCR in sentinels and confirmed by fecal flotation and direct cecal examination of both sentinels and colony animals. The outbreak led to a widespread survey of all facilities for pinworms by using environmental PCR from ventilated rack exhaust plenums. Environmental PCR suggested an unexpected widespread contamination of all ventilated racks holding nonautoclaved cages, but results could not be confirmed in sentinel or colony animals by fecal flotation, cecal and colonic examination, or cage PCR testing. After additional investigation, the unexpected environmental PCR results were confirmed as false-positive findings due to the nonspecificity of the assay, leading to the amplification of rhabditid nematodes, which are not infectious in rodents but which contaminated the corncob bedding. PMID:25650980

  2. False-positive results after environmental pinworm PCR testing due to Rhabditid nematodes in Corncob bedding.

    PubMed

    Leblanc, Mathias; Berry, Kristina; Graciano, Sandy; Becker, Brandon; Reuter, Jon D

    2014-11-01

    Modern rodent colonies are housed in individually ventilated cages to protect the animals from contamination with adventitious pathogens. Standard health monitoring through soiled-bedding sentinels does not always detect infections, especially in the context of low pathogen prevalence. Recently proposed alternatives include analyzing environmental samples from the cages or rack exhaust by PCR to improve the detection of rodent pathogens but optimal sampling strategies have not yet been established for different microorganisms. Although generally very sensitive and specific, these molecular assays are not foolproof and subject to false-positive and -negative results and should always be interpreted cautiously with an overall understanding of the intrinsic controls and all the variables that may affect the results. Here, we report a limited Aspiculuris tetraptera outbreak in a mouse barrier facility that was detected by fecal PCR in sentinels and confirmed by fecal flotation and direct cecal examination of both sentinels and colony animals. The outbreak led to a widespread survey of all facilities for pinworms by using environmental PCR from ventilated rack exhaust plenums. Environmental PCR suggested an unexpected widespread contamination of all ventilated racks holding nonautoclaved cages, but results could not be confirmed in sentinel or colony animals by fecal flotation, cecal and colonic examination, or cage PCR testing. After additional investigation, the unexpected environmental PCR results were confirmed as false-positive findings due to the nonspecificity of the assay, leading to the amplification of rhabditid nematodes, which are not infectious in rodents but which contaminated the corncob bedding.

  3. Case Report: Direct Access Genetic Testing and A False-Positive Result For Long QT Syndrome.

    PubMed

    Predham, Sarah; Hamilton, Sara; Elliott, Alison M; T Gibson, William

    2016-02-01

    We report the case of a woman who pursued direct access genetic testing and then presented with concerns regarding a positive test result for Long-QT syndrome. Although the result ultimately proved to be a false positive, this case illustrates that costs associated with follow-up of direct access genetic testing results can be non-trivial for both the patient and for health care systems. Here we raise policy questions regarding the appropriate distribution of these costs. We also discuss the possibility that, when confronted by a direct access genetic test result that reports high risk for one or more actionable diseases, a family physician might feel compelled to act out of a desire to avoid liability, even when information regarding the accuracy and validity of the testing were not easily accessible. This case outlines lessons that can easily be translated into clinical practice, not only by genetic counselors, but also by family physicians, medical specialists and members of the public.

  4. Occult Hepatitis B Virus Infection in Nigerian Blood Donors and Hepatitis B Virus Transmission Risks

    PubMed Central

    Fagbami, Ademola H.; Adekanle, Olusegun; Ojurongbe, Olusola; Bock, C.-Thomas; Kremsner, Peter G.; Velavan, Thirumalaisamy P.

    2015-01-01

    Background Occult hepatitis B virus infection (OBI) characterized by the absence of detectable HBsAg remains a potential threat in blood safety. We investigated the actual prevalence, viral factors and genotype of OBI infections in Nigerian blood donors. Methods Serum collected from two blood banks were reconfirmed as HBsAg seronegative by ELISA. Forty HBsAg positive samples were employed as controls. HBV-DNA was amplified from all donors and viral loads were determined using quantitative real-time PCR. Antibodies to the HBV core, surface and HBe antigen (anti-HBc,anti-HBs,HBeAg) were measured. The PreS/S and PreC/C regions of the HBV genome were sequenced. Results Of the 429 blood donors, 72(17%) were confirmed as OBI by DNA detection in different reference labs and excluded the concern of possible contamination. Of the 72 OBI samples, 48(67%) were positive for anti-HBc, 25(35%) positive for anti-HBs, and 2(3%) positive for HBeAg. Of the 72 OBI samples, 31(43%) were seropositive for either anti-HBc, anti-HBs or HBeAg, 21 (30%) positive for both anti-HBc and anti-HBs,one positive for both anti-HBc and HBeAg. None of the OBI samples were positive for all three serological markers. The viral load was <50copies/ml in the OBI samples and genotype E was predominant. The L217R polymorphism in the reverse transcriptase domain of the HBV polymerase gene was observed significantly higher in OBI compared with HBsAg positive individuals (P<0.0001). Conclusion High incidence of OBI is relevant in high endemic areas worldwide and is a general burden in blood safety. This study signifies the high prevalence of OBI and proposes blood donor samples in Nigeria should be pre-tested for OBI by nucleic acid testing (NAT) and/or anti-HBc prior to transfusion to minimize the HBV infection risk. PMID:26148052

  5. OIE white spot syndrome virus PCR gives false-positive results in Cherax quadricarinatus.

    PubMed

    Claydon, Kerry; Cullen, Bradford; Owens, Leigh

    2004-12-13

    White spot syndrome virus (WSSV) is an intranuclear bacilliform virus (IBV) that is a serious, notifiable crustacean pathogen. The Office International des Epizooties (OIE) PCR protocol for WSSV uses primer sets initially developed by Lo et al. (1996). It yields a first-step PCR amplicon of 1441 bp and a nested PCR amplicon of 941 bp. An amplicon (941 bp) purported to specifically detect WSSV was obtained when using template DNA extracted from Cherax quadricarinatus in a WSSV PCR detection protocol recommended by the OIE. Sequencing and analysis of the 941 bp amplicon and an occasional 550 bp amplicon from C. quadricarinatus revealed no phylogenetic relationship with WSSV, and suggested a possible lack of sufficient primer specificity for WSSV in the OIE test. This suggestion was supported by the fact that the OIE outer primer sequence (146F1) was present in both the forward and reverse position of the 941 bp and the forward position of the 550 bp nested amplicons from C. quadricarinatus. As WSSV is a notifiable pathogen, the consequences of false-positive results are harsh in WSSV-free zones and can lead to incorrect quarantine and unnecessary destruction of animals. Therefore, urgent attention and revision is necessary for the current OIE PCR protocol for WSSV detection.

  6. Risk for Neurobehavioral Disinhibition in Prenatal Methamphetamine-Exposed Young Children with Positive Hair Toxicology Results

    PubMed Central

    Himes, Sarah K.; LaGasse, Linda L.; Derauf, Chris; Newman, Elana; Smith, Lynne M.; Arria, Amelia M.; Grotta, Sheri A. Della; Dansereau, Lynne M.; Abar, Beau; Neal, Charles R.; Lester, Barry M.; Huestis, Marilyn A.

    2014-01-01

    Background The objective was to evaluate effects of prenatal methamphetamine exposure (PME) and postnatal drug exposures identified by child hair analysis on neurobehavioral disinhibition at 6.5 years of age. Methods Mother-infant pairs were enrolled in the Infant Development, Environment, and Lifestyle (IDEAL) Study in Los Angeles, Honolulu, Tulsa and Des Moines. PME was determined by maternal self-report and/or positive meconium results. At the 6.5-year follow-up visit, hair was collected and analyzed for methamphetamine, tobacco, cocaine, and cannabinoid markers. Child behavioral and executive function test scores were aggregated to evaluate child neurobehavioral disinhibition. Hierarchical linear regression models assessed the impact of PME, postnatal substances, and combined PME with postnatal drug exposures on the child’s neurobehavioral disinhibition aggregate score. Past year caregiver substance use was compared to child hair results. Results A total of 264 children were evaluated. Significantly more PME children (n=133) had hair positive for methamphetamine/amphetamine (27.1% versus 8.4%) and nicotine/cotinine (38.3% versus 25.2%) than children without PME (n=131). Overall, no significant differences in analyte hair concentrations were noted between groups. Significant differences in behavioral and executive function were observed between children with and without PME. No independent effects of postnatal methamphetamine or tobacco exposure, identified by positive hair test, were noted and no additional neurobehavioral disinhibition was observed in PME children with postnatal drug exposures, as compared to PME children without postnatal exposure. Conclusions Child hair testing offered a non-invasive means to evaluate postnatal environmental drug exposure, although no effects from postnatal drug exposure alone were seen. PME, alone and in combination with postnatal drug exposures, was associated with behavioral and executive function deficits at 6.5 years

  7. Newborn bloodspot results: predictive value of screen positive test for thalassaemia major.

    PubMed

    Streetly, Allison; Latinovic, Radoslav; Henthorn, Joan; Daniel, Yvonne; Dormandy, Elizabeth; Darbyshire, Phil; Mantio, Debbie; Fraser, Laura; Farrar, Lisa; Will, Andrew; Tetlow, Lesley

    2013-12-01

    There are limited published data on the performance of the percentage of haemoglobin A (Hb A) as a screening test for beta thalassaemia major in the newborn period. This paper aims to analyse data derived from a national newborn bloodspot screening programme for sickle cell disease on the performance of haemoglobin A (Hb A) as a screening test for beta thalassaemia major in the newborn period. Newborn bloodspot sickle cell screening data from 2,288,008 babies were analysed. Data reported to the NHS Sickle Cell and Thalassaemia Screening Programme in England for the period 2005 to 2012 were also reviewed to identify any missed cases (4,599,849 babies). Within the cohort of 2,288,008 births, 170 babies were identified as screen positive for beta thalassaemia major using a cut-point of 1.5% HbA. There were 51 identified through look-back methods and 119 prospectively identified from 4 screening laboratories. Among 119 babies with prospective data, 7 were lost to follow up and 15 were false positive results. Using a cut-off value of 1.5% Hb A as a percentage of the total haemoglobin as a screening test for beta thalassaemia major in the newborn provides an estimated sensitivity of 99% (from the look back arm of the study) with a positive predictive value of 87% (from the prospective arm of the study). Excluding infants born before 32 weeks gestation, the positive predictive value rose to 95%. A haemoglobin A value of less than 1.5% is a reliable screening test for beta thalassaemia major in the newborn period.

  8. Lifecourse socioeconomic position and alcohol use in young adulthood: results from the French TEMPO cohort study

    PubMed Central

    Yaogo, Ahmed; Fombonne, Eric; Kouanda, Seni; Lert, France; Melchior, Maria

    2013-01-01

    Aims To examine the relationship between lifetime socioeconomic position and alcohol use in young adults. Methods Study participants (n=1,103, age 22–35 years in 2009) belong to the French TEMPO cohort study and are all offspring of participants of the GAZEL cohort study. Alcohol use was assessed by the WHO AUDIT questionnaire (none, low or intermediate alcohol use, alcohol abuse). Childhood socioeconomic position was measured using parental income through the GAZEL cohort study in 1989 (low: ≤2592€/month vs. Intermediate/high: >2592€/month). Adult socioeconomic position was measured by participants’ educational level (<=high school degree vs. > high school degree). Combining family income and educational attainment, we ascertained participants’ social trajectory (stable high, upward, downward and stable low). Data were analyzed using multinomial regression analyses controlled for demographic, social, psychological and family characteristics. Results Participants’ social trajectory was associated with alcohol abstinence: compared to participants with a stable high social trajectory, those with an upward, downward or low social trajectory were more likely to abstain from alcohol (compared to a stable high social trajectory, sex and age-adjusted ORs: OR=2.22, 95% CI 1.35–3.65 for an upward social trajectory; OR=3.20, 95% CI 1.78–5.73 for a downward social trajectory; OR= 3.27, 95% CI 1.75–6.12 for a stable low social trajectory). Additionally, participants with a downward social trajectory were disproportionately likely to abuse alcohol (sex and age-adjusted OR: 1.48, 95% CI 0.89–2.48). In multivariate analyses, social trajectory remained associated with alcohol abstinence. Conclusions Lifelong socioeconomic position may shape patterns of alcohol use early in life. PMID:23900495

  9. Reduction of misleading ("false") positive results in mammalian cell genotoxicity assays. I. Choice of cell type.

    PubMed

    Fowler, Paul; Smith, Katie; Young, Jamie; Jeffrey, Laura; Kirkland, David; Pfuhler, Stefan; Carmichael, Paul

    2012-02-18

    Current in vitro mammalian cell genotoxicity assays show a high rate of positive results, many of which are misleading when compared with in vivo genotoxicity or rodent carcinogenicity data. P53-deficiency in many of the rodent cell lines may be a key factor in this poor predictivity. As part of an European Cosmetics Industry Association initiative for improvement of in vitro mammalian cell assays, we have compared several rodent cell lines (V79, CHL, CHO) with p53-competent human peripheral blood lymphocytes (HuLy), TK6 human lymphoblastoid cells, and the human liver cell line, HepG2. We have compared in vitro micronucleus (MN) induction following treatment with 19 compounds that were accepted as producing misleading or "false" positive results in in vitro mammalian cell assays [6]. Of these, six chemicals (2-ethyl-1,3-hexandiol, benzyl alcohol, urea, sodium saccharin, sulfisoxazole and isobutyraldehyde) were not toxic and did not induce any MN at concentrations up to 10mM. d,l-Menthol and ethionamide induced cytotoxicity, but did not induce MN. o-Anthranilic acid was not toxic and did not induce MN in V79, CHL, CHO, HuLy and HepG2 cells up to 10mM. Toxicity was induced in TK6 cells, although there were no increases in MN frequency up to and above the 55% toxicity level. The other 10 chemicals (1,3-dihydroxybenzene, curcumin, propyl gallate, p-nitrophenol, ethyl acrylate, eugenol, tert-butylhydroquinone, 2,4-dichlorophenol, sodium xylene sulfonate and phthalic anhydride) produced cytotoxicity in at least one cell type, and were evaluated further for MN induction in most or all of the cell types listed above. All these chemicals induced MN at concentrations <10mM, with levels of cytotoxicity below 60% (measured as the replication index) in at least one cell type. The rodent cell lines (V79, CHO and CHL) were consistently more susceptible to cytotoxicity and MN induction than p53-competent cells, and are therefore more susceptible to giving misleading positive

  10. Investor Outlook: Significance of the Positive LCA2 Gene Therapy Phase III Results.

    PubMed

    Schimmer, Joshua; Breazzano, Steven

    2015-12-01

    Spark Therapeutics recently reported positive phase III results for SPK-RPE65 targeting the treatment of visual impairment caused by RPE65 gene mutations (often referred to as Leber congenital amaurosis type 2, or LCA2, but may include other retinal disorders), marking an important inflection point for the field of gene therapy. The results highlight the ability to successfully design and execute a randomized trial of a gene therapy and also reinforce the potentially predictive nature of early preclinical and clinical data. The results are expected to pave the way for the first approved gene therapy product in the United States and should sustain investor interest and confidence in gene therapy for many approaches, including retina targeting and beyond.

  11. Return of individual genetic results in a high-risk sample: enthusiasm and positive behavioral change.

    PubMed

    Hartz, Sarah M; Olfson, Emily; Culverhouse, Robert; Cavazos-Rehg, Patricia; Chen, Li-Shiun; DuBois, James; Fisher, Sherri; Kaphingst, Kimberly; Kaufman, David; Plunk, Andrew; Ramnarine, Shelina; Solomon, Stephanie; Saccone, Nancy L; Bierut, Laura J

    2015-05-01

    The goal of this study was to examine participant responses to disclosure of genetic results in a minority population at high risk for depression and anxiety. Eighty-two subjects in a genetic study of nicotine dependence were offered personalized genetic results. All were nicotine-dependent and 64% self-identified as African American. Pathway Genomics was used to evaluate genetic risks for five complex diseases. Participants returned 4-8 weeks after enrollment for in-person genetic counseling interviews and evaluation of baseline measures. A telephone follow-up was performed 4-8 weeks later to assess responses to results. Fifty of the 82 subjects (61%) were interested in receiving genetic results. These participants had multiple risk factors, including high baseline measures of depression (66%) and anxiety (32%), as well as low rates of employment (46%), adequate health literacy (46%), and health insurance (45%). Pathway Genomics reported "increased risk" for at least one disease in 77% of subjects. Ninety-five percent of participants reported that they appreciated the genetic results, and receiving these results was not associated with changes in symptoms of depression or anxiety. Furthermore, after return of genetic results, smoking cessation attempts increased (P = 0.003). Even in an underserved population at high risk for adverse psychological reactions, subjects responded positively to personalized genetic results.

  12. The use of EMDR in positive verbal material: results from a patient study

    PubMed Central

    Matthijssen, Suzy Johanna Martina Adriana; van den Hout, Marcel

    2016-01-01

    Background According to the working memory (WM) theory of eye movement desensitisation and reprocessing (EMDR), dual tasks that tax WM during memory recall reduce image vividness and emotionality of memory during future recalls when no dual task is carried out. There is some evidence that WM taxing also reduces vividness and emotionality of auditory or verbal imagery. Objective The present study tests the effect of eye movements (EM) on positive verbal material (verbal imagery), which is used in different parts of the EMDR protocol. In the Dutch version of the standard EMDR protocol, a procedure “Positive Closure” (PC) is performed, which uses verbal imagery under dual task condition (EM). The value of EM in this procedure has not been established and according to the WM account would be counterproductive. Two earlier studies with undergraduates, with a set-up comparable to the present one, showed no additive value of the EM in the procedure, but no counterproductive effect either. Method Thirty-six patients rated the belief in possessing two positive personality traits and emotionality of the traits. They then had an EMDR session targeting a negative memory and recalled and re-rated the belief and emotionality of the traits afterward. Subsequently, they recalled one trait while dual tasking (EM) and the other trait without dual tasking. Afterward, they re-rated the belief and emotionality. Results EM did not affect the belief in possessing the trait or the emotionality. Secondary analysis shows an effective EMDR session itself enhances the belief in the traits, compared to a less or non-effective EMDR session. Conclusions EM are not effective in enhancing the belief in possessing a personality trait or the emotionality. If replicated by other patient studies, this suggests elimination of the PC procedure. Highlights of the article In this study the additive value of EM on verbal material (in the procedure Positive Closure) is not found. No effect of the

  13. [Positioning Ecuador in the global health agenda as a result of sector reform].

    PubMed

    Luna, Cristina; Emanuele, Carlos Andrés; Torre, Daniel De La

    2017-06-08

    Analyze strategies implemented by Ecuador's Ministry of Public Health (MPH) to position the country in the global health agenda during the period 2011-2015 as a result of health sector reform. Documentary review and interviews with stakeholders in national and international agencies with respect to positioning in the global health sphere during the study period. It was observed that the reform process produced a new framework to manage international health relations. The MPH implemented strategies and mechanisms to place national health priorities and interests on the global health agenda at bilateral, regional, and global levels. As a result, the country took a leadership role in certain processes and attained recognition at various international forums. The MPH reform process contributed to recognition and establishment of Ecuador's public policy priorities in the global health agenda through strategies such as giving importance to putting national priorities on the global health agenda, guiding the global health approach exercised by the highest health authority, developing technical capabilities and skills in the International Relations Office, and raising awareness in technical bodies.

  14. The epidemiology of viral hepatitis among people who inject drugs: Results of global systematic reviews

    PubMed Central

    Nelson, Paul; Mathers, Bradley; Cowie, Benjamin; Hagan, Holly; Jarlais, Don Des; Horyniak, Danielle; Degenhardt, Louisa

    2011-01-01

    Background Injecting drug use (IDU) is an important risk for viral hepatitis transmission. Detailed, transparent estimates of the scale of the problem at regional and global levels have never been made. We report national, regional and global prevalence and population size estimates for hepatitis C (HCV) and hepatitis B (HBV) among people who inject drugs. Methods Systematic search of peer-reviewed (Medline/Embase/PsycINFO) and grey literature databases, conference abstracts and online resources, with a widely distributed call for additional data. From 4386 peer-reviewed and 1019 grey literature sources, 1125 were reviewed in full. Studies were extracted to a customised database and graded according their methods. Serological reports of HCV antibodies/anti-HCV, HBV antibodies/anti-HBc, and/or HBV surface antigen/HBsAg among IDUs samples with n>40 participants, <100% HIV-positive, and sampling frames that did not exclude participants on the basis of age or sex were included. Using endorsed decision rules, prevalence estimates were calculated with anti-HCV and anti-HBV as proxies for exposure and HBsAg for current infection. These were combined with IDU population sizes to estimate the number of HBV and HCV positive IDUs. Findings Eligible reports of anti-HCV among IDUs were located for 77 countries. Prevalence was 60–80% in 26 countries and >80% in 12. We estimate worldwide about 10.0 million (range 6.0–15.2M) IDUs might be anti-HCV positive. China, (1.6M), the USA (1.5M) and the Russian Federation (1.3M) had by far the largest such populations. HBsAg reports were found for 59 countries, ranging from 5–10% in 21 countries and over 10% in 10. Worldwide, 6.4 million IDU might be anti-HBc positive (2.3–9.7M), and 1.2 million (0.3–2.7M) HBsAg positive. Interpretation The prevalence of anti-HCV among IDUs is far greater than HIV. Viral hepatitis clearly poses a challenge to public health. Variation in the coverage and quality of existing research creates

  15. Detection of circulating prostate tumor cells: alternative spliced variant of PSM induced false-positive result.

    PubMed

    Hisatomi, Hisashi; Nagao, Kumi; Kawakita, Mutsuji; Matsuda, Tadashi; Hirata, Hiroyuki; Yamamoto, Shigeki; Nakamoto, Takaaki; Harasawa, Hiroshi; Kaneko, Noboru; Hikiji, Kazumasa; Tsukada, Yutaka

    2002-11-01

    RT-nested PCR has been introduced as a highly specific and sensitive assay method to detect the prostate-specific membrane antigen (PSM) mRNA in peripheral blood. However, appreciable percentages of false-positive cases have been reported. Additionally, primer sets reported previously could not discriminate between PSM and PSM', an alternatively spliced variant, mRNA. These isoforms can be produced from a single gene. Switches in alternative splicing patterns are often controlled with strict cell-type or developmental-stage specificity. Therefore, it is most important to discriminate between PSM mRNA and PSM' mRNA. Using our highly specific primer sets, PSM mRNA was detected in 3 of 24 peripheral blood samples of normal male volunteers (12.5%) and was not detected in peripheral blood of 11 normal female volunteers. PSM' mRNA was detected in 5 of 24 peripheral blood samples of normal male volunteers (20.8%) and in 4 of 11 of normal female volunteers (36.4%). PSM' mRNA induced false-positive results, it is important for genetic diagnosis of prostate cancer to discriminate between PSM and PSM' using our primer sets with high specificity. The advances in the uniquely designed primer sets may allow researchers to detect a real PSM mRNA without PSM' mRNA.

  16. Adherent cell assay results affected by variable z-position mixing.

    PubMed

    Carramanzana, Nelson; Ross, Sandra; Biddlecombe, Gloria; Lin, Chi-Hwei; Johnson, Michael

    2010-04-01

    We demonstrate that modifying mixing dynamics after addition of organic solute into aqueous buffers dramatically affects cell morphology and protein expression. Variable z-position (VZP) or varying the height of aspiration and dispense positions during mixing eliminates artifactual effects. Here, we tested 4 adherent cell types and show effects of VZP on quantitative imaging, protein expression, viability, and morphology. The result: The quantitation of cytoplasmic fluorescence within the fields of interest of the phalloidin-actin stain assay improved by 47% and fluorescence variability emitted by cells expressing green fluorescence protein (GFP) fusion proteins decreased by 15%. Assays that perform measurement by averaged reading of the entire well are somewhat susceptible. For example, protein production decreased 8% on the hypoxia response element (HRE)-luciferase assay. VZP did not affect quantitative cell viability, deviate the half maximal effective dose concentration (EC(50)) values or alter expected curve patterns. VZP is a valuable systematic process for cellular assay workflows as it efficiently folds organic solute into the aqueous solution.

  17. How do we manage blood donors and recipients after a positive Zika screening result?

    PubMed

    Jimenez, Alexandra; Shaz, Beth H; Kessler, Debra; Bloch, Evan M

    2017-09-01

    Zika virus (ZIKV) is a mosquito-borne flavivirus that is the focus of an ongoing pandemic. ZIKV is notable for its severe neurologic sequelae in babies born to infected mothers. High rates of subclinical infection, as evidenced by the finding of ZIKV RNA in asymptomatic donors, raise concerns of risk to the blood supply. To date, a total of four suspected cases of transfusion-transmitted ZIKV have been reported (all in Brazil), none of which were associated with clinical infection in the transfusion recipients. In 2016, the US Food and Drug Administration issued a guidance mandating national blood donor screening for ZIKV in the United States. Five days after implementation of donor screening at our facility, we encountered a ZIKV-positive donor. We provide a practical approach to donor, recipient, and blood product management in the setting of a positive donor ZIKV result. Such has been informed by the challenges we faced in the workup of a ZIKV-reactive donation and recipient lookback. © 2017 AABB.

  18. Musculoskeletal pain at various anatomical sites and socioeconomic position: Results of a national survey.

    PubMed

    Leclerc, A; Chastang, J-F; Taiba, R; Pascal, P; Cyr, D; Plouvier, S; Descatha, A

    2016-10-01

    Prevalence of musculoskeletal pain according to sites of pain and associated factors in the community has not been thoroughly documented. The association between pain and socioeconomic position has been studied by several authors, but without details in most studies regarding sites of pain, whereas the relations with social position could differ according to the site of pain. The objective of this study was to explore these differences in the community in France. The national Health and Occupational History survey was conducted in France in 2006 in subjects aged 20-74 years. Self-assessment of pain at various sites in the previous year was recorded. Five sites were considered here: back, neck, shoulder, upper limb, and lower limb. After a description of prevalence according to gender and age, the associations with socioeconomic position at the beginning of the subjects' working life, in seven categories, were studied with logistic models adjusted for age. The analyses were limited to those aged 30-74 years and were conducted separately for men and women. Of the 5520 males and 6643 females studied, prevalence was the highest for back pain (35% for males, 37% for females). Pain was globally more frequent for women. For all sites of pain an increase with age was significant for women. This was not observed in men for back pain (highest prevalence in the 40- to 49-year-old age group) or neck pain. Overall, prevalence of pain was the lowest for professionals (reference category in the analyses). For males, the first occupation as a farmer or blue-collar worker was associated with an increased prevalence for most sites of pain, with odds ratios close to 2. For females, prevalence was increased for more socioeconomic categories, as compared to professionals. Among the five sites, neck pain was an exception: for both men and women, no association was observed between neck pain and socioeconomic position. Although exploratory, these results are consistent with the

  19. TOPEX/POSEIDON operational orbit determination results using global positioning satellites

    NASA Technical Reports Server (NTRS)

    Guinn, J.; Jee, J.; Wolff, P.; Lagattuta, F.; Drain, T.; Sierra, V.

    1994-01-01

    Results of operational orbit determination, performed as part of the TOPEX/POSEIDON (T/P) Global Positioning System (GPS) demonstration experiment, are presented in this article. Elements of this experiment include the GPS satellite constellation, the GPS demonstration receiver on board T/P, six ground GPS receivers, the GPS Data Handling Facility, and the GPS Data Processing Facility (GDPF). Carrier phase and P-code pseudorange measurements from up to 24 GPS satellites to the seven GPS receivers are processed simultaneously with the GDPF software MIRAGE to produce orbit solutions of T/P and the GPS satellites. Daily solutions yield subdecimeter radial accuracies compared to other GPS, LASER, and DORIS precision orbit solutions.

  20. Positive Medication Changes Resulting from Comprehensive and Noncomprehensive Medication Reviews in a Medicare Part D Population.

    PubMed

    Buhl, Allison; Augustine, Jill; Taylor, Ann M; Martin, Rose; Warholak, Terri L

    2017-03-01

    Health care organizations face the challenge of reducing costs while improving health outcomes. Currently, more than 39 million seniors are enrolled in a Medicare Part D prescription benefit plan, many of whom also qualify for medication therapy management (MTM) services. MTM programs provide valuable services designed to prevent or resolve medication-related problems (MRPs). Two core components of all MTM programs include comprehensive medication reviews (CMRs) with followup interventions and focused non-CMR interventions. Currently, there is limited research comparing the rate of MRPs resolved by CMR and non-CMR interventions. To determine whether CMRs versus non-CMR interventions resulted in more pharmacist-initiated intervention recommendations and positive medication changes. This retrospective, cross-sectional quality improvement project evaluated outcomes for individuals who received interventions following a CMR compared with those who received non-CMR interventions as part of a comprehensive MTM program. For this project, eligible individuals qualified for an MTM program. A positive medication change was defined as the addition of an appropriate medication or the removal of an inappropriate medication within 120 days of a pharmacist recommendation. Differences between the groups were calculated using the Wilcoxon rank sum test. During the 2-year period (2012 and 2013), 788,756 beneficiaries were enrolled in the MTM program and evaluated for potential MRPs. In both years, pharmacists recommended more medication changes per member for those receiving a CMR (0.81 in 2012 and 0.82 in 2013) compared with the non-CMR group (0.68 in 2012 and 0.61 in 2013; P value < 0.001 for both years). However, recommendations made via non-CMR interventions (representing the vast majority of all medication reviews) were more likely to result in a positive medication change (OR = 1.24, 95% CI = 1.21-1.28 for 2012; OR = 1.26, 95% CI = 1.22-1.30 for 2013). These quality

  1. Positive Psychotherapy for Smoking Cessation: Treatment Development, Feasibility and Preliminary Results.

    PubMed

    Kahler, Christopher W; Spillane, Nichea S; Day, Anne; Clerkin, Elise; Parks, Acacia; Leventhal, Adam M; Brown, Richard A

    2014-01-01

    Low positive and high negative affect predict low rates of smoking abstinence among smokers making a quit attempt. Positive Psychotherapy can both increase positive affect and decrease negative affect and therefore may be a useful adjunct to behavioral smoking counseling. The purpose of the present study was to assess the feasibility and acceptability of a Positive Psychotherapy for Smoking Cessation (PPT-S) intervention that integrates standard smoking cessation counseling with nicotine patch and a package of positive psychology interventions. We delivered PPT-S to 19 smokers who were low in positive affect at baseline. Rates of session attendance and satisfaction with treatment were high, and most participants reported using and benefiting from the positive psychology interventions. Almost one-third of participants (31.6%) sustained smoking abstinence for 6 months after their quit date. Future studies to assess the relative efficacy of PPT-S compared to standard smoking cessation treatment are warranted.

  2. False-positive fluorodeoxyglucose positron emission tomography results after chemotherapy in patients with metastatic seminoma.

    PubMed

    Decoene, Jasper; Winter, Christian; Albers, Peter

    2015-01-01

    The treatment of residual masses after chemotherapy in seminomas remains a controversial topic. Postchemotherapy retroperitoneal lymph node dissection (PC-RPLND) in all patients would lead to severe overtreatment with a high rate of complications and additional procedures. For this reason, fluorodeoxyglucose positron emission tomography (FDG-PET) was introduced. FDG-PET has an accuracy of 88%. In 15% of cases, FDG-PET findings are false positive (FP) with unclear consequences. Therefore, we retrospectively investigated the rate of unnecessary procedures due to FP results on FDG-PET. Between July 2003 and September 2013 we performed 305 PC-RPLNDs in 277 patients, 22 because of metastatic seminoma. Of them, 11 patients had a preoperative FDG-PET at least 6 weeks after chemotherapy. Indication for surgery was a marker-negative progression of the lesion in 7 patients who did not undergo FDG-PET, a marker-negative progression with a negative result on FDG-PET in 2 patients, and a positive result on FDG-PET with normal markers in 9 patients. Furthermore, PC-RPLND was indicated in 3 patients because of ureteral compression/infiltration with ureteral stents or nephrostomies. In 1 patient, there was uncertainty whether the initial retroperitoneal tumor contained choriocarcinoma elements. Standardized uptake values (SUVs) were recorded for all patients undergoing FDG-PET. The FDG-PET findings were FP in 7 of 11 (64%) patients. The median age of the patients was 45.4 years (39-49). The median SUV in the patients was 6.6 (3.1-11.6), and the median diameter of the residual mass was 6.8 cm (2.9-11). In 4 of 7 patients, intraoperative or postoperative complications occurred (polar artery ligation with functional loss, bilateral non-nerve-sparing technique with retrograde ejaculation, ureteral replacement with an ileal segment, and pulmonary embolism). In patients with metastatic seminoma who received chemotherapy, FDG-PET is a valuable tool to evaluate whether the residual mass

  3. Can handling E85 motor fuel cause positive breath alcohol test results?

    PubMed

    Ran, Ran; Mullins, Michael E

    2013-09-01

    Hand-held breath alcohol analyzers are widely used by police in traffic stops of drivers suspected of driving while intoxicated (DWI). E85 is a motor fuel consisting of 85% ethanol and 15% gasoline or other hydrocarbons, and is available at nearly 2,600 stations in the USA. We sought to determine whether handling E85 fuel could produce measurable breath alcohol results using a hand-held analyzer and to see if this would be a plausible explanation for a positive breath alcohol test. Five healthy adult subjects dispensed or transferred 8 US gallons of E85 fuel in each of four scenarios. We measured breath alcohol concentration in g/210 L of exhaled breath using the BACTrack S50 at 0, 2, 4, 6, 8, 10, 15 and 20 min after each fuel-handling scenario. Most of the subjects had no detectable breath alcohol after handling E85 motor fuel. Transient elevations (0.02-0.04 g/210 L) in breath alcohol measurement occurred up to 6 min after handling E85 in a minority of subjects. We conclude that it is unlikely that handling E85 motor fuel would result in erroneous prosecution for DWI.

  4. Rates of False-Positive Classification Resulting From the Analysis of Additional Embedded Performance Validity Measures.

    PubMed

    Silk-Eglit, Graham M; Stenclik, Jessica H; Miele, Andrea S; Lynch, Julie K; McCaffrey, Robert J

    2015-01-01

    Several studies have documented improvements in the classification accuracy of performance validity tests (PVTs) when they are combined to form aggregated models. Fewer studies have evaluated the impact of aggregating additional PVTs and changing the classification threshold within these models. A recent Monte Carlo simulation demonstrated that to maintain a false-positive rate (FPR) of ≤.10, only 1, 4, 8, 10, and 15 PVTs should be analyzed at classification thresholds of failing at least 1, at least 2, at least 3, at least 4, and at least 5 PVTs, respectively. The current study sought to evaluate these findings with embedded PVTs in a sample of real-life litigants and to highlight a potential danger in analytic flexibility with embedded PVTs. Results demonstrated that to maintain an FPR of ≤.10, only 3, 7, 10, 14, and 15 PVTs should be analyzed at classification thresholds of failing at least 1, at least 2, at least 3, at least 4, and at least 5 PVTs, respectively. Analyzing more than these numbers of PVTs resulted in a dramatic increase in the FPR. In addition, in the most extreme case, flexibility in analyzing and reporting embedded PVTs increased the FPR by 67%. Given these findings, a more objective approach to analyzing and reporting embedded PVTs should be introduced.

  5. Flight Test Results from Real-Time Relative Global Positioning System Flight Experiment on STS-69

    NASA Technical Reports Server (NTRS)

    Park, Young W.; Brazzel, Jack P., Jr.; Carpenter, J. Russell; Hinkel, Heather D.; Newman, James H.

    1996-01-01

    A real-time global positioning system (GPS) Kalman filter has been developed to support automated rendezvous with the International Space Station (ISS). The filter is integrated with existing Shuttle rendezvous software running on a 486 laptop computer under Windows. In this work, we present real-time and postflight results achieved with the filter on STS-69. The experiment used GPS data from an Osborne/Jet propulsion Laboratory TurboRouge receiver carried on the Wake Shield Facility (WSF) free flyer and a Rockwell Collins 3M receiver carried on the Orbiter. Real time filter results, processed onboard the Shuttle and replayed in near-time on the ground, are based on single vehicle mode operation and on 5 to 20 minute snapshots of telemetry provided by WSF for dual-vehicle mode operation. The Orbiter and WSF state vectors calculated using our filter compare favorably with precise reference orbits determined by the University of Texas Center for Space Research. The lessons learned from this experiment will be used in conjunction with future experiments to mitigate the technology risk posed by automated rendezvous and docking to the ISS.

  6. Positive EtG findings in hair as a result of a cosmetic treatment.

    PubMed

    Sporkert, Frank; Kharbouche, Hicham; Augsburger, Marc P; Klemm, Clementine; Baumgartner, Markus R

    2012-05-10

    In a case of a driving ability assessment, hair analysis for ethyl glucuronide (EtG) was requested by the authorities. The person concerned denied alcohol consumption and did not present any clinical sign of alcoholism. However, EtG was found in concentrations of up to 910pg/mg in hair from different sampling dates suggesting an excessive drinking behavior. The person declared to use a hair lotion on a regularly base. To evaluate a possible effect of the hair lotion, prospective blood and urine controls as well as hair sampling of scalp and pubic hair were performed. The traditional clinical biomarkers of ethanol consumption, CDT and GGT, were inconspicuous in three blood samples taken. EtG was not detected in all collected urine samples. The hair lotion was transmitted to our laboratory. The ethanol concentration in this lotion was determined with 35g/L. The EtG immunoassay gave a positive result indicating EtG, which could be confirmed by GC-MS/MS-NCI. In a follow-up experiment the lotion was applied to the hair of a volunteer over a period of six weeks. After this treatment, EtG could be measured in the hair at a concentration of 72pg/mg suggesting chronic and excessive alcohol consumption. Overnight incubation of EtG free hair in the lotion yielded an EtG concentration of 140pg/mg. In the present case, the positive EtG hair findings could be interpreted as the result of an EtG containing hair care product. To our knowledge, the existence of such a product has not yet been reported, and it is exceptionally unusual to find EtG in cosmetics. Therefore, external sources for hair contamination should always be taken into account when unusual cosmetic treatment is mentioned. In those cases, it is recommended to analyze the hair product for a possible contamination with EtG. The analysis of body hair can help to reveal problems occurring from cosmetic treatment of head hair. As a consequence, the assessment of drinking behavior should be based on more than one

  7. GNSS Antenna Caused Near-Field Interference Effect in Precise Point Positioning Results

    NASA Astrophysics Data System (ADS)

    Dawidowicz, Karol; Baryła, Radosław

    2017-06-01

    Results of long-term static GNSS observation processing adjustment prove that the often assumed "averaging multipath effect due to extended observation periods" does not actually apply. It is instead visible a bias that falsifies the coordinate estimation. The comparisons between the height difference measured with a geometrical precise leveling and the height difference provided by GNSS clearly verify the impact of the near-field multipath effect. The aim of this paper is analysis the near-field interference effect with respect to the coordinate domain. We demonstrate that the way of antennas mounting during observation campaign (distance from nearest antennas) can cause visible changes in pseudo-kinematic precise point positioning results. GNSS measured height differences comparison revealed that bias of up to 3 mm can be noticed in Up component when some object (additional GNSS antenna) was placed in radiating near-field region of measuring antenna. Additionally, for both processing scenario (GPS and GPS/GLONASS) the scattering of results clearly increased when additional antenna crosses radiating near-field region of measuring antenna. It is especially true for big choke ring antennas. In short session (15, 30 min.) the standard deviation was about twice bigger in comparison to scenario without additional antenna. When we used typical surveying antennas (short near-field region radius) the effect is almost invisible. In this case it can be observed the standard deviation increase of about 20%. On the other hand we found that surveying antennas are generally characterized by lower accuracy than choke ring antennas. The standard deviation obtained on point with this type of antenna was bigger in all processing scenarios (in comparison to standard deviation obtained on point with choke ring antenna).

  8. Positive reinforcement training in rhesus macaques-training progress as a result of training frequency.

    PubMed

    Fernström, A-L; Fredlund, H; Spångberg, M; Westlund, K

    2009-05-01

    Positive reinforcement training (PRT) efficiency was examined as a function of training frequency in 33 pair- or triple-housed female rhesus macaques. The animals were trained three times a week, once a day or twice a day, using PRT and a clicker as a secondary reinforcer. All animals were trained on 30 sessions, with an average of 5 min per training session per animal. The behaviors, trained in succession, were Targeting (reliably touching and following a Target); Collaborating (dominant animals allowing subordinates to train while stationing); Box-training (accepting being enclosed in a small compartment while responding to Target training) and initial Injection training.Fulfilled criteria for Targeting were obtained in 32/33 animals in a median of nine training sessions. Collaboration was obtained in 27/33 animals in a median of 15 training sessions. However, only four animals completed Box-training during the 30 training sessions and started Injection training. When comparing training success in terms of number of training sessions, training twice a day was less efficient than the other two treatments. In terms of daily progress, our results suggest that from a management perspective, daily training is more conducive to quick training success than thrice weekly training. In addition, in this study no further advantages could be gained from training twice a day.

  9. College football, elections, and false-positive results in observational research.

    PubMed

    Fowler, Anthony; Montagnes, B Pablo

    2015-11-10

    A recent, widely cited study [Healy AJ, Malhotra N, Mo CH (2010) Proc Natl Acad Sci USA 107(29):12804-12809] finds that college football games influence voting behavior. Victories within 2 weeks of an election reportedly increase the success of the incumbent party in presidential, senatorial, and gubernatorial elections in the home county of the team. We reassess the evidence and conclude that there is likely no such effect, despite the fact that Healy et al. followed the best practices in social science and used a credible research design. Multiple independent sources of evidence suggest that the original finding was spurious-reflecting bad luck for researchers rather than a shortcoming of American voters. We fail to estimate the same effect when we leverage situations where multiple elections with differing incumbent parties occur in the same county and year. We also find that the purported effect of college football games is stronger in counties where people are less interested in college football, just as strong when the incumbent candidate does not run for reelection, and just as strong in other parts of the state outside the home county of the team. Lastly, we detect no effect of National Football League games on elections, despite their greater popularity. We conclude with recommendations for evaluating surprising research findings and avoiding similar false-positive results.

  10. College football, elections, and false-positive results in observational research

    PubMed Central

    Fowler, Anthony; Montagnes, B. Pablo

    2015-01-01

    A recent, widely cited study [Healy AJ, Malhotra N, Mo CH (2010) Proc Natl Acad Sci USA 107(29):12804–12809] finds that college football games influence voting behavior. Victories within 2 weeks of an election reportedly increase the success of the incumbent party in presidential, senatorial, and gubernatorial elections in the home county of the team. We reassess the evidence and conclude that there is likely no such effect, despite the fact that Healy et al. followed the best practices in social science and used a credible research design. Multiple independent sources of evidence suggest that the original finding was spurious—reflecting bad luck for researchers rather than a shortcoming of American voters. We fail to estimate the same effect when we leverage situations where multiple elections with differing incumbent parties occur in the same county and year. We also find that the purported effect of college football games is stronger in counties where people are less interested in college football, just as strong when the incumbent candidate does not run for reelection, and just as strong in other parts of the state outside the home county of the team. Lastly, we detect no effect of National Football League games on elections, despite their greater popularity. We conclude with recommendations for evaluating surprising research findings and avoiding similar false-positive results. PMID:26504202

  11. Screening pharmaceuticals for possible carcinogenic effects: initial positive results for drugs not previously screened

    PubMed Central

    Friedman, Gary D.; Udaltsova, Natalia; Chan, James; Quesenberry, Charles P; Habel, Laurel A.

    2010-01-01

    Objective We screened commonly used prescription drugs for possible carcinogenic effects. Methods In a large health care program we identified 105 commonly used drugs, not previously screened. Recipients were followed for up to 12½ years for incident cancer. Nested case-control analyses of 55 cancer sites and all combined included up to ten matched controls per case, with lag of at least two years between drug dispensing and cancer. Positive associations entailed a relative risk (RR) of 1.50, with p≤ 0.01 and higher risk for three or more, than for one prescription. Evaluation included further analyses, searches of the literature, and clinical judgment. Results There were 101 associations of interest for 61 drugs. Sixty-six associations were judged to have involved substantial confounding. We found evidence that of the remaining 35, the following associations may not be due to chance: sulindac with gallbladder cancer and leukemia, hyoscyamine with non-Hodgkin lymphoma, nortriptyline with esophageal and hepatic cancer, oxazepam with lung cancer, both fluoxetine and paroxetine with testicular cancer, hydrochlorothiazide with renal and lip cancer, and nifedipine with lip cancer. Conclusions These preliminary findings suggest that further studies are indicated regarding sulindac, hyoscyamine, nortriptyline, oxazepam, fluoxetine, paroxetine, hydrochlorothiazide and nifedipine. PMID:19582585

  12. Real Time Precise Point Positioning: Preliminary Results for the Brazilian Region

    NASA Astrophysics Data System (ADS)

    Marques, Haroldo; Monico, João.; Hirokazu Shimabukuro, Milton; Aquino, Marcio

    2010-05-01

    GNSS positioning can be carried out in relative or absolute approach. In the last years, more attention has been driven to the real time precise point positioning (PPP). To achieve centimeter accuracy with this method in real time it is necessary to have available the satellites precise coordinates as well as satellites clocks corrections. The coordinates can be used from the predicted IGU ephemeris, but the satellites clocks must be estimated in a real time. It can be made from a GNSS network as can be seen from EUREF Permanent Network. The infra-structure to realize the PPP in real time is being available in Brazil through the Brazilian Continuous Monitoring Network (RBMC) together with the Sao Paulo State GNSS network which are transmitting GNSS data using NTRIP (Networked Transport of RTCM via Internet Protocol) caster. Based on this information it was proposed a PhD thesis in the Univ. Estadual Paulista (UNESP) aiming to investigate and develop the methodology to estimate the satellites clocks and realize PPP in real time. Then, software is being developed to process GNSS data in the real time PPP mode. A preliminary version of the software was called PPP_RT and is able to process GNSS code and phase data using precise ephemeris and satellites clocks. The PPP processing can be accomplished considering the absolute satellite antenna Phase Center Variation (PCV), Ocean Tide Loading (OTL), Earth Body Tide, among others. The first order ionospheric effects can be eliminated or minimized by ion-free combination or parameterized in the receiver-satellite direction using a stochastic process, e.g. random walk or white noise. In the case of ionosphere estimation, a pseudo-observable is introduced in the mathematical model for each satellite and the initial value can be computed from Klobuchar model or from Global Ionospheric Map (GIM). The adjustment is realized in the recursive mode and the DIA (Detection Identification and Adaptation) is used for quality control. In

  13. Limb position drift results from misalignment of proprioceptive and visual maps.

    PubMed

    Patterson, Jacqueline R; Brown, Liana E; Wagstaff, David A; Sainburg, Robert L

    2017-03-27

    Previous work (Brown et al., 2003a,b) has shown that limb position drifts when individuals make repetitive movements in the absence of visual feedback. The purpose of this study was to examine whether limb position drift might reflect a misalignment in visual and proprioceptive maps by examining the nature of information used to specify new movements from a drifted limb position. In a virtual reality (VR) environment, participants made continuous movements with their dominant right hand between two targets positioned 15cm apart, paced by a 0.625-Hz metronome. After 5 cycles, cursor feedback of the hand was removed for the next 44 cycles, which induced an average drift in hand position of roughly 5cm. On the 50th cycle, participants were required to move to one of 6 new targets from the drifted hand position. Kinematic analysis indicated that movement direction was unambiguously determined by the visual input marked by the original start position, or the last-seen hand position. Forward dynamics analysis revealed that current limb configuration was used to inform joint torques to produce this parallel direction. For new movement specification, accurate proprioceptive information about the drifted limb position was used, even though it was apparently not available for detecting drift in the first place. Movement distance varied directly with the extent of limb drift, although the differentiation of visual and proprioceptive control of distance could not be analyzed, as our control conditions were not significantly different for this measure. We suggest that movement drift, in the absence of visual feedback during cyclic repetitive movements, reflects a misalignment between largely accurate visual and proprioceptive maps, rather than a weighted fusion of the two modalities.

  14. Ceftaroline Plus Ampicillin Against Gram-Positive Organisms: Results from E-Test Synergy Assays.

    PubMed

    D'Arezzo, Silvia; Mazzarelli, Antonio; Venditti, Carolina; Nisii, Carla; Petrosillo, Nicola; De Giuli, Chiara; Vulcano, Antonella; Paglia, Maria Grazia; Bordi, Eugenio; Di Caro, Antonino; Taglietti, Fabrizio

    2017-06-01

    In an era of increasing drug resistance and limited numbers of antimicrobials in the drug production pipeline, healthcare-associated infections represent a growing public health threat. When therapeutic options are limited, clinicians often resort to using antimicrobial combinations that produce a synergistic effect on the target pathogen. Novel antibiotics are therefore welcome in the daily practice of medicine. For example, ceftaroline is a broad-spectrum cephalosporin active against a variety of bacteria, including methicillin-resistant Staphylococcus aureus, but with limited activity against enterococci, particularly Enterococcus faecium. In this study, we tested the efficacy of ceftaroline against clinical isolates of gram-positive bacteria (S. aureus, Enterococcus faecalis, and E. faecium) by the broth microdilution and E-test assays, and then evaluated the synergistic effect of ceftaroline and ampicillin using the E-test method. The time-kill assay was used to confirm the data on selected strains. This drug combination has been recently shown to be effective against E. faecalis and could offer the advantage of cost-effectiveness (compared to other synergistic associations) as well as good tolerability. The E-test was chosen because of its relative simplicity of use that makes it suitable for routine clinical laboratories as a quick tool to guide clinicians when confronted with difficult-to-treat infections that may require an empirical approach. Our results indicate the presence of a synergistic effect of ceftaroline and ampicillin on most of the strains used, especially E. faecium and E. faecalis. The fact that two of those Enterococcus strains were vancomycin resistant suggests that the possible use of this combination for combating the spread of vancomycin-resistant enterococci should be explored.

  15. Long-term results of the Medtronic Mosaic porcine bioprosthesis in the aortic position.

    PubMed

    Anselmi, Amedeo; Flécher, Erwan; Ruggieri, Vito Giovanni; Harmouche, Majid; Langanay, Thierry; Corbineau, Hervé; Verhoye, Jean-Philippe; Leguerrier, Alain

    2014-06-01

    We addressed the long-term results of the Medtronic Mosaic porcine prosthesis in the aortic position. From 1994 to 2004, 1007 Mosaic valves were used for aortic valve replacement. The data were prospectively collected, retrospectively analyzed, and stratified according to patient age at surgery (group 1, <70 years; group 2, 70-75 years; group 3, 76-80 years; and group 4, >80 years), using both actual (cumulative risks) and actuarial methods. Operative mortality was 5% (valve related in 14%). Globally, 8122.17 patient-years were available (average follow-up, 8.5 ± 3.9 years; 99.8% complete). Overall, survival at 15 years was lower among the elderly strata (P < .0001). Freedom from structural valve deterioration (SVD) was 95.1% (actual) and 86.3% (actuarial; 24 SVD events). Survival free from SVD was lower in group 1 (P = .003) but comparable among the other groups. Overall freedom at 15 years from the composite endpoint (any valve-related adverse events) was 82% (actual) and 71.3% (actuarial). No meaningful intergroup differences were found in survival free from the composite endpoint (P = .9) or freedom from valve-related mortality (P = .8). Younger patients at surgery did not show accelerated degeneration. No relationship could be established between prosthetic size and SVD. The implantation of a bioprosthesis in patients aged 70 years or older remains fully justified. The rate of SVD was higher in younger patients, mainly owing to their greater life expectancy. Patients younger than 70 can receive a bioprosthesis, provided that the correct information regarding the expected durability has been provided. This might be better accomplished through the actual methodology. Copyright © 2014 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

  16. Prostate-Specific Membrane Antigen PET/CT: False-Positive Results due to Sarcoidosis?

    PubMed Central

    Hermann, Robert M.; Djannatian, Manoutschehr; Czech, Norbert; Nitsche, Mirko

    2016-01-01

    We report on a 72-year-old male patient who developed sarcoidosis of the mediastinal lymph nodes, the liver, and the prostate 11 years ago. Seven years later, he underwent transurethral resection of the prostate by laser due to hematuria. Pathology of the resected chips showed a ‘granulomatous prostatitis with epitheloid cells’. Malignancy was histologically excluded at that time. Four years later, he was diagnosed with an undifferentiated prostate carcinoma, with a Gleason score of 5 + 4 = 9. After initiation of antihormonal therapy, he underwent radical prostatectomy and pelvic lymphadenectomy, which revealed a pT3b pN1 carcinoma with infiltrated resection margins. Three months later, the prostate-specific antigen level was 1.4 ng/ml, and a local recurrence was suspected by ultrasound; consequently, a 68Ga-prostate-specific membrane antigen (PSMA) PET/CT was performed. This examination seemed to confirm the local recurrence, a right pelvic lymph node metastasis, and a hepatic metastasis. However, ultrasound with contrast medium could not confirm the metastatic spread to the liver. In palliative intention, radiotherapy of the pelvis was done. After 50 Gy, the supposed recurrence had markedly shrunk, and an additional boost dose with 16.2 Gy was applied. Two years later, the patient is still free of disease. Due to this clinical development, we doubt the diagnosis of a fulminant progression of the prostate cancer as suspected by PSMA-PET/CT. Instead, we suspect a recurrence of the previously proven sarcoidosis leading to false-positive results. Our focus in this report is on the interaction between PSMA-PET/CT and sarcoidosis. Another report on a case of sarcoidosis of the spleen seems to confirm this possibility [Kobe et al: Clin Nucl Med 2015;40: 897–898]. PMID:27721768

  17. Hepatitis B Virus Infection in HIV-Positive Individuals in the UK Collaborative HIV Cohort (UK CHIC) Study

    PubMed Central

    Price, Huw; Bansi, Loveleen; Sabin, Caroline A.; Bhagani, Sanjay; Burroughs, Andrew; Chadwick, David; Dunn, David; Fisher, Martin; Main, Janice; Nelson, Mark; Pillay, Deenan; Rodger, Alison; Taylor, Chris; Gilson, Richard

    2012-01-01

    Background Hepatitis B virus (HBV) infection is an increasingly important cause of morbidity and mortality in HIV-infected adults. This study aimed to determine the prevalence and incidence of HBV in the UK CHIC Study, a multicentre observational cohort. Methods and Findings 12 HIV treatment centres were included. Of 37,331 patients, 27,450 had at least one test (HBsAg, anti-HBs or anti-HBc) result post-1996 available. 16,043 were white, 8,130 black and 3,277 other ethnicity. Route of exposure was homosexual sex 15,223 males, heterosexual sex 3,258 males and 5,384 females, injecting drug use 862 and other 2,723. The main outcome measures used were the cumulative prevalence and the incidence of HBV coinfection. HBV susceptible patients were followed up until HBsAg and/or anti-HBc seroconversion incident infection, evidence of vaccination or last visit. Poisson regression was used to determine associated factors. 25,973 had at least one HBsAg test result. Participants with HBsAg results were typically MSM (57%) and white (59%) (similar to the cohort as a whole). The cumulative prevalence of detectable HBsAg was 6.9% (6.6 to 7.2%). Among the 3,379 initially HBV-susceptible patients, the incidence of HBV infection was 1.7 (1.5 to 1.9)/100 person-years. Factors associated with incident infection were older age and IDU. The main limitation of the study was that 30% of participants did not have any HBsAg results available. However baseline characteristics of those with results did not differ from those of the whole cohort. Efforts are on-going to improve data collection. Conclusions The prevalence of HBV in UK CHIC is in line with estimates from other studies and low by international standards. Incident infection continued to occur even after entry to the cohort, emphasising the need to ensure early vaccination. PMID:23145150

  18. Positive Results for All Students Dispel Fears of Leaving Some Behind.

    ERIC Educational Resources Information Center

    WorkAmerica, 1999

    1999-01-01

    New studies dispel the fear that high academic standards set up some students to fail or drop out. This research finds that raising academic standards has a positive impact for all students in the following ways: (1) students take more demanding courses, learn more, and score higher on tests; (2) nationwide, dropout rates are falling and high…

  19. How could canal-pluggings result in intensive direction changing type of positional nystagmus?

    PubMed

    Arai, Y; Henn, V; Boehmer, A; Suzuki, J

    1989-01-01

    The objectives of this study in Rhesus monkeys is to observe the sequences which appear in the oculo-spinal-motor system after selected semicircular canals had been plugged. The left anterior and the right posterior canals in a monkey "LARP", the left anterior and posterior canals in "LALP", and the left lateral canal in "LL" were plugged under intubation general anesthesia. Three-dimensional eye recordings were performed, using two scleral coils. Behavior, posture, and vestibulo-ocular reflex were studied. Compensation was established in the light within 2 days. In darkness, no spontaneous nystagmus was recorded in the sitting position. The monkey "LALP" developed marked positional nystagmus. When the head position was changed up to 360 degrees in 15 degrees steps, horizontal, vertical and torsional eye movements showed remarkable changes. Spontaneous direction changing nystagmus in darkness was also recorded in "LALP". To conclude, direction changing positional nystagmus, which was seen for several months after the canal plugging, was difficult to explain by the damage to the adjacent ampullary and/or otolithic endorgans, but may be explained by the limited otolithic compensation in the earth parallel plane for the defective dynamic canal inputs. These observations and conclusions were from experiments using three monkeys only and should still be confirmed in more extended experiments.

  20. Positive Darwinian selection results in resistance to cardioactive toxins in true toads (Anura: Bufonidae)

    PubMed Central

    Moore, David J.; Halliday, Damien C. T.; Rowell, David M.; Robinson, Anthony J.; Keogh, J. Scott

    2009-01-01

    Members of the Family Bufonidae, true toads, are famous for their endogenously synthesized cardioactive steroids that serve as defensive toxins. Evolution of resistance to these toxins is not understood. We sequenced a key region of the toxin's binding site in the Na+/K+ ATPase for relevant taxa representing Hyloidea (including bufonids), Ranoidea and Archaeobatrachia and tested for positive selection in a phylogenetic context. Bufonidae were distinct from other Hyloidea at 4–6 of 12 sites and, with one exception, had a homologous amino acid sequence. Melanophryniscus stelzneri had a distinct sequence, consistent with other independent evidence for a differentiated toxin. Tests within Bufonidae detected positive selection within the binding region, providing, to our knowledge, the first evidence of this type for positive selection within Amphibia. There was no evidence for positive selection on Bufonidae or M. stelzneri lineages. Sequence change in Leptodactylus ocellatus, a leptodactylid predator of Bufonidae, provides a molecular basis for predator resistance possibly associated with gene duplication. PMID:19465576

  1. False-positive technetium 99m depreotide scintigraphy resulting from round atelectasis.

    PubMed

    Thomas, Linda P; Balingit, Antonio G; Morison, David S; Gilman, Matthew D

    2003-04-01

    The authors report two cases of round atelectasis that showed increased accumulation of technetium (Tc) 99m depreotide on planar and single photon emission computed tomographic scintigraphy. It should be considered that round atelectasis is a potential nonmalignant cause for positive 99mTc depreotide scintigraphy.

  2. Cancer awareness and socio-economic position: results from a population-based study in Denmark.

    PubMed

    Hvidberg, Line; Pedersen, Anette Fischer; Wulff, Christian Nielsen; Vedsted, Peter

    2014-08-09

    Differences in cancer awareness between individuals may explain variations in healthcare seeking behaviour and ultimately also variations in cancer survival. It is therefore important to examine cancer awareness and to investigate possible differences in cancer awareness among specific population subgroups. The aim of this study is to assess awareness of cancer symptoms, risk factors and perceived 5-year survival from bowel, breast, ovarian, and lung cancer in a Danish population sample and to analyse the association between these factors and socio-economic position indicators. A population-based telephone survey was carried out among 1,000 respondents aged 30-49 years and 2,000 respondents aged 50 years and older using the Awareness and Beliefs about Cancer measure. Information on socio-economic position was obtained by data linkage through Statistics Denmark. Prevalence ratios were used to determine the association between socio-economic position and cancer awareness. A strong socio-economic gradient in cancer awareness was found. People with a low educational level and a low household income were more likely to have a lower awareness of cancer symptoms, cancer risk factors and the growing risk of cancer with age. Furthermore, men and people outside the labour force tended to be less aware of these factors than women and people within the labour force. However, women were more likely than men to lack awareness of the relationship between age and cancer risk. No clear associations were found between socio-economic position and lack of awareness of 5-year survival from bowel, breast, ovarian, and lung cancers. As cancer awareness has shown to be positively associated with cancer-related behaviour, e.g. healthcare seeking, consideration must be given to tackle inequalities in cancer awareness and to address this issue in future public health strategies, which should be targeted at and tailored to the intended recipient groups.

  3. Tropomyosin IgE-positive results are a good predictor of shrimp allergy.

    PubMed

    Gámez, C; Sánchez-García, S; Ibáñez, M D; López, R; Aguado, E; López, E; Sastre, B; Sastre, J; del Pozo, V

    2011-10-01

    Shrimp is a common cause of food allergy. Our aims were to determine the value of IgE antibodies in the diagnosis of shrimp allergy and to study red shrimp (Solenocera melantho) tropomyosin both as a new allergen and as a cross-reactive IgE-binding protein. We have studied 45 subjects. Skin prick test (SPT) was carried out in all subjects, and specific IgE (sIgE) to shrimp, recombinant and natural shrimp tropomyosins rPen a 1 and nPen m 1, recombinant Der p 10, and Dermatophagoides pteronyssinus was assessed by fluoroimmunoassay and/or immunoblotting. Double-blind, placebo-controlled food challenges were carried out to confirm diagnosis of shrimp allergy. Also, in vitro inhibition tests were performed to evaluate cross-reactivity. Shrimp allergy was confirmed in 18 shrimp-allergic patients. Skin prick test and IgE antibodies to shrimp were positive in all shrimp-allergic patients; sIgE to rPen a 1 was detected in 98% of these patients. Of the 18 shrimp-tolerant patients, 61% had positive SPT to shrimp, 55% were IgE-positive to shrimp, and 33% showed IgE antibodies to rPen a 1. Determination of IgE to rPen a 1 yielded a positive predictive value of 0.72 and a negative predictive value of 0.91. IgE levels to rPen a 1 provided additional value to the diagnosis of shrimp allergy. Some allergens in mite extract are recognized by patients who are allergic to shrimp, though their clinical relevance remains unknown. © 2011 John Wiley & Sons A/S.

  4. Peptizer, a tool for assessing false positive peptide identifications and manually validating selected results.

    PubMed

    Helsens, Kenny; Timmerman, Evy; Vandekerckhove, Joël; Gevaert, Kris; Martens, Lennart

    2008-12-01

    False positive peptide identifications are a major concern in the field of peptidecentric, mass spectrometry-driven gel-free proteomics. They occur in regions where the score distributions of true positives and true negatives overlap. Removal of these false positive identifications necessarily involves a trade-off between sensitivity and specificity. Existing postprocessing tools typically rely on a fixed or semifixed set of assumptions in their attempts to optimize both the sensitivity and the specificity of peptide and protein identification using MS/MS spectra. Because of the expanding diversity in available proteomics technologies, however, these postprocessing tools often struggle to adapt to emerging technology-specific peculiarity. Here we present a novel tool named Peptizer that solves this adaptability issue by making use of pluggable assumptions. This research-oriented postprocessing tool also includes a graphical user interface to perform efficient manual validation of suspect identifications for optimal sensitivity recovery. Peptizer is open source software under the Apache2 license and is written in Java.

  5. Adjusting for temporal change in trophic position results in reduced rates of contaminant decline.

    PubMed

    Hebert, Craig E; Weseloh, D V Chip

    2006-09-15

    The development of ecological tracers to track the flow of energy and nutrients through food webs has provided new insights into the factors that are important in regulating diet composition in wildlife. The Great Lakes Herring Gull Monitoring Program has provided information regarding temporal trends in levels of bioaccumulative contaminants since the early 1970s. In recent years, data from this program have also been generated to examine ecological changes in the Great Lakes. Because the contaminants that are evaluated as part of this program biomagnify, food is the primary determinant of contaminant concentrations in the eggs that are analyzed annually. Fluctuations in diet composition could affect the interpretation of temporal trends by affecting exposure to contaminants. Retrospective analyses involving ecological tracers, i.e., stable nitrogen isotopes and fatty acids, have shown temporal change in the diets of Great Lakes herring gulls at some monitoring colonies. These dietary differences have led to temporal variation in the trophic position of herring gulls. Given that higher trophic level organisms incur greater exposure to biomagnifying contaminants, it is necessary to adjust for these temporal changes in trophic position to get an accurate indication of how contaminant burdens are changing within the Great Lakes ecosystem. Here, we outline a method to adjust for temporal changes in indicator species trophic position and discuss how these adjustments affect the interpretation of contaminant temporal trend monitoring data.

  6. Occult hepatitis B virus infection in HIV positive patients at a tertiary healthcare unit in eastern India.

    PubMed

    Saha, Debraj; Pal, Ananya; Sarkar, Neelakshi; Das, Dipanwita; Blackard, Jason T; Guha, Subhasish Kamal; Saha, Bibhuti; Chakravarty, Runu

    2017-01-01

    Occult HBV infection (OBI), defined by the presence of HBV DNA in absence of hepatitis B surface antigen (HBsAg), is a significant concern in the HIV-infected population. Of 441 HIV+/HBsAg- patients analyzed, the overall prevalence of OBI was 6.3% (28/441). OBI was identified in 21 anti-HBc positives (17.8%), as well as among those who lacked any HBV-specific serological markers (2.2%). Comparison with HIV/HBV co-infection revealed that the levels of CD4, ALT, and HBV DNA were significantly lower during occult infection. Discrete differences were also observed with respect to quasispecies divergence. Additionally, subgenotype D1 was most frequent in occult infection, while D2 was widespread during chronic infection. The majority (~90%) of occult D1 sequences had the sQ129R mutation in the surface gene. This study highlights several distinct features of OBI in India and underscores the need for additional HBV DNA screening in HIV-positive individuals.

  7. Occult hepatitis B virus infection in HIV positive patients at a tertiary healthcare unit in eastern India

    PubMed Central

    Saha, Debraj; Pal, Ananya; Sarkar, Neelakshi; Das, Dipanwita; Blackard, Jason T.; Guha, Subhasish Kamal; Saha, Bibhuti

    2017-01-01

    Occult HBV infection (OBI), defined by the presence of HBV DNA in absence of hepatitis B surface antigen (HBsAg), is a significant concern in the HIV-infected population. Of 441 HIV+/HBsAg- patients analyzed, the overall prevalence of OBI was 6.3% (28/441). OBI was identified in 21 anti-HBc positives (17.8%), as well as among those who lacked any HBV-specific serological markers (2.2%). Comparison with HIV/HBV co-infection revealed that the levels of CD4, ALT, and HBV DNA were significantly lower during occult infection. Discrete differences were also observed with respect to quasispecies divergence. Additionally, subgenotype D1 was most frequent in occult infection, while D2 was widespread during chronic infection. The majority (~90%) of occult D1 sequences had the sQ129R mutation in the surface gene. This study highlights several distinct features of OBI in India and underscores the need for additional HBV DNA screening in HIV-positive individuals. PMID:28591184

  8. Risk factors for false positive and for false negative test results in screening with fecal occult blood testing.

    PubMed

    Stegeman, Inge; de Wijkerslooth, Thomas R; Stoop, Esther M; van Leerdam, Monique; van Ballegooijen, M; Kraaijenhagen, Roderik A; Fockens, Paul; Kuipers, Ernst J; Dekker, Evelien; Bossuyt, Patrick M

    2013-11-15

    Differences in the risk of a false negative or a false positive fecal immunochemical test (FIT) across subgroups may affect optimal screening strategies. We evaluate whether subgroups are at increased risk of a false positive or a false negative FIT result, whether such variability in risk is related to differences in FIT sensitivity and specificity or to differences in prior CRC risk. Randomly selected, asymptomatic individuals were invited to undergo colonoscopy. Participants were asked to undergo one sample FIT and to complete a risk questionnaire. We identified patient characteristics associated with a false negative and false positive FIT results using logistic regression. We focused on statistically significant differences as well as on variables influencing the false positive or negative risk for which the odds ratio exceeded 1.25. Of the 1,426 screening participants, 1,112 (78%) completed FIT and the questionnaire; 101 (9.1%) had advanced neoplasia. 102 Individuals were FIT positive, 65 (64%) had a false negative FIT result and 66 (65%) a false positive FIT result. Participants at higher age and smokers had a significantly higher risk of a false negative FIT result. Males were at increased risk of a false positive result, so were smokers and regular NSAID users. FIT sensitivity was lower in females. Specificity was lower for males, smokers and regular NSAID users. FIT sensitivity was lower in women. FIT specificity was lower in males, smokers and regular NSAID users. Our results can be used for further evidence based individualization of screening strategies.

  9. Prevalence of hepatitis B virus seromarkers in young adults vaccinated at birth; impact on the epidemiology of hepatitis B infection in iran.

    PubMed

    Saffar, Hiva; Ajami, Abolghasem; Saffar, Mohammed Jafar; Shojaei, Jalil; Sotudeh-Anvari, Maryam; Shams-Esfandabad, Kiarash; Khalilian, Ali Reza

    2014-05-01

    The epidemiological impact and the duration of protection provided by infant hepatitis B (HB) vaccination are unknown. This study was designed to determine the hepatitis B virus (HBV) infection seromarkers in young adults who have been vaccinated against HBV as the first group of Iranian neonates during 1993 and 1994. We recruited 510 young adults with a history of complete HB vaccination at birth. HBV seromarkers (HB surface antigen (HBs Ag), antibody against HBs Ag (Anti-HBs), and antibody against HB core antigen (Anti-HBc) were measured using ELISA method. Anti-HBs titers ≥ 10 IU/L were considered protective and titers more than 300 IU/L were indicative of a natural boosting. Positive results for Anti-HBc and HBs Ag were considered as breakthrough infection and possible vaccine failure, respectively. The history of acute symptomatic clinical hepatitis was also investigated. Anti-HBs seropositivity rate was detected in 224 of 510 [95% CI: 39-47] young adults. Breakthrough infection (positive sera for Anti-HBc without chronic infection) was observed in 18 [95% CI: 2.5-3.5] subjects. There were neither HBs Ag positive results nor symptomatic hepatitis cases. The study results indicated that the neonatal HBV immunization induced a long-term protection against HBV and was very efficacious in reducing chronic HBV infection rate in vaccinated young adults in Iran.

  10. Perceived Family Support and Antiretroviral Adherence in HIV-Positive Individuals: Results from a Community-Based Positive Living With HIV Study.

    PubMed

    Poudel, Krishna C; Buchanan, David R; Amiya, Rachel M; Poudel-Tandukar, Kalpana

    2015-01-01

    The purpose of this study was to examine the association between perceived family support, either positive or negative, and adherence to antiretroviral medication regimens among HIV-positive individuals in the Kathmandu Valley, Nepal. We measured past 3-month antiretroviral adherence among 233 HIV-positive individuals, in relation to perceived family support, both positive (in terms of emotional and instrumental support) and negative (in the form of negative interactions), using the 10-item Nepali Family Support and Difficulty Scale. Medium and high levels of perceived emotional support from family were associated with reduced risk of antiretroviral nonadherence, compared with low levels of perceived emotional support (adjusted odds ratio [AOR]  = 0.37, 95% confidence interval [CI] [0.16, 0.88], and AOR  = 0.23, 95% CI [0.08, 0.64], respectively). Conversely, higher levels of felt emotional distance (AOR  = 1.46, 95% CI [1.00, 2.14]) and experienced physical harm (AOR  = 2.04, 95% CI [1.07, 3.91]) were associated with increased risk of nonadherence. The results support the recommendation that service providers need to be aware of the significant role of family support in shaping antiretroviral adherence and to consider ways to strengthen positive family support while minimizing negative family interactions to increase adherence rates.

  11. Factors to predict positive results of gonadotropin releasing hormone stimulation test in girls with suspected precocious puberty.

    PubMed

    Nam, Hyo-Kyoung; Rhie, Young Jun; Son, Chang Sung; Park, Sang Hee; Lee, Kee-Hyoung

    2012-02-01

    Sometimes, the clinical findings and the results of the gonadotropin-releasing hormone (GnRH) stimulation test are inconsistent in girls with early breast development and bone age advancement. We aimed to investigate the factors predicting positive results of the GnRH stimulation test in girls with suspected central precocious puberty (CPP). We reviewed the records of 574 girls who developed breast budding before the age of 8 yr and underwent the GnRH stimulation test under the age of 9 yr. Positive results of the GnRH stimulated peak luteinizing hormone (LH) level were defined as 5 IU/L and over. Girls with the initial positive results (n = 375) showed accelerated growth, advanced bone age and higher serum basal LH, follicle-stimulating hormone, and estradiol levels, compared to those with the initial negative results (n = 199). Girls with the follow-up positive results (n = 64) showed accelerated growth and advanced bone age, compared to those with the follow-up negative results. In the binary logistic regression, the growth velocity ratio was the most significant predictive factor of positive results. We suggest that the rapid growth velocity is the most useful predictive factor for positive results in the GnRH stimulation test in girls with suspected precocious puberty.

  12. Prescription drugs associated with false-positive results when using faecal immunochemical tests for colorectal cancer screening.

    PubMed

    Ibáñez-Sanz, Gemma; Garcia, Montse; Rodríguez-Moranta, Francisco; Binefa, Gemma; Gómez-Matas, Javier; Domènech, Xènia; Vidal, Carmen; Soriano, Antonio; Moreno, Víctor

    2016-10-01

    The most common side effect in population screening programmes is a false-positive result which leads to unnecessary risks and costs. To identify factors associated with false-positive results in a colorectal cancer screening programme with the faecal immunochemical test (FIT). Cross-sectional study of 472 participants with a positive FIT who underwent colonoscopy for confirmation of diagnosis between 2013 and 2014. A false-positive result was defined as having a positive FIT (≥20μg haemoglobin per gram of faeces) and follow-up colonoscopy without intermediate/high-risk lesions or cancer. Women showed a two-fold increased likelihood of a false-positive result compared with men (adjusted OR, 2.3; 95%CI, 1.5-3.4), but no female-specific factor was identified. The other variables associated with a false-positive result were successive screening (adjusted OR, 1.5; 95%CI, 1.0-2.2), anal disorders (adjusted OR, 3.1; 95%CI, 2.1-4.5) and the use of proton pump inhibitors (adjusted OR, 1.8; 95%CI, 1.1-2.9). Successive screening and proton pump inhibitor use were associated with FP in men. None of the other drugs were related to a false-positive FIT. Concurrent use of proton pump inhibitors at the time of FIT might increase the likelihood of a false-positive result. Further investigation is needed to determine whether discontinuing them could decrease the false-positive rate. Copyright © 2016 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  13. A robotic needle-positioning and guidance system for CT-guided puncture: Ex vivo results.

    PubMed

    Kettenbach, Joachim; Kara, Levent; Toporek, Grzegorz; Fuerst, Martin; Kronreif, Gernot

    2014-10-01

    To test the feasibility of a robotic needle-guidance platform during CT-guided puncture ex vivo. Thin copper wires inserted into a torso phantom served as targets. The phantom was placed on a carbon plate and the robot-positioning unit (RPU) of the guidance platform (iSYS Medizintechnik GmbH, Kitzbuehel, Austria) was attached. Following CT imaging and automatic registration a double oblique trajectory was planned and the RPU was remotely moved into appropriate position and angulation. A 17G-puncture needle was then manually inserted until the preplanned depth, permanently guided by the RPU. The CT scan was repeated and the distance between the actual needle tip and the target was evaluated. Automatic registration was successful in ten experiments and the median duration of an experiment was 9.6 (6.4-46.0) minutes. The angulation of the needle path in x-y and z-axis was within 15.6° to 32.6°, and -32.8° to 3.2°, respectively and the needle insertion depth was 92.8 ± 14.4 mm. The Euclidean distance between the actual needle tip and the target was 2.3 ± 0.8 (range, 0.9-3.7) mm. Automatic registration and accurate needle placement close to small targets was demonstrated. Study settings and torso phantom were very close to the clinical reality.

  14. Prediction of 3D internal organ position from skin surface motion: results from electromagnetic tracking studies

    NASA Astrophysics Data System (ADS)

    Wong, Kenneth H.; Tang, Jonathan; Zhang, Hui J.; Varghese, Emmanuel; Cleary, Kevin R.

    2005-04-01

    An effective treatment method for organs that move with respiration (such as the lungs, pancreas, and liver) is a major goal of radiation medicine. In order to treat such tumors, we need (1) real-time knowledge of the current location of the tumor, and (2) the ability to adapt the radiation delivery system to follow this constantly changing location. In this study, we used electromagnetic tracking in a swine model to address the first challenge, and to determine if movement of a marker attached to the skin could accurately predict movement of an internal marker embedded in an organ. Under approved animal research protocols, an electromagnetically tracked needle was inserted into a swine liver and an electromagnetically tracked guidewire was taped to the abdominal skin of the animal. The Aurora (Northern Digital Inc., Waterloo, Canada) electromagnetic tracking system was then used to monitor the position of both of these sensors every 40 msec. Position readouts from the sensors were then tested to see if any of the movements showed correlation. The strongest correlations were observed between external anterior-posterior motion and internal inferior-superior motion, with many other axes exhibiting only weak correlation. We also used these data to build a predictive model of internal motion by taking segments from the data and using them to derive a general functional relationship between the internal needle and the external guidewire. For the axis with the strongest correlation, this model enabled us to predict internal organ motion to within 1 mm.

  15. High numbers of false-positive stress tests are the result of inappropriate testing.

    PubMed

    Foy, Andrew; Rier, Jeremy; Kozak, Mark

    2014-01-01

    Patients who underwent coronary angiography preceded by stress testing during the period January 2009 through March 2012 were evaluated using the CathPCI database. The predictive accuracy of stress echocardiography (SE) and single-photon emission computed tomography (SPECT) were determined and used to back calculate the pretest probability of the population being tested. In total, 2662 catheterizations were performed, 866 (33%) of which were preceded by stress imaging. Overall, the positive predictive values of SE and SPECT did not differ significantly (61% and 66%, P = .15) and were much lower in certain subgroups. The overall pretest probabilities of patients without a documented history of coronary artery disease undergoing SE and SPECT in the study population were estimated to be 18% and 27%, respectively. This study shows that stress testing is performed too often in low-risk patients in whom it is unlikely to improve clinical decision making.

  16. Positive state observer for the automatic control of the depth of anesthesia-Clinical results.

    PubMed

    Nogueira, Filipa N; Mendonça, T; Rocha, P

    2016-09-13

    The depth of anesthesia (DoA) is a crucial feature in general anesthesia. Nowadays the DoA is usually evaluated by the bispectral index (BIS). According to the surgical procedure, different reference levels for the BIS may be clinically required. This can be achieved by the simultaneous administration of an analgesic (e.g. remifentanil) and an hypnotic (eg propofol). As a contribution to the effort of automating the processes of drug delivery in general anesthesia, in this paper, a positive state observer is designed for the implementation of a control scheme proposed for the automatic administration of propofol and of remifentanil, in order to track a desired level for the BIS. It is proved and illustrated by simulations that the controller-observer scheme has a very good performance. This scheme was implemented, tested and evaluated both by means of simulations and for a set of patients during surgical procedures. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  17. The benefits of health information technology: a review of the recent literature shows predominantly positive results.

    PubMed

    Buntin, Melinda Beeuwkes; Burke, Matthew F; Hoaglin, Michael C; Blumenthal, David

    2011-03-01

    An unprecedented federal effort is under way to boost the adoption of electronic health records and spur innovation in health care delivery. We reviewed the recent literature on health information technology to determine its effect on outcomes, including quality, efficiency, and provider satisfaction. We found that 92 percent of the recent articles on health information technology reached conclusions that were positive overall. We also found that the benefits of the technology are beginning to emerge in smaller practices and organizations, as well as in large organizations that were early adopters. However, dissatisfaction with electronic health records among some providers remains a problem and a barrier to achieving the potential of health information technology. These realities highlight the need for studies that document the challenging aspects of implementing health information technology more specifically and how these challenges might be addressed.

  18. Position but not color deviants result in visual mismatch negativity in an active oddball task.

    PubMed

    Berti, Stefan

    2009-05-06

    Changes in the visual environment might be detected automatically. This function is provided by the sensory systems and showed, for instance, by the pop-out phenomenon. Automatic change detection is also observable within visual oddball paradigms, where rare changes are introduced in an irrelevant stimulus feature; the detection of deviant stimuli is accompanied by a negative component (so-called visual mismatch negativity) in the human event-related brain potential. In this study, the deviating stimulus feature was embedded in a task-relevant object presented in the focus of attention. With this, visual mismatch negativity was observable only with position deviants presented in the upper visual half field but not by lower half field presentation or color deviants.

  19. Preliminary results with saturable microchannel array plates. [featuring positive ion feedback elimination

    NASA Technical Reports Server (NTRS)

    Timothy, J. G.

    1974-01-01

    Microchannel array plates with a performance comparable to that of a conventional channel electron multiplier have been obtained for the first time. These array plates employ an angled electrostatic field to inhibit the feedback of positive ions within the microchannels. Saturated output pulse height distributions with modal gain values in excess of 10 million have been obtained and stable operation demonstrated over a range of ambient pressures from 0.0000001 to 0.00008 torr. However, a time-dependent reduction in the gain has been observed with these experimental plates because of the accumulation of charge on the insulating strips which are inserted in the wall of the microchannel to establish the angled electrostatic field.

  20. Neratinib in HER-2-positive breast cancer: results to date and clinical usefulness

    PubMed Central

    Chan, Arlene

    2016-01-01

    The management of HER-2-positive breast cancer has improved significantly with the use of targeted agents to the HER-2 signaling pathway. Despite the improved survival achieved with the use of trastuzumab and chemotherapy in both the adjuvant and metastatic setting, patients may still recur or progress; whilst preclinical data demonstrate that these cancer cells remain addicted to the HER-2 oncogene. Neratinib, an oral small molecule tyrosine-kinase inhibitor has efficacy in the metastatic and adjuvant setting of patients who have previously received trastuzumab-based treatment. Diarrhea, being a class effect of tyrosine-kinase inhibitor, is the most common side effect seen following neratinib administration, but recent data suggests that a prophylactic loperamide regimen can reduce the incidence of grade 3 diarrhea. Phase I through to III clinical trials of neratinib will be reviewed, with discussion of the postulated mechanism underlying diarrheal events and its management. PMID:27583026

  1. Hepatitis B Reactivation in a HBsAg-Negative, HBcAb-Positive Patient Receiving Fludarabine for the Treatment of Chronic Lymphocytic Leukaemia.

    PubMed

    Toscanini, Federica; De Leo, Pasqualina; Calcagno, Giuseppe; Malfatti, Federica; Grasso, Alessandro; Anselmo, Marco

    2011-01-01

    Hepatitis B virus (HBV) reactivation is an increasingly recognized cause of morbidity and mortality in patients undergoing chemotherapy. In haematology, the risk of reactivation of B hepatitis among HBsAg-positive patients has been documented; therefore, use of lamivudine prophylaxis is recommended before starting chemotherapy. Differently, for HBsAg-negative patients with markers of previous HBV infection (i.e., presence of isolated anti-HBc positivity) (anticore patients) management strategies are not univocal. We describe a rare case of HBV reactivation in an anticore patient after fludarabine therapy for chronic lymphocytic leukaemia. The patient fully recovered after a 6-month course of lamivudine with persistent HBV-DNA clearance and loss of HBsAg. The most important feature of this case is that fludarabine alone infrequently determines HBV reactivation, especially in anticore patients. Therefore, we suggest that patients candidates to receive fludarabine therapy should be considered for lamivudine prophylaxis, not only if HBsAg-positive, but even if anticore-positive only.

  2. Scapular position after the open Latarjet procedure: results of a computed tomography scan study.

    PubMed

    Cerciello, Simone; Edwards, T Bradley; Cerciello, Giuliano; Walch, Gilles

    2015-02-01

    The aim of this study was to investigate, through a computed tomography (CT) scan analysis, the effects of the Latarjet procedure on scapular position in an axial plane. Twenty healthy young male subjects (mean age, 22 years; range, 18-27 years) were enrolled as a control group. Twenty young male patients (mean age, 23 years; range, 17-30 years) with recurrent anterior shoulder dislocation were enrolled as the study group. CT cuts at a proper level allowed the identification of an α angle, which defined the tilt of the scapula relative to the anterior-posterior axis. In the control population, the α angles on the right and left shoulders were 48° (44°-52°) and 48° (44°-54°), respectively. In the study group, the preoperative α angles at the affected and healthy shoulders were 49° (46°-52°) and 49° (44°-52°), respectively. At day 45, the corresponding angles were 45° (40°-50°) and 49° (46°-52°). At 6 months, the average α angle of the shoulder operated on was 52° (46°-58°). The α angle value was restored in 5 cases, increased in 9 cases (mean, 8°), and decreased in 6 cases (mean, 3°). A general symmetry of scapular position was observed during CT scan analysis. This balance was lost initially after the Latarjet procedure, with a decrease of the α angle and scapular protraction. Six months after surgery, a small trend toward scapular retraction was conversely observed; however, the data were not statistically significant. Copyright © 2015 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  3. 49 CFR 40.155 - What does the MRO do when a negative or positive test result is also dilute?

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Transportation PROCEDURES FOR TRANSPORTATION WORKPLACE DRUG AND ALCOHOL TESTING PROGRAMS Medical Review Officers and the Verification Process § 40.155 What does the MRO do when a negative or positive test result...

  4. 49 CFR 40.155 - What does the MRO do when a negative or positive test result is also dilute?

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Transportation PROCEDURES FOR TRANSPORTATION WORKPLACE DRUG AND ALCOHOL TESTING PROGRAMS Medical Review Officers and the Verification Process § 40.155 What does the MRO do when a negative or positive test result...

  5. 49 CFR 40.155 - What does the MRO do when a negative or positive test result is also dilute?

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Transportation PROCEDURES FOR TRANSPORTATION WORKPLACE DRUG AND ALCOHOL TESTING PROGRAMS Medical Review Officers and the Verification Process § 40.155 What does the MRO do when a negative or positive test result...

  6. 49 CFR 40.155 - What does the MRO do when a negative or positive test result is also dilute?

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Transportation PROCEDURES FOR TRANSPORTATION WORKPLACE DRUG AND ALCOHOL TESTING PROGRAMS Medical Review Officers and the Verification Process § 40.155 What does the MRO do when a negative or positive test result...

  7. 49 CFR 40.155 - What does the MRO do when a negative or positive test result is also dilute?

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Transportation PROCEDURES FOR TRANSPORTATION WORKPLACE DRUG AND ALCOHOL TESTING PROGRAMS Medical Review Officers and the Verification Process § 40.155 What does the MRO do when a negative or positive test result...

  8. Ruling out False-Positive Urinary Legionella pneumophila Serogroup 1 and Streptococcus pneumoniae Antigen Test Results by Heating Urine

    PubMed Central

    Pontoizeau, C.; Dangers, L.; Jarlier, V.; Luyt, C. E.; Guiller, E.; Fievet, M. H.; Lecsö-Bornet, M.; Aubry, A.

    2014-01-01

    We report here false-positive urinary Legionella pneumophila serogroup 1 and Streptococcus pneumoniae antigen test results due to rabbit antilymphocyte serum treatment and provide a simple and fast solution to rule them out by heating urine. PMID:25253788

  9. Occult hepatitis B in blood donors in Indonesia: altered antigenicity of the hepatitis B virus surface protein

    PubMed Central

    Thedja, Meta D.; Roni, Martono; Harahap, Alida R.; Siregar, Nurjati C.; Ie, Susan I.

    2010-01-01

    Background and aims Occult hepatitis B virus infection (OBI) poses a challenge to the safety of blood donation. The prevalence of OBI is not well documented in Indonesia, although this information in such an endemic country is needed. This study was aimed to evaluate the prevalence of occult hepatitis B in blood donors from two cities of Indonesia, and to study the genetic variation and its effect on the predicted antigenicity of HBsAg. Methods Serum samples of 309 regular blood donors negative for HBsAg were tested for anti-HBs and anti-HBc. Hepatitis B virus (HBV) DNA isolated from anti-HBc-positive samples were analyzed by polymerase chain reaction, cloned and sequenced. Antigenic properties of identified HBsAg mutants were predicted by calculation of the antigenic index. Results Of the 309 HBsAg-negative samples, anti-HBc was positive in 134 (43.4%) and HBV DNA was detected in 25 (8.1%). Seven of the viremic samples had nucleotide substitutions (A521G, A551T, C582T, and A562G) in the S gene, causing amino acid mutations (T123A, M133L, and T143M) in the ‘a’ determinant of HBsAg that resulted in changes in the predicted antigenicity. Conclusions OBI was detected in blood donors’ samples in Indonesia. Anti-HBc was shown to be a better screening parameter than HBsAg, however, it might result in the loss of donors particularly in endemic countries. HBsAg detection failure in this study might be due to mutations altering the protein antigenicity and/or the low-level carriage of HBV. PMID:21063484

  10. A False Positive Dengue Fever Rapid Diagnostic Test Result in a Case of Acute Parvovirus B19 Infection.

    PubMed

    Izumida, Toshihide; Sakata, Hidenao; Nakamura, Masahiko; Hayashibara, Yumiko; Inasaki, Noriko; Inahata, Ryo; Hasegawa, Sumiyo; Takizawa, Takenori; Kaya, Hiroyasu

    2016-01-01

    An outbreak of dengue fever occurred in Japan in August 2014. We herein report the case of a 63-year-old man who presented with a persistent fever in September 2014. Acute parvovirus B19 infection led to a false positive finding of dengue fever on a rapid diagnostic test (Panbio Dengue Duo Cassette(TM)). To the best of our knowledge, there are no previous reports of a false positive result for dengue IgM with the dengue rapid diagnostic test. We believe that epidemiological information on the prevalence of parvovirus B19 is useful for guiding the interpretation of a positive result with the dengue rapid diagnostic test.

  11. The effect of tongue position and resulting vertical dimension on masticatory muscle activity. A cross-sectional study.

    PubMed

    Valdés, C; Gutiérrez, M; Falace, D; Astaburuaga, F; Manns, A

    2013-09-01

    The purpose of this study was to: (a) compare the tonic electromyographic (EMG) activity of the temporalis and masseter muscles between two tongue positions, (b) compare the vertical dimension (VD) resulting from each tongue position and (c) determine the influence of the VD on the tonic EMG activity for each tongue position. Thirty-three healthy dental students with natural dentition and bilateral molar support, between the ages of 18 and 22 years, with no prior history of oro-facial injury, or current or past pain in the jaw, mouth, or tongue participated in the study. Tonic masseteric and temporalis EMG activities were recorded using surface electrodes. Subjects were instructed to passively place the tongue either on the anterior hard palate or in the floor of the mouth. At each tongue position, the resulting EMG and VD were recorded. No significant difference in EMG activity was found for either the masseter (P-value = 0·5376) or temporalis muscle (P-value = 0·7410), between the two tongue positions. However, there was a significant difference in the VD resulting from the two different tongue positions, being greater with the tongue placed in the floor of the mouth. There was no statistically significant correlation between VD and EMG activity for both tongue positions. In spite of the lack of difference in the effect of both tongue positions on the masseteric and temporalis EMG activity, an increment of the VD was registered for the floor of mouth-tongue position. However, VD was not correlated with EMG activity for both tongue positions. © 2013 John Wiley & Sons Ltd.

  12. Positive results for drug combo in I-SPY 2 trial.

    PubMed

    2014-02-01

    In results from one part of the I-SPY 2 trial announced at the 2013 San Antonio Breast Cancer Symposium, neoadjuvant veliparib plus carboplatin improved outcomes for women with triple-negative breast cancer.

  13. [Afatinib as first-line therapy in mutation-positive EGFR. Results by type of mutation].

    PubMed

    Vidal, Óscar Juan

    2016-04-01

    The discovery of endothelial growth factor receptor (EGFR) mutations has laid the foundations for personalized medicine in non-small cell lung carcinoma (NSCLC). In phase III trials, the first-generation tyrosine kinase inhibitors (TKI), gefitinib and erlotinib, demonstrated greater efficacy compared with chemotherapy in patients with EGFR mutations, achieving progression-free survival of 8-13.5 months. Afatinib, a second-generation irreversible pan-ErbB inhibitor, is the first TKI that has shown a benefit in overall survival (OS) compared with chemotherapy in EGFR mutation-positive NSCLC when used as first-line treatment. Exon 19 deletion (Del19) and the single-point substitution mutation (L858R) in exon 21, called activating mutations due to their ability to confer sensitivity to TKI, represent approximately 90% of the EGFR mutations in NSCLC. Distinct sensitivity to TKI has been observed depending on the type of mutation, with greater progression-free survival in patients with the Del19 mutation. The analysis of OS in the LUX-Lung 3 and LUX-Lung 6 trials showed a statistically significant increase in survival in afatinib-treated patients with the Del 19 mutation, but no significant increase in that of patients with the L858R mutation. Direct comparison of afatinib and gefitinib as first-line therapy (LUX-Lung 7 trial) showed a statistically-significant increase in progression-free survival (hazard ratio: 0.73; 95% confidence interval, 0.57-0.95; p=0.0165) with afatinib. In the analysis by type of mutation, this benefit was observed for both the Del19 and the L858R mutations.

  14. A comparison of two position estimate algorithms that use ILS localizer and DME information. Simulation and flight test results

    NASA Technical Reports Server (NTRS)

    Knox, C. E.; Vicroy, D. D.; Scanlon, C.

    1984-01-01

    Simulation and flight tests were conducted to compare the accuracy of two algorithms designed to compute a position estimate with an airborne navigation computer. Both algorithms used ILS localizer and DME radio signals to compute a position difference vector to be used as an input to the navigation computer position estimate filter. The results of these tests show that the position estimate accuracy and response to artificially induced errors are improved when the position estimate is computed by an algorithm that geometrically combines DME and ILS localizer information to form a single component of error rather than by an algorithm that produces two independent components of error, one from a DMD input and the other from the ILS localizer input.

  15. Functional result relating to the positioning of the graft in anterior cruciate ligament reconstruction☆

    PubMed Central

    de Melo Silva Júnior, Otávio; do Nascimento Ohashi, Bruno; de Almeida, Murilo Oliveira; Reis Gonçalves, Murilo

    2015-01-01

    Objective To ascertain the coronal angles for the femoral and tibial tunnels that provide the best postoperative result from anterior cruciate ligament (ACL) reconstruction surgery, through assessing the variables of the IKDC and Lysholm–Tegner questionnaires and the hop test. Methods Sixteen patients with a single unilateral ACL injury who underwent this surgery between 24 and 36 months earlier were evaluated. They were divided into four groups in which the tibial and femoral tunnel angles were greater than or less than 65° in the coronal plane. Results The results demonstrated that a more vertical angle for the tibial tunnel (72°) and a more horizontal angle for the femoral tunnel (60°), with valgus alignment of 12° correlated with the best values for the variables studied. This may indicate that the long-term results from this surgery are excellent. Conclusion A more horizontal femoral angle and a more vertical tibial angle produced better assessments in the tests that were applied and in the functional results evaluated. PMID:26229897

  16. The Position of Turkey among OECD Member and Candidate Countries According to PISA 2009 Results

    ERIC Educational Resources Information Center

    Acar, Tulin

    2012-01-01

    The aim of the study is to determine the status of Turkey among OECD (Organisation for Economic Co-operation and Development) members and candidate countries through cluster and discriminant analyses according to PISA (Programme for International Student Assessment) 2009 results. The study includes 475460 fifteen year-old students from 65…

  17. False Positive Functional Analysis Results as a Contributor of Treatment Failure during Functional Communication Training

    ERIC Educational Resources Information Center

    Mann, Amanda J.; Mueller, Michael M.

    2009-01-01

    Research has shown that functional analysis results are beneficial for treatment selection because they identify reinforcers for severe behavior that can then be used to reinforce replacement behaviors either differentially or noncontingently. Theoretically then, if a reinforcer is identified in a functional analysis erroneously, a well researched…

  18. Fatal hepatitis B reactivation treated with entecavir in an isolated anti-HBs positive lymphoma patient: a case report and literature review.

    PubMed

    Ferreira, Rosa; Carvalheiro, Joana; Torres, Joana; Fernandes, Alexandra; Giestas, Sílvia; Mendes, Sofia; Agostinho, Cláudia; Campos, Mário J

    2012-01-01

    Hepatitis B virus (HBV) reactivation is a well-recognized complication that occurs in lymphoma patients who undergo chemotherapy. Only very few cases of HBV reactivation in patients with isolated antibody against hepatitis B surface antigen (anti-HBs) have been reported. We present a case of a 78-year-old woman diagnosed with diffuse large B cell non-Hodgkin's lymphoma who only displayed a positive anti-HBs, as the single possible marker of occult HBV infection, before starting therapy. She was treated with several chemotherapeutic regimens (including rituximab) for disease relapses during 3 years. Forty days after the last cycle of chemotherapy, she presented with jaundice, markedly elevated serum aminotransferase levels, and coagulopathy. HBV serology showed positivity for HBsAg, anti-HBc and anti-HBs. HBV DNA was positive. Antiviral treatment with entecavir was promptly initiated, but the patient died from liver failure. A review of the literature of HBV reactivation in patients with detectable anti-HBs levels is discussed.

  19. The effects of booster vaccination on hepatitis B vaccine in anti-HBs negative infants of HBsAg-positive mothers after primary vaccination.

    PubMed

    Gu, Hua; Yao, Jun; Zhu, Wei; Lv, Huakun; Cheng, Suyun; Ling, Luoya; Xia, Shichang; Chen, Yongdi

    2013-06-01

    The purpose of this study was to investigate the changes in anti-HBs IgG levels after booster vaccinations in anti-HBs negative infants of HBsAg-positive mothers. After primary vaccination, the immunization effects of different dosages of booster vaccinations of hepatitis B vaccine (CHO) were compared. A group of 472 newborns were vaccinated with three-dose hepatitis B vaccine at birth, 1 mo and 6 mo of age. Blood serum was collected within 6-12 mo after the third dose, and HBsAg, anti-HBs and anti-HBc levels were determined. Of this group, 101 infants who were both anti-HBs and HBsAg negative were revaccinated with 20 μg hepatitis B vaccine (CHO), and their antibody titers were monitored. Among these 101 infants, the anti- HBs positive rates (defined as anti-HBs ≥ 100 mIU/ml) differed after the first and the third dose (79% and 90%, respectively (p<0.05), while differences in the corresponding geometric mean titers (GMTs) were not statistically significant (629 ± 3 mIU/ml and 572 ± 3 mIU/ml respectively, p<0.05). The anti-HBs GMTs after booster vaccination were 10-fold larger than those before booster vaccination. We conclude that a single booster dose is generally adequate for infants of HBsAg-positive mothers, whereas a further booster dose should be given for non-responders.

  20. Emergence of Hepatitis B Virus Genotype F in Aligarh Region of North India

    PubMed Central

    Sami, Hiba; Rizvi, Meher; Azam, Mohd; Mukherjee, Rathindra M.; Shukla, Indu; Ajmal, M. R.; Malik, Abida

    2013-01-01

    Introduction. HBV genotypes and subtypes are useful clinical and epidemiological markers. In this study prevalent HBV genotypes were assessed in relation to serological profile and clinical status. Material & Methods. 107 cases of HBV were genotyped. Detailed clinical history was elicited from them. HBsAg, HBeAg, anti-HBs, anti-HBe, and anti-HBc-IgM were assessed. HBV genotyping was performed using Kirschberg's type specific primers (TSP-PCR), heminested PCR, and Naito's monoplex PCR. Nucleotide sequencing was performed. Results. A total of 97 (91%) were genotyped following the methods of Kirschberg et al./Naito et al. Genotype D was by far the most prevalent genotype 91 (85.04%) in this region. A surprising finding was the detection of genotype F in 5 (4.67%) of our patients. Genotype A strangely was observed only in one case. In 85.7% genotype D was associated with moderate to severe liver disease, 43.9% HBeAg, and 18.7% anti-HBc-IgM positivity. Majority of genotype F (80%) was seen in mild to moderate liver disease. It was strongly associated with HBeAg 60% and 20% anti-HBc-IgM positivity. Conclusion. Emergence of genotype F in India merits further study regarding its clinical implications and treatment modalities. Knowledge about HBV genotypes can direct a clinician towards more informed management of HBV patients. PMID:24381592

  1. Long-term results after transcatheter aortic valve implantation: positive and side effects.

    PubMed

    Godino, C; Pavon, A G; Colombo, A

    2013-08-01

    The scientific and technological progress in the field of medicine has allowed to treat patients with severe aortic valve stenosis and with a high perioperative risk. Before the introduction of transcatheter aortic valve implantation (TAVI), patients considered at high risk for surgical treatment were managed with medical therapy or with balloon aortic valvuloplasty. With more than 50000 transcatheter aortic valves implanted in patients around the world, TAVI has demonstrated to be a valid alternative to surgical aortic valve replacement in inoperable and high-risk patients. The PARTNER trial was the first randomized controlled trial to demonstrate that TAVI is not inferior to SAVR in high-risk patients. However, despite some encouraging short-term results medium and long-term outcomes are not always so encouraging. In this review, we will present the immediate results and distinct TAVI-related drawbacks and relative impact on the long-term outcome. New technology advances promise to simplify TAVI and to improve the results by reducing the rate of TAVI-specific issues such as paravalvular aortic regurgitation, annular rupture, and conduction disturbances which may impact on the clinical outcome. Therefore, we believe that when some of these weaknesses will be overcome, even patients at lower risk might benefit from TAVI in the near future.

  2. Results of a two-position reactor neutrino-oscillation experiment

    SciTech Connect

    Greenwood, Z.D.; Kropp, W.R.; Mandelkern, M.A.; Nakamura, S.; Pasierb-Love, E.L.; Price, L.R.; Reines, F.; Riley, S.P.; Sobel, H.W.; Baumann, N.; Gurr, H.S.

    1996-06-01

    A search for vacuum neutrino oscillations in the range {Delta}{ital m}{sup 2}{approx_gt}0.01 eV{sup 2} with sin{sup 2}2{theta}{approx_gt}0.05 was performed with a detector placed at two different distances (18 and 24 m) from a production reactor at the Savannah River Site. The results observed are inconsistent with oscillations in this region and consistent with other reactor experiments. {copyright} {ital 1996 The American Physical Society.}

  3. Second Positive Phototropism Results from Coordinated Co-Action of the Phototropins and Cryptochromes1

    PubMed Central

    Whippo, Craig W.; Hangarter, Roger P.

    2003-01-01

    Phototropism and hypocotyl growth inhibition are modulated by the coaction of different blue-light photoreceptors and their signaling pathways. How seedlings integrate the activities of the different blue-light photoreceptors to coordinate these hypocotyl growth responses is still unclear. We have used time-lapse imaging and a nontraditional mathematical approach to conduct a detailed examination of phototropism in wild-type Arabidopsis and various blue-light photoreceptor mutants. Our results indicate that high fluence rates of blue light (100 μmol m–2 s–1) attenuate phototropism through the coaction of the phototropin and cryptochrome blue-light photoreceptors. In contrast, we also demonstrate that phototropins and cryptochromes function together to enhance phototropism under low fluence rates (<1.0 μmol m–2 s–1) of blue light. Based on our results, we hypothesize that phototropins and cryptochromes regulate phototropism by coordinating the balance between stimulation and inhibition of growth of the hypocotyl depending on the fluence rate of blue light. PMID:12857830

  4. Second positive phototropism results from coordinated co-action of the phototropins and cryptochromes.

    PubMed

    Whippo, Craig W; Hangarter, Roger P

    2003-07-01

    Phototropism and hypocotyl growth inhibition are modulated by the coaction of different blue-light photoreceptors and their signaling pathways. How seedlings integrate the activities of the different blue-light photoreceptors to coordinate these hypocotyl growth responses is still unclear. We have used time-lapse imaging and a nontraditional mathematical approach to conduct a detailed examination of phototropism in wild-type Arabidopsis and various blue-light photoreceptor mutants. Our results indicate that high fluence rates of blue light (100 micro mol m(-)(2) s(-)(1)) attenuate phototropism through the coaction of the phototropin and cryptochrome blue-light photoreceptors. In contrast, we also demonstrate that phototropins and cryptochromes function together to enhance phototropism under low fluence rates (<1.0 micro mol m(-)(2) s(-)(1)) of blue light. Based on our results, we hypothesize that phototropins and cryptochromes regulate phototropism by coordinating the balance between stimulation and inhibition of growth of the hypocotyl depending on the fluence rate of blue light.

  5. The management of isolated positive syphilis enzyme immunoassay results in HIV-negative patients attending a sexual health clinic.

    PubMed

    Thorley, Nicola; Adebayo, Michael; Smit, Erasmus; Radcliffe, Keith

    2016-08-01

    An unconfirmed positive treponemal enzyme immunoassay (enzyme immunoassay positive, Treponema pallidum particle agglutination negative and rapid plasma reagin negative) presents a clinical challenge to distinguish early syphilis infection from false-positive results. These cases are referred for syphilis line assay (INNO-LIA) and recalled for repeat syphilis serology. We performed a retrospective audit to establish the proportion of HIV-negative cases with unconfirmed positive enzyme immunoassay results, the proportion of these cases that received an INNO-LIA test and repeat syphilis serology testing and reviewed the clinical outcomes; 0.35% (80/22687) cases had an unconfirmed positive treponemal enzyme immunoassay result. Repeat syphilis serology was performed in 80% (64/80) cases, but no additional cases of syphilis were identified. Eighty-eight per cent (70/80) received an INNO-LIA test; 14% (5/37) unconfirmed enzyme immunoassay-positive cases with no prior history of syphilis were confirmed on INNO-LIA assay, supporting a diagnosis of latent syphilis. As a confirmatory treponemal test, the INNO-LIA assay may be more useful than repeat syphilis serological testing. © The Author(s) 2016.

  6. Decision outcomes in women offered noninvasive prenatal test (NIPT) for positive Down screening results.

    PubMed

    Lo, Tsz-Kin; Chan, Kelvin Yuen-Kwong; Kan, Anita Sik-Yau; So, Po-Lam; Kong, Choi-Wah; Mak, Shui-Lam; Lee, Chung-Nin

    2017-09-19

    In this first Asian study, the decision outcomes (decision conflict, decision regret, and anxiety) of 262 pregnant women offered noninvasive prenatal test (NIPT) for high-risk Down screening results were assessed. Decision conflict was experienced by 3.5% and level of decisional regret low (mean score 15.7, 95%CI 13.2-18.3). All 13 cases of decisional regret were NIPT acceptors. Elevated anxiety was experienced by 55.9% at the time of decision making about NIPT and persistent in 30.3%. Insufficient knowledge about NIPT was associated with elevated anxiety at decision making (p = .011) and with decisional regret (p = .016). Decisional regret was associated with prolonged anxiety (p = .010).

  7. Evaluation of antibody frequency against HBV, HCV and HTLV-1

    PubMed Central

    Tahaei, Seyed Mohammad Ebrahim; Fatemi, Seyed Reza; Azimzadeh, Pedram; Mirsattari, Dariush; Sanati, Azar; Sharifian, Afsaneh

    2012-01-01

    Aim This study was designed to evaluate the frequency of antibody against these viruses in individuals attending the endoscopy ward of Taleghani hospital Tehran, Iran. Background Blood-borne viruses such as hepatitis B and hepatitis C virus and HTLV-1 virus are among the world’s public health problems. Hepatitis viruses cause liver problems and HTLV-1 infection can lead to adult T-Cell lymphoma (ATL). Patients and methods Blood samples of 219 individuals attending the endoscopy ward of Taleghani hospital between years 2009-2011 were collected. A questionnaire containing demographic data was completed for each subject. Blood samples were tested for antibody against HTLV-1, HCV and HBc by ELISA (Dia.pro Italy). In case of positive results for anti-HBc, samples were also tested for HBs Ag antigen. Results Ninety two subjects were male and 127 were female. Mean age of the population was 39.87 ± 16.47. None of the subjects had anti-HCV antibody, while 4 of them had anti-HTLV-1 antibody and 26 anti-HBc antibody; which only two of these individuals had HBs Antibody. Conclusion The results of this study show that frequency of anti-HCV and anti-HTLV-1 antibodies are very low, while the frequency of anti-HBc was higher in the population. Since HTLV-1 is the causative agent of a type of blood cancer, it seems that screening of donated bloods in this region should be considered. PMID:24834218

  8. The clinical impact of a false-positive urine cocaine screening result on a patient's pain management.

    PubMed

    Kim, James A; Ptolemy, Adam S; Melanson, Stacy E F; Janfaza, David R; Ross, Edgar L

    2015-06-01

    The urine of a patient admitted for chest and epigastric pain tested positive for cocaine using an immunoassay-based drug screening method (positive/negative cutoff concentration 150 ng/mL). Despite the patient's denial of recent cocaine use, this positive cocaine screening result in conjunction with a remote history of drug misuse impacted the patient's recommended pain therapy. Specifically, these factors prompted the clinical team to question the appropriateness of opioids and other potentially addictive therapeutics during the treatment of cancer pain from previously undetected advanced pancreatic carcinoma. After pain management and clinical pathology consultation, it was decided that the positive cocaine screening result should be confirmed by gas chromatography-mass spectrometry (GC-MS) testing. This more sensitive and specific analytical technique revealed that both cocaine and its primary metabolite benzoylecgonine were undetectable (i.e., less than the assay detection limit of 50 ng/mL), thus indicating that the positive urine screening result was falsely positive. With this confirmation, the pain management service team was reassured in offering intrathecal pump (ITP) therapy for pain control. ITP implantation was well tolerated, and the patient eventually achieved excellent pain relief. However, ITP therapy most likely would not have been utilized without the GC-MS confirmation testing unless alternative options failed and extensive vigilant monitoring was initiated. As exemplified in this case, confirmatory drug testing should be performed on specimens with unexpected immunoassay-based drug screening results. To our knowledge, this is the first report of a false-positive urine cocaine screening result and its impact on patient management. Wiley Periodicals, Inc.

  9. False-positive results in metagenomic virus discovery: a strong case for follow-up diagnosis.

    PubMed

    Rosseel, T; Pardon, B; De Clercq, K; Ozhelvaci, O; Van Borm, S

    2014-08-01

    A viral metagenomic approach using virion enrichment, random amplification and next-generation sequencing was used to investigate an undiagnosed cluster of dairy cattle presenting with high persistent fever, unresponsive to anti-microbial and anti-inflammatory treatment, diarrhoea and redness of nose and teat. Serum and whole blood samples were taken in the predicted hyperviraemic state of an animal that a few days later presented with these clinical signs. Bioinformatics analysis of the resulting data from the DNA virus identification workflow (a total of 32 757 sequences with average read length 335 bases) initially demonstrated the presence of parvovirus-like sequences in the tested blood sample. Thorough follow-up using specific real-time RT-PCR assays targeting the detected sequence fragments confirmed the presence of these sequences in the original sample as well as in a sample of an additional animal, but a contamination with an identical genetic signature in negative extraction controls was demonstrated. Further investigation using an alternative extraction method identified a contamination of the originally used Qiagen extraction columns with parvovirus-like nucleic acids or virus particles. Although we did not find any relevant virus that could be associated with the disease, these observations clearly illustrate the importance of using a proper control strategy and follow-up diagnostic tests in any viral metagenomic study.

  10. Effect of poppy seed consummation on the positive results of opiates screening in biological samples.

    PubMed

    Jankovicová, Katarína; Ulbrich, Pavol; Fuknová, Mária

    2009-04-01

    Poppy seed is a popular substance of many traditional Slovak cakes. We can eat quite great amount of it, sometimes more than 50 g. Existing problem in interpreting the results of opiate urine analysis in case of drug abuse arises from the natural occurrence of opiate alkaloids in poppy seed. Interpretation of morphine presence in urine sample is in some cases a problem because morphine present in the urine sample may come from different "sources". The presence of additional, respectively, other opiate in urine sample is significant help when interpreting the presence of morphine. We used poppy seed bought in supermarket for our experiment. Presence of morphine and codeine was determined in poppy seed extracts, whereas the concentration of majority opiate-morphine was 0.9 mg/100 g (9 ppm). This poppy seed was used for two series of experiment-poppy seed consummation, where four persons consumed 100g of poppy seed in the first series and 50 g in the second series. Urine samples were taken in regular 1h intervals where first urine sample was given for testing 3 h after consummation. Concentrations of total opiates were determined in each urine sample by screening examination. Morphine concentrations were determined in selected urine samples using GC/MS with internal standard.

  11. Interpretation of positive troponin results among patients with and without myocardial infarction

    PubMed Central

    Tecson, Kristen M.; Arnold, William; Barrett, Tyler; Birkhahn, Robert; Daniels, Lori B.; DeFilippi, Christopher; Headden, Gary; Peacock, W. Frank; Reed, Michael; Singer, Adam J.; Schussler, Jeffrey M.; Smith, Stephen; Than, Martin P.

    2017-01-01

    Measuring cardiac troponins is integral to diagnosing acute myocardial infarction (AMI); however, troponins may be elevated without AMI, and the use of multiple different assays confounds comparisons. We considered characteristics and serial troponin values in emergency department chest pain patients with and without AMI to interpret troponin excursions. We compared serial troponin in 124 AMI and non-AMI patients from the observational Performance of Triage Cardiac Markers in the Clinical Setting (PEARL) study who presented with chest pain and had at least one troponin value exceeding the 99th percentile of normal. Because 8 assays were used during data collection, we employed a method of scaling the troponin value to the corresponding assay's 99th percentile upper reference limit to standardize the results. In 81 AMI patients, 96% had elevated troponin at the first test following initial elevation, compared to 73% of the 43 non-AMI patients (P < 0.001). Scaling troponin to the 99th percentile of normal yielded a median value that was 4.8 [2.2, 14.1] times higher than the 99th percentile cutpoint among AMI patients, compared to 2.3 [1.5, 6.5] times higher among non-AMI patients (P = 0.04). The rise in serial scaled troponin values distinguished the AMI patients. Scaling to the 99th percentile was useful for comparing troponin when different assays were utilized. PMID:28127121

  12. A study of genotyping for management of human papillomavirus-positive, cytology-negative cervical screening results.

    PubMed

    Schiffman, M; Burk, R D; Boyle, S; Raine-Bennett, T; Katki, H A; Gage, J C; Wentzensen, N; Kornegay, J R; Aldrich, C; Tam, T; Erlich, H; Apple, R; Befano, B; Castle, P E

    2015-01-01

    The effective management of women with human papillomavirus (HPV)-positive, cytology-negative results is critical to the introduction of HPV testing into cervical screening. HPV typing has been recommended for colposcopy triage, but it is not clear which combinations of high-risk HPV types provide clinically useful information. This study included 18,810 women with Hybrid Capture 2 (HC2)-positive, cytology-negative results and who were age ≥30 years from Kaiser Permanente Northern California. The median follow-up was 475 days (interquartile range [IQR], 0 to 1,077 days; maximum, 2,217 days). The baseline specimens from 482 cases of cervical intraepithelial neoplasia grade 3 or cancer (CIN3+) and 3,517 random HC2-positive noncases were genotyped using 2 PCR-based methods. Using the case-control sampling fractions, the 3-year cumulative risks of CIN3+ were calculated for each individual high-risk HPV type. The 3-year cumulative risk of CIN3+ among all women with HC2-positive, cytology-negative results was 4.6%. HPV16 status conferred the greatest type-specific risk stratification; women with HC2-positive/HPV16-positive results had a 10.6% risk of CIN3+, while women with HC-2 positive/HPV16-negative results had a much lower risk of 2.4%. The next most informative HPV types and their risks in HPV-positive women were HPV33 (5.9%) and HPV18 (5.9%). With regard to the etiologic fraction, 20 of 71 cases of cervical adenocarcinoma in situ (AIS) and adenocarcinoma in the cohort were positive for HPV18. HPV16 genotyping provides risk stratification useful for guiding clinical management; the risk among HPV16-positive women clearly exceeds the U.S. consensus risk threshold for immediate colposcopy referral. HPV18 is of particular interest because of its association with difficult-to-detect glandular lesions. There is a less clear clinical value of distinguishing the other high-risk HPV types. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

  13. A Study of Genotyping for Management of Human Papillomavirus-Positive, Cytology-Negative Cervical Screening Results

    PubMed Central

    Burk, R. D.; Boyle, S.; Raine-Bennett, T.; Katki, H. A.; Gage, J. C.; Wentzensen, N.; Kornegay, J. R.; Aldrich, C.; Tam, T.; Erlich, H.; Apple, R.; Befano, B.; Castle, P. E.

    2014-01-01

    The effective management of women with human papillomavirus (HPV)-positive, cytology-negative results is critical to the introduction of HPV testing into cervical screening. HPV typing has been recommended for colposcopy triage, but it is not clear which combinations of high-risk HPV types provide clinically useful information. This study included 18,810 women with Hybrid Capture 2 (HC2)-positive, cytology-negative results and who were age ≥30 years from Kaiser Permanente Northern California. The median follow-up was 475 days (interquartile range [IQR], 0 to 1,077 days; maximum, 2,217 days). The baseline specimens from 482 cases of cervical intraepithelial neoplasia grade 3 or cancer (CIN3+) and 3,517 random HC2-positive noncases were genotyped using 2 PCR-based methods. Using the case-control sampling fractions, the 3-year cumulative risks of CIN3+ were calculated for each individual high-risk HPV type. The 3-year cumulative risk of CIN3+ among all women with HC2-positive, cytology-negative results was 4.6%. HPV16 status conferred the greatest type-specific risk stratification; women with HC2-positive/HPV16-positive results had a 10.6% risk of CIN3+, while women with HC-2 positive/HPV16-negative results had a much lower risk of 2.4%. The next most informative HPV types and their risks in HPV-positive women were HPV33 (5.9%) and HPV18 (5.9%). With regard to the etiologic fraction, 20 of 71 cases of cervical adenocarcinoma in situ (AIS) and adenocarcinoma in the cohort were positive for HPV18. HPV16 genotyping provides risk stratification useful for guiding clinical management; the risk among HPV16-positive women clearly exceeds the U.S. consensus risk threshold for immediate colposcopy referral. HPV18 is of particular interest because of its association with difficult-to-detect glandular lesions. There is a less clear clinical value of distinguishing the other high-risk HPV types. PMID:25339396

  14. Evaluation of antibody frequency against HBV, HCV and HTLV-1.

    PubMed

    Tahaei, Seyed Mohammad Ebrahim; Mohebbi, Seyed Reza; Fatemi, Seyed Reza; Azimzadeh, Pedram; Mirsattari, Dariush; Sanati, Azar; Sharifian, Afsaneh

    2012-01-01

    This study was designed to evaluate the frequency of antibody against these viruses in individuals attending the endoscopy ward of Taleghani hospital Tehran, Iran. Blood-borne viruses such as hepatitis B and hepatitis C virus and HTLV-1 virus are among the world's public health problems. Hepatitis viruses cause liver problems and HTLV-1 infection can lead to adult T-Cell lymphoma (ATL). Blood samples of 219 individuals attending the endoscopy ward of Taleghani hospital between years 2009-2011 were collected. A questionnaire containing demographic data was completed for each subject. Blood samples were tested for antibody against HTLV-1, HCV and HBc by ELISA (Dia.pro Italy). In case of positive results for anti-HBc, samples were also tested for HBs Ag antigen. Ninety two subjects were male and 127 were female. Mean age of the population was 39.87 ± 16.47. None of the subjects had anti-HCV antibody, while 4 of them had anti-HTLV-1 antibody and 26 anti-HBc antibody; which only two of these individuals had HBs Antibody. The results of this study show that frequency of anti-HCV and anti-HTLV-1 antibodies are very low, while the frequency of anti-HBc was higher in the population. Since HTLV-1 is the causative agent of a type of blood cancer, it seems that screening of donated bloods in this region should be considered.

  15. [Does a positive finding of tetrahydrocannabinol in the blood result from ingestion of Indian frankincense (Boswellia serrata)?].

    PubMed

    Skopp, Gisela; Schmitt, Georg

    2012-01-01

    The exculpatory statement that a positive THC finding in the blood is due to the consumption of hemp products or passive exposure to cannabis smoke has been disproved by the monitoring of hemp products and recent passive inhalation studies conducted in social settings, which showed that these conditions are unlikely to produce a positive result in the blood. The defense that the ingestion of Indian olibanum may result in a positive THC concentration in the blood is unusual; it is based on older publications where authors had speculated on a possible association of the synthetic pathways of THC from terpenoid precursors also being present in olibanum and the biogenesis of THC in hemp. It had further been speculated whether chemical or plant-derived pathways may also occur in humans. A thorough understanding of the different pathways and recently published results have outdated these speculations.

  16. Reduction of misleading ("false") positive results in mammalian cell genotoxicity assays. II. Importance of accurate toxicity measurement.

    PubMed

    Fowler, Paul; Smith, Robert; Smith, Katie; Young, Jamie; Jeffrey, Laura; Kirkland, David; Pfuhler, Stefan; Carmichael, Paul

    2012-08-30

    In a previous publication, Fowler et al. [4] demonstrated that the seemingly high rate of false or misleading positive results obtained in in vitro cytogenesis assays for genotoxicity - when compared with in vivo genotoxicity or rodent carcinogenicity data - was greater when rodent cell lines were used that were also reported to have mutant or non-functional p53. As part of a larger project for improvement of in vitro mammalian cell assays, we have investigated the impact of different toxicity measures, commonly used in in vitro cytogenetic assays, on the occurrence of misleading positive results. From a list of 19 chemicals that produce "false" positive results in in vitro mammalian cell assays [10], six substances that had given positive responses in CHO, CHL and TK6 cells [4], were evaluated for micronucleus induction in vitro, with different measures of toxicity for selection of the top concentration. The data show that estimating toxicity by relative cell count (RCC) or replication index (RI) consistently underestimates the toxicity observed by other measures (Relative Population Doubling, RPD, or Relative Increase in Cell Count, RICC). RCC and RI are more likely to lead to selection of concentrations for micronucleus scoring that are highly cytotoxic and thus could potentially lead to artefacts of toxicity being scored (elevated levels of apoptosis and necrosis), generating misleading positive results. These results suggest that a further reduction in the frequency of misleading positive results in in vitro cytogenetic assays can be achieved with this set of chemicals, by avoiding the use of toxicity measures that underestimate the level of toxicity induced. Copyright © 2012 Elsevier B.V. All rights reserved.

  17. Prevalence of markers of hepatitis B virus infection or vaccination in HBsAg-negative subjects

    PubMed Central

    De Paschale, Massimo; Manco, Maria Teresa; Belvisi, Luisa; Brando, Bruno; Latella, Stefania; Agrappi, Carlo; Mirri, Paola; Gatti, Arianna; Clerici, Pierangelo

    2012-01-01

    Background. The implementation of mass vaccinations against hepatitis B virus (HBV) has significantly reduced the prevalence of HBsAg-positive subjects. At the same time, the prevalence of the other markers of infection has decreased, but there has been an increase in the percentage of subjects with markers of a successful vaccination. It has been suggested that increasing immigration from countries in which this virus is highly endemic is changing the epidemiology of HBV infection. The aim of this study was to assess the prevalence of the serological markers of HBV in Italian and non-Italian HBsAg-negative subjects. Materials and methods. In the years 2007–2008, 8,018 samples from HBsAg-negative subjects (7,521 Italians and 497 non-Italians) were received for detection of anti-HBs and/or anti-HBc. The findings in the 1,358 samples from candidate blood donors were compared with those obtained in 1991 and 1999. Results. The rate of anti-HBc positivity was 18.3% in the Italian samples and 32.8% in the non-Italian samples; the corresponding percentages of anti-HBs/anti-HBc positive samples (indicating past infection), anti-HBs positive only samples (vaccination) and anti-HBc positive only were, 11.3% vs. 22.5%, 25.8% vs. 17.2%, and 6.9% vs. 9.9% in Italians and non-Italians, respectively. The differences were more marked when stratified by age. In relation to candidate blood donors, simultaneous positivity for anti-HBs and anti-HBc decreased from 11.0% in 1991 to 8.1% in 1999 and 3.9% in 2007–2008, whereas isolated anti-HBs positivity increased from 2.2% in 1991 to 21.4% in 1999 and 42.9% in 2007–2008. Conclusions. The frequency of markers of past infection among Italians has decreased over time as a result of mass vaccination and is significantly lower than that observed in non-Italians. The increasing number of immigrants from countries in which HBV is highly endemic is changing the epidemiology of HBV infection in Italy. PMID:22682333

  18. Positive serology for viral hepatitis and donor self-exclusion in Southern Brazil.

    PubMed

    Maccarini, Julia De Luca; Nazario, Carlos Alberto Kuntz; Ferreira, Jovino Dos Santos; Ceglio, William Queiroz Guimarães Wiegandt; Serpa, Rômulo Cavalcante; Ferreira, Vera Lúcia Paes Cavalcanti; Lucca Schiavon, Leonardo de; Narciso-Schiavon, Janaína Luz

    2013-01-01

    Despite the great advances in serological testing for transfusion-transmitted infections, the selection of blood donors by blood bank operators remains the only way to avoid transmission within the testing window period. Part of this selection is the self-exclusion form, on which the donors can exclude their blood from donation without any explanation. This study assessed the clinical and epidemiological characteristics related to positivity for viral hepatitis and to the use of the confidential self-exclusion (CSE) form. This transversal study analyzed the data collected from blood donors' files in a hospital in Southern Brazil. Univariate and multivariate analyses identified the clinical and epidemiological variables related to positive serologies of viral hepatitis and to whether the donor was self-excluded. Of the 3,180 donors included in this study, 0.1% tested positive for HBsAg, 2.1% for anti-HBc, and 0.9% for anti-HCV. When the 93 donors with positive serologies for viral hepatitis were compared with those who were negative, a greater proportion of the positive serology group was found to have had a history of blood transfusions (OR=4.908; 95%CI=1.628 - 14.799; p<0.01), had repeatedly donated (OR=2.147; 95%CI=1.236 - 3.729; p<0.01), and used the CSE form for self-exclusion (OR=7.139; 95%CI=2.045 - 24.923; p<0.01). No variables were independently associated with self-exclusion. A history of blood transfusion, repeated donations, and self-exclusion are factors that should be considered during viral hepatitis screenings in blood banks.

  19. Initial report of a hepatitis investigation in rural Belize.

    PubMed

    Hoffman, K J; Gaydos, J C; Krieg, R E; Duncan, J F; MacArthy, P O; Ticehurst, J R; Jaramillo, R; Reyes, L G; Sjogren, M H; Legters, L J

    1993-01-01

    In spring 1991, Belizian health officials expressed concern about a possible hepatitis outbreak in a banana farming district. A study was designed to identify cases and to address the serological prevalence of hepatitis virus markers. Three populations were studied: (i) persons meeting a clinical case definition for hepatitis; (ii) designated banana workers; and (iii) people in a random sample of households in the community. Information was collected using questionnaires and sera were collected for laboratory testing. This report presents the preliminary results of a study conducted in June 1991. Among people who met the clinical case definition, 24% of 42 tested had immunoglobulin M antibody to hepatitis B virus (HBV) core antigen (anti-HBc IgM). In the worker and household survey populations, 284 and 280 people, respectively, were tested for anti-HBc IgM. In each group, 4% were positive. HBV surface antigen was found in 37% of 43 clinical cases, 18% of workers, and 13% of people in the household survey. Among the 3 study populations, the prevalence of HBV core antibody (anti-HBc) ranged from 73% to 81%. Almost all tested persons had evidence of prior hepatitis A virus infection. Evidence of prior infection with hepatitis viruses A and B was widespread, but an aetiology could not be established for most of the clinical cases. However, the prevalence of hepatitis B markers in this population was very high compared to other reports from the Caribbean.

  20. Prevalence and risk factors for hepatitis B virus infections among visitors to an STD clinic.

    PubMed Central

    van Duynhoven, Y T; van de Laar, M J; Schop, W A; Rothbarth, P H; van der Meijden, W I; van Loon, A M; Sprenger, M J

    1997-01-01

    OBJECTIVE: To determine the prevalence and risk factors for hepatitis B virus (HBV) infections among individuals attending an STD clinic in a low endemic region. STUDY DESIGN: A total of 1228 women and 1648 men attending the STD clinic at the University Hospital Rotterdam, Netherlands, were examined for HBV infection by determination of hepatitis B surface antigen (HBsAg) and antibodies to hepatitis B core antigen (anti-HBc). Demographic characteristics, information on sexual behaviour, and intravenous drug use were recorded. RESULTS: The seroprevalence of HBsAg was 1.4% in women and 2.1% in men (0% in homosexual men). The seroprevalence of anti-HBc was 13% in women and 20% in men (36% in homosexual men). Native country, intravenous drug use, a history of STD, and the number of partners in the past half year (inversely) were independent risk factors for HBsAg positivity in women and heterosexual men. For anti-HBc independent associations were observed for native country, age, intravenous drug use, commercial sex, number of lifetime partners, homosexual contacts, orogenital contact (inverse), and a history of STD. CONCLUSION: The HBV prevalence in the STD clinic attendants was high, exceeding the national estimate, and indicates that the STD clinic population may be considered a high risk group. Our data confirmed an increased risk for HBV infections among established risk groups. Therefore, these risk groups should be routinely screened to identify HBV cases for counselling and contact tracing. PMID:9582467

  1. Seropositivity of Hepatitis B and C among Syrian Multi-transfused Patients with Hemoglobinopathy

    PubMed Central

    Yazaji, Widad; Habbal, Wafa; Monem, Fawza

    2016-01-01

    Background and objectives Blood transfusion is a lifesaving therapy for patients with hemoglobinopathies. However, the need of frequent transfusion carries the risk of transmitting hepatitis B and C infections which are intermediately prevalent in Syria. Despite screening blood donations with sensitive methods, the risk of transmission is still present when infectious blood is donated within the window period. This study aimed to investigate the incidence of HBV and HCV seropositivity, and its association with multiple transfusions among Syrian hemoglobinopathies patients. Materials and Methods HBsAg, anti-HBc, anti-HBs and anti-HCV were tested for 159 Syrian multi-transfused patients by Enzyme-Linked Immunosorbent Assay (ELISA). Results Thirty-nine of 159 (24.5%) multi-transfused patients were HBsAg/anti-HBc or anti-HCV positive, 26 (16%) of which never visited the dentist, and they either tested postsurgically negative for HBsAg and anti-HCV or never underwent a surgical procedure. On the contrary of anti-HCV seropositivity, HBsAg/anti-HBc seropositivity was significantly associated with the number of blood transfusions, number of blood units and age (P < 0.001). Conclusion About one-sixth of our patients most likely acquired HBV/HCV infection via blood transfusion. Administering HBV vaccine, ensuring the immune status, and monitoring hepatitis markers might considerably minimize the incidence of viral hepatitis among multi-transfused patients. PMID:27648209

  2. Results of levator-advancement blepharoptosis repair using a standard protocol: effect of epinephrine-induced eyelid position change.

    PubMed Central

    Bartley, G B; Lowry, J C; Hodge, D O

    1996-01-01

    PURPOSE: Blepharoptosis repair by levator advancement is successful in most instances, but the postoperative eyelid level is not uniformly predictable. This study was undertaken to evaluate the possible effect of epinephrine (from local anesthetic) on eyelid position. METHODS: Seventeen adults with acquired unilateral ptosis as a result of levator aponeurosis dehiscence underwent levator aponeurosis advancement. The distance between the upper eyelid margin and the central corneal light reflex was measured preoperatively with the patient in both the upright and the supine position, 10 minutes after injection of 1.0 mL of anesthetic solution (2% lidocaine with 1:100,000 epinephrine and 12 U hyaluronidase per mL) in the supine position, intraoperatively after skin closure in the supine position, and 1 week or more postoperatively in the upright position. The ptotic lid was positioned intraoperatively in relation to the contralateral unoperated lid according to the change (presumably) induced by epinephrine stimulation of Müller's muscle. RESULTS: Eleven (65%) of the 17 patients had final postoperative lid positions within 1 mm between eyes. Two patients (12%) had undercorrection. Four patients (24%) had overcorrection by > 1 mm. The overcorrected lids were satisfactorily positioned, however, and none required further surgery; in 3 of these 4 patients, the unoperated lid had become ptotic, probably as a result of Hering's law. Differences between operated and unoperated lids and between the different times of measurement were analyzed. Significant changes in lid position occurred in the ptotic lids after injection (mean, +1.1 +/- 1.5 mm; median, +1.0 mm; P = .004) and in the final intraoperative difference between operated and unoperated lids (mean, +0.8 +/- 0.9 mm; median, +1.0 mm; P = .003). The change in the unoperated lid from preoperative upright to preoperative supine was significantly greater in the 6 failures (mean, -0.8 +/- 0.6 mm; median, -1.0 mm) than in

  3. Training Yields Positive Results.

    ERIC Educational Resources Information Center

    Reclaiming Children and Youth, 2002

    2002-01-01

    Because youth who are in residential facilities are sometimes dangerous to themselves or others, there are times when physical restraints must be used for the safety of both residents and staff. But the use of restraints is coming under increased scrutiny because of potential dangers. In this article facilities share how training can help reduce…

  4. Recovery of positive future thinking within a high-risk parasuicide group: results from a pilot randomized controlled trial.

    PubMed

    MacLeod, A K; Tata, P; Evans, K; Tyrer, P; Schmidt, U; Davidson, K; Thornton, S; Catalan, J

    1998-11-01

    The research examined: (i) whether high risk parasuicide patients showed a deficit in positive future thinking but no increase in negative future thinking; and (ii) whether such a deficit could be remedied by a brief, manual-assisted psychological intervention (manual assisted cognitive-behaviour therapy; MACT). A cross-sectional, mixed model design was used to assess differences between a sample of high risk parasuicide patients and matched controls on future thinking. A longitudinal mixed model design was used to assess changes in future thinking in the different groups over time. Parasuicide patients with a history of previous suicidal behaviour and personality disturbance were compared with a matched group of community controls on an adapted fluency measure of future thinking, which measured both quantitative and qualitative aspects of anticipated experiences. Patients were then randomly allocated to either the specific intervention (MACT) or treatment as usual (TAU) and assessed again at 6 month follow-up. Parasuicide patients showed reduced positive future thinking but no increased negative future thinking. Patients who received MACT showed a significant improvement in positive future thinking over the follow-up period whereas the TAU group showed no such improvement. However, interpretation of this finding was made more difficult by the control group also showing a significant improvement in positive future thinking. The results confirm that parasuicide patients exhibit a relative deficit in positive future thinking and suggest that this lack of positive future thinking may be remedied, at least partly, by a brief intervention.

  5. The Effect of False-Positive Results on Subsequent Participation in Chest X-ray Screening for Lung Cancer

    PubMed Central

    Sato, Akira; Hamada, Shota; Urashima, Yuki; Tanaka, Shiro; Okamoto, Hiroaki; Kawakami, Koji

    2016-01-01

    Background High attendance rates and regular participation in disease screening programs are important contributors to program effectiveness. The objective of this study was to examine the effects of an initial false-positive result in chest X-ray screening for lung cancer on subsequent screening participation. Methods This historical cohort study analyzed individuals who first participated in a lung cancer screening program conducted by Yokohama City between April 2007 and March 2011, and these participants were retrospectively tracked until March 2013. Subsequent screening participation was compared between participants with false-positive results and those with negative results in evaluation periods between 365 (for the primary outcome) and 730 days. The association of screening results with subsequent participation was evaluated using a generalized linear regression model, with adjustment for characteristics of patients and screening. Results The proportions of subsequent screening participation within 365 days were 12.9% in 3132 participants with false-positive results and 6.7% in 15 737 participants with negative results. Although the differences in attendance rates were reduced with longer cutoffs, participants with false-positive results were consistently more likely to attend subsequent screening than patients with negative results (P < 0.01). The predictors of subsequent screening participation were false-positive results (risk ratio [RR] 1.72; 95% confidence interval [CI], 1.54–1.92), older age (RR 1.17; 95% CI, 1.11–1.23), male sex (RR 1.46; 95% CI, 1.29–1.64), being a current smoker (RR 0.80; 95% CI, 0.69–0.93), current employment (RR 0.79; 95% CI, 0.70–0.90), and being screened at a hospital cancer center (vs public health centers; RR 1.36; 95% CI, 1.15–1.60). Conclusions Our findings indicated that subsequent participation in lung cancer screening was more likely among participants with false-positive results in an initial screening than

  6. Anticipated and Actual Reactions to Receiving HIV Positive Results Through Self-Testing Among Gay and Bisexual Men

    PubMed Central

    Carballo-Diéguez, Alex; Ibitoye, Mobolaji; Frasca, Timothy; Brown, William; Balan, Iván

    2014-01-01

    We explored anticipated and actual reactions to receiving HIV positive results through self-testing with a diverse group of 84 gay and bisexual men in New York City. Grounded Theory was used to investigate these reactions in a two-phase study, one hypothetical, followed by a practical phase in which self-tests were distributed and used. Three major themes emerged when participants were asked about their anticipated reactions to an HIV positive self-test result: managing emotional distress, obtaining HIV medical care, and postponing sexual activity. When participants were asked about their anticipated reactions to a partner’s HIV positive self-test result, five themes emerged: provide emotional support; refrain from engaging in sex with casual partner; avoid high-risk sexual activity with both main and casual partners; seek medical services; and obtain a confirmatory test result. Although none of the participants tested positive, seven of their partners did. Participants provided emotional support and linked their partners to support services. The availability of HIV self-testing kits offers potential opportunities to tackle HIV infection among individuals with high-risk practices. PMID:24858480

  7. What Lies beneath Seemingly Positive Campus Climate Results: Institutional Sexism, Racism, and Male Hostility toward Equity Initiatives and Liberal Bias

    ERIC Educational Resources Information Center

    Vaccaro, Annemarie

    2010-01-01

    This article presents qualitative results from a campus climate study at one predominately white university. Data analysis uncovered "what lies beneath" a seemingly positive campus climate. Gender differences in survey responses suggest that men and women experienced the climate in vastly different ways. Additionally, lack of deep diversity…

  8. Does Gender Influence Emotions Resulting from Positive Applause Feedback in Self-Assessment Testing? Evidence from Neuroscience

    ERIC Educational Resources Information Center

    Liu, Chia-Ju; Huang, Chin-Fei; Liu, Ming-Chi; Chien, Yu-Cheng; Lai, Chia-Hung; Huang, Yueh-Min

    2015-01-01

    Computerized self-assessment testing can help learners reflect on learning content and can also promote their motivation toward learning. However, a positive affective state is the key to achieving these learning goals. This study aims to examine learning gains and emotional reactions resulting from receiving emotional feedback in the form of…

  9. Does Gender Influence Emotions Resulting from Positive Applause Feedback in Self-Assessment Testing? Evidence from Neuroscience

    ERIC Educational Resources Information Center

    Liu, Chia-Ju; Huang, Chin-Fei; Liu, Ming-Chi; Chien, Yu-Cheng; Lai, Chia-Hung; Huang, Yueh-Min

    2015-01-01

    Computerized self-assessment testing can help learners reflect on learning content and can also promote their motivation toward learning. However, a positive affective state is the key to achieving these learning goals. This study aims to examine learning gains and emotional reactions resulting from receiving emotional feedback in the form of…

  10. Consequences of Increasing Time to Colonoscopy Examination After Positive Result From Fecal Colorectal Cancer Screening Test.

    PubMed

    Meester, Reinier G S; Zauber, Ann G; Doubeni, Chyke A; Jensen, Christopher D; Quinn, Virginia P; Helfand, Mark; Dominitz, Jason A; Levin, Theodore R; Corley, Douglas A; Lansdorp-Vogelaar, Iris

    2016-10-01

    Delays in diagnostic testing after a positive result from a screening test can undermine the benefits of colorectal cancer (CRC) screening, but there are few empirical data on the effects of such delays. We used microsimulation modeling to estimate the consequences of time to colonoscopy after a positive result from a fecal immunochemical test (FIT). We used an established microsimulation model to simulate an average-risk United States population cohort that underwent annual FIT screening (from ages 50 to 75 years), with follow-up colonoscopy examinations for individuals with positive results (cutoff, 20 μg/g) at different time points in the following 12 months. Main evaluated outcomes were CRC incidence and mortality; additional outcomes were total life-years lost and net costs of screening. For individuals who underwent diagnostic colonoscopy within 2 weeks of a positive result from an FIT, the estimated lifetime risk of CRC incidence was 35.5/1000 persons, and mortality was 7.8/1000 persons. Every month added until colonoscopy was associated with a 0.1/1000 person increase in cancer incidence risk (an increase of 0.3%/month, compared with individuals who received colonoscopies within 2 weeks) and mortality risk (increase of 1.4%/month). Among individuals who received colonoscopy examinations 12 months after a positive result from an FIT, the incidence of CRC was 27.0/1000 persons (increase of 4%, compared with 2 weeks), and mortality was 9.1/1000 persons (increase of 16%). Total years of life gained for the entire screening cohort decreased from an estimated 93.7/1000 persons with an almost immediate follow-up colonoscopy (cost savings of $208 per patient, compared with no colonoscopy) to 84.8/1000 persons with follow-up colonoscopies at 12 months (decrease of 9%; cost savings of $100/patient, compared with no colonoscopy). By using a microsimulation model of an average-risk United States screening cohort, we estimated that delays of up to 12 months after a

  11. Production of 2-Aminophenoxazin-3-one by Staphylococcus aureus Causes False-Positive Results in β-Galactosidase Assays

    PubMed Central

    Tse, Herman; Chan, Elaine; Lam, Ching-Wan; Leung, Ka-Fai; Chow, Pat; Lee, Kim-Chung; Sze, Kong-Hung; Cheung, Stanley K. K.; Tse, Man-Kit; Ho, Pak-Leung; Leung, Sze-Pui; Lau, Susanna K. P.; Woo, Patrick C. Y.

    2012-01-01

    Staphylococcus aureus can be distinguished from similar coagulase-positive staphylococci by its absence of β-galactosidase activity. This is commonly tested using o-nitrophenyl-β-d-galactopyranoside (ONPG) as the substrate. Unexpectedly, 111 and 58 of 123 isolates displayed apparent β-galactosidase activity in the ONPG assay and on the Vitek 2 system, respectively. Compositional analysis showed that the yellow coloration of the positive ONPG assay resulted from production of 2-aminophenoxazin-3-one. Alternative β-galactosidase substrates like X-Gal (5-bromo-4-chloro-3-indolyl-β-d-galactopyranoside) should be used for testing staphylococci. PMID:22972831

  12. Men with negative results of guaiac-based fecal occult blood test have higher prevalences of colorectal neoplasms than women with positive results.

    PubMed

    Brenner, Hermann; Hoffmeister, Michael; Birkner, Berndt; Stock, Christian

    2014-06-15

    Guaiac-based fecal occult blood tests (gFOBTs) are the most commonly applied tests for colorectal cancer screening globally but have relatively poor sensitivity to detect colorectal neoplasms. Men have higher prevalences of colorectal neoplasms than women. In case of a positive gFOBT result, participants are referred to colonoscopy, independent of sex. To assess performance of gFOBT in routine screening practice, we assessed age and sex specific prevalences (age groups: 55-59, 60-64, 65-69 and 70-74) of colorectal neoplasms in 182,956 women and men undergoing colonoscopy for primary screening and in 20,884 women and men undergoing colonoscopy to follow-up a positive gFOBT in Bavaria, Germany, in 2007-2009. We conducted model calculations to estimate prevalences among gFOBT negative individuals. Analogous model calculations were performed for women and men tested positive or negative with fecal immunochemical tests. In all age groups (55-59, 60-64, 65-69 and 70-74 years), men undergoing colonoscopy for primary screening had substantially higher prevalences of any colorectal neoplasms and essentially the same prevalences of advanced colorectal neoplasms compared to women undergoing colonoscopy to follow-up a positive gFOBT. Model calculations suggest that men with negative gFOBT likewise have substantially higher prevalences of colorectal neoplasms than gFOBT positive women in each age group. Model calculations further indicate that no such sex paradoxon occurs, and a much clearer risk stratification can be achieved with fecal immunochemical tests. Our findings underline need to move forward from and overcome shortcomings of gFOBT-based colorectal cancer screening. © 2013 UICC.

  13. Area-based socioeconomic position and adult glioma: a hierarchical analysis of surveillance epidemiology and end results data.

    PubMed

    Plascak, Jesse J; Fisher, James L

    2013-01-01

    Glioma rates vary by demographic factors and geo-political boundaries and this variation suggests higher glioma rates in groups of higher socioeconomic position. The primary goal of this analysis is to investigate the relationship between glioma and county socioeconomic position using U.S. Surveillance Epidemiology and End Results (SEER) data. Cases were individuals 25+ years diagnosed with glioma between 2000 and 2006 and residing within the SEER-17 catchment area. County-, sex-, race-, age-specific rates were created in order to investigate individual-level associations (population data from U.S. Census 2000). A Bayesian hierarchical Poisson spatial conditionally autoregressive (CAR) model was utilized to simultaneously estimate individual- and county-level associations while controlling for county spatial dependence. Those residing in counties of the second, third, and fourth highest quartiles of socioeconomic position have glioma incidence rates that are 1.10 (95% CI: 1.02,1.19), 1.11 (95% CI: 1.02,1.20), 1.14 (95% CI: 1.05,1.23) times that of the first quartile, respectively. A CAR model properly controlled for error spatial dependence. Investigated lag times suggest year 2000 census data yields superior model fit. Demographically adjusted rates of glioma are elevated in counties of higher socioeconomic position. More well-grounded theory concerning the glioma-socioeconomic position association along with socioeconomic data collected at multiple levels is recommended for future studies investigating this relationship.

  14. False data, positive results in neurobiology: moving beyond the epigenetics of blood and saliva samples in mental disorders.

    PubMed

    Cariaga-Martinez, A; Alelú-Paz, R

    2016-12-12

    Many psychiatric diseases are influenced by a set of several genetic and environmental factors that genetics alone cannot explain. Specifically, in schizophrenia and bipolar disorder the absence of consistently replicated genetic effects together with evidence for lasting changes in gene expression after environmental exposures suggest a role of epigenetic mechanisms in its pathophysiological mechanisms. In this field, the presence of positive results could potentially uncover molecular mechanisms of deregulated gene expression in these complex disorders. In this commentary we have reviewed the positive data obtained over the last 5 years from the scientific literature published in PubMed and we have shown that these results are based on peripheral samples (blood, saliva and other fluids) that do not allow us to obtain reliable and/or valid results, under any circumstances. Finally, we highlight the need to employ human brain samples in the epigenetic study of mental disorders.

  15. Probing indiscretions: contamination of cardiac troponin reagent by very high patient samples causes false-positive results.

    PubMed

    Gould, Michael J; Wilgen, Urs; Pretorius, Carel J; Ungerer, Jacobus P J

    2012-07-01

    Cardiac troponin (cTn) has become the standard biomarker for the diagnosis of acute coronary syndromes. False-positive cTnI results have previously been reported on the Beckman Coulter analysers, which were shown to be random, not reproducible and occurred more commonly than expected. Our investigation ensued after a patient sample with an inordinately elevated cTnI was analysed, followed by a series of false-positive results being reported. The implications of falsely elevated cTnI results on patient care could be considerable. Multiple experiments with patient sample pools with concentrations below the 99th percentile to extremely high (0.025, 15, 175 and 884 μg/L) were conducted in varying sequences of high and low samples on the Beckman Coulter Access2, UniCel DxI600 and UniCel DxI800 analysers. Our results demonstrate a significant increase in cTnI concentrations in the negative pool after analysis of high pool samples in various sequences. This increase is sufficient to cause elevations above the 99th percentile cut-off and false-positive cTnI results. These findings were reproducible on all three analysers. Our study is highly suggestive of carryover and cTnI reagent pack contamination by the pipettors on the Access2, DxI600 and DxI800 analysers when patient samples with extremely high cTnI concentrations are analysed, leading to potential false-positive cTnI results on subsequent samples.

  16. Performance of 14 rubella IgG immunoassays on samples with low positive or negative haemagglutination inhibition results.

    PubMed

    Huzly, Daniela; Hanselmann, Ingeborg; Neumann-Haefelin, Dieter; Panning, Marcus

    2016-01-01

    Rubella IgG testing is routinely done in prenatal care and seroepidemiological studies. Recently concern was raised that seropositivity rates were decreasing questioning vaccination policies. Manufacturers of rubella IgG assays and authors of seroepidemiological studies use different cut-offs for the definition of seropositivity. As rubella virus circulation is reduced since many years, seronegativity rates might be overestimated using an inappropriate cut-off. Using different cut-off definitions we compared fourteen current rubella IgG immunoassays for sensitivity and qualitative result concordance in samples with low positive or negative haemagglutination inhibition (HI) titre. 150 clinical samples from patients and health care workers were included in the study. All samples were measured in 14 different rubella IgG immunoassays. Seropositivity was defined using recombinant rubella IgG immunoblot as reference standard. The concordance of qualitative results using the manufacturers cut-off definitions was 56.4% if grey-zone results were analysed separately and 69.8% if grey-zone results were defined as positive. Using universal cut-offs of 10 IU/ml or 15 IU/ml the concordance was 70% and 61.4% respectively. Using the different cut-off definitions up to 71 out of the 124 immunoblot-positive samples tested negative in the immunoassays. The mean coefficient of variation (CV) of quantitative results in positive samples was 51% (range 19-113%). Determination of rubella immunity by measurement of rubella-IgG in a population with high vaccination coverage with current assays leads to a high number of false negative results. The value of routine rubella antibody testing in countries with high vaccination coverage should be discussed. Copyright © 2015 Elsevier B.V. All rights reserved.

  17. A custom-made guide-wire positioning device for hip surface replacement arthroplasty: description and first results.

    PubMed

    Raaijmaakers, Martijn; Gelaude, Frederik; De Smedt, Karla; Clijmans, Tim; Dille, Jeroen; Mulier, Michiel

    2010-07-14

    Hip surface replacement arthroplasty (SRA) can be an alternative for total hip arthroplasty. The short and long-term outcome of hip surface replacement arthroplasty mainly relies on the optimal size and position of the femoral component. This can be defined before surgery with pre-operative templating. Reproducing the optimal, templated femoral implant position during surgery relies on guide wire positioning devices in combination with visual inspection and experience of the surgeon. Another method of transferring the templated position into surgery is by navigation or Computer Assisted Surgery (CAS). Though CAS is documented to increase accurate placement particularly in case of normal hip anatomy, it requires bulky equipment that is not readily available in each centre. A custom made neck jig device is presented as well as the results of a pilot study. The device is produced based on data pre-operatively acquired with CT-scan. The position of the guide wire is chosen as the anatomical axis of the femoral neck. Adjustments to the design of the jig are made based on the orthopedic surgeon's recommendations for the drill direction. The SRA jig is designed as a slightly more-than-hemispherical cage to fit the anterior part of the femoral head. The cage is connected to an anterior neck support. Four knifes are attached on the central arch of the cage. A drill guide cylinder is attached to the cage, thus allowing guide wire positioning as pre-operatively planned. Custom made devices were tested in 5 patients scheduled for total hip arthroplasty. The orthopedic surgeons reported the practical aspects of the use of the neck-jig device. The retrieved femoral heads were analyzed to assess the achieved drill place in mm deviation from the predefined location and orientation compared to the predefined orientation. The orthopedic surgeons rated the passive stability, full contact with neck portion of the jig and knife contact with femoral head, positive. There were no guide

  18. Quantitative hepatitis B core antibody levels in the natural history of hepatitis B virus infection.

    PubMed

    Song, L-W; Liu, P-G; Liu, C-J; Zhang, T-Y; Cheng, X-D; Wu, H-L; Yang, H-C; Hao, X-K; Yuan, Q; Zhang, J; Kao, J-H; Chen, D-S; Chen, P-J; Xia, N-S

    2015-02-01

    We previously demonstrated that pretreatment quantitative anti-hepatitis B core protein (qAnti-HBc) levels can predict the treatment response for both interferon and nucleoside analogue therapy, but the characteristics of qAnti-HBc during chronic hepatitis B virus (HBV) infection remain poorly understood. To understand this issue, the qAnti-HBc levels were evaluated in individuals with past HBV infection, occult HBV infection and chronic HBV infection in the immune tolerance phase, immune clearance phase, low-replicative phase and hepatitis B e antigen (HBeAg)-negative hepatitis phase. Individuals with hepatitis B surface antigen (n = 598, 3.74 ± 0.90 log10 IU/mL) had significantly higher (p < 0.001, approximately 1000-fold) serum qAnti-HBc levels than those who had occult HBV, and serum qAnti-HBc levels were significantly higher in the occult HBV group than in the past HBV infection group (p < 0.001). qAnti-HBc levels were positively correlated with alanine aminotransferase levels (R = 0.663, p < 0.001), and subjects with an abnormal alanine aminotransferase level had a higher qAnti-HBc level (p < 0.001). Serum qAnti-HBc level varied in different phases of HBV infection, as determined by host immune status. Serum qAnti-HBc level is strongly associated with hepatitis activity in subjects with chronic HBV infection. Copyright © 2014 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  19. [False positive result in mammography and its association with the presence of obesity: a case-control study].

    PubMed

    Castro-Ibarra, Marisela; Menchaca-Díaz, Rufino; Cabrales-Ruvalcaba, J Jesús; Luna-V Gómez, Rosa Alicia

    2016-01-01

    To analyze the association between a false positive result in mammography and obesity, inside the breast cancer early detection program in women affiliated to the Institute of Security and Social Services for Government and Municipality workers of the State of Baja California (ISSSTECALI). A case-control, retrospective study was done in women affiliated to ISSSTECALI to whom a mammography was performed between 2009 and 2012. Women with a false positive result in mammography were included as cases. Controls were women with a true negative result in mammography. Three controls were randomly selected for each case. Obesity was established with the body mass index (BMI) consigned in the woman's clinical file. Age and estrogen replacement therapy were included as co-variables. Seventy nine cases were identified and 237 controls were included. Obesity was observed in 54.4% of cases and in 41.3% of controls (odds ratio: 1.69; 95% confidence interval for odds ratio: 1.01-2.82; p value: 0.043). A logistic regression model including covariables maintained the observed association (p = 0.044). No association was found with analyzed co-variables. A false positive result in mammography was associated with the presence of obesity.

  20. Neisseria Species Identification Assay for the Confirmation of Neisseria gonorrhoeae-Positive Results of the COBAS Amplicor PCR▿

    PubMed Central

    Mangold, Kathy A.; Regner, MaryAnn; Tajuddin, Mohammed; Tajuddin, Aamair M.; Jennings, Lawrence; Du, Hongyan; Kaul, Karen L.

    2007-01-01

    Screening assays for Neisseria gonorrhoeae exhibit low positive predictive values, particularly in low-prevalence populations. A new real-time PCR assay that detects and identifies individual Neisseria spp. using melt curve analysis was compared to two previously published supplementary assays. NsppID, a 16S rRNA real-time PCR/melt curve assay developed to distinguish N. gonorrhoeae from other Neisseria spp., was compared to real-time PCR assays targeting genes reportedly specific for N. gonorrhoeae, the cppB gene and the porA pseudogene. A total of 408 clinical specimens (324 female endocervical swabs and 84 male urine or urogenital swab specimens) were screened using the COBAS Amplicor assay for Chlamydia trachomatis and N. gonorrhoeae (CT/NG) (Roche Diagnostics, Indianapolis, IN) followed by confirmatory testing via real-time PCR. The NsppID assay detected Neisseria spp. in 150/181 COBAS-positive specimens (82%), including six dual infections, and identified N. gonorrhoeae in 102 (56%) specimens. Sixty-nine of 181 (38%) specimens were positive for N. gonorrhoeae by porA pseudogene, and 115/181 (64%) were positive for cppB. However, cppB was also positive in 15% of COBAS-negative specimens, more than either NsppID (4%) or porA pseudogene (2%) assays. The porA pseudogene assay had the highest specificity for both genders but the lowest sensitivity, especially in female specimens. NsppID had a slightly lower specificity but greater sensitivity and overall accuracy. The least desirable confirmatory assay was cppB, due to poor specificity. The NsppID assay is an accurate confirmatory assay for N. gonorrhoeae detection. In addition, the NsppID assay can identify the non-N. gonorrhoeae species responsible for the majority of false-positive results from the COBAS Amplicor CT/NG assay. PMID:17360838

  1. Preliminary results of a laboratory study of positive streamer discharges from vapor-grown ice crystals subjected to electric fields

    NASA Astrophysics Data System (ADS)

    Petersen, D.; Bailey, M.

    2008-12-01

    The initiation of lightning remains a subject of ongoing scientific debate, due in large part to a lack of sufficiently detailed observations. Recently, theoretical descriptions of lightning initiation have focused on the problem of the relatively weak thundercloud electric field by proposing physical processes, primarily those associated with runaway breakdown, whereby this weak field might be significantly boosted. While hypothesis that runaway breakdown is necessary for lightning initiation is compelling, it cannot be considered complete as the transition to lightning leader is not a trivial step. Such a transition must involve processes capable of converting the diffuse electric field energy into a hot leader channel. Such processes likely include the streamer discharge as an element, with such streamers possibly originating as corona discharges on nearby hydrometeors. Of interest to this study is the positive streamer discharge on an ice hydrometeor. We present preliminary results of a laboratory investigation of positive streamer discharges on vapor-grown ice crystals that were subjected to electric fields while growing in a water vapor diffusion chamber. The resulting data shows the electric fields required for generating single and multiple positive streamer discharges as a function of ice crystal habit, size and temperature and ambient air pressure. These results provide useful information for investigating the role of hydrometeor-generated streamer discharges in the lightning initiation event.

  2. Knowledge, attitudes and practices of HIV-positive patients regarding disclosure of HIV results at Betesda Clinic in Namibia

    PubMed Central

    2013-01-01

    Abstract Background This study examined the practices, knowledge, attitudes, and the reasons for disclosure and non-disclosure of HIV-positive patients with regard to the disclosure of HIV results at Betesda Clinic in Windhoek, Namibia. Objectives The objectives of the study were to determine knowledge, attitudes, and practices of HIV-positive patients regarding the disclosure of HIV status at Betesda Clinic in Namibia, and to determine the reasons for disclosure and non-disclosure. Methods This was a cross-sectional descriptive study and 263 HIV-positive patients were enrolled in the study. Results Analyses revealed that knowledge on disclosure was good, with 68% who thought it was important. The majority (73%) have disclosed and 60% disclosed within 1 week of receiving their results. The most common reasons for disclosure were that 32% needed help, 25% wanted his or her partner to go for testing, and 20% wanted to let relatives know. Reasons for non-disclosure were mainly the fear of gossip (79%). Seventy-three per cent had disclosed to their partners, and 23% had disclosed to more than one person. People's reactions were supportive in 43%, whereas 29% understood, 9% accepted and 6% were angry. Upon disclosure 40% received help, 24% of partners were tested, 23% received psychological support and 5% were stigmatised. Disclosure was higher amongst the married and cohabitating. Conclusion The attitude was positive with regard to knowledge of disclosure, with most participants thinking that disclosure was important and good. The attitudes and actual practices of disclosure were encouraging; however, people are disclosing only to trusted individuals in the society and the fear of stigma is still present although the actual stigma was very low.

  3. Differential Global Positioning System for the Surface-Towed Ordnance Locating System: Testing, results, and user`s guide

    SciTech Connect

    Stewart, T.L.; Hubbard, C.W.

    1993-10-01

    Researchers at Pacific Northwest Laboratory integrated and tested a Global Positioning System (GPS) for use with the Naval Explosive Ordnance Disposal Technology Center`s (NEODTC) Surface-Towed Ordnance Locating System (STOLS). The GPS automatically and continuously provides latitude, longitude, and elevation information at the mobile GPS unit. The results of testing the GPS are shown in this report. The results reveal accuracies in the submeter range in real time and within a few centimeters using post-processing software. A description of hardware and software components is also included, along with system drawings and parts lists.

  4. [False positive results or what's the probability that a significant P-value indicates a true effect?

    PubMed

    Cucherat, Michel; Laporte, Silvy

    2017-05-08

    The use of statistical test is central in the clinical trial. At the statistical level, obtaining a P<0.05 allows to claim the effectiveness of the new studied treatment. However, given its underlying mathematical logic the concept of "P value" is often misinterpreted. It is often assimilated, mistakenly, to the likelihood that treatment is ineffective. Actually the "P value" gives an indirect information about the plausibility of the existence of treatment effect. With "P<0.05", the probability that the treatment is effective may vary depending on other statistical parameters which are the alpha level of risk, the power of the study and especially the a priori probability of the existence of treatment effect. A "P<0.05" does not always produce the same degree of certainty. Thus there exist situations where the risk of a result "P<0.05" is in reality a false positive is very high. This is the case if the power is low, if there is an inflation of the alpha risk or if the result is exploratory or chance discoveries. This possibility is important to take into consideration when interpreting the results of clinical trials in order to avoid pushing ahead significant results in appearance, but which are likely to be actually false positive results. Copyright © 2017 Société française de pharmacologie et de thérapeutique. Published by Elsevier Masson SAS. All rights reserved.

  5. A nonnatural head-neck position (Rollkur) during training results in less acute stress in elite, trained, dressage horses.

    PubMed

    van Breda, Eric

    2006-01-01

    This study measured parameters of stress in recreational, trained horses (REC; n = 7) and elite (International Grand Prix level) trained, dressage horses (DRES; n = 5). The training of the DRES horses uses an unnatural head-neck position (Rollkur), whereas in the REC horses such training techniques are not common. The study measured stress by using heart rate variability analysis for 30 min postfeeding in the morning and 30 min postexercise after a morning training session. The study found no significant difference at rest between the REC and DRES horses. During the posttraining measurements, however, the DRES horses showed, among others, a less sympathetic and increased parasympathetic dominance. These results suggest that DRES horses tend to have less acute stress than do REC horses postexercise. The findings of this study suggest maintaining the health and well-being of DRES horses despite nonnatural, biomechanical positions.

  6. Occult hepatitis B virus infection in the setting of hepatitis C virus (HCV) and human immunodeficiency virus (HIV) co-infection: clinically relevant or a diagnostic problem?

    PubMed

    Rodríguez-Torres, M; Gonzalez-Garcia, J; Bräu, N; Solá, R; Moreno, S; Rockstroh, J; Smaill, F; Mendes-Correa, M C; DePamphilis, J; Torriani, F J

    2007-06-01

    The clinical relevance of occult hepatitis B virus (HBV) infection, defined as detectable HBV DNA serum/liver, in the absence of hepatitis B surface antigen (HBsAg), is unclear. We determined the prevalence of serum occult HBV infection in HIV/HCV co-infected patients enrolled in APRICOT, a randomized multinational trial that investigated the efficacy and safety of peginterferon alfa-2a (40 kDa) plus ribavirin for treatment of HCV. We also examined the effect of prior HBV exposure to liver histology at baseline. Only HBsAg-negative patients were eligible. At screening, serum HBV DNA was assessed by commercial assay (detection limit = 200 copies/mL). Patients were divided into four serological groups: anti-HBs+/anti-HBc+; anti-HBs-/anti-HBc+; anti-HBs+/ anti-HBc-; anti-HBs-/anti-HBc-. Baseline liver biopsy grade and stage were compared among groups. Serum HBV DNA was undetectable in all patients, (n = 866). Results of anti-HBs and anti-HBc was available for 176 patients: 60 (34.1%) anti-HBs+/anti-HBc+; 60 (34.1%) anti-HBs-/anti-HBc+; 11 (6.3%) anti-HBs+/anti-HBc-; 45 (25.6%) anti-HBs-/anti-HBc-. There were no differences among the groups in the histological grade or stage at baseline liver biopsies. Occult HBV infection in serum was not detected in this large immunocompetent cohort. Moreover, prior exposure to HBV did not appear to have any affect on baseline liver histology.

  7. Hepatitis B (HBV), Hepatitis C (HCV) and Hepatitis Delta (HDV) Viruses in the Colombian Population—How Is the Epidemiological Situation?

    PubMed Central

    Alvarado-Mora, Mónica Viviana; Gutierrez Fernandez, María Fernanda; Gomes-Gouvêa, Michele Soares; de Azevedo Neto, Raymundo Soares; Carrilho, Flair José; Pinho, João Renato Rebello

    2011-01-01

    Background Viral hepatitis B, C and delta still remain a serious problem worldwide. In Colombia, data from 1980s described that HBV and HDV infection are important causes of hepatitis, but little is known about HCV infection. The aim of this study was to determine the currently frequency of HBV, HCV and HDV in four different Colombian regions. Methodology/Principal Findings This study was conducted in 697 habitants from 4 Colombian departments: Amazonas, Chocó, Magdalena and San Andres Islands. Epidemiological data were obtained from an interview applied to each individual aiming to evaluate risk factors related to HBV, HCV or HDV infections. All samples were tested for HBsAg, anti-HBc, anti-HBs and anti-HCV markers. Samples that were positive to HBsAg and/or anti-HBc were tested to anti-HDV. Concerning the geographical origin of the samples, the three HBV markers showed a statistically significant difference: HBsAg (p = 0.033) and anti-HBc (p<0.001) were more frequent in Amazonas and Magdalena departments. Isolated anti-HBs (a marker of previous vaccination) frequencies were: Chocó (53.26%), Amazonas (32.88%), Magdalena (17.0%) and San Andrés (15.33%) - p<0.001. Prevalence of anti-HBc increased with age; HBsAg varied from 1.97 to 8.39% (p = 0.033). Amazonas department showed the highest frequency for anti-HCV marker (5.68%), while the lowest frequency was found in San Andrés Island (0.66%). Anti-HDV was found in 9 (5.20%) out of 173 anti-HBc and/or HBsAg positive samples, 8 of them from the Amazonas region and 1 from them Magdalena department. Conclusions/Significance In conclusion, HBV, HCV and HDV infections are detected throughout Colombia in frequency levels that would place some areas as hyperendemic for HBV, especially those found in Amazonas and Magdalena departments. Novel strategies to increase HBV immunization in the rural population and to strengthen HCV surveillance are reinforced by these results. PMID:21559488

  8. Do positive or negative experiences of social support relate to current and future health? Results from the Doetinchem Cohort Study

    PubMed Central

    2012-01-01

    Background Cross-sectional studies have reported associations between social support and health, but prospective evidence is less conclusive. This study aims to investigate the associations of positive and negative experiences of social support with current and future lifestyle factors, biological risk factors, self-perceived health and mental health over a 10-year period. Methods Data were from 4,724 Dutch men and women aged 26-65 years who participated in the second (1993-1997) and in the third (1998-2002) or fourth (2003-2007) study round of the Doetinchem Cohort Study. Social support was measured at round two using the Social Experiences Checklist. Health was assessed by several indicators such as smoking, alcohol consumption, physical activity, fruit and vegetable intake, overweight, hypertension, hypercholesterolemia, self-perceived health and mental health. Tertiles of positive and negative experiences of social support were analysed in association with repeated measurements of prevalence and incidence of several health indicators using generalised estimating equations (GEE). Results Positive and negative experiences of social support were associated with prevalence and incidence of poor mental health. For the lowest tertile of positive support, odds ratios were 2.74 (95% CI 2.32-3.23) for prevalent poor mental health and 1.86 (95% CI 1.39-2.49) for incident poor mental health. For the highest tertile of negatively experienced support, odds ratios for prevalent and incident poor mental health were 3.28 (95% CI 2.78-3.87) and 1.60 (95% CI 1.21-2.12), respectively. Low levels of positive experiences of social support were also associated with low current intake of fruits and vegetables, but not with future intake. Negative experiences of social support were additionally associated with current smoking, physical inactivity, overweight and poor self-perceived health. Furthermore, high levels of negative experiences of social support were associated with future

  9. Factors associated with false-positive results from fingerstick OraQuick ADVANCE rapid HIV 1/2 antibody test.

    PubMed

    Rifkin, Samara B; Owens, Lauren E; Greenwald, Jeffrey L

    2012-01-01

    Identify factors associated with false-positive rapid HIV antibody tests. This retrospective cohort study with nested case-controls involved patients tested for HIV by Boston Medical Center (BMC) affiliates. Cases had a reactive fingerstick OraQuick ADVANCE rapid HIV 1/2 antibody test and a negative Western blot. Controls had nonreactive rapid tests. We compared the prevalence of HIV risk factors between cases and the total nonreactive population and the prevalence of other clinical factors between cases and controls. Of the 15 094 tests, 14 937 (98.9%) were negative and 11 (0.07%) were false positives (specificity of 99.9%). Cases were more likely to have had an HIV-infected sex partner and to be tested at certain sites compared to true negatives. More cases than controls had O-negative blood type. O-negative blood type and sex with an HIV-infected person may increase false-positive HIV fingerstick results. More targeted studies should examine these risk factors.

  10. [Setting the preferential retinal locus. Part 1. Analysis of the rehabilitation results as a function of positioning].

    PubMed

    Riss-Jayle, M; Giorgi, R; Barthes, A

    2008-03-01

    The aim of this study was to compare the various positions of preferred retinal locus (PRL) with the results of low vision rehabilitation to reading in view to elucidate the mechanisms involved. We studied 100 visually impaired subjects who came to the center for rehabilitation of low vision. The technique is based on a scanning laser ophthalmoscope recording, compared with angiofluorographic pictures to obtain the PRL position with respect to the fovea. It is shown that unsuccessful rehabilitations are not related to the eccentricity or to the angular value of the PRL but are only correlated to its absence. The difficulties that arise from the multiplicity of the PRL or from the confinement of the fovea by an annular scotoma can be overcome with the help of rehabilitation. The upper and right positions are manifestly dominant, but they do not favor reading or writing. We believe that their purpose is to favor the integration of the new visual message of visually impaired people to facilitate their daily life activities. Therefore, using one or another of these peexisting PRL during eccentric viewing training should be preferred.

  11. Psychological effects of false-positive results in cystic fibrosis newborn screening: a two-year follow-up.

    PubMed

    Beucher, Julie; Leray, Emmanuelle; Deneuville, Eric; Roblin, Monique; Pin, Isabelle; Bremont, François; Turck, Dominique; Giniès, Jean-Louis; Foucaud, Pascal; Rault, Gilles; Derelle, Jocelyne; David, Valérie; Journel, Hubert; Marchand, Sophie; Veillard, David; Roussey, Michel

    2010-05-01

    To evaluate parental stress after a false-positive result at the time of the cystic fibrosis (CF) newborn screening (NBS), attributable to heterozygotism or persistent hypertrypsinemia. A prospective study was conducted in 86 French families at 3, 12, and 24 months after NBS. A psychologist conducted interviews with a questionnaire, the Perceived Stress Scale, and the Vulnerable Child Scale. Overall, 96.5% of parents said they had been anxious at the time of the sweat test. However, 86% felt entirely reassured 3 months after the test. The mean Perceived Stress Scale score did not differ from that observed in the French population. Mean Vulnerable Child Scale scores were high, associated with a low Parental Perception of Child Vulnerability. These results did not differ significantly at 1 and 2 years. In total, 86% to 100% of families no longer worried about CF. All parents stated that they would have the test performed again for another child. CF NBS can lead to false-positive results, causing parental anxiety, which quickly decreases after a sweat test performed soon after the phone call.

  12. Prevalence and risk factors of hepatitis B and C virus infections in an impoverished urban community in Dhaka, Bangladesh

    PubMed Central

    2010-01-01

    Background Viral hepatitis is a serious global public health problem affecting billions of people globally, and both hepatitis B virus (HBV) and hepatitis C virus (HCV) infections are rapidly spreading in the developing countries including Bangladesh due to the lack of health education, poverty, illiteracy and lack of hepatitis B vaccination. Also there is lack of information on their prevalence among the general population. So, a population-based serological survey was conducted in Dhaka to determine the prevalence and risk factors of HBV and HCV infections. Methods Healthy individuals were selected for demographic and behavioural characteristics by stratified cluster sampling and blood tested for hepatitis B surface antigen (HBsAg), antibody to HBV core antigen (anti-HBc), and anti-HCV antibodies (anti-HCV). Results From June 2005-November 2006, 1997 participants were screened for HBsAg, anti-HBc and anti-HCV, 738 (37%) were males with mean (SD) age of 24 (14) years. HBV-seropositivity was documented in 582 (29%) participants: 14 (0.7%) were positive for HBsAg, 452 (22.6%) for anti-HBc and 116 (5.8%) for both HBsAg and anti-HBc. Four (0.2%) participants were positive for anti-HCV, and another five (0.3%) for both anti-HBc and anti-HCV. Ninety-six/246 (39%) family members residing at same households with HBsAg positive participants were also HBV-seropositive [74 (30.1%) for anti-HBc and 22 (8.9%) for both HBsAg and anti-HBc], which was significantly higher among family members (39%) than that of study participants (29%) (OR 1.56; p < 0.001). In bivariate analysis, HBV-seropositivity was significantly associated with married status (OR 2.27; p < 0.001), history of jaundice (OR 1.35; p = 0.009), surgical operations (OR 1.26; p = 0.04), needle-stick injuries (OR 2.09; p = 0.002), visiting unregistered health-care providers (OR 1.40; p = 0.008), receiving treatment for sexually transmitted diseases (STD) (OR 1.79; p = 0.001), animal bites (OR 1.73; p < 0.001); ear

  13. Prevalence and risk factors of hepatitis B and C virus infections in an impoverished urban community in Dhaka, Bangladesh.

    PubMed

    Ashraf, Hasan; Alam, Nur H; Rothermundt, Christian; Brooks, Abdullah; Bardhan, Pradip; Hossain, Lokman; Salam, Mohammed A; Hassan, Mohammed S; Beglinger, Christoph; Gyr, Niklaus

    2010-07-15

    Viral hepatitis is a serious global public health problem affecting billions of people globally, and both hepatitis B virus (HBV) and hepatitis C virus (HCV) infections are rapidly spreading in the developing countries including Bangladesh due to the lack of health education, poverty, illiteracy and lack of hepatitis B vaccination. Also there is lack of information on their prevalence among the general population. So, a population-based serological survey was conducted in Dhaka to determine the prevalence and risk factors of HBV and HCV infections. Healthy individuals were selected for demographic and behavioural characteristics by stratified cluster sampling and blood tested for hepatitis B surface antigen (HBsAg), antibody to HBV core antigen (anti-HBc), and anti-HCV antibodies (anti-HCV). From June 2005-November 2006, 1997 participants were screened for HBsAg, anti-HBc and anti-HCV, 738 (37%) were males with mean (SD) age of 24 (14) years. HBV-seropositivity was documented in 582 (29%) participants: 14 (0.7%) were positive for HBsAg, 452 (22.6%) for anti-HBc and 116 (5.8%) for both HBsAg and anti-HBc. Four (0.2%) participants were positive for anti-HCV, and another five (0.3%) for both anti-HBc and anti-HCV. Ninety-six/246 (39%) family members residing at same households with HBsAg positive participants were also HBV-seropositive [74 (30.1%) for anti-HBc and 22 (8.9%) for both HBsAg and anti-HBc], which was significantly higher among family members (39%) than that of study participants (29%) (OR 1.56; p < 0.001). In bivariate analysis, HBV-seropositivity was significantly associated with married status (OR 2.27; p < 0.001), history of jaundice (OR 1.35; p = 0.009), surgical operations (OR 1.26; p = 0.04), needle-stick injuries (OR 2.09; p = 0.002), visiting unregistered health-care providers (OR 1.40; p = 0.008), receiving treatment for sexually transmitted diseases (STD) (OR 1.79; p = 0.001), animal bites (OR 1.73; p < 0.001); ear-nose-body piercing in females

  14. SU-E-J-94: Positioning Errors Resulting From Using Bony Anatomy Alignment for Treating SBRT Lung Tumor

    SciTech Connect

    Frame, C; Ding, G

    2014-06-01

    Purpose: To quantify patient setups errors based on bony anatomy registration rather than 3D tumor alignment for SBRT lung treatments. Method: A retrospective study was performed for patients treated with lung SBRT and imaged with kV cone beam computed tomography (kV-CBCT) image-guidance. Daily CBCT images were registered to treatment planning CTs based on bony anatomy alignment and then inter-fraction tumor movement was evaluated by comparing shift in the tumor center in the medial-lateral, anterior-posterior, and superior-inferior directions. The PTV V100% was evaluated for each patient based on the average daily tumor displacement to assess the impact of the positioning error on the target coverage when the registrations were based on bony anatomy. Of the 35 patients studied, 15 were free-breathing treatments, 10 used abdominal compression with a stereotactic body frame, and the remaining 10 were performed with BodyFIX vacuum bags. Results: For free-breathing treatments, the range of tumor displacement error is between 1–6 mm in the medial-lateral, 1–13 mm in the anterior-posterior, and 1–7 mm in the superior-inferior directions. These positioning errors lead to 6–22% underdose coverage for PTV - V100% . Patients treated with abdominal compression immobilization showed positional errors of 0–4mm mediallaterally, 0–3mm anterior-posteriorly, and 0–2 mm inferior-superiorly with PTV - V100% underdose ranging between 6–17%. For patients immobilized with the vacuum bags, the positional errors were found to be 0–1 mm medial-laterally, 0–1mm anterior-posteriorly, and 0–2 mm inferior-superiorly with PTV - V100% under dose ranging between 5–6% only. Conclusion: It is necessary to align the tumor target by using 3D image guidance to ensure adequate tumor coverage before performing SBRT lung treatments. The BodyFIX vacuum bag immobilization method has the least positioning errors among the three methods studied when bony anatomy is used for

  15. Specific chemoluminescence and immunoasdorption tests for anti-DFS70 antibodies avoid false positive results by indirect immunofluorescence.

    PubMed

    Bizzaro, Nicola; Tonutti, Elio; Tampoia, Marilina; Infantino, Maria; Cucchiaro, Francesco; Pesente, Fiorenza; Morozzi, Gabriella; Fabris, Martina; Villalta, Danilo

    2015-12-07

    To evaluate two new diagnostic methods for the identification of anti-DFS70 antibodies in samples showing a DFS70-staining pattern by indirect immunofluorescence (IIF). We studied 731 patients: 576 were collected consecutively among those that in the ANA test on HEp-2 cells had produced a DFS70 fluorescence pattern and 155 were a consecutive series of patients sent by referring physicians for routine ANA testing. As controls we studied 50 patients with autoimmune diseases and 120 patients with active infectious disease. All 731 sera were assayed for anti-DFS70 antibodies by a specific chemoluminescence assay (CLIA); 70 randomly selected IIF-positive sera and 35 samples from patients with autoimmune diseases were studied by inhibition tests using the HEp-2 Select method. Assays performed with the CLIA-DFS70 method were positive in 30.4% of the samples presenting a DFS70 pattern by IIF, in 1.3% of the routine ANA sera, in 1.6% of the infectious sera and in none of the 50 autoimmune controls. However, as the IIF-DFS70 positive group included 106 patients with systemic autoimmune rheumatic diseases (SARD), 11 of which were DFS70 positive by CLIA, the prevalence of DFS70 antibodies in SARD was 7.5%. The ANA test performed after the use of HEp-2 Select showed an inhibition in 95.7% of the sera. No change in fluorescence intensity and pattern morphology between the native sera and the same sera tested with the solution containing the DFS70 antigen was observed in the 35 samples from patients with autoimmune diseases. To avoid misinterpretation of ANA pattern and consequent diagnostic errors, confirmation of the DFS70-IIF pattern by CLIA or other specific methods is mandatory before reporting the presence of anti-DFS70 antibodies. The HEp-2 Select test in most cases eliminates the interference by anti-DFS70 antibodies and avoids the possible reporting of false positive results. Copyright © 2015 Elsevier B.V. All rights reserved.

  16. A Study of HPV Typing for the Management of HPV-Positive ASC-US Cervical Cytologic Results

    PubMed Central

    Schiffman, Mark; Vaughan, Laurence; Raine-Bennett, Tina R.; Castle, Philip E.; Katki, Hormuzd A.; Gage, Julia C.; Fetterman, Barbara; Befano, Brian; Wentzensen, Nicolas

    2015-01-01

    Background In US cervical screening, immediate colposcopy is recommended for women with HPV-positive ASC-US (equivocal) cytology. We evaluated whether partial typing by Onclarity™ (BD) might identify HPV-positive women with low enough CIN3+ risk to permit 1-year follow-up instead. Methods The NCI-Kaiser Permanente Northern California Persistence and Progression Cohort includes a subset of 13,890 women aged 21+ with HC2 (Qiagen)-positive ASC-US at enrollment; current median follow-up is 3.0 years. Using stratified random sampling, we typed 2,079 archived enrollment specimens including 329 women subsequently diagnosed with CIN3+, 563 with CIN2, and 1,187 with Results The 3-year CIN3+ risk for all HC2-positive women with ASC-US was 5.2%; this establishes the “benchmark” risk for colposcopic referral. Hierarchically, 3-year cumulative risks for each typing channel were 16.0% for HPV16, 7.4% for HPV18, 7.0% for HPV31, 7.1% for grouped HPV33/58, 4.4% for HPV52, 3.9% for HPV45, 2.7% for HPV51, 1.6% for HPV39/68/35, and 1.3% for HPV59/56/66. Discussion ASC-US linked to HPV16, HPV18, HPV31, or HPV33/58 warrants immediate colposcopy. Optimal management of women with HPV52 or HPV45 is uncertain. Risk of women with only HPV51, HPV39/68/35, or HPV59/56/66 might be low enough to recommend 1-year retesting permitting viral clearance. This strategy would defer colposcopy for 40% of women with HPV-positive ASC-US, half of whom would be cotest-negative at 1-year return. Approximately 10% of those with CIN3 diagnosable at enrollment would be delayed 1 year instead. Cost-effectiveness analyses are needed. PMID:26148763

  17. Substantial decline in hepatitis B virus infections following vaccine introduction in Tajikistan

    PubMed Central

    Khetsuriani, Nino; Tishkova, Faina; Jabirov, Shamsidin; Wannemuehler, Kathleen; Kamili, Saleem; Pirova, Zulfiya; Mosina, Liudmila; Gavrilin, Eugene; Ursu, Pavel; Drobeniuc, Jan

    2015-01-01

    Background Tajikistan, considered highly endemic area for hepatitis B virus (HBV) in a pre-vaccine era, introduced hepatitis B vaccine in 2002 and reported ≥80% coverage with three doses of hepatitis B vaccine (HepB3) since 2004. However, the impact of vaccine introduction has not been assessed. Methods We tested residual serum specimens from a 2010 national serosurvey for vaccine-preventable diseases in Tajikistan and assessed the prevalence of HBV infection across groups defined based on the birth cohorts’ routine infant hepatitis B vaccination program implementation and HepB3 coverage achieved (≥80% versus <80%). Serosurvey participants were selected through stratified multi-stage cluster sampling among residents of all regions of Tajikistan aged 1–24 years. All specimens were tested for antibodies against HBV core antigen (anti-HBc) and those found positive were tested for HBV surface antigen (HBsAg). Seroprevalence and 95% confidence intervals were calculated and compared across subgroups using Satterthwaite-adjusted chi-square tests, accounting for the survey design and sampling weights. Results A total of 2188 samples were tested. Prevalence of HBV infection markers was lowest among cohorts with ≥80% HepB3 coverage (ages, 1–6 years): 2.1% (95% confidence interval, 1.1–4.3%) for anti-HBc, 0.4% (0.1–1.3%) for HBsAg, followed by 7.2% (4.1–12.4%) for anti-HBc and 2.1% (0.7–6.1%) for HBsAg among cohorts with <80% HepB3 coverage (ages, 7–8 years), by 12.0% (8.7–16.3%) for anti-HBc and 3.5% (2.2–5.6%) for HBsAg among children’s cohorts not targeted for vaccination (ages, 9–14 years), and 28.9% (24.5–33.8%) for anti-HBc and 6.8% (4.5–10.1%) for HBsAg among unvaccinated adult cohorts (ages, 15–24 years). Differences across groups were significant (p < 0.001, chi-square) for both markers. Conclusions The present study demonstrates substantial impact of hepatitis B vaccine introduction on reducing HBV infections in Tajikistan. To

  18. SU-C-210-06: Quantitative Evaluation of Dosimetric Effects Resulting From Positional Variations of Pancreatic Tumor Volumes

    SciTech Connect

    Yu, S; Sehgal, V; Wei, R; Lawrenson, L; Kuo, J; Hanna, N; Ramsinghani, N; Daroui, P; Al-Ghazi, M

    2015-06-15

    Purpose: The aim of this study is to quantify dosimetric effects resulting from variation in pancreatic tumor position assessed by bony anatomy and implanted fiducial markers Methods: Twelve pancreatic cancer patients were retrospectively analyzed for this study. All patients received modulated arc therapy (VMAT) treatment using fiducial-based Image Guided Radiation Therapy (IGRT) to the intact pancreas. Using daily orthogonal kV and/or Cone beam CT images, the shift needed to co-register the daily pre-treatment images to reference CT from fiducial to bone (Fid-Bone) were recorded as Left-Right (LR), Anterior-Posterior (AP) and Superior-Inferior (SI). The original VMAT plan iso-center was shifted based on KV bone matching positions at 5 evenly spaced fractions. Dose coverage of the planning target volumes (PTVs) (V100%), mean dose to liver, kidney and stomach/duodenum were assessed in the modified plans. Results: A total of 306 fractions were analyzed. The absolute fiducial-bone positional shifts were greatest in the SI direction, (AP = 2.7 ± 3.0, LR = 2.8 ± 2.8, and SI 6.3 ± 7.9 mm, mean ± SD). The V100% was significantly reduced by 13.5%, (Fid-Bone = 95.3 ± 2.0 vs. 82.3 ± 11.8%, p=0.02). This varied widely among patients (Fid-Bone V100% Range = 2–60%), where 33% of patients had a reduction in V100% of more than 10%. The impact on OARs was greatest to the liver (Fid-Bone= 14.6 vs. 16.1 Gy, 10%), and stomach, (Fid-Bone = 23.9 vx. 25.5 Gy, 7%), however was not statistically significant (p=0.10 both). Conclusion: Compared to matching by fiducial markers, matching by bony anatomy would have substantially reduced the PTV coverage by 13.5%. This reinforces the importance of online position verification based on fiducial markers. Hence, implantation of fiducial markers is strongly recommended for pancreatic cancer patients undergoing intensity modulated radiation therapy treatments.

  19. Phenotypic Consequences Resulting from a Methionine-to-Valine Substitution at Position 48 in the HPr Protein of Streptococcus salivarius

    PubMed Central

    Plamondon, Pascale; Brochu, Denis; Thomas, Suzanne; Fradette, Julie; Gauthier, Lucie; Vaillancourt, Katy; Buckley, Nicole; Frenette, Michel; Vadeboncoeur, Christian

    1999-01-01

    In gram-positive bacteria, the HPr protein of the phosphoenolpyruvate:sugar phosphotransferase system (PTS) can be phosphorylated on a histidine residue at position 15 (His15) by enzyme I (EI) of the PTS and on a serine residue at position 46 (Ser46) by an ATP-dependent protein kinase (His∼P and Ser-P, respectively). We have isolated from Streptococcus salivarius ATCC 25975, by independent selection from separate cultures, two spontaneous mutants (Ga3.78 and Ga3.14) that possess a missense mutation in ptsH (the gene encoding HPr) replacing the methionine at position 48 by a valine. The mutation did not prevent the phosphorylation of HPr at His15 by EI nor the phosphorylation at Ser46 by the ATP-dependent HPr kinase. The levels of HPr(Ser-P) in glucose-grown cells of the parental and mutant Ga3.78 were virtually the same. However, mutant cells growing on glucose produced two- to threefold less HPr(Ser-P)(His∼P) than the wild-type strain, while the levels of free HPr and HPr(His∼P) were increased 18- and 3-fold, respectively. The mutants grew as well as the wild-type strain on PTS sugars (glucose, fructose, and mannose) and on the non-PTS sugars lactose and melibiose. However, the growth rate of both mutants on galactose, also a non-PTS sugar, decreased rapidly with time. The M48V substitution had only a minor effect on the repression of α-galactosidase, β-galactosidase, and galactokinase by glucose, but this mutation abolished diauxie by rendering cells unable to prevent the catabolism of a non-PTS sugar (lactose, galactose, and melibiose) when glucose was available. The results suggested that the capacity of the wild-type cells to preferentially metabolize glucose over non-PTS sugars resulted mainly from inhibition of the catabolism of these secondary energy sources via a HPr-dependent mechanism. This mechanism was activated following glucose but not lactose metabolism, and it did not involve HPr(Ser-P) as the only regulatory molecule. PMID:10559156

  20. Meta-analysis of cholecystectomy in symptomatic patients with positive hepatobiliary iminodiacetic acid scan results without gallstones.

    PubMed

    Mahid, Suhal S; Jafri, Nadim S; Brangers, Baylor C; Minor, Kyle S; Hornung, Carlton A; Galandiuk, Susan

    2009-02-01

    To study the clinical results of surgical management in patients with right upper quadrant pain, a positive hepatobiliary iminodiacetic acid (HIDA) scan result, and no gallstones. Health care databases and gray literature. Each article was scrutinized to determine whether it met inclusion criteria. Only abstracts, full articles, and gray literature that passed the detailed screening procedure were included. Case reports, letters, comments, reviews, and abstracts with insufficient details to meet inclusion criteria were excluded. Gallbladder ejection fraction assessed by means other than cholecystokinin HIDA scan were also excluded. Three reviewers independently abstracted the following data from each article: first author, year of publication, journal, type of study, location of study population, institution where the study was conducted, symptoms recorded, imaging modality used to establish the absence of gallstones, HIDA scan ejection fraction, number of cases and controls, number of males and females in each group, method of follow-up, and number of cases lost to follow-up. Ten studies met inclusion criteria (N = 615). Follow-up ranged from 3 to 64 months. Surgical treatment was 15-fold more likely than medical treatment to result in symptom improvement, with 4% of patients reporting no symptom improvement with surgery. Sensitivity analysis in patients with complete symptom relief following surgery revealed an 8-fold greater odds difference than those treated medically (indicating variation in study reporting). Patients without gallstones who have right upper quadrant pain and a positive HIDA scan result are more likely to experience symptom relief following cholecystectomy than those treated medically. There is, however, wide variability in data reporting, particularly with respect to symptom relief and duration of follow-up. Cholecystectomy is indicated in symptomatic patients without gallstones who have a low-ejection fraction HIDA scan.

  1. Can elevated lactate and LDH produce a false positive enzymatic ethanol result in live patients presenting to the emergency department?

    PubMed

    Nacca, Nicholas; Hodgman, Michael J; Lao, Kirselle; Elkins, Matthew; Holland, Michael G

    2017-08-16

    There have been allegations in the courtroom that elevated serum lactic acid in trauma victims can yield a falsely elevated serum ethanol assay. Most hospitals utilize an indirect method of ethanol measurement where a serum sample is added to a mix of alcohol dehydrogenase and oxidized nicotinamide adenine dinucleotide (NAD+). This allows any ethanol in the patient's serum to be metabolized to acetaldehyde, and in the process results in the reduction of NAD + to NADH. NADH is then measured using spectrophotometry. The courtroom allegation stems from the concept that oxidation of lactate to pyruvate by lactate dehydrogenase (LDH) results in the same molar-for-molar reduction of NAD + to NADH, and could therefore theoretically cause patients with elevated lactate and LDH to have a falsely elevated ethanol concentration. Patients with elevated lactic acid and LDH concentrations who presented to a university hospital from 20 April 2015 to 13 December 2015 were identified to provide possible test specimens. If a sufficient amount of serum was available, the sample was used to re-run the lactate and LDH concentration simultaneously with an enzymatic ethanol assay. Any samples that had elevated lactic acid and LDH concentrations on this retesting, and also yielded a positive ethanol concentration, were sent for confirmatory gas chromatography testing of ethanol concentrations. A control group of 20 samples with normal lactate and LDH were included. A total of 37 samples were included in the final analysis. Only 4 patients had an elevated enzymatic ethanol concentration, and all 4 also had a measurable GC ethanol concentration. The lactate in this dataset ranged from 2.4 to 24.2 mmol/L, with a mean of 6.53 mmol/L (normal value 0.5-2.2). The LDH ranged from 242 to 8838 U/L with a mean of 1695 U/L (normal value 122-225 U/L). Twenty control samples were run on patients with normal lactate and LDH, none of which yielded a positive enzymatic ethanol result

  2. Commissioning results of the narrow-band beam position monitor system upgrade in the APS storage ring.

    SciTech Connect

    Singh, O.

    1999-04-20

    When using a low emittance storage ring as a high brightness synchrotron radiation source, it is critical to maintain a very high degree of orbit stability, both for the short term and for the duration of an operational fill. A fill-to-fill reproducibility is an additional important requirement. Recent developments in orbit correction algorithms have provided tools that are capable of achieving a high degree of orbit stability. However, the performance of these feedback systems can be severely limited if there are errors in the beam position monitors (BPMs). The present orbit measurement and correction system at the APS storage ring utilizes 360 broad-band-type BPMs that provide turn-by-turn diagnostics and an ultra-stable orbit: < 1.8 micron rms vertically and 4.5 microns rms horizontally in a frequency band of 0.017 to 30 Hz. The effects of beam intensity and bunch pattern dependency on these BPMs have been significantly reduced by employing offset compensation correction. Recently, 40 narrow-band switching-type BPMs have been installed in the APS storage ring, two in each of 20 operational insertion device straight sections, bringing the total number of beam position monitors to 400. The use of narrow-band BPM electronics is expected to reduce sensitivity to beam intensity, bunch pattern dependence, and long-term drift. These beam position monitors are used for orbit correction/feedback and machine protection interlocks for the insertion device beamlines. The commissioning results and overall performance for orbit stability are provided.

  3. Lateral expansion and carbon exchange of a boreal peatland in Finland resulting in 7000 years of positive radiative forcing

    NASA Astrophysics Data System (ADS)

    Mathijssen, Paul J. H.; Kähkölä, Noora; Tuovinen, Juha-Pekka; Lohila, Annalea; Minkkinen, Kari; Laurila, Tuomas; Väliranta, Minna

    2017-03-01

    Data on past peatland growth patterns, vegetation development, and carbon (C) dynamics during the various Holocene climate phases may help us to understand possible future climate-peatland feedback mechanisms. In this study, we analyzed and radiocarbon dated several peat cores from Kalevansuo, a drained bog in southern Finland. We investigated peatland succession and C dynamics throughout the Holocene. These data were used to reconstruct the long-term atmospheric radiative forcing, i.e., climate impact of the peatland since initiation. Kalevansuo peat records revealed a general development from fen to bog, typical for the southern boreal zone, but the timing of ombrotrophication varied in different parts of the peatland. Peat accumulation patterns and lateral expansion through paludification were influenced by fires and climate conditions. Long-term C accumulation rates were overall lower than the average values found from literature. We suggest the low accumulation rates are due to repeated burning of the peat surface. Drainage for forestry resulted in a nearly complete replacement of typical bog mosses by forest species within 40 years after drainage. The radiative forcing reconstruction suggested positive values (warming) for the first 7000 years following initiation. The change from positive to negative forcing was triggered by an expansion of bog vegetation cover and later by drainage. The strong relationship between peatland area and peat type with radiative forcing suggests a possible feedback for future changing climate, as high-latitude peatlands may experience prominent regime shifts, such as fen to bog transitions.

  4. A grounded theory of positive youth development through sport based on results from a qualitative meta-study.

    PubMed

    Holt, Nicholas L; Neely, Kacey C; Slater, Linda G; Camiré, Martin; Côté, Jean; Fraser-Thomas, Jessica; MacDonald, Dany; Strachan, Leisha; Tamminen, Katherine A

    2017-01-01

    The overall purpose of this study was to create a model of positive youth development (PYD) through sport grounded in the extant qualitative literature. More specifically, the first objective was to review and evaluate qualitative studies of PYD in sport. The second objective was to analyze and synthesize findings from these studies. Following record identification and screening, 63 articles were retained for analysis. Meta-method analysis revealed strengths of studies were the use of multiple data collection and validity techniques, which produced high-quality data. Weaknesses were limited use of 'named' methodologies and inadequate reporting of sampling procedures. Philosophical perspectives were rarely reported, and theory was used sparingly. Results of an inductive meta-data analysis produced three categories: PYD climate (adult relationships, peer relationships, and parental involvement), life skills program focus (life skill building activities and transfer activities), and PYD outcomes (in personal, social, and physical domains). A model that distinguishes between implicit and explicit processes to PYD is presented.

  5. Foraging rates of larval dragonfly colonists are positively related to habitat isolation: results from a landscape-level experiment.

    PubMed

    McCauley, Shannon J; Brodin, Tomas; Hammond, John

    2010-03-01

    There is increasing evidence of intraspecific variation in dispersal behavior. Individual differences in dispersal behavior may be correlated with other traits that determine the impact individuals have on patches they colonize. We established habitat patches-artificial pools-across a landscape, and these pools were naturally colonized by dragonfly larvae. Larvae were collected from pools at different levels of isolation and held under common lab conditions for 5 months. We then compared larval foraging rates. Foraging rate was positively related to habitat isolation, and colonists from the most isolated artificial pools had significantly higher foraging rates than individuals from the least isolated pools. Our results indicate that spatial patterns in colonist behavior can develop across a landscape independent of species-level dispersal limitation. This finding suggests that studies of community structure across space should include an assessment of the distribution of phenotypes as well as species-level dispersal limitation patterns.

  6. Comparison of daptomycin MIC results by DIN, NCCLS, SFM, and SRGA methods for 297 Gram-positive organisms.

    PubMed

    Koeth, Laura M; Leclercq, Roland; Olsson-Liljequist, Barbro

    2004-01-01

    Daptomycin is a novel lipopeptide antibiotic with potent in vitro antibacterial activity against Gram-positive pathogens. For daptomycin minimal inhibitory concentration (MIC) testing, National Committee for Clinical Laboratory Standards (NCCLS) recommends the use of broth containing physiological levels of calcium (50 microg/ml). The daptomycin susceptibility of 297 organisms was determined by NCCLS (Mueller-Hinton (MH) broth), Deutsches Institut für Normung (DIN; isotonic broth), Société Française de Microbiologie (SFM; three batches MH agar), and Swedish Reference Group for Antibiotics (SRGA; PDM agar). All media were supplemented to 50 microg/ml Ca(2+). There was good correlation between DIN and SFM methods (for staphylococci) with NCCLS results. Enterococci MICs using SFM methods were one to three dilutions lower and pneumococci results were one dilution higher than NCCLS. SRGA results were higher than NCCLS by one to four dilutions. Use of isotonic agar is an accepted alternative to isosensitest agar for the DIN method.

  7. False Positive STEMI Activations in a Regional Network: Comprehensive Analysis and Clinical Impact. Results From the Catalonian Codi Infart Network.

    PubMed

    Regueiro, Ander; Fernández-Rodríguez, Diego; Freixa, Xavier; Bosch, Xavier; Martín-Yuste, Victoria; Brugaletta, Salvatore; Roqué, Mercè; Sabaté, Manel; Masotti, Mónica

    2017-07-12

    ST-segment elevation myocardial infarction (STEMI) network activation by a noncardiologist reduces delay times but may increase the rate of false-positive STEMI diagnoses. We aimed to determine the prevalence, predictors, and clinical impact of false-positive activations within the Catalonian STEMI network (Codi Infart). From January 2010 through December 2011, all consecutive patients treated within the Codi Infart network were included. Code activations were classified as appropriate if they satisfied both electrocardiogram and clinical STEMI criteria. Appropriate activations were classified as false positives using 2 nonexclusive definitions: a) "angiographic" if a culprit coronary artery was not identified, and b) "clinical" if the discharge diagnosis was other than STEMI. In total, 5701 activations were included. Appropriate activation was performed in 87.8% of the episodes. The rate of angiographic false positives was 14.6%, while the rate of clinical false positives was 11.6%. Irrespective of the definition, female sex, left bundle branch block, and previous myocardial infarction were independent predictors of false-positive STEMI diagnoses. Using the clinical definition, hospitals without percutaneous coronary intervention and patients with complications during the first medical contact also had a false-positive STEMI diagnoses rate higher than the mean. In-hospital and 30-day mortality rates were similar for false-positive and true-positive STEMI patients after adjustment for possible confounders. False-positive STEMI diagnoses were frequent. Outcomes were similar for patients with a true-positive or false-positive STEMI diagnosis treated within a STEMI network. The presence of any modifiable predictors of a false-positive STEMI diagnosis warrants careful assessment to optimize the use of STEMI networks. Copyright © 2017 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  8. Laparoscopic adjustable gastric banding via pars flaccida versus perigastric positioning: technique, complications, and results in 2,549 patients.

    PubMed

    Di Lorenzo, Nicola; Furbetta, Francesco; Favretti, Franco; Segato, Giovanni; De Luca, Maurizio; Micheletto, Giancarlo; Zappa, Marco; De Meis, Paolo; Lattuada, Ezio; Paganelli, Michele; Lucchese, Marcello; Basso, Nicola; Capizzi, Francesco D; Di Cosmo, Leonardo; Mancuso, Vincenzo; Civitelli, Simona; Gardinazzi, Angelo; Giardiello, Cristiano; Veneziani, Augusto; Boni, Marcello; Borrelli, Vincenzo; Schettino, Angelo; Forestieri, Pietro; Pilone, Vincenzo; Camperchioli, Ida; Lorenzo, Michele

    2010-07-01

    Retrospective multicenter analysis of the results of two different approaches for band positioning: perigastric and pars flaccida. Data were collected from the database of the Italian Group for LapBand (GILB). Patients operated from January 2001 to December 2004 were selected according to criteria of case-control studies to compare two different band positioning techniques: perigastric (PG group) and pars flaccida (PF group). Demographics, laparotomic conversion, postoperative complications, and weight loss parameters were considered. Data are expressed as mean +/- standard deviation. 2,549 patients underwent the LapBand System procedure [age: 40 +/- 11.7 years; sex: 2,130 female, 419 male; body mass index (BMI): 46.4 +/- 6.9 kg/m(2); excess weight (EW): 60.1 +/- 23.6 kg; %EW: 90.1 +/- 32.4]. During this period 1,343/2,549 (52.7%) were operated via the pars flaccida (PF group) and 1,206/2,549 (47.3%) via the perigastric approach (PG group). Demographics for both groups were similar. Thirty-day mortality was absent in both groups. Operative time was significantly longer in the PG group (80 +/- 20 min versus 60 +/- 40 min; p < 0.05). Hospital stay was similar in the two groups (2 +/- 2 days). Laparotomic conversion was significantly higher in the PG group (6 versus 2 patients; p < 0.001). Overall postoperative complication rate was 172/2,549 (6.7%) and was linked to gastric pouch dilation/slippage (67/172), intragastric migration/erosion (17/172), and tube/port failure (88/172). Gastric pouch dilation and intragastric migration were significantly more frequent in the PG group: 47 versus 20 (p < 0.001) and 12 versus 5 (p < 0.001), respectively. Patients eligible for minimum 3-year follow-up were 1,118/1,206 (PG group) and 1,079/1,343 (PF group). Mean BMI was 33.8 +/- 12.1 kg/m(2) (PG group) and 32.4 +/- 11.7 kg/m(2) (PF group) (p = ns), and mean percentage excess weight loss (%EWL) was 47.2 +/- 25.4 and 48.9 +/- 13.2 in PG and PF groups, respectively (p = ns

  9. Organizational predictors of colonoscopy follow-up for positive fecal occult blood test results: an observational study

    PubMed Central

    Partin, Melissa R.; Burgess, Diana J.; Burgess, James F.; Gravely, Amy; Haggstrom, David; Lillie, Sarah E; Nugent, Sean; Powell, Adam A; Shaukat, Aasma; Walter, Louise C.; Nelson, David B.

    2014-01-01

    Background This study assessed the contribution of organizational structures and processes identified from facility surveys to follow-up for positive Fecal Occult Blood Tests (FOBT+). Methods We identified 74,104 patients with FOBT+ results from 98 Veterans Health Administration (VHA) facilities between 8/16/09-3/20/11 and followed them until 9/30/11 for completion of colonoscopy. We identified patient characteristics from VHA administrative records, and organizational factors from facility surveys completed by Primary Care and Gastroenterology Chiefs. We estimated predictors of colonoscopy completion within 60 days and 6 months using hierarchical logistic regression models. Results 30% of patients with FOBT+ results received colonoscopy within 60 days and 49% within 6 months. Having Gastroenterology or Laboratory staff notify Gastroenterology providers directly about FOBT+ cases was a significant predictor of 60-day (odds ratio (OR)=1.85, p=0.01) and 6-month follow-up (OR 1.25, p=0.008). Additional predictors of 60-day follow-up included adequacy of colonoscopy appointment availability (OR 1.43, p=0.01) and frequent individual feedback to Primary Care providers about FOBT+ referral timeliness (OR 1.79, p=0.04). Additional predictors of 6-month follow-up included using guideline-concordant surveillance intervals for low-risk adenomas (OR 1.57, p=0.01) and using group appointments and combined verbal-written methods for colonoscopy preparation instruction (OR 1.48, p=0.0001). Conclusion Directly notifying Gastroenterology providers about FOBT+ results, employing guideline-concordant adenoma surveillance intervals, and using colonoscopy preparations instruction methods that provide both verbal and written information may increase overall follow-up rates. Enhancing follow-up within 60-days may require increased colonoscopy capacity and feedback to Primary Care providers. Impact These findings may inform organizational-level interventions to improve FOBT+ follow

  10. Human epidermal growth factor receptor 2 positive (HER2+) metastatic breast cancer: how the latest results are improving therapeutic options.

    PubMed

    Jiang, Hanfang; Rugo, Hope S

    2015-11-01

    Human epidermal growth factor receptor 2 positive (HER2+) metastatic breast cancer (MBC) remains an incurable disease, and approximately 25% of patients with HER2+ early breast cancer still relapse after adjuvant trastuzumab-based treatment. HER2 is a validated therapeutic target that remains relevant throughout the disease process. Recently, a number of novel HER2 targeted agents have become available, including lapatinib (a small molecule tyrosine kinase inhibitor of both HER2 and the epidermal growth factor receptor), pertuzumab (a new anti-HER2 monoclonal antibody) and ado-trastuzumab emtansine (T-DM1, a novel antibody-drug conjugate), which provide additional treatment options for patients with HER2+ MBC. The latest clinical trials have demonstrated improved outcome with treatment including pertuzumab or T-DM1 compared with standard HER2 targeted therapy. Here we review the clinical development of approved and investigational targeted agents for the treatment of HER2+ MBC, summarize the latest results of important clinical trials supporting use of these agents in the treatment of HER2+ MBC, and discuss how these results impact therapeutic options in clinical practice.

  11. 49 CFR 655.46 - Return to duty following refusal to submit to a test, verified positive drug test result and/or...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... test, verified positive drug test result and/or breath alcohol test result of 0.04 or greater. 655.46... OPERATIONS Types of Testing § 655.46 Return to duty following refusal to submit to a test, verified positive drug test result and/or breath alcohol test result of 0.04 or greater. Where a covered employee refuses...

  12. 49 CFR 655.46 - Return to duty following refusal to submit to a test, verified positive drug test result and/or...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... test, verified positive drug test result and/or breath alcohol test result of 0.04 or greater. 655.46... OPERATIONS Types of Testing § 655.46 Return to duty following refusal to submit to a test, verified positive drug test result and/or breath alcohol test result of 0.04 or greater. Where a covered employee refuses...

  13. Ways to Promote the Positive Development of Children and Youth. Research-to-Results Brief. Publication #2008-11

    ERIC Educational Resources Information Center

    Zarrett, Nicole; Lerner, Richard M.

    2008-01-01

    This brief discusses the elements and features that define positive youth development and highlights some ways to support the positive development of children and youth. Specifically, this brief addresses the critical role that particular out-of-school time settings (regular family dinners and organized activity programs) can play in supporting…

  14. A grounded theory of positive youth development through sport based on results from a qualitative meta-study

    PubMed Central

    Holt, Nicholas L.; Neely, Kacey C.; Slater, Linda G.; Camiré, Martin; Côté, Jean; Fraser-Thomas, Jessica; MacDonald, Dany; Strachan, Leisha; Tamminen, Katherine A.

    2017-01-01

    ABSTRACT The overall purpose of this study was to create a model of positive youth development (PYD) through sport grounded in the extant qualitative literature. More specifically, the first objective was to review and evaluate qualitative studies of PYD in sport. The second objective was to analyze and synthesize findings from these studies. Following record identification and screening, 63 articles were retained for analysis. Meta-method analysis revealed strengths of studies were the use of multiple data collection and validity techniques, which produced high-quality data. Weaknesses were limited use of ‘named’ methodologies and inadequate reporting of sampling procedures. Philosophical perspectives were rarely reported, and theory was used sparingly. Results of an inductive meta-data analysis produced three categories: PYD climate (adult relationships, peer relationships, and parental involvement), life skills program focus (life skill building activities and transfer activities), and PYD outcomes (in personal, social, and physical domains). A model that distinguishes between implicit and explicit processes to PYD is presented. PMID:27695511

  15. BE-POSITIVE: Beyond progression after tyrosine kinase inhibitor in EGFR- positive non small cell lung cancer patients: Results from a multicenter Italian observational study.

    PubMed

    Vavalà, Tiziana; Follador, Alessandro; Tiseo, Marcello; Galetta, Domenico; Morabito, Alessandro; Di Maio, Massimo; Martelli, Olga; Caffo, Orazio; Piovano, Pier Luigi; Cortinovis, Diego; Zilembo, Nicoletta; Casartelli, Clelia; Banna, Giuseppe Luigi; Ardizzoia, Antonio; Barzelloni, Maria Luisa; Bearz, Alessandra; Genestreti, Giovenzio; Mucciarini, Claudia; Filipazzi, Virginio; Menis, Jessica; Rizzo, Elisa; Barbieri, Fausto; Rijavec, Erika; Cecere, Fabiana; Bria, Emilio; Spitaleri, Gianluca; Rossi, Antonio; Novello, Silvia

    2016-05-01

    Non-small-cell-lung-cancer (NSCLC) patients harbouring epidermal growth factor receptor (EGFR) mutations develop drug resistance after 9-12 months of EGFR tyrosine kinase inhibitors (TKIs) therapy pointing out the issue of the second-line treatment choice. From June 2009 until May 2013 patients affected by advanced NSCLC harbouring EGFR mutations receiving first-line TKI were collected mainly retrospectively in 24 Italian Centers. Primary objective was to describe the percentage of EGFR mutated patients receiving second-line therapy after progression to first-line EGFR-TKIs assessing the type, the activity in terms of objective response rate (ORR), efficacy in terms of progression free survival (PFS) and overall survival (OS), and safety of second-line treatment. Secondary objective was to describe the efficacy of first-line EGFR-TKIs. 312 patients were included. Most of them were females (203, 65.1%), never smokers (200, 64.1%), with adenocarcinoma histology (290, 92.9%). The most common mutations were EGFR exon 19 deletion and L858R, detected in 186 and 97 cases (59.6% and 31.1%), respectively. At data cut-off, 274 patients (95.1%) received any second-line treatment (including best supportive care or local treatments only). A total of 163 patients received second-line systemic therapy with an ORR of 20.9% (95% CI:14.62-27.10), a median PFS and OS of 4.7 (95% CI:3.81-5.26) and 24.5 (95% CI:21.65-27.37) months, respectively. Grade 3-4 hematological and non-hematological toxicities were reported in 9% and 6.3% of 144 patients treated with chemotherapy while non-hematological toxicity was reported in 4 cases of the 17 patients receiving second-line target agents. BE-Positive is the first multicenter observational study reporting outcomes of therapies in a "real-life Caucasian EGFR-mutated population", highlighting the need of further researches about new treatment strategies in this setting. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  16. Positive Surgical Margins in Radical Prostatectomy Patients Do Not Predict Long-term Oncological Outcomes: Results from SEARCH

    PubMed Central

    Mithal, Prabhakar; Howard, Lauren E.; Aronson, William J.; Terris, Martha K.; Cooperberg, Matthew R.; Kane, Christopher J.; Amling, Christopher; Freedland, Stephen J.

    2015-01-01

    Purpose To assess the impact of positive surgical margins (PSMs) on long-term outcomes after radical prostatectomy (RP), including metastasis, castrate-resistant prostate cancer (CRPC), and prostate cancer-specific mortality (PCSM). Materials and Methods Retrospective study of 4,051 men in SEARCH treated by RP from 1988–2013. Proportional hazard models were used to estimate hazard ratios of PSMs in predicting BCR, CRPC, metastases, and PCSM. To determine if PSMs were more predictive in certain patients, analyses were stratified by pathological Gleason score, stage, and pre-operative PSA. Results Median follow-up was 6.6 years (IQR 3.2–10.6) and 1,127 patients had over 10 years of follow-up. During this time, 302 (32%) men experienced BCR, 112 (3%) developed CRPC, 144 (4%) developed metastases, and 83 (2%) died of PC. There were 1600 (40%) men with PSMs. In unadjusted models, PSMs were significantly associated with all adverse outcomes: BCR, CRPC, metastases and PCSM (all p ≤ 0.001). After adjusting for demographic and pathological characteristics, margins were associated with increased risk of only BCR (HR 1.98, p<0.001), and not CRPC, metastases, or PCSM (HR ≤ 1.20, p>0.18). Similar results were seen when stratified by pathological Gleason score, stage, or PSA, and when patients who underwent adjuvant therapy were excluded. Conclusions PSMs after RP are not an independent risk factor for CRPC, metastasis, or PCSM overall or within any subset. In the absence of other high-risk features, PSMs alone may not be an indication for adjuvant treatment. PMID:26010160

  17. Assessment of sputum smear-positive but culture-negative results among newly diagnosed pulmonary tuberculosis patients in Tanzania.

    PubMed

    Mnyambwa, Nicholaus Peter; Ngadaya, Esther S; Kimaro, Godfather; Kim, Dong-Jin; Kazwala, Rudovick; Petrucka, Pammla; Mfinanga, Sayoki G

    2017-01-01

    Diagnosis of pulmonary tuberculosis (TB) in technology-limited countries is widely achieved by smear microscopy, which has limited sensitivity and specificity. The frequency and clinical implication of smear-positive but culture-negative among presumptive TB patients remains unclear. A cross-sectional substudy was conducted which aimed to identify the proportion of nontuberculous mycobacteria (NTM) infections among 94 "smear-positive culture-negative" patients diagnosed between January 2013 and June 2016 in selected health facilities in Tanzania. Out of 94 sputa, 25 (26.60%) were GeneXpert® mycobacteria TB positive and 11/94 (11.70%) repeat-culture positive; 5 were Capilia TB-Neo positive and confirmed by GenoType MTBC to be Mycobacterium tuberculosis/Mycobacterium canettii. The remaining 6 Capilia TB-Neo negative samples were genotyped by GenoType® CM/AS, identifying 3 (3.19%) NTM, 2 Gram positive bacteria, and 1 isolate testing negative, together, making a total of 6/94 (6.38%) confirmed false smear-positives. Twenty-eight (29.79%) were confirmed TB cases, while 60 (63.83%) remained unconfirmed cases. Out of 6 (6.38%) patients who were HIV positive, 2 patients were possibly coinfected with mycobacteria. The isolation of NTM and other bacteria among smear-positive culture-negative samples and the presence of over two third of unconfirmed TB cases emphasize the need of both advanced differential TB diagnostic techniques and good clinical laboratory practices to avoid unnecessary administration of anti-TB drugs.

  18. Results.

    ERIC Educational Resources Information Center

    Zemsky, Robert; Shaman, Susan; Shapiro, Daniel B.

    2001-01-01

    Describes the Collegiate Results Instrument (CRI), which measures a range of collegiate outcomes for alumni 6 years after graduation. The CRI was designed to target alumni from institutions across market segments and assess their values, abilities, work skills, occupations, and pursuit of lifelong learning. (EV)

  19. Continuous positive airway pressure therapy in non-sleepy patients with obstructive sleep apnea: results of a meta-analysis

    PubMed Central

    Zhang, Dongmei; Luo, Jinmei; Qiao, Yixian

    2016-01-01

    Background Although continuous positive airway pressure (CPAP) has become the first line of therapy for obstructive sleep apnea (OSA), it remains controversial whether non-sleepy patients could benefit from CPAP treatment. Methods We searched the online databases Medline, Embase, the Cochrane library and the Cochrane Central Registry of Controlled Trials to select eligible control trials, including non-sleepy OSA patients and those patients treated by CPAP or either sham CPAP or no CPAP. Results Seven eligible studies (1,541 patients) were included. The pooled estimates of the mean changes after CPAP treatment for the systolic blood pressure (SBP) and diastolic blood pressure (DBP) were −0.51 mmHg (95% CI, −3.39 to 2.38 mmHg; P=0.73) and −0.92 mmHg (95% CI, −1.39 to −0.46 mmHg; P<0.001), respectively. CPAP should not improve subjective sleepiness in the minimally symptomatic OSA patients, as the change in the Epworth sleepiness scale (ESS) was −0.51 (95% CI, −1.68 to 0.67; P=0.397). However, CPAP can effectively reduce AHI or ODI by 15.57 events/h (95% CI, −29.32 to −1.82; P=0.026) compared to controls. However, the risk of cardiovascular events did not significantly decrease [odds ratio (OR), 0.80; 95% CI, 0.50 to 1.26; P=0.332] in the end. Conclusions CPAP treatment can reduce OSA severity in non-sleepy patients and minutely reduce the DBP, but CPAP seems to have no overall beneficial effects on subjective sleepiness, SBP, or cardiovascular risk. PMID:27867549

  20. The effect of landscape position and aspect on chemical weathering and soil formation: contrasting field and model results

    NASA Astrophysics Data System (ADS)

    Vanwalleghem, Tom; Román, Andrea; Giráldez, Juan

    2016-04-01

    Interest in modelling pedogenesis has increased greatly over the past few years, with the emergence of detailed pedon-scale models (e.g. Soilgen) on the one hand and landscape-scale models (e.g. marm3D, MILESD, LORICA) on the other. Pore water chemistry and chemical weathering is not (well) represented in the latter and needs to be improved in order to adequately model the evolution of soils and of the critical zone. The objective of this work is to analyse the spatial variability of chemical weathering and to develop a new soil landscape model that accounts for this. Here, we present field and model results from the Santa Clotilde Critical Zone Observatory, S Spain. A new model, MILESD2, was developed to integrate the effect of landscape evolution and soil formation. This model is based on a daily spatially-explicit soil water balance. Average soil water content, temperature and deep percolation fluxes are linked to weathering and soil formation processes. Model input (temperature and precipitation) for the last 25 000 years was generated on a daily time by combining palaeoclimate data and the WXGEN weather generator. The soil-landscape model was applied to a 48 km2 semi-natural catchment in Southern Spain, with soils developed on granite. Model-generated runoff was used for a first validation against discharge observations. Next, soil formation output was contrasted against experimental data from 10 soil profiles along two catenas. Field data showed an important variation in mobile regolith thickness, between 0,44 and 1,10m, and in chemical weathering along the catena. Southern slopes were characterized by shallower, stonier and carbon-poor soils, while soils on north-facing slopes were deeper, more fine-textured and had a higher carbon content. Chemical depletion fraction was found to vary between 0,41 and 0,72. The lowest overall weathering intensity was found on plateau positions. South facing slopes revealed slightly lower weathering compared to north facing

  1. [Can the position of a patient influence the result of an ultrasound examination of venous valve insufficiency?].

    PubMed

    Musil, D

    2004-10-01

    The goal of our work was to test sensitivity of the duplex ultrasound examination in making a sapheno-femoral junction diagnosis in lying patients. For this reason we tried to find out whether in ultrasound examination of lumen diameter of the great saphenous vein (B-mode) the speed of blood flow and reflux detection (CFM, pulse Doppler detection) are influenced by the position of a patient when lying and when standing. We examined 70 lower limbs of 70 different patients (47 women and 23 men) in whom the sapheno-femoral junction was not diagnosed when examined in the lying position. The difference in the lumen diameter of the great saphenous vein measured when lying and when standing was statistically significant in our group of patients (p < 0.01). Decreased blood flow when standing was also statistically significant (p < 0.01). In any of the 50 examined lower limbs with the competent sapheno-femoral junction during the Valsalvov's manoeuvre when lying was not proved reflux nor it was proved when standing ( CFM, pulse Doppler detection). The examination of the venous reflux in the lying position is a physiologic, delicate, and at the same time reliable method. The lying position is comfortable for both the patient and the physician and as we proved, compared to ultrasonography in the vertical position, it does not lack needed sensitivity.

  2. Constitutional variants are not associated with HER2-positive breast cancer: results from the SIGNAL/PHARE clinical cohort.

    PubMed

    Pivot, Xavier; Romieu, Gilles; Fumoleau, Pierre; Rios, Maria; Bonnefoi, Hervé; Bachelot, Thomas; Soulié, Patrick; Jouannaud, Christelle; Bourgeois, Hugues; Petit, Thierry; Tennevet, Isabelle; Assouline, David; Mathieu, Marie-Christine; Jacquin, Jean-Philippe; Lavau-Denes, Sandrine; Darut-Jouve, Ariane; Ferrero, Jean-Marc; Tarpin, Carole; Lévy, Christelle; Delecroix, Valérie; Trillet-Lenoir, Véronique; Cojocarasu, Oana; Meunier, Jérôme; Pierga, Jean-Yves; Agostini, Cécile; Kerbrat, Pierre; Faure-Mercier, Céline; Blanché, Hélène; Sahbatou, Mourad; Boland, Anne; Bacq, Delphine; Besse, Céline; Calvo, Fabien; Renaud, Alexia; Deleuze, Jean-François; Pauporté, Iris; Thomas, Gilles; Cox, David G

    2017-01-01

    Human epidermal growth factor receptor 2-positive breast cancer is a subtype of interest regarding its outcome and the impressive impact of human epidermal growth factor receptor 2 targeted therapy. Constitutional variants may be involved in the aetiology of human epidermal growth factor receptor 2-positive breast cancer, and we propose a case-case study to test the hypothesis that single nucleotide polymorphisms may be associated with human epidermal growth factor receptor 2 status. A Genome-Wide Association Study was used in a cohort of 9836 patients from the SIGNAL/PHARE study (NCT00381901-RECF1098). The main goal was to identify variants specifically related to human epidermal growth factor receptor 2-positive breast cancer. A two-staged genotyping strategy was carried out to cover as large a proportion of the genome as possible. All subjects were genotyped using the Illumina HumanCore Exome chip set. Principal Components Analysis and k-means were then used to characterize the ancestry of the participants. A random sample of subjects from the main "European" cluster was genotyped with the Omni5 chip set. These data were then used to impute missing genotypes from the remaining subjects genotyped only using the HumanCore Exome array. From the 9836 patients, a total of 8703 cases including 3230 patients with human epidermal growth factor receptor 2-positive breast cancer were analyzed. Despite having 80% power to detect an odds ratio of 1.23 in this population, no variant achieved genome-wide significance for association with the occurrence of human epidermal growth factor receptor 2-positive breast cancer vs. any other subtype of breast tumour. Our study was unable to identify constitutional polymorphisms that are strongly associated with human epidermal growth factor receptor 2-positive status among breast cancer patients.

  3. Student Drug Testing in the Context of Positive and Negative School Climates: Results from a National Survey

    ERIC Educational Resources Information Center

    Sznitman, Sharon R.; Dunlop, Sally M.; Nalkur, Priya; Khurana, Atika; Romer, Daniel

    2012-01-01

    Positive school climates and student drug testing have been separately proposed as strategies to reduce student substance use in high schools. However, the effects of drug testing programs may depend on the favorability of school climates. This study examined the association between school drug testing programs and student substance use in schools…

  4. Increasing Elementary School Students' Subjective Well-Being through a Classwide Positive Psychology Intervention: Results of a Pilot Study

    ERIC Educational Resources Information Center

    Suldo, Shannon M.; Hearon, Brittany V.; Bander, Bryan; McCullough, Mollie; Garofano, Jeffrey; Roth, Rachel A.; Tan, Sim Yin

    2015-01-01

    There is growing interest in school-based programs to promote students' subjective well-being (SWB). Students with greater SWB tend to have stronger relationships with their teachers and classmates, as well as behave in more positive ways. Drawing from theory and research pertinent to promoting children's SWB, we developed an 11-session classwide…

  5. Increasing Elementary School Students' Subjective Well-Being through a Classwide Positive Psychology Intervention: Results of a Pilot Study

    ERIC Educational Resources Information Center

    Suldo, Shannon M.; Hearon, Brittany V.; Bander, Bryan; McCullough, Mollie; Garofano, Jeffrey; Roth, Rachel A.; Tan, Sim Yin

    2015-01-01

    There is growing interest in school-based programs to promote students' subjective well-being (SWB). Students with greater SWB tend to have stronger relationships with their teachers and classmates, as well as behave in more positive ways. Drawing from theory and research pertinent to promoting children's SWB, we developed an 11-session classwide…

  6. Student Drug Testing in the Context of Positive and Negative School Climates: Results from a National Survey

    ERIC Educational Resources Information Center

    Sznitman, Sharon R.; Dunlop, Sally M.; Nalkur, Priya; Khurana, Atika; Romer, Daniel

    2012-01-01

    Positive school climates and student drug testing have been separately proposed as strategies to reduce student substance use in high schools. However, the effects of drug testing programs may depend on the favorability of school climates. This study examined the association between school drug testing programs and student substance use in schools…

  7. DSS1/DSS2 astrometry for 1101 First Byurakan Survey blue stellar objects: Accurate positions and other results

    NASA Astrophysics Data System (ADS)

    Mickaelian, A. M.

    2004-10-01

    Accurate measurements of the positions of 1101 First Byurakan Survey (FBS) blue stellar objects (the Second part of the FBS) have been carried out on the DSS1 and DSS2 (red and blue images). To establish the accuracy of the DSS1 and DSS2, measurements have been made for 153 AGN for which absolute VLBI coordinates have been published. The rms errors are: 0.45 arcsec for DSS1, 0.33 arcsec for DSS2 red, and 0.59 arcsec for DSS2 blue in each coordinate, the corresponding total positional errors being 0.64 arcsec, 0.46 arcsec, and 0.83 arcsec, respectively. The highest accuracy (0.42 arcsec) is obtained by weighted averaging of the DSS1 and DSS2 red positions. It is shown that by using all three DSS images accidental errors can be significantly reduced. The comparison of DSS2 and DSS1 images made it possible to reveal positional differences and proper motions for 78 objects (for 62 of these for the first time), including new high-probability candidate white dwarfs, and to find objects showing strong variability, i.e. high-probability candidate cataclysmic variables. Table 1 is only available in electronic form at the CDS via anonymous ftp to cdsarc.u-strasbg.fr (130.79.128.5) or via http://cdsweb.u-strasbg.fr/cgi-bin/qcat?J/A+A/426/367

  8. Low biotinidase activity in plasma of some preterm infants: possible source of false-positive screening results.

    PubMed

    Suormala, T; Wick, H; Baumgartner, E R

    1988-06-01

    Screening for biotinidase deficiency has been added recently to some national screening programmes. To clarify the problem of false-positive screening tests in premature infants, we have studied biotinidase activities in the plasma of this population in more detail. In 64 newborns (premature and term babies) biotinidase activities correlated positively with gestational age from the 2nd to the 30th day of life. During the 1st-3rd day the activities were below the normal adult range in all 64 infants. In 56 infants the activities subsequently increased gradually and reached the normal adult range during the 4th-40th day of life. In contrast, the biotinidase activities in eight preterm infants dropped during the 3rd-7th day of life. Impaired liver function as a possible cause for this finding could be ruled out in these infants. The lowest activities in these infants were measured during the 4th-6th day of life, i.e. unfortunately at a time when samples for the screening are normally taken. According to our data, 4-8 out of 48 preterm or small-for-date infants with biotinidase activities ranging from 4.7%-26% of the mean adult value would have given false-positive screening tests. A positive screening test was also obtained in a newborn and in an older unrelated child with a partial biotinidase deficiency. In these children the biotinidase activity did not rise but remained slightly below or at the lower range for heterozygotes (at 31% and 38% of the mean adult value). Currently we do not know whether such individuals are heterozygotes, or whether they have a variant of biotinidase deficiency. However, these children have developed normally without biotin therapy.

  9. A new radiographic method for evaluation of the position of the carpus in the coronal plane: results in normal subjects.

    PubMed

    Aufauvre, B; Herzberg, G; Garret, J; Berthonneaud, E; Dimnet, J

    1999-01-01

    The methods used to quantify pathological variations of the position of the carpus in the coronal plane, mainly ulnar translation of the carpus from trauma or rheumatoid disease, are often difficult to use in arthritic or postsurgical wrists; moreover, they require the measurement of the whole length of the third metacarpal. The aim of this study was to determine a reliable and easy-to-use index to analyse the position of the carpus in the coronal plane. One hundred PA X-rays of normal wrists were studied, of which 56 presented with a medial hamate facet of the lunate. An index of position of the carpus in the coronal plane is defined as the ratio of orthogonal distances from [1] the most medial point of the distal radius and [2] the most medial point of the capitate to the long axis of the radius: its mean value being 1.06 (+/- 0.13) in this series of normal wrists. The index is influenced by the presence of a medial hamate facet of the lunate, but is not dependent on the ulnar head and radial styloid process, nor on the length of the third metacarpal. To help to define the usefulness of the index in quantifying the different types of ulnar carpal translations in clinical practice, further studies are required.

  10. Preliminary results of real-time PPP-RTK positioning algorithm development for moving platforms and its performance validation

    NASA Astrophysics Data System (ADS)

    Won, Jihye; Park, Kwan-Dong

    2015-04-01

    Real-time PPP-RTK positioning algorithms were developed for the purpose of getting precise coordinates of moving platforms. In this implementation, corrections for the satellite orbit and satellite clock were taken from the IGS-RTS products while the ionospheric delay was removed through ionosphere-free combination and the tropospheric delay was either taken care of using the Global Pressure and Temperature (GPT) model or estimated as a stochastic parameter. To improve the convergence speed, all the available GPS and GLONASS measurements were used and Extended Kalman Filter parameters were optimized. To validate our algorithms, we collected the GPS and GLONASS data from a geodetic-quality receiver installed on a roof of a moving vehicle in an open-sky environment and used IGS final products of satellite orbits and clock offsets. The horizontal positioning error got less than 10 cm within 5 minutes, and the error stayed below 10 cm even after the vehicle start moving. When the IGS-RTS product and the GPT model were used instead of the IGS precise product, the positioning accuracy of the moving vehicle was maintained at better than 20 cm once convergence was achieved at around 6 minutes.

  11. Can in vitro mammalian cell genotoxicity test results be used to complement positive results in the Ames test and help predict carcinogenic or in vivo genotoxic activity? II. Construction and analysis of a consolidated database.

    PubMed

    Kirkland, David; Zeiger, Errol; Madia, Federica; Corvi, Raffaella

    2014-12-01

    A Workshop sponsored by EURL ECVAM was held in Ispra, Italy in 2013 to consider whether the in vitro mammalian cell genotoxicity test results could complement and mitigate the implications of a positive Ames test response for the prediction of in vivo genotoxicity and carcinogenicity, and if patterns of results could be identified. Databases of Ames-positive chemicals that were tested for in vivo genotoxicity and/or carcinogenicity were collected from different sources and analysed individually (Kirkland et al., in this issue). Because there were overlaps and inconsistent test results among chemicals in the different databases, a combined database which eliminated the overlaps and evaluated the inconsistencies was considered preferable for addressing the above question. A database of >700 Ames-positive chemicals also tested in vivo was compiled, and the results in in vitro mammalian cell tests were analysed. Because the database was limited to Ames-positive chemicals, the majority (>85%) of carcinogens (103/119) and in vivo genotoxins (83/88) were positive when tested in both in vitro gene mutation and aneugenicity/clastogenicity tests. However, about half (>45%) of chemicals that were not carcinogenic (19/28) or genotoxic in vivo (33/73) also gave the same patterns of positive mammalian cell results. Although the different frequencies were statistically significant, positive results in 2 in vitro mammalian cell tests did not, per se, add to the predictivity of the positive Ames test. By contrast, negative results for both in vitro mammalian cell endpoints were rare for Ames-positive carcinogens (3/119) and in vivo genotoxins (2/88) but, were significantly more frequent for Ames-positive chemicals that are not carcinogenic (4/28) or genotoxic in vivo (14/73). Thus, in the case of an Ames-positive chemical, negative results in 2 in vitro mammalian cell tests covering both mutation and clastogenicity/aneugenicity endpoints should be considered as indicative of

  12. Relationship between intra-articular adhesions and disc position in temporomandibular joints: Magnetic resonance and arthroscopic findings and clinical results.

    PubMed

    Millon-Cruz, Alejandrina; Martín-Granizo, Rafael; Encinas, Alejandro; Berguer, Alberto

    2015-05-01

    The objective of this study was to evaluate the relationship between intra-articular adhesions (IA) and disc position on magnetic resonance imaging (MRI) and direct arthroscopic vision, and to compare the presence of IA and clinical symptoms in patients diagnosed with internal derangements (ID) of temporomandibular joint (TMJ), along with their clinical outcomes. A total of 67 patients (134 TMJs) were included in the study. All patients were refractory to previous conservative treatment, and MRI was performed before surgery in all cases. The incidence of IA was evaluated in relation to disc displacement, type of displacement (with or without reduction), and stage of ID according to the Wilkes-Bronstein classification. Patients were divided into an adhesion and non-adhesion group. The association between the two groups with respect to preoperative clinical parameters (maximal interincisal opening, locking duration, joint pain, patient age) and postoperative parameters at 6 and 12 months was evaluated. The incidence of IA was 44% and the most common location was the anterior recess of the joint. IA were found in 58.3% of the joints with disc displacement without reduction, and in 28.9% of those with disc displacement with reduction (p < 0.05). In joints with well-positioned discs, adhesions were found in 15% of the cases. Patient age and locking duration were significantly higher in the adhesions group (p < 0.05). In relation to clinical outcome, there was no clinically relevant difference between groups at 6 and 12 months. In TMJ with disc displacement without reduction, the presence of IA was significantly higher than in joints with well-positioned discs or displacement with reduction, which leads to the hypothesis that disc hypomobility is an important factor in the genesis of adhesions. Copyright © 2015 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  13. HIV viral suppression results in higher antibody responses in HIV-positive women vaccinated with the quadrivalent human papillomavirus vaccine.

    PubMed

    Money, Deborah M; Moses, Erin; Blitz, Sandra; Vandriel, Shannon M; Lipsky, Nancy; Walmsley, Sharon L; Loutfy, Mona; Trottier, Sylvie; Smaill, Fiona; Yudin, Mark H; Klein, Marina; Harris, Marianne; Cohen, Jeffrey; Wobeser, Wendy; Bitnun, Ari; Lapointe, Normand; Samson, Lindy; Brophy, Jason; Karatzios, Christos; Ogilvie, Gina; Coutlée, François; Raboud, Janet

    2016-09-14

    To evaluate the immunogenicity and safety of the quadrivalent HPV (qHPV) vaccine in HIV-positive women over 24months. Between November 2008 and December 2012, 372 women aged 15 and older were enrolled from 14 Canadian HIV outpatient clinics in an open label cohort study. The qHPV vaccine (0.5mL) was administered intramuscularly at months 0, 2 and 6. The primary study endpoint was seroconversion to any of the HPV types targeted by the qHPV vaccine. Antibody levels were measured at 0, 2, 7, 12, 18, and 24months. Adverse events were recorded throughout. Of 372 participants enrolled, 310 (83%) received at least one dose of the qHPV vaccine and 277 (74%) received all three doses. Ninety-five percent (293/308) were seronegative for at least one vaccine type at baseline. The median age was 38years (IQR 32-45, range 15-66), 36% were white, 44% black and 13% were of Indigenous origin. Seventy-two percent of participants had a suppressed HIV viral load (VL<40c/ml) at baseline, with a median CD4 count of 510cells/mm(3) (376-695). Month 7 HPV type-specific seroconversion rates were 99.0%, 98.7%, 98.1% and 93.6% for HPV types 6, 11, 16 and 18 respectively in the per-protocol population. Participants with suppressed HIV VL at first vaccine had a 1.74-3.05fold higher peak antibody response compared to those without (p from 0.006 to <0.0001). This study is the first to examine the qHPV vaccine in HIV-positive women out to 24months and the first to include HIV-positive women through to age 66. The qHPV vaccine was well tolerated, and highly immunogenic. As women with suppressed viral load had higher antibody responses, planning HPV vaccination to occur when persons are virologically suppressed would be optimal for maximizing immune response. Findings provide strong evidence that older HIV-positive women can still benefit from HPV vaccination. http://www.isrctn.com/ISRCTN33674451. Copyright © 2016. Published by Elsevier Ltd.

  14. A human immunodeficiency virus screening algorithm to address the high rate of false-positive results in pregnant women in Japan.

    PubMed

    Shima-Sano, Takako; Yamada, Rika; Sekita, Kazuyo; Hankins, Raleigh W; Hori, Hiromasa; Seto, Hiroshi; Sudo, Koji; Kondo, Makiko; Kawahara, Kazuo; Tsukahara, Yuki; Inaba, Noriyuki; Kato, Shingo; Imai, Mitsunobu

    2010-02-23

    Prenatal human immunodeficiency virus (HIV) testing is essential for the prevention of mother-to-child transmission. However, false-positive results of screening testing are a concern as they may cause unnecessary emotional stress to pregnant women waiting for confirmatory test results. In regions with an extremely low prevalence, the positive predictive values of screening are unacceptably low rate. Here, we propose a HIV screening algorithm consisting of serial two fourth-generation enzyme immunoassays to reduce the number of false-positive screening results. When 6461 pregnant women presenting to two maternity hospitals located in the Tokyo metropolitan area of Japan from September, 2004 to January, 2006 were tested using Enzygnost HIV Integral as a first screening test, 27 showed positive reactions. When these positive reaction samples were tested using VIDAS HIV DUO Quick as a second screening test, only one of them had a positive reaction, and the remaining 26 were nonreactive. Confirmatory Western blots and nucleic acid amplification test also showed that one was positive and the remaining 26 were negative; the subject who was positive with the confirmatory tests was identical to the subject who was positive with the second screening test. Thus, by adding the second screening test, the false-positive rate was improved from 0.4% to 0%, and the positive predictive value from 3.7% to 100%, compared with the single screening test. By applying our serial screening algorithm to HIV testing in maternity hospitals, many uninfected pregnant women would not need to receive confirmatory tests and be subjected to emotional turmoil while waiting for their confirmatory test results. This algorithm would be suitable for HIV testing of pregnant women living in low prevalence regions such as Japan.

  15. False positive hepatitis C antibody test results in left ventricular assist device recipients: increased risk with age and transfusions.

    PubMed

    Minamoto, Grace Y; Lee, Doreen; Colovai, Adriana; Levy, Dana; Vasovic, Ljiljana; Roach, Keith W; Shuter, Jonathan; Goldstein, Daniel; D'Alessandro, David; Jorde, Ulrich P; Muggia, Victoria A

    2017-01-01

    Left ventricular assist devices (LVADs) have been successfully used in patients with heart failure. However, LVADs may trigger immune activation, leading to higher frequencies of autoantibodies. We describe the clinical, epidemiological, and laboratory characteristics of LVAD recipients with false positive hepatitis C (FPHC) serology among 39 consecutive adult LVAD recipients who bridged to heart transplantation from January 2007 to January 2013 at Montefiore Medical Center. FPHC patients were identified as those with post-LVAD positive hepatitis C ELISA antibody tests and negative confirmatory testing with hepatitis C RNA PCR and/or radioimmunoblot assay. Ten (26%) patients previously seronegative for hepatitis C were found to have FPHC after device placement. Of the 39 patients, 32 had HeartMate II devices. The mean age at LVAD placement was 55 years. FPHC correlated with older age at the time of LVAD implantation and with receipt of packed red blood cell transfusions, but not with gender, fresh frozen plasma transfusions, panel reactive antibodies, globulin fraction, rheumatoid factor, or anticardiolipin antibodies. Clinicians should be aware of this increased risk of FPHC in older LVAD patients and those more heavily transfused in order to avoid unnecessary apprehension and possible delay in transplantation. Further studies should be done to evaluate the possible relationship between transfused blood products and immunomodulation.

  16. False positive hepatitis C antibody test results in left ventricular assist device recipients: increased risk with age and transfusions

    PubMed Central

    Lee, Doreen; Colovai, Adriana; Levy, Dana; Vasovic, Ljiljana; Roach, Keith W.; Shuter, Jonathan; Goldstein, Daniel; D’Alessandro, David; Jorde, Ulrich P.; Muggia, Victoria A.

    2017-01-01

    Left ventricular assist devices (LVADs) have been successfully used in patients with heart failure. However, LVADs may trigger immune activation, leading to higher frequencies of autoantibodies. We describe the clinical, epidemiological, and laboratory characteristics of LVAD recipients with false positive hepatitis C (FPHC) serology among 39 consecutive adult LVAD recipients who bridged to heart transplantation from January 2007 to January 2013 at Montefiore Medical Center. FPHC patients were identified as those with post-LVAD positive hepatitis C ELISA antibody tests and negative confirmatory testing with hepatitis C RNA PCR and/or radioimmunoblot assay. Ten (26%) patients previously seronegative for hepatitis C were found to have FPHC after device placement. Of the 39 patients, 32 had HeartMate II devices. The mean age at LVAD placement was 55 years. FPHC correlated with older age at the time of LVAD implantation and with receipt of packed red blood cell transfusions, but not with gender, fresh frozen plasma transfusions, panel reactive antibodies, globulin fraction, rheumatoid factor, or anticardiolipin antibodies. Clinicians should be aware of this increased risk of FPHC in older LVAD patients and those more heavily transfused in order to avoid unnecessary apprehension and possible delay in transplantation. Further studies should be done to evaluate the possible relationship between transfused blood products and immunomodulation. PMID:28203425

  17. Unusual presentation of hepatitis B serological markers in an Amerindian community of Venezuela with a majority of occult cases

    PubMed Central

    2011-01-01

    Background Occult hepatitis B infection (OBI) is characterized by the presence of hepatitis B virus (HBV) DNA in the absence of HBsAg in the serum of patients. The aim of this study was to characterize HBV infection among a Piaroa community, an Amerindian group which exhibits significant evidence of exposure to HBV but relatively low presence of HBsAg, and to explore the presence of OBI in this population. Results Of 150 sera, with 17% anti-HBc and 1.3% HBsAg prevalence, 70 were tested for the presence of HBV DNA. From these, 25 (36%) were found positive for HBV DNA by PCR in the core region. Two of these 25 sera were HBsAg positive, indicating an overt infection. Of the remaining 68 sera tested, 23 exhibited OBI. Of these, 13 were HBV DNA out of 25 anti-HBc positive (52%) and 10 HBV DNA positive, out of 43 anti-HBc negative (23%), with a statistical significance of p = 0.03. Viral DNA and HBsAg were present intermittently in follow up sera of 13 individuals. Sequence analysis in the core region of the amplified DNA products showed that all the strains belonged to HBV genotype F3. The OBI isolates displayed 96-100% nucleotide identity between them. One isolate exhibited the co-circulation of a wild type variant with a variant with a premature stop codon at the core protein, and a variant exhibiting a deletion of 28 amino acids. Conclusions The frequency of OBI found in this Amerindian group warrants further studies in other communities exhibiting different degrees of HBV exposure. PMID:22152023

  18. 49 CFR 655.46 - Return to duty following refusal to submit to a test, verified positive drug test result and/or...

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... test, verified positive drug test result and/or breath alcohol test result of 0.04 or greater. 655.46... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION PREVENTION OF ALCOHOL MISUSE AND PROHIBITED DRUG USE IN TRANSIT... drug test result and/or breath alcohol test result of 0.04 or greater. Where a covered employee...

  19. 49 CFR 655.46 - Return to duty following refusal to submit to a test, verified positive drug test result and/or...

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... test, verified positive drug test result and/or breath alcohol test result of 0.04 or greater. 655.46... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION PREVENTION OF ALCOHOL MISUSE AND PROHIBITED DRUG USE IN TRANSIT... drug test result and/or breath alcohol test result of 0.04 or greater. Where a covered employee...

  20. 49 CFR 655.46 - Return to duty following refusal to submit to a test, verified positive drug test result and/or...

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... test, verified positive drug test result and/or breath alcohol test result of 0.04 or greater. 655.46... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION PREVENTION OF ALCOHOL MISUSE AND PROHIBITED DRUG USE IN TRANSIT... drug test result and/or breath alcohol test result of 0.04 or greater. Where a covered employee...

  1. The valvo-pump, an axial blood pump implanted at the heart valve position: concept and initial results.

    PubMed

    Yamazaki, K; Okamoto, E; Yamamoto, K; Mitamura, Y; Tanaka, T; Yozu, R

    1992-06-01

    The valvo-pump, an axial nonpulsatile blood pump implanted at the heart valve position, has been developed. The valvo-pump consists of an impeller and a motor, which are encased in a housing. An impeller with 5 vanes (22.0 mm in diameter) is used. The impeller is connected to a samarium-cobalt-rare earth magnet direct current (DC) brushless motor measuring 21.3 mm in diameter and 18.5 mm in length. Sealing is achieved by means of a ferrofluidic seal. A pump flow of 10.5 L/min was obtained at a pump differential pressure of 3.3 kPa (25 mm Hg), and a flow of 4.9 L/min was obtained at 7.0 kPa (53 mm Hg). Sealing was kept perfect against a pressure of 29.3 kPa (220 mm Hg) at 9,000 rpm.

  2. The precise computation of geoid undulation differences with comparison to results obtained from the global positioning system

    NASA Technical Reports Server (NTRS)

    Engelis, T.; Rapp, R. H.; Tscherning, C. C.

    1984-01-01

    Ellipsoidal height differences have been determined for 13 station pairs in the central Ohio region using measurements made with the Global Positioning System. This information was used to compute geoid undulation differences based on known orthometric heights. These differences were compared to gravimetrically-computed undulations (using a Stokes integration procedure, and least squares collocation having an internal r.m.s. agreement of plus or minus 1 cm in undulation differences). The two sets of undulation differences have an r.m.s. discrepancy of plus or minus 5 cm while the average station separation is of the order of 14 km. This good agreement suggests that gravimetric data can be used to compute accurate geoid undulation differences that can be used to convert ellipsoidal height differences obtained from GPS to orthometric height differences.

  3. Preliminary results on the effect of sensor position on unobtrusive rollover detection for sleep monitoring in smart homes.

    PubMed

    Townsend, Daphne I; Goubran, Rafik; Frize, Monique; Knoefel, Frank

    2009-01-01

    Older adults experience increased sleep movement disorders and sleep fragmentation, and these are associated with serious health consequences such as falls. Monitoring sleep fragmentation and restlessness in older adults can reveal information about their daily and long-term health status. Long-term home monitoring is only realistic within the contact of unobtrusive, non-contact sensors. This paper presents exploratory work using the pressure sensor array as an instrument for rollover detection. The sensor output is used to calculate a center of gravity signal, from which five features are extracted. These features are used in a decision tree to classify detected movements in two categories; rollovers and other movements. Rollovers were detected with a sensitivity and specificity of 82% and 100% respectively, and a Mathew's correlation coefficient of 0.86 when data from all sensor positions were included. Intrapositional and interpositional effects of movements on sensors placed throughout the bed are described.

  4. Prolonged moderate pressure recruitment manoeuvre results in lower optimal positive end-expiratory pressure and plateau pressure.

    PubMed

    Lowhagen, K; Lindgren, S; Odenstedt, H; Stenqvist, O; Lundin, S

    2011-02-01

    In acute lung injury (ALI)/acute respiratory distress syndrome (ARDS), recruitment manoeuvres (RMs) are used frequently. In pigs with induced ALI, superior effects have been found using a slow moderate-pressure recruitment manoeuvre (SLRM) compared with a vital capacity recruitment manoeuvre (VICM). We hypothesized that the positive recruitment effects of SLRM could also be achieved in ALI/ARDS patients. Our primary research question was whether the same compliance could be obtained using lower RM pressure and subsequent positive end-expiratory pressure (PEEP). Secondly, optimal PEEP levels following the RMs were compared, and the use of volume-dependent compliance (VDC) to identify successful lung recruitment and optimal PEEP was evaluated. We performed a prospective randomised cross-over study where 16 ventilated patients with early ALI/ARDS each were subjected to the two RMs, followed by decremental PEEP titration. Volume-dependent initial, middle and final compliance (C(ini) , C(mid) and C(fin) ) were determined. Electric impedance tomography and end-expiratory lung volume measurements were used to follow lung volume changes. The maximum response in compliance, PaO₂/FIO₂, venous admixture and C(ini) /C(fin) after recruitment, during decremental PEEP, was at significantly lower PEEP and plateau pressure after SLRM than VICM. Fewer patients responded in gas exchange after the SLRM, which was not the case for lung mechanics. The response in C(ini) was more pronounced than in conventional compliance. The same compliance increase is achieved with SLRM as with VICM, and lower PEEP can be used, with correspondingly lower plateau pressures. VDC seems promising to identify successful recruitment and optimal PEEP. © 2011 The Authors. Journal compilation © 2011 The Acta Anaesthesiologica Scandinavica Foundation.

  5. Studies on a radioassay for intrinsic factor antibody: comparison of methods and false positive results due to elevated serum B12 levels.

    PubMed

    Muckerheide, M M; Wolfman, J A; Rohde, D A; McManamy, G E

    1984-09-01

    Availability of a kit method (Corning Immo Phase IFAB) for intrinsic factor antibody (IFAB) has made it possible for a routine radioimmunoassay (RIA) laboratory to test for the antibody, thereby providing another aid in diagnosing pernicious anemia. Comparison of data from a charcoal method with the kit method was favorable, each method detecting 35 (74%) positives and 12 (26%) negatives of 47 pernicious anemia patients. Compared with a charcoal method study the kit method had fewer false positives due to elevated serum B12. False positive results occurred for only 24 hours after a 1-mg injection of B12, and results remained negative the following seven days. The authors' studies supported the manufacturer's statement that results are unreliable when the serum B12 level exceeds 3,500 pg/ml. Clinical experience with the Corning Immo Phase IFAB test and false positive results is summarized.

  6. Development and application of a method for predicting rotor free wake positions and resulting rotor blade air loads. Volume 1: Model and results

    NASA Technical Reports Server (NTRS)

    Sadler, S. G.

    1971-01-01

    Rotor wake geometries are predicted by a process similar to the startup of a rotor in a free stream. An array of discrete trailing and shed vortices is generated with vortex strengths corresponding to stepwise radial and azimuthal blade circulations. The array of shed and trailing vortices is limited to an arbitrary number of azimuthal steps behind each blade. The remainder of the wake model of each blade is an arbitrary number of trailing vortices. Vortex element end points were allowed to be transported by the resultant velocity of the free stream and vortex-induced velocities. Wake geometry, wake flow, and wake-induced velocity influence coefficients are generated by this program for use in the blade loads portion of the calculations. Blade loads computations include the effects of nonuniform inflow due to a free wake, nonlinear airfoil characteristics, and response of flexible blades to the applied loads. Computed wake flows and blade loads are compared with experimentally measured data. Predicted blade loads, response and shears and moments are obtained for a model rotor system having two independent rotors. The effects of advance ratio, vertical separation of rotors, different blade radius ratios, and different azimuthal spacing of the blades of one rotor with respect to the other are investigated.

  7. Clinical Spectrum Time Course in Anti Jo-1 Positive Antisynthetase Syndrome: Results From an International Retrospective Multicenter Study.

    PubMed

    Cavagna, Lorenzo; Nuño, Laura; Scirè, Carlo Alberto; Govoni, Marcello; Longo, Francisco Javier Lopez; Franceschini, Franco; Neri, Rossella; Castañeda, Santos; Sifuentes Giraldo, Walter Alberto; Caporali, Roberto; Iannone, Florenzo; Fusaro, Enrico; Paolazzi, Giuseppe; Pellerito, Raffaele; Schwarting, Andreas; Saketkoo, Lesley Ann; Ortego-Centeno, Norberto; Quartuccio, Luca; Bartoloni, Elena; Specker, Christof; Murcia, Trinitario Pina; La Corte, Renato; Furini, Federica; Foschi, Valentina; Corral, Javier Bachiller; Airò, Paolo; Cavazzana, Ilaria; Martínez-Barrio, Julia; Hinojosa, Michelle; Giannini, Margherita; Barsotti, Simone; Menke, Julia; Triantafyllias, Kostantinos; Vitetta, Rosetta; Russo, Alessandra; Bajocchi, Gianluigi; Bravi, Elena; Barausse, Giovanni; Bortolotti, Roberto; Selmi, Carlo; Parisi, Simone; Montecucco, Carlomaurizio; González-Gay, Miguel Angel

    2015-08-01

    Anti Jo-1 antibodies are the main markers of the antisynthetase syndrome (ASSD), an autoimmune disease clinically characterized by the occurrence of arthritis, myositis, and interstitial lung disease (ILD). These manifestations usually co-occur (for practical purpose complete forms) in the same patient, but cases with only 1 or 2 of these findings (for practical purpose incomplete forms) have been described. In incomplete forms, the ex novo occurrence of further manifestations is possible, although with frequencies and timing not still defined. The aim of this international, multicenter, retrospective study was to characterize the clinical time course of anti Jo-1 positive ASSD in a large cohort of patients. Included patients should be anti Jo-1 positive and with at least 1 feature between arthritis, myositis, and ILD. We evaluated the differences between complete and incomplete forms, timing of clinical picture appearance and analyzed factors predicting the appearance of further manifestations in incomplete ASSD. Finally, we collected 225 patients (58 males and 167 females) with a median follow-up of 80 months. At the onset, complete ASSD were 44 and incomplete 181. Patients with incomplete ASSD had frequently only 1 of the classic triad findings (110 cases), in particular, isolated arthritis in 54 cases, isolated myositis in 28 cases, and isolated ILD in 28 cases. At the end of follow-up, complete ASSD were 113, incomplete 112. Only 5 patients had an isolated arthritis, only 5 an isolated myositis, and 15 an isolated ILD. During the follow-up, 108 patients with incomplete forms developed further manifestations. Single main feature onset was the main risk factor for the ex novo appearance of further manifestation. ILD was the prevalent ex novo manifestation (74 cases). In conclusion, ASSD is a condition that should be carefully considered in all patients presenting with arthritis, myositis, and ILD, even when isolated. The ex novo appearance of further

  8. Choice of the specialty of diagnostic radiology by results of the competitive examination to assign residency positions from 2006 to 2015.

    PubMed

    Murias Quintana, E; Sánchez Lasheras, F; Fernández-Somoano, A; Romeo Ladrero, J M; Costilla García, S M; Cadenas Rodríguez, M; Baladrón Romero, J B

    To analyze the profile of residency candidates choosing the specialty of diagnostic radiology in function of variables related to the positions available in different years. We compiled the data published on the Spanish Ministry of Health's website during the acts celebrated to allow residency candidates to choose positions based on the results of the competitive examinations held from 2006 to 2015, comparing the specialty of diagnostic radiology with the other specialties available in terms of positions available, net questions, sex, nationality, and order of choice of the position. The specialty of diagnostic radiology occupied the 16(th) position in the ranking of specialties according to the median number of order in the choice for each of the positions offered in the years studied. The first diagnostic radiology residency position was usually assigned after 75 candidates had chosen other specialties, and the last position was usually assigned after 3700 to 4100 candidates had chosen their positions. During the period studied, of those who chose diagnostic radiology 58% were women and 76% were Spanish nationality. Candidates preferred hospitals in the Autonomous Community of Madrid, and the hospital chosen with the lowest median position (highest score on the competitive examination) was the Hospital Clínic de Barcelona. Diagnostic radiology is chosen by candidates with good positioning in the ranking according to official examination results, is less likely than other specialties to be chosen by women, and is chosen mostly by Spanish physicians. Candidates prefer large hospitals in provincial capitals. Copyright © 2017 SERAM. Publicado por Elsevier España, S.L.U. All rights reserved.

  9. Logistic model for determining factors associated with HIV infection among blood donor candidates at the Fundação HEMOPE

    PubMed Central

    Queiroz, Niedja Maristone Barreto; Sampaio, Divaldo de Almeida; Santos, Eufrázio de Souza; Bezerra, Ana Cristina de Souza

    2012-01-01

    Objective To determine factors associated with HIV infection in blood donor candidates in Recife, Brazil. Methods A transversal study was performed of 106,203 blood donor candidates found eligible by the routine clinical screening process in the blood bank in Recife of the Fundação de Hematologia e Hemoterapia de Pernambuco (HEMOPE) in the period from January 1998 to November 2003. Additional indirect immune and western blot confirmation tests for HIV infection were performed and the candidates were classified as HIV positive or negative. The Chi-squared test and stepwise multiple logistic regression were conducted to examine any association between HIV infection and age, gender, place of residence, schooling, number of donations and serological tests for core hepatitis B antigen virus (anti-HBc), the hepatitis C antivirus (anti-HCV), human T-type antivirus lymph cells (anti-HTLV 1 and 2), serological tests for syphilis (VDRL) and the hepatitis B virus surface antigen (HBsAg). Results In the observed sample, 0.204% of blood donor candidates were found to be HIV positive. Among the studied variables, the age, education level, residency, donation type, and serologic status for anti-HBc and VDRL tests were found to be associated with HIV infection. Conclusions The younger, spontaneous donor candidates living in the Recife metropolitan area with a low level of education and positive for anti-HBc and VDRL have an higher risk of HIV infection than the other candidates. Data such as these are useful to understand the dynamics of infection and to guide healthcare policies. PMID:23049423

  10. Computerized physician order entry-based system to prevent HBV reactivation in patients treated with biologic agents: the PRESCRIB project.

    PubMed

    Sampedro, Blanca; Hernández-López, Cándido; Ferrandiz, José Ramón; Illaro, Aitziber; Fábrega, Emilio; Cuadrado, Antonio; Iruzubieta, Paula; Menéndez, Susana; Cabezas, Joaquín; Crespo, Javier

    2014-07-01

    Computerized physician order entry (CPOE) applications are widely used to prevent medical errors. In our center, a CPOE system has been in use since 2009 on both the inpatient and outpatient levels. A new and simple alert was introduced in the CPOE system to notify healthcare providers of the potential risk of viral reactivation when prescribing biological therapies, thereby facilitating the request for a serological profile (hepatitis B surface antigen [HBsAg], anti-HBc, and anti-HBs) in patients who have not had these tests. Between May 2012 and May 2013, a total of 1,076 patients undergoing biological treatment were included in the implementation of the CPOE in our hospital, resulting in the identification of 4 HBsAg-positive and 69 anti-HBc-positive/HBsAg-negative patients, two of them with positive viral loads. Since the implementation of this alert system, over 90% of patients who were prescribed a biological drug (BD) have undergone serological screening to detect hepatitis B virus (HBV) infection. The use of the alert system has increased the screening rate from less than 50% to 94% for HBsAg and from less than 30% to 85% for anti-HBc in patients for whom a BD is prescribed. Six patients received prophylactic antiviral therapy. No patient had HBV reactivation. This study demonstrates the feasibility of implementing a CPOE system that has allowed our hospital to increase the rate of HBV screening. Its use has facilitated the identification of patients at high risk for HBV reactivation and permitted physicians to prescribe prophylactic measures according to current guidelines. © 2014 by the American Association for the Study of Liver Diseases.

  11. Lack of evidence for significant hepatitis B transmission in Australian Rules footballers.

    PubMed

    Siebert, D J; Lindschau, P B; Burrell, C J

    1995-03-20

    To determine the prevalence of markers of past hepatitis B infection among participants in Australian Rules football, to estimate the potential exposure of Australians to hepatitis B virus (HBV) in contact sport. A point prevalence survey for antibody to hepatitis B surface antigen (anti-HBs) and core antigen (anti-HBc), supported by a questionnaire used to determine the history of risk and exposure, in South Australian National Football League (SANFL) players supervised at club level by general practitioners and sports medicine specialists. Of 245 players from seven clubs, 49 were excluded from the study because they had been previously vaccinated. Of 196 eligible participants, 117 submitted blood samples and, of these, 85 returned questionnaires. One player was positive for anti-HBc (a prevalence rate of 0.85%). This individual and three anti-HBc-negative players were positive for anti-HBs in the absence of a history of vaccination. We could not ascertain whether these additional three players had been previously infected, or vaccinated without this fact having been recorded on the questionnaires. No single behavioural factor correlated with positive anti-HBs results. The prevalence of markers of past hepatitis B infection in SANFL football players was no different to that in blood donors of the same age group from the same city. There was no evidence for any additional HBV transmission due to participation in football over that in the blood donor population. Vaccination of footballers and people engaged in similar sports is of benefit in conferring protection on the individual, but would be unlikely to make a significant public health impact on community rates of HBV infection.

  12. Results of using the global positioning system to maintain the time and frequency synchronization in the Deep Space Network

    NASA Technical Reports Server (NTRS)

    Clements, P. A.; Kirk, A.; Unglaub, R.

    1987-01-01

    There are two hydrogen maser clocks located at each signal processing center (SPC) in the DSN. Close coordination of the time and frequency of the SPC clocks is needed to navigate spacecraft to the outer planets. A recent example was the Voyager spacecraft's encounter with Uranus in January 1986. The clocks were adjusted with the goal of minimizing time and frequency offsets between the SPCs at encounter. How time and frequency at each SPC is estimated using data acquired from the Global Positioning System Timing Receivers operating on the NBS-BIH (National Bureau of Standards-Bureau International de l'Heure) tracking schedule is described. These data are combined with other available timing receiver data to calculate the time offset estimates. The adjustment of the clocks is described. It was determined that long range hydrogen maser drift is quite predictable and adjustable within limits. This enables one to minimize time and frequency differences between the three SPCs for many months by matching the drift rates of the three standards. Data acquisition and processing techniques using a Kalman filter to make estimates of time and frequency offsets between the clocks at the SPCs and UTC(NBS) (Coordinated Universal Time realized at NBS) are described.

  13. Allergic contact stomatitis to dodecyl gallate? A review of the relevance of positive patch test results to gallates.

    PubMed

    Gamboni, Sarah E; Palmer, Amanda M; Nixon, Rosemary L

    2013-08-01

    Gallic acid esters or gallates are antioxidants used as preservatives in food and cosmetics. Few cases of gallates causing allergic contact dermatitis (ACD) have been reported in the literature. We present a case report of a 42-year-old beauty therapist who presented with a swollen tongue. Patch testing was positive to dodecyl gallate, commonly reported as being present in edible oil and oily foods such as margarine. Our patient avoided foods presumed to contain gallates and at the 6-week review reported a substantial improvement in her tongue symptoms. We reviewed our database and found 16 (7%) definitely or possibly relevant reactions to dodecyl gallate, seven (15%) definitely or possibly relevant reactions to propyl gallate and six (3%) definitely or possibly relevant reactions to octyl gallate. Most reactions were attributed to margarine, moisturising cream and lipstick. These products are often mentioned in the literature as containing gallates; however, ingredient labelling and discussions with manufacturers made it difficult to establish whether they are currently present in foods. Ascertaining relevance for these reactions is not always possible.

  14. Anti-NMDAR antibodies in new-onset psychosis. Positive results in an HIV-infected patient.

    PubMed

    Arboleya, Susana; Clemente, Antonio; Deng, Savannah; Bedmar, Marta; Salvador, Isabel; Herbera, Patricia; Cunill, Vanessa; Vives-Bauza, Cristòfol; Haro, Josep Maria; Canellas, Francesca; Julià, Maria Rosa

    2016-08-01

    The role of neuronal surface autoantibodies (NSAs) in non-encephalitic psychosis is of recent and controversial interest. Most of the studies relating NSAs with psychosis are retrospective and only focused on the N-methyl-d-aspartate glutamate receptor (NMDAR). Our goal was to evaluate the prevalence of IgG antibodies against the NMDAR NR1 subunit (NMDAR-Abs) along with five additional NSAs in 61 first psychotic episode patients and 47 matched controls. We found two patients positive for NMDAR-Abs (3.3%). One of them was eventually considered to have been misdiagnosed and reclassified as encephalitis. The other met the criteria for bipolar I disorder, presented no neurological symptoms and had a comorbid HIV infection of vertical transmission. This is the first reported case of an HIV-infected patient with psychosis associated with NSAs. This study shows that patients presenting with clinically incomplete forms of anti-NMDAR encephalitis, with predominant or isolated psychiatric symptoms, can remain undetected if no ancillary tests are performed. To improve patient diagnosis and treatment of individuals with a first psychotic episode, more detailed neurological examinations might be needed. Further studies are required to better clarify the role of NSAs in the neuropsychiatric effects of HIV infection.

  15. Application of the Global Positioning System to crustal deformation measurements. 3: Result from the southern California borderlands

    SciTech Connect

    Larson, K.M.

    1993-12-01

    Five years of measurements from the Global Positioning System (GPS) satellites collected between 1986 and 1991 are used to investigate deformation in the offshore regions of southern California. GPS provides the first practical technique to make precise geodetic measurements in the region. The geodetic network is situated along the California coastline from Vandenberg (120.6 deg W, 34.6 deg N) to San Diego, with additional sites on Santa Cruz, San Nicolas, Santa Catalina, Santa Rosa, and San Clemente Islands. The precision of horizontal interstation vectors is subcentimeter, and the interstation vector rate between Owens Valley Radio Observatory (OVRO) and Vandenberg agrees with the very long baseline interferometry derived rate to within one standard deviation. No significant motion is observed in th e western Santa Barbara Channel between Vandenberg and Santa Rosa Island, 0.5 +/- 1.6 mm/yr, where the quoted uncertainties are one standard deviation. Motions in the eastern Santa Barbara Channel are consistent with compressional deformation of 6 +/- 1 mm/yr at N16 +/- 3 deg E. This motion is in agreement with seismicity and an independent geodetic analysis for the period 1971-1987 (Larsen, 1991). San Clemente Island is moving relative to San Diego at the rate of 5.9 +/- 1.8/yr at a direction of N38 +/- 20 deg W. The motion between San Nicolas Island and San Clemente Island, 0.8 +/- 1.5 mm/yr, is insignificant.

  16. [Clinical resulting risks in the persons injured in the traffic accident depending on the role and position in the traffic].

    PubMed

    Hur'iev, S O; Chundak, S S; Satsyk, S P

    2013-03-01

    Clinical resulting risks of the abdominal organs trauma in the injured persons, as a consequence of a traffic accident, constitute an important component of multicomponent polysystem trauma for the sign of taking part in a traffic.

  17. Expression of GLUT-1 and GLUT-3 in xanthogranulomatous cholecystitis induced a positive result on ¹⁸F-FDG PET: report of a case.

    PubMed

    Sawada, Shigeaki; Shimada, Yutaka; Sekine, Shinichi; Shibuya, Kazuto; Yoshioka, Isaku; Matsui, Koshi; Okumura, Tomoyuki; Yoshida, Toru; Nagata, Takuya; Uotani, Hideyuki; Tsukada, Kazuhiro

    2013-01-01

    Although several reports have revealed that fluorine-18 fluorodeoxyglucose positron emission tomography ((18)F-FDG PET) is useful for differentiating between benign and malignant lesions in the gallbladder, the positive results of (18)F-FDG PET are not specific for malignancy because (18)F-FDG is also accumulated in inflammatory lesions. It is known that the most important pathway for (18)F-FDG to enter the cell body is mediated by the facilitative glucose transporter-1 (GLUT-1) through GLUT-3. We herein present a case of xanthogranulomatous cholecystitis (XGC) with a positive result on (18)F-FDG PET. In this case, GLUT-1 and GLUT-3 were both positively expressed in inflammatory cells at the gallbladder wall of XGC and this is the first report to reveal GLUT expression in XGC. This report reveals that surgeons should carefully consider the appropriate treatment of gallbladder tumor, even with a positive result on (18)F-FDG PET.

  18. Alcohol use and positive screening results for depression and anxiety are highly prevalent among Chinese children with strabismus.

    PubMed

    Lin, Shibin; Congdon, Nathan; Yam, Jason C S; Huang, Yuqiang; Qiu, Kunliang; Ma, Di; Chen, Bin; Li, Liping; Zhang, Mingzhi

    2014-04-01

    To study associations between strabismus and alcohol use, anxiety, and depression among 10- to 17-year-old children in Guangdong, southern China. Cross-sectional, population-based study. Among 7537 children aged 6-17 years from 9 randomly selected primary and middle schools, ocular alignment was assessed with the Hirschberg light reflex, cover-uncover testing, and alternate cover testing at distance (6 m) and near (40 cm). Additionally, 4000 children (53.1%) aged 10+ years received self-administered questionnaires containing screening questions on alcohol use, anxiety, and depression. Examinations were completed on 7464 of 7537 subjects (99.0%), including 3928 boys (52.6%), with a mean age of 11.1 ± 1.8 years. The prevalence of any strabismus, including exotropia (2.7%), esotropia (0.2%), and intermittent exotropia (3.9%), was 6.8%. Strabismus was more prevalent in urban students (7.3%) and female subjects (7.4%) compared to rural students (6.0%) and male subjects (6.2%) (all P < .05). In multivariate regression models, any strabismus was associated with older age and rural vs urban residence. Among 3903 children (97.6%) answering questionnaires, history of alcohol use (62.3% vs 36.3%) and positive screening responses for depression (26.0% vs 11.6%) and anxiety (10.3% vs 4.9%) were significantly (P < .01 for all) more common among children with strabismus. These Chinese children with strabismus had a significantly higher prevalence of alcohol use and possible markers of emotional problems than children without strabismus. Further research should focus on the appropriateness of classifying surgical treatment for strabismus as "cosmetic" (ineligible for reimbursement) under China's rural health insurance. Copyright © 2014 Elsevier Inc. All rights reserved.

  19. Predictive Value of Dental Maturity for a Positive Gonadotropin-Releasing Hormone Stimulation Test Result in Girls with Precocious Puberty.

    PubMed

    Baik, Jee Seon; Choi, Jin Woo; Kim, Su Jin; Kim, Ji Hyun; Kim, Sollip; Kim, Jae Hyun

    2017-02-01

    Dental maturity is associated with skeletal maturity, which is advanced in girls with central precocious puberty (CPP). We investigated the performance of dental maturity as a screening method for CPP using mandibular second premolar and molar calcification stages, assessed the associated anthropometric and laboratory factors, and evaluated pubertal response predictors using the gonadotropin-releasing hormone stimulation test (GnRHST) in prepubertal and pubertal girls. A prospective case-control study was conducted in girls, aged 7.0-8.9 years, classified into pubertal (peak luteinizing hormone [LH] after GnRHST ≥ 5 IU/L), prepubertal (peak LH < 5 IU/L), and control groups. Auxological and biochemical tests, panoramic radiographs, and GnRHSTs in participants with breast development were conducted. Dental maturity was assessed using the Demirjian index (DI). We included 103 girls (pubertal, 40; prepubertal, 19; control, 44). Chronological age (CA) was not significantly different between groups. Bone age (BA) and BA advancement was higher in the pubertal and prepubertal groups. Increased DI values at the mandibular second premolar and molar were significantly associated with CA, BA, BA advancement, height standard deviation score (SDS), peak LH after GnRHST, and insulin-like growth factor-I (IGF-I) (all P < 0.05). Moreover, odds ratio (OR) of the mandibular second premolar and molar (a DI value of ≥ E) for predicting a positive response to GnRHST was 8.7 (95% confidence intervals [CI], 2.9-26.1) and 5.2 (95% CI, 2.2-12.7), respectively. Dental maturity was a strong predictor for diagnosing CPP. Determining dental maturity in girls with suspected precocious puberty might help determine the performance of GnRHSTs.

  20. Predictive Value of Dental Maturity for a Positive Gonadotropin-Releasing Hormone Stimulation Test Result in Girls with Precocious Puberty

    PubMed Central

    2017-01-01

    Dental maturity is associated with skeletal maturity, which is advanced in girls with central precocious puberty (CPP). We investigated the performance of dental maturity as a screening method for CPP using mandibular second premolar and molar calcification stages, assessed the associated anthropometric and laboratory factors, and evaluated pubertal response predictors using the gonadotropin-releasing hormone stimulation test (GnRHST) in prepubertal and pubertal girls. A prospective case-control study was conducted in girls, aged 7.0–8.9 years, classified into pubertal (peak luteinizing hormone [LH] after GnRHST ≥ 5 IU/L), prepubertal (peak LH < 5 IU/L), and control groups. Auxological and biochemical tests, panoramic radiographs, and GnRHSTs in participants with breast development were conducted. Dental maturity was assessed using the Demirjian index (DI). We included 103 girls (pubertal, 40; prepubertal, 19; control, 44). Chronological age (CA) was not significantly different between groups. Bone age (BA) and BA advancement was higher in the pubertal and prepubertal groups. Increased DI values at the mandibular second premolar and molar were significantly associated with CA, BA, BA advancement, height standard deviation score (SDS), peak LH after GnRHST, and insulin-like growth factor-I (IGF-I) (all P < 0.05). Moreover, odds ratio (OR) of the mandibular second premolar and molar (a DI value of ≥ E) for predicting a positive response to GnRHST was 8.7 (95% confidence intervals [CI], 2.9–26.1) and 5.2 (95% CI, 2.2–12.7), respectively. Dental maturity was a strong predictor for diagnosing CPP. Determining dental maturity in girls with suspected precocious puberty might help determine the performance of GnRHSTs. PMID:28049241

  1. Factors involved in continuance of atazanavir-based regimens: Results from a cohort of HIV1-positive patients.

    PubMed

    Giacomelli, Andrea; Oreni, Letizia; Franzetti, Marco; Di Cristo, Valentina; Colella, Elisa; Ridolfo, Anna Lisa; Galli, Massimo; Rusconi, Stefano

    2016-05-01

    We evaluated predictive factors involved in durability and therapeutic failure of atazanavir (ATV)-based antiretroviral regimens with or without ritonavir (r) in real life setting. This retrospective study of HIV-1-positive patients evaluated the factors related to ATV continuance and the time-dependent probability of therapeutic failure (HIV-RNA >200 copies/mL and concomitant discontinuation of ATV). We also investigated the rate of therapeutic failure and the variations in total bilirubin levels from starting unboosted ATV-based regimens. The study involved 1030 patients: 183 treatment-naïve patients (17.8%) started ATV/r (17 subsequently switched to unboosted ATV); 653 (63.4%) switched to ATV/r from previous antiretroviral regimens (121 subsequently switched to unboosted ATV); and 194 (18.8%) switched to unboosted ATV from previous ATV-free regimens. The median ATV follow-up was 28 months (interquartile range 7-56). The risk of ATV discontinuation was significantly lower in patients switched to unboosted ATV from ATV/r (HR 0.45; p < 0.0001). The discontinuation of ATV correlated with female gender (HR 1.26; p = 0.035), use of a zidovudine/didanosine/stavudine containing backbone (HR 1.8; p = 0.004), and a baseline CD4+ cell counts of <200/μL (HR 1.54; p = 0.003), the last of which was also associated with a higher risk of therapeutic failure (HR 2.42; p = 0.001). Total bilirubin levels were significantly lower in the patients switching from ATV/r to unboosted ATV. Unboosted ATV-based therapies are safe and effective options in patients whose immuno-virological conditions are stable, and allow the long-term survival of ATV-containing regimens.

  2. Pharmacist independent prescribing in critical care: results of a national questionnaire to establish the 2014 UK position.

    PubMed

    Bourne, Richard S; Whiting, Paul; Brown, Lisa S; Borthwick, Mark

    2016-04-01

    Clinical pharmacist practice is well established in the safe and effective use of medicines in the critically ill patient. In the UK, independent pharmacist prescribers are generally recognised as a valuable and desirable resource. However, currently, there are only anecdotal reports of pharmacist-independent prescribing in critical care. The aim of this questionnaire was to determine the current and proposed future independent prescribing practice of UK clinical pharmacists working in adult critical care. The questionnaire was distributed electronically to UK Clinical Pharmacy Association members (closed August 2014). There were 134 responses to the questionnaire (response rate at least 33%). Over a third of critical care pharmacists were practising independent prescribers in the specialty, and 70% intended to be prescribers within the next 3 years. Pharmacists with ≥5 years critical care experience (P < 0.001) or worked in a team (P = 0.005) were more likely to be practising independent prescribers. Pharmacists reported significant positives to the use of independent prescribing in critical care both in patient care and job satisfaction. Independently, prescribing was routine in: dose adjustment for multi-organ failure, change in route or formulation, correction prescribing errors, therapeutic drug monitoring and chronic medication. The majority of pharmacist prescribers reported they spent ≤5% of their clinical time prescribing and accounted for ≤5% of new prescriptions in critical care patients. Most critical care pharmacists intend to be practising as independent prescribers within the next 3 years. The extent and scope of critical care pharmacist prescribing appear to be of relatively low volume and within niche prescribing areas. © 2015 Royal Pharmaceutical Society.

  3. Influence of analytical bias and imprecision on the number of false positive results using Guideline-Driven Medical Decision Limits.

    PubMed

    Hyltoft Petersen, Per; Klee, George G

    2014-03-20

    Diagnostic decisions based on decision limits according to medical guidelines are different from the majority of clinical decisions due to the strict dichotomization of patients into diseased and non-diseased. Consequently, the influence of analytical performance is more critical than for other diagnostic decisions where much other information is included. The aim of this opinion paper is to investigate consequences of analytical quality and other circumstances for the outcome of "Guideline-Driven Medical Decision Limits". Effects of analytical bias and imprecision should be investigated separately and analytical quality specifications should be estimated accordingly. Use of sharp decision limits doesn't consider biological variation and effects of this variation are closely connected with the effects of analytical performance. Such relationships are investigated for the guidelines for HbA1c in diagnosis of diabetes and in risk of coronary heart disease based on serum cholesterol. The effects of a second sampling in diagnosis give dramatic reduction in the effects of analytical quality showing minimal influence of imprecision up to 3 to 5% for two independent samplings, whereas the reduction in bias is more moderate and a 2% increase in concentration doubles the percentage of false positive diagnoses, both for HbA1c and cholesterol. An alternative approach comes from the current application of guidelines for follow-up laboratory tests according to clinical procedure orders, e.g. frequency of parathyroid hormone requests as a function of serum calcium concentrations. Here, the specifications for bias can be evaluated from the functional increase in requests for increasing serum calcium concentrations. In consequence of the difficulties with biological variation and the practical utilization of concentration dependence of frequency of follow-up laboratory tests already in use, a kind of probability function for diagnosis as function of the key-analyte is proposed

  4. Self-reported HIV-positive status but subsequent HIV-negative test result using rapid diagnostic testing algorithms among seven sub-Saharan African military populations

    PubMed Central

    Hale, Braden R.; Tran, Bonnie R.; Thomas, Anne G.; Grillo, Michael P.; Jacobs, Marni B.; McAnany, Jennifer; Shaffer, Richard A.

    2017-01-01

    HIV rapid diagnostic tests (RDTs) combined in an algorithm are the current standard for HIV diagnosis in many sub-Saharan African countries, and extensive laboratory testing has confirmed HIV RDTs have excellent sensitivity and specificity. However, false-positive RDT algorithm results have been reported due to a variety of factors, such as suboptimal quality assurance procedures and inaccurate interpretation of results. We conducted HIV serosurveys in seven sub-Saharan African military populations and recorded the frequency of personnel self-reporting HIV positivity, but subsequently testing HIV-negative during the serosurvey. The frequency of individuals who reported they were HIV-positive but subsequently tested HIV-negative using RDT algorithms ranged from 3.3 to 91.1%, suggesting significant rates of prior false-positive HIV RDT algorithm results, which should be confirmed using biological testing across time in future studies. Simple measures could substantially reduce false-positive results, such as greater adherence to quality assurance guidelines and prevalence-specific HIV testing algorithms as described in the World Health Organization’s HIV testing guidelines. Other measures to improve RDT algorithm specificity include classifying individuals with weakly positive test lines as HIV indeterminate and retesting. While expansion of HIV testing in resource-limited countries is critical to identifying HIV-infected individuals for appropriate care and treatment, careful attention to potential causes of false HIV-positive results are needed to prevent the significant medical, psychological, and fiscal costs resulting from individuals receiving a false-positive HIV diagnosis. PMID:28686678

  5. Psychological distress with direct-to-consumer genetic testing: a case report of an unexpected BRCA positive test result.

    PubMed

    Dohany, Lindsay; Gustafson, Shanna; Ducaine, Whitney; Zakalik, Dana

    2012-06-01

    We report a case of a client who discovered she had a BRCA mutation following direct-to-consumer (DTC) genetic testing in the absence of genetic counseling. After testing she presented for genetic counseling with anxiety, distress, and a deficit of knowledge about what the DTC genetic testing revealed. Genetic counseling helped alleviate distress while empowering the client to apply the results of testing to improve medical management. Despite recent studies demonstrating no negative psychological impact of DTC genetic testing on the consumer, this case illustrates that significant psychological distress and confusion can occur as a result of DTC genetic testing for highly penetrant single gene disorders. Pre- and post-test genetic counseling in conjunction with DTC genetic testing may alleviate consumers' distress and empower clients to proactively utilize their result information.

  6. Prevalence of hepatitis B and C markers among refugees in Athens

    PubMed Central

    Roussos, Anastasios; Goritsas, Constantin; Pappas, Thomas; Spanaki, Maria; Papadaki, Panagiota; Ferti, Angeliki

    2003-01-01

    AIM: To assess the prevalence of hepatitis B and C serological markers in a population of refugees living in Athens. METHODS: One hundred and thirty refugees (81 males and 49 females, mean age ± SD: 31.7 ± 8 years) were included in the study. The hepatitis B virus surface antigen (HBsAg), the hepatitis B virus core antibody (anti-HBc) and the hepatitis C virus antibody (anti-HCV) were detected using a third-generation immunoassay. RESULTS: Twenty individuals (15.4%) were HBsAg positive and 69 (53.1%) were anti-HBc positive. The prevalence of HBsAg and anti-HBc was higher among refugees from Albania and Asia (statistical significant difference, P < 0.008 and P < 0.001 respectively). The prevalence of these markers was found irrelevant to age or sex. Anti-HCV was detected in the serum of 3 individuals (2.3%). No differences among age, sex or ethnicity regarding anti-HCV prevalence were found. CONCLUSION: It can be concluded that refugees living in Athens are an immigrant population characterized by a high incidence of HBV infection. The prevalence of HBV markers is higher among refugees from Albania and Asia. It is therefore believed that the adherence to general precautions and the initiation of HBV vaccination programs will be necessary in the future, especially in these communities. Although the prevalence of HCV infection seems to be relatively low, extended epidemiological surveys are needed to provide valid results. PMID:12717844

  7. Estimates for the sensitivity and false-positive rates for second trimester serum screening for Down syndrome and trisomy 18 with adjustment for cross-identification and double-positive results.

    PubMed

    Benn, P A; Ying, J; Beazoglou, T; Egan, J F

    2001-01-01

    Second trimester screening for fetal Down syndrome and trisomy 18 is available through separate protocols that combine the maternal age-specific risk and the analysis of maternal serum markers. We have determined the extent to which additional Down syndrome affected pregnancies may be identified through trisomy 18 screening, and the extent to which additional cases of trisomy 18 may be screen-positive for Down syndrome. The combined false-positive rate, taking into consideration those pregnancies that are screen-positive by both protocols, has also been determined. Sensitivity and false-positive rates were determined by computer simulation of results that incorporated previously published statistical variables into the model. Using second trimester risk cut-offs of 1:270 for Down syndrome and 1:100 for trisomy 18, it was found that few additional cases of Down syndrome are identified through trisomy 18 screening. However, approximately 6-10% of trisomy 18 affected pregnancies will be screen-positive for Down syndrome but screen-negative for trisomy 18. For women aged 40 or more, the false-positive rate for trisomy 18 exceeds 1% and approximately half of these cases will also be screen-positive for Down syndrome. For a population with maternal ages equivalent to that in the United States in 1998, after adjusting for the cross-identification, the sensitivity for three-analyte trisomy 18 screening is 78%. If this testing is performed in conjunction with Down syndrome "triple" screening, the Down syndrome sensitivity is 75% and the combined false-positive rate is 8.5%. If the three-analyte trisomy 18 screening is performed with the Down syndrome "quad" screen, the trisomy 18 sensitivity remains at 78%, the Down syndrome sensitivity is 79%, and combined false-positive rate is 7.5%. Sensitivity and false-positive rates are also provided for other widely used Down syndrome and trisomy 18 risk cut-offs. Sensitivity and false-positive rates that take into consideration

  8. Factors associated with abandonment of infants born to HIV positive women: results from a Ukrainian birth cohort

    PubMed Central

    Bailey, Heather; Semenenko, Igor; Pilipenko, Tatyana; Malyuta, Ruslan; Thorne, Claire

    2012-01-01

    Social marginalisation and other challenges facing HIV-positive pregnant women in Ukraine may put them at increased risk of relinquishing their infants to the state. We described rates of infant abandonment (exclusive non-parental care to most recent follow up, censored at two years of age) and investigated associated factors using logistic regression models, in 4759 mother-infant pairs enrolled across six Ukrainian sites in the European Collaborative Study from 2000 to May 2009. Median maternal age was 26.0 years, 81.8% were married or cohabiting and 60.6% were nulliparous at enrolment. An injecting drug use (IDU) history was reported by 18.4%, 80.2% took antiretroviral therapy (ART) antenatally and most deliveries were vaginal. A small but significant proportion of infants had been cared for exclusively in institutions by their second birthday (2.1% overall), decreasing from 3.8% (15/393) in 2000-02 to 1.6% (49/3136) in 2006-09 (p<0.01), concurrent with prevention of mother-to-child transmission (PMTCT) scale-up. A further 1% of infants spent some time in non-parental care. Antenatal ART was associated with an 88% reduced abandonment risk (AOR 0.12), versus receipt of single dose nevirapine only, and this was reflected in HIV infection prevalence in the two groups (17.1% of abandoned infants versus 6.6% in parental care). Mothers without a cohabiting partner or husband were more likely to abandon (AOR 4.08), as were active IDUs (AOR 3.27) and those with ≥1 previous children (AOR 1.89 for second-born, AOR 2.56 for subsequent births). Women delivering by elective caesarean section were less likely to abandon (AOR 0.37 versus vaginal), as were those leaving full time education later (AOR 0.61 for 17-18 years versus ≤16 years, AOR 0.23 for ≥19 years versus ≤16 years). Interventions to extend family planning and IDU harm reduction services along with non-stigmatising antenatal care to marginalised women are needed, and may reduce abandonment. PMID:20824547

  9. Prospective Associations of Low Positive Emotionality with First Onsets of Depressive and Anxiety Disorders: Results from a 10-Wave Latent Trait-State Modeling Study

    PubMed Central

    Kendall, Ashley D.; Zinbarg, Richard E.; Mineka, Susan; Bobova, Lyuba; Prenoveau, Jason M.; Revelle, William; Craske, Michelle G.

    2015-01-01

    Unipolar depressive disorders (DDs) and anxiety disorders (ADs) co-occur at high rates and can be difficult to distinguish from one another. Cross-sectional evidence has demonstrated that whereas all these disorders are characterized by high negative emotion, low positive emotion shows specificity in its associations with DDs, social anxiety disorder (SAD), and possibly generalized anxiety disorder (GAD). However, it remains unknown whether low positive emotionality, a personality trait characterized by the tendency to experience low positive emotion over time, prospectively marks risk for the initial development of these disorders. We aimed to help address this gap. Each year for up to 10 waves, participants (n = 627, mean age = 17 years at baseline) completed self-report measures of mood and personality, and a structured clinical interview. A latent trait-state decomposition technique was used to model positive emotionality and related personality traits over the first three years of the study. Survival analyses were used to test the prospective associations of low positive emotionality with first onsets of disorders over the subsequent six-year follow-up among participants with no relevant disorder history. The results showed that low positive emotionality was a risk marker for DDs, SAD, and GAD, although evidence for its specificity to these disorders versus the remaining ADs was inconclusive. Additional analyses revealed that the risk effects were largely accounted for by the overlap of low positive emotionality with neuroticism. The implications for understanding the role of positive emotionality in DDs and ADs are discussed. PMID:26372005

  10. Reduction of misleading ("false") positive results in mammalian cell genotoxicity assays. III: sensitivity of human cell types to known genotoxic agents.

    PubMed

    Fowler, Paul; Smith, Robert; Smith, Katie; Young, Jamie; Jeffrey, Laura; Carmichael, Paul; Kirkland, David; Pfuhler, Stefan

    2014-06-01

    We have demonstrated previously that the seemingly high rate of "false" or "misleading" positive results from in vitro micronucleus assays (MNvit) was greater when rodent derived cell lines and certain toxicity measures, such as relative cell count or replication index, were used. These studies suggested that the use of a human cell type with functional p53 and a toxicity measure that included a function of cell proliferation could dramatically reduce the detection of misleading positive results. A reduced "false positive rate" should not be at the expense of a loss of sensitivity of the assay. Therefore, we have investigated the sensitivity of the MNvit assay to known genotoxic agents using three cell types shown previously to be less prone to misleading positives, namely human lymphocytes (HuLy), TK6 and HepG2 cells. The 17 chemicals are well characterised and are from a list of chemicals known to produce positive results in in vitro mammalian cell assays. These data demonstrated a high sensitivity of the assay in which TK6 and HuLy cells were employed, such that 15 out of the 17 chemicals were correctly identified. By contrast, the use of HepG2 cells resulted in far fewer than expected positive responses. In conclusion, using TK6 and HuLy cells in preference to long established rodent cell lines in order to improve specificity does not compromise the sensitivity of the MNvit to detect known genotoxic agents. Copyright © 2014 Elsevier B.V. All rights reserved.

  11. Hepatitis B Vaccination in End-Stage Pulmonary Disease Patients Evaluated for Lung Transplantation: A Retrospective Single-Center Evaluation.

    PubMed

    Wald, Alexandra; Deterding, Lea; Maier, Melanie; Liebert, Uwe G; Berg, Thomas; Wirtz, Hubert; Wiegand, Johannes

    2016-06-14

    BACKGROUND In times of limited organs for transplantation, anti-HBc-positive organs can be accepted for lung transplantation to increase the number of donors. Transplant recipients should be vaccinated against hepatitis B to prevent HBV infection. However, response after HBV vaccination has only been poorly evaluated in patients with end-stage pulmonary disease. MATERIAL AND METHODS Anti-HBs titers of 40 anti-HBc negative patients with end-stage pulmonary disease evaluated for lung transplantation were analyzed with the Architect® system (Abbott, Germany). Responders, partial responders, or non-responders after HBV vaccination were defined by anti-HBs titers >100 IU/L, 10-100 IU/L, and <10 IU/L, respectively. RESULTS There were 34/40 individuals (85%) vaccinated against hepatitis B, and 6 were not vaccinated. Response, partial response, and non-response after vaccination were observed in 10/34 (29.4%), 11/34 (32.4%), and 13/34 (38.2%) of patients, respectively. Response to vaccination did not correlate with sex, pulmonary disease, comorbidities, immunosuppressive therapy, or smoking status. CONCLUSIONS Although 85% of patients evaluated for lung transplantation were vaccinated against hepatitis B, 38.2% did not show an anti-HBs titer >10 IU/L. Thus, anti-HBs titers should be regularly monitored. Nonresponders should be considered for booster vaccinations, alternative vaccination schedules, or prophylactic treatment with a nucleos(t)ide analogue in case of transplantation of an anti-HBc-positive organ.

  12. Characteristics of escape mutations from occult hepatitis B virus infected patients with hematological malignancies in South Egypt

    PubMed Central

    Elkady, Abeer; Iijima, Sayuki; Aboulfotuh, Sahar; Mostafa Ali, Elsayed; Sayed, Douaa; Abdel-Aziz, Nashwa M; Ali, Amany M; Murakami, Shuko; Isogawa, Masanori; Tanaka, Yasuhito

    2017-01-01

    AIM To investigate the prevalence and virological characteristics of occult hepatitis B virus (HBV) infections in patients with hematological malignancies in South Egypt. METHODS Serum samples were collected from 165 patients with hematological malignancies to monitor titers of HBV DNA, hepatitis B surface antigen (HBsAg), and antibodies to HBV core (anti-HBc) and surface antigens. Serum samples negative for HBsAg and positive for anti-HBc were subjected to nucleic acid extraction and HBV DNA detection by real-time polymerase chain reaction. DNA sequences spanning the S region were analyzed in cases with occult HBV infection. In vitro comparative study of constructed 1.24-fold wild type and S protein mutant HBV genotype D clones was further performed. RESULTS HBV DNA was detected in 23 (42.6%) of 54 patients with hematological malignancies who were HBsAg negative, but anti-HBc positive, suggesting the presence of occult HBV infection. The complete HBV genome was retrieved from 6 occult HBV patients, and P120T and S143L were detected in 3 and 2 cases, respectively. Site directed mutagenesis was done to produce 1.24-fold genotype D clones with amino acid mutations T120 and L143. The in vitro analyses revealed that a lower level of extracellular HBsAg was detected by chemiluminescence enzyme immunoassay (CLEIA) with the clone containing T120 mutation, compared with the wild type or the clone with S143L mutation despite the similar levels of extracellular and intracellular HBsAg detected by Western blot. Southern blot experiments showed that the levels of intracellular HBV DNA were not different between these clones. CONCLUSION Occult HBV infection is common in patients with hematological malignancies and associated with P120T and S143L mutations. 120T mutation impairs the detection of HBsAg by CLEIA.

  13. Blood discard rate and the prevalence of infectious and contagious diseases in blood donors from provincial towns of the state of Paraná, Brazil

    PubMed Central

    Borelli, Sueli Donizete; Mazzola, Jocimara Costa; Matta, Alessandra Cristina Gobbi; Takemoto, Angélica Yukari; Bértoli, Marta

    2013-01-01

    Background So that an improvement in the selection of donors can be achieved and the risk to the recipient of transfused blood can be reduced, prospective donors are submitted to clinical and serological screening. Objective This study investigated the blood discard rate and the rate of infectious and contagious diseases in blood donors from provincial towns of the state of Paraná, Brazil. Methods This study was an exploratory cross-sectional descriptive investigation with a quantitative approach of donations between January and December 2011. Results In the study period the Regional Blood center in Maringá, Brazil received 8337 blood donations from people living in the city and neighboring towns. However, 278 (3.33%) donations were discarded during serological screening owing to one or more positive serological markers. A total of 46.4% of the discarded blood units were confirmed positive by serology with anti-HBc being the most common (66.7%), followed by syphilis (22.5%), HBsAg (4.7%), anti-hepatitis C virus (3.1%), human immunodeficiency virus (1.5%) and Chagas' disease (1.5%). The rate of infectious-contagious diseases that can be transmitted by blood transfusions was 1.55% (129/8337) of the donor population with a frequency of 1.03% for anti-HBc and 0.35% for syphilis. Conclusion This study demonstrates a high prevalence of the anti-HBc marker in prospective blood donors from provincial towns in the state of Paraná, Brazil. PMID:24478604

  14. The long-term results and changing patterns of biological valves at the mitral position in contemporary practice in Japan

    PubMed Central

    Abe, Tomonobu; Ito, Hideki; Mutsuga, Masato; Fujimoto, Kazuro; Terazawa, Sachie; Narita, Yuji; Oshima, Hideki; Usui, Akihiko

    2016-01-01

    ABSTRACT Mitral valve surgery has changed with the wide acceptance of mitral valve repair. The aim of this study is to obtain the long-term results of patients who underwent mitral valve replacement (MVR) using a biological prosthesis in contemporary practice in Japan. From January 1990 to December 2013, 76 patients underwent MVR using a biological prosthesis with or without concomitant surgery. Data were obtained by means of a questionnaire and a telephone interview. The mean follow-up period was 4.26 years. The etiologies of the patients included dilated cardiomyopathy (DCM) (n=20 [26.3%]), ischemic mitral regurgitation (n=7 [9.2%]). There is a trend towards decreasing number of rheumatic and degenerative disease and increasing number of DCM and ischemic mitral regurgitation. Three patients (3.9%) died in the perioperative period. The 5- and 10-year overall survival rates were 69.6% and 31.7%, respectively. The 5- and 10-year freedom from valve related death were 95.6% and 80.6 %, respectively. The linearized rates of valve-related complications were as follows: thromboembolism (0.63%/patient/year), bleeding (1.25%/patient/year). One patient underwent reoperation for structural degeneration 13 years after the first operation. The present study shows the long-term results of mitral valve replacement with bioproshtesis in a contemporary case series. The practice pattern is changing. The low rate of valve-related complication justify the current patient selection. PMID:28008192

  15. Seroprevalence and Risk Factors for Hepatitis B in an Adult Population: The First Report from Birjand, South Khorasan, Iran

    PubMed Central

    Ziaee, Masood; Ebrahimzadeh, Azadeh; Azarkar, Zohreh; Namaei, Mohammad Hasan; Saburi, Amin; Fereidouni, Mohammad; Bijari, Bita; Karamian, Mehdi; Sharifzadeh, Gholamreza

    2016-01-01

    Background Infection with the hepatitis B virus (HBV) is an important global health problem. Knowledge of the geographic distribution pattern of HBV infection can help to control the spread of the disease. Objectives To determine the prevalence of HBV infections and risk factors for the disease for the first time in Birjand, Southeastern Iran. Methods This was an analytical cross-sectional study conducted in 2013 - 2014 of 5235 HBV cases in Birjand, South Khorasan Iran. Subjects aged 15 - 70 y were selected using the cluster sampling method. Blood samples were taken and tested at a reference laboratory for the hepatitis B core antibody (anti-HBc). Seropositive specimens were tested for the hepatitis B surface antigen (HBsAg). Results The mean age (± SD) was 39.07 (± 14.04) y, and 786 (15%) subjects were anti-HBc positive. The prevalence of HBsAg was 1.6% (n = 85). The prevalence of anti-HBc seropositivity was significantly higher in subjects with a lower level of education (P = 0.09), older subjects (P = 0.001), intravenous (IV) drug users (P<0.05), subjects with piercings (P < 0.001), and subjects with a positive history of familial HBV or HCV infection (P < 0.05). It was also significantly higher in those who drank alcohol (P = 0.09) or had a history of blood transfusions (P = 0.001), cupping (P = 0.004), hospital admission (P = 0.03), or endoscopy (P = 0.002). The rate of HBsAg positivity was significantly higher in subjects with a history of cupping (P=0.03), a positive history of familial HBV or HCV infection (P < 0.05), and older subjects (P = 0.015). Conclusions Although the frequency of HBsAg seropositivity in the present study was close to that observed in the overall Iranian population, the seroprevalence of anti-HBc was higher, possibly due to the exposure of the elderly to more risk factors. The risk factors were similar. These included a history of blood transfusions, cupping, hospital admission, endoscopy, or familial HBV/HCV infection, in addition

  16. A rare case of Addison's disease, hepatitis, thyreoiditis, positive IgG anti-tissue transglutaminase antibodies and partial IgA deficiency

    PubMed Central

    Mihaylova, Snejina; Yankova, Petja; Atanasova, Iliana; Nikolova-Vlahova, Milena; Naumova, Elissaveta

    2016-01-01

    Introduction Selective IgA deficiency (IgAD) is the most prevalent type of primary immune deficiencies, but partial IgA deficiency is even more common. Addison's disease is a rare condition associated with primary adrenal insufficiency due to infection or autoimmune destruction of the adrenals. The association between IgA deficiency and Addison's disease is very rare. Case and laboratory data We observed a 22-year-old male patient with marked darkening of the skin, especially on the palms and areolae, jaundice on the skin and sclera, astheno-adynamia, hypotension (80/50 mm Hg), and pain in the right hypochondrium. The laboratory investigations revealed increased serum levels of total and indirect bilirubin, AST, ALT, GGT and LDH, negative HBsAg, anti-HBc IgM, anti-HCV and anti-HAV IgM, very low serum IgA levels (0.16 g/l) with normal IgG and IgM, negative ANA, ANCA, AMA, LKM-1, anti-GAD-60, anti-IA-2, anti-thyroglobulin antibodies, a mild increase in anti-TPO antibodies titer, a marked increase in IgG anti-tissue transglutaminase antibodies, with no typical changes in cellular immunity, negative T-SPOT-TB test, HLA – A*01; B*08; DRB1*03; DQB1*02, karyotype – 46, XY. Conclusions We present a rare case of partial IgA deficiency with Addison's disease, hepatitis, thyroiditis and positive anti-tissue transglutaminase antibodies. IgAD and some autoimmune disorders share several predisposing HLA genes, thus explaining the increased prevalence of IgAD in certain patient groups. PMID:27536208

  17. A rare case of Addison's disease, hepatitis, thyreoiditis, positive IgG anti-tissue transglutaminase antibodies and partial IgA deficiency.

    PubMed

    Baleva, Marta P; Mihaylova, Snejina; Yankova, Petja; Atanasova, Iliana; Nikolova-Vlahova, Milena; Naumova, Elissaveta

    2016-01-01

    Selective IgA deficiency (IgAD) is the most prevalent type of primary immune deficiencies, but partial IgA deficiency is even more common. Addison's disease is a rare condition associated with primary adrenal insufficiency due to infection or autoimmune destruction of the adrenals. The association between IgA deficiency and Addison's disease is very rare. We observed a 22-year-old male patient with marked darkening of the skin, especially on the palms and areolae, jaundice on the skin and sclera, astheno-adynamia, hypotension (80/50 mm Hg), and pain in the right hypochondrium. The laboratory investigations revealed increased serum levels of total and indirect bilirubin, AST, ALT, GGT and LDH, negative HBsAg, anti-HBc IgM, anti-HCV and anti-HAV IgM, very low serum IgA levels (0.16 g/l) with normal IgG and IgM, negative ANA, ANCA, AMA, LKM-1, anti-GAD-60, anti-IA-2, anti-thyroglobulin antibodies, a mild increase in anti-TPO antibodies titer, a marked increase in IgG anti-tissue transglutaminase antibodies, with no typical changes in cellular immunity, negative T-SPOT-TB test, HLA - A*01; B*08; DRB1*03; DQB1*02, karyotype - 46, XY. We present a rare case of partial IgA deficiency with Addison's disease, hepatitis, thyroiditis and positive anti-tissue transglutaminase antibodies. IgAD and some autoimmune disorders share several predisposing HLA genes, thus explaining the increased prevalence of IgAD in certain patient groups.

  18. Motivated self-stereotyping: heightened assimilation and differentiation needs result in increased levels of positive and negative self-stereotyping.

    PubMed

    Pickett, Cynthia L; Bonner, Bryan L; Coleman, Jill M

    2002-04-01

    This research was conducted to explore the impact of assimilation and differentiation needs on content-specific self-stereotyping. According to optimal distinctiveness theory (M. B. Brewer, 1991), social identities serve the function of satisfying individuals' need for assimilation (in-group inclusion) and their need for differentiation (distinctiveness from others). It was proposed that one of the ways optimal social identities are maintained is through self-stereotyping. In 3 studies, the needs for assimilation and differentiation were experimentally manipulated, and support was found for increased self-stereotyping in response to heightened need arousal across both self-report and behavioral measures and across different social groups. Results also demonstrated that only those participants who were highly identified with their in-group were willing to engage in negative self-stereotyping.

  19. CS(2) blinds in Brassica crops: false positive results in the dithiocarbamate residue analysis by the acid digestion method.

    PubMed

    Perz, R C; van Lishaut, H; Schwack, W

    2000-03-01

    Various members of the Brassicaceae family (cauliflower, savoy cabbage, red cabbage, turnip-rooted cabbage) grown without any application of pesticides were analyzed according to the acid digestion method commonly used for the determination of dithiocarbamate fungicide residues. Depending on postharvest treatments, high non-anthropogenic CS(2) values up to 4 mg/kg were found in some cases, especially in frozen raw cabbage samples, exceeding maximum residue limits. To explore phytogenic CS(2) occurrences, two model substances (phenylisothiocyanate and methyl tryptaminedithiocarbamate) representing natural mustard oils and brassinines, respectively, were analyzed for their acid hydrolysis decomposition products. In both cases, COS was found generally, but CS(2) was readily formed during acid digestion, too, when sulfides were present. The results obtained clearly demonstrate that CS(2) values determined by using the acid digestion method of crops rich in secondary metabolism sulfur compounds have to be interpreted carefully.

  20. Reasons for Lack of Diagnostic Colonoscopy After Positive Result on Fecal Immunochemical Test in a Safety-Net Health System.

    PubMed

    Martin, Jason; Halm, Ethan A; Tiro, Jasmin A; Merchant, Zahra; Balasubramanian, Bijal A; McCallister, Katharine; Sanders, Joanne M; Ahn, Chul; Bishop, Wendy Pechero; Singal, Amit G

    2017-01-01

    Effective colorectal cancer screening depends on timely diagnostic evaluation in patients with abnormal results on fecal immunochemical tests (FITs). Although prior studies suggest low rates of follow-up colonoscopy, there is little information among patients in safety-net health systems and few data characterizing reasons for low follow-up rates. This study aimed to characterize factors contributing to lack of follow-up colonoscopy in a racially diverse and socioeconomically disadvantaged cohort of patients with abnormal results on FIT ("abnormal FIT" for brevity) receiving care in an integrated safety-net health system. We performed a retrospective electronic medical record review of patients aged 50-64 years with abnormal FIT at a population-based safety-net health system between January 2010 and July 2013. Review of electronic medical records focused on patients without follow-up colonoscopy to characterize patient-, provider-, and system-level reasons for lack of diagnostic evaluation. We used logistic regression analysis to identify predictors of follow-up colonoscopy within 12 months of abnormal FIT. Of 1267 patients with abnormal FIT, 536 (42.3%) failed to undergo follow-up colonoscopy within 1 year. Failure was attributable to patient-level factors in 307 (57%) cases, provider factors in 97 (18%) cases, and system factors in 118 (22%) cases. In multivariate analysis, follow-up colonoscopy was less likely among those aged 61-64 years (odds ratio 0.63, 95% confidence interval 0.46-0.87) compared with 50-55 year olds. Nearly half (42%) of patients with abnormal FIT failed to undergo follow-up colonoscopy within 1 year. Lack of diagnostic evaluation is related to a combination of patient-, provider-, and system-level factors, highlighting the need for multilevel interventions to improve follow-up colonoscopy completion rates. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Effects of a health education and telephone counseling program on patients with a positive fecal occult blood test result for colorectal cancer screening: A randomized controlled trial.

    PubMed

    Chiu, Hui-Chuan; Hung, Hsin-Yuan; Lin, Hsiu-Chen; Chen, Shu-Ching

    2016-11-17

    Our purpose was to evaluate the effects of a health education and telephone counseling program on knowledge and attitudes about colorectal cancer and screening and the psychological impact of positive screening results. A randomized controlled trial was conducted with 2 groups using a pretest and posttest measures design. Patients with positive colorectal cancer screening results were selected and randomly assigned to an experimental (n = 51) or control (n = 51) group. Subjects in the experimental group received a health education and telephone counseling program, while the control group received routine care only. Patients were assessed pretest before intervention (first visit to the outpatient) and posttest at 4 weeks after intervention (4 weeks after first visit to the outpatient). Patients in the experimental group had a significantly better level of knowledge about colorectal cancer and the psychological impact of a positive screening result than did the control group. Analysis of covariance revealed that the health education and telephone counseling program had a significant main effect on colorectal cancer knowledge. A health education and telephone counseling program can improve knowledge about colorectal cancer and about the psychological impact in patients with positive colorectal cancer screening results. The health education and telephone counseling program is an easy, simple, and convenient method of improving knowledge, improving attitudes, and alleviating psychological distress in patients with positive colorectal cancer screening results, and this program can be expanded to other types of cancer screening. Copyright © 2016 John Wiley & Sons, Ltd.

  2. Sequence homologies between Mycoplasma and Chlamydia spp. lead to false-positive results in chlamydial cell cultures tested for mycoplasma contamination with a commercial PCR assay.

    PubMed

    Maass, Viola; Kern, Jan Marco; Poeckl, Matthias; Maass, Matthias

    2011-10-01

    Mycoplasma contamination is a frequent problem in chlamydial cell culture. After obtaining contradictory contamination results, we compared three commercial PCR kits for mycoplasma detection. One kit signaled contamination in mycoplasma-free Chlamydia pneumoniae cultures. Sequencing of cloned PCR products revealed primer homology with the chlamydial genome as the basis of this false-positive result.

  3. Is Underweight Associated with more Positive Body Image? Results of a Cross-Sectional Study in Adolescent Girls and Boys.

    PubMed

    Kantanista, Adam; Król-Zielińska, Magdalena; Borowiec, Joanna; Osiński, Wiesław

    2017-02-09

    The aim of the study was to investigate the relationship between body image and prevalence of underweight, normal weight, and overweight in adolescents. The study included 1702 girls and 1547 boys, aged 14-16 years, who completed questionnaire assessing body satisfaction. The participants' BMI status: underweight, normal weight or overweight was determined on the basis of BMI cut-off values. Results revealed that more girls (p < .001) showed low body satisfaction (44.8%) and fewer girls (p < .001) had high body satisfaction (17.6%) compared to boys (28.5% and 29.0%, respectively). A two-way ANOVA revealed a significant interaction between BMI status and gender on body satisfaction F(2, 3243) = 4.10, p = .017, η2 = .003. In boys, body satisfaction was higher in normal weight and underweight in comparison to overweight individuals (p < .001). Underweight girls presented higher body satisfaction than those who were normal weight and overweight (p < .001). Our findings indicated that, in relation to gender, BMI status can be associated with different body satisfaction in adolescents. This should be taken into consideration when designing programs aimed at obesity and disordered eating prevention and body image improvement. Due to the fact that underweight girls and boys have high body satisfaction, this can lead to behaviors that maintain low body weight in adolescents and in turn this may have negative health consequences.

  4. What constitutes a positive result in hair analysis: proposal for the establishment of cut-off values.

    PubMed

    Kintz, P; Mangin, P

    1995-01-05

    Hair is still a seldom used specimen in most laboratories but its analysis has the potential of making a valuable contribution. Despite the many worthwhile reports, the scientific community at large still has reservations about the validity of hair analysis. Some of this is due to a lack of consensus among the active investigators on how to interpret the results from an analysis of hair. In USA, passive exposure seems to be a major problem, which can only be eliminated with difficulty. On the other hand, in Europe, scientists are performing standard decontamination procedures. It would be very helpful if a group of active researchers on hair analysis, representative of academic, government and private laboratories could define what are the areas of agreement and what are the issues that require further efforts to get a consensus. We propose the following guidelines: (1) a complete decontamination procedure, including the analysis of the wash solution; (2) two distinct analytical methods (immunoassay and GC/MS, or two different GC/MS methods); (3) the establishment of cut-off values (using 30-mg hair samples), 0.5 ng/mg of 6-MAM in the case of heroin abuse, and 1 ng/mg of cocaine in the case of cocaine abuse, which can be decreased to 0.5 ng/mg when use is supported by other evidence of drug intake.

  5. Gamification and the Internet: Experts Expect Game Layers to Expand in the Future, with Positive and Negative Results.

    PubMed

    Anderson, Janna; Rainie, Lee

    2012-08-01

    This analysis of the opinions of 1,021 Internet stakeholders was aimed at gauging current opinions about the potential future of game mechanics online. Nearly 5,000 people who are engaged in some way in Internet-related leadership or interests were invited to read a pair of opposing 2020 gamification scenarios and offer their written views on the likely future of gamification online by 2020. The result is not projectable to any population other than these respondents. A slight majority of 53 percent agreed with a proposed scenario that game mechanics will become a part of everyday life for most Internet users by 2020; a great majority of respondents said game elements will play a vital role in specific realms such as health and education by then. Some respondents said people will be resistant if game layers are built into too many aspects of people's daily lives. Some shared concerns that game-design approaches can be used to manipulate people without their knowledge.

  6. [Factors which influence the position towards euthanasia : Results of a representative survey among older people in Germany].

    PubMed

    Roesinger, Mathias; Prudlik, Laura; Pauli, Sara; Hendlmeier, Ingrid; Noyon, Alexander; Schäufele, Martina

    2016-12-13

    Until now older adults have not been a target group for surveys regarding their personal attitudes towards euthanasia, although they are closest to chronic illness and death. To determine the attitudes of older adults towards euthanasia and controversial topics in the context of illness, euthanasia and care (e. g. palliative care) on the basis of a representative sample. The study was based on a postal survey of a representative random sample of the population aged 65 years and older (n = 3500) from a city in southern Germany using a standardized questionnaire. A total of 1068 persons completed the questionnaire (response rate 30.5%). Assisted death was supported by 74.2% of the respondants and assisted suicide by 80.4%. According to multiple logistic regression analysis the support decreased with increasing strength of religious faith and a non-German country of origin. Of the participants 53.3% were worried about being a burden to their family, especially people with a limited state of health. People who shared this concern showed significantly more support for both types of euthanasia. More than 40% feared that people with severe and incurable illnesses would be more likely to be forced into a premature death (slippery slope argument). This concern was associated with a decreasing support of euthanasia. The results indicate that the strong approval of the legalization of assisted death and assisted suicide by older people is motivated not only by their desire for a self-determined death but also by fears and concerns. The findings have important implications for counseling, palliative care and treatment.

  7. Positive penicillin allergy testing results: a systematic review and meta-analysis of papers published from 2010 through 2015.

    PubMed

    Harandian, Farnoush; Pham, Donavan; Ben-Shoshan, Moshe

    2016-08-01

    β-lactam antibiotics are the most widely used group of antibiotics, given their effectiveness for the most common bacterial pathogens and their relatively low price. Adverse reactions, mainly cutaneous, are often reported to be associated with their use and hence, less effective and usually more costly alternative antibiotics are prescribed. However, it is not clear what is the risk of immediate immune-mediated (i.e. developing within one hour of administration) and potentially life-threatening reactions among those using β-lactam antibiotic. We conducted a systematic review to assess the prevalence of immediate adverse reactions to β-lactam antibiotics, specifically penicillin derivatives, in patients with a reported adverse reaction to β-lactam antibiotics. In addition, we determined the effect of age on the prevalence of immediate reactions. Assessing the true risk of using β-lactam antibiotics in patients with a reported allergy could prevent physicians from unnecessarily discouraging the use of β-lactam antibiotics. We conducted a systematic review and a meta-analysis using the PubMed, OVID, and Embase databases of work published in English and in French in the last 5 years. Studies were only eligible if they established the prevalence of immediate penicillin reactions with skin testing or challenges in case of negative skin tests. The meta-analysis was conducted using Stata version 12.0. The prevalence of immediate reactions to penicillin derivatives in patients reporting a β-lactam hypersensitivity is 1.98% (95%CI; 1.35%, 2.60%) in the pediatric (under 18 years old) group, 7.78% (95%CI; 6.53%, 9.04%) in the adult group, and 2.84% (95%CI; 1.77%, 3.91%) in the combined group, as tested in various studies, using skin tests and oral challenges. The I(2) value ranged between 87.2% and 97.0%. Our results indicate that the prevalence of immediate reactions is higher in adults than in children. However, wide confidence intervals and a large study

  8. Mailed participant reminders are associated with improved colonoscopy uptake after a positive FOBT result in Ontario's ColonCancerCheck program.

    PubMed

    Stock, David; Rabeneck, Linda; Baxter, Nancy N; Paszat, Lawrence F; Sutradhar, Rinku; Yun, Lingsong; Tinmouth, Jill

    2015-03-13

    Timely follow-up of fecal occult blood screening with colonoscopy is essential for achieving colorectal cancer mortality reduction. This study evaluates the effectiveness of two ongoing interventions designed to improve colonoscopy uptake after a positive fecal occult blood test (FOBT) result within Ontario's population-wide ColonCancerCheck program. The first was a revision of mailed FOBT lab results to physicians to explicitly define a positive FOBT and to recommend colonoscopy. The second was a letter to participants informing them of the positive FOBT and urging them to seek appropriate follow-up. Prospective cohort study using Ontario's ColonCancerCheck program data sets (2008-2011), linked to provincial administrative health databases. Crude rate ratios were calculated to assess determinants of colonoscopy uptake among an Ontario-wide FOBT-positive cohort with rolling enrolment, followed from October 2008 through February 2011. Segmented time-series regression was used to assess the average additional change in colonoscopy uptake after FOBT-positive status following the introduction of two ongoing interventions among the same cohort. A notification mailed directly to FOBT-positive screening participants was observed to increase colonoscopy uptake, beyond the modest average underlying increase throughout the study period, by an average of 3% per month (multivariable-adjusted RR: 1.03, 95% CI: 1.00-1.06). However, revision of the existing FOBT result notification to physicians was observed to have no effect. Direct participant notification of a positive FOBT result improved adherence with follow-up colonoscopy in Ontario's population-wide ColonCancerCheck program. Further participant-directed interventions may be effective means of maximizing adherence in population-wide screening.

  9. The reliability of HBV core antibody in serological screening for hepatitis B virus.

    PubMed

    Ba Alawi, Fatma; Robertson, Peter W; LePage, Amelia K; Jayamaha, Jude; Baleriola, Cristina; Rawlinson, William D

    2013-08-01

    Accurate diagnosis of hepatitis B virus (HBV) infection is essential for infection control, treatment and screening of potential blood, organ and tissue donors. We assessed the sensitivity of the HBsAg and HBcAb as screening assays alone and in combination for detecting HBV infection in a series of Australian patients. The performance of the Architect (Abbott Diagnostics, Germany) and the Elecsys (Roche Diagnostics, Germany) platforms were assessed for detection of HBcAb. There were 2778 blood samples assessed using the COBAS Ampliprep/TaqMan test for HBV DNA, of which 331 sera had concurrent HBV serology testing. This allowed determination of the correlation between HBV DNA and different serological markers. Of the 331 sera, 260 had sufficient residual volume to be retested for HBcAb using both Elecsys and the Architect assays. Of the 331 patients, one (0.3%) was negative by the Architect Anti-HBc II assay, in the presence of HBV DNA and positive HBsAg, consistent with recent infection. Positive HBcAb in the absence of HBV DNA was found in 67 of 331 (20.2%) patients. Of these, 18 of 67 had isolated HBcAb with negative results on all other tests, with 12 of 18 (3.6%) demonstrating low HBcAb signals on chemiluminscent microparticle assay. No cases of detectable HBV DNA in the presence of negative serology were found. When the HBcAb was used as a marker for past exposure or chronic HBV infection, the Architect Anti-HBc II assay demonstrated sensitivity and specificity of 98% and 79.9%, respectively, compared to 90% and 78.9%, respectively, for the Elecsys Anti-HBc assay. The combination of the Architect Anti-HBc II and HBsAg assays, as per conventional solid organ donor and recipient screening protocols, had 90% specificity and 100% sensitivity for determining HBV infection. This study shows that the use of combined HBsAg and HBcAb is sensitive and reliable for screening and predicting HBV nucleic acid test (NAT) positivity, whereas HBcAb alone missed an acute

  10. [Delivery in free position perhaps a solution to change delivery in traditional position in delivery rooms in Africa: results of a prospective study in Cotonou in Bénin].

    PubMed

    Dénakpo, Justin; Lokossou, Antionne; Tonato-Bagnan, Josiane Angéline; Alao, Jules; Hounkpatin, Benjamin; Komongui, Didier Gounou; Tamou-Tabé, D A; Perrin, René-Xavier

    2012-10-01

    In most of Africa's birthing units, women are often forbidden to stand during labour and delivery. This study aimed to determine the effect of a freely vertical position (standing,sitting, crouching) compared with the traditional supine position on the course of delivery and on perinatal and maternal outcomes(including the satisfaction level of mothers).Methods: We compared a group of 490 women who chose to deliver in a freely vertical position with 490 women who delivered in a traditional position, at the Hopital de Ia mere et de l'enfant Lagune of Cotonou, from January 1, 2009, to December 31,2011. Variables studied include length of labour, type of delivery,frequency of episiotomy, fetal and neonatal well-being indices(fetal heart rate, Apgar score, resuscitation), and postnatal maternal outcomes (perineal tears, hemorrhagic complications),including maternal satisfaction. Descriptive analysis includes comparisons between those two groups.Results: Both groups had similar maternal (25 years old) and gestational (39 weeks) ages. The "Choice of position" group had a greater number of nulliparous women (53% vs. 40%,P < 0.001) and a higher educational level (high-school diploma and postgraduate training: 77.5% vs. 45.1 %; P < 0.001 ). The average length of the active phase was shortened by 20 minutes in women who freely chose their delivery position (P < 0.01 ).Moreover, these women experienced spontaneous delivery in higher numbers, with 10 times fewer assisted deliveries (0.4%vs. 4.3%; P < 0.01) and two times fewer episiotomy interventions(3.5% vs. 8.0%; P < 0.01) than their counterparts. When women freely choose their delivery position, there are close to three times fewer cases of fetal heart rate anomalies and meconium liquor (2.9% vs. 8.9%; P < 0.01 and 0.4% vs. 1.4%; P < 0.01 ).Perineal and cervical tears are rare and occur in similar numbers in both groups, and the same can be said of cases of postpartum hemorrhage. The number of satisfied mothers is higher in

  11. Seroprevalence of Borrelia burgdorferi in Horses Presented for Coggins Testing in Southwest Virginia and Change in Positive Test Results Approximately 1 Year Later.

    PubMed

    Funk, R A; Pleasant, R S; Witonsky, S G; Reeder, D S; Werre, S R; Hodgson, D R

    2016-07-01

    Lyme disease can affect people, dogs, and horses, but it remains poorly understood, especially in the horse. Determining the seroprevalence of Borrelia burgdorferi in horses in different geographic areas will enable better understanding of the epidemiology of the disease, thus improving diagnosis and treatment of affected animals. To determine the seroprevalence of B. burgdorferi in horses in southwest Virginia. Horses presented for routine Coggins testing from January 2013 to January 2014 had additional blood drawn for Lyme Multiplex Assay testing. Of 492 samples collected, 250 samples were analyzed using the Lyme Multiplex Assay. Of the 83 horses that had positive test results to at least 1 outer surface protein (Osp), 63 were available for follow-up testing 5-17 months later (June 2014). Thirty-three percent of horses had positive results for antibodies to at least 1 Osp. Horses with a positive outer surface protein F (OspF) result were older (14.5 ± 0.79) than horses with a negative OspF result (11.6 ± 0.53). Of the horses available for follow-up testing, 63% had the same result as that of the initial test. There was no difference in test result between initial and follow-up testing. Horses seropositive to B. burgdorferi are common in Virginia, and older horses are more likely to have a positive test result for OspF than younger horses. Follow-up testing indicated that the majority of horses that were positive on initial testing did not have a different test result 5-17 months later. Copyright © 2016 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

  12. A Cross Section Study to Determine the Prevalence of Antibodies against HIV Infection among Hepatitis B and C Infected Individuals

    PubMed Central

    Flores, Geane L.; de Almeida, Adilson J.; Miguel, Juliana C.; Cruz, Helena M.; Portilho, Moyra M.; de P. Scalioni, Letícia; Marques, Vanessa A.; Lewis-Ximenez, Lia Laura; Lampe, Elisabeth; Melo Villar, Livia

    2016-01-01

    (1) Background: There are limited data regarding human immunodeficiency virus (HIV) prevalence among hepatitis B virus (HBV) or hepatitis C virus (HCV) infected individuals. The aim of this cross-sectional study is to determine the prevalence of HBV and HCV infection among HIV individuals; (2) Methods: A total of 409 patients (126 HBV+ and 283 HCV+) referred to the Brazilian Reference Laboratory for Viral Hepatitis from 2010 to 2013 donated serum samples. Anti-HIV, HBsAg, anti-HBc, anti-HBs, anti-HBcIgM, anti-HBe, HBeAg, and anti-HCV antibodies were measured, and anti-HCV positive samples were tested for viral RNA and genotype; (3) Results: The anti-HIV antibody prevalence was 10.31% and 4.59% among HBV+ and HCV+ patients, respectively. The HCV mean (SD) viral load was log 5.14 ± 1.64 IU/mL, and genotype I was most prevalent (163/283). Anti-HBs and anti-HBc were detected in 40% and 26% of HCV+ individuals, respectively. Among the HBV+ population, the presence of anti-HIV antibodies was associated with male gender, marital status (married), tattoo, sexual orientation, sexual practices (oral sex and anal sex), history of sexually transmitted diseases (STDs), history of viral hepatitis treatment, and a sexual partner with hepatitis or HIV. For the HCV+ group, the presence of anti-HIV antibodies was associated with female gender, marital status (married), anal intercourse, previous history of STDs, and number of sexual partners; (4) Conclusion: A high prevalence of anti-HIV antibodies was found among individuals with HBV and HCV, showing the importance of education programmes towards HIV infection among HBV- and HCV-infected individuals. PMID:26978383

  13. Update on occult hepatitis B virus infection.

    PubMed

    Makvandi, Manoochehr

    2016-10-21

    The event of mutations in the surface antigen gene of hepatitis B virus (HBV) results in undetectable hepatitis B surface antigen with positive/negative anti-hepatitis B core (anti-HBc) antibody status in serum and this phenomenon is named occult hepatitis B infection (OBI). The presence of anti-HBc antibody in serum is an important key for OBI tracking, although about 20% of OBI cases are negative for anti-HBc antibody. The diagnosis of OBI is mainly based on polymerase chain reaction (PCR) and real-time PCR assays. However, real-time PCR is a more reliable method than PCR. OBI is a great issue for the public health problem and a challenge for the clinical entity worldwide. The persistence of OBI may lead to the development of cirrhosis and hepatocellular carcinoma. With regard to OBI complications, the screening of HBV DNA by the highly sensitive molecular means should be implemented for: (1) patients with a previous history of chronic or acute HBV infection; (2) patients co-infected with hepatitis C virus/human immunodeficiency virus; (3) patients undergoing chemotherapy or anti-CD20 therapy; (4) recipients of organ transplant; (5) blood donors; (6) organ transplant donors; (7) thalassemia and hemophilia patients; (8) health care workers; (9) patients with liver related disease (cryptogenic); (10) hemodialysis patients; (11) patients undergoing lamivudine or interferon therapy; and (12) children in time of HBV vaccination especially in highly endemic areas of HBV. Active HBV vaccination should be implemented for the close relatives of patients who are negative for OBI markers. Thus, the goal of this review is to evaluate the rate of OBI with a focus on status of high risk groups in different regions of the world.

  14. Update on occult hepatitis B virus infection

    PubMed Central

    Makvandi, Manoochehr

    2016-01-01

    The event of mutations in the surface antigen gene of hepatitis B virus (HBV) results in undetectable hepatitis B surface antigen with positive/negative anti-hepatitis B core (anti-HBc) antibody status in serum and this phenomenon is named occult hepatitis B infection (OBI). The presence of anti-HBc antibody in serum is an important key for OBI tracking, although about 20% of OBI cases are negative for anti-HBc antibody. The diagnosis of OBI is mainly based on polymerase chain reaction (PCR) and real-time PCR assays. However, real-time PCR is a more reliable method than PCR. OBI is a great issue for the public health problem and a challenge for the clinical entity worldwide. The persistence of OBI may lead to the development of cirrhosis and hepatocellular carcinoma. With regard to OBI complications, the screening of HBV DNA by the highly sensitive molecular means should be implemented for: (1) patients with a previous history of chronic or acute HBV infection; (2) patients co-infected with hepatitis C virus/human immunodeficiency virus; (3) patients undergoing chemotherapy or anti-CD20 therapy; (4) recipients of organ transplant; (5) blood donors; (6) organ transplant donors; (7) thalassemia and hemophilia patients; (8) health care workers; (9) patients with liver related disease (cryptogenic); (10) hemodialysis patients; (11) patients undergoing lamivudine or interferon therapy; and (12) children in time of HBV vaccination especially in highly endemic areas of HBV. Active HBV vaccination should be implemented for the close relatives of patients who are negative for OBI markers. Thus, the goal of this review is to evaluate the rate of OBI with a focus on status of high risk groups in different regions of the world. PMID:27818588

  15. Next-generation sequencing indicates false-positive MRD results and better predicts prognosis after SCT in patients with childhood ALL.

    PubMed

    Kotrova, M; van der Velden, V H J; van Dongen, J J M; Formankova, R; Sedlacek, P; Brüggemann, M; Zuna, J; Stary, J; Trka, J; Fronkova, E

    2017-02-27

    Minimal residual disease (MRD) monitoring via quantitative PCR (qPCR) detection of Ag receptor gene rearrangements has been the most sensitive method for predicting prognosis and making post-transplant treatment decisions for patients with ALL. Despite the broad clinical usefulness and standardization of this method, we and others have repeatedly reported the possibility of false-positive MRD results caused by massive B-lymphocyte regeneration after stem cell transplantation (SCT). Next-generation sequencing (NGS) enables precise and sensitive detection of multiple Ag receptor rearrangements, thus providing a more specific readout compared to qPCR. We investigated two cohorts of children with ALL who underwent SCT (30 patients and 228 samples). The first cohort consisted of 17 patients who remained in long-term CR after SCT despite having low MRD positivity (<0.01%) at least once during post-SCT monitoring using qPCR. Only one of 27 qPCR-positive samples was confirmed to be positive by NGS. Conversely, 10 of 15 samples with low qPCR-detected MRD positivity from 13 patients who subsequently relapsed were also confirmed to be positive by NGS (P=0.002). These data show that NGS has a better specificity in post-SCT ALL management and indicate that treatment interventions aimed at reverting impending relapse should not be based on qPCR only.Bone Marrow Transplantation advance online publication, 27 February 2017; doi:10.1038/bmt.2017.16.

  16. High Rates of Hepatitis B Virus (HBV), Hepatitis C Virus (HCV), and Human Immunodeficiency Virus Infections and Uncommon HBV Genotype/Subtype and HCV Subtype Distributions among Transgender Individuals in Surabaya, Indonesia.

    PubMed

    Hadikusumo, Alfonsus Adrian; Utsumi, Takako; Amin, Mochamad; Khairunisa, Siti Qamariyah; Istimagfirah, Anittaqwa; Wahyuni, Rury Mega; Lusida, Maria Inge; Soetjipto; Rianto, Edhi; Juniastuti; Hayashi, Yoshitake

    2016-11-22

    Transgender people are at a high risk for sexually transmitted viruses such as hepatitis B virus (HBV) and human immunodeficiency virus (HIV). Moreover, Indonesia has a moderate-to-high rate of HBV infection and rapid epidemic growth of HIV infection; hepatitis C virus (HCV) infection can co-occur with HBV and HIV infections. In this study, 10 of 107 individuals (9.3%) were positive for HBV surface antigen (HBsAg) and/or HBV DNA, whereas 19 of 101 individuals (18.8%) with negative results for HBsAg were positive for HBV core antibody (anti-HBc). Seven of the 107 individuals (6.5%) were anti-HCV positive, and 16 of the 100 tested samples (16.0%) were HIV positive. Genotype and subtype analyses of all 10 HBV DNA (6 HBsAg positive and 4 anti-HBc positive) strains showed that 3 were of the HBV genotype/HBsAg subtype C/adrq(+), one was of C/adw2, and 5 were of B/adw2. The HCV subtype distribution showed that 33.3% were of HCV-1b, and 66.7% were of HCV-3k (n = 6). These distributions differed from those found in the general population of Surabaya, Indonesia. Interestingly, HIV subtype analysis showed a high prevalence of HIV, with possible recombinants of CRF01_AE and subtype B.

  17. Determination of ANA specificity using multiplexed fluorescent microsphere immunoassay in patients with ANA positivity at high titres after infliximab treatment: preliminary results.

    PubMed

    Caramaschi, Paola; Ruzzenente, Orazio; Pieropan, Sara; Volpe, Alessandro; Carletto, Antonio; Bambara, Lisa Maria; Biasi, Domenico

    2007-05-01

    To evaluate ANA specificity using the fully automated multiplexed fluorescent microsphere immunoassay in patients affected either by rheumatoid arthritis or ankylosing spondylitis who developed strong positivity for ANA as assessed by indirect immunofluorescent method on HEp-2 cells during infliximab treatment. Three men affected by ankylosing spondylitis and 12 women affected by rheumatoid arthritis who developed ANA positivity at high titres during infliximab treatment underwent the identification of ANA specificity by multiplexed fluorescent microsphere immunoassay; moreover anti-DNA and anti-ENA antibodies were tested by indirect immunofluorescence and ELISA method, respectively. In 4 out of 15 cases, the determination of ANA reactivity by multiplexed fluorescent microsphere immunoassay was also performed on the serum collected before infliximab administration. One patient affected by rheumatoid arthritis showed multiple ANA reactivities against SS-A, SS-B, RNP, Sm, Jo-1 and histones; one patient affected by ankylosing spondylitis resulted positive for the same autoantibodies, except for anti-Sm antibody. Moreover, two patients, one with rheumatoid arthritis and one with ankylosing spondylitis, showed single antibody specificity to SS-B and RNP, respectively. The remaining 11 cases did not show any positivity. Instead, all the patients resulted negative for anti-ENA antibodies by the ELISA method. In the four cases tested for ANA specificity by multiplexed fluorescent microsphere immunoassay before and after infliximab administration no difference was found. The search for anti-DNA antibody always resulted negative by both the traditional immunofluorescent assay and the novel technique. The use of multiplexed fluorescent microsphere immunoassay in patients treated with infliximab with ANA positivity at high titres allowed to find some ANA specificities which were not revealed by ELISA method. Nevertheless, the majority of patients resulted negative in spite of

  18. Importance of Local Control in Early-Stage Prostate Cancer: Outcomes of Patients With Positive Post-Radiation Therapy Biopsy Results Treated in RTOG 9408

    SciTech Connect

    Krauss, Daniel J.; Hu, Chen; Bahary, Jean-Paul; Souhami, Luis; Gore, Elizabeth M.; Chafe, Susan Maria Jacinta; Leibenhaut, Mark H.; Narayan, Samir; Torres-Roca, Javier; Michalski, Jeff; Zeitzer, Kenneth L.; Donavanik, Viroon; Sandler, Howard; McGowan, David G.; Jones, Christopher U.; Shipley, William U.

    2015-07-15

    Purpose: The purpose of this study was to assess the association between positive post-radiation therapy (RT) biopsy results and subsequent clinical outcomes in males with localized prostate cancer. Methods and Materials: Radiation Therapy Oncology Group study 94-08 analyzed 1979 males with prostate cancer, stage T1b-T2b and prostate-specific antigen concentrations of ≤20 ng/dL, to investigate whether 4 months of total androgen suppression (TAS) added to RT improved survival compared to RT alone. Patients randomized to receive TAS received flutamide with luteinizing hormone releasing hormone (LHRH) agonist. According to protocol, patients without evidence of clinical recurrence or initiation of additional endocrine therapy underwent repeat prostate biopsy 2 years after RT completion. Statistical analysis was performed to evaluate the impact of positive post-RT biopsy results on clinical outcomes. Results: A total of 831 patients underwent post-RT biopsy, 398 were treated with RT alone and 433 with RT plus TAS. Patients with positive post-RT biopsy results had higher rates of biochemical failure (hazard ratio [HR] = 1.7; 95% confidence interval [CI] = 1.3-2.1) and distant metastasis (HR = 2.4; 95% CI = 1.3-4.4) and inferior disease-specific survival (HR = 3.8; 95% CI = 1.9-7.5). Positive biopsy results remained predictive of such outcomes after correction for potential confounders such as Gleason score, tumor stage, and TAS administration. Prior TAS therapy did not prevent elevated risk of adverse outcome in the setting of post-RT positive biopsy results. Patients with Gleason score ≥7 with a positive biopsy result additionally had inferior overall survival compared to those with a negative biopsy result (HR = 1.56; 95% CI = 1.04-2.35). Conclusions: Positive post-RT biopsy is associated with increased rates of distant metastases and inferior disease-specific survival in patients treated with definitive RT and was associated with inferior overall

  19. Improvement in the specificity of assays for detection of antibody to hepatitis B core antigen.

    PubMed Central

    Weare, J A; Robertson, E F; Madsen, G; Hu, R; Decker, R H

    1991-01-01

    Reducing agents dramatically alter the specificity of competitive assays for antibody to hepatitis B core antigen (anti-HBc). A specificity improvement was demonstrated with a new assay which utilizes microparticle membrane capture and chemiluminescence detection as well as a current radioimmunoassay procedure (Corab: Abbott Laboratories, Abbott Park, Ill.). The effect was most noticeable with elevated negative and weakly reactive samples. In both systems, reductants increased separation of a negative population (n = 160) from assay cutoffs. With a selected population (n = 307), inclusion of reductant eliminated apparent anti-HBc activity in 54 of 81 samples in the 30 to 70% inhibition range. Reductant-stable anti-HBc samples were strongly associated with the presence of antibody to hepatitis B surface antigen (21 of 27). The association persisted below the detection limits of current assays to 0.3 to 0.4 Paul Ehrlich Institute units per ml. Only 1 of 54 reduction-sensitive borderline samples was confirmed to be positive for antibody to hepatitis B surface antigen. The modified procedures had unchanged or slightly improved sensitivity for immunoglobulin G (IgG)-associated anti-HBc activity. Although IgM anti-HBc detection was reduced from four- to eightfold in the presence of reductants, sensitivities remained at least twofold greater than tha of an enzyme immunoassay (Corzyme M; Abbott) designed to detect acute-phase levels of IgM anti-HBc. The use of reducing agents should significantly improve the reliability of anti-HBc testing, especially near assay cutoffs. PMID:2037678

  20. Prevalence of hepatitis B & hepatitis C virus infections in potential blood donors in rural Vietnam

    PubMed Central

    Viet, Le; Lan, Nguyen Thi Ngoc; Ty, Phung Xuan; Björkvoll, Björn; Hoel, Hedda; Gutteberg, Tore; Husebekk, Anne; Larsen, Stig; Skjerve, Eystein; Husum, Hans

    2012-01-01

    Background & objectives: Safe blood and blood products should be offered to all patients in need for blood transfusion. The objectives of the present study were to establish prevalence estimates for hepatitis B and hepatitis C virus infections as a foundation for safe blood transfusion in rural Vietnam, and to check the accuracy of the laboratory analysis used for hepatitis testing of blood donors in Vietnam. Methods: A cross-sectional study was conducted in two rural communities in Quang Tri, Vietnam. A total of 1,200 blood samples collected from potential blood donors were tested by an enzyme immunoassay technique (EIA) for detection of hepatitis surface antigen (HBsAg), antibodies to hepatitis B core antigen (anti-HBc), and antibodies to hepatitis C antigen (anti-HCV). The EIA test outcome was validated by a chemiluminescent micro particle immunoassay technique (CMIA). Results: The prevalence of HBsAg and anti-HBc in the study population was 11.4 per cent (95% CI 9.6 - 13.2) and 51.7 per cent (95% CI 48.8 - 54.5), respectively, the prevalences being higher in males than females. The prevalence of anti-HCV was 0.17 per cent. The test agreement between the EIA and CMIA techniques was high both for HBsAg detection (κ = 0.91; 95% CI: 0.83 - 0.99) and for anti-HBc detection (κ = 0.89; 95% CI 0.81 - 0.97). Compared to CMIA results, the positive and negative predictive values of the EIA tests were found to be 94.9 per cent (95% CI 87.5 - 98.6) and 97.5 per cent (95% CI 86.8 - 99.9) for HBsAg, and 92.4 per cent (95% CI 84.2 - 97.2) and 100 per cent (95% CI 91.2 - 100) for anti-HBc. Interpretation & conclusions: The study shows that hepatitis B virus infection is endemic in rural areas of Vietnam and that almost half of the population is or has been infected. Hepatitis C infection is rare, but false negative test results cannot be ruled out. Also, the results indicate that the EIA performance in blood donor screening in Vietnam may be sub-optimal, missing 2.5 per cent

  1. Primers determine the sensitivity of PCR-mediated hepatitis B virus DNA detection and pretreatment of PCR mixture with 8-methoxypsoralen eliminates false-positive results.

    PubMed

    Keum, W K; Park, C E; Lee, J H; Khil, L Y; Kang, I; Kim, S S; Jung, J C; Oh, S M; Woo, H J; Lee, J H; Kim, Y C; Yoon, Y; Choi, J W; Ha, J

    1997-04-30

    Most methods for the diagnosis of hepatitis B virus (HBV) infection largely depend on viral DNA detection by polymerase chain reaction (PCR) or radioimmunological assay of viral antigens or antibodies. The quality assurance program recently established in Europe reported that PCR-mediated HBV DNA detection methods used in many laboratories produced a high rate of false-positive and false-negative results. Thus, we attempted to improve the conditions of current PCR methods for detection of HBV DNA. In the present study, we applied a recently developed method of releasing HBV DNA from virion by NaOH treatment of patient serum. Using four different primer sets specific to the HBV core region, we found that the sensitivity of first-round PCR can be improved by more than two orders of magnitude depending on the primers. The second round of PCR using nested primers was sensitive enough to detect up to 10(-6) pg of the HBV DNA, which is equivalent to approximately 3 copies of the HBV genome. Among the approximately 800 HBV-infected patient sera investigated in our laboratory, more than 60% of the tested samples gave positive results in the first-round PCR. The rate of positive results obtained using our experimental conditions is very high in comparison with other reports. The reamplification of the first-round PCR reaction mixture with the nested primers produced practically 100% positive results. For diagnosis of HBV infection, we routinely used 1 microliter of patient serum, which was found to be optimum in our laboratory. Surprisingly, from 20% of our positive results, even serum diluted to 1/100 (0.01 microliter) produced a stronger signal than 1 microliter. This observation suggests that direct PCR amplification of HBV DNA released from serum by NaOH treatment has to be compensated by other DNA detection methods for correct quantitation. In order to eliminate the false positive signal resulting from the carry-over due to massive screening of a large number of

  2. Factors Associated With Rates of False-Positive and False-Negative Results From Digital Mammography Screening: An Analysis of Registry Data.

    PubMed

    Nelson, Heidi D; O'Meara, Ellen S; Kerlikowske, Karla; Balch, Steven; Miglioretti, Diana

    2016-02-16

    Women screened with digital mammography may receive false-positive and false-negative results and subsequent imaging and biopsies. How these outcomes vary by age, time since the last screening, and individual risk factors is unclear. To determine factors associated with false-positive and false-negative digital mammography results, additional imaging, and biopsies among a general population of women screened for breast cancer. Analysis of registry data. Participating facilities at 5 U.S. Breast Cancer Surveillance Consortium breast imaging registries with linkages to pathology databases and tumor registries. 405,191 women aged 40 to 89 years screened with digital mammography between 2003 and 2011. A total of 2963 were diagnosed with invasive cancer or ductal carcinoma in situ within 12 months of screening. Rates of false-positive and false-negative results and recommendations for additional imaging and biopsies from a single screening round; comparisons by age, time since the last screening, and risk factors. Rates of false-positive results (121.2 per 1000 women [95% CI, 105.6 to 138.7]) and recommendations for additional imaging (124.9 per 1000 women [CI, 109.3 to 142.3]) were highest among women aged 40 to 49 years and decreased with increasing age. Rates of false-negative results (1.0 to 1.5 per 1000 women) and recommendations for biopsy (15.6 to 17.5 per 1000 women) did not differ greatly by age. Results did not differ by time since the last screening. False-positive rates were higher for women with risk factors, particularly family history of breast cancer; previous benign breast biopsy result; high breast density; and, for younger women, low body mass index. Confounding by variation in patient-level characteristics and outcomes across registries and regions may have been present. Some factors, such as numbers of first- and second-degree relatives with breast cancer and diagnoses associated with previous benign biopsy results, were not examined. False-positive

  3. Cytogenetic confirmation of a positive NIPT result: evidence-based choice between chorionic villus sampling and amniocentesis depending on chromosome aberration.

    PubMed

    Van Opstal, Diane; Srebniak, Malgorzata I

    2016-01-01

    It has been shown that in non-invasive prenatal testing (NIPT) there is a small chance of a false-positive or false-negative result. This is partly due to the fact that the fetal cell-free DNA present in maternal plasma is derived from the cytotrophoblast of chorionic villi (CV), which is not always representative for the fetal karyotype due to chromosomal mosaicism. Therefore, a positive NIPT result should always be confirmed with invasive testing, preferably amniocentesis, in order to investigate the fetal karyotype. However, since this invasive test can only be safely performed after 15.5 weeks of gestation while NIPT can be done from the 10(th) week of gestation, this potentially means an unacceptable long waiting time for the prospective parents to receive a definitive result. Based on our experience with cytogenetic investigations in CV and the literature, we determined whether CV sampling may be appropriate for confirmation of an abnormal NIPT result.

  4. The Mechanical Design and Preliminary Testing Results of Beam Position Monitors for the LANSCE Isotope Production Facility and Switchyard Kicker Projects

    NASA Astrophysics Data System (ADS)

    O'Hara, J. F.; Gilpatrick, J. D.; Ledford, J. E.; Shurter, R. B.; Roybal, R. J.; Bentley, B. E.

    2002-12-01

    The Los Alamos Neutron Science Center (LANSCE-1) Beam Diagnostic Team is providing Beam Position Monitors (BPMs) to the LANSCE Facility for use in two on-going projects: The Isotope Production Facility (IPF) and The Switchyard Kicker Upgrade (SYK). The BPM designs for both projects are very similar. The BPMs are classic, four, micro-stripline units having one end terminated in a 50-ohm load. This paper will discuss the position measurement requirements, mechanical design, fabrication, and alignment issues encountered for both sets of BPMs, as well as report the results obtained from the initial taught wire testing of the IPF BPMs.

  5. Human T-lymphotropic virus type 1 (HTLV-1) prevalence and quantitative detection of DNA proviral load in individuals with indeterminate/positive serological results.

    PubMed

    Vitone, Francesca; Gibellini, Davide; Schiavone, Pasqua; D'Antuono, Antonietta; Gianni, Lorenzo; Bon, Isabella; Re, Maria Carla

    2006-03-02

    HTLV-1 infection is currently restricted to endemic areas. To define the prevalence of HTLV-1 infection in patients living in Italy, we first carried out a retrospective serological analysis in a group of people originating from African countries referred to our hospital from January 2003 to February 2005. We subsequently applied a real time PCR on peripheral blood mononuclear cells from subjects with positive or indeterminate serological results. All the sera were first analysed by serological methods (ELISA and/or Western Blotting) and then the peripheral blood mononuclear cells from subjects with positive or inconclusive serological results were analyzed for the presence of proviral DNA by a sensitive SYBR Green real time PCR. In addition, twenty HTLV-I ELISA negative samples were assayed by real time PCR approach as negative controls. Serological results disclosed serum reactivity by ELISA (absorbance values equal or greater than the cut-off value) in 9 out of 3408 individuals attending the Sexually Transmitted Diseases Clinic and/or Oncology Department, and 2 out 534 blood donors enrolled as a control population. Irrespective of positive or inconclusive serological results, all these subjects were analyzed for the presence of proviral DNA in peripheral blood mononuclear cells by SYBR real time PCR. A clear-cut positive result for the presence of HTLV-1 DNA was obtained in two subjects from endemic areas. SYBR real time PCR cut short inconclusive serological results. This rapid and inexpensive assay showed an excellent linear dynamic range, specificity and reproducibility readily revealing and quantifying the presence of virus in PBMCs. Our results highlight the need to monitor the presence of HTLV-1 in countries which have seen a large influx of immigrants in recent years. Epidemiological surveillance and correct diagnosis are recommended to verify the prevalence and incidence of a new undesirable phenomenon.

  6. Reliability of Disk Diffusion Test Results for the Antimicrobial Susceptibility Testing of Nosocomial Gram-positive Microorganisms: Is E-test Method Better?

    PubMed Central

    Khalili, Hossein; Soltani, Rasool; Negahban, Sorrosh; Abdollahi, Alireza; Gholami, Keirollah

    2012-01-01

    Disk diffusion test is the usual applicable method for assessing the antimicrobial susceptibility pattern in most institutions and hospitals. The aim of this study was to determine the reliability of resistant-reported results of disk diffusion test for 6 routinely used antibiotics against Gram-positive microorganisms of nosocomial origin, using E-test method. Over a 1-year period, clinical specimens (e.g. blood, tracheal secretions, wound secretions, urine, etc.) were obtained from hospitalized patients with defined nosocomial infection and were cultured. Isolated Gram-positive bacteria underwent disk diffusion test for cephalothin, oxacillin, clindamycin, ciprofloxacin, vancomycin, teicoplanin (only for Enterococci), and meropenem antibiotics. E-test method was performed for all isolates resistant or intermediately sensitive to the disks of any mentioned antibiotics. Data showed compatible results of disk diffusion test with the results of E-test method for cephalothin, oxacillin, ciprofloxacin, vancomycin, and teicoplanin. None of ciprofloxacin- and vancomycin-resistant isolates in disk diffusion test showed sensitivity in E-test method. Significant differences between the results of disk diffusion and E-test methods were observed for clindamycin and meropenem against S.aureus (p = 0.01 and 0.04, respectively) and Enterococcus spp (p = 0.03 and 0.02, respectively). In order to increase the reliability of antimicrobial susceptibility results, it is recommended to perform E-test for nosocomial Gram-positive microorganisms that show antibiotic resistance by disk diffusion test and it is more important for clindamycin and meropenem. PMID:24250479

  7. Reliability of Disk Diffusion Test Results for the Antimicrobial Susceptibility Testing of Nosocomial Gram-positive Microorganisms: Is E-test Method Better?

    PubMed

    Khalili, Hossein; Soltani, Rasool; Negahban, Sorrosh; Abdollahi, Alireza; Gholami, Keirollah

    2012-01-01

    Disk diffusion test is the usual applicable method for assessing the antimicrobial susceptibility pattern in most institutions and hospitals. The aim of this study was to determine the reliability of resistant-reported results of disk diffusion test for 6 routinely used antibiotics against Gram-positive microorganisms of nosocomial origin, using E-test method. Over a 1-year period, clinical specimens (e.g. blood, tracheal secretions, wound secretions, urine, etc.) were obtained from hospitalized patients with defined nosocomial infection and were cultured. Isolated Gram-positive bacteria underwent disk diffusion test for cephalothin, oxacillin, clindamycin, ciprofloxacin, vancomycin, teicoplanin (only for Enterococci), and meropenem antibiotics. E-test method was performed for all isolates resistant or intermediately sensitive to the disks of any mentioned antibiotics. Data showed compatible results of disk diffusion test with the results of E-test method for cephalothin, oxacillin, ciprofloxacin, vancomycin, and teicoplanin. None of ciprofloxacin- and vancomycin-resistant isolates in disk diffusion test showed sensitivity in E-test method. Significant differences between the results of disk diffusion and E-test methods were observed for clindamycin and meropenem against S.aureus (p = 0.01 and 0.04, respectively) and Enterococcus spp (p = 0.03 and 0.02, respectively). In order to increase the reliability of antimicrobial susceptibility results, it is recommended to perform E-test for nosocomial Gram-positive microorganisms that show antibiotic resistance by disk diffusion test and it is more important for clindamycin and meropenem.

  8. Case report of a false positive result of the Xpert(®) MTB/RIF assay for rifampicin resistance in Mycobacterium tuberculosis complex.

    PubMed

    Claessens, Jolien; Mathys, Vanessa; Derdelinckx, Inge; Saegeman, Veroniek

    2016-06-10

    In the present case, we report a false positive result for the detection of rifampicin (RIF) resistance by the Xpert(®) MTB/RIF assay, version G4.Miliary Mycobacterium tuberculosis infection (miliary TB) was suspected in a 50-year old Angolan woman. Imaging of the thorax and abdomen displayed diffuse lesions. The Xpert(®) MTB/RIF assay conducted on the broncho-alveolar lavage (BAL) fluid was positive for TB and positive for RIF resistance. Confirmatory molecular tests and the phenotypic drug susceptibility determination supported the diagnosis of TB but not RIF resistance. The patient was treated successfully with a conventional therapeutic scheme. Because, the Xpert(®) MTB/RIF assay allows the simultaneous detection of TB and RIF resistance, the World Health Organisation (WHO) recommends its use as initial diagnostic test, over microscopy, culture and phenotypic drug susceptibility testing. Even though specificity of the Xpert(®) MTB/RIF assay version G4 is high, false positive test results remain possible and have to be considered for the interpretation of the RIF resistance detection by Xpert(®) MTB/RIF assay.

  9. Positive skin and serologic test results of diagnostic assays for bovine tuberculosis and subsequent isolation of Mycobacterium interjectum in a pygmy hippopotamus (Hexaprotodon liberiensis).

    PubMed

    Bouts, Tim; Vordermeier, Martin; Flach, Edmund; Routh, Andrew

    2009-09-01

    A 20-yr-old male pygmy hippopotamus (Hexaprotodon liberiensis), weighing 250 kg, arrived at Zoological Society London Whipsnade Zoo (United Kingdom) from a captive collection in Portugal. A quarantine health check was performed including a comparative intradermal tuberculosis (IDTB) test. Assessment of the comparative IDTB test at 72 hr revealed a strong positive reaction at the bovine site. Serum was tested with a rapid immunochromatographic assay (TB STAT-PAK) and was positive for tuberculosis antibodies. The tuberculosis tests were repeated 6 wk later with the same positive test outcome. In addition, a broncho-alveolar lavage (BAL) was submitted for mycobacterial culture. The positive IDTB test and TB STAT-PAK results were supported by multiantigen print immunoassay (MAPIA). Based on these results, the animal was suspected to be infected with Mycobacterium tuberculosis complex organisms and was euthanized. No gross or histologic signs of tuberculosis were found at postmortem examination. Mycobacterium interjectum was cultured from the BAL but not from necropsy samples. The antigens used in the TB STAT-PAK and MAPIA tests are reportedly specific for the M. tuberculosis complex, and so it is possible this animal presented with a latent case of tuberculosis or had a previous tuberculosis infection that resolved prior to testing. Cross-reactions with nontuberculous mycobacteria have been described with TB STAT-PAK and MAPIA tests. However, Western blotting analysis using serum from this animal did not recognize M. interjectum proteins of equivalent size to the M. tuberculosis-Mycobacterium bovis proteins recognized in the MAPIA. Thus, antigenic cross-reactivity with M. interjectum can be deemed less likely, but other nontuberculous mycobacterial proteins cannot be ruled out. It is therefore possible that false-positive reactions were obtained. These results highlight the difficulty of diagnosing tuberculosis in the absence of pathology and the presence of

  10. Relationship between results of in vitro susceptibility tests and outcomes following treatment with pirlimycin hydrochloride in cows with subclinical mastitis associated with gram-positive pathogens.

    PubMed

    Apparao, Dhananjay; Oliveira, Leane; Ruegg, Pamela L

    2009-06-01

    To determine the association between results of in vitro antimicrobial susceptibility tests and outcomes in cows that received intramammary treatment with pirlimycin hydrochloride for subclinical mastitis associated with gram-positive pathogens. Case-control study. 132 dairy cows (178 mammary glands with subclinical mastitis caused by 194 pathogen isolates). Cows with positive results for a California mastitis test (CMT) were assigned to receive 50 mg of pirlimycin via intramammary administration into each CMT-positive mammary gland every 24 hours for 2 consecutive days or no treatment. Duplicate milk samples were collected before treatment and approximately 21 days later. Target pathogens included coagulase-negative Staphylococcus spp (n = 118 isolates), Streptococcus spp (28), Staphylococcus aureus (7), and other gram-positive cocci (30). Antimicrobial susceptibilities were determined via broth microdilution. Overall treatment success rate was 66% (128/194) for both groups. In vitro resistance to pirlimycin ranged from 0% (0/7 isolates of S aureus) to 50% (13/26 isolates of other gram-positive cocci). For the treated group, 62 of 94 (66%) target pathogens were classified as treatment successes and 32 (34%) were classified as failures. Similarly for the control group, 66 of 100 (66%) target pathogens were classified as treatment successes, whereas 34 (34%) were classified as failures. Many target pathogens from cows with subclinical mastitis were eliminated without treatment, and treatment with pirlimycin did not improve the treatment success rate. Results of in vitro antimicrobial susceptibility tests were not useful as predictors of treatment success following intramammary treatment with pirlimycin.

  11. Screening for latent tuberculosis in Norwegian health care workers: high frequency of discordant tuberculin skin test positive and interferon-gamma release assay negative results

    PubMed Central

    2013-01-01

    Background Tuberculosis (TB) presents globally a significant health problem and health care workers (HCW) are at increased risk of contracting TB infection. There is no diagnostic gold standard for latent TB infection (LTBI), but both blood based interferon-gamma release assays (IGRA) and the tuberculin skin test (TST) are used. According to the national guidelines, HCW who have been exposed for TB should be screened and offered preventive anti-TB chemotherapy, but the role of IGRA in HCW screening is still unclear. Methods A total of 387 HCW working in clinical and laboratory departments in three major hospitals in the Western region of Norway with possible exposure to TB were included in a cross-sectional study. The HCW were asked for risk factors for TB and tested with TST and the QuantiFERON®TB Gold In-Tube test (QFT). A logistic regression model analyzed the associations between risk factors for TB and positive QFT or TST. Results A total of 13 (3.4%) demonstrated a persistent positive QFT, whereas 214 (55.3%) had a positive TST (≥ 6 mm) and 53 (13.7%) a TST ≥ 15 mm. Only ten (4.7%) of the HCW with a positive TST were QFT positive. Origin from a TB-endemic country was the only risk factor associated with a positive QFT (OR 14.13, 95% CI 1.37 - 145.38, p = 0.026), whereas there was no significant association between risk factors for TB and TST ≥ 15 mm. The five HCW with an initial positive QFT that retested negative all had low interferon-gamma (IFN-γ) responses below 0.70 IU/ml when first tested. Conclusions We demonstrate a low prevalence of LTBI in HCW working in hospitals with TB patients in our region. The “IGRA-only” seems like a desirable screening strategy despite its limitations in serial testing, due to the high numbers of discordant TST positive/IGRA negative results in HCW, probably caused by BCG vaccination or boosting due to repetitive TST testing. Thus, guidelines for TB screening in HCW should be updated in order to

  12. Factors Associated with Rates of False-positive and False-negative Results from Digital Mammography Screening: An Analysis of Registry Data

    PubMed Central

    Nelson, Heidi D.; O’Meara, Ellen S.; Kerlikowske, Karla; Balch, Steven; Miglioretti, Diana

    2016-01-01

    Background Women screened with digital mammography may experience false-positive and false-negative results and subsequent additional imaging and biopsies. It is unclear how these outcomes vary by age, time since last screening, and individual risk factors. Objective To determine factors associated with false-positive and false-negative digital mammography results, additional imaging, and biopsies among a general population of women screened for breast cancer. Design Analysis of registry data. Setting Participating facilities at five U.S. Breast Cancer Surveillance Consortium breast imaging registries with linkages to pathology databases and tumor registries. Patients 405,191 women aged 40–89 years screened with digital mammography between 2003–2011; 2,963 were diagnosed with invasive cancer or ductal carcinoma in situ within 12 months of screening. Measurements Rates of false-positive and false-negative results and recommendations for additional imaging and biopsies from a single screening round, and comparisons by age, time since last screening, and risk factors. Results Rates of false-positive results (121.2/1,000 women; 95% CI 105.6 to 138.7) and recommendations for additional imaging (124.9/1,000; 95% CI 109.3 to 142.3) were highest among women aged 40–49 years and decreased with age; rates of false-negative results (1.0 to 1.5/1,000) and recommendations for biopsy (5.6 to 17.5/1,000) did not differ greatly by age. Results did not differ by time since last screening. All rates were higher for women with risk factors, particularly family history of breast cancer, previous benign breast biopsy, high breast density, and low body mass index for younger women. Limitations Additional factors were not examined, including numbers of first- and second-degree relatives with breast cancer and diagnoses of previous benign biopsies. Conclusions False-positive results and additional imaging are common, particularly for younger women and those with risk factors, while

  13. Risk assessment of false-positive quantitative real-time PCR results in food, due to detection of DNA originating from dead cells.

    PubMed

    Wolffs, Petra; Norling, Börje; Rådström, Peter

    2005-03-01

    Real-time PCR technology is increasingly used for detection and quantification of pathogens in food samples. A main disadvantage of nucleic acid detection is the inability to distinguish between signals originating from viable cells and DNA released from dead cells. In order to gain knowledge concerning risks of false-positive results due to detection of DNA originating from dead cells, quantitative PCR (qPCR) was used to investigate the degradation kinetics of free DNA in four types of meat samples. Results showed that the fastest degradation rate was observed (1 log unit per 0.5 h) in chicken homogenate, whereas the slowest rate was observed in pork rinse (1 log unit per 120.5 h). Overall results indicated that degradation occurred faster in chicken samples than in pork samples and faster at higher temperatures. Based on these results, it was concluded that, especially in pork samples, there is a risk of false-positive PCR results. This was confirmed in a quantitative study on cell death and signal persistence over a period of 28 days, employing three different methods, i.e. viable counts, direct qPCR, and finally floatation, a recently developed discontinuous density centrifugation method, followed by qPCR. Results showed that direct qPCR resulted in an overestimation of up to 10 times of the amount of cells in the samples compared to viable counts, due to detection of DNA from dead cells. However, after using floatation prior to qPCR, results resembled the viable count data. This indicates that by using of floatation as a sample treatment step prior to qPCR, the risk of false-positive PCR results due to detection of dead cells, can be minimized.

  14. Comparative Efficacy and Safety of Adjuvant Letrozole Versus Anastrozole in Postmenopausal Patients With Hormone Receptor-Positive, Node-Positive Early Breast Cancer: Final Results of the Randomized Phase III Femara Versus Anastrozole Clinical Evaluation (FACE) Trial.

    PubMed

    Smith, Ian; Yardley, Denise; Burris, Howard; De Boer, Richard; Amadori, Dino; McIntyre, Kristi; Ejlertsen, Bent; Gnant, Michael; Jonat, Walter; Pritchard, Kathleen I; Dowsett, Mitch; Hart, Lowell; Poggio, Susan; Comarella, Lisa; Salomon, Herve; Wamil, Barbara; O'Shaughnessy, Joyce

    2017-04-01

    Purpose The Letrozole (Femara) Versus Anastrozole Clinical Evaluation (FACE) study compared the efficacy and safety of adjuvant letrozole versus anastrozole in postmenopausal patients with hormone receptor (HR) -positive and node-positive early breast cancer (eBC). Methods Postmenopausal women with HR-positive and node-positive eBC were randomly assigned to receive adjuvant therapy with either letrozole (2.5 mg) or anastrozole (1 mg) once per day for 5 years or until recurrence of disease. Patients were stratified on the basis of the number of lymph nodes and human epidermal growth factor receptor 2 status. The primary end point was 5-year disease-free survival (DFS), and the key secondary end points were overall survival and safety. Results A total of 4,136 patients were randomly assigned to receive either letrozole (n = 2,061) or anastrozole (n = 2,075). The final analysis was done at 709 DFS events (letrozole, 341 [16.5%]; anastrozole, 368 [17.7%]). The 5-year estimated DFS rate was 84.9% for letrozole versus 82.9% for anastrozole arm (hazard ratio, 0.93; 95% CI, 0.80 to 1.07; P = .3150). Exploratory analysis showed similar DFS with letrozole and anastrozole in all evaluated subgroups. The 5-year estimated overall survival rate was 89.9% for letrozole versus 89.2% for anastrozole arm (hazard ratio, 0.98; 95% CI, 0.82 to 1.17; P = .7916). Most common grade 3 to 4 adverse events (> 5% of patients) reported for letrozole versus anastrozole were arthralgia (3.9% v 3.3%, and 48.2% v 47.9% for all adverse events), hypertension (1.2% v 1.0%), hot flushes (0.8% v 0.4%), myalgia (0.8% v 0.7%), dyspnea (0.8% v 0.5%), and depression (0.8% v 0.6%). Conclusion Letrozole did not demonstrate significantly superior efficacy or safety compared with anastrozole in postmenopausal patients with HR-positive, node-positive eBC.

  15. Safety of mid-septal electrode placement in implantable cardioverter defibrillator recipients--results of the SPICE (Septal Positioning of ventricular ICD Electrodes) study.

    PubMed

    Kolb, Christof; Solzbach, Ulrich; Biermann, Jürgen; Semmler, Verena; Kloppe, Axel; Klein, Norbert; Lennerz, Carsten; Szendey, Istvan; Andrikopoulos, George; Tzeis, Stylianos; Asbach, Stefan

    2014-07-01

    Detrimental effects of right ventricular (RV) apical pacing have directed the interest toward alternative pacing sites such as the RV mid-septum. As safety data are scarce for implantable cardioverter defibrillator (ICD) recipients the study aims to evaluate ICD lead performance in the mid-septal position. A total of 299 ICD recipients (79% male, aged 65.2 ± 12.1 years, 83% primary prevention of sudden cardiac death) were randomized to receive the RV ICD electrode either in a mid-septal (n=145) or apical (n=154) location. Event-free survival was evaluated at 3 (primary endpoint) and 12 months (secondary endpoint). Events included a composite of lead revision, suboptimal right ventricular electrode performance (including defibrillation thresholds (DFT)>25 J) or lead position not in accordance with randomized location. Event-free survival at 3 (12) months was observed in 80.6% (72.3%) of patients randomized to a mid-septal and in 82.2% (72.1%) of patients randomized to an apical lead position, p=0.726 (p=0.969). Pre-defined margins for non-inferiority were not reached at 3 or 12 months. High DFT was found in 7 patients (5.0%) of the mid-septal and in 3 (2.2%) patients of the apical group (p=0.209). In ICD recipients electrode positioning to the RV mid-septum or the RV apex results in slightly different rates concerning the survival free of lead revision, suboptimal right ventricular electrode performance or non-randomized lead position. Non-inferiority of the mid-septal lead location cannot be concluded. This should be taken into consideration when a mid-septal lead position is pursued. ClinicalTrials.gov identifier NCT00745745. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  16. ASSOCIATION BETWEEN POSITIVE CANINE HEARTWORM (DIROFILARIA IMMITIS) ANTIGEN RESULTS AND PRESENCE OF ACANTHOCHEILONEMA ODENDHALI MICROFILARIA IN CALIFORNIA SEA LIONS (ZALOPHUS CALIFORNIANUS).

    PubMed

    Krucik, David D R; Van Bonn, William; Johnson, Shawn P

    2016-03-01

    This study establishes a relationship between positive canine heartworm (Dirofilaria immitis) test results frequently observed in California sea lions (Zalophus californianus) and infection with the filarid nematode Acanthocheilonema odendhali. Four commercially available canine heartworm antigen tests were evaluated for cross-reaction with A. odendhali in California sea lions. Sera were tested from fifteen California sea lions with A. odendhali-associated microfilaremia, confirmed by blood smear, and with no evidence of D. immitis infection at necropsy. Ninety-five percent of tests were falsely positive for D. immitis. This study also determined that the prevalence of A. odendhali infection in stranded California sea lions from central California is approximately 23% by comparing the number of findings of mircofilaremia to the total number of California sea lions sampled at The Marine Mammal Center between 2005 and 2011, inclusive. Acanthocheilonema odenhali microfilaremia in California sea lions is likely to cross-react with canine heartworm antigen tests, and clinicians should interpret results with caution.

  17. Depletion of T regulatory cells through selection of CD127-positive cells results in a population enriched in memory T cells: implications for anti-tumor cell therapy

    PubMed Central

    Touil, Soumia; Rosenzwajg, Michelle; Landau, Dan Avi; Le Corvoisier, Philippe; Frédéric, Charlotte; Klatzmann, David; Maury, Sébastien; Cohen, José L.

    2012-01-01

    Background Donor lymphocyte infusions can induce remissions in patients with relapse after allogeneic hematopoietic stem cell transplantation. Nevertheless, some grafted patients never display any signs of alloreactivity, either following allogeneic hematopoietic stem cell transplantation or after donor lymphocyte infusions. Consequently, they do not develop graft-versus-host disease and frequently do not respond to donor lymphocyte infusions. In a recently published clinical trial, we observed that elimination of CD4+CD25+Foxp3+ natural regulatory T cells from the donor lymphocyte product could improve alloreactivity and the associated anti-tumor effect in a small proportion of patients with relapsed hematologic malignancies. Here, we aimed to improve the effect of donor lymphocyte infusion by modifying the procedure for depletion of T regulatory cells. Design and Methods We directly compared depletion of regulatory T cells from human peripheral blood mononuclear cells achieved by selection of CD127-positive cells or by selection of CD25-negative cells. We tested the manipulated products (i) in vitro in mixed lymphocyte reactions and against pathogen-derived recall antigens and (ii) in vivo in experimental graft-versus-host disease. Results In vitro, we found that depletion of regulatory T cells through CD127 positive selection improved both alloreactive and pathogen-specific immune responses. In vivo, we observed accelerated donor T-cell division and enhanced graft-versus-host disease due to efficient regulatory T-cell depletion accompanied by enrichment in memory T cells. Conclusions Our results show that the strategy of CD127 positive selection is an efficient way of eliminating regulatory T cells from donor lymphocyte infusions and improves alloreactivity. This supports the investigation of CD127 positive selection in place of elimination of CD25-positive cells for clinical applications. PMID:22581007

  18. Screening for latent tuberculosis in Norwegian health care workers: high frequency of discordant tuberculin skin test positive and interferon-gamma release assay negative results.

    PubMed

    Gran, Gerd; Aßmus, Jörg; Dyrhol-Riise, Anne Ma

    2013-04-17

    Tuberculosis (TB) presents globally a significant health problem and health care workers (HCW) are at increased risk of contracting TB infection. There is no diagnostic gold standard for latent TB infection (LTBI), but both blood based interferon-gamma release assays (IGRA) and the tuberculin skin test (TST) are used. According to the national guidelines, HCW who have been exposed for TB should be screened and offered preventive anti-TB chemotherapy, but the role of IGRA in HCW screening is still unclear. A total of 387 HCW working in clinical and laboratory departments in three major hospitals in the Western region of Norway with possible exposure to TB were included in a cross-sectional study. The HCW were asked for risk factors for TB and tested with TST and the QuantiFERON®TB Gold In-Tube test (QFT). A logistic regression model analyzed the associations between risk factors for TB and positive QFT or TST. A total of 13 (3.4%) demonstrated a persistent positive QFT, whereas 214 (55.3%) had a positive TST (≥ 6 mm) and 53 (13.7%) a TST ≥ 15 mm. Only ten (4.7%) of the HCW with a positive TST were QFT positive. Origin from a TB-endemic country was the only risk factor associated with a positive QFT (OR 14.13, 95% CI 1.37 - 145.38, p=0.026), whereas there was no significant association between risk factors for TB and TST ≥ 15 mm. The five HCW with an initial positive QFT that retested negative all had low interferon-gamma (IFN-γ) responses below 0.70 IU/ml when first tested. We demonstrate a low prevalence of LTBI in HCW working in hospitals with TB patients in our region. The "IGRA-only" seems like a desirable screening strategy despite its limitations in serial testing, due to the high numbers of discordant TST positive/IGRA negative results in HCW, probably caused by BCG vaccination or boosting due to repetitive TST testing. Thus, guidelines for TB screening in HCW should be updated in order to secure accurate diagnosis of LTBI and offer proper

  19. Lapatinib or Trastuzumab Plus Taxane Therapy for Human Epidermal Growth Factor Receptor 2-Positive Advanced Breast Cancer: Final Results of NCIC CTG MA.31.

    PubMed

    Gelmon, Karen A; Boyle, Frances M; Kaufman, Bella; Huntsman, David G; Manikhas, Alexey; Di Leo, Angelo; Martin, Miguel; Schwartzberg, Lee S; Lemieux, Julie; Aparicio, Samuel; Shepherd, Lois E; Dent, Susan; Ellard, Susan L; Tonkin, Katia; Pritchard, Kathleen I; Whelan, Timothy J; Nomikos, Dora; Nusch, Arnd; Coleman, Robert E; Mukai, Hirofumi; Tjulandin, Sergei; Khasanov, Rustem; Rizel, Shulamith; Connor, Anne P; Santillana, Sergio L; Chapman, Judith-Anne W; Parulekar, Wendy R

    2015-05-10

    The efficacy of lapatinib versus trastuzumab combined with taxanes in the first-line setting of human epidermal growth factor receptor 2 (HER2) -positive metastatic breast cancer (BC) is unknown. The MA.31 trial compared a combination of first-line anti-HER2 therapy (lapatinib or trastuzumab) and taxane therapy for 24 weeks, followed by the same anti-HER2 monotherapy until progression. Stratification was by prior (neo)adjuvant anti-HER2 therapy, prior (neo)adjuvant taxane, planned taxane, and liver metastases. The primary end point was intention-to-treat (ITT) progression-free survival (PFS), defined as time from random assignment to progression by RECIST (version 1.0) criteria, or death for patients with locally assessed HER2-positive tumors. The primary test statistic was a stratified log-rank test for noninferiority. PFS was also assessed for patients with centrally confirmed HER2-positive tumors. From July 17, 2008, to December 1, 2011, 652 patients were accrued from 21 countries, resulting in 537 patients with centrally confirmed HER2-positive tumors. Median follow-up was 21.5 months. Median ITT PFS was 9.0 months with lapatinib and 11.3 months with trastuzumab. By ITT analysis, PFS was inferior for lapatinib compared with trastuzumab, with a stratified hazard ratio (HR) of 1.37 (95% CI, 1.13 to 1.65; P = .001). In patients with centrally confirmed HER2-positive tumors, median PFS was 9.1 months with lapatinib and 13.6 months with trastuzumab (HR, 1.48; 95% CI, 1.20 to 1.83; P < .001). More grade 3 or 4 diarrhea and rash were observed with lapatinib (P < .001). PFS results were supported by the secondary end point of overall survival, with an ITT HR of 1.28 (95% CI, 0.95 to 1.72; P = .11); in patients with centrally confirmed HER2-positive tumors, the HR was 1.47 (95% CI, 1.03 to 2.09; P = .03). As first-line therapy for HER2-positive metastatic BC, lapatinib combined with taxane was associated with shorter PFS and more toxicity compared with trastuzumab

  20. Assessment of skin sensitization under REACH: A case report on vehicle choice in the LLNA and its crucial role preventing false positive results.

    PubMed

    Watzek, Nico; Berger, Franz; Kolle, Susanne Noreen; Kaufmann, Tanja; Becker, Matthias; van Ravenzwaay, Bennard

    2017-04-01

    In the EU, chemicals with a production or import volume in quantities of one metric ton per year or more have to be tested for skin sensitizing properties under the REACH regulation. The murine Local Lymph Node Assay (LLNA) and its modifications are widely used to fulfil the data requirement, as it is currently considered the first-choice method for in vivo testing to cover this endpoint. This manuscript describes a case study highlighting the importance of understanding the chemistry of the test material during testing for 'skin sensitization' of MCDA (mixture of 2,4- and 2,6-diamino-methylcyclohexane) with particular focus on the vehicle used. While the BrdU-ELISA modification of the LLNA using acetone/olive oil (AOO) as vehicle revealed expectable positive results. However, the concentration control analysis unexpectedly revealed an instability of MCDA in the vehicle AOO. Further studies on the reactivity showed MCDA to rapidly react with AOO under formation of various imine structures, which might have caused the positive LLNA result. The repetition of the LLNA using propylene glycol (PG) as vehicle did not confirm the positive results of the LLNA using AOO. Finally, a classification of MCDA as skin sensitizer according to the Globally Harmonized System (GHS) was not justified. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. False-positive amphetamine/ecstasy (MDMA/3,4-methylenedioxymethamphetamine) (CEDIA) and ecstasy (MDMA/3,4-methylenedioxymethamphetamine) (DRI) test results with fenofibrate.

    PubMed

    Kaplan, Yusuf Cem; Erol, Almla; Karadaş, Barş

    2012-10-01

    This case report describes a false-positive amphetamine/ecstasy [3,4-methylenedioxymethamphetamine (MDMA)] and ecstasy (MDMA) screen after therapeutic use of antihyperlipidemic drug, fenofibrate. A 60-year-old male patient was admitted to inpatient psychiatry unit with the diagnosis of alcohol dependency. He was prescribed diazepam 30 mg/day, thiamine 300 mg/day, and naltrexone 50 mg/day. He had also been using fenofibrate 267 mg/day for 3 years for hyperlipidemia and trazodone 100 mg/day for 5 months for insomnia. On routine, urine drugs-of-abuse screening amphetamine/MDMA (CEDIA) test was positive for 4 different occasions and MDMA (DRI) test was positive on 5 different occasions. Gas chromatography/mass spectrometry confirmation of the first positive 3 samples were negative for amphetamine and MDMA. After discontinuation of fenofibrate, amphetamine/MDMA, and MDMA immunoassay results turned out to be negative. Caution should be given to interpretation of amphetamine/MDMA (CEDIA) and MDMA (DRI) tests in patients taking fenofibrate. Specific confirmation with a suitable method should be used to prevent erroneous interpretations.

  2. Agreement between QuantiFERON®-TB Gold In-Tube and the tuberculin skin test and predictors of positive test results in Warao Amerindian pediatric tuberculosis contacts

    PubMed Central

    2014-01-01

    Background Interferon-gamma release assays have emerged as a more specific alternative to the tuberculin skin test (TST) for detection of tuberculosis (TB) infection, especially in Bacille Calmette-Guérin (BCG) vaccinated people. We determined the prevalence of Mycobacterium tuberculosis infection by TST and QuantiFERON®-TB Gold In-Tube (QFT-GIT) and assessed agreement between the two test methods and factors associated with positivity in either test in Warao Amerindian children in Venezuela. Furthermore, progression to active TB disease was evaluated for up to 12 months. Methods 163 HIV-negative childhood household contacts under 16 years of age were enrolled for TST, QFT-GIT and chest X-ray (CXR). Follow-up was performed at six and 12 months. Factors associated with TST and QFT-GIT positivity were studied using generalized estimation equations logistic regression models. Results At baseline, the proportion of TST positive children was similar to the proportion of children with a positive QFT-GIT (47% vs. 42%, p = 0.12). Overall concordance between QFT-GIT and TST was substantial (kappa 0.76, 95% CI 0.46-1.06). Previous BCG vaccination was not associated with significantly increased positivity in either test (OR 0.68, 95% CI 0.32-1.5 for TST and OR 0.51, 95% CI 0.14-1.9 for QFT-GIT). Eleven children were diagnosed with active TB at baseline. QFT-GIT had a higher sensitivity for active TB (88%, 95% CI 47-98%) than TST (55%, 95% CI 24-83%) while specificities were similar (respectively 58% and 55%). Five initially asymptomatic childhood contacts progressed to active TB disease during follow-up. Conclusion Replacement of TST by the QFT-GIT for detection of M. tuberculosis infection is not recommended in this resource-constrained setting as test results showed substantial concordance and TST positivity was not affected by previous BCG vaccination. The QFT-GIT had a higher sensitivity than the TST for the detection of TB disease. However, the value of the QFT

  3. Prevalence, Predictors, and Same Day Treatment of Positive VIA Enhanced by Digital Cervicography and Histopathology Results in a Cervical Cancer Prevention Program in Cameroon.

    PubMed

    DeGregorio, Geneva A; Bradford, Leslie S; Manga, Simon; Tih, Pius M; Wamai, Richard; Ogembo, Rebecca; Sando, Zacharie; Liu, Yuxin; Schwaiger, Constance; Rao, Sowmya R; Kalmakis, Karen; Kennedy Sheldon, Lisa; Nulah, Kathleen; Welty, Edith; Welty, Thomas; Ogembo, Javier Gordon

    2016-01-01

    In 2007, the Cameroon Baptist Convention Health Services (CBCHS) implemented a screen-and-treat cervical cancer prevention program using visual inspection with acetic acid enhanced by digital cervicography (VIA-DC). We retrospectively analyzed 46,048 medical records of women who received care through the CBCHS Women's Health Program from 2007 through 2014 to determine the prevalence and predictors of positive VIA-DC, rates of same day treatment, and cohort prevalence of invasive cervical cancer (ICC). Of the 44,979 women who were screened for cervical cancer, 9.0% were VIA-DC-positive, 66.8% were VIA-DC-negative, 22.0% were VIA-DC-inadequate (normal ectocervix, but portions of the transformation zone were obscured), and 2.2% were VIA-DC-uncertain (cervical abnormalities confounding VIA-DC interpretation). Risk factors significantly associated with VIA-DC-positive screen were HIV-positivity, young age at sexual debut, higher lifetime number of sexual partners, low education status and higher gravidity. In 2014, 31.1% of women eligible for cryotherapy underwent same day treatment. Among the 32,788 women screened from 2007 through 2013, 201 cases of ICC were identified corresponding to a cohort prevalence of 613 per 100,000. High rate of VIA-DC-positive screens suggests a significant burden of potential cervical cancer cases and highlights the need for expansion of cervical cancer screening and prevention throughout the 10 regions of Cameroon. VIA-DC-inadequate rates were also high, especially in older women, and additional screening methods are needed to confirm whether these results are truly negative. In comparison to similar screening programs in sub-Saharan Africa there was low utilization of same day cryotherapy treatment. Further studies are required to characterize possible program specific barriers to treatment, for example cultural demands, health system challenges and cost of procedure. The prevalence of ICC among women who presented for screening was high

  4. Hepatitis B virus markers in the population of Dar es Salaam, Tanzania.

    PubMed

    Haukenes, G; Shao, J F; Mbena, E; Rustad, S

    1987-09-01

    A total of 542 serum samples from healthy adults (medical students and medical staff, blood donors and pregnant women) residing in or near the city of Dar es Salaam, Tanzania were examined for markers of hepatitis B virus (HBV) infection. Of these samples, 95 (17.5%) were not found to contain any HBV marker when examined by enzyme-linked immunoassay for hepatitis B surface antigen (HBsAg), antibody to hepatitis B surface antigen (anti-HBs) and antibody to hepatitis B core antigen (anti-HBc). HBsAg was demonstrated in 52 (9.6%) samples of which 7 (13.5%) were positive for hepatitis Be antigen (HBeAg) and 17 (32.7%) were positive for anti-HBc IgM. None of 9 HBsAg positive pregnant women were carriers of HBeAg. These results show that hepatitis B infection is very common in this country. The relatively low prevalence of HBeAg among HBsAg carriers may indicate that transmission of hepatitis B at birth is not of major importance.

  5. Sero-epidemiology of hepatitis B markers in the population of Tuscany, Central Italy, 20 years after the implementation of universal vaccination.

    PubMed

    Boccalini, Sara; Pellegrino, Elettra; Tiscione, Emila; Pesavento, Giovanna; Bechini, Angela; Levi, Miriam; Rapi, Stefano; Mercurio, Stefano; Mannelli, Francesco; Peruzzi, Marta; Berardi, Cesare; Bonanni, Paolo

    2013-03-01

    Italy was one of the first industrialized countries to introduce a program of universal vaccination against hepatitis B in 1991. Twenty years later we verified the impact of universal immunisation on the epidemiology of hepatitis B infection by analyzing the prevalence of specific viral markers (anti-HBs, anti-HBc and HBsAg). The ELISA tests were performed on residual blood samples collected by 0.05% of the resident population aged 1-50 years in Tuscany (Italy). About 63% of subjects aged < 30 years were anti-HBs positive compared to about 25% in older subjects, without differences between genders. About 22% of subjects over 40 years were anti-HBc-positive compared to 5% in the younger age groups. The number of HBsAg-positive subjects was almost 10 fold higher in the unvaccinated age groups than in the cohorts involved in the universal vaccination program. The results of our study show the persisting high anti-HBs reactivity in vaccinated cohorts, while HBV markers related to natural exposure or persistent infection remain remarkably higher in older age groups. This sero-epidemiological study supports with prevalence data the downward incidence trend of acute hepatitis B highlighted by epidemiological surveillance systems, and corroborates the forecast for elimination of hepatitis B in Italy in a few decades.

  6. Triaging HPV-positive women with p16/Ki-67 dual-stained cytology: Results from a sub-study nested into the ATHENA trial.

    PubMed

    Wright, Thomas C; Behrens, Catherine M; Ranger-Moore, James; Rehm, Susanne; Sharma, Abha; Stoler, Mark H; Ridder, Ruediger

    2017-01-01

    In addition to genotyping for HPV16/18, dual-immunostaining for p16/Ki-67 has shown promise as a triage of HPV-positive women. We assessed the performance of p16/Ki-67 dual-stained cytology for triaging HPV-positive women undergoing primary HPV screening. All women ≥25years with valid cervical biopsy and cobas® HPV Test results from the cross-sectional phase of ATHENA who were referred to colposcopy (n=7727) were eligible for enrolment. p16/Ki-67 dual-stained cytology was retrospectively performed on residual cytologic material collected into a second liquid-based cytology vial during the ATHENA enrolment visit. The diagnostic performance of dual-stained cytology, with or without HPV16/18 genotyping, for the detection of biopsy-confirmed cervical intraepithelial neoplasia grade 3 or worse (CIN3+) was determined and compared to Pap cytology. Furthermore, the number of colposcopies required per CIN3+ detected was determined. Dual-stained cytology was significantly more sensitive than Pap cytology (74.9% vs. 51.9%; p<0.0001) for triaging HPV-positive women, whereas specificity was comparable (74.1% vs. 75.0%; p=0.3198). Referral of all HPV16/18 positive women combined with dual-stained cytology triage of women positive for 12 "other" HPV genotypes provided the highest sensitivity for CIN3+ (86.8%; 95% CI: 81.9-90.8). A similar strategy but using Pap cytology for the triage of women positive for 12 "other" HPV genotypes was less sensitive (78.2%; 95% CI: 72.5-83.2; p=0.0003), but required a similar number of colposcopies per CIN3+ detected. p16/Ki-67 dual-stained cytology, either alone or combined with HPV16/18 genotyping, represents a promising approach as a sensitive and efficient triage for colposcopy of HPV-positive women when primary HPV screening is utilized. Copyright © 2016. Published by Elsevier Inc.

  7. Regional Nodal Irradiation After Breast Conserving Surgery for Early HER2-Positive Breast Cancer: Results of a Subanalysis From the ALTTO Trial.

    PubMed

    Gingras, Isabelle; Holmes, Eileen; De Azambuja, Evandro; Nguyen, David H A; Izquierdo, Miguel; Anne Zujewski, Jo; Inbar, Moshe; Naume, Bjorn; Tomasello, Gianluca; Gralow, Julie R; Wolff, Antonio C; Harris, Lyndsay; Gnant, Michael; Moreno-Aspitia, Alvaro; Piccart, Martine J; Azim, Hatem A

    2017-08-01

    Two randomized trials recently demonstrated that regional nodal irradiation (RNI) could reduce the risk of recurrence in early breast cancer; however, these trials were conducted in the pretrastuzumab era. Whether these results are applicable to human epidermal growth factor receptor 2 (HER2)-positive breast cancer patients treated with anti-HER2-targeted therapy is unknown. This retrospective analysis was performed on patients with node-positive breast cancer who were enrolled in the Adjuvant Lapatinib and/or Trastuzumab Treatment Optimization phase III adjuvant trial and subjected to BCS. The primary objective of the present study was to examine the effect of RNI on disease-free survival (DFS). A multivariable cox regression analysis adjusted for number of positive lymph nodes, tumor size, grade, age, hormone receptors status, presence of macrometastatis, treatment arm, and chemotherapy timing was carried out to investigate the relationship between RNI and DFS. One thousand six hundred sixty-four HER2-positive breast cancer patients were included, of whom 878 (52.8%) had received RNI to the axillary, supraclavicular, and/or internal mammary lymph nodes. Patients in the RNI group had higher nodal burden and more frequently had tumors larger than 2 cm. At a median follow-up of 4.5 years, DFS was 84.3% in the RNI group and 88.3% in the non-RNI group. No differences in regional recurrence (0.9 % vs 0.6 %) or in overall survival (93.6% vs 95.3%) were observed between the two groups. After adjustment in multivariable analysis, there was no statistically significant association between RNI and DFS (hazard ratio = 0.96, 95% confidence interval = 0.71 to 1.29). Our analysis did not demonstrate a DFS benefit of RNI in HER2-positive, node-positive patients treated with adjuvant HER2-targeted therapy. The benefit of RNI in HER2-positive breast cancer needs further testing within randomized clinical trials.

  8. The yield of a positive MRI of the spine as imaging criterion in the ASAS classification criteria for axial spondyloarthritis: results from the SPACE and DESIR cohorts.

    PubMed

    Ez-Zaitouni, Zineb; Bakker, Pauline Ac; van Lunteren, Miranda; de Hooge, Manouk; van den Berg, Rosaline; Reijnierse, Monique; Fagerli, Karen Minde; Landewé, Robert Bm; Ramonda, Roberta; Jacobsson, Lennart Th; Saraux, Alain; Lenczner, Gregory; Feydy, Antoine; Pialat, Jean Baptiste; Thévenin, Fabrice; van Gaalen, Floris A; van der Heijde, Désirée

    2017-10-01

    To assess the prevalence of spinal inflammation on MRI in patients with chronic back pain (CBP) of maximally 3 years duration and to evaluate the yield of adding a positive MRI-spine as imaging criterion to the Assessment of SpondyloArthritis international Society (ASAS) classification criteria for axial spondyloarthritis (axSpA). Baseline imaging of the sacroiliac joints (X-SI), MRI of the sacroiliac joints (MRI-SI) and MRI-spine were scored by ≥2 experienced central readers per modality in the SPondyloArthritis Caught Early (SPACE) and DEvenir des Spondylarthropathies Indifférenciées Récentes (DESIR) cohorts. Inflammation suggestive of axSpA was assessed in the entire spine. A positive MRI-spine was defined by the presence of ≥5 inflammatory lesions. Alternative less strict definitions were also tested. In this study, 541 and 650 patients with CBP from the SPACE and DESIR cohorts were included. Sacroiliitis on X-SI and MRI-SI was found in 40/541 (7%) and 76/541 (14%) patients in SPACE, and in DESIR in 134/650 (21%) and 231/650 (36%) patients, respectively. In SPACE and DESIR, a positive MRI-spine was seen in 4/541 (1%) and 48/650 (7%) patients. Of the patients without sacroiliitis on imaging, 3/447 (1%) (SPACE) and 8/382 (2%) (DESIR) patients had a positive MRI-spine. Adding positive MRI-spine as imaging criterion led to new classification in only one patient in each cohort, as the other patients already fulfilled the clinical arm. Other definitions of a positive MRI-spine yielded similar results. In two cohorts of patients with CBP with a maximum symptom duration of 3 years, a positive MRI-spine was rare in patients without sacroiliitis on MRI-SI and X-SI. Addition of MRI-spine as imaging criterion to the ASAS axSpA criteria had a low yield of newly classified patients and is therefore not recommended. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is

  9. Long-term Results from Cyclocryotherapy Applied to the 3O'clock and 9O'clock Positions in Blind Refractory Glaucoma Patients

    PubMed Central

    Kim, Byoung Seon; Kim, Young Jun; Seo, Seong Wook; Yoo, Ji Myong

    2015-01-01

    Purpose To report the long-term follow-up results after cyclocryotherapy, applied to the 3-o'clock and 9-o'clock positions in blind refractory glaucoma patients. Methods We retrospectively reviewed the charts of 19 blind patients, and a total of 20 eyes with refractory glaucoma who were treated with cyclocryotherapy. Cyclocryotherapy treatments were performed using a retinal cryoprobe. The temperature of each cyclocryotherapy spot was -80℃ and each spot was maintained in place for 60 seconds. Six cyclocryotherapy spots were placed in each quadrant, including the 3-o'clock and 9-o'clock positions. Results The mean baseline pretreatment intraocular pressure (IOP) in all eyes was 50.9 ± 12.5 mmHg, which significantly decreased to a mean IOP at last follow-up of 14.1 ± 7.1 mmHg (p < 0.001). The mean number of antiglaucoma medications that patients were still taking at last follow-up was 0.3 ± 0.6. Devastating post-procedure phthisis occurred in only one eye. Conclusions Cyclocryotherapy, performed at each quadrant and at the 3-o'clock and 9-o'clock position, is an effective way to lower IOP and, thus, is a reasonable treatment option for refractory glaucoma patients who experience with ocular pain and headaches. PMID:25646060

  10. Positive screening and carrier results for the England-wide universal newborn sickle cell screening programme by ethnicity and area for 2005–07

    PubMed Central

    Latinovic, Radoslav; Henthorn, Joan

    2010-01-01

    Aims The overall aim of the new national newborn programme is to identify infants at risk of sickle cell disease to allow early detection and to minimise deaths and complications. Methods Universal screening for sickle cell disease was introduced in England between September 2003 and July 2006. The 13 newborn laboratories each screen between 25 000 and 110 000 babies a year using the existing dried bloodspot cards. The specified conditions to be screened for include sickle cell anaemia (Hb SS), Hb SC disease, Hb S/β thalassaemia, Hb S/DPunjab and Hb S/OArab. Data are reported on screening results by ethnic group and geographical area. Results The prevalence of screen positive results across England is 1:2000. There is a 25-fold variation by geographical area. African babies make up 61% of all screen positive results despite representing only 4% of total births. Combined carrier rates vary widely by ethnicity, from 1.85 per 1000 (1:540) in ‘White British’ to 145 per 1000 (1:7) in ‘African’ babies. Refusal rates for screening show variation by ethnicity. Conclusions These results provide useful information both about the frequency of these conditions and the carrier state and their geographic and ethnic distribution across England. This can be used to refine counselling information and are also useful to target and plan services and public information. PMID:20591912

  11. Faster methods for estimating arc centre position during VAR and results from Ti-6Al-4V and INCONEL 718 alloys

    NASA Astrophysics Data System (ADS)

    Nair, B. G.; Winter, N.; Daniel, B.; Ward, R. M.

    2016-07-01

    Direct measurement of the flow of electric current during VAR is extremely difficult due to the aggressive environment as the arc process itself controls the distribution of current. In previous studies the technique of “magnetic source tomography” was presented; this was shown to be effective but it used a computationally intensive iterative method to analyse the distribution of arc centre position. In this paper we present faster computational methods requiring less numerical optimisation to determine the centre position of a single distributed arc both numerically and experimentally. Numerical validation of the algorithms were done on models and experimental validation on measurements based on titanium and nickel alloys (Ti6Al4V and INCONEL 718). The results are used to comment on the effects of process parameters on arc behaviour during VAR.

  12. Agreement between QuantiFERON®-TB Gold In-Tube and the tuberculin skin test and predictors of positive test results in Warao Amerindian pediatric tuberculosis contacts.

    PubMed

    Verhagen, Lilly M; Maes, Mailis; Villalba, Julian A; d'Alessandro, Adriana; Rodriguez, Lazaro Perez; España, Mercedes F; Hermans, Peter W M; de Waard, Jacobus H

    2014-07-11

    Interferon-gamma release assays have emerged as a more specific alternative to the tuberculin skin test (TST) for detection of tuberculosis (TB) infection, especially in Bacille Calmette-Guérin (BCG) vaccinated people. We determined the prevalence of Mycobacterium tuberculosis infection by TST and QuantiFERON®-TB Gold In-Tube (QFT-GIT) and assessed agreement between the two test methods and factors associated with positivity in either test in Warao Amerindian children in Venezuela. Furthermore, progression to active TB disease was evaluated for up to 12 months. 163 HIV-negative childhood household contacts under 16 years of age were enrolled for TST, QFT-GIT and chest X-ray (CXR). Follow-up was performed at six and 12 months. Factors associated with TST and QFT-GIT positivity were studied using generalized estimation equations logistic regression models. At baseline, the proportion of TST positive children was similar to the proportion of children with a positive QFT-GIT (47% vs. 42%, p = 0.12). Overall concordance between QFT-GIT and TST was substantial (kappa 0.76, 95% CI 0.46-1.06). Previous BCG vaccination was not associated with significantly increased positivity in either test (OR 0.68, 95% CI 0.32-1.5 for TST and OR 0.51, 95% CI 0.14-1.9 for QFT-GIT). Eleven children were diagnosed with active TB at baseline. QFT-GIT had a higher sensitivity for active TB (88%, 95% CI 47-98%) than TST (55%, 95% CI 24-83%) while specificities were similar (respectively 58% and 55%). Five initially asymptomatic childhood contacts progressed to active TB disease during follow-up. Replacement of TST by the QFT-GIT for detection of M. tuberculosis infection is not recommended in this resource-constrained setting as test results showed substantial concordance and TST positivity was not affected by previous BCG vaccination. The QFT-GIT had a higher sensitivity than the TST for the detection of TB disease. However, the value of the QFT-GIT as an adjunct in diagnosing TB disease is

  13. How to reduce false positive results when undertaking in vitro genotoxicity testing and thus avoid unnecessary follow-up animal tests: Report of an ECVAM Workshop.

    PubMed

    Kirkland, David; Pfuhler, Stefan; Tweats, David; Aardema, Marilyn; Corvi, Raffaella; Darroudi, Firouz; Elhajouji, Azeddine; Glatt, Hansruedi; Hastwell, Paul; Hayashi, Makoto; Kasper, Peter; Kirchner, Stephan; Lynch, Anthony; Marzin, Daniel; Maurici, Daniela; Meunier, Jean-Roc; Müller, Lutz; Nohynek, Gerhard; Parry, James; Parry, Elizabeth; Thybaud, Veronique; Tice, Ray; van Benthem, Jan; Vanparys, Philippe; White, Paul

    2007-03-30

    Workshop participants agreed that genotoxicity tests in mammalian cells in vitro produce a remarkably high and unacceptable occurrence of irrelevant positive results (e.g. when compared with rodent carcinogenicity). As reported in several recent reviews, the rate of irrelevant positives (i.e. low specificity) for some studies using in vitro methods (when compared to this "gold standard") means that an increased number of test articles are subjected to additional in vivo genotoxicity testing, in many cases before, e.g. the efficacy (in the case of pharmaceuticals) of the compound has been evaluated. If in vitro tests were more predictive for in vivo genotoxicity and carcinogenicity (i.e. fewer false positives) then there would be a significant reduction in the number of animals used. Beyond animal (or human) carcinogenicity as the "gold standard", it is acknowledged that genotoxicity tests provide much information about cellular behaviour, cell division processes and cellular fate to a (geno)toxic insult. Since the disease impact of these effects is seldom known, and a verification of relevant toxicity is normally also the subject of (sub)chronic animal studies, the prediction of in vivo relevant results from in vitro genotoxicity tests is also important for aspects that may not have a direct impact on carcinogenesis as the ultimate endpoint of concern. In order to address the high rate of in vitro false positive results, a 2-day workshop was held at the European Centre for the Validation of Alternative Methods (ECVAM), Ispra, Italy in April 2006. More than 20 genotoxicity experts from academia, government and industry were invited to review data from the currently available cell systems, to discuss whether there exist cells and test systems that have a reduced tendency to false positive results, to review potential modifications to existing protocols and cell systems that might result in improved specificity, and to review the performance of some new test systems

  14. Linking HIV-positive Jail Inmates to Treatment, Care, and Social Services After Release: Results from a Qualitative Assessment of the COMPASS Program

    PubMed Central

    Cornwall, Alexandra; Fu, Jeannia; Bazerman, Lauri; Loewenthal, Helen; Beckwith, Curt

    2010-01-01

    Approximately 17% of individuals living with HIV/AIDS pass through the correctional system each year. Jails provide a unique opportunity to diagnose and treat HIV infection among high-risk, transient populations with limited access to medical services. In 2007, the US Health Resources and Services Administration funded a multi-site demonstration project entitled Enhancing Linkages to HIV Primary Care in Jail Settings that aims to improve diagnosis and treatment services for HIV-positive jail detainees and link them to community-based medical care and social services upon release. We performed an evaluation of the Rhode Island demonstration site entitled Community Partnerships and Supportive Services fo