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Sample records for oral provocation tests

  1. [Transient global amnesia (TGA) during an oral provocation test].

    PubMed

    Hirschfeld, G; Sperfeld, A D; Kassubek, J; Scharffetter-Kochanek, K; Sunderkötter, C

    2007-02-01

    After the oral administration of the COX 2 inhibitor rofecoxib (Vioxx) as part of an oral provocation test, a 64-year-old woman developed acute anterograde and retrograde amnesia which lasted for several hours. The patient did not show symptoms of anaphylaxis. Neurological examination did not reveal focal symptoms or an epileptic seizure. Diffusion-weighted magnetic resonance imaging only showed a small region of increased signal intensity in the left hippocampus. The patient thus had no anaphylactic drug reaction, but a transient global amnesia (TGA) or amnestic episode. TGA is an acute, reversible, cerebral dysfunctional state which lasts from 1 h up to maximally 24 h and which is associated with anterograde and retrograde amnesia. While about half of the cases appear to occur spontaneously, other cases are preceded by physically or emotionally stressful events. In our patient it may have been the emotional distress caused by the oral provocation testing that has triggered the TGA. When TGA occurs during oral challenge of drugs, we recommend repeating the oral challenge of the tested drug.

  2. [Chronic urticaria. Provocation test].

    PubMed

    Giménez Camarasa, J M

    1976-01-01

    Sixty patients of ages ranging from 11 to 64, with chronic urticaria from 2 months to 50 years duration, were studied with the provocation test. We found responses in 33.3% of patients. Tartrazine was the most common inducer, specially in those patients sensitive to aspirin with increased salicilate blood levels. As we did not use aspirin as inducer the results with tartrazine are more relevant and can be used to detect a positive response to aspirin. The relation between tartrazine and aspirin was not observed in patients with pressure or cholinergic urticaria. The provocation test is most useful in patients with chronic urticaria of unknown cause. 4 hydroxybenzoic acid and sodium acid and sodium benzoate were the more common inducers in the latter patients. We feel that the provocation test is a useful tool to study patients with chronic urticaria. Tartrazine, 4 hydroxybenzoic acid, sodium benzoate, tiramin and penicilin are included in the test. The responders should eliminate the offender from their diet.

  3. Value of oral provocation tests to aspirin and food additives in the routine investigation of asthma and chronic urticaria.

    PubMed

    Genton, C; Frei, P C; Pécoud, A

    1985-07-01

    Nonsteroidal anti-inflammatory drugs and certain food or drug additives are known to induce acute bronchospasms, angioneurotic edema, and urticaria in susceptible patients. Thirty-four patients (17 with asthma and 17 with urticaria), whose case history suggested such intolerance, were challenged orally with increasing doses of seven compounds: acetylsalicylic acid, glafenine, sodium benzoate, sulfur dioxide, potassium sorbate, sodium glutamate, and tartrazine. Among 162 oral provocation tests, 38 were positive (20% decrease in peak flow rate or appearance of acute urticaria/angioneurotic edema). Twenty-four of the 34 patients (nine with asthma and 15 with urticaria) were intolerant to at least one compound. However, no serious reaction was observed. In 20 of these 24 patients (six with asthma and 14 with urticaria), a diet free of additives and nonsteroidal anti-inflammatory drugs resulted, within 5 days, in a marked improvement of symptoms, which persisted 8 to 14 mo after starting the diet. Age, prevalence of IgE-mediated allergy, and nasal polyposis were similar in patients with or without reactions of intolerance. Under the conditions used, oral provocation tests proved to be feasible, safe, and useful in many patients not helped by existing methods.

  4. Oral provocation tests with aspirin and food additives in asthmatic patients.

    PubMed

    Hong, S P; Park, H S; Lee, M K; Hong, C S

    1989-12-01

    Aspirin and food additives are known to induce bronchoconstriction, angioedema or urticaria in susceptible patients. To evaluate the incidence of hypersensitivity to aspirin and food additives, 36 subjects with bronchial asthma, 33 of whom were non-allergic asthmatics and 3 were allergic asthmatics who had a history of aspirin sensitivity, were challenged orally with six compounds: acetylsalicylic acid (ASA), sodium bisulfite, tartrazine, sodium benzoate, 4-hydroxy benzoic acid, and monosodium L-glutamate. Significant bronchoconstrictions were found in 15 (41.7%) of the 36 subjects tested. Eight of the 15 subjects showed positive asthmatic responses to the aspirin, two showed asthmatic responses to the food additives, and five responded to both aspirin and the food additives. It is suggested that ASA and food additives could be causes of clinically significant bronchoconstriction in moderately severe non-allergic asthmatic patients.

  5. De-labelling self-reported penicillin allergy within the emergency department through the use of skin tests and oral drug provocation testing.

    PubMed

    Marwood, Joseph; Aguirrebarrena, Gonzalo; Kerr, Stephen; Welch, Susan A; Rimmer, Janet

    2017-04-05

    Self-reported penicillin allergy is common among patients attending the ED, but is a poor predictor of true immunoglobulin E-mediated hypersensitivity to penicillin. We hypothesise that with a combination of skin testing and drug provocation testing, selected patients can be safely de-labelled of their allergy. This prospective study enrolled a sample of patients presenting to an urban academic ED between 2011 and 2016 with a self-reported allergy to penicillin. Standardised skin prick and intradermal testing with amoxicillin and both major and minor determinants of penicillin was performed in the department. If negative, testing was followed by a graded oral challenge of amoxicillin over 9 days. The primary end point was the allergy status of participants at the end of the study. A total of 100 patients (mean age 42; standard deviation 14 years; 54% women) completed the testing. Of these, 81% (95% confidence interval 71.9-88.2) showed no hypersensitivity to penicillin and were labelled non-allergic. The majority (16/19) of allergies were confirmed by skin testing, with three suspected allergies detected by the oral challenge. Women were more likely than men to have a true penicillin allergy, with odds ratio of 4.0 (95% confidence interval 1.23-13.2). There were no serious adverse events. Selected patients in the ED who self-report an allergy to penicillin can be safely tested there for penicillin allergy, using skin tests and oral drug provocation testing. This testing allows a significant de-labelling of penicillin allergy, with the majority of these patients able to tolerate penicillin without incident. © 2017 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  6. [Indications for the aspirin provocation test in the asthmatic].

    PubMed

    Michel, O; Naeije, N; Bracamonte, M; Sergysels, R; Duchateau, J

    1984-01-01

    Oral provocation tests using aspirin (n = 55), tartrazine (n = 37) and benzoate (n = 28) were performed in 55 asthmatic patients. A positive aspirin provocation test was observed in 15 patients (27%). These patients often had a past history of aspirin intolerance, 53% of them also had nasal polyposis and 5 out of 12 had associated tartrazine intolerance, while 2 out of 8 had associated benzoate intolerance. The authors consider that these features may help the clinician to detect the asthmatic patient at high risk of aspirin intolerance in whom a provocation test should be performed.

  7. Fixed drug eruption and intradermal provocation tests.

    PubMed

    Mahboob, Atiya; Haroon, Tahir Saeed; Iqbal, Zafar; Saleemi, Munir Akhtar; Munir, Asma

    2008-12-01

    To determine the role of Intradermal Provocation (IDP) tests in Fixed Drug Eruption (FDE). Quasi-experimental study. Dermatology Unit, Shaikh Zayed Hospital, Lahore, from August 2004 to July 2006. The tests were performed in 96 patients in two stages. At stage I, suspected drugs were given intradermally. Changes at injection site in FDE lesions or any systemic effects were observed. In patients showing no response to IDP, Oral Provocation (OP) was performed (stage II) and its effects in FDE lesions or any systemic effect were observed. The positive response of FDE lesions after IDP and OP were compared with local changes at injection site. Control intradermal tests were repeated in normal persons with drugs and in FDE patients with distilled water on normal skin. At stage I, 46 positive cases had local signs of erythematous indurated nodule with or without hemorrhagic centre, urticarial weal with hemorrhagic centre and erythematous indurated nodule with central vesicle. At stage II, 41 patients had similar local signs. The changes at injection site to those of FDE lesions were compared. Z-test for proportions showed no significant difference between groups (p-value > 0.05). Control tests were negative. The drug producing erythematous indurated nodule with or without hemorrhagic centre, vesicle or urticarial weal with hemorrhagic centre at injection site was the most likely drug causing fixed eruption.

  8. Provocative Testing for Coronary Reactivity and Spasm

    PubMed Central

    Zaya, Melody; Mehta, Puja K.; Merz, C. Noel Bairey

    2014-01-01

    Coronary spasm is an important and often overlooked etiology of chest pain. While coronary spasm, or Prinzmetal’s angina, has been thought of as benign, contemporary studies have shown serious associated adverse outcomes including acute coronary syndrome, arrhythmia, and death. Definitive diagnosis of coronary spasm can at times be difficult given the transience of symptoms. Numerous agents have been historically described for provocative testing. We provide a review of literature for the role of provocation testing in the diagnosis of coronary spasm. PMID:24201078

  9. Fixed Drug Eruption Due to Allopurinol: Positive Oral Provocation

    PubMed Central

    Lee, Hyun Jong; Kim, Hei Sung; Park, Young Min; Kim, Hyung Ok

    2011-01-01

    A fixed drug eruption (FDE) is characterized by the presence of a solitary or multiple, pruritic, well-circumscribed, erythematous plaques. These lesions have tendency to recur at same sites and heal with residual hyperpigmenation. With repeated attacks, the size and/or number of the lesions may increase. So far, more than 100 drugs have been implicated in causing FDEs, including ibuprofen, sulfonamide, naproxen, and tetracylines. FDE caused by allopurinol has been rarely reported in the literature, but there has been no confirmed case based on oral provocation test. Herein, we report a case of FDE in which the lesions recurred whenever allopurinol was administered for the treatment of gout. A 64-year-old male experienced repeated episodes of well-demarcated dusky erythematous patches on the whole body for 2 months. He took allopurinol intermittently for amelioration of his gout symptom, but denied other medication history. Pruritic erythematous edema developed on the previous lesions 12 hours after oral provocation of 200 mg of allopurinol. PMID:22346289

  10. Paroxysmal atrial fibrillation during intracoronary acetylcholine provocation test.

    PubMed

    Saito, Yuichi; Kitahara, Hideki; Shoji, Toshihiro; Tokimasa, Satoshi; Nakayama, Takashi; Sugimoto, Kazumasa; Fujimoto, Yoshihide; Kobayashi, Yoshio

    2016-12-22

    Intracoronary acetylcholine (ACh) provocation test is useful to diagnose vasospastic angina. However, paroxysmal atrial fibrillation (AF) often occurs during intracoronary ACh provocation test, leading to disabling symptoms. The aim of this study was to investigate the incidence and predictors of paroxysmal AF during the test. A total of 377 patients without persistent AF who underwent intracoronary ACh provocation test were included. Paroxysmal AF during ACh provocation test was defined as documented AF on electrocardiogram during the procedure. There were 31 patients (8%) with paroxysmal AF during the test. Of these, 11 (35%) required antiarrhythmic drugs, but none received electrical cardioversion. All of them recovered sinus rhythm within 48 h. At procedure, paroxysmal AF occurred mostly during provocation for the right coronary artery (RCA) rather than for the left coronary artery (LCA) (90 vs. 10%). Multivariate logistic regression analysis demonstrated that a history of paroxysmal AF (OR 4.38 CI 1.42-13.51, p = 0.01) and body mass index (OR 0.88 CI 0.78-0.99, p = 0.03) were independent predictors for occurrence of paroxysmal AF during intracoronary ACh provocation test. In conclusions, paroxysmal AF mostly occurs during ACh provocation test for the RCA, especially in patients with a history of paroxysmal AF and lower body mass index. It may be better to initially administer intracoronary ACh in the LCA when the provocation test is performed.

  11. Bronchial provocation tests in clinical practice.

    PubMed

    Borges, Marcos de Carvalho; Ferraz, Erica; Vianna, Elcio Oliveira

    2011-01-01

    Bronchial hyperresponsiveness, which consists of an exaggerated response of the airways to bronchoconstrictor stimuli, is one of the main characteristics of asthma, presented in nearly all asthmatic patients. Bronchial hyperresponsiveness may also be present in other diseases, such as allergic rhinitis, chronic obstructive pulmonary disease, cystic fibrosis, heart failure and respiratory infection, and with some medications, such as β-blockers. Bronchial provocation tests (also known as bronchial challenges) are used to evaluate bronchial responsiveness. These tests have become increasingly used over the last 20 years, with the development and validation of accurate, safe and reproducible tests, and with the publication of well-detailed protocols. Several stimuli can be used in a bronchial challenge, and they are classified as direct and indirect stimuli. There are many indications for a bronchial challenge. In this review, we discuss the main differences between direct and indirect stimuli, and the use of bronchial challenges in clinical practice, especially for confirming diagnoses of asthma, exercise-induced bronchoconstriction and cough-variant asthma, and for use among elite-level athletes.

  12. Importance of a second spasm provocation test: Four cases with an initial negative spasm provocation test.

    PubMed

    Teragawa, Hiroki; Fujii, Yuichi; Uchimura, Yuko; Ueda, Tomohiro

    2017-03-26

    The spasm provocation test (SPT) is an important test in the diagnosis of vasospastic angina (VSA). In many cases, this test is performed as the gold standard test, and VSA is considered not present if the SPT is negative. However, some patients continue to experience chest symptoms despite a negative SPT. In this study, we report four cases in which SPT was repeated to evaluate chest symptoms despite the negative results of the first SPT. Two men in their 70s, one woman in her 60s, and one woman in her 70s, all with chest symptoms, underwent a second SPT at 4, 3, 2, and 3 years, respectively, after the first SPT, which was negative. Three patients had positive results in the second SPT (75%). In conclusion, even when SPT is negative, the diagnosis of VSA should be made with clinical symptoms in consideration. In some cases, a second SPT may be required to confirm the diagnosis of VSA.

  13. Importance of a second spasm provocation test: Four cases with an initial negative spasm provocation test

    PubMed Central

    Teragawa, Hiroki; Fujii, Yuichi; Uchimura, Yuko; Ueda, Tomohiro

    2017-01-01

    The spasm provocation test (SPT) is an important test in the diagnosis of vasospastic angina (VSA). In many cases, this test is performed as the gold standard test, and VSA is considered not present if the SPT is negative. However, some patients continue to experience chest symptoms despite a negative SPT. In this study, we report four cases in which SPT was repeated to evaluate chest symptoms despite the negative results of the first SPT. Two men in their 70s, one woman in her 60s, and one woman in her 70s, all with chest symptoms, underwent a second SPT at 4, 3, 2, and 3 years, respectively, after the first SPT, which was negative. Three patients had positive results in the second SPT (75%). In conclusion, even when SPT is negative, the diagnosis of VSA should be made with clinical symptoms in consideration. In some cases, a second SPT may be required to confirm the diagnosis of VSA. PMID:28400927

  14. Quantitative skin prick and bronchial provocation tests with platinum salt.

    PubMed Central

    Merget, R; Schultze-Werninghaus, G; Bode, F; Bergmann, E M; Zachgo, W; Meier-Sydow, J

    1991-01-01

    Occupational asthma due to platinum salts is a frequent disease in platinum refineries. The diagnosis is based upon a history of work related symptoms and a positive skin prick test with platinum salts. Bronchial provocation tests have not been performed in epidemiological studies because the skin test is believed to be highly specific and sensitive. As no reliable data about this issue currently exist, this study assesses the use of skin prick and bronchial provocation tests with methacholine and platinum salt in platinum refinery workers. Twenty seven of 35 workers, who were referred to our clinic with work related symptoms and nine control subjects with bronchial hyperreactivity underwent a skin prick test and bronchial provocation with methacholine and platinum salt. For skin prick and bronchial provocation tests with platinum salt a 10(-2)-10(-8) mol/l hexachloroplatinic acid solution, in 10-fold dilutions was used. Four of the 27 subjects and all controls showed neither a bronchial reaction nor a skin reaction. Twenty three subjects were considered allergic to platinum salt; 22 of these showed a fall of 50% or more in specific airway conductance after inhalation of the platinum salt solution. Four workers experienced a positive bronchial reaction despite a negative skin prick test. No correlation of responsiveness to methacholine with responsiveness to platinum salt was found, but the skin prick test correlated with the bronchial reaction to platinum salt (rs = 0.50, p less than 0.023, n = 22). One dual reaction was seen in bronchial provocation tests. Side effects of both skin tests and bronchial provocation tests with platinum salt were rare and were not encountered in workers without a skin reaction to platinum salt. It is concluded that bronchial provocation tests with platinum salts should be performed on workers with work related symptoms but negative skin tests with platinum salts. PMID:1772797

  15. Inhaled Mannitol as a Laryngeal and Bronchial Provocation Test.

    PubMed

    Tay, Tunn Ren; Hoy, Ryan; Richards, Amanda L; Paddle, Paul; Hew, Mark

    2017-03-01

    Timely diagnosis of vocal cord dysfunction (VCD), more recently termed "inducible laryngeal obstruction," is important because VCD is often misdiagnosed as asthma, resulting in delayed diagnosis and inappropriate treatment. Visualization of paradoxical vocal cord movement on laryngoscopy is the gold standard for diagnosis, but is limited by poor test sensitivity. Provocation tests may improve the diagnosis of VCD, but the diagnostic performance of current tests is less than ideal. Alternative provocation tests are required. This pilot study demonstrates the feasibility of using inhaled mannitol for concurrent investigation of laryngeal and bronchial hyperresponsiveness. Consecutive patients with suspected VCD seen at our institution's asthma clinic underwent flexible laryngoscopy at baseline and following mannitol challenge. VCD was diagnosed on laryngoscopy based on inspiratory adduction, or >50% expiratory adduction of the vocal cords. Bronchial hyperresponsiveness after mannitol challenge was also assessed. We evaluated the interrater agreement of postmannitol laryngoscopy between respiratory specialists and laryngologists. Fourteen patients with suspected VCD in the context of asthma evaluation were included in the study. Mannitol provocation demonstrated VCD in three of the seven patients with normal baseline laryngoscopy (42.9%). Only two patients had bronchial hyperresponsiveness. There was substantial interrater agreement between respiratory specialists and laryngologists, kappa = 0.696 (95% confidence interval: 0.324-1) (P = 0.006). Inhaled mannitol can be used to induce VCD. It is well tolerated and can evaluate laryngeal and bronchial hyperresponsiveness at the same setting. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  16. Usefulness of House Dust Mite Nasal Provocation Test in Asthma

    PubMed Central

    Kim, Soo-Jeong; Won, Joo-Min; Park, Myeong-Soo

    2017-01-01

    Purpose We previously reported that the skin prick test was sensitive and the serum specific immunoglobulin E test was specific for predicting positive airway responses to house dust mites (HDMs) in patients with asthma. Because the nose and bronchus are one airway, the nasal provocation test would be more specific for predicting the bronchial responses to HDM than the skin test. Methods The allergy skin prick test and nasal and bronchial provocation tests using HDM (Dermatophagoides farinae) were performed in 41 young men (age, 19–28 years) who wanted military certification for asthma. The nasal responses to HDM was scored according to the severity of rhinorrhea, sneezing, and nose itching. Results The prevalence of a positive skin prick test to HDM did not significantly differ between patients with (n=24) and without (n=17) an early airway reaction (EAR; 79.2% vs 70.6%, P=0.534). However, the prevalence of a positive nasal test was significantly higher in the airway responders than in the others (37.5% vs 0%, P=0.005). The concordance of a positive response to the nasal test (κ=0.332, P=0.004) but not to the skin prick test (κ=0.091, P=0.529) was significant with an EAR. The diagnostic sensitivity of the nasal test (37.5%) was lower than that of the skin prick test (79.2%), but the specificity was higher (100% vs 29.4%). Conclusions The skin prick test is more sensitive, whereas the nasal test is more specific and accurate, for predicting an EAR to HDM in patients with asthma. PMID:28102060

  17. Pro and Contra: Provocation Tests in Drug Hypersensitivity

    PubMed Central

    Soyer, Ozge; Sahiner, Umit Murat; Sekerel, Bulent Enis

    2017-01-01

    Drug provocation test (DPT) is the controlled administration of a drug to diagnose immune- or non-immune-mediated drug hypersensitivity and the last step for accurate recognition of drug hypersensitivity reactions when the previous diagnostic evaluations are negative or unavailable. A DPT is performed only if other conventional tests fail to yield conclusive results. In each clinical presentation, “to provoke or not to provoke” a patient should be decided after careful assessment of the risk–benefit ratio. Well-defined benefits of DPT include confirmative exclusion of diagnoses of drug hypersensitivity and provision of safe alternatives. However, disadvantages such as safety, difficulty in interpretations of results, lack of objective biomarkers, risks of resensitization, efficiency in daily practice, and lack of standardized protocols, are poorly debated. This review summarizes the current published research concerning DPT, with particular emphasis on the advantages and disadvantages of DPT in an evidence-based manner. PMID:28677662

  18. Diagnosis of sacroiliac joint pain: validity of individual provocation tests and composites of tests.

    PubMed

    Laslett, Mark; Aprill, Charles N; McDonald, Barry; Young, Sharon B

    2005-08-01

    Previous research indicates that physical examination cannot diagnose sacroiliac joint (SIJ) pathology. Earlier studies have not reported sensitivities and specificities of composites of provocation tests known to have acceptable inter-examiner reliability. This study examined the diagnostic power of pain provocation SIJ tests singly and in various combinations, in relation to an accepted criterion standard. In a blinded criterion-related validity design, 48 patients were examined by physiotherapists using pain provocation SIJ tests and received an injection of local anaesthetic into the SIJ. The tests were evaluated singly and in various combinations (composites) for diagnostic power. All patients with a positive response to diagnostic injection reported pain with at least one SIJ test. Sensitivity and specificity for three or more of six positive SIJ tests were 94% and 78%, respectively. Receiver operator characteristic curves and areas under the curve were constructed for various composites. The greatest area under the curve for any two of the best four tests was 0.842. In conclusion, composites of provocation SIJ tests are of value in clinical diagnosis of symptomatic SIJ. Three or more out of six tests or any two of four selected tests have the best predictive power in relation to results of intra-articular anaesthetic block injections. When all six provocation tests do not provoke familiar pain, the SIJ can be ruled out as a source of current LBP.

  19. Intracoronary Acetylcholine Provocation Testing for Assessment of Coronary Vasomotor Disorders.

    PubMed

    Ong, Peter; Athanasiadis, Anastasios; Sechtem, Udo

    2016-08-18

    Intracoronary acetylcholine provocation testing (ACH-test) is an established method for assessment of epicardial coronary artery spasm in the catheterization laboratory which was introduced more than 30 years ago. Due to the short half-life of acetylcholine it can only be applied directly into the coronary arteries. Several studies have demonstrated the safety and clinical usefulness of this test. However, acetylcholine testing is only rarely applied in the U.S. or Europe. Nevertheless, it has been shown that 62% of Caucasian patients with stable angina and unobstructed coronary arteries on coronary angiography suffer from coronary vasomotor disorders that can be diagnosed with acetylcholine testing. In recent years it has been appreciated that the ACH-test not only assesses the presence of epicardial spasm but that it can also be useful for the detection of coronary microvascular spam. In such cases no epicardial spasm is seen after injection of acetylcholine but ischemic ECG shifts are present together with a reproduction of the patient's symptoms during the test. This article describes the experience with the ACH-test and its implementation in daily clinical routine.

  20. The effects of distraction on symptoms during drug provocation test

    PubMed Central

    CILDAG, SONGUL; SENTURK, TASKIN; SARGIN, GOKHAN

    2017-01-01

    Background Some patients may have psychosomatic complaints due to their previous experiences during the drug hypersensitivity reaction. Worry about being hurt due to an administered drug is termed nocebo effect, which is the opposite of the placebo effect. In our study, we investigated the effect of distraction on symptoms during drug provocation test. Methods Our study included 112 patients who underwent DPTs for alternative purposes in our clinic. Previous hypersensitivity reactions of all the patients had objective signs. Patients were divided into two groups for the DPT. Sixty-three patients were kept busy during the test, performing tasks such as filling questionnaires, arranging files in alphabetical and numerical order, and doing archiving (Group 1). Forty-nine patients did not perform any tasks during the test (Group 2). Reactions that occurred during the test were recorded. Results During the DPT, 5 patients in Group 1 (5/63, 7.9%) and 17 patients in Group 2 (17/49, 34.7%), i.e. a total of 22 patients (22/112, 19.6%), had a reaction. There was a statistically significant difference between Group 1 and Group 2 according to the frequency of the reaction development. Conclusions Patient psychosomatic complaints during DPTs are proportional to their association with previous allergic reactions. In order to prevent such reactions, it may be beneficial to keep the patients busy with an activity in order to distract them during the test. PMID:28246492

  1. Evaluation of the conjunctival provocation test in allergy diagnosis.

    PubMed

    García-Ortega, P; Costa, B; Richart, C

    1989-09-01

    Conjunctival provocation tests (CPT) were performed in 65 respiratory allergic patients, 24 of them with a clinical history of allergic conjunctivitis and 41 who had never complained of allergic conjunctivitis, to assess the role of the conjunctiva as a target organ. The usefulness of CPT and RAST to identify symptom-related and symptom-unrelated allergen in 51 patients sensitized to two allergens but only symptomatic to one of them was also studied. Conjunctiva was found to react in a similar way to skin in patients with and without clinical conjunctivitis. CPT was positive for both symptom-related and symptom-unrelated allergens in 33 of the 51 pluri-sensitized patients. Nevertheless, in the 18 patients showing positive CPT to only one allergen, agreement with clinical data was generally found. Thus CPT appears to be a useful test in the evaluation of atopic sensitization in patients reactive to a single allergen, but not in the identification of clinically relevant allergens in individuals who are skin or RAST positive to multiple agents.

  2. Conjunctival provocation tests with codeine phosphate. Effect of disodium cromoglycate.

    PubMed

    Campbell, A M; Demoly, P; Michel, F B; Bousquet, J

    1993-07-01

    The reactivity of ocular mast cells is poorly characterized in man. Provocation tests with codeine phosphate, a molecule known to activate connective tissue mast cells, were performed in ten normal subjects. Ten-fold increasing concentrations of codeine phosphate (10(-5) to 10(-1) mg/mL) were tested in both eyes until a positive challenge was observed. Schirmer strips were placed under the eyelid and left for five minutes. A negative control was performed ten days later. All subjects had a strongly positive reaction for the same codeine phosphate concentration (10(-1) mg/mL). Histamine was released in 8/10 subjects (control: 7.06 +/- 4.19 nM/L, codeine phosphate: 18.2 +/- 15.7 nM/L, P < .018), PGD2 was released in 8/10 subjects (control: 0 codeine phosphate: 273.3 +/- 408.9 ng/L). Disodium cromoglycate blocked the release of histamine and PGD2. Codeine phosphate is potent at causing mast cell activation in the eye and this effect is blocked by disodium cromoglycate.

  3. Oral Testing.

    ERIC Educational Resources Information Center

    de Charruf, Laurie Frey

    1984-01-01

    Oral tests for speaking skills evaluate two major skills: linguistic competence, including accuracy of pronunciation, vocabulary, and structure, and communication ease. Four factors affect students' oral performance: verbal intelligence, short-term auditory and visual memory, sound-symbol association skill, and grammatical analysis. Personality…

  4. Posterior pelvic pain provocation test is negative in patients with lumbar herniated discs.

    PubMed

    Gutke, Annelie; Hansson, Eva Roos; Zetherström, Gunilla; Ostgaard, Hans Christian

    2009-07-01

    The classification of pelvic girdle pain can only be reached after lumbar causes have been excluded by a clinical examination. During clinical examination, the posterior pelvic pain provocation test is a well-established method for verifying pelvic girdle pain. However, a criticism of pelvic pain provocation tests is that they may have an effect on lumbar structures, thus yielding false-positive results. The posterior pelvic pain provocation test was performed with four groups of patients: patients with computed tomography-verified disc herniations (1) on the waiting list for surgery (14 women; 9 men); (2) 6 weeks after disc surgery (18 women, 12 men); (3) pregnant women seeking care for pelvic girdle pain (n = 25); and (4) women with persistent pelvic girdle pain after delivery (n = 32). The sensitivity of the posterior pelvic pain provocation test was 0.88 and the specificity was 0.89. The positive predictive value was 0.89 and the negative predictive value was 0.87. Analysis of only women showed similar results. In our study, the posterior pelvic pain provocation test was negative in patients with a well-defined lumbar diagnosis of lumbar disc herniation, both before and after disc surgery. Our results are an important step toward the more accurate classification of lumbopelvic pain.

  5. A new provocative test for carpal tunnel syndrome. Assessment of wrist flexion and nerve compression.

    PubMed

    Tetro, A M; Evanoff, B A; Hollstien, S B; Gelberman, R H

    1998-05-01

    To establish the value of median nerve compression with wrist flexion as a provocative test for carpal tunnel syndrome (CTS), we performed a prospective study of 64 patients (95 hands) with CTS confirmed by electrodiagnostic studies and 50 normal subjects (96 hands). We recorded results for the common provocative tests (Tinel's percussion test, Phalen's wrist flexion test and the carpal compression test) and the new test which combines wrist flexion with median nerve compression. Using a receiver operator characteristic curve (ROC) technique, we found that the optimal cut-off time for the wrist-flexion and median-nerve compression test was 20 s, giving a sensitivity of 82% and a specificity of 99%. These results were significantly better than for Phalen's wrist flexion test (61% and 83%, respectively) and for the sensitivity of Tinel's test (74%). The positive predictive values of the wrist flexion and median-nerve compression test, which is more important clinically, were 99%, 95% and 81% at population prevalences of 50%, 20% and 5%, respectively. These were significantly better than those of the three other provocative tests at each prevalence. Electrodiagnostic studies have significant false-positive and false-negative rates in CTS, and therefore provocative tests remain important in its diagnosis. We have shown that wrist flexion combined with the median-nerve compression test at 20 s, is significantly better than the other methods, and may thus be clinically useful.

  6. Provocation tests for the diagnosis of food-dependent exercise-induced anaphylaxis.

    PubMed

    Asaumi, Tomoyuki; Yanagida, Noriyuki; Sato, Sakura; Shukuya, Akinori; Nishino, Makoto; Ebisawa, Motohiro

    2016-02-01

    Little has been reported regarding provocation tests for the diagnosis of food-dependent exercise-induced anaphylaxis (FDEIA), especially in children and adolescents. Hence, we here aimed to examine the usefulness and safety of such tests for FDEIA. We retrospectively analyzed 41 patients with 184 provocation tests. The patients underwent ergometer stress tests after ingesting the suspected foods along with aspirin. When one or more allergic symptoms appeared, we judged the provocation test as positive. Based on 30 positive test results (16%), we diagnosed 20 patients (49%) as FDEIA. The major causative foods were as follows: wheat alone (five patients), combination of wheat and shrimp (three patients), combination of wheat and apple (two patients), and peach alone (two patients). The symptoms appeared within 45 min after initiating exercise in 29 tests (97%). The most frequent symptoms were cutaneous symptoms, which appeared in 25 tests (83%). Of the 30 positive tests, 6 (20%) required administration of adrenaline. After discharge, the patients with negative test results had no episodes of FDEIA due to the suspected foods that they had been tested for. Provocation tests enabled us to confirm the diagnosis of FDEIA when positive and to exclude the diagnosis when negative. However, as severe symptoms may appear, these tests should be performed in a hospital under constant supervision of a physician. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  7. Cigarette Smoking-Induced Acute Eosinophilic Pneumonia: A Case Report Including a Provocation Test

    PubMed Central

    Bok, Gene Hyun; Kim, Yang-Ki; Lee, Young Mok; Kim, Ki-Up; Hwang, Jung Hwa; Kim, Dong Won

    2008-01-01

    The mechanism and cause of acute eosinophilic pneumonia are largely unknown. Many factors including the smoking of cigarettes have been suggested, but none have been proven to directly cause acute eosinophilic pneumonia. The authors report a case of acute eosinophilic pneumonia in a young Asian male who recently started smoking. The diagnosis was made based on his clinical course and results of chest radiography, lung spirometry, bronchoalveolar lavage, and transbronchial lung biopsies. After administration of methylprednisolone, his clinical course rapidly improved. A provocation test was designed to establish a connection between cigarette smoking and the development of acute eosinophilic pneumonia. After the provocation test, the patient showed identical symptoms, increase in sputum eosinophils, and worsening of pulmonary function. The results of the provocation test suggest that smoking may directly cause acute eosinophilic pneumonia, and support previous reports of cigarette smoking-induced acute eosinophilic pneumonia. PMID:18303214

  8. Reliability of provocative tests of motion sickness susceptibility

    NASA Technical Reports Server (NTRS)

    Calkins, D. S.; Reschke, M. F.; Kennedy, R. S.; Dunlop, W. P.

    1987-01-01

    Test-retest reliability values were derived from motion sickness susceptibility scores obtained from two successive exposures to each of three tests: (1) Coriolis sickness sensitivity test; (2) staircase velocity movement test; and (3) parabolic flight static chair test. The reliability of the three tests ranged from 0.70 to 0.88. Normalizing values from predictors with skewed distributions improved the reliability.

  9. Hip range of motion and provocative physical examination tests reliability and agreement in asymptomatic volunteers

    PubMed Central

    Prather, H; Harris-Hayes, M; Hunt, D; Steger-May, K; Mathew, V; Clohisy, JC

    2012-01-01

    Objective The objectives of this study are the following: 1) report passive hip ROM in asymptomatic young adults, 2) report the intra-tester and inter-tester reliability of hip ROM measurements among testers of multiple disciplines, 3) report the results of provocative hip tests and tester agreement. Design descriptive epidemiology study Setting tertiary university Participants Twenty-eight young adult volunteers without musculoskeletal symptoms, history of disorder or surgery involving the lumbar spine or lower extremities were enrolled and completed the study. Methods Asymptomatic young adult volunteers completed questionnaires and were examined by two blinded examiners during a single session. The testers were physical therapists and physicians. Hip range of motion and provocative tests were completed by both examiners on each hip. Main Outcome Measurements Inter and intra-rater reliability for ROM and agreement for provocative tests was determined. Results Twenty-eight asymptomatic adults with mean age 31 years old (range 18–51 years) and mean modified Harris Hip Score of 99.5 ± 1.5 and UCLA Activity score of 8.8 ± 1.2 completed the study. Intra-rater agreement was excellent for all hip range of motion measurements, with intraclass correlation coefficients (ICCs) ranging from 0.76 to 0.97 with similar agreement if the examiner was a physical therapist or a physician. Excellent inter-rater reliability was found for hip flexion ICC 0.87 (95% CI 0.78 to 0.92), supine internal rotation ICC 0.75 (95% CI 0.60 to 0.84) and prone internal rotation ICC 0.79 (95% CI 0.66 to 0.87). The least reliable measurements were supine hip abduction (ICC 0.34) and supine external rotation (ICC 0.18). Agreement between examiners ranged from 96–100% for provocative hip tests which included the hip impingement, resisted straight leg raise, FABER/Patrick’s and log roll tests. Conclusions Specific hip ROM measures show excellent inter-rater reliability and provocative hip tests

  10. Avoidance of nonsteroidal anti-inflammatory drugs after negative provocation tests in urticaria/angioedema reactions: Real-world experience.

    PubMed

    Bommarito, Luisa; Zisa, Giuliana; Riccobono, Francesca; Villa, Elisa; D'Antonio, Cristian; Calamari, Ambra M; Poppa, Mariangela; Moschella, Adele; Di Pietrantonj, Carlo; Galimberti, Maurizio

    2014-01-01

    Drug provocation tests (DPTs) are the gold standard in diagnosing nonsteroidal anti-inflammatory drug (NSAID) hypersensitivity; however, only few data about follow-up of patients with negative DPTs are actually available. The aim of this study was to assess patients' behavior in taking NSAIDs again and to evaluate NSAID tolerability after negative allergological workup. This is a follow-up study involving patients evaluated for history of cutaneous reactions (urticaria and or angioedema) after NSAID intake and with negative DPTs with the suspected NSAID. Patients were asked during a phone interview about the intake of NSAIDs, tolerance, or reasons of avoidance. The negative predictive value (NPV) of NSAIDs DPTs was calculated. One hundred eleven of 142 patients were successfully contacted; 46/111 (41.44%) took the same NSAID previously tested with two adverse reactions reported (4.34%). Fifty-three of 111 (47.74%) patients did not take the same NSAID, but 34 of them took at least another strong cyclooxygenase (COX) 1 inhibitor, with 1 adverse reaction (2.94%) and 19 of them took only weak COX-1 inhibitors. Twelve of 111 patients (10.8%) did not take any NSAID. Reasons for drug avoidance were mainly fear of reactions (70.8%) and no need (29.2%). NPV, overall, was 96.97% (95% confidence interval, 91-99%). Although NSAID hypersensitivity diagnosis was ruled out by oral provocation test, the majority of patients with a history of urticaria/angioedema avoided the intake of the tested NSAIDs for fear of new reactions, particularly when strong COX-1 inhibitor NSAIDs were involved. The high NPV value of DPT resulting from this study should reassure NSAID intake.

  11. Leukotriene D4 nasal provocation test: Rationale, methodology and diagnostic value

    PubMed Central

    ZHU, ZHENG; XIE, YANQING; GUAN, WEIJIE; GAO, YI; XIA, SHU; LIANG, JIANXIN; ZHENG, JINPING

    2016-01-01

    Cysteinyl leukotrienes (LT) play a vital role in the pathogenesis of allergic rhinitis (AR), but few studies have investigated the nasal mucosal physiological response to LTs in AR patients. The aim of the present study was to establish the methodology and investigate the diagnostic value and safety of a leukotriene D4 (LTD4) nasal provocation test. LTD4 nasal provocation tests were performed in 26 AR patients and 16 normal control subjects. Nasal airway responsiveness was assessed by calculating the concentration of LTD4 required to cause a 60% increase in nasal airway resistance (PC60NAR-LTD4), which was measured using rhinomanometry and a composite symptom score. Receiver operating characteristic (ROC) curve was applied to evaluate the diagnostic value of LTD4 nasal provocation test, and adverse events were recorded. The study protocol was registered with the U.S. National Institutes of Health (https://clinicaltrials.gov/ct2/show/NCT01963741). PC60NAR-LTD4 in AR was significantly lower compared with that of normal controls [8.36 (IQR, 10.00) vs. 17.00 (IQR, 0.00) µg/ml, P=0.005]. Composite symptom score was higher in AR as compared with normal controls (1.19±0.94 vs. 0.12±0.50, P<0.001). The symptom scores included sneezing (0.12±0.34 vs. 0.00±0.00, P=0.149), rhinorrhea (0.79±0.66 vs. 0.06±0.25, P<0.001) and chemosis or itching of the eyes (0.06±0.25 vs. 0.21±0.42, P=0.216). High diagnostic value was indicated by the ROC [AUC: 0.822, 95%CI (0.665, 0.961)]. No serious adverse events were observed. Thus, the present results indicate that AR patients exhibited nasal hyperactivity to LTD4, and the established procedure of LTD4 nasal provocation testing is effective and safe for use in the diagnosis of AR. PMID:27347089

  12. The evaluation of drug provocation tests in pediatric allergy clinic: a single center experience.

    PubMed

    Vezir, Emine; Erkocoglu, Mustafa; Civelek, Ersoy; Kaya, Aysenur; Azkur, Dilek; Akan, Aysegül; Ozcan, Celal; Toyran, Muge; Ginis, Tayfur; Misirlioglu, Emine Dibek; Kocabas, Can Naci

    2014-01-01

    Drug provocation tests (DPTs) are gold standard to diagnose drug allergy. Our goal was to evaluate the results and safety of diagnostic methods including DPTs during childhood. Between January 2010 and February 2013 DPTs were performed and evaluated, prospectively, in children who attended our pediatric allergy clinic with a suspected drug hypersensitivity reaction. One hundred ninety-eight suspected drug reactions in 175 patients (88 boys and 87 girls) were evaluated. The median age of the subjects at the time of the suspected drug-induced hypersensitivity reaction and at the time of the study was 56 (interquartile range [IQR] = 24-120 months) months and 76 (IQR = 35-149 months) months, respectively. Suspected drugs were beta-lactam antibiotics in 108 cases (54.5%), non-beta-lactam antibiotics in 22 cases (11.1%), and nonsteroid anti-inflammatory drugs in 52 cases (26.3%). The history was compatible with immediate-type reactions in 69 cases (34.8%). Skin-prick tests were not positive in any of the cases. Intradermal tests were positive in three cases (4%). DPTs were positive in 13 (6.8%) of 191 provocation cases, which were performed with culprit drugs. Our results suggest that a positive clinical history is not enough to make a diagnosis of drug allergy, which highlights the significance of undertaking further diagnostic evaluation especially for DPTs.

  13. Dumping symptoms and incidence of hypoglycaemia after provocation test at 6 and 12 months after laparoscopic sleeve gastrectomy.

    PubMed

    Papamargaritis, Dimitris; Koukoulis, George; Sioka, Eleni; Zachari, Eleni; Bargiota, Alexandra; Zacharoulis, Dimitris; Tzovaras, George

    2012-10-01

    A previous study has demonstrated that symptoms suggestive of dumping syndrome appear after a provocation test early after laparoscopic sleeve gastrectomy (LSG) in 45 % of patients, and these are mainly related to early dumping. The aim of this study is to evaluate the evolution of dumping symptoms during the first postoperative year. Twenty-five non-diabetic morbidly obese patients (6 male, 19 female) were evaluated with an oral glucose tolerance test (OGTT) preoperatively, at 6 weeks and at 6 months postoperatively. In addition, 12 of them repeated the OGTT at 12 months after LSG. Sigstad score was used to separate dumpers from non-dumpers and Arts' questionnaire to differentiate between early and late dumping. Insulin and glucose levels were also measured. Sigstad score remained significantly elevated at 6 and 12 months postoperatively compared to preoperative values. Symptoms suggestive of dumping syndrome were recorded in 40 % of patients at 6 months and in 33 % at 12 months postoperatively. Arts' questionnaire demonstrated that early dumping score remained higher compared to baseline at 6 and 12 months postoperatively. Late dumping scores increased gradually during the time and that difference was statistically significant at 12 months after LSG. Hypoglycaemia occurred at 33 % of patients both at 6 and 12 months postoperatively. Symptoms suggestive of dumping syndrome after provocation still exist at 6 and 12 months in a significant proportion of patients after LSG and include both early and late dumping. These findings are consistent with the high incidence of hypoglycaemia after OGTT at 6 and 12 months after LSG.

  14. [Comparison of recovery time in a cold provocation test performed according to Polish requirements and ISO 14835-1 standard].

    PubMed

    Harazin, Barbara

    2010-01-01

    A cold provocation test is used to assess the presence and extent of the peripheral vascular disorders in the upper extremities of workers exposed to hand-arm vibration. A quantitative evaluation of vascular response to cold provocation is determined by measuring the finger skin temperature. In the study two methods of cold exposure were used to assess the effect of water temperature and immersion duration on recovery time in subjects with the acropoikilothermic thermoregulation. In the study two cold provocation tests were performed. One test consisted of a 10 min immersion of both hands in cold water at 14 degrees C (Polish requirements) and the second one adequately, of a 5 min immersion in cold water at 12 degrees C (ISO 14835-1:2004 standard). Twenty young (aged 22-24 years) and healthy subjects took part in each test. Finger skin temperature was measured on all fingers of both hands before and after immersion. The mean recovery time of the cold provocation test was longer in the group examined by ISO 14835-1:2004 standard requirements than in the group examined by the method used in Poland. Immersion parameters used in the cold provocation test performed in acropoikilotherms have a significant effect on recovery time.

  15. Scopolamine provocation-based pharmacological MRI model for testing procognitive agents.

    PubMed

    Hegedűs, Nikolett; Laszy, Judit; Gyertyán, István; Kocsis, Pál; Gajári, Dávid; Dávid, Szabolcs; Deli, Levente; Pozsgay, Zsófia; Tihanyi, Károly

    2015-04-01

    There is a huge unmet need to understand and treat pathological cognitive impairment. The development of disease modifying cognitive enhancers is hindered by the lack of correct pathomechanism and suitable animal models. Most animal models to study cognition and pathology do not fulfil either the predictive validity, face validity or construct validity criteria, and also outcome measures greatly differ from those of human trials. Fortunately, some pharmacological agents such as scopolamine evoke similar effects on cognition and cerebral circulation in rodents and humans and functional MRI enables us to compare cognitive agents directly in different species. In this paper we report the validation of a scopolamine based rodent pharmacological MRI provocation model. The effects of deemed procognitive agents (donepezil, vinpocetine, piracetam, alpha 7 selective cholinergic compounds EVP-6124, PNU-120596) were compared on the blood-oxygen-level dependent responses and also linked to rodent cognitive models. These drugs revealed significant effect on scopolamine induced blood-oxygen-level dependent change except for piracetam. In the water labyrinth test only PNU-120596 did not show a significant effect. This provocational model is suitable for testing procognitive compounds. These functional MR imaging experiments can be paralleled with human studies, which may help reduce the number of false cognitive clinical trials.

  16. Edrophonium provocative testing for the evaluation of upper gastrointestinal hypersensitivity in patients with nonulcer dyspepsia.

    PubMed

    Tsutsui, Shinichi; Mine, Kazunori; Handa, Masanori; Hayashi, Haruo; Hosoi, Masako; Kinukawa, Naoko; Kubo, Chiharu

    2006-08-01

    The aim of this study was to examine if edrophonium provocative testing is useful for evaluating upper gastrointestinal hypersensitivity in patients with nonulcer dyspepsia (NUD). A questionnaire rating dyspeptic symptoms was done for 58 patients with NUD. The patients were then given an intravenous infusion of saline followed by 5 mg of edrophonium. Baseline esophageal manometry was also done. Patients whose usual symptoms were reproduced (48.3%) had significantly higher symptom scores (13.0 [8.5, 17.0] vs. 8.5 [6.0, 11.0]; P = 0.015) and a significantly higher number of symptoms (4.0 [2.5, 6.0] vs. 3.0 [1.0, 4.0]; P = 0.010) than patients whose usual symptoms were not reproduced. The presence of an esophageal motility disorder was not significantly different between the two groups. These findings suggest upper gastrointestinal hypersensitivity in the patients whose symptoms were reproduced. Edrophonium provocative testing might be useful for evaluating upper gastrointestinal hypersensitivity in patients with NUD.

  17. Impact of pharmacological spasm provocation test in patients with a history of syncope.

    PubMed

    Sueda, Shozo; Kohno, Hiroaki

    2017-09-13

    Coronary artery spasm is involved in the pathogenesis of various cardiac disorders. We investigated patients with a history of syncope who underwent elective coronary angiography. We retrospectively analyzed 5781 consecutive patients who had diagnostic or follow-up angiography during a 26-year period. During this period, we found 95 patients with a history of syncope before elective coronary angiography. Pharmacological spasm provocation testing was performed in 64 patients with a history of syncope (<1 year). Positive pharmacological response was observed in 48 patients, while the remaining 16 patients had negative tests. Positive spasm was defined as a transient ≥90% narrowing with ischemic electrocardiographic changes. Among the 64 patients, definite coronary spastic angina (CSA) was found in 35 patients (54.7%) and suspected CSA was found in 13 patients (20.3%). Among the 35 patients with definite CSA, 22 patients (62.9%) had chest symptoms before syncope, but 13 (37.1%) had no chest symptom before syncope. No difference in clinical characteristics was observed between the two groups. Focal spasm during pharmacological spasm provocation tests was significantly higher in patients with chest symptoms than in those without chest symptoms before syncope (54.3 vs. 12.0%, p < 0.002). CSA was observed in 75.0% of patients with a history of syncope (<1 year). Thirteen patients with definite CSA had neither chest pain nor chest pressure before syncope. We should therefore investigate coronary artery spasm as a potential etiology in patients with a history of syncope.

  18. Lorazepam Provocation Test in Purported Schizophrenia with Lack of Treatment Response

    PubMed Central

    2014-01-01

    Some patients with severe mental disorders are refractory to psychotherapeutic or psychopharmacological interventions. We present a patient who at the age of 19 developed several schizophrenia - suspect symptoms. Soon inexplicable general seizures where observed. He was treated with antipsychotics, but had two bouts of malignant neuroleptic syndrome. Electroconvulsive therapy (ECT) gave some symptom relief and he continued on maintenance ECT for years with weekly intervals. Interruption of this treatment pattern rapidly increased symptom load. After seven years a lorazepam provocation test was performed as he had a new relapse after 3 weeks without ECT. In the ensuing hours his aggressiveness and nonsense speaking rapidly diminished. Kahlbaums observation of seizures as part of a catatonia was not understood in this case. The publication of the new DSM-V diagnosis of catatonia may hopefully reduce the probability of treating a patient for schizophrenia for years without access to a more targeted medication and ECT plan. PMID:25553236

  19. The asthma six-minute provocation test and mountain climbing in children.

    PubMed

    Wekesa, M; Langhof, H; Sack, P

    1994-01-01

    We investigated the intensity of exercise in the asthma six-minute provocation test (ASMT) for asthmatic patients and mountain climbing. Six asthmatic boys with mean age 11.7 +/- 2.1 years and mean weight 44.5 +/- 13.2 kg participated in this study. HR, FEV1 and RR values were recorded. In both forms of exercise, the participants achieved intensities of over 160 beats/min. EIA was diagnosed in five of them after the SSMT. There was not much variability in the PEFR values observed during mountain climbing. The rise in systolic pressure was within normal. The echocardiogram (ECG) was not pathologic. Further investigations are required to establish the suitability of mountain climbing as an appropriate form of sport for asthmatics.

  20. Echocardiographic Epicardial Adipose Tissue Thickness Is Associated with Symptomatic Coronary Vasospasm during Provocative Testing.

    PubMed

    Nishio, Susumu; Kusunose, Kenya; Yamada, Hirotsugu; Hirata, Yukina; Ise, Takayuki; Yamaguchi, Koji; Yagi, Shusuke; Soeki, Takeshi; Wakatsuki, Tetsuzo; Shimabukuro, Michio; Sata, Masataka

    2017-08-23

    Epicardial adipose tissue (EAT) is the ectopic visceral fat surrounding the heart, which plays an important role in atherosclerosis of the coronary arteries via endothelial damage. Several studies have also suggested that vasospasm with angina (VSA) causes endothelial dysfunction in the coronary arteries. The aim of this study was to evaluate the thickness of EAT in the anterior interventricular groove (EAT-AIG) using echocardiography in patients who had no obstructive coronary artery disease and were suspected of having VSA. Sixty-five patients who underwent intracoronary acetylcholine provocation testing for clinical indications were prospectively enrolled. VSA was diagnosed by coronary artery stenosis increase of >90% and the presentation of chest pain with ischemic changes on electrocardiography. Subjects were divided into two groups, with and without significant coronary spasm (VSA group, 30 patients; non-VSA group, 35 patients), consistent with acetylcholine provocation testing. EAT-AIG thickness was significantly greater in the VSA group than in the non-VSA group (8.2 ± 2.7 vs 6.1 ± 2.5 mm, P = .002). By receiver operating characteristic analysis, EAT-AIG thickness had a high C statistic (area under the curve = 0.81, P < .001) after adjustment for conventional risk factors (smoking, diabetes mellitus, and dyslipidemia). EAT-AIG thickness had incremental diagnostic value over other conventional risk factors (area under the curve = 0.81 vs 0.64, P for comparison = .020). EAT-AIG thickness, which is noninvasively and easily measured using transthoracic echocardiography, can be one of multiple clinical variables associated with VSA. Copyright © 2017 American Society of Echocardiography. Published by Elsevier Inc. All rights reserved.

  1. Immediate hypersensitivity to iodinated contrast media: diagnostic accuracy of skin tests and intravenous provocation test with low dose.

    PubMed

    Sesé, L; Gaouar, H; Autegarden, J-E; Alari, A; Amsler, E; Vial-Dupuy, A; Pecquet, C; Francès, C; Soria, A

    2016-03-01

    The diagnosis of HSR to iodinated contrast media (ICM) is challenging based on clinical history and skin tests. This study evaluates the negative predictive value (NPV) of skin tests and intravenous provocation test (IPT) with low-dose ICM in patients with suspected immediate hypersensitivity reaction (HSR) to ICM. Thirty-seven patients with suspected immediate hypersensitivity reaction to ICM were included retrospectively. Skin tests and a single-blind placebo-controlled intravenous provocation test (IPT) with low-dose iodinated contrast media (ICM) were performed. Skin tests with ICM were positive in five cases (one skin prick test and five intradermal test). Thirty-six patients were challenged successfully by IPT, and only one patient had a positive challenge result, with a grade I reaction by the Ring and Messmer classification. Ten of 23 patients followed up by telephone were re-exposed to a negative tested ICM during radiologic examination; two experienced a grade I immediate reaction. For immediate hypersensitivity reaction to ICM, the NPV for skin tests and IPT with low dose was 80% (95% CI 44-97%). © 2016 John Wiley & Sons Ltd.

  2. Evaluation of finger skin temperature by cold provocation test for diagnosis of vibration induced white finger (VWF).

    PubMed

    Tomida, K; Morioka, I; Kaewboonchoo, O; Yamamoto, H; Miyai, N; Ishii, N; Miyashita, K

    1998-01-01

    Clinical data of workers (40-69 yrs) operating chain saws for a ten-year period from 1986 to 1995 were analyzed to assess the evaluation standard of finger skin temperature for a cold provocation test (10 degrees C 10 min). Screening points of finger skin temperature for screening 191 workers with a vibration induced white finger (VWF) were obtained from receiver operating characteristic (ROC) curves. The screening points at 5 min and 10 min after a cold provocation were approximately equal to 50th percentiles of 217 workers with no symptoms (NS group). The screening points of recovery rates at 5 min and 10 min after a cold provocation almost agreed with 50th percentiles in NS group. A new evaluation standard was prepared in reference to these screening points and finger skin temperatures by fraction in NS group. The new one will be useful for the health care of workers operating vibrating tools under present working conditions.

  3. Provocative use tests in CAPB-allergic subjects with CAPB-containing product.

    PubMed

    Fartasch, M; Diepgen, T L; Kuhn, M; Basketter, D A

    1999-07-01

    Cocamidopropyl betaine (CAPB) has been identified as a cause of contact allergy in personal care products. Furthermore, it has been suggested that chemicals responsible are impurities, especially dimethylaminopropylamine (DMAPA). However, skin contact concentrations with these impurities, especially DMAPA, are very low. The aim of the study was to analyse whether subjects with previous positive patch tests to CAPB would react in provocative use tests of a product containing CAPB. 10 individuals with a clinical history of contact allergy to CAPB (by positive patch test and history) took part in a ROAT which used a CAPB-based shower gel at 25% (DMAPA concentration < 1 ppm). None of the subjects showed positive allergic reactions. 1 of the test subjects did experience a flare of atopic dermatitis at the treatment site. Later, all 10 subjects were patch tested to 3 different concentrations of CAPB and DMAPA (0.1%, 0.3%, 1%) to verify the threshold that was capable of inducing a positive test reaction. 5/10 showed clear + reactions to 1% CAPB (typically at D3), whilst a further 3 gave marginal and/or irritant reactions. Only 1 of the subjects showed an allergic reaction to DMAPA. Finally, in uncontrolled use testing with the shower gel, none of the test subjects reported any adverse skin reactions. Thus, the study confirmed that CAPB-sensitive individuals can use a CAPB-based rinse-off product without the risk of experiencing an allergic reaction to CAPB.

  4. GLENOHUMERAL MUSCLE ACTIVATION DURING PROVOCATIVE TESTS DESIGNED TO DIAGNOSE SUPERIOR LABRUM ANTERIOR-POSTERIOR LESIONS

    PubMed Central

    Wood, Vanessa J.C.; Sabick, Michelle B.; Pfeiffer, Ron P.; Kuhlman, Seth M.; Christensen, Jason H.; Curtin, Michael J.

    2012-01-01

    Background Despite considerable medical advances, arthroscopy remains the only definitive means of Superior Labrum Anterior-Posterior (SLAP) lesion diagnosis. Natural shoulder anatomic variants limit the reliability of radiographic findings and clinical evaluations are not consistent. Accurate clinical diagnostic techniques would be advantageous due to the invasiveness, patient risk, and financial cost associated with arthroscopy. Purpose The purpose was to examine the behavior of the joint stabilizing muscles in provocative tests for SLAP lesions. Electromyography was used to characterize the muscle behavior, with particular interest in the long head biceps brachii (LHBB), as activation of the long head and subsequent tension in the biceps tendon should, based on related research, elicit labral symptoms in SLAP lesion patients. Study Design Controlled Laboratory Study Methods Volunteers (N=21) without a history of shoulder pathology were recruited. The tests analyzed were Active Compression, Speed's, Pronated Load, Biceps I, Biceps II, Resisted Supination External Rotation, and Yergason's. Tests were performed with a dynamometer to improve reproducibility. Muscle activity was recorded for the long and short heads of the biceps brachii, anterior deltoid, pectoralis major, latissimus dorsi, infraspinatus, and supraspinatus. Muscle behavior for each test was characterized by peak activation and proportion of muscle activity. Results Speed's, Active Compression Palm-Up, Bicep I and Bicep II, produced higher long head activations. Resisted Supination External Rotation, Bicep I, Bicep II, and Yergason's, produced a higher LHBB proportion. Conclusion Bicep I, and Bicep II elicited promising long head behavior (high activation and selectivity). Speed's and Active Compression Palm-Up elicited higher activation of the LHBB , and Resisted Supination and Yergason's elicited selective LHBB activity. These top performing tests utilize a unique range of test variables that may

  5. Yield of routine provocative cardiac testing among patients in an emergency department-based chest pain unit.

    PubMed

    Hermann, Luke K; Newman, David H; Pleasant, W Andrew; Rojanasarntikul, Dhanadol; Lakoff, Daniel; Goldberg, Scott A; Duvall, W Lane; Henzlova, Milena J

    2013-06-24

    The American Heart Association recommends routine provocative cardiac testing in accelerated diagnostic protocols for coronary ischemia. The diagnostic and therapeutic yield of this approach are unknown. To assess the yield of routine provocative cardiac testing in an emergency department-based chest pain unit. We examined a prospectively collected database of patients evaluated for possible acute coronary syndrome between March 4, 2004, and May 15, 2010, in the emergency department-based chest pain unit of an urban academic tertiary care center. Patients with signs or symptoms of possible acute coronary syndrome and without an ischemic electrocardiography result or a positive biomarker were enrolled in the database. All patients were evaluated by exercise stress testing or myocardial perfusion imaging. Demographic and clinical features, results of routine provocative cardiac testing and angiography, and therapeutic interventions were recorded. Diagnostic yield (true-positive rate) was calculated, and the potential therapeutic yield of invasive therapy was assessed through blinded, structured medical record review using American Heart Association designations (class I, IIa, IIb, or lower) for the potential benefit from percutaneous intervention. In total, 4181 patients were enrolled in the study. Chest pain was initially reported in 93.5%, most (73.2%) were at intermediate risk for coronary artery disease, and 37.6% were male. Routine provocative cardiac testing was positive for coronary ischemia in 470 (11.2%), of whom 123 underwent coronary angiography. Obstructive disease was confirmed in 63 of 123 (51.2% true positive), and 28 (0.7% overall) had findings consistent with the potential benefit from revascularization (American Heart Association class I or IIa). In an emergency department-based chest pain unit, routine provocative cardiac testing generated a small therapeutic yield, new diagnoses of coronary artery disease were uncommon, and false-positive results

  6. Reliability of the nitroglycerin provocative test in the diagnosis of neurovascular headaches.

    PubMed

    Sances, G; Tassorelli, C; Pucci, E; Ghiotto, N; Sandrini, G; Nappi, G

    2004-02-01

    Nitroglycerin administration provokes spontaneous-like migraine attacks in migraine and cluster headache (CH) patients. Nitroglycerin-induced migraine-like headache has been used as an experimental model of migraine. In this paper, we evaluate the possibility of using the nitroglycerin provocative test (NPT) as a supportive measure in the diagnosis of primary neurovascular headaches by assessing its reliability on a large population and adopting strict criteria for rating the response as positive or negative. Our population consisted of 197 migraineurs, 42 subjects suffering from cluster headache and 53 healthy controls. In migraine without aura, the test sensitivity was 82.1%, specificity 96.2% and accuracy 85.5%, while in subjects suffering from migraine with aura, the reliability of the NPT was less satisfactory (sensitivity 13.6%, specificity 96.2% and accuracy 72%). In CH patients tested during the active phase of the disease the sensitivity was 80.6%, specificity 100% and accuracy 92.9%. NPT is an easy, low-cost and reliable method for supporting the diagnosis of migraine without aura and cluster headache.

  7. Dynamic Changes in Heart Rate Variability and Nasal Airflow Resistance during Nasal Allergen Provocation Test.

    PubMed

    Seppänen, Tiina M; Alho, Olli-Pekka; Seppänen, Tapio

    2016-01-01

    Allergic rhinitis is a major chronic respiratory disease and an immunoneuronal disorder. We aimed at providing further knowledge on the function of the neural system in nasal allergic reaction. Here, a method to assess simultaneously the nasal airflow resistance and the underlying function of autonomic nervous system (ANS) is presented and used during the nasal provocation of allergic and nonallergic subjects. Continuous nasal airflow resistance and spectral heart rate variability parameters show in detail the timing and intensity differences in subjects' reactions. After the provocation, the nasal airflow resistance of allergic subjects showed a positive trend, whereas LF/HF (Low Frequency/High Frequency) ratio and LF power showed a negative trend. This could imply a gradual sympathetic withdrawal in allergic subjects after the allergen provocation. The groups differed significantly by these physiological descriptors. The proposed method opens entirely new opportunities to research accurately concomitant changes in nasal breathing function and ANS.

  8. Dynamic Changes in Heart Rate Variability and Nasal Airflow Resistance during Nasal Allergen Provocation Test

    PubMed Central

    Seppänen, Tiina M.; Alho, Olli-Pekka; Seppänen, Tapio

    2016-01-01

    Allergic rhinitis is a major chronic respiratory disease and an immunoneuronal disorder. We aimed at providing further knowledge on the function of the neural system in nasal allergic reaction. Here, a method to assess simultaneously the nasal airflow resistance and the underlying function of autonomic nervous system (ANS) is presented and used during the nasal provocation of allergic and nonallergic subjects. Continuous nasal airflow resistance and spectral heart rate variability parameters show in detail the timing and intensity differences in subjects' reactions. After the provocation, the nasal airflow resistance of allergic subjects showed a positive trend, whereas LF/HF (Low Frequency/High Frequency) ratio and LF power showed a negative trend. This could imply a gradual sympathetic withdrawal in allergic subjects after the allergen provocation. The groups differed significantly by these physiological descriptors. The proposed method opens entirely new opportunities to research accurately concomitant changes in nasal breathing function and ANS. PMID:27196870

  9. Provocation tests with the offending nonsteroidal anti-inflammatory drugs in patients with urticaria/angioedema reactions.

    PubMed

    Zisa, Giuliana; Riccobono, Francesca; Bommarito, Luisa; D'Antonio, Cristian; Calamari, Ambra Marianna; Poppa, Mariangela; Moschella, Maria Adele; Di Pietrantonj, Carlo; Galimberti, Maurizio

    2012-01-01

    The provocation test (PT) with the suspected drug represents the gold standard in the diagnosis of non-IgE hypersensitivity reactions to nonsteroidal anti-inflammatory drugs (NSAIDs). Nevertheless, there is no consensus regarding the clinical management of suspected NSAID-sensitive patients. This study assessed if a PT with the suspected drug is a reliable and safe proceeding to confirm NSAID hypersensitivity in patients with a clinical history of urticaria/angioedema (Urt/AE). It also analyzed different patient characteristics (such as gender, age, atopy, dermographism, time interval between the last drug reaction, and number of previous NSAID reactions) in relation to PT positivity. One hundred fifty-nine patients with Urt/AE apparently related to assumption of one or more NSAIDs underwent PT with the suspected drugs. Moreover, to distinguish single/multiple NSAID reactivity in patients who did not tolerate the offending NSAID, another strong cyclooxygenase-1 inhibitor PT was performed. PT was negative in 142/159 patients (89.31%), ruling out a diagnosis of NSAIDs hypersensitivity; 17/159 patients (10.69%) experienced a reaction of Urt/AE during the PT: 8 patients were diagnosed as single reactors to NSAIDs and 4 as multiple reactors to NSAIDs. Those with a history of multiple NSAID reactions and male patients were both more likely to have a positive PT. Our results suggest that in all patients with history of NSAID cutaneous reactions, the NSAID hypersensitivity should be confirmed by an oral PT and that the diagnostic proceeding can safely start with the offending NSAID.

  10. [Effects and significance of methacholine bronchial provocation tests and salbutamol bronchial dilation test on measurements of fractional exhaled nitric oxide in patients with asthma].

    PubMed

    Liu, Jielu; Yu, Huapeng; Tan, Xiaomei; Wu, Shuhan; Zhang, Pan; Fang, Zekui; Wang, Cuilan; He, Xi

    2016-03-01

    To study the effects and significance of methacholine (Mch) bronchial provocation tests and salbutamol bronchial dilation test on measurements of fractional exhaled nitric oxide (FeNO) in patients with asthma. This was a prospective study conducted between November 2014 and August 2015. A total of 135 patients with asthma visiting the respiratory clinic of Zhujiang Hospital were enrolled. The patients received either Mch bronchial provocation test or salbutamol bronchial dilation test based on their FEV1/FVC values and cooperative degree. Mch bronchial provocation test was performed by using Astograph Jupiter-21 (Astograh group) or APS-Pro airway reaction testing apparatus (APS group), and salbutamol bronchial dilation test was performed by using Jaeger spirometer (Dilation group). We compared the differences between FeNO values measured before examinations (Pre-FeNO) and 5 min after completion of these examinations (Post-FeNO). The geometric mean of Pre-FeNO and Post-FeNO was 28.07 ppb and 24.08 ppb respectively in the Astograh group, with a significant decrease of the FeNO value after the examination (Z=-3.093, P=0.002). A significant difference between Pre-FeNO and Post-FeNO was found in patients who had positive provocation results in the Astograh group (Z=-2.787, P=0.005), but not in the patients with negative results (Z=-1.355, P=0.176). The geometric mean of FeNO in the APS group decreased significantly from 27.95 ppb to 23.15 ppb after the examination was completed (Z=-5.170, P=0.000); both in patients with positive saline or Mch provocation results and in patients with negative provocation results, the differences between Pre-FeNO and Post-FeNO in the APS group being significant (Z=-2.705, -3.709, -2.371, P=0.002, 0.000, 0.018). No difference of FeNO change(ΔFeNO) was observed between the 2 Mch bronchial provocation test groups (U<918.000, P=0.117). The geometric mean of Pre-FeNO was 36.74 ppb and that of Post-FeNO was 34.79 ppb in the Dilation group; the

  11. Feasibility and outcomes of ajmaline provocation testing for Brugada syndrome in children in a specialist paediatric inherited cardiovascular diseases centre

    PubMed Central

    McMillan, Merlin Ranald; Day, Thomas George; Bartsota, Margarita; Mead-Regan, Sarah; Bryant, Rory; Mangat, Jasveer; Abrams, Dominic; Lowe, Martin; Kaski, Juan Pablo

    2014-01-01

    Objectives Brugada syndrome (BrS) is an inherited arrhythmia syndrome that causes sudden cardiac death in the young. The class Ia antiarrhythmic ajmaline can be used to provoke the diagnostic ECG pattern. Its use has been established in adults, but little data exist on the ajmaline provocation test in children. This study aims to determine the safety and feasibility of ajmaline provocation testing in a large paediatric cohort in a specialist paediatric inherited cardiac diseases centre. Methods 98 consecutive ajmaline tests were performed in 95 children between September 2004 and July 2012 for family history of BrS (n=46 (48%)); family history of unexplained sudden cardiac death (n=39 (41%); symptoms with suspicious ECG abnormalities (n=9 (10%)). Three patients were retested with age, due to the possibility of age-related penetrance. ECG parameters were measured at baseline and during maximal ajmaline effect. Results The mean patient age was 12.55 years, 43% were female. Nineteen patients (20%) had a positive ajmaline test. There were no arrhythmias or adverse events during testing. Ajmaline provoked significant prolongation of the PR, QRS and QTc in all patients. Mean follow-up was 3.62 years with no adverse outcomes reported in any patients with BrS. There were no predictors of a positive ajmaline provocation test on multivariable analysis. One patient who tested negative at 12 years of age, subsequently tested positive at 15 years of age. Conclusions Ajmaline testing appears safe and feasible in children when performed in an appropriate setting by an experienced team. Test positivity may change with age in individuals, suggesting that the test should be repeated in the late teenage years or early adulthood. PMID:25332787

  12. Possible role of an endovascular provocative test in the diagnosis of glossopharyngeal neuralgia as a vascular compression syndrome.

    PubMed

    Matsushima, T; Goto, Y; Ishioka, H; Mihara, F; Fukui, M

    1999-01-01

    We utilized endovascular provocative techniques to identify the indications for microvascular decompression surgery in a serious case of glossopharyngeal neuralgia. This is the first reported case in which an endovascular provocative test was applied for diagnosis of glossopharyngeal neuralgia as a vascular compression syndrome. A 68-year-old woman presented with severe paroxysmal facial pain which could not be controlled by medical therapy. Partial effectiveness to carbamazepine led us to wonder whether or not the selection of microvascular decompression surgery would be appropriate. Pre-operative angiography was performed. During the examination a microcatheter was inserted into the right posterior inferior cerebellar artery (PICA), and an attack of typical glossopharyngeal neuralgia occurred. The patient thus underwent microvascular decompression surgery. The PICA was verified to compress the glossopharyngeal nerve and therefore was moved to induce decompression. The patient has since experienced no further pain for one year postoperatively. The diagnosis of glossopharyngeal neuralgia is sometimes complex and it is difficult to select the most appropriate surgical modality. In such cases this endovascular provocative technique may thus be useful for making a definitive decision or microvascular decompression surgery.

  13. Reliability and validity of three pain provocation tests used for the diagnosis of chronic proximal hamstring tendinopathy.

    PubMed

    Cacchio, Angelo; Borra, Fabrizio; Severini, Gabriele; Foglia, Andrea; Musarra, Frank; Taddio, Nicola; De Paulis, Fosco

    2012-09-01

    The clinical assessment of chronic proximal hamstring tendinopathy (PHT) in athletes is a challenge to sports medicine. To be able to compare the results of research and treatments, the methods used to diagnose and evaluate PHT must be clearly defined and reproducible. To assess the reliability and validity of three pain provocation tests used for the diagnosis of PHT. Ninety-two athletes with (N=46) and without (N=46) PHT were examined by one physician and two physiotherapists, who were trained in the examination techniques before the study. The examiners were blinded to the symptoms and identity of the athletes. The three pain provocation tests examined were the Puranen-Orava, bent-knee stretch and modified bent-knee stretch tests. Intraclass correlation coefficients (ICCs) based on the repeated measures analysis of variance were used to analyse the intraexaminer and interexaminer reliability, while sensitivity, specificity, predictive values and likelihood ratios were used to determine the validity of the three tests. The ICC values in all three tests revealed a high correlation (range 0.82 to 0.88) for the interexaminer reliability and a high-to-very high correlation (range 0.87 to 0.93) for the intraexaminer reliability. All three tests displayed a moderate-to-high validity, with the highest degree of validity being yielded by the modified bent-knee stretch test. All three pain provocation tests proved to be of potential value in assessing chronic PHT in athletes. However, we recommend that they be used in conjunction with other objective measures, such as MRI.

  14. A systematic review of the diagnostic accuracy of provocative tests of the neck for diagnosing cervical radiculopathy

    PubMed Central

    Pool, Jan J. M.; van Tulder, Maurits W.; Riphagen, Ingrid I.; de Vet, Henrica C. W.

    2006-01-01

    Clinical provocative tests of the neck, which position the neck and arm inorder to aggravate or relieve arm symptoms, are commonly used in clinical practice in patients with a suspected cervical radiculopathy. Their diagnostic accuracy, however, has never been examined in a systematic review. A comprehensive search was conducted in order to identify all possible studies fulfilling the inclusion criteria. A study was included if: (1) any provocative test of the neck for diagnosing cervical radiculopathy was identified; (2) any reference standard was used; (3) sensitivity and specificity were reported or could be (re-)calculated; and, (4) the publication was a full report. Two reviewers independently selected studies, and assessed methodological quality. Only six studies met the inclusion criteria, which evaluated five provocative tests. In general, Spurling’s test demonstrated low to moderate sensitivity and high specificity, as did traction/neck distraction, and Valsalva’s maneuver. The upper limb tension test (ULTT) demonstrated high sensitivity and low specificity, while the shoulder abduction test demonstrated low to moderate sensitivity and moderate to high specificity. Common methodological flaws included lack of an optimal reference standard, disease progression bias, spectrum bias, and review bias. Limitations include few primary studies, substantial heterogeneity, and numerous methodological flaws among the studies; therefore, a meta-analysis was not conducted. This review suggests that, when consistent with the history and other physical findings, a positive Spurling’s, traction/neck distraction, and Valsalva’s might be indicative of a cervical radiculopathy, while a negative ULTT might be used to rule it out. However, the lack of evidence precludes any firm conclusions regarding their diagnostic value, especially when used in primary care. More high quality studies are necessary in order to resolve this issue. PMID:17013656

  15. [Case of food-dependent exercise-induced anaphylaxis diagnosed by the provocation test with cuttlefish after the pretreatment with 1.5 g of aspirin].

    PubMed

    Nakamura, Kazuko; Inomata, Naoko; Okawa, Tomoko; Maeda, Nobuko; Kirino, Mio; Shiomi, Kazuo; Ikezawa, Zenro

    2010-12-01

    A 29-year-old woman had an episode of urticaria at the age of 17 while exercising after eating fried cuttlefish. For years thereafter, she experienced several episodes of urticaria after eating seafood. At the age of 29, she ate grilled seafood, including cuttlefish for supper after taking loxoprofen for lumbago. One hour later, she developed generalized urticaria accompanied by nausea, abdominal pain, swelling of the lips, and dyspnea while walking; she was taken to a hospital. She was then referred to us for further examination of the etiology of her anaphylactic reactions. The level of specific IgE measured using Immuno CAP was negative for all kinds of foods, including cuttlefish. However, a skin prick test was positive for raw and cooked cuttlefish. Provocation tests were performed on admission by combining the intake of cuttlefish and aspirin under the suspicion of cuttlefish allergy enhanced by nonsteroidal anti-inflammatory drugs and exercise. As a result, she developed no symptoms except for slight itching of the oral mucosa after eating 20 g or 100 g of cuttlefish with or without concomitant administration of 0.5 g of aspirin. Finally, generalized urticaria appeared after challenge with cuttlefish and 1.5 g of aspirin. She was diagnosed with food-dependent exercise-induced anaphylaxis (FDEIA) caused by cuttlefish. She has not developed urticaria since she started to avoid eating cuttlefish. Our results indicated that in provocation tests for the diagnosis of FDEIA, allergic reactions could not only be induced by food intake but could also be enhanced by aspirin in a dose-dependent manner.

  16. Automatic conjunctival provocation test combining Hough circle transform and self-calibrated color measurements

    NASA Astrophysics Data System (ADS)

    Bista, Suman Raj; Sárándi, István.; Dogan, Serkan; Astvatsatourov, Anatoli; Mösges, Ralph; Deserno, Thomas M.

    2013-02-01

    Computer-aided diagnosis is developed for assessment of allergic rhinitis/rhinoconjunctivitis measuring the relative redness of sclera under application of allergen solution. Images of the patient's eye are taken using a commercial digital camera. The iris is robustly localized using a gradient-based Hough circle transform. From the center of the pupil, the region of interest within the sclera is extracted using geometric anatomy-based apriori information. The red color pixels are extracted thresholding in the hue, saturation and value color space. Then, redness is measured by taking mean of saturation projected into zero hue. Evaluation is performed with 98 images taken from 14 subjects, 8 responders and 6 non-responders, which were classified according to an experienced otorhinolaryngologist. Provocation is performed with 100, 1,000 and 10,000 AU/ml allergic solution and normalized to control images without provocation. The evaluation yields relative redness of 1.01, 1.05, 1.30 and 0.95, 1.00, 0.96 for responders and non-responders, respectively. Variations in redness measurements were analyzed according to alteration of parameters of the image processing chain proving stability and robustness of our approach. The results indicate that the method improves visual inspection and may be suitable as reliable surrogate endpoint in controlled clinical trials.

  17. An evaluation of the darkroom prone provocative test in family members of primary angle closure glaucoma patients.

    PubMed

    Sihota, R; Mohan, S; Dada, T; Gupta, V; Pandey, R M; Ghate, D

    2007-07-01

    To compare ocular biometric parameters with darkroom prone provocative test (DRPPT) in family members of primary angle closure glaucoma (PACG) patients. One hundred and forty-nine family members of 46 PACG patients underwent ocular examination included slit lamp biomicroscopy, gonioscopy, fundus examination using +90 D lens, Goldmann applanation tonometry, darkroom prone provocative test, perimetry on Humphrey's field analyzer II and optic disc evaluation using HRT II. Ultrasonic ocular biometry and the DRPPT were then performed. IOP>or=8 mmHg rise from baseline with iridocorneal touch was considered as a positive test. Of the 149 family members examined, 55 (36.9%) were found to have PACG. Forty (72.7%) of these had subacute PACG and 15 (27.3%) were found to have chronic PACG. Thirty-nine (70.3%) of the affected members showed a positive DRPPT. Mean anterior chamber depth (ACD) was 2.03+/-0.3, 2.3+/-0.4, 2.7+/-0.3 mm (P=0.0001) and mean lens thickness was 4.41+/-0.39, 3.99+/-0.5, 3.93+/-0.4 mm (P=0.0001) in DRPPT positives, borderlines and negatives respectively. ROC curve (ACD) plotted showed cutoff value of 2.07 mm (sensitivity 88.57%) for screening. Anterior chamber is shallowest, lens is thickest and axial length is shortest in affected and DRPPT positive, family members of PACG patients.

  18. Diagnosing painful sacroiliac joints: A validity study of a McKenzie evaluation and sacroiliac provocation tests.

    PubMed

    Laslett, Mark; Young, Sharon B; Aprill, Charles N; McDonald, Barry

    2003-01-01

    Research suggests that clinical examination of the lumbar spine and pelvis is unable to predict the results of diagnostic injections used as reference standards. The purpose of this study was to assess the diagnostic accuracy of a clinical examination in identifying symptomatic and asymptomatic sacroiliac joints using double diagnostic injections as the reference standard. In a blinded concurrent criterion-related validity design study, 48 patients with chronic lumbopelvic pain referred for diagnostic spinal injection procedures were examined using a specific clinical examination and received diagnostic intraarticular sacroiliac joint injections. The centralisation and peripheralisation phenomena were used to identify possible discogenic pain and the results from provocation sacroiliac joint tests were used as part of the clinical reasoning process. Eleven patients had sacroiliac joint pain confirmed by double diagnostic injection. Ten of the 11 sacroiliac joint patients met clinical examination criteria for having sacroiliac joint pain. In the primary subset analysis of 34 patients, sensitivity, specificity and positive likelihood ratio (95% confidence intervals) of the clinical evaluation were 91% (62 to 98), 83% (68 to 96) and 6.97(2.70 to 20.27) respectively. The diagnostic accuracy of the clinical examination and clinical reasoning process was superior to the sacroiliac joint pain provocation tests alone. A specific clinical examination and reasoning process can differentiate between symptomatic and asymptomatic sacroiliac joints

  19. Noninvasive ergonovine maleate provocative testing for coronary artery spasm: the need for routine thallium-201 imaging

    SciTech Connect

    Shanes, J.G.; Krone, R.J.; Fisher, K.; Shah, B.; Eisenkramer, G.; Humphrey, J.R.

    1983-01-01

    We administered ergonovine and used both electrocardiographic monitoring and thallium-/sup 201/ (/sup 201/Tl) imaging to detect reversible ischemia in 100 patients. Patients already established as having coronary artery spasm and those with nonbypassed, proximal, high-grade coronary artery stenosis were excluded. No complication occurred in any patient. The use of thallium imaging in addition to electrocardiographic monitoring resulted in a higher degree of sensitivity than did ECG monitoring alone. Fourteen patients demonstrated evidence of coronary artery spasm as documented by /sup 201/Tl imaging but of the 14, significant ECG changes occurred in only 50%, and classic ST segment elevation in 21%. Thus, in carefully selected patients the noninvasive provocation of coronary spasm can be accomplished safely, but ECG monitoring must be combined with thallium-/sup 201/ imaging to achieve an acceptable degree of sensitivity.

  20. Endovascular treatment of intracranial infectious aneurysms in eloquent cortex with super-selective provocative testing: Case series and literature review.

    PubMed

    Fusco, Matthew R; Stapleton, Christopher J; Griessenauer, Christoph J; Thomas, Ajith J; Ogilvy, Christopher S

    2016-04-01

    Intracranial infectious aneurysms (IIAs) are a rare subgroup of intracranial aneurysms. Often erroneously termed mycotic aneurysms, these lesions most often result from infectious endocarditis and involve the distal anterior cortical circulation. Diagnosis typically follows headaches or septic infarcts, although increasing numbers of lesions are found incidentally, during screening protocols for infectious endocarditis. Open surgical treatment was previously the mainstay of treatment; however, these IIAs are often fusiform and quite fragile, making open surgical obliteration difficult and typically requiring lesion trapping. Current treatment techniques more commonly involve endovascular coil embolization or parent vessel occlusion. Many of these lesions occur distally, in or around the eloquent cortex, making embolization potentially dangerous. We present cases that highlight the use of super-selective provocative testing with sodium amobarbital and lidocaine, to help clarify and predict the risk of parent vessel occlusion in IIAs located in the eloquent cortex.

  1. Reliability of a seated three-dimensional passive intervertebral motion test for mobility, end-feel, and pain provocation in patients with cervicalgia.

    PubMed

    Manning, Dana M; Dedrick, Gregory S; Sizer, Phillip S; Brismée, Jean-Michel

    2012-08-01

    Neck pain can be evaluated with passive intervertebral motion (PIVM). No study has evaluated the reliability of three-dimensional (3D) segmental PIVM testing of the cervical spine in symptomatic subjects in a functional, seated position. The purpose of this study was to evaluate inter-rater reliability of such 3D PIVM technique for pain provocation, hypomobility, and end-feel detection. Subjects (n = 63), age 44±15·6 years, neck pain 3·4±1·6 cm with visual analog scale, were evaluated by two of three raters with varied manual therapy education and experience. To perform the test, the rater passively invoked side-bending motion at each cervical joint from C2-C3 to C6-C7, allowing segmental synkinetic rotation and extension to occur. Each joint was assessed for hypomobility, hard end-feel, and pain provocation. Kappa statistics were used to determine the inter-rater reliability for each variable for joints C2-C3 through C6-C7 for both the most painful and least painful sides. Percent agreements for pain provocation, hypomobility, and end-feel ranged 65-83%, 62-84%, and 68-87%, respectively. Kappa values for pain provocation, hypomobility, and end-feel on the most painful side were fair to moderate (0·29-0·53, 0·21-0·48, and 0·25-0·50, respectively), and on the least painful side were fair to substantial (0·43-0·65, 0·33-0·58, and 0·28-0·60, respectively). This is the first investigation to assess reliability of 3D cervical segmental testing in sitting and to assess reliability of end-feel. The seated 3D PIVM test has sufficient clinical reliability for use in patients with cervicalgia for the assessment of hypomobility, end-feel, and pain provocation.

  2. Catecholamine release after physical exercise. A new provocative test for early diagnosis of pheochromocytoma in multiple endocrine neoplasia type 2.

    PubMed

    Telenius-Berg, M; Adolfsson, L; Berg, B; Hamberger, B; Nordenfelt, I; Tibblin, S; Welander, G

    1987-01-01

    A simple and practical provocative test is needed for early asymptomatic pheochromocytoma, which is a major risk for patients with multiple endocrine neoplasia type 2 (MEN-2). We measured plasma catecholamines before and after submaximal exercise in 26 MEN-2 gene carriers, eight of whom with asymptomatic pheochromocytoma, nine with medullary thyroid carcinoma and 10 after uni- or bilateral adrenalectomy. Seventeen clinically healthy individuals and 11 patients with neurovegetative lability and symptoms mimicking pheochromocytoma served as controls. Plasma adrenaline, noradrenaline and dopamine increased after exercise except for adrenaline after bilateral adrenalectomy. The post-exercise levels of adrenaline and the adrenaline/dopamine ratio were significantly higher in the pheochromocytoma patients compared to the healthy controls and the patients with neurovegetative lability, while the patients with medullary thyroid carcinoma represented an intermediate group with a high probability of developing adrenal tumors. The present method is a physiological test with a high sensitivity and specificity. It is practical and well suited for repeated examinations and seems to be of value for the detection of early pheochromocytoma in MEN-2 patients. Furthermore, the test could be used in the differential diagnosis between pheochromocytoma and neurovegetative lability.

  3. [Characteristics and limitation of portable bedside swallowing test in elderly with dementia: comparison between the repetitive saliva swallowing test and the simple swallowing provocation test].

    PubMed

    Baba, Yuki; Teramoto, Shinji; Hasegawa, Hiroshi; Machida, Ayako; Akishita, Masahiro; Toba, Kenji

    2005-05-01

    Several bedside portable swallowing tests have been advocated for screening for dysphagia. However, the clinical usefulness and limitation of these tests have not been examined in elderly patients with dementia. We performed the repetitive saliva swallowing test (RSST) and the simple swallowing provocation test (SSPT) in 37 elderly inpatients (81.8 +/- 1.2 years old). Simultaneously, cognitive and verbal communication ability were assessed by the Hasegawa Dementia Scale revised version (HDSR) and the Mini-Communication Test (MCT). RSST was completed only in 22 patients (59%), whereas SSPT was successfully completed in all cases. Scores of HDSR and MCT were significantly lower in patients who were unable to cooperate with RSST compared to successful examinees (HDSR: 7 +/- 1 vs 15 +/- 3, p < 0.0; MCT: 47 +/- 8 vs 81 +/- 5, p < 0.01). Dysphagia was detected in 14 patients (64%) by RSST and 5 (14%) by SSPT. Patients with dysphagia showed significantly lower cognitive function (p < 0.05) and verbal communication ability (p < 0.05). In conclusion, RSST is more sensitive to detect dysphagia in elderly patients; however, compliance with RSST is strongly influenced by the patient's cognitive function and verbal communication ability. Comprehensive geriatric assessment will help to choose an alternative test for dysphagia such as SSPT which is more specific test for aspiration pneumonia.

  4. The Oral Language Proficiency Test.

    ERIC Educational Resources Information Center

    Lowe, Pardee, Jr.

    This booklet describes the test used by the federal government to determine oral proficiency in a foreign language. The test is essentially an oral interview, conducted by two testers, and lasting from 15 to 30 minutes, although the format can vary. Proficiency levels range from 0 (for no practical speaking proficiency) to 5 (for speaking…

  5. Provocation of Migraine after Maximal Exercise: A Test-Retest Study.

    PubMed

    Varkey, Emma; Grüner Sveälv, Bente; Edin, Fredrik; Ravn-Fischer, Annica; Cider, Åsa

    2017-01-01

    Exercise is often recommended in migraine treatment, but strenuous physical activity is also reported as a migraine trigger. The main aim of this study was to evaluate whether migraine can be triggered by a maximal exercise test, using a prospective test-retest method. A secondary aim was to compare the participants who responded to the maximal exercise test with a migraine attack with those who did not suffer a migraine attack after the test. A total of 19 patients reporting exercise as a potential trigger for their migraines were included in the study. After a baseline period of 1 month with measurements of migraine frequency, a cycle ergometer test until exhaustion was used twice on each patient. A total of 14 patients were test-retested, and of these, 3 reported migraine following both tests, 5 after one of the tests, and 6 did not report migraine after either test. We observed a higher risk of migraine after 1 or 2 tests in patients with a higher baseline migraine frequency (p = 0.036). In conclusion, the study showed that although maximal aerobic exercise can trigger migraine attacks, it does not always provoke an attack even in those who report exercise as a migraine trigger. © 2017 S. Karger AG, Basel.

  6. Comparison of levocabastine, a new selective H1-receptor antagonist, and disodium cromoglycate, in a nasal provocation test with allergen.

    PubMed Central

    Kolly, M; Pécoud, A

    1986-01-01

    The effect of intranasal administration of levocabastine, a new selective H1-receptor antagonist, was investigated in a nasal provocation test (NPT) performed with allergens. The NPT allowed a quantitative estimation of the nasal allergic threshold (concentration of allergen necessary to trigger the reaction). In addition, the intensity of the three major rhinitis symptoms (obstruction, rhinorrhea and sneezing) was determined. Twelve adult patients, allergic to grass pollen, underwent a first NPT without pretreatment ('initial NPT'); the NPT was then repeated after the single intranasal administration of either placebo, 8 mg disodium cromoglycate (DSCG) or 0.2 mg levocabastine in a double-blind random order. The NPTs gave reproducible results since both the threshold and symptom intensities were similar in the initial NPT and in the NPT performed after placebo. The reaction threshold increased in 8/12 patients after DSCG (0.05 less than P less than 0.1) and in 9/12 patients after levocabastine (P less than 0.05). Levocabastine clearly inhibited rhinorrhea (P less than 0.001) and sneezing (P less than 0.02) but did not influence the nasal obstruction. DSCG inhibited rhinorrhea only (P less than 0.01). The intranasal administration of levocabastine might be useful in the treatment of allergic rhinitis. PMID:2876723

  7. Validation of a Symptom Provocation Test for Laboratory Studies of Abdominal Pain and Discomfort in Children and Adolescents

    PubMed Central

    Walker, Lynn S.; Williams, Sara E.; Smith, Craig A.; Garber, Judy; Van Slyke, Deborah A.; Lipani, Tricia; Greene, John W.; Mertz, Howard; Naliboff, Bruce D.

    2011-01-01

    Objective Assessed the convergent and discriminant validity of a water load symptom provocation test (WL-SPT) in creating visceral sensations similar to the naturally occurring sensations experienced by children with functional abdominal pain. Methods Participants were pediatric patients with functional abdominal pain (N = 110) and healthy school children (N = 120) between the ages of 8 and 16 years. Pain patients completed questionnaires describing gastrointestinal (GI) and nongastrointestinal (non-GI) symptoms associated with their typical abdominal pain episodes. Weeks later, the WL-SPT was administered to pain patients and well children. Before and immediately following the WL-SPT, children rated their symptoms. Results The WL-SPT produced (a) significant increases in children’s GI symptoms that were reliably predicted by the children’s naturally occurring GI symptoms, and (b) significantly greater increases in GI symptoms in pain patients than in well children. Conclusions The WL-SPT produces clinically relevant symptoms for laboratory studies of children with functional abdominal pain. PMID:16861396

  8. Final heights of boys with normal growth hormone responses to provocative tests following priming.

    PubMed

    Gonc, E Nazli; Kandemir, Nurgun; Ozon, Alev; Alikasifoglu, Ayfer

    2008-10-01

    Priming with sex steroids prior to growth hormone (GH) stimulation tests for the diagnosis of GH deficiency is still debatable. We analyzed the auxological data of boys with growth retardation who had normal GH responses to stimulation tests only after priming to establish the validity of priming in the diagnosis of GH deficiency. We also analyzed the effect of different protocols for priming and their efficiency in the diagnosis of GH deficiency. Fifty boys with growth retardation who failed to respond to unprimed GH stimulation tests but responded normally to primed tests were included in the study. Thirty-one of 50 boys responded to GH stimulation tests after single low dose testosterone, 11/50 boys after single conventional dose, and 8/50 boys with multiple-dose testosterone. The study group was followed till final height; height velocity, final height and height SDS were compared to parental and mid-parental heights to determine whether or not the children achieved their height potential. Mean final height SDS of the study group (-1.27 +/- 0.72 SDS) was similar to mid-parental (-1.38 +/- 0.72 SDS) (p = 0.249) and maternal height SDS (-1.26 +/- 1.05 SDS) (p = 0.941), whereas it was greater than the paternal height SDS (-1.7 +/- 0.86) (p = 0.001). The final height SDS of the study group was correlated to maternal, paternal and mid-parental height SDS. Height velocity after the test was greater than the previous height velocity. Final height SDS of the boys who responded to the GH stimulation tests with different priming protocols were compared and found to be similar. Normal responders in primed GH tests grow normally to their target height, suggesting that priming might be a valuable method in the assessment of GH status. Use of priming in the GH stimulation tests of peripubertal boys with decreased growth rate may help avoid unnecessary GH therapy. Multiple-dose testing might exclude GHD in a patient population who failed to respond to a single dose of

  9. [Provocative tests in the diagnosis of childhood onset growth hormone insufficiency].

    PubMed

    Gonçalves, Jean-Pierre; Correia, Filipa; Cardoso, Helena; Borges, Teresa; Oliveira, Maria João

    2014-01-01

    Introdução: A incidência da deficiência de hormona do crescimento é de 1:4000 a 1:10000, sendo a principal indicação para tratamento com hormona do crescimento recombinante.Objectivos: Avaliar os resultados dos testes de estimulação da hormona do crescimento e identificar factores preditivos para o diagnóstico da deficiência de hormona do crescimento.Material e Métodos: Estudo observacional, analítico e transversal. Foram analisados dados clínicos e auxológicos e os resultados dos exames de diagnóstico de crianças e adolescentes submetidos a testes de estimulação farmacológica da hormona do crescimento (01/01/2008 a 31/05/2012). O diagnóstico definitivo de deficiência de hormona do crescimento foi efectuado mediante dois testes com estímulos farmacológicos diferentes negativos (pico máximo da hormona do crescimento < 7 ng/mL) ou um teste negativo associado à presença de alterações anatómicas da região hipotálamo-hipofisária, observadas na ressonância magnética cerebral. Para análise estatística, foram realizados o testes de t student, do qui- quadrado, correlação de Pearson e a regressão logística. Foi considerado como nível de significância estatística (p) um valor igual ou menor que 0,05.Resultados: Realizaram-se testes de estimulação em 89 doentes, com mediana de idade igual a 10 [3-17] anos, 67% do sexo masculino e 77% pré-púberes. Os fármacos utilizados no primeiro teste de estimulação foram a clonidina (n = 85) e a insulina (n = 4). Foram diagnosticados 22 casos de deficiência de hormona do crescimento. Nos casos submetidos a dois testes, os valores máximos de hormona do crescimento apresentaram uma correlação moderada entre si (r = 0,593, p = 0,01). Verificou-se que as variáveis estatura (z-score) e pico máximo de hormona do crescimento obtido no primeiro teste têm valor preditivo no diagnóstico de deficiência de hormona do crescimento.Discussão: A determinação do IGF-1 não demonstrou ser

  10. Provocative use test of nickel coins in nickel-sensitized subjects and controls.

    PubMed

    Zhai, H; Chew, A-L; Bashir, S J; Reagan, K E; Hostynek, J J; Maibach, H I

    2003-08-01

    Consensus exists on levels of nickel release that are well tolerated in exposure to nickel-containing items in direct and continuous contact with skin (e.g. watches). The clinical relevance of nickel-containing coins eliciting nickel dermatitis associated with extensive occupational exposure (e.g. coins handled by cashiers) has not been determined. To examine whether nickel-containing coins might be an elicitor of allergic contact dermatitis (ACD) in occupational settings with extensive exposure to coins (i.e. cashiers). Eighteen subjects (10 nickel sensitized and eight non-nickel sensitized) completed this study after screening of history, physical examination and diagnostic patch testing (5% nickel sulphate). Each volunteer handled 10 coins (nickel-containing coins or non-nickel-containing coins) in a cross-over design at 5-min intervals (5 min handling followed by 5 min rest) for 8 h per day, for a total of 12 days excluding the weekend. One hand was gloved while the other was not during coin handling. Visual scoring and bioengineering measurements were recorded at each of four predetermined sites at baseline (day 1), end of day 5 and day 12 (last day of exposure). There were no statistical differences for either visual or bioengineering data comparing: (i) nickel-sensitized vs. non-nickel-sensitized subjects handling nickel-containing coins at day 1, day 5 and day 12; (ii) day 12 vs. day 1 (baseline) for nickel-sensitized subjects handling nickel-containing coins; (iii) handling of nickel-containing coins vs. non-nickel-containing coins by nickel-sensitized subjects at day 5 and day 12; (iv) gloved hand vs. ungloved hand of nickel-sensitized subjects handling nickel-containing coins at day 12. Limitations of the method and clinical extrapolation are detailed. Individuals handling these nickel-containing coins daily did not develop ACD, as judged by visual signs or bioengineering parameters.

  11. [Nasal allergenic provocation test].

    PubMed

    Becerril Angeles, M H; Pérez López, A; Azuara Pliego, E

    2000-01-01

    This is a method to evaluate both specific sensitivity to allergens in the nasal mucosa, IgE-mediated hypersensitivity, and antiinflammatory and antiallergic drugs efficacy, whose objectives are for research in diagnosis and treatment. The method is based in allergen extracts delivery in the nasal mucosa and the post-challenge measurement of rhinitis symptoms, vasoactive mediators release quantification and nasal obstruction degree evaluated by rhinomanometry. Nasal allergen challenge is a procedure of diagnostic and therapeutic evaluation usefulness, that must be performed in selected patients, in adequate facilities, by experts physicians, with standardised allergen dosages, in an specific nasal area, with objective measurements (rhinomanometry, mediators and secretions of the allergic response) and symptoms scoring that allow get reliable results in patients with allergic rhinitis under study.

  12. Reliability of a seated three-dimensional passive intervertebral motion test for mobility, end-feel, and pain provocation in patients with cervicalgia

    PubMed Central

    Manning, Dana M; Dedrick, Gregory S; Sizer, Phillip S; Brismée, Jean-Michel

    2012-01-01

    Objectives: Neck pain can be evaluated with passive intervertebral motion (PIVM). No study has evaluated the reliability of three-dimensional (3D) segmental PIVM testing of the cervical spine in symptomatic subjects in a functional, seated position. The purpose of this study was to evaluate inter-rater reliability of such 3D PIVM technique for pain provocation, hypomobility, and end-feel detection. Methods: Subjects (n = 63), age 44±15·6 years, neck pain 3·4±1·6 cm with visual analog scale, were evaluated by two of three raters with varied manual therapy education and experience. To perform the test, the rater passively invoked side-bending motion at each cervical joint from C2–C3 to C6–C7, allowing segmental synkinetic rotation and extension to occur. Each joint was assessed for hypomobility, hard end-feel, and pain provocation. Kappa statistics were used to determine the inter-rater reliability for each variable for joints C2–C3 through C6–C7 for both the most painful and least painful sides. Results: Percent agreements for pain provocation, hypomobility, and end-feel ranged 65–83%, 62–84%, and 68–87%, respectively. Kappa values for pain provocation, hypomobility, and end-feel on the most painful side were fair to moderate (0·29–0·53, 0·21–0·48, and 0·25–0·50, respectively), and on the least painful side were fair to substantial (0·43–0·65, 0·33–0·58, and 0·28–0·60, respectively). Discussion: This is the first investigation to assess reliability of 3D cervical segmental testing in sitting and to assess reliability of end-feel. The seated 3D PIVM test has sufficient clinical reliability for use in patients with cervicalgia for the assessment of hypomobility, end-feel, and pain provocation. PMID:23904752

  13. Drug Testing in Oral Fluid

    PubMed Central

    Drummer, Olaf H

    2006-01-01

    Over the last decade there have been considerable developments in the use of oral fluid (saliva) for drug testing. Oral fluid can provide a quick and non-invasive specimen for drug testing. However, its collection may be thwarted by lack of available fluid due to a range of physiological factors, including drug use itself. Food and techniques designed to stimulate production of oral fluid can also affect the concentration of drugs. Current applications are mainly focused on drugs of abuse testing in employees at workplaces where drug use has safety implications, in drivers of vehicles at the roadside and in other situations where drug impairment is suspected. Testing has included alcohol (ethanol) and a range of clinical tests eg antibodies to HIV, therapeutic drugs and steroids. Its main application has been for testing for drugs of abuse such as the amphetamines, cocaine and metabolites, opioids such as morphine, methadone and heroin, and for cannabis. Oral fluid concentrations of basic drugs such as the amphetamines, cocaine and some opioids are similar or higher than those in plasma. Tetrahydrocannabinol (THC), the major species present from cannabis use, displays similar concentrations in oral fluid compared to blood in the elimination phase. However, there is significant local absorption of the drug in the oral cavity which increases the concentrations for a period after use of drug. Depot effects occur for other drugs introduced into the body that allow local absorption, such as smoking of tobacco (nicotine), cocaine, amphetamines, or use of sub-lingual buprenorphine. Screening techniques are usually an adaptation of those used in other specimens, with an emphasis on the parent drug since this is usually the dominant species present in oral fluid. Confirmatory techniques are largely based on mass spectrometry (MS) with an emphasis on Liquid Chromatography-Mass Spectrometry (LC-MS), due to low sample volumes and the low detection limits required. Drug testing

  14. Methodology of oral sensory tests.

    PubMed

    Jacobs, R; Wu, C-H; Van Loven, K; Desnyder, M; Kolenaar, B; Van Steenberghed, D

    2002-08-01

    Different methods of oral sensory tests including light touch sensation, two-point discrimination, vibrotactile function and thermal sensation were compared. Healthy subjects were tested to assess the results obtained from two psychophysical approaches, namely the staircase and the ascending & descending method of limits for light touch sensation and two-point discrimination. Both methods appeared to be reliable for examining oral sensory function. The effect of topical anaesthesia was also evaluated but no conclusion could be drawn as too few subjects were involved. Newly developed simple testing tools for two-point discrimination and thermal sensation in a clinical situation were developed prior to this study and tested for their reproducibility. Thermal sensation could be reliably detected in repeated trials. Although the hand-held instruments have some drawbacks, the outcome of these instruments in a clinical environment is suitable for assessing oral sensory function. Three different frequencies (32, 128 and 256 Hz) were used to estimate the vibrotactile function. Different threshold levels were found at different frequencies.

  15. Urinary LTE4 is higher after nasal provocation test with L-ASA in bronchial than in only nasal responders.

    PubMed

    Micheletto, C; Visconti, M; Tognella, S; Trevisan, F; Dal Negro, R W

    2007-05-01

    Aspirin induced asthma (AIA) is a syndrome characterised by intolerance to acetylsalycilic acid (ASA), nasal polyps and bronchial asthma, being the metabolic shift of arachidonic acid toward the lipoxygenase pathway and hyper-production of cysteinyl-leukotrienes (cys-LTs) the current pathogenetic hypothesis. The research for both sensitive indicators and safe diagnostic tests is still attracting. Aim of the study was to compare the levels of urinary LTE4 in baseline and after Nasal Provocation Test (NPT) with L-ASA from subjects affected by aspirinin-Intolerance and characterized by only a nasal response to ASA to those from subjects with both a nasal and a bronchial response to the same challenge. After their written consent, 74 subjects with mill to moderate AIA (16 male, mean age 45.3 years +/- 12.3 sd, mean basal FEV1 = 78.1% pred. +/- 6.2.4sd, FEV1 reversibility = 14.3% bsln +/- 2.1 ds after salbutamol 200 mcg) performed a NPT with L-ASA (total maximal dose 25 mg). Spirometry (FEV1), acoustic rinometry (nasal volume--VOL; nasal Resistance--Req; AR; TM Hood Lab., USA), and urinary LTE4 (Cayman Chemical, MI, USA, via Triturus System, Grifols, Spain) were checked in all subjects in basal conditions and 90' after NPT. t test between means +/- sd, assuming p < 0.05, and linear regression between all variables considered. In 69 ASA-intolerant-asthmatics, mean FEV1 did not change significantly following NPT (78.7% pred. +/- 5.1 sd in baseline; 78.5% pred. +/- 4.1 sd after NPT, p = ns) even though in the presence of a significant decrease of VOL. (12.6 cm3 +/- 4.1 sd in baseline; 6.2 cm3 +/- 4.6 sd after NPT, p = 0.003); of a substantial increase in Req (0.9 cm H2O/l/min +/- 0.1 ds in baseline; 2.4 cmH2O/l/min +/- 0.2 after NPT, p = 0.04), and of urinary LTE4 excretion (333.0 pg/mg +/- 161.7 in bsln; 558.0 pg/mg +/- 171.690' after NPT with L-SA, p = 0.02). In only 5 subjects, the nasal response occurred concomitantly to a significant bronco-constriction after the NPT

  16. Tanzania Filariasis Project: a provocative day test with diethylcarbamazine for the detection of microfilariae of nocturnally periodic Wuchereria bancrofti in the blood

    PubMed Central

    McMahon, J. E.; Marshall, T. F. de C.; Vaughan, J. P.; Kolstrup, N.

    1979-01-01

    In coastal Tanzania, an area where the microfilariae (mf) of Wuchereria bancrofti exhibit nocturnal periodicity, the administration of 2 mg diethylcarbamazine (DEC) per kg body weight in the daytime provoked mf to enter the peripheral blood. In persons on normal daily activities the daytime DEC provocative method proved to be as sensitive in detecting microfilaraemia as was the examination of night blood. Its use in routine surveys is therefore justified. Although mf densities by day and night were highly correlated (r = 0.83) they tended to be lower after provocative daytime DEC than in the corresponding night blood, except in very light infections. This method was also useful in assessing the parasitological response to mass chemotherapy with DEC, but, in comparison with the results of the night blood examinations, the sensitivity and magnitude of the counts in persons remaining positive progressively decreased as the period of DEC administration increased. A correction factor has to be calculated to take account of this, and/or additional night blood samples must be taken. The dose of 2 mg of DEC per kg body weight used was readily acceptable to the people in coastal East Africa, whose cooperation is difficult to obtain for night blood surveys. Apart from W. bancrofti, the only human filarial infection occasionally encountered in this area was Dipetalonema perstans. Because of the risk of a severe Mazzotti reaction the test is contraindicated in onchocerciasis endemic regions. Severe reactions may also occur in subjects with loaiasis. PMID:396052

  17. The influence of European legislation on the use of diagnostic test allergens for nasal allergen provocation in routine care of patients with allergic rhinitis.

    PubMed

    Klimek, L; Hammerbacher, A S; Hellings, P W; Fokkens, W J; Hoffmann, H J; Muraro, A; Papadopoulos, N

    2015-09-01

    In patients with allergic rhinitis (AR), the nasal provocation test (NPT) is the standard procedure to evaluate the clinical response of the nasal mucosa to allergens with a high specificity and sensitivity. In AR, it is the only test that really measures the response of the diseased mucosa to allergens while skin prick test and serum IgE confirm the clinical suspicion of sensitization. Moreover, it is of special relevance in the detection of patients with Local Allergic Rhinitis (LAR), where general sensitization cannot be measured. For the evaluation of therapeutic interventions, NPT has been used for the clinical monitoring of antiallergic drugs and allergen specific immunotherapy. Legislation within the European Union (EU) defines allergens used for diagnostic tests like NPT to be medicinal products according to Directive 2001/83 EC, but national law is considering these products to be medicinal devices in a number of EU countries. Thus, NPT products are governed by different legislations and therefore standards throughout the EU. In consequence, allergens used for diagnostic purposes need different registrations and Marketing Authorization by national authorities. After a transition period, regulations of EU Directives are to be implemented in national law by all member states. At the moment, most EU countries have not fully implemented these Directives, however, it can be expected that most countries will implement it and enforce their rules within the next years. This development has a tremendous impact on the availability of diagnostic allergens for NPT in Europe and will make make nasal provocation testing very difficult if not impossible. We describe the current situation of diagnostic allergens under the special legislative conditions in the EU with special focus on allergen products used for NPT and the consequences for the diagnosis of AR and LAR.

  18. An integrated glucose-insulin model to describe oral glucose tolerance test data in type 2 diabetics.

    PubMed

    Jauslin, Petra M; Silber, Hanna E; Frey, Nicolas; Gieschke, Ronald; Simonsson, Ulrika S H; Jorga, Karin; Karlsson, Mats O

    2007-10-01

    An integrated model for the glucose-insulin system describing oral glucose tolerance test data was developed, extending on a previously introduced model for intravenous glucose provocations. Model extensions comprised the description of glucose absorption by a chain of transit compartments with a mean transit time of 35 minutes, a bioavailability of 80%, and a representation of the incretin effect, expressed as a direct effect of the glucose absorption rate on insulin secretion. The ability of the model to predict the incretin effect was assessed by simulating the observed difference in insulin response following an oral glucose tolerance test compared with an isoglycemic glucose infusion mimicking an oral glucose tolerance test profile. The extension of the integrated glucose-insulin model to gain information from oral glucose tolerance test data considerably expands its range of applications because the oral glucose tolerance test is one of the most common glucose challenge experiments for assessing the efficacy of hypoglycemic agents in clinical drug development.

  19. Topical provocation in fixed drug eruption due to metamizol and naproxen.

    PubMed

    Ozkaya-Bayazit, E

    2004-07-01

    The aim of this study was to investigate the usefulness of topical provocation in the diagnosis of metamizol- and naproxen-induced fixed drug eruption (FDE). Five patients with metamizol- and four patients with naproxen-induced FDE established by oral provocation were tested with the causative drugs at concentrations of 10%, 20%, and 50% in white petrolatum both on previously involved and uninvolved skin using the occlusive patch test technique. Additionally, four patients with metamizol- and five patients with naproxen-induced FDE, and 20 healthy controls were tested openly with drug preparations in dimethyl sulfoxide (DMSO). Tape-stripping occlusive patch testing in petrolatum remained negative in all. Open testing with drug preparations in DMSO revealed positive results in all four patients tested with metamizol mainly at concentrations of 20%, and in three of five patients tested with naproxen exclusively at concentrations of 50%. No positive reaction was seen on previously uninvolved skin and in healthy controls with any drug concentration and pure DMSO. In conclusion, repeated open testing with concentrations of the drugs up to 50% in DMSO seems to be a reliable test method in metamizol-induced FDE whereas oral provocation is still the most reliable method for naproxen-induced FDE as false negative results were common when testing topically with naproxen.

  20. Provocative discography: Current status

    PubMed Central

    2005-01-01

    Low back pain is a common clinical problem that may be due to a variety of causes, including disc disease. Provocative discography is an imaging-guided procedure in which a contrast agent is injected into the nucleus pulposus of the disc. Despite its controversial history, it remains the only imaging technique that provides both anatomical and functional information about a diseased disc. Disc morphology is usually assessed on either radiographs or computed tomography (CT), or both. Functional evaluation of the disc consists of pain provocation and careful assessment of the patient's response to pain. As provocative discography is an invasive procedure, it should not be used as a screening study in patients with back pain. It should instead be reserved for carefully- selected patients whose painful symptoms cannot be explained by findings on non-invasive imaging modalities such as magnetic resonance imaging or CT, and who are not responsive to conservative measures. Discography is helpful in selection of patients and disc levels to be operated upon. Careful application of indications and meticulous technique are however required if a successful outcome is to be expected. PMID:21625274

  1. Provocative dose of methacholine causing a 20% drop in FEV1 should be used to interpret methacholine challenge tests with modern nebulizers.

    PubMed

    Dell, Sharon D; Bola, Sundeep S; Foty, Richard G; Marshall, Laura C; Nelligan, Kathleen A; Coates, Allan L

    2015-03-01

    The American Thoracic Society guidelines (1999) for methacholine challenge tests (MCTs) using the 2-minute tidal breathing protocol were developed for the now-obsolete English-Wright (EW) nebulizer. In addition, the guideline recommendation to use the provocative concentration of methacholine causing a 20% drop in FEV1 (PC20) rather than the provocative dose of methacholine causing a 20% drop in FEV1 (PD20) for determining the level of bronchial hyperresponsiveness has been challenged. To determine if cumulative dose or concentration of methacholine delivered to the airways is the determinant for airway responsiveness and to validate use of the AeroEclipse* II BAN (Aero; Trudell Medical International, London, ON, Canada) nebulizer compared with use of the reference standard EW nebulizer. Subjects with asthma (10-18 yr old) participated in randomized, controlled cross-over experiments comparing four MCT protocols using standard methacholine concentrations, but varying: (1) methacholine starting concentration (testing for cumulative effect); (2) nebulizer (EW versus Aero); and (3) inhalation time. PD20 was calculated using nebulizer output rate, inhalation time, and preceding doses delivered. ANOVA analyses were used to compare geometric means of PC20 and PD20 between protocols. A total of 32 subjects (17 male) participated. PC20 differed when starting concentration varied (0.46 vs. 0.80 mg/ml; P<0.0001), whereas PD20 did not (0.06 vs. 0.08 mg). PC20 differed with the EW versus the Aero nebulzer with 30-second inhalation (1.19 vs. 0.43 mg/ml; P=0.0006) and the EW versus the Aero nebulizer with 20-second inhalation (1.91 vs. 0.89 mg/ml; P=0.0027), whereas PD20 did not (0.07 vs. 0.06 mg and 0.11 vs. 0.09 mg, respectively). In MCTs, the cumulative dose (PD20), not the PC20, determines bronchial responsiveness. Modern nebulizers may be used for the test if clinical interpretation is based on PD20. Clinical trial registered with www.clinicaltrials.gov (NCT01288482).

  2. Effect of patient characteristics on the yield of prolonged baseline head-up tilt testing and the additional yield of drug provocation.

    PubMed Central

    Fitzpatrick, A. P.; Lee, R. J.; Epstein, L. M.; Lesh, M. D.; Eisenberg, S.; Sheinman, M. M.

    1996-01-01

    OBJECTIVE: To define the value of tilt testing and hte additional yield of drug provocation over prolonged baseline tilt in different patient subgroups. (Many different protocols are in use for head-up tilt testing in heterogeneous groups of patients. Not all patients in reported series have recurrent syncope, and there is often a wide age range and a variable incidence of structural heart disease.) DESIGN: In a prospective study, baseline 60 degrees head-up tilt testing was undertaken for 45 minutes, initially without drug provocation. Patients who remained symptom free were given intravenous isoprenaline (isoproterenol) and further tilting or edrophonium (10 mg bolus) during tilt, in an order determined randomly before the start of the test. If they were symptom free after the first drug, they were given the other drug. A positive test was recorded when syncope or pre-syncope occurred with a rapid fall (> 30%) in blood pressure. The impact on tilt result of the type of symptoms, presence of significant structural heart disease (SHD), presence of a non-cardiovascular cause of sudden diminished consciousness (SDC), and age was then assessed by subgroup analysis. PATIENTS: 145 patients (73 female, mean age 51 (25), range 8-94) with one or more episodes of pre-syncope or syncope. RESULTS: 39 patients (27%, 21 female, age 49 (25) years) had positive tests and 106 (73%, 52 female, age 52 (25) years) negative tests. 27 (69%) had a positive test during baseline tilt at 20.5 (10.8) minutes, five (13%) with isoprenaline infusion, and seven (18%) with edrophonium bolus. Patients with recurrent syncope rather than single syncopal episodes or single or recurrent pre-syncope were more likely to have a positive tilt test (41% v 17%, P < 0.005) and patients with SHD or SDC (69/14 patients) were much less likely than patients without (16% v 42%, P < 0.0001). The yield of positive tests was similar if patients were below (26%) or above (27%) the mean age (50 years). When multiple

  3. Secretin-receptor and secretin-receptor-variant expression in gastrinomas: Correlation with clinical and tumoral features and secretin and calcium provocative test results.

    PubMed Central

    Long, Scott H.; Berna, Marc J.; Thill, Michelle; Pace, Andrea; Pradhan, Tapas K.; Hoffmann, K. Martin; Serrano, Jose; Jensen, Robert T.

    2008-01-01

    Context/Objectives The diagnosis of Zollinger-Ellison syndrome (ZES) requires secretin testing in 60%. Even with secretin the diagnosis may be difficult because variable responses occur and 6–30% have negative testing. The basis for variability or negative responses is unclear. It is unknown if the tumor density of secretin receptors or the presence of a secretin-receptor-variant, which can act as a dominant-negative, are important. The aim of this study was to investigate these possibilities. Patients/Methods Secretin-receptor and variant mRNA expression was determined in gastrinomas using real-time-PCR from 54 ZES patients. Results were correlated with Western blotting, secretin-receptor immunohistochemistry, with gastrin-provocative-test results and tumoral/clinical/laboratory features. Results Secretin-receptor mRNA was detectible in all gastrinomas but varied 132-fold with a mean of 0.89±0.12 molecules/β-actin. Secretin-receptor PCR results correlated closely with Western blotting (r=0.95,p<0.0001) and receptor-immunohistochemistry (p=0.0015, r=0.71). The variant was detected in all gastrinomas but levels varied 102-fold and were 72-fold lower than the total. Secretin-receptor levels correlated with variant levels, Δsecretin, but not Δcalcium and with tumor location, but not growth, extent or clinical responses. Variant levels did not correlate with the Δsecretin. Detailed analysis provides no evidence variant expression modified the secretin-receptor response or accounted for negative tests. Conclusions Secretin-receptor and secretin-receptor-variant expression occur in all gastrinomas. Because the expression of the total but not variant correlated with the secretin results and no evidence for dominant negative activity of the variant was found, our results suggest the total-secretin-receptor density is an important determinant of the secretin test response. PMID:17711922

  4. An Indirect Test of Oral Proficiency.

    ERIC Educational Resources Information Center

    Herzog, Martha; Shaw, Victor

    The development of an indirect oral proficiency test for foreign languages by the Defense Language Institute is described. The technique uses taped questions to elicit answers, also taped, that are evaluated according to the Foreign Service Institute's oral proficiency rating scale of 0 to 5. Tape recordings are used because of the large numbers…

  5. Zip1, Zip2, and Zip8 mRNA expressions were associated with growth hormone level during the growth hormone provocation test in children with short stature.

    PubMed

    Sun, Ping; Wang, Shifu; Jiang, Yali; Tao, Yanting; Tian, Yuanyuan; Zhu, Kai; Wan, Haiyan; Zhang, Lehai; Zhang, Lianying

    2013-10-01

    Short stature of children is affected by multiple factors. One of them is growth hormone (GH) deficiency. Growth hormone therapy can increase the final height of children with growth hormone deficiency. Zinc is found to induce dimerization and to enhance the bioactivity of human GH. Two gene families have been identified involved in zinc homeostasis. Previous studies in our laboratory have shown that Zip1, Zip2, Zip6, and ZnT1 mRNA were associated with zinc level in established human breast cancer in nude mice model; Zip8 was significantly lower in zinc-deficient Wistar rats in kidney. In this study, five zinc transporters: Zip1, Zip2, Zip6, Zip8, and ZnT1 were chosen. We aimed to investigate the mRNA expression of zinc transporters and to explore the relationship between zinc transporters and growth hormone in short stature children. Growth hormone provocation test is used to confirm the diagnosis of growth hormone deficiency. Six short children for the test were enrolled. At the same time, 15 sex- and age-matched normal children were enrolled as control. The expression levels of zinc transporters in peripheral blood mononuclear cells were determined by quantitative real-time PCR. Zip1 and Zip2 mRNA expression positively correlated with growth hormone level (r = 0.5133, P = 0.0371; r = 0.6719, P = 0.0032); Zip8 mRNA expression negatively correlated with growth hormone level (r = -0.5264, P = 0.0285) during the test in short stature children. The average expression level of Zip2 was significantly higher and Zip6, Zip8 mRNA levels were significantly lower in short stature children than in health controls at 0 min (P < 0.05, P < 0.05).

  6. [Circulatory reactions to the LBNP provocative test in the 1st crew of the Saliut-6 orbital station].

    PubMed

    Degtiarev, V A; Andriiakov, L Ia; Mikhaĭlov, V M; Ragozin, V N; Adamchik, Zh G

    1980-01-01

    During the first two weeks of space flight the crewmembers showed circulation reactions to LBNP that were typical of reduced orthostatic tolerance. At later flight stages (beginning with mission day 49) the Commander displayed a gradual recovery of the cardiovascular function. The Flight-Engineer exhibited reactions indicating his decreased tolerance of LBNP tests.

  7. Provocative mechanical tests of the peripheral nervous system affect the joint torque-angle during passive knee motion.

    PubMed

    Andrade, R J; Freitas, S R; Vaz, J R; Bruno, P M; Pezarat-Correia, P

    2015-06-01

    This study aimed to determine the influence of the head, upper trunk, and foot position on the passive knee extension (PKE) torque-angle response. PKE tests were performed in 10 healthy subjects using an isokinetic dynamometer at 2°/s. Subjects lay in the supine position with their hips flexed to 90°. The knee angle, passive torque, surface electromyography (EMG) of the semitendinosus and quadriceps vastus medialis, and stretch discomfort were recorded in six body positions during PKE. The different maximal active positions of the cervical spine (neutral; flexion; extension), thoracic spine (neutral; flexion), and ankle (neutral; dorsiflexion) were passively combined for the tests. Visual analog scale scores and EMG were unaffected by body segment positioning. An effect of the ankle joint was verified on the peak torque and knee maximum angle when the ankle was in the dorsiflexion position (P < 0.05). Upper trunk positioning had an effect on the knee submaximal torque (P < 0.05), observed as an increase in the knee passive submaximal torque when the cervical and thoracic spines were flexed (P < 0.05). In conclusion, other apparently mechanical unrelated body segments influence torque-angle response since different positions of head, upper trunk, and foot induce dissimilar knee mechanical responses during passive extension.

  8. Test Anxiety in Written and Oral Examinations

    ERIC Educational Resources Information Center

    Sparfeldt, Jorn R.; Rost, Detlef H.; Baumeister, Ulrike M.; Christ, Oliver

    2013-01-01

    The distinction of different test anxiety reactions (e.g., worry, emotionality) is well established. Recently, additional relevance has been given to school-subject-specific test anxiety factors. The present study explored a further aspect concerning the structure of test anxiety experiences, specifically oral versus written examination modes. A…

  9. How Accurate Are Oral Reading Tests?

    ERIC Educational Resources Information Center

    Schell, Leo M.

    Errors in oral reading tests result from inaccuracies that tend to creep in because children are not totally consistent while taking a test and from inaccuracies caused when the examiner does not catch a word recognition error, giving credit for an answer that is more wrong than right or vice versa. Every test contains a standard error of…

  10. Test Anxiety in Written and Oral Examinations

    ERIC Educational Resources Information Center

    Sparfeldt, Jorn R.; Rost, Detlef H.; Baumeister, Ulrike M.; Christ, Oliver

    2013-01-01

    The distinction of different test anxiety reactions (e.g., worry, emotionality) is well established. Recently, additional relevance has been given to school-subject-specific test anxiety factors. The present study explored a further aspect concerning the structure of test anxiety experiences, specifically oral versus written examination modes. A…

  11. Classification of Oral Proficiency Tests.

    ERIC Educational Resources Information Center

    Madsen, Harold S.; Jones, Randall L.

    A recently conducted survey has disclosed that during the past few years there has been a significant increase in the development of speaking tests. Examination of 100 speaking tests revealed many varieties and many considerations in preparing and using them. Among these are the purpose for its use, the background of the examinee, the criteria…

  12. IDEA Oral Language Proficiency Test (IPT II).

    ERIC Educational Resources Information Center

    Stansfield, Charles W.

    The IDEA Oral Language Proficiency Test (IPT II), an individually-administered measure of speaking and listening proficiency in English as a Second Language designed for secondary school students, is described and discussed. The test consists of 91 items and requires 5-25 minutes to administer. Raw scores are converted to one of seven proficiency…

  13. Non-verbal Effects in Oral Testing.

    ERIC Educational Resources Information Center

    Seddon, G. M.; Pedrosa, M. A.

    1990-01-01

    Investigated the effects of nonverbal communication during oral examinations by testing two groups of British secondary students, one group in a face-to-face situation. Finds nonverbal effects increased the mean scores by two points but could not conclude that the increase was a result of student appearance and gestures. (CH)

  14. Non-verbal Effects in Oral Testing.

    ERIC Educational Resources Information Center

    Seddon, G. M.; Pedrosa, M. A.

    1990-01-01

    Investigated the effects of nonverbal communication during oral examinations by testing two groups of British secondary students, one group in a face-to-face situation. Finds nonverbal effects increased the mean scores by two points but could not conclude that the increase was a result of student appearance and gestures. (CH)

  15. Screening tests for predicting the prognosis of oral intake in elderly patients with acute pneumonia.

    PubMed

    Oba, Shoko; Tohara, Haruka; Nakane, Ayako; Tomita, Makoto; Minakuchi, Shunsuke; Uematsu, Hiroshi

    2017-01-01

    Many elderly patients with pneumonia have aspiration pneumonia. Therefore they must temporarily abstain from oral intake. However, it is difficult to predict whether or not they will be able to start oral intake. The reason is the standard method to evaluate deglutition about pneumonia patients has not been established. In this study we aimed to develop a simple and convenient method that predicts the prognosis of oral intake as nutrition among elderly patients with acute stage pneumonia. Participants were 77 inpatients fasting due to aspiration risk with acute pneumonia. (86.0 ± 7.7 years; range 68-105 years; men: n = 34, women: n = 43) during September 2011 and August 2013. Their consciousness levels were determined by Glasgow coma scale (GCS) and swallowing function and cough reflex were evaluated by repetitive saliva swallowing test (RSST), modified water swallow test, simple swallowing provocation test and cough test. Oral intake status at discharge was considered as the objective variable, and these tests were considered as explanatory variables. Then receiver operating characteristic (ROC) curve and the area under the curve (AUC) for each was done. From the ROC curve analysis, GCS ≥14 had the largest AUC (0.79) with a sensitivity and specificity of 0.71 and 0.80. That was followed by RSST ≥1, AUC (0.77) with a sensitivity and specificity of 0.81 and 0.67. These results suggest that GCS and RSST could be useful screening tests for prognostic prediction of oral intake capability in elderly patients with acute pneumonia.

  16. Diagnostic performance of cold provocation test with hands immersion in water at 10°C for 5 min evaluated in vibration-induced white finger patients and matched controls.

    PubMed

    Mahbub, M H; Ishitake, Tatsuya; Kurozawa, Youichi; Toibana, Norikuni; Ide, Fuyoumi; Ohnari, Hiroto; Tanigawa, Kazuko; Takahashi, Yukio; Harada, Noriaki

    2011-10-01

    This study aimed to explore the diagnostic ability of the cold provocation test with hands immersion in water at 10°C for 5 min in diagnosing vibration-induced white finger (VWF). Finger skin temperature (FST) was measured in 20 VWF patients and 20 matched healthy controls, at palmar side of the distal phalanges of fingers from both hands before, during, and after hands immersion in water at 10°C (for 5 min with waterproof coverings put on both hands). Data from 4 fingers (except thumb) were evaluated at five time points: just before immersion, last minute during immersion, and at 5th, 10th, and 15th min during the post-immersion or recovery period. A positive group difference between patients and controls was revealed during the recovery period. During recovery at 95 and 70% specificity, the sensitivity ranged from 20 to 30% and 50 to 70% for evaluation with average FST for 4 fingers and 15-35% and 60-65% for evaluation with minimum FST among 4 fingers, respectively. Overall, evaluation of absolute FST at 15th min of recovery offered better diagnostic ability. The cold provocation test with hands immersion in water at 10°C for 5 min could discriminate VWF patients from healthy controls; however, this test has a limited diagnostic value in diagnosing patients with VWF.

  17. Developing Oral Placement Tests for Community-Based Language Programs.

    ERIC Educational Resources Information Center

    Applebaum, Sheila Dermer; Taborek, Elizabeth

    1986-01-01

    Two Toronto community English-as-a-second-language (ESL) programs used oral interview tests to place adults in appropriate programs. Instruments used included: Foreign Service Oral Interview; Ilyin Oral Interview; object-oriented testing; group testing; performance in authentic situations; Ontario Test of English as a Second Language; and George…

  18. To Be an Explainer: A Reporting Test of Oral Proficiency.

    ERIC Educational Resources Information Center

    Sunderland, Jane; And Others

    1988-01-01

    Evaluation of Chinese-speaking students' responses to a "Reporting Test" of oral proficiency in English as a foreign language indicated that the test may be valid and applicable for assessing oral proficiency. (CB)

  19. Work Group report: oral food challenge testing.

    PubMed

    Nowak-Wegrzyn, Anna; Assa'ad, Amal H; Bahna, Sami L; Bock, S Allan; Sicherer, Scott H; Teuber, Suzanne S

    2009-06-01

    Oral food challenges are procedures conducted by allergists/immunologists to make an accurate diagnosis of immediate, and occasionally delayed, adverse reactions to foods. The timing of the challenge is carefully chosen based on the individual patient history and the results of skin prick tests and food specific serum IgE values. The type of the challenge is determined by the history, the age of the patient, and the likelihood of encountering subjective reactions. The food challenge requires preparation of the patient for the procedure and preparation of the office for the organized conduct of the challenge, for a careful assessment of the symptoms and signs and the treatment of reactions. The starting dose, the escalation of the dosing, and the intervals between doses are determined based on experience and the patient's history. The interpretation of the results of the challenge and arrangements for follow-up after a challenge are important. A negative oral food challenge result allows introduction of the food into the diet, whereas a positive oral food challenge result provides a sound basis for continued avoidance of the food.

  20. Monitoring breath during oral glucose tolerance tests.

    PubMed

    Ghimenti, S; Tabucchi, S; Lomonaco, T; Di Francesco, F; Fuoco, R; Onor, M; Lenzi, S; Trivella, M G

    2013-03-01

    The evolution of breath composition during oral glucose tolerance tests (OGTTs) was analysed by thermal desorption/gas chromatography/mass spectrometry in 16 subjects and correlated to blood glucose levels. The glucose tolerance tests classified five of the subjects as diabetics, eight as affected by impaired glucose tolerance and three as normoglycaemic. Acetone levels were generally higher in diabetics (average concentration values: diabetics, 300 ± 40 ppbv; impaired glucose tolerance, 350 ± 30 ppbv; normoglycaemic, 230 ± 20 ppbv) but the large inter-individual variability did not allow us to identify the three groups by this parameter alone. The exhalation of 3-hydroxy-butan-2-one and butane-2,3-dione, likely due to the metabolization of glucose by bacteria in the mouth, was also observed. Future work will involve the extension of the analyses to other volatile compounds by attempting to improve the level of discrimination between the various classes of subjects.

  1. Oral Fluid Testing for Drugs of Abuse

    PubMed Central

    Bosker, Wendy M.; Huestis, Marilyn A.

    2011-01-01

    BACKGROUND Oral fluid (OF) is an exciting alternative matrix for monitoring drugs of abuse in workplace, clinical toxicology, criminal justice, and driving under the influence of drugs (DUID) programs. During the last 5 years, scientific and technological advances in OF collection, point-of-collection testing devices, and screening and confirmation methods were achieved. Guidelines were proposed for workplace OF testing by the Substance Abuse and Mental Health Services Administration, DUID testing by the European Union’s Driving under the Influence of Drugs, Alcohol and Medicines (DRUID) program, and standardization of DUID research. Although OF testing is now commonplace in many monitoring programs, the greatest current limitation is the scarcity of controlled drug administration studies available to guide interpretation. CONTENT This review outlines OF testing advantages and limitations, and the progress in OF that has occurred during the last 5 years in collection, screening, confirmation, and interpretation of cannabinoids, opioids, amphetamines, cocaine, and benzodiazepines. We examine controlled drug administration studies, immunoassay and chromatographic methods, collection devices, point-of-collection testing device performance, and recent applications of OF testing. SUMMARY Substance Abuse and Mental Health Services Administration approval of OF testing was delayed because questions about drug OF disposition were not yet resolved, and collection device performance and testing assays required improvement. Here, we document the many advances achieved in the use of OF. Additional research is needed to identify new bio-markers, determine drug detection windows, characterize OF adulteration techniques, and evaluate analyte stability. Nevertheless, there is no doubt that OF offers multiple advantages as an alternative matrix for drug monitoring and has an important role in DUID, treatment, workplace, and criminal justice programs. PMID:19745062

  2. Interpretation of Oral Fluid Tests for Drugs of Abuse

    PubMed Central

    CONE, EDWARD J.; HUESTIS, MARILYN A.

    2009-01-01

    Oral fluid testing for drugs of abuse offers significant advantages over urine as a test matrix. Collection can be performed under direct observation with reduced risk of adulteration and substitution. Drugs generally appear in oral fluid by passive diffusion from blood, but also may be deposited in the oral cavity during oral, smoked, and intranasal administration. Drug metabolites also can be detected in oral fluid. Unlike urine testing, there may be a close correspondence between drug and metabolite concentrations in oral fluid and in blood. Interpretation of oral fluid results for drugs of abuse should be an iterative process whereby one considers the test results in the context of program requirements and a broad scientific knowledge of the many factors involved in determining test outcome. This review delineates many of the chemical and metabolic processes involved in the disposition of drugs and metabolites in oral fluid that are important to the appropriate interpretation of oral fluid tests. Chemical, metabolic, kinetic, and analytic parameters are summarized for selected drugs of abuse, and general guidelines are offered for understanding the significance of oral fluid tests. PMID:17332074

  3. Oral Communication Testing: A Handbook for the Foreign Language Teacher.

    ERIC Educational Resources Information Center

    Linder, Cathy, Ed.

    This handbook is a compendium of communication testing techniques submitted by French teachers from the United States, France, and Canada. The majority of the handbook consists of sample oral communication tests. The introductory section defines communication, outlines communications testing, and discusses listening comprehension, oral expression,…

  4. Serum progranulin concentrations are not responsive during oral lipid tolerance test and oral glucose tolerance test.

    PubMed

    Schmid, A; Leszczak, S; Ober, I; Schäffler, A; Karrasch, T

    2015-07-01

    The postprandial regulation of progranulin by oral uptake of lipids and carbohydrates in healthy individuals has not yet been investigated. The regulation of progranulin in 2 large cohorts of healthy volunteers during oral lipid tolerance test (OLTT; n=100) and oral glucose tolerance test (OGTT; n=100) was analyzed. One hundred healthy volunteers underwent OLTT and OGTT in an outpatient setting. Venous blood was drawn at 0 hours (h) (fasting) and at 2, 4, and 6 h in OLTT or 1 and 2 h in OGTT. A novel OLTT solution completely free of carbohydrates and protein was applied. Subjects were characterized by anthropometric and laboratory parameters. Serum concentrations of progranulin were measured by enzyme-linked immunosorbent assay (ELISA). Circulating progranulin levels remained unchanged during OLTT and OGTT. Fasting progranulin levels ranged between 31.3±8.7 and 40.6±7.7 ng/ml and were not different in subgroups addressing BMI, gender, family history, smoking habits, and hormonal contraception. There was a reciprocal correlation of progranulin with HDL (negative) and LDL cholesterol levels (positive). In healthy adults, fasting and postprandial circulating progranulin levels are not different in BMI subgroups. Oral uptake of carbohydrates and lipids does not influence circulating progranulin levels in a short-term manner. A postprandial and short-term regulation of this adipokine is absent, at least in healthy subjects. There is a negative correlation of progranulin with HDL cholesterol, but a positive correlation with LDL cholesterol. This reciprocal association might be of physiological importance for an individual's atherosclerotic risk.

  5. The Oral Interview - A Criterion-Referenced Test?

    ERIC Educational Resources Information Center

    Lowe, Pardee, Jr.

    The oral interview may be viewed as a criterion-referenced test for making either/or decisions about functional use of spoken language. Speech production can be tested by either the oral interview or the Valdis (1972) "Performance Objectives for Speaking," and dialogue between the two systems can be profitable. Current literature on…

  6. Guidelines for European workplace drug testing in oral fluid.

    PubMed

    Cooper, Gail; Moore, Christine; George, Claire; Pichini, Simona

    2011-05-01

    Over the past decade, oral fluid has established itself as a robust testing matrix for monitoring drug use or misuse. Commercially available collection devices provide opportunities to collect and test oral fluid by the roadside and near-patient testing with both clinical and criminal justice applications. One of the main advantages of oral fluid relates to the collection of the matrix which is non-invasive, simple, and can be carried out under direct observation making it ideal for workplace drug testing. Laboratories offering legally defensible oral fluid workplace drug testing must adhere to national and international quality standards (ISO/IEC 17025); however, these standards do not address issues specific to oral fluid testing. The European Workplace Drug Testing Society (EWDTS) recognizes the importance of providing best practice guidelines to organizations offering testing and those choosing to use oral fluid drug testing to test their employees. The aim of this paper is to present the EWDTS guidelines for oral fluid workplace drug testing. Copyright © 2011 John Wiley & Sons, Ltd.

  7. Provocative Questions in Cancer: NCI Seminar

    Cancer.gov

    science writers' seminar to discuss various aspects of one of NCI’s signature efforts -- the Provocative Questions project. Discussion will focus on the scientific research that surrounds some of these questions.

  8. [Randomized double-blind study (third place blinded) to examine the effectiveness and side effects of methacholine in the nonspecific bronchial provocation test].

    PubMed

    Huber, H; Lauschner, R; Papenfuss, F; Allmers, H; Baur, X

    2000-03-01

    Softly and effectiveness of methacholine for the diagnosis of non-specific bronchial hyperresponsiveness [BHR] were tested in a third place blinded study. 61 patients suspected to suffer from BHR took part. 56 subjects provided complete data and were included in the study. 27 participants were challenged with methacholine 0.33% (verum) and 29 patients received NaCl 0.9% (placebo). The challenge was applied as 5-step-test using a storage bag. The doses were elevated by doubling the aerosol volume. A positive test result was assumed when basal specific airway resistance (sRt) reduplicated and simultaneously 2.0 (kPa*s) was attained. Ten out of 27 subjects in the verum group (33.3%) had a positive test result whereas in the placebo group only one subject showed a reaction (3.5%). A statistically significant association between the change of sRt and the cumulative methacholine dose was confirmed in the verum group (p < 0.002), whereas this effect could not be observed in patients challenged with placebo (p = 0.20). Side effects did not occur. We conclude that inhalative challenge with methacholine 0.33% applied as a 5-step-test is suitable to objectify BHR. The substantial benefit of the applied test scheme is the short range of time in which the challenge can be performed (approximately 20 min) and that dilution series of the test substance (methacholine 0.33%) are not required.

  9. Relationships between more than 90% coronary luminal narrowing induced by ergonovine provocation test and ECG ischemic change as well as chest symptoms.

    PubMed

    Sueda, Shozo; Kohno, Hiroaki

    2017-08-14

    In the clinic, patients with ≥90% luminal narrowing during ergonovine (ER) testing had variable response. We investigated ischemic findings and chest symptoms in patients with ≥90% luminal narrowing when performing ER tests, retrospectively. We performed 1210 ER tests over 26 years (1991-2016). We analyzed chest symptoms and positive ischemic ECG changes during ER tests. More than 90% luminal narrowing was found in 352 patients (29.1%) including 211 patients in the right coronary artery (RCA) and 217 patients in the left coronary artery (LCA). Chest symptom was observed in 290 patients (82.4%) including 162 patients in the RCA and 179 patients in the LCA. ST elevation was found in 154 patients including 98 in the RCA and 73 patients in the LCA, while ST depression was recognized in 81 patients including 38 patients in the RCA and 62 patients in the LCA. Two-third of patients with ≥90% luminal narrowing had significant ischemic ECG changes, whereas 60.5% of patients with ≥90% luminal narrowing complained usual chest pain accompanied with significant ischemic ECG changes. Unusual chest symptom was complained in 7.1% of patients with ≥90% luminal narrowing. Neither chest symptom nor ECG changes was found in 48 patients (13.6%) with ≥90% luminal narrowing. We should understand some limitation to diagnose positive coronary spasm during ER tests.

  10. Comparison of Urine and Oral Fluid for Workplace Drug Testing

    PubMed Central

    Casolin, Armand

    2016-01-01

    Aims To determine the relative detection rates of urine versus oral fluid testing in a safety sensitive industry and the correlation with diagnosed substance use disorders and possible impairment at work. Methods The trial involved 1,500 paired urine and oral fluid tests performed in accordance with Australian Standard/New Zealand Standard (AS/NZS) 4308:2008 and AS 4760:2006. Workers who returned a positive test were screened for substance use disorders, as defined by DSM-5, and for possible impairment at work following that particular episode of substance use. Results Substances were detected in 3.7% (n = 56) of urine samples and 0.5% (n = 8) of oral fluid samples (p < 0.0001). One worker (0.07%) had a substance detected on oral fluid alone versus 49 workers (3.3%) who had substances detected on urine alone. Twelve workers returned a positive result, defined as being consistent with the use of an illicit drug or a controlled substance without a clinical indication and prescription. Nine workers tested positive on urine alone, one on oral fluid alone and two on both (p = 0.0114). Of note, 6/11 workers who tested positive on urine had possible impairment at work and 2/11 had a substance use disorder versus 2/3 and 0/3, respectively, who tested positive on oral fluid. Conclusions Urine drug testing performed in accordance with AS/NZS 4308:2008 is more likely to detect overall substance use and illicit drug use than oral fluid testing conducted in accordance with AS 4760:2006. Urine testing performed in accordance with AS/NZS 4308:2008 may also be more likely to detect workers with possible impairment at work and substance use disorders than oral fluid testing performed in accordance with AS 4760:2006. PMID:27344042

  11. Comparison of Urine and Oral Fluid for Workplace Drug Testing.

    PubMed

    Casolin, Armand

    2016-09-01

    To determine the relative detection rates of urine versus oral fluid testing in a safety sensitive industry and the correlation with diagnosed substance use disorders and possible impairment at work. The trial involved 1,500 paired urine and oral fluid tests performed in accordance with Australian Standard/New Zealand Standard (AS/NZS) 4308:2008 and AS 4760:2006. Workers who returned a positive test were screened for substance use disorders, as defined by DSM-5, and for possible impairment at work following that particular episode of substance use. Substances were detected in 3.7% (n = 56) of urine samples and 0.5% (n = 8) of oral fluid samples (p < 0.0001). One worker (0.07%) had a substance detected on oral fluid alone versus 49 workers (3.3%) who had substances detected on urine alone. Twelve workers returned a positive result, defined as being consistent with the use of an illicit drug or a controlled substance without a clinical indication and prescription. Nine workers tested positive on urine alone, one on oral fluid alone and two on both (p = 0.0114). Of note, 6/11 workers who tested positive on urine had possible impairment at work and 2/11 had a substance use disorder versus 2/3 and 0/3, respectively, who tested positive on oral fluid. Urine drug testing performed in accordance with AS/NZS 4308:2008 is more likely to detect overall substance use and illicit drug use than oral fluid testing conducted in accordance with AS 4760:2006. Urine testing performed in accordance with AS/NZS 4308:2008 may also be more likely to detect workers with possible impairment at work and substance use disorders than oral fluid testing performed in accordance with AS 4760:2006. © The Author 2016. Published by Oxford University Press.

  12. Assessing English Language Learners' Oral Performance: A Comparison of Monologue, Interview, and Group Oral Test

    ERIC Educational Resources Information Center

    Ahmadi, Alireza; Sadeghi, Elham

    2016-01-01

    In the present study we investigated the effect of test format on oral performance in terms of test scores and discourse features (accuracy, fluency, and complexity). Moreover, we explored how the scores obtained on different test formats relate to such features. To this end, 23 Iranian EFL learners participated in three test formats of monologue,…

  13. Assessing English Language Learners' Oral Performance: A Comparison of Monologue, Interview, and Group Oral Test

    ERIC Educational Resources Information Center

    Ahmadi, Alireza; Sadeghi, Elham

    2016-01-01

    In the present study we investigated the effect of test format on oral performance in terms of test scores and discourse features (accuracy, fluency, and complexity). Moreover, we explored how the scores obtained on different test formats relate to such features. To this end, 23 Iranian EFL learners participated in three test formats of monologue,…

  14. Bilingual Oral Language Test (BOLT-English). Technical Report.

    ERIC Educational Resources Information Center

    Cohen, Sam; And Others

    The Bilingual Oral Language Test (BOLT-English) was pilot tested in January 1976, field tested in April 1976, and again in October, November 1976, on a population of more than 3,000 students in the San Francisco Bay Area, Pomona, Riverside, and Palm Springs, California. Results reported include concurrent validity values of .9 and .86 when…

  15. Convergent and Discriminant Validation of Oral Language Proficiency Tests.

    ERIC Educational Resources Information Center

    Bachman, Lyle F.; Palmer, Adrian S.

    In a study designed to validate oral language proficiency tests, it is planned to administer a series of tests to 100 native Mandarin Chinese-speaking subjects (foreign students and their spouses). The tests will measure communicative competence in speaking (ability to speak, exhibiting control of linguistic, sociolinguistic, and pragmatic rules;…

  16. Provocation of sudden heart rate oscillation with adenosine exposes abnormal QT responses in patients with long QT syndrome: a bedside test for diagnosing long QT syndrome

    PubMed Central

    Viskin, Sami; Rosso, Raphael; Rogowski, Ori; Belhassen, Bernard; Fourey, Dana; Zeltser, David; Rozovski, Uri; Levitas, Aviva; Wagshal, Abraham; Katz, Amos; Oliva, Antonio; Pollevick, Guido D.; Antzelevitch, Charles

    2006-01-01

    Aims As arrhythmias in the long QT syndrome (LQTS) are triggered by heart rate deceleration or acceleration, we speculated that the sudden bradycardia and subsequent tachycardia that follow adenosine injection would unravel QT changes of diagnostic value in patients with LQTS. Methods and results Patients (18 LQTS and 20 controls) received intravenous adenosine during sinus rhythm. Adenosine was injected at incremental doses until atrioventricular block or sinus pauses lasting 3 s occurred. The QT duration and morphology were studied at baseline and at the time of maximal bradycardia and subsequent tachycardia. Despite similar degree of adenosine-induced bradycardia (longest R-R 1.7 + 0.7 vs. 2.2 + 1.3 s for LQTS and controls, P = NS), the QT interval of LQT patients increased by 15.8 + 13.1%, whereas the QT of controls increased by only 1.5 + 6.7% (P<0.001). Similarly, despite similar reflex tachycardia (shortest R-R 0.58 + 0.07 vs. 0.55 + 0.07 s for LQT patients and controls, P = NS), LQTS patients developed greater QT prolongation (QTc = 569 + 53 vs. 458 + 58 ms for LQT patients and controls, P<0.001). The best discriminator was the QTc during maximal bradycardia. Notched T-waves were observed in 72% of LQT patients but in only 5% of controls during adenosine-induced bradycardia (P<0.001). Conclusion By provoking transient bradycardia followed by sinus tachycardia, this adenosine challenge test triggers QT changes that appear to be useful in distinguishing patients with LQTS from healthy controls. PMID:16105845

  17. Reactivity to laboratory stress provocation predicts relapse to cocaine.

    PubMed

    Back, Sudie E; Hartwell, Karen; DeSantis, Stacia M; Saladin, Michael; McRae-Clark, Aimee L; Price, Kimber L; Moran-Santa Maria, Megan M; Baker, Nathaniel L; Spratt, Eve; Kreek, Mary Jeanne; Brady, Kathleen T

    2010-01-01

    Cocaine dependence is a chronic relapsing disorder characterized by periods of abstinence and high rates of return to drug using behavior. Elevated levels of stress have been associated with relapse to cocaine; however, the nature of this association is not well understood. The relationship between reactivity to three human laboratory provocations and relapse to cocaine was investigated. Participants were 53 cocaine-dependent individuals who were admitted for a 2-day inpatient stay during which a psychosocial provocation (i.e., the Trier Social Stress Task), a pharmacological provocation (i.e., administration of 1 microg/kg corticotrophin releasing hormone; CRH), and a drug cue exposure paradigm were completed. Adrenocortico-trophic hormone (ACTH), cortisol, heart rate, and subjective cocaine craving and stress were assessed at baseline and at multiple time points post-task. Participants' cocaine use was monitored for approximately 1 month following testing. The majority (72.3%) of participants relapsed to cocaine during the follow-up period. In response to the CRH and drug cue exposure, elevated subjective craving and stress were significant predictors of cocaine use during follow-up. In response to the Trier, attenuated neuroendocrine responses were significant predictors of cocaine use. The findings provide further evidence of the ability of laboratory paradigms to predict relapse. The observed associations between stress reactivity and subsequent cocaine use highlight the clinical importance of the findings. Predictors of relapse may vary based on the type of provocation utilized. Interventions aimed at normalizing stress response, as measured using laboratory paradigms, may prove useful in relapse prevention. Published by Elsevier Ireland Ltd.

  18. Reactivity to Laboratory Stress Provocation Predicts Relapse to Cocaine

    PubMed Central

    Back, Sudie E.; Hartwell, Karen; DeSantis, Stacia M.; Saladin, Michael; McRae-Clark, Aimee L.; Price, Kimber L.; Maria, Megan M. Moran-Santa; Baker, Nathaniel L.; Spratt, Eve; Kreek, Mary Jeanne; Brady, Kathleen T.

    2009-01-01

    Background Cocaine dependence is a chronic relapsing disorder characterized by periods of abstinence and high rates of return to drug using behavior. Elevated levels of stress have been associated with relapse to cocaine; however, the nature of this association is not well understood. Methods The relationship between reactivity to three human laboratory provocations and relapse to cocaine was investigated. Participants were 53 cocaine-dependent individuals who were admitted for a 2-day inpatient stay during which a psychosocial provocation (i.e., the Trier Social Stress Task), a pharmacological provocation (i.e., administration of 1ųg/kg corticotrophin releasing hormone; CRH), and a drug cue exposure paradigm were completed. Adrenocorticotrophic hormone (ACTH), cortisol, heart rate, and subjective cocaine craving and stress were assessed at baseline and at multiple time points post-task. Participants’ cocaine use was monitored for approximately one month following testing. Results The majority (72.3%) of participants relapsed to cocaine during the follow-up period. In response to the CRH and drug cue exposure, elevated subjective craving and stress were significant predictors of cocaine use during follow-up. In response to the Trier, attenuated neuroendocrine responses were significant predictors of cocaine use. Conclusions The findings provide further evidence of the ability of laboratory paradigms to predict relapse. The observed associations between stress reactivity and subsequent cocaine use highlight the clinical importance of the findings. Predictors of relapse may vary based on the type of provocation utilized. Interventions aimed at normalizing stress response, as measured using laboratory paradigms, may prove useful in relapse prevention. PMID:19726138

  19. NSAID-exacerbated respiratory disease: a meta-analysis evaluating prevalence, mean provocative dose of aspirin and increased asthma morbidity.

    PubMed

    Morales, D R; Guthrie, B; Lipworth, B J; Jackson, C; Donnan, P T; Santiago, V H

    2015-07-01

    The prevalence and mean provocative dose of oral aspirin (MPDA) triggering respiratory reactions in people with asthma have been inconsistently reported, and the relationship between NSAID-exacerbated respiratory disease (NERD) and asthma morbidity was less well quantified. A systematic review was performed by identifying studies diagnosing NERD using blinded, placebo-controlled oral provocation challenge tests (OPCTs) or by self-reported history in people with asthma. Data were extracted, and effect estimates for changes in respiratory function, MPDA and asthma morbidity were pooled using random-effects meta-analysis. The prevalence of NERD in adults with asthma was 9.0% (95% CI 6-12%) using OPCTs and 9.9% (95% CI 9.4-10.5%) using self-reported history from questionnaires. The MPDA in adults with NERD was 85.8 mg (95% CI 73.9-97.6). In people with NERD, the risk of: uncontrolled asthma was increased twofold (RR 1.96 (95% CI 1.25-3.07)); severe asthma and asthma attacks was increased by 60% (RR 1.58 (95% CI 1.15-2.16) and RR 1.59 (95% CI 1.21-2.09), respectively); emergency room visits was increased by 80% (RR 1.79 (95% CI 1.29-2.49)); and asthma hospitalization was increased by 40% (RR 1.37 (95% CI 1.12-1.67)) compared to people with NSAID-tolerant asthma. Respiratory reactions triggered by oral aspirin in people with asthma are relatively common. At the population level, the prevalence of NERD was similar when measured using appropriately conducted OPCTs or by self-reported history. On average, respiratory reactions were triggered by clinically relevant doses of oral aspirin. Asthma morbidity was significantly increased in people with NERD who potentially require more intensive monitoring and follow-up. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  20. Continuous Assessment in the Oral Communication Class: Teacher Constructed Test.

    ERIC Educational Resources Information Center

    Nair-Venugopal, Shanta

    The oral communication course for English majors at the National University of Malaysia includes testing designed by faculty and coordinated with the curriculum. This practice is based on the ideas that a teacher who has been actively involved in curriculum design is in a good position to design a test for that curriculum, and that teacher-made…

  1. Testing Speaking Proficiency: The Oral Interview. Q & A.

    ERIC Educational Resources Information Center

    Lowe, Pardee, Jr.; Liskin-Gasparro, Judith E.

    The oral interview (OI) was developed to meet the need for a testing procedure of second language speaking skills. It has been refined and expanded several times since first developed in the 1950's for use by the U.S. Government. Now known as the American Council on the Teaching of Foreign Languages/Educational Testing Services (ACTFL/ETS) scale,…

  2. Effects of birth asphyxia on the modulation of pharyngeal provocation-induced adaptive reflexes

    PubMed Central

    Gulati, Ish K.; Shubert, Theresa R.; Sitaram, Swetha; Wei, Lai

    2015-01-01

    Perinatal asphyxia and aerodigestive symptoms are troublesome. We tested the hypothesis that pharyngeal provocation alters proximal and distal aerodigestive reflex coordination and kinetics in infants with hypoxic ischemic encephalopathy (HIE), compared with healthy controls. Specifically, we characterized the sensory-motor properties of pharyngeal provocation-induced effects on upper esophageal sphincter (UES) and lower esophageal sphincter (LES) reflexes. Ten orally fed controls (32.0 ± 1.5 wk gestation) and 25 infants with HIE (38.1 ± 0.4 wk gestation) were evaluated at 39.7 ± 0.9 and 41.9 ± 0.6 wk postmenstrual age respectively. Pharyngo-esophageal reflexes evoked upon graded water stimuli were tested using water-perfusion micromanometry methods. Analysis included sensory-motor characteristics of pharyngeal reflexive swallow (PRS), pharyngo-UES-contractile reflex (PUCR), esophageal body-waveform kinetics, and pharyngo-LES-relaxation reflex (PLESRR). For controls vs. infants with HIE, median appearance, pulse, grimace, activity, respiration (APGAR) scores were 6 vs. 1 at 1 min (P < 0.001) and 8 vs. 3 at 5 min (P < 0.001). Upon pharyngeal- stimulation, HIE infants (vs. controls) had frequent PUCR (P = 0.01); increased UES basal tone (P = 0.03); decreased LES basal tone (P = 0.002); increased pharyngeal-waveforms per stimulus (P = 0.03); decreased frequency of LES relaxation (P = 0.003); and decreased proximal esophageal contractile amplitude (P = 0.002), with prolonged proximal esophageal contractile duration (P = 0.008). Increased tonicity and reactivity of the UES and dysregulation of LES may provide the pathophysiological basis for pooling of secretions, improper bolus clearance, and aspiration risk. Deficits in function at the nuclear or supranuclear level involving glossopharyngeal and vagal neural networks and respiratory regulatory pathways involved with aerodigestive protection may be contributory. PMID:26272260

  3. Evaluation of Oral Glucose Tolerance Test in Children With Epilepsy.

    PubMed

    Varlamis, Sotirios; Vavatsi, Norma; Pavlou, Evangelos; Kotsis, Vasileios; Spilioti, Martha; Kavga, Maria; Varlamis, George; Sotiriadou, Foteini; Agakidou, Eleni; Voutoufianakis, Spyridon; Evangeliou, Athanasios E

    2013-11-01

    Glucose metabolism of children with drug-resistant epilepsy, controlled by antiepileptic drugs epilepsy, and first-time nonfebrile seizures was studied through the performance of an oral glucose tolerance test and through insulin, C-peptide, and glycosylated hemoglobin measurements. In the refractory epilepsy group, there were more abnormal oral glucose tolerance test results (62.07%) in comparison to the controlled epilepsy group (25%) and the group of first-time seizures (21.21%). There was a significant difference between the group of refractory epilepsy and every other group concerning the abnormality of the oral glucose tolerance test (P < .05). The mean values of insulin, HbA1c, and C-peptide levels were normal for all groups. The results of the present study suggest that there is a distinction of refractory epilepsies from the drug-controlled ones and the first-induced seizures relating to their metabolic profile, regardless of the type of seizures.

  4. Unconscious Provocations - America and Japan Before 1941

    DTIC Science & Technology

    2012-03-20

    but a sophisticated foreign policy approach toward China is America’s most prudent course. 15. SUBJECT TERMS China, Foreign Policy , Deterrence...20 March 2012 WORD COUNT: 5,553 PAGES: 26 KEY TERMS: China, Foreign Policy , Deterrence CLASSIFICATION: Unclassified Rising powers, such...sophisticated foreign policy approach toward China is America’s most prudent course. UNCONSCIOUS PROVOCATIONS – AMERICA AND JAPAN BEFORE

  5. Oral Toxicity Study and Skin Sensitization Test of a Cricket

    PubMed Central

    Ryu, Hyeon Yeol; Lee, Somin; Ahn, Kyu Sup; Kim, Hye Jin; Lee, Sang Sik; Ko, Hyuk Ju; Lee, Jin Kyu; Cho, Myung-Haing; Ahn, Mi Young; Kim, Eun Mi; Lim, Jeong Ho; Song, Kyung Seuk

    2016-01-01

    Crickets have been attracting considerable interest in the field of nutrition and toxicology due to the global exhaustion of food resulting from a growing population. The cricket is normally eaten in several countries after roasting, similar to the grasshopper; however, safety evaluation data on cricket powder is limited. Here, we performed general toxicity studies of cricket powder including a single, 2-week repeated dose range evaluation test, a 13-week repeated oral dose toxicity test in Sprague-Dawley rats, a single oral dose toxicity test in Beagle dogs, and a skin sensitization test in guinea pigs following the Organization for Economic Cooperation and Development test guidelines 406 and 408 in addition to Good Laboratory Practice. To investigate the NOAEL and target organs of cricket powder, Sprague-Dawley rats were allocated to 4 groups: vehicle control, 1,250 mg/kg, 2,500 mg/kg, 5,000 mg/kg dose test groups and cricket powder was administered over 13 weeks after single dose and dose range finding studies in rats based on the results of the single oral administration toxicity study in rats and Beagle dogs. The results of the study showed that the NOAEL of cricket powder was over 5,000 mg/kg for both sexes of rats without adverse effects in a 13-week repeated oral toxicity study and there was no skin hypersensitivity reaction. Therefore, our results reveal that crickets can be widely used as a new substitute food or nutrient resource. PMID:27123167

  6. A Comparison of Oral and Written Responses on Cloze Tests.

    ERIC Educational Resources Information Center

    Beagle, Barbara A.

    To determine the effect of oral responses on cloze test, particularly at the primary grade level and with students of below average reading ability, was the purpose of this study. A total of 135 students from second, fourth, and sixth grades were included in the study. At each grade level the students were divided into above-average, average, and…

  7. Using Automatic Speech Recognition Technology with Elicited Oral Response Testing

    ERIC Educational Resources Information Center

    Cox, Troy L.; Davies, Randall S.

    2012-01-01

    This study examined the use of automatic speech recognition (ASR) scored elicited oral response (EOR) tests to assess the speaking ability of English language learners. It also examined the relationship between ASR-scored EOR and other language proficiency measures and the ability of the ASR to rate speakers without bias to gender or native…

  8. Applications of Oral Proficiency Testing to Foreign Language. Instruction.

    ERIC Educational Resources Information Center

    American Council on the Teaching of Foreign Languages, Hastings-on-Hudson, NY.

    A guide to the adaptation of oral proficiency testing for classroom language instruction contains excerpts of projects by participants in an American Council on the Teaching of Foreign Languages (ACTFL) workshop. The excerpts are examples of proficiency based curricula and materials designed to personalize instruction and simulate real-life…

  9. Using Automatic Speech Recognition Technology with Elicited Oral Response Testing

    ERIC Educational Resources Information Center

    Cox, Troy L.; Davies, Randall S.

    2012-01-01

    This study examined the use of automatic speech recognition (ASR) scored elicited oral response (EOR) tests to assess the speaking ability of English language learners. It also examined the relationship between ASR-scored EOR and other language proficiency measures and the ability of the ASR to rate speakers without bias to gender or native…

  10. Planes, Politics and Oral Proficiency: Testing International Air Traffic Controllers

    ERIC Educational Resources Information Center

    Moder, Carol Lynn; Halleck, Gene B.

    2009-01-01

    This study investigates the variation in oral proficiency demonstrated by 14 Air Traffic Controllers across two types of testing tasks: work-related radio telephony-based tasks and non-specific English tasks on aviation topics. Their performance was compared statistically in terms of level ratings on the International Civil Aviation Organization…

  11. Planes, Politics and Oral Proficiency: Testing International Air Traffic Controllers

    ERIC Educational Resources Information Center

    Moder, Carol Lynn; Halleck, Gene B.

    2009-01-01

    This study investigates the variation in oral proficiency demonstrated by 14 Air Traffic Controllers across two types of testing tasks: work-related radio telephony-based tasks and non-specific English tasks on aviation topics. Their performance was compared statistically in terms of level ratings on the International Civil Aviation Organization…

  12. Oral Solid Dosage Form Disintegration Testing - The Forgotten Test.

    PubMed

    Al-Gousous, Jozef; Langguth, Peter

    2015-09-01

    Since its inception in the 1930s, disintegration testing has become an important quality control (QC) test in pharmaceutical industry, and disintegration test procedures for various dosage forms have been described by the different pharmacopoeias, with harmonization among them still not quite complete. However, because of the fact that complete disintegration does not necessarily imply complete dissolution, much more research has been focused on dissolution rather than on disintegration testing. Nevertheless, owing to its simplicity, disintegration testing seems to be an attractive replacement to dissolution testing as recognized by the International Conference on Harmonization guidelines, in some cases. Therefore, with proper research being carried out to overcome the associated challenges, the full potential of disintegration testing could be tapped saving considerable efforts allocated to QC testing and quality assurance. © 2014 Wiley Periodicals, Inc. and the American Pharmacists Association.

  13. Interpretation of coagulation test results under direct oral anticoagulants.

    PubMed

    Mani, H

    2014-06-01

    Diagnostic of global coagulation parameters is part of the daily clinical routine practice in conservative as well in operative disciplines. The correct interpretation of in vitro test results in context to the ex vivo influence of anticoagulant drugs and the in vivo hemostatic system of the individual patient is dependent on the doctors clinical and laboratory experience. This article shortly reviews the laboratory interference of oral anticoagulants including the target-specific inhibitors dabigatran, rivaroxaban and apixaban on coagulation parameters and discusses the potential of several methods for measuring the anticoagulant effect of the direct oral anticoagulants.

  14. Neutral red uptake cytotoxicity tests for estimating starting doses for acute oral toxicity tests.

    PubMed

    Stokes, William S; Casati, Silvia; Strickland, Judy; Paris, Michael

    2008-05-01

    In vitro cytotoxicity assays can be used as alternative toxicity tests to reduce the total number of animals needed for acute oral toxicity tests. This unit describes two methods for determining the in vitro cytotoxicity of test substances using neutral red uptake (NRU) and using the in vitro data to determine starting doses for in vivo acute oral systemic toxicity tests, e.g., the up-and-down procedure or the acute toxic class method. The use of the NRU methods to determine starting doses for acute oral toxicity tests may reduce the number of animals required, and for relatively toxic substances, this approach may also reduce the number of animals that die or require humane euthanasia due to severe toxicity. An interlaboratory validation study has demonstrated that the methods are useful and reproducible for these purposes. Two standardized protocols provide details for performing NRU tests with rodent and human cells.

  15. A new modified wetting test and an alternative disintegration test for orally disintegrating tablets.

    PubMed

    Hooper, Patrick; Lasher, Jason; Alexander, Kenneth S; Baki, Gabriella

    2016-02-20

    Industrial manufacturing of solid oral dosage forms require quality tests, such as friability, hardness, and disintegration. The United States Pharmacopeia (USP) disintegration test uses 900mL of water. However, recent studies of orally disintegrating tablets (ODTs) have shown that this volume does not accurately portray the oral environment. In our study, various tests were conducted with a more moderate amount of water that accurately resembles the oral environment. A simulated wetting test was performed to calculate the water absorption ratio. Results showed that wetting was comparable to disintegration. Although the wetting test worked for most types of ODTs, it had limitations that produced inaccurate results. This led to the use of a modified shaking water bath test. This test was found to work for all types of ODT products and was not subject to the limitations of the wetting test. The shake test could provide disintegration times rather than water permeation times; however, it could not be used to calculate the water absorption ratio. A strong correlation was observed between the standardized shake test and the USP disintegration times for the tablets. This shake test could be used during the development stages and quality tests for ODTs with relative ease.

  16. Are You Insulting Me? Exposure to Alcohol Primes Increases Aggression Following Ambiguous Provocation

    PubMed Central

    Pedersen, William C.; Vasquez, Eduardo A.; Bartholow, Bruce D.; Grosvenor, Marianne; Truong, Ana

    2014-01-01

    Considerable research has shown that alcohol consumption can increase aggression and produce extremes in other social behaviors. Although most theories posit that such effects are caused by pharmacological impairment of cognitive processes, recent research indicates that exposure to alcohol-related constructs, in the absence of consumption, can produce similar effects. Here we tested the hypothesis that alcohol priming is most likely to affect aggression in the context of ambiguous provocation. Experiment 1 showed that exposure to alcohol primes increased aggressive retaliation but only when an initial provocation was ambiguous; unambiguous provocation elicited highly aggressive responses regardless of prime exposure. Experiment 2 showed that alcohol prime exposure effects are relatively short-lived and that perceptions of the provocateur's hostility mediated effects of prime exposure on aggression. These findings suggest modification and extension of existing models of alcohol-induced aggression. PMID:24854477

  17. Physiological Parameters for Oral Delivery and In vitro Testing

    PubMed Central

    Mudie, Deanna M.; Amidon, Gordon L.; Amidon, Gregory E.

    2010-01-01

    Pharmaceutical solid oral dosage forms must undergo dissolution in the intestinal fluids of the gastrointestinal tract before they can be absorbed and reach the systemic circulation. Therefore, dissolution is a critical part of the drug-delivery process. The rate and extent of drug dissolution and absorption depend on the characteristics of the active ingredient as well as properties of the dosage form. Just as importantly, characteristics of the physiological environment such as buffer species, pH, bile salts, gastric emptying rate, intestinal motility, and hydrodynamics can significantly impact dissolution and absorption. While significant progress has been made since 1970 when the first compendial dissolution test was introduced (USP Apparatus 1), current dissolution testing does not take full advantage of the extensive physiologic information that is available. For quality control purposes, where the question is one of lot-to-lot consistency in performance, using nonphysiologic test conditions that match drug and dosage form properties with practical dissolution media and apparatus may be appropriate. However, where in vitro – in vivo correlations are desired, it is logical to consider and utilize knowledge of the in vivo condition. This publication critically reviews the literature that is relevant to oral human drug delivery. Physiologically relevant information must serve as a basis for the design of dissolution test methods and systems that are more representative of the human condition. As in vitro methods advance in their physiological relevance, better in vitro - in vivo correlations will be possible. This will, in turn, lead to in vitro systems that can be utilized to more effectively design dosage forms that have improved and more consistent oral bioperformance. PMID:20822152

  18. Statistical Profiling of Academic Oral English Proficiency Based on an ITA Screening Test

    ERIC Educational Resources Information Center

    Choi, Ick Kyu

    2013-01-01

    At the University of California, Los Angeles, the Test of Oral Proficiency (TOP), an internally developed oral proficiency test, is administered to international teaching assistant (ITA) candidates to ensure an appropriate level of academic oral English proficiency. Test taker performances are rated live by two raters according to four subscales.…

  19. Statistical Profiling of Academic Oral English Proficiency Based on an ITA Screening Test

    ERIC Educational Resources Information Center

    Choi, Ick Kyu

    2013-01-01

    At the University of California, Los Angeles, the Test of Oral Proficiency (TOP), an internally developed oral proficiency test, is administered to international teaching assistant (ITA) candidates to ensure an appropriate level of academic oral English proficiency. Test taker performances are rated live by two raters according to four subscales.…

  20. Breath hydrogen test after oral lactose in postgastrectomy patients.

    PubMed

    Welsh, J D; Griffiths, W J

    1980-11-01

    The purpose of this study was to compare breath hydrogen tests after oral lactose ingestion in nonoperated subjects and postgastrectomy patients. Simultaneous oral lactose tolerance tests and breath hydrogen tests were performed in 50 subjects. Twenty of the 30 subjects without prior gastric surgery had normal lactase activities and low breath hydrogen concentrations. The other 10 subjects had low lactase levels and increased breath hydrogen concentrations. The remaining 20 subjects had prior gastric surgery. Seven of these had normal lactase activities, no history of milk intolerance and low breath hydrogen concentrations. Two of the postgastrectomy patients had low intestinal lactases, milk intolerance, and high breath hydrogens. The remaining 11 postgastrectomy patients had normal intestinal lactases but high breath hydrogens. Eight of the 11 had milk intolerance while two of the other three had not consumed milk since childhood. From these studies the following conclusions can be reached: 1)a low lactose breath hydrogen test in the postgastrectomy subject correctly identifies the individual with normal lactase activity. However, high breath hydrogen responses, may be found in either those with lactase deficiency or normal lactase activity. 2) Lactose malabsorption would appear to explain the milk intolerance in the postgastrectomy patient with normal lactase activity.

  1. Large Dataset of Acute Oral Toxicity Data Created for Testing ...

    EPA Pesticide Factsheets

    Acute toxicity data is a common requirement for substance registration in the US. Currently only data derived from animal tests are accepted by regulatory agencies, and the standard in vivo tests use lethality as the endpoint. Non-animal alternatives such as in silico models are being developed due to animal welfare and resource considerations. We compiled a large dataset of oral rat LD50 values to assess the predictive performance currently available in silico models. Our dataset combines LD50 values from five different sources: literature data provided by The Dow Chemical Company, REACH data from eChemportal, HSDB (Hazardous Substances Data Bank), RTECS data from Leadscope, and the training set underpinning TEST (Toxicity Estimation Software Tool). Combined these data sources yield 33848 chemical-LD50 pairs (data points), with 23475 unique data points covering 16439 compounds. The entire dataset was loaded into a chemical properties database. All of the compounds were registered in DSSTox and 59.5% have publically available structures. Compounds without a structure in DSSTox are currently having their structures registered. The structural data will be used to evaluate the predictive performance and applicable chemical domains of three QSAR models (TIMES, PROTOX, and TEST). Future work will combine the dataset with information from ToxCast assays, and using random forest modeling, assess whether ToxCast assays are useful in predicting acute oral toxicity. Pre

  2. Suppressing a motivationally-triggered action tendency engages a response control mechanism that prevents future provocation.

    PubMed

    Freeman, Scott M; Alvernaz, Dominic; Tonnesen, Alexandra; Linderman, David; Aron, Adam R

    2015-02-01

    Reward-predicting stimuli can induce maladaptive behavior by provoking action tendencies that conflict with long-term goals. Earlier, we showed that when human participants were permitted to respond for a reward in the presence of a task-irrelevant, reward-predicting stimulus (i.e. goCS+ trials), the CS+ provoked an action tendency to respond compared to when a non-rewarding CS- stimulus was present (i.e. goCS- trials). However, when participants were not permitted to respond, response suppression was recruited to mitigate the action tendency that was triggered by the motivating CS+ stimulus (i.e. on nogoCS+ trials) (Freeman et al., 2014). Here we tested the hypothesis that repeated response suppression over a motivationally-triggered action tendency would reduce subsequent CS+ provocation. We compared groups of participants who had different proportions of nogoCS+ trials, and we measured CS+ provocation on go trials via reaction time. Our results showed that CS+ provocation on go trials was reduced monotonically as the proportion of nogoCS+ trials increased. Further analysis showed that these group differences were best explained by reduced provocation on goCS+ trials that followed nogoCS+ (compared to nogoCS-) trials. Follow-up experiments using a neurophysiological index of motor activity replicated these effects and also suggested that, following nogoCS+ trials, a response suppression mechanism was in place to help prevent subsequent CS+ provocation. Thus, our results show that performing response suppression in the face of a motivating stimulus not only controls responding at that time, but also prevents provocation in the near future.

  3. Suppressing a motivationally-triggered action tendency engages a response control mechanism that prevents future provocation

    PubMed Central

    Freeman, Scott M.; Alvernaz, Dominic; Tonnesen, Alexandra; Linderman, David; Aron, Adam R.

    2015-01-01

    Reward-predicting stimuli can induce maladaptive behavior by provoking action tendencies that conflict with long-term goals. Earlier, we showed that when human participants were permitted to respond for a reward in the presence of a task-irrelevant, reward-predicting stimulus (i.e. goCS+ trials), the CS+ provoked an action tendency to respond compared to when a non-rewarding CS− stimulus was present (i.e. goCS− trials). However, when participants were not permitted to respond, response suppression was recruited to mitigate the action tendency that was triggered by the motivating CS+ stimulus (i.e. on nogoCS+ trials) (Freeman, Razhas, & Aron, 2014). Here we tested the hypothesis that repeated response suppression over a motivationally-triggered action tendency would reduce subsequent CS+ provocation. We compared groups of participants who had different proportions of nogoCS+ trials, and we measured CS+ provocation on go trials via reaction time. Our results showed that CS+ provocation on go trials was reduced monotonically as the proportion of nogoCS+ trials increased. Further analysis showed that these group differences were best explained by reduced provocation on goCS+ trials that followed nogoCS+ (compared to nogoCS−) trials. Follow-up experiments using a neurophysiological index of motor activity replicated these effects and also suggested that, following nogoCS+ trials, a response suppression mechanism was in place to help prevent subsequent CS+ provocation. Thus, our results show that performing response suppression in the face of a motivating stimulus not only controls responding at that time, but also prevents provocation in the near future. PMID:25592370

  4. Symptoms suggestive of dumping syndrome after provocation in patients after laparoscopic sleeve gastrectomy.

    PubMed

    Tzovaras, George; Papamargaritis, Dimitris; Sioka, Eleni; Zachari, Eleni; Baloyiannis, Ioannis; Zacharoulis, Dimitris; Koukoulis, George

    2012-01-01

    Dumping syndrome is a well-known complication after upper gastrointestinal (GI) surgery. There are scarce data in the literature about the incidence of dumping after bariatric operations but, certainly no relation between this syndrome and laparoscopic sleeve gastrectomy (LSG) has been attempted. We conducted a prospective clinical study in order to evaluate the potential presence, incidence and severity of Dumping syndrome after LSG. Thirty one non-diabetic morbidly obese patients (eight male, 23 female) eligible for LSG were evaluated. Median age was 38 (22-58 years) and mean body mass index (BMI) was 45.55 (± 5.37). The diagnosis of dumping syndrome was based on clinical provocation of signs and symptoms using an oral glucose challenge before and 6 weeks after the operation. The Sigstad's dumping score was estimated in order to separate dumpers from non-dumpers, and the Arts questionnaire was completed to distinguish between early and late dumping. Moreover, blood glucose levels during the oral glucose challenge were measured. No patient had symptoms of dumping after provocation preoperatively, whereas after LSG 9 patients (29%) experienced definite dumping and other 5 patients (16%) symptoms suggestive of dumping syndrome. Arts' questionnaire demonstrated that dumping occurrence after LSG was associated with early symptoms. Late hypoglycaemia occurred in one patient. A significant proportion of patients after LSG experienced dumping syndrome upon provocation. It seems that LSG should no longer be considered as a pure restrictive procedure, and it might be an option for heavy sweeters by changing their food tolerance patterns.

  5. Philosophical Provocation: The Lifeblood of Clinical Ethics.

    PubMed

    McCullough, Laurence B

    2017-02-01

    The daily work of the clinical ethics teacher and clinical ethics consultant falls into the routine of classifying clinical cases by ethical type and proposing ethically justified alternatives for the professionally responsible management of a specific type of case. Settling too far into this routine creates the risk of philosophical inertia, which is not good either for the clinical ethicist or for the field of clinical ethics. The antidote to this philosophical inertia and resultant blinkered vision of clinical ethics is sustained, willing exposure to philosophical provocation. The papers in this clinical ethics issue of the Journal of Medicine and Philosophy provide just such philosophical provocation related to core topics in clinical ethics: the distinction between clinical practice and clinical research; telemedicine, or medicine at a distance; illness narratives; the concept of the placebo effect; and sex reassignment. © The Author 2017. Published by Oxford University Press, on behalf of the Journal of Medicine and Philosophy Inc. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  6. Facial flushing during provocation in women.

    PubMed

    Drummond, P D

    1999-05-01

    Facial flushing was studied in 38 young women who scored high or low on trait anger. To induce anger in the subjects, their task was to solve a difficult puzzle, with or without harassment from a female research assistant. Facial blood flow increased in response to provocation, together with increases in cardiovascular and electrodermal activity. Flushing was associated with large increases in electrodermal activity and small increases in diastolic blood pressure. Subjects high in trait anger reported most anger and embarrassment, but physiological activity did not differ from subjects with low trait anger. The findings suggest that sympathetically mediated vasodilatation in facial blood vessels competes with cutaneous vasoconstriction during anger. Unpleasant sensations of facial warmth might heighten aversive emotional experiences, but dilatation of facial blood vessels could also act as a type of "safety valve" by opposing increases in blood pressure. An angry predisposition may influence the subjective experience of anger in women, but does not seem to have a major influence on physiological reactivity to mild provocation.

  7. Field testing of the Alere DDS2 Mobile Test System for drugs in oral fluid.

    PubMed

    Moore, Christine; Kelley-Baker, Tara; Lacey, John

    2013-06-01

    A preliminary field evaluation of a second-generation handheld oral fluid testing device, the Alere DDS2 Mobile Test System (DDS2), is described. As part of a larger study, drivers were randomly stopped at various locations across California (in 2012) and asked to submit voluntarily to a questionnaire regarding their drug and alcohol use, a breath alcohol test and collection of oral fluid with the Quantisal device. The Quantisal-collected oral fluid samples were sent for laboratory-based analyses. At one location, 50 drivers were asked to submit an additional oral fluid sample using the DDS2 collection device; these samples were analyzed by using the DDS2 mobile test system. Thirty-eight donors (76%) provided specimens that were successfully run on the mobile system; in 12 cases (24%), the device failed to provide a valid result. Thirty-two of the 38 collected samples were negative for all drugs; five were positive for tetrahydrocannabinol and one was positive for methamphetamine using the mobile device. These results corresponded exactly with the laboratory-based results from the Quantisal oral fluid collection.

  8. On-Site Test for Cannabinoids in Oral Fluid

    PubMed Central

    Desrosiers, Nathalie A.; Lee, Dayong; Schwope, David M.; Milman, Garry; Barnes, Allan J.; Gorelick, David A.; Huestis, Marilyn A.

    2013-01-01

    Background Oral fluid (OF) testing offers noninvasive sample collection for on-site drug testing; however, to date, test performance for Δ9-tetrahydrocannabinol (THC) detection has had unacceptable diagnostic sensitivity. On-site tests must accurately identify cannabis exposure because this drug accounts for the highest prevalence in workplace drug testing and driving under the influence of drugs (DUID) programs. Methods Ten cannabis smokers (9 males, 1 female) provided written informed consent to participate in this institutional review board–approved study and smoked 1 6.8%-THC cigarette ad libitum. OF was collected with the Draeger DrugTest® 5000 test cassette and Quantisal™ device 0.5 h before and up to 22 h after smoking. Test cassettes were analyzed within 15 min (n = 66), and Quantisal GC-MS THC results obtained within 24 h. Final THC detection times and test performances were assessed at different cannabinoid cutoffs. Results Diagnostic sensitivity, diagnostic specificity, and efficiency at DrugTest 5000's 5 μg/L screening cutoff and various THC confirmation cutoffs were 86.2–90.7,75.0 –77.8, and 84.8–87.9%, respectively. Last detection times were >22 h, longer than previously suggested. Confirmation of 11-nor-9-carboxy-THC, absent in THC smoke, minimized the potential for passive OF contamination and still provided 22-h windows of detection, appropriate for workplace drug testing, whereas confirmation of cannabidiol, and/or cannabinol yielded shorter 6-h windows of detection, appropriate for DUID OF testing. Conclusions The DrugTest 5000 on-site device provided high diagnostic sensitivity for detection of cannabinoid exposure, and the selection of OF confirmation analytes and cutoffs provided appropriate windows of detection to meet the goals of different drug testing programs. PMID:22912396

  9. Effects of Targeted Test Preparation on Scores of Two Tests of Oral English as a Second Language

    ERIC Educational Resources Information Center

    Farnsworth, Tim

    2013-01-01

    This study investigated the effect of targeted test preparation, or coaching, on oral English as a second language test scores. The tests in question were the Basic English Skills Test Plus (BEST Plus), a scripted oral interview published by the Center for Applied Linguistics, and the Versant English Test (VET), a computer-administered and…

  10. Effects of Targeted Test Preparation on Scores of Two Tests of Oral English as a Second Language

    ERIC Educational Resources Information Center

    Farnsworth, Tim

    2013-01-01

    This study investigated the effect of targeted test preparation, or coaching, on oral English as a second language test scores. The tests in question were the Basic English Skills Test Plus (BEST Plus), a scripted oral interview published by the Center for Applied Linguistics, and the Versant English Test (VET), a computer-administered and…

  11. Imbalance in habitual versus goal directed neural systems during symptom provocation in obsessive-compulsive disorder

    PubMed Central

    Banca, Paula; Voon, Valerie; Vestergaard, Martin D.; Philipiak, Gregor; Almeida, Inês; Pocinho, Fernando; Relvas, João

    2015-01-01

    Intrusive thoughts and compulsive urges to perform stereotyped behaviours are typical symptoms of obsessive-compulsive disorder. Emerging evidence suggests a cognitive bias towards habit formation at the expense of goal-directed performance in obsessive-compulsive disorder. In this study, we test this hypothesis using a novel individualized ecologically valid symptom provocation design: a live provocation functional magnetic resonance imaging paradigm with synchronous video-recording of behavioural avoidance responses. By pairing symptom provocation with online avoidance responses on a trial-by-trial basis, we sought to investigate the neural mechanisms leading to the compulsive avoidance response. In keeping with the model of habit formation in obsessive-compulsive disorder, we hypothesized that this disorder would be associated with lower activity in regions implicated in goal-directed behaviours and higher activity in regions implicated in habitual behaviours. Fifteen patients with obsessive-compulsive disorder and 15 healthy control volunteers participated in this functional magnetic resonance imaging study. Online stimuli were individually tailored to achieve effective symptom provocation at neutral, intermediate and strong intensity levels. During the symptom provocation block, the participant could choose to reject or terminate the provoking stimuli resulting in cessation of the symptom provocation. We thus separately analysed the neural correlates of symptom provocation, the urge to avoid, rejection and relief. Strongly symptom-provoking conditions evoked a dichotomous pattern of deactivation/activation in patients, which was not observed either in control conditions or in healthy subjects: a deactivation of caudate-prefrontal circuits accompanied by hyperactivation of subthalamic nucleus/putaminal regions. This finding suggests a dissociation between regions engaged in goal-directed and habitual behaviours. The putaminal hyperactivity during patients

  12. Imbalance in habitual versus goal directed neural systems during symptom provocation in obsessive-compulsive disorder.

    PubMed

    Banca, Paula; Voon, Valerie; Vestergaard, Martin D; Philipiak, Gregor; Almeida, Inês; Pocinho, Fernando; Relvas, João; Castelo-Branco, Miguel

    2015-03-01

    Intrusive thoughts and compulsive urges to perform stereotyped behaviours are typical symptoms of obsessive-compulsive disorder. Emerging evidence suggests a cognitive bias towards habit formation at the expense of goal-directed performance in obsessive-compulsive disorder. In this study, we test this hypothesis using a novel individualized ecologically valid symptom provocation design: a live provocation functional magnetic resonance imaging paradigm with synchronous video-recording of behavioural avoidance responses. By pairing symptom provocation with online avoidance responses on a trial-by-trial basis, we sought to investigate the neural mechanisms leading to the compulsive avoidance response. In keeping with the model of habit formation in obsessive-compulsive disorder, we hypothesized that this disorder would be associated with lower activity in regions implicated in goal-directed behaviours and higher activity in regions implicated in habitual behaviours. Fifteen patients with obsessive-compulsive disorder and 15 healthy control volunteers participated in this functional magnetic resonance imaging study. Online stimuli were individually tailored to achieve effective symptom provocation at neutral, intermediate and strong intensity levels. During the symptom provocation block, the participant could choose to reject or terminate the provoking stimuli resulting in cessation of the symptom provocation. We thus separately analysed the neural correlates of symptom provocation, the urge to avoid, rejection and relief. Strongly symptom-provoking conditions evoked a dichotomous pattern of deactivation/activation in patients, which was not observed either in control conditions or in healthy subjects: a deactivation of caudate-prefrontal circuits accompanied by hyperactivation of subthalamic nucleus/putaminal regions. This finding suggests a dissociation between regions engaged in goal-directed and habitual behaviours. The putaminal hyperactivity during patients

  13. The Potential Role of Oral Fluid in Antidoping Testing

    PubMed Central

    Anizan, Sebastien; Huestis, Marilyn A.

    2015-01-01

    BACKGROUND Currently, urine and blood are the only matrices authorized for antidoping testing by the World Anti-Doping Agency (WADA). Although the usefulness of urine and blood is proven, issues remain for monitoring some drug classes and for drugs prohibited only in competition. The alternative matrix oral fluid (OF) may offer solutions to some of these issues. OF collection is easy, noninvasive, and sex neutral and is directly observed, limiting potential adulteration, a major problem for urine testing. OF is used to monitor drug intake in workplace, clinical toxicology, criminal justice, and driving under the influence of drugs programs and potentially could complement urine and blood for antidoping testing in sports. CONTENT This review outlines the present state of knowledge and the advantages and limitations of OF testing for each of the WADA drug classes and the research needed to advance OF testing as a viable alternative for antidoping testing. SUMMARY Doping agents are either prohibited at all times or prohibited in competition only. Few OF data from controlled drug administration studies are available for substances banned at all times, whereas for some agents prohibited only in competition, sufficient data may be available to suggest appropriate analytes and cutoffs (analytical threshold concentrations) to identify recent drug use. Additional research is needed to characterize the disposition of many banned substances into OF; OF collection methods and doping agent stability in OF also require investigation to allow the accurate interpretation of OF tests for antidoping monitoring. PMID:24153253

  14. New insulin sensitivity index from the oral glucose tolerance test.

    PubMed

    Kazama, Youichiro; Takamura, Toshinari; Sakurai, Masaru; Shindo, Hisakazu; Ohkubo, Eizho; Aida, Kaoru; Harii, Norikazu; Taki, Katsumi; Kaneshige, Masahiro; Tanaka, Shoichiro; Shimura, Hiroki; Endo, Toyoshi; Kobayashi, Tetsuro

    2008-01-01

    A new insulin sensitivity index was devised on the basis of an autoregressive model and its validity was investigated. Using data from the 75-g oral glucose tolerance test (OGTT), 115 subjects were divided into 3 groups: 40 with normal glucose tolerance, 34 with impaired glucose tolerance, and 41 with type 2 diabetes mellitus. The new insulin sensitivity index: oral glucose insulin sensitivity index (GSI) was calculated from five sets of plasma glucose and insulin levels obtained at 0, 30, 60, 90 and 120 min during OGTT using a formula based on an autoregressive model. Forty-three of the 115 subjects were examined for insulin sensitivity index (ISI) by euglycemic hyperinsulinemic clamp. GSI decreased in the order of normal glucose tolerance group>impaired glucose tolerance group>diabetic group. There was a significant correlation between GSI and the ISI derived from euglycemic hyperinsulinemic clamp study data in all 43 subjects who underwent both tests (r=0.72; P<0.0001). The ISI calculated by previous methods poorly correlated with the ISIs obtained by euglycemic hyperinsulinemic clamp study. In conclusion, this new insulin sensitivity index based on the data obtained from OGTT using an autoregressive model is comparable to an insulin sensitivity index by euglycemic hyperinsulinemic clamp technique and may be superior to previous indexes that have been devised to determine insulin sensitivity from OGTT data.

  15. The Power of the Provocative: Exploring World History Content

    ERIC Educational Resources Information Center

    Ashkettle, Bryan L.

    2013-01-01

    This study addresses how my freshman world history students come to understand controversial issues as provocative within the secondary social studies classroom, and in what ways does their engagement with provocative issues influence their understanding of the content and the world around them. In addition, this research study seeks to discover…

  16. The Power of the Provocative: Exploring World History Content

    ERIC Educational Resources Information Center

    Ashkettle, Bryan L.

    2013-01-01

    This study addresses how my freshman world history students come to understand controversial issues as provocative within the secondary social studies classroom, and in what ways does their engagement with provocative issues influence their understanding of the content and the world around them. In addition, this research study seeks to discover…

  17. [Benign paroxysmal positional vertigo: provocation and freeing manoeuvres].

    PubMed

    Herreros Fernández, M L; Beato Martínez, A; Barja Tur, J; Moreno Juara, A; González Laguillo, A

    2008-08-01

    The benign paroxystic positional vertigo (BPPV) is defined by brief episodic vertigo attacks and accompanied by a rotary-linear nystagmus, triggered by head position changes and is always produced in that position. The theory that better explains the BPPV is canalithiasis: free-floating particles leave the utricular macula and enter one of the semicircular canals, producing an endolymphatic movement that stimulates the cupula and produces vertigo and nystagmus. The diagnosis is based on a typical clinical history, normal ear and neurological examination and provocation maneuvers, such as the Dix-Hallpike test, reproduce the vertigo attacks. The treatments are the liberatory maneuvers, such as the Epley maneuver which makes the vertigo disappear. We present two cases of vertigo with a compatible clinic history of BPPV, where the Dix-Hallpike maneuver confirmed the diagnosis. The treatment in both cases was the Epley maneuver.

  18. [Flat curves of oral glucose tolerance tests (author's transl)].

    PubMed

    Slama, G; Tchobroutsky, G

    1980-04-26

    Patients are often referred to diabetologists on account of a flat curve of oral glucose tolerance test. This abnormality, however, is virtually never associated with a serious metabolic disorder and in any case, it never points to a disease that cannot be diagnosed by questioning or by straightforward clinical examination, nor confirmed by a more specific laboratory test. The curve may be flat for technical reasons (e.g. rejection of the glucose administered, timing of blood withdrawals and assays), for physiological reasons (differences between venous and arteriolo-capillary blood), or for pathological reasons (interaction with drugs, pituitary, thyroid or adrenal insufficiency, digestive malabsorption) but it never implies organic hypoglycaemia nor diabetes mellitus.

  19. Shortened forms of provocative lead chelation

    SciTech Connect

    Sokas, R.K.; Atleson, J.; Keogh, J.P.

    1988-05-01

    Shortened urinary lead collections following provocative chelation have been standardized for pediatric patients, but have not been considered adequate for adults. This study compared shortened urine collections for lead excretion post chelation with standard 24-hour collections. Thirty-five patients without known current lead exposure and with serum creatinine measurements less than 2 mg/dL were hospitalized and had provocative chelation performed as follows: One gram of CaNa2-ethylenediaminetetraacetic acid (EDTA) was administered in 250 mL of a 5% dextrose in water solution intravenously over one hour; the same dose was repeated 12 hours later. A 24-hour urine collection for lead excretion was begun at the time of initiation of the first dose. At three hours and six hours from start of first dose, each patient was instructed to void, total volume to that point was recorded, and a 10-mL aliquot was withdrawn for lead measurement. Both three-hour and six-hour urinary lead excretion following a single dose of EDTA correlated linearly with 24-hour lead excretion post chelation (r = .89 and .94, respectively). When a 24-hour level of 600 micrograms was defined as true positive the three-hour collection had a sensitivity of 76% and specificity of 95% and six-hour urinary lead excretion had 82% sensitivity and 100% specificity. Mild renal insufficiency (reflected by serum creatinine levels between 1.5 and 2.1 mg/dL) did not significantly alter the correlation between three-, six-, and 24-hour urinary post-chelation lead excretion.

  20. Do precursor tests influence the performance of Oral Hygiene students in subsequent semester tests?

    PubMed

    Bookhan, V; Warren, N; Schoeman, Hs

    2014-11-01

    Precursor tests may be useful educational tools in dentistry to enhance learning among Oral Hygiene students, but their application and possible effect on the subsequent performance of these students have not been studied. To determine whether precursor tests, used as dental educational and formative assessment tools, influence the performance of undergraduate Oral Hygiene students in ensuing formal semester tests in the discipline of Basic Restorative Dentistry. This descriptive cross sectional study involved seventeen consenting Oral Hygiene students. An electronic Odontology Theory Test (OTT) and an electronic Objective Structured Practical Test (OSPT), were prepared and introduced as precursor tests prior to scheduled semester tests in the Division of Restorative Dentistry (Department of Odontology). Eleven (65%) of the seventeen students completed the precursor OTT, as well as the precursor OSPT, fourteen days prior to their scheduled semester OTT and semester OSPT and sixty two days prior to their final examinations. The results of the precursor and the semester tests were entered into a Microsoft Excel database for comparative analysis, using a Student's t-test. For both OTT and OSPT tests there were significant differences between the means of the scores of the students for precursor and semester tests (OTT: p = 0.0009; OSPT: p = 0.0180). The students performed significantly better in their precursor OTT, whilst their performance in the OSPT was significantly better in the semester test. In the context of this investigation, the precursor OTT did not enhance the performance of the students in their semester OTT, whilst the precursor OSPT was associated with an enhanced performance of the students in their semester OSPT.

  1. Evaluation of a Self-Administered Oral Glucose Tolerance Test

    PubMed Central

    Bethel, M. Angelyn; Price, Hermione C.; Sourij, Harald; White, Sarah; Coleman, Ruth L.; Ring, Arne; Kennedy, Irene E.C.; Tucker, Lynne; Holman, Rury R.

    2013-01-01

    OBJECTIVE To assess the feasibility of using a disposable, self-administered, capillary blood sampling oral glucose tolerance test (OGTT) device in a community setting. RESEARCH DESIGN AND METHODS Eighteen healthy and 12 type 2 diabetic volunteers underwent six 75-g OGTTs using a prototype device in the following three settings: unaided at home (twice); unaided but observed in clinic (twice); and performed by a nurse with simultaneous laboratory glucose assays of 0- and 120-min venous plasma samples (twice). The device displayed no results. A detachable data recorder returned to the clinic provided plasma-equivalent 0- and 120-min glucose values and key parameters, including test date, start and end times, and time taken to consume the glucose drink. RESULTS The device was universally popular with participants and was perceived as easy to use, and the ability to test at home was well liked. Device failures meant that 0- and 120-min glucose values were obtained for only 141 (78%) of the 180 OGTTs performed, independent of setting. Device glucose measurements showed a mean bias compared with laboratory-measured values of +0.9 at 5.0 mmol/L increasing to +4.4 at 15.0 mmol/L. Paired device glucose values were equally reproducible across settings, with repeat testing showing no training effect regardless of setting order. CONCLUSIONS Self-administered OGTTs can be performed successfully by untrained individuals in a community setting. With improved device reliability and appropriate calibration, this novel technology could be used in routine practice to screen people who might need a formal OGTT to confirm the presence of impaired glucose tolerance or diabetes. PMID:23321216

  2. Evaluation of a self-administered oral glucose tolerance test.

    PubMed

    Bethel, M Angelyn; Price, Hermione C; Sourij, Harald; White, Sarah; Coleman, Ruth L; Ring, Arne; Kennedy, Irene E C; Tucker, Lynne; Holman, Rury R

    2013-06-01

    To assess the feasibility of using a disposable, self-administered, capillary blood sampling oral glucose tolerance test (OGTT) device in a community setting. Eighteen healthy and 12 type 2 diabetic volunteers underwent six 75-g OGTTs using a prototype device in the following three settings: unaided at home (twice); unaided but observed in clinic (twice); and performed by a nurse with simultaneous laboratory glucose assays of 0- and 120-min venous plasma samples (twice). The device displayed no results. A detachable data recorder returned to the clinic provided plasma-equivalent 0- and 120-min glucose values and key parameters, including test date, start and end times, and time taken to consume the glucose drink. The device was universally popular with participants and was perceived as easy to use, and the ability to test at home was well liked. Device failures meant that 0- and 120-min glucose values were obtained for only 141 (78%) of the 180 OGTTs performed, independent of setting. Device glucose measurements showed a mean bias compared with laboratory-measured values of +0.9 at 5.0 mmol/L increasing to +4.4 at 15.0 mmol/L. Paired device glucose values were equally reproducible across settings, with repeat testing showing no training effect regardless of setting order. Self-administered OGTTs can be performed successfully by untrained individuals in a community setting. With improved device reliability and appropriate calibration, this novel technology could be used in routine practice to screen people who might need a formal OGTT to confirm the presence of impaired glucose tolerance or diabetes.

  3. Provocation by eucapnic voluntary hyperpnoea to identify exercise induced bronchoconstriction

    PubMed Central

    Anderson, S; Argyros, G; Magnussen, H; Holzer, K

    2001-01-01

    The International Olympic Committee Medical Commission (IOC-MC) requires notification for use of a ß2 agonist at the Winter Olympic Games in Salt Lake City. This notification will be required seven days before the event and must be accompanied by objective evidence that justifies the need to use one. The IOC-MC has expressed the viewpoint that, at present, eucapnic voluntary hyperpnoea (EVH) is the optimal laboratory challenge to confirm that an athlete has exercise induced bronchoconstriction (EIB). The EVH test recommended was specifically designed to identify EIB. EVH has been performed in thousands of subjects in both the laboratory and the field. The test requires the subject to hyperventilate dry air containing 5% carbon dioxide at room temperature for six minutes at a target ventilation of 30 times the subject's forced expiratory volume in one second (FEV1). The test conditions can be modified to simulate the conditions that give the athlete their symptoms with exercise. A reduction in FEV1 of 10% or more of the value before the test is considered positive. Key Words: hyperpnoea; bronchial provocation; exercise PMID:11579071

  4. Coronary Spastic Angina Induced after Oral Desmopressin (DDAVP) Administration

    PubMed Central

    Adachi, Yusuke; Sakakura, Kenichi; Akashi, Naoyuki; Wada, Hiroshi; Momomura, Shin-ichi; Fujita, Hideo

    2016-01-01

    A 60-year-old man was prescribed oral desmopressin (1-deamino-8-D-arginine vasopressin acetate trihydrate; DDAVP) for nocturnal polyuria. One week after starting to take desmopressin, he frequently felt chest pain while resting. Coronary angiography revealed no organic stenosis; however, an acetylcholine provocation test showed severe coronary spasm with ST elevation. He was diagnosed with coronary spastic angina, and we stopped the oral desmopressin and added diltiazem. While DDAVP should dilate the coronary vessels in healthy subjects, it may provoke coronary vasospasm in patients with endothelial dysfunction. We should be careful to avoid triggering coronary spasm when administering DDAVP to patients that may have potential endothelial dysfunction. PMID:27980260

  5. Oral Fluid Testing for Pertussis, England and Wales, June 2007–August 2009

    PubMed Central

    Amirthalingam, Gayatri; Fry, Norman K.; Litt, David; Harrison, Timothy G.; Wagner, Karen; Crowcroft, Natasha S.; Miller, Elizabeth

    2014-01-01

    Existing pertussis surveillance systems tend to underidentify less severe cases among older children and adults. For routine follow-up of notified, nonconfirmed, clinically diagnosed pertussis cases, use of an oral fluid test was pilot tested in England and Wales during June 2007–August 2009. During that period, 1,852 cases of pertussis were confirmed by established laboratory methods and another 591 by oral fluid testing only. Although introduction of serologic testing in 2002 led to the greatest increase in ascertainment of pertussis, oral fluid testing increased laboratory ascertainment by 32% overall; maximal increase (124%) occurred among children 5–9 years of age. Patients whose pertussis was confirmed by oral fluid testing were least likely to be hospitalized, suggesting that milder community cases were being confirmed by this method. Oral fluid testing is an easily administered, noninvasive surveillance tool that could further our understanding of pertussis epidemiology and thereby contribute to decisions on vaccination strategies. PMID:24856627

  6. Ecological validity of the five digit test and the oral trails test.

    PubMed

    Paiva, Gabrielle Chequer de Castro; Fialho, Mariana Braga; Costa, Danielle de Souza; Paula, Jonas Jardim de

    2016-01-01

    Tests evaluating the attentional-executive system are widely used in clinical practice. However, proximity of an objective cognitive test with real-world situations (ecological validity) is not frequently investigated. The present study evaluate the association between measures of the Five Digit Test (FDT) and the Oral Trails Test (OTT) with self-reported cognitive failures in everyday life as measured by the Cognitive Failures Questionnaire (CFQ). Brazilian adults from 18-to-65 years old voluntarily performed the FDT and OTT tests and reported the frequency of cognitive failures in their everyday life through the CFQ. After controlling for the age effect, the measures of controlled attentional processes were associated with cognitive failures, yet the cognitive flexibility of both FDT and OTT accounted for by the majority of variance in most aspects of the CFQ factors. The FDT and the OTT measures were predictive of real-world problems such as cognitive failures in everyday activities/situations.

  7. Cutaneous Adverse Drug Reactions with Antimalarials and Allergological Skin Tests.

    PubMed

    Soria, Angèle; Barbaud, Annick; Assier, Haudrey; Avenel-Audran, Martine; Tétart, Florence; Raison-Peyron, Nadia; Amarger, Stéphanie; Girardin, Pascal; Francès, Camille

    2015-01-01

    Currently used antimalarial drugs (AM) are hydroxychloroquine and chloroquine, which are prescribed for many autoimmune disorders. The value of skin tests on cutaneous adverse drug reactions (CADR) with AM remains unknown. The main objective of this retrospective study is to know whether skin tests for AM are useful and how to manage the recovery of AM therapy in these patients. All patients referred for suspected CADR secondary to AM between 2001 and 2014 in eight French dermatology centers were retrospectively reviewed. We report herein a retrospective series of 20 patients with CADR and AM involvement. Skin tests, performed in 14/20 patients, were negative in all cases. Six patients had an oral provocation test with recurrence of CADR in 1 case. We encourage dermatologists to perform oral provocation tests in nonsevere CADR in order to allow AM rechallenge at progressive doses. © 2015 S. Karger AG, Basel.

  8. A Review of the IDEA Oral Language Proficiency Test Forms C & D-English.

    ERIC Educational Resources Information Center

    Cook, Allison A.

    The IDEA Oral Language Proficiency Test (IPT-I), forms C and D, aims to determine the level of English oral language proficiency as it relates to accepted levels of NonEnglish speaking (NES), limited English speaking (LES), and fluent English speaking (FES) designations in order to place students in an appropriate classroom setting. The test was…

  9. Short head-up tilt test potentiated with oral nitroglycerine: comparison with a conventional test using isoproterenol.

    PubMed

    Nava, Santiago; Mont, Lluís; Silva, Rose M F L; Rogel, Ulises; Osorio, Paulo; Bartholomay, Eduardo; Berruezo, Antonio; Chueca, Enrique; Brugada, Josep

    2004-08-01

    Conventional tilt test protocols are time consuming and there is no consensus regarding the optimal duration of the test and the provocative drug to be used. This study evaluated the diagnostic power of a short nitroglycerine test against a conventional isoproterenol protocol. A cohort of 128 patients with unexplained syncope was studied. A group of 64 consecutive patients were tilted with a short nitroglycerine test consisting of a passive phase of 15 minutes and if this proved negative, 400 microg of sublingual nitroglycerin spray for a further 15 minutes. The control group consisted of 64 patients tilted with a conventional isoproterenol protocol with a passive phase of 30 minutes and a drug-challenge phase of 20 minutes. In the nitroglycerine protocol 39 (60.9%) patients showed a positive response versus 27(42.2%) in the isoproterenol group (P = 0.034). The duration of the protocol was 23.2 +/- 7.2 minutes in the nitroglycerine group versus 41.1 +/- 15.5 minutes with isoproterenol (P = 0.001). The time until syncope was 18.87 +/- 6.1 versus 29 +/- 18, respectively (P = 0.002). For evaluating unexplained syncope the short tilt test protocol with nitroglycerine is less time consuming, easier to perform, and has a higher rate of positive response than a conventional isoproterenol protocol.

  10. A Comparison of Written and Oral Methods of Testing in Science.

    ERIC Educational Resources Information Center

    Seddon, G. M.; And Others

    1990-01-01

    Discussed in this study is whether there are differences in the assessment of student understanding as measured by written tests versus oral tests. Age and sex differences as well as the impact of different languages and cultures were investigated. (KR)

  11. Exogenous cortisol facilitates responses to social threat under high provocation.

    PubMed

    Bertsch, Katja; Böhnke, Robina; Kruk, Menno R; Richter, Steffen; Naumann, Ewald

    2011-04-01

    Stress is one of the most important promoters of aggression. Human and animal studies have found associations between basal and acute levels of the stress hormone cortisol and (abnormal) aggression. Irrespective of the direction of these changes--i.e., increased or decreased aggressive behavior--the results of these studies suggest dramatic alterations in the processing of threat-related social information. Therefore, the effects of cortisol and provocation on social information processing were addressed by the present study. After a placebo-controlled pharmacological manipulation of acute cortisol levels, we exposed healthy individuals to high or low levels of provocation in a competitive aggression paradigm. Influences of cortisol and provocation on emotional face processing were then investigated with reaction times and event-related potentials (ERPs) in an emotional Stroop task. In line with previous results, enhanced early and later positive, posterior ERP components indicated a provocation-induced enhanced relevance for all kinds of social information. Cortisol, however, reduced an early frontocentral bias for angry faces and--despite the provocation-enhancing relevance--led to faster reactions for all facial expressions in highly provoked participants. The results thus support the moderating role of social information processing in the 'vicious circle of stress and aggression'.

  12. Orally administered glucagon-like peptide-1 affects glucose homeostasis following an oral glucose tolerance test in healthy male subjects.

    PubMed

    Steinert, R E; Poller, B; Castelli, M C; Friedman, K; Huber, A R; Drewe, J; Beglinger, C

    2009-12-01

    Glucagon-like peptide-1 (GLP-1) exerts several effects on glucose homeostasis and reduces food intake. After its release from intestinal L cells, GLP-1 is subject to (i) rapid breakdown by dipeptidyl peptidase IV and (ii) high liver extraction. The highest concentrations of GLP-1 are found in the splanchnic blood rather than in the systemic circulation. An oral delivery system would mimic endogenous secretion. Here we investigated the pharmacokinetic/pharmacodynamic (PK/PD) effects of a single dose (2 mg) of oral GLP-1 administered prior to an oral glucose tolerance test (OGTT) in 16 healthy males. GLP-1 was rapidly absorbed from the gut, leading to tenfold higher plasma concentrations compared with controls. The PD profile was consistent with reported pharmacology; GLP-1 significantly stimulated basal insulin release (P < 0.027), with marked effects on glucose levels. The postprandial glucose peak was delayed with GLP-1, suggesting an effect on gastric emptying.

  13. Concomitant dynamic changes in autonomic nervous system function and nasal airflow resistance during allergen provocation.

    PubMed

    Seppänen, Tiina M; Alho, Olli-Pekka; Seppänen, Tapio

    2015-01-01

    Allergic rhinitis is a major chronic respiratory disease which more than 500 million people suffer from around the world. It is considered to be an immuno-neuronal disorder, but little is known about the part played by the neural system in nasal allergic reaction. This is due mainly to the lack of objective measurement techniques producing accurate, reliable and continuous measurement data about the dynamic changes in nasal respiratory function. Here, a method to assess the association of nasal airflow resistance and the underlying function of autonomic nervous system (ANS) is presented and used during the birch pollen provocation test. Ten allergic volunteers were challenged with allergen. Continuous nasal airflow resistance and spectral heart rate variability parameters were computed and analyzed for the dynamic changes. The derived signals show in detail the timing and intensity differences in subjects' reactions. After the provocation, the nasal airflow resistance rose gradually, whereas LF power and LF/HF ratio decreased gradually for all subjects. This implies gradually increasing sympathetic withdrawal in allergic patients during the provocation with allergen. The proposed method opens entirely new possibilities to assess accurately the dynamic and short-term changes in non-stationary nasal function and could increase the accuracy and reliability of diagnostics and assessment of the effect of nasal treatments.

  14. A Reproducible Oral Microcosm Biofilm Model for Testing Dental Materials

    PubMed Central

    Rudney, J.D.; Chen, R.; Lenton, P.; Li, J.; Li, Y.; Jones, R.S.; Reilly, C.; Fok, A.S.; Aparicio, C.

    2012-01-01

    Aims Most studies of biofilm effects on dental materials use single-species biofilms, or consortia. Microcosm biofilms grown directly from saliva or plaque are much more diverse, but difficult to characterize. We used the Human Oral Microbial Identification Microarray (HOMIM) to validate a reproducible oral microcosm model. Methods and Results Saliva and dental plaque were collected from adults and children. Hydroxyapatite and dental composite disks were inoculated with either saliva or plaque, and microcosm biofilms were grown in a CDC biofilm reactor. In later experiments, the reactor was pulsed with sucrose. DNA from inoculums and microcosms were analyzed by HOMIM for 272 species. Microcosms included about 60% of species from the original inoculum. Biofilms grown on hydroxyapatite and composites were extremely similar. Sucrose-pulsing decreased diversity and pH, but increased the abundance of Streptococcus and Veilonella. Biofilms from the same donor, grown at different times, clustered together. Conclusions This model produced reproducible microcosm biofilms that were representative of the oral microbiota. Sucrose induced changes associated with dental caries. Significance and Impact of the Study This is the first use of HOMIM to validate an oral microcosm model that can be used to study the effects of complex biofilms on dental materials. PMID:22925110

  15. Oral Reading Fluency Testing: Pitfalls for Children with Speech Disorders

    ERIC Educational Resources Information Center

    Howland, Karole; Scaler Scott, Kathleen

    2016-01-01

    As school districts nationwide have moved toward data driven intervention, oral reading fluency measures have become a prevalent means to monitor progress by assessing the degree to which a child is becoming a fast (and therefore fluent) reader. This article reviews results of a survey of speech-language pathologists (SLPs) working with children…

  16. Oral Reading Fluency Testing: Pitfalls for Children with Speech Disorders

    ERIC Educational Resources Information Center

    Howland, Karole; Scaler Scott, Kathleen

    2016-01-01

    As school districts nationwide have moved toward data driven intervention, oral reading fluency measures have become a prevalent means to monitor progress by assessing the degree to which a child is becoming a fast (and therefore fluent) reader. This article reviews results of a survey of speech-language pathologists (SLPs) working with children…

  17. Oral Proficiency Testing in College-Level Foreign Language Programs. A Handbook for Foreign Language Departments.

    ERIC Educational Resources Information Center

    Wing, Barbara H.; Mayewski, Sandi F.

    A handbook designed to acquaint college and university language departments with recent developments in oral proficiency testing gives an overview of the rationale, development, procedures, and implications of oral proficiency evaluation. The discussion is placed in the context of college and university language teaching. An overview section…

  18. A Review and Critique of the Preschool IDEA Oral Language Test (Pre-IPT): Spanish.

    ERIC Educational Resources Information Center

    Amado, Alfred J.

    The Preschool IDEA Oral Language Proficiency Test: Spanish (Pre-IPT:Spanish) developed by W. Williams and E. Dalton (1989) purports to determine the level of oral language proficiency for preschool children, aged 3 to 5 years. The instrument is designed to identify the dominant language of bilingual or primarily Spanish-speaking children, and the…

  19. Comparison of the in-feed glucose test and the oral sugar test.

    PubMed

    Smith, S; Harris, P A; Menzies-Gow, N J

    2016-03-01

    The in-feed oral glucose test (OGT) and oral sugar test (OST) are advocated as field tests of insulin sensitivity in horses and ponies but have not been directly compared. To compare the insulin response to OGT and OST in 8 ponies and 5 horses of unknown insulin sensitivity. Experimental, randomised crossover study. Animals were fasted for 8 h overnight before and throughout testing. They were fed 1 g/kg bwt glucose powder with chaff (OGT) or 0.15 ml/kg bwt corn syrup (Karo™ Light Syrup; OST) was administered per os in a randomised crossover study with 48 h between tests. Blood samples were obtained at 0, 30, 60, 75, 90, 120 and 180 min. The maximal insulin concentration (Cmaxi ), time to maximal insulin concentration (Tmaxi ) and area under the curve of insulin concentration over time (AUCi ) for the tests were compared using Student's paired t test. The effect of individual subject, horse or pony and test were analysed using a linear mixed model. The OGT Cmaxi (mean ± s.d.; 154 ± 116 μiu/ml), Tmaxi (136 ± 52 min) and AUCi (15,308 ± 9886 μiu/ml/min) were significantly (P<0.05) greater compared with the OST Cmaxi (72 ± 55 μiu/ml), Tmaxi (63 ± 25 min) and AUCi (5980 ± 4151 μiu/ml/min). The Cmaxi , Tmaxi and AUCi varied significantly between individual subjects. The Tmaxi was significantly different between horses and ponies during OGT and OST. Using previously defined criteria of insulin dysregulation, OGT identified 7/13 animals as insulin resistant, whereas OST identified 5/13 animals as insulin resistant. The OGT and OST showed agreement in identification of insulin dysregulation in 85% of equine subjects. Results of the OGT and OST are not comparable in all cases. Further work is required to establish which test more accurately diagnoses insulin dysregulation in horses and ponies. © 2015 EVJ Ltd.

  20. Lumbar diskogenic pain, provocation diskography, and imaging correlates.

    PubMed

    Maus, Timothy P; Aprill, Charles N

    2012-07-01

    Diskogenic pain refers to pain mediated by the intrinsic innervation of the intervertebral disk. It is experienced as pain centered at the symptomatic spine segment (axial pain) without radicular features or radiculopathy. There is no pathoanatomic gold standard; histologic examination cannot identify a painful disk. The current reference standard for diskogenic pain is provocation diskography. This article reviews diskogenic pain, the history of provocation diskography, and its current use in the diagnosis of lumbar diskogenic pain. The extensive literature describing imaging features which may predict a positive diskogram, and allow non-invasive diagnosis of diskogenic pain, is examined. Copyright © 2012 Elsevier Inc. All rights reserved.

  1. Human Correlates of Provocative Questions in Pancreatic Pathology

    PubMed Central

    McDonald, Oliver G.; Maitra, Anirban; Hruban, Ralph H.

    2012-01-01

    Studies of cell lines and of animal models of pancreatic cancer have raised a number of provocative questions about the nature and origins of human pancreatic cancer and have provided several leads into exciting new approaches for the treatment of this deadly cancer. In addition, clinicians with little or no contact with human pathology have challenged the way that pancreatic pathology is practiced, suggesting that “genetic signals” may be more accurate than today’s multi-modal approach to diagnoses. In this review we consider eight provocative issues in pancreas pathology, with an emphasis on “the evidence derived from man.” PMID:23060061

  2. Testing Oral Communication in the Foreign Language Classroom. Language in Education: Theory and Practice, No. 17.

    ERIC Educational Resources Information Center

    Bartz, Walter H.

    The construction of tests of oral competence in a foreign language requires consideration of several factors. The face validity of the test, or the degree to which students feel they are performing a real communicative act, is illustrated with a number of model testing situations. Content validity, or the ability of a test to measure what has been…

  3. A Revised Spanish/English Oral Proficiency Test, 1974 Field Test Results. Research and Development Memorandum No. 134.

    ERIC Educational Resources Information Center

    Ramirez, Arnulfo G.; Politzer, Robert L.

    A revised Spanish/English oral-proficiency test battery was administered to 40 Spanish-surnamed pupils equally divided by sex at grade levels 1, 3, 5, and 7. The test battery included parallel Spanish and English versions of: (1) a 12-item vocabulary pretest, (2) a 32-item vocabulary-by-domain test consisting of four sections--home, neighborhood,…

  4. Peer Provocation in Physical Education: Experiences of Botswana Adolescents

    ERIC Educational Resources Information Center

    Shehu, Jimoh

    2009-01-01

    Critical incidents of peer provocation in physical education were investigated among 675 junior secondary school students in Botswana. Data were generated through a brief, open-ended questionnaire requesting the students to narrate their experiences of bad, hurtful and offensive peer behaviours during physical education classes. Six overlapping…

  5. Provocative Pedagogies in e-Learning: Making the Invisible Visible

    ERIC Educational Resources Information Center

    Sinclair, Anne

    2009-01-01

    The purpose of this case study was to explore the experiences of participants (practicing teachers) involved in an online course entitled: "Reflective Practice for Teachers." Using a provocative pedagogy in the course, the teachers were challenged to confront beliefs and assumptions about teaching and learning and become active participants in the…

  6. Children's Moral and Affective Judgments Regarding Provocation and Retaliation.

    ERIC Educational Resources Information Center

    Smetana, Judith G.; Campione-Barr, Nicole; Yell, Nicole

    2003-01-01

    Children's moral judgments, attributions of emotion, and their associations were examined in hypothetical, prototypical situations and situations of provocation and peer retaliation. Children judged prototypical and provoked moral transgressions (hitting and teasing). Hypothetical moral transgressions were judged to be more serious and deserving…

  7. Supervised oral HIV self-testing is accurate in rural KwaZulu-Natal, South Africa.

    PubMed

    Martínez Pérez, Guillermo; Steele, Sarah J; Govender, Indira; Arellano, Gemma; Mkwamba, Alec; Hadebe, Menzi; van Cutsem, Gilles

    2016-06-01

    To achieve UNAIDS 90-90-90 targets, alternatives to conventional HIV testing models are necessary in South Africa to increase population awareness of their HIV status. One of the alternatives is oral mucosal transudates-based HIV self-testing (OralST). This study describes implementation of counsellor-introduced supervised OralST in a high HIV prevalent rural area. Cross-sectional study conducted in two government-run primary healthcare clinics and three Médecins Sans Frontières-run fixed-testing sites in uMlalazi municipality, KwaZulu-Natal. Lay counsellors sampled and recruited eligible participants, sought informed consent and demonstrated the use of the OraQuick(™) OralST. The participants used the OraQuick(™) in front of the counsellor and underwent a blood-based Determine(™) and a Unigold(™) rapid diagnostic test as gold standard for comparison. Primary outcomes were user error rates, inter-rater agreement, sensitivity, specificity and predictive values. A total of 2198 participants used the OraQuick(™) , of which 1005 were recruited at the primary healthcare clinics. Of the total, 1457 (66.3%) were women. Only two participants had to repeat their OraQuick(™) . Inter-rater agreement was 99.8% (Kappa 0.9925). Sensitivity for the OralST was 98.7% (95% CI 96.8-99.6), and specificity was 100% (95% CI 99.8-100). This study demonstrates high inter-rater agreement, and high accuracy of supervised OralST. OralST has the potential to increase uptake of HIV testing and could be offered at clinics and community testing sites in rural South Africa. Further research is necessary on the potential of unsupervised OralST to increase HIV status awareness and linkage to care. © 2016 John Wiley & Sons Ltd.

  8. The Effects of a Provocation on Aggression for Three Types of Alcohol Users.

    ERIC Educational Resources Information Center

    Baldwin, Joseph J.; Randoph, Daniel Lee

    1982-01-01

    Investigated the effects of a provocation on aggression for three types of alcohol users. The results indicated that the provocation elicited significantly more feelings of hostility and verbal aggression. However, there were no significant level effects, nor a significant interaction between level of drinking and presence of a provocation.…

  9. Research and Practice on College English Oral Test--A Case Study of Beijing Institute of Petrochemical Technology

    ERIC Educational Resources Information Center

    Yan, Jiaolan; Zhang, Weiran; Yu, Yuan; Chang, Jie; Ding, Guangwei

    2015-01-01

    Based on the description of implementation of College English oral test from the points of the necessity, feasibility, and implementation process, this study analyzed the current situation of university students' oral English, oral English ability, the college entrance examination results, and a band-4 written test and established their…

  10. The Effects of Group Members' Personalities on a Test Taker's L2 Group Oral Discussion Test Scores

    ERIC Educational Resources Information Center

    Ockey, Gary J.

    2009-01-01

    The second language group oral is a test of second language speaking proficiency, in which a group of three or more English language learners discuss an assigned topic without interaction with interlocutors. Concerns expressed about the extent to which test takers' personal characteristics affect the scores of others in the group have limited its…

  11. Diagnostic tests for oral cancer and potentially malignant disorders in patients presenting with clinically evident lesions.

    PubMed

    Macey, Richard; Walsh, Tanya; Brocklehurst, Paul; Kerr, Alexander R; Liu, Joseph L Y; Lingen, Mark W; Ogden, Graham R; Warnakulasuriya, Saman; Scully, Crispian

    2015-05-29

    Oral squamous cell carcinoma is the most common form of malignancy of the lip and oral cavity, often being proceeded by potentially malignant disorders (PMD). Early detection can reduce the malignant transformation of PMD and can improve the survival rate for oral cancer. The current standard of scalpel biopsy with histology is painful for patients and involves a delay whilst histology is completed; other tests are available that are unobtrusive and provide immediate results. To estimate the diagnostic accuracy of index tests for the detection of oral cancer and PMD of the lip and oral cavity, in people presenting with clinically evident lesions. To estimate the relative accuracy of the different index tests. The electronic databases were searched on 30 April 2013. We searched MEDLINE (OVID) (1946 to April 2013) and four other electronic databases (the Cochrane Diagnostic Test Accuracy Studies Register, the Cochrane Oral Health Group's Trials Register, EMBASE (OVID) and MEDION (Ovid)). There were no restrictions on language in the searches of the electronic databases. We conducted citation searches and screened reference lists of included studies for additional references. We selected studies that reported the diagnostic test accuracy of the following index tests when used as an adjunct to conventional oral examination in detecting PMD or oral squamous cell carcinoma of the lip or oral cavity: vital staining, oral cytology, light-based detection and oral spectroscopy, blood or saliva analysis (which test for the presence of biomarkers in blood or saliva). Two review authors independently screened titles and abstracts for relevance. Eligibility, data extraction and quality assessment were carried out by at least two authors, independently and in duplicate. Studies were assessed for methodological quality using QUADAS-2. Meta-analysis was used to combine the results of studies for each index test using the bivariate approach to estimate the expected values of

  12. Justifying the Use of a Second Language Oral Test as an Exit Test in Hong Kong: An Application of Assessment Use Argument Framework

    ERIC Educational Resources Information Center

    Jia, Yujie

    2013-01-01

    This study employed Bachman and Palmer's (2010) Assessment Use Argument framework to investigate to what extent the use of a second language oral test as an exit test in a Hong Kong university can be justified. It also aimed to help test developers of this oral test identify the most critical areas in the current test design that might need…

  13. Justifying the Use of a Second Language Oral Test as an Exit Test in Hong Kong: An Application of Assessment Use Argument Framework

    ERIC Educational Resources Information Center

    Jia, Yujie

    2013-01-01

    This study employed Bachman and Palmer's (2010) Assessment Use Argument framework to investigate to what extent the use of a second language oral test as an exit test in a Hong Kong university can be justified. It also aimed to help test developers of this oral test identify the most critical areas in the current test design that might need…

  14. European Guidelines for Workplace Drug Testing in Oral Fluid.

    PubMed

    Brcak, Michaela; Beck, Olof; Bosch, Tessa; Carmichael, Duncan; Fucci, Nadia; George, Claire; Piper, Mark; Salomone, Alberto; Schielen, Wim; Steinmeyer, Stefan; Taskinen, Sanna; Weinmann, Wolfgang

    2017-06-28

    These guidelines for Legally Defensible Workplace Drug Testing have been prepared and updated by the European Workplace Drug Testing Society (EWDTS). The European Guidelines are designed to establish best practice procedures whilst allowing individual countries to operate within the requirements of national customs and legislation. The EWDTS recommends that all European laboratories that undertake legally defensible workplace drug testing should use these guidelines as a template for accreditation. These guidelines are relevant to laboratory-based testing only. These guidelines follow current best practices and are constantly under review. This article is protected by copyright. All rights reserved.

  15. Dissolution test development for complex veterinary dosage forms: oral boluses.

    PubMed

    Fahmy, Raafat; Marnane, Bill; Bensley, Dennis; Hollenbeck, R Gary

    2002-01-01

    Fundamental aspects of electrolyte chemistry were used to design an appropriate dissolution medium with the capacity to maintain sink conditions throughout the test. Dissolution of various bolus dosage forms was studied using USP Apparatus II at various stirring speeds. Complete dissolution of each drug in the designed medium was achieved, and there is evidence that such a dissolution test could be discriminating. This review details the development of potentially discriminating in vitro dissolution tests for veterinary boluses using USP Apparatus II and examines the potential role of such testing during product quality assessments, in the evaluation of postapproval manufacturing changes and for the establishment of the generic equivalence of veterinary products.

  16. Helicobacter Pylori - Specific Antigen Tests in Saliva to Identify an Oral Infection.

    PubMed

    Yu, Yajie; Zhao, Lin; Wang, Shumin; Yee, John Kc

    2017-05-01

    Over the past twenty years, the existence of oral Helicobacter pylori (H. pylori) infection has been controversial and is still disputed. It proposes that living H. pylori do not exist in the oral cavity. However, the progressive loss of efficacy of standard eradication therapies has made the treatment of H. pylori more challenging than ever due to oral H. pylori infection. We conducted a study to explore the existence of oral H. pylori infection among 4321 adults. A total 4321 adults (age range, 20-89 years old) comprising 2849 men and 1472 women were recruited by annual physical exam and evaluated using the saliva H. pylori antigen test (HPS) to diagnose oral H. pylori infection and the urea breath test (UBT) to diagnose stomach H. pylori infection. According to the classification on age grouping of World Health Organization, patients were divided into three age groups: A group, the young age subgroup (<45 years); B group, the middle age subgroup (45 to 59 years); C group, the old age subgroup (60-74 years) and D group, the elder subgroup (75-89 years). We found the positive rate of oral H. pylori was 59.59% in the 95% confidence interval (CI) ranges on A group. The lowest positive rate of H. pylori in D group was 25.48% in the 95% confidence interval CI ranges. There was a statistically significant difference (p<0.001) between A, B, C, and D groups but no significant difference between men and women. HPS could identify oral H. pylori infection of individuals who have no risk for H. pylori gastric infection. The positive rate of oral H. pylori was 59.59% and this varies across different age groups. This information was not provided by UBT methods. It further identified that the prevalence of oral H. pylori infection is lower in the elder group that may be associated with fewer number of teeth. © 2017 by the Association of Clinical Scientists, Inc.

  17. Physiological reactions to fear provocation in dogs.

    PubMed

    Hydbring-Sandberg, E; von Walter, L W; Höglund, K; Svartberg, K; Swenson, L; Forkman, B

    2004-03-01

    Fear is a common behavioral problem in dogs. In this paper, we studied the association between behavioral and physiological responses in two potentially fear-eliciting situations. The aim was to establish whether it is possible to separate dogs of the collie breed that are fearful of floors and gunshots from those that are not by studying changes in heart rate and hematocrit, plasma cortisol, progesterone, testosterone, vasopressin, and beta-endorphin concentrations. Thirteen privately owned male dogs of the collie breed were studied during a floor test, using different types of floors, and a subsequent gunshot test. Seven of the dogs were identified as being fearful of floors and six were declared as fearless. Out of the 13 dogs, seven were fearful of gunshots and six were fearless of gunshots. Since fear of floors did not always occur concomitantly with fear of gunshots, there were consequently four different groups of dogs. The heart rate increased during the floor test in all groups, but dogs that were fearful of floors had higher heart rates than dogs that were fearless of floors. Dogs that were fearful of gunshots had higher heart rates, higher hematocrit levels and higher plasma concentrations of cortisol, progesterone, vasopressin, and beta-endorphins during the gunshot test than did dogs that were found to be fearless of gunshots. Plasma cortisol and progesterone increased drastically during the gunshot test in dogs identified as being fearful of gunshots. In fearful dogs, the testosterone concentration increased after completion of the floor test and before the gunshot test started, but there were no significant differences in testosterone between the groups. Since dogs fearful of gunshots had increased levels of several physiological parameters, the results demonstrated that this fear is a serious stress for the individual, a fear which it is possible to register with physiological variables.

  18. Empirical Profiles of Academic Oral English Proficiency from an International Teaching Assistant Screening Test

    ERIC Educational Resources Information Center

    Choi, Ikkyu

    2017-01-01

    Language proficiency constitutes a crucial barrier for prospective international teaching assistants (ITAs). Many US universities administer screening tests to ensure that ITAs possess the required academic oral English proficiency for their TA duties. Such ITA screening tests often elicit a sample of spoken English, which is evaluated in terms of…

  19. Zertifikat Deutsch als Fremdsprache and the Oral Proficiency Interview: A Comparison of Test Scores and Examinations.

    ERIC Educational Resources Information Center

    Lalande, John F.; Schweckendiek, Jurgen

    1986-01-01

    Investigates what correlations might exist between an individual's score on the Zertifikat Deutsch als Fremdsprache and on the Oral Proficiency Interview. The tests themselves are briefly described. Results indicate that the two tests appear to correlate well in their evaluation of speaking skills. (SED)

  20. Interacting in Pairs in a Test of Oral Proficiency: Co-Constructing a Better Performance

    ERIC Educational Resources Information Center

    Brooks, Lindsay

    2009-01-01

    This study, framed within sociocultural theory, examines the interaction of adult ESL test-takers in two tests of oral proficiency: one in which they interacted with an examiner (the individual format) and one in which they interacted with another student (the paired format). The data for the eight pairs in this study were drawn from a larger…

  1. Performance of Elementary-Grade African American Students on the Gray Oral Reading Tests

    ERIC Educational Resources Information Center

    Craig, Holly K.; Thompson, Connie A.; Washington, Julie A.; Potter, Stephanie L.

    2004-01-01

    Purpose: African American students perform disproportionately more poorly on standardized reading assessments than their majority peers. Poor reading performances may be related to test biases inherent in standardized reading instruments. The purpose of this investigation was to examine the appropriateness of the Gray Oral Reading Tests-Third…

  2. The effect of literacy on oral language processing: Implications for aphasia tests.

    PubMed

    Tsegaye, Mulugeta Tarekegne; De Bleser, Ria; Iribarren, Carolina

    2011-06-01

    Most studies investigating the impact of literacy on oral language processing have shown that literacy provides phonological awareness skills in the processing of oral language. The implications of these results on aphasia tests could be significant and pose questions on the adequacy of such tools for testing non-literate individuals. Aiming at examining the impact of literacy on oral language processing and its implication on aphasia tests, this study tested 12 non-literate and 12 literate individuals with a modified Amharic version of the Bilingual Aphasia Test (Paradis and Amberber, 1991, Bilingual Aphasia Test. Amharic version. Hillsdale, NJ: Lawrence Erlbaum.). The problems of phonological awareness skills in oral language processing in non-literates are substantiated. In addition, compared with literate participants, non-literate individuals demonstrated difficulties in the word/sentence-picture matching tasks. This study has also revealed that the Amharic version of the Bilingual Aphasia Test may be viable for testing Amharic-speaking non-literate individuals with aphasia when modifications are incorporated.

  3. Empirical Profiles of Academic Oral English Proficiency from an International Teaching Assistant Screening Test

    ERIC Educational Resources Information Center

    Choi, Ikkyu

    2017-01-01

    Language proficiency constitutes a crucial barrier for prospective international teaching assistants (ITAs). Many US universities administer screening tests to ensure that ITAs possess the required academic oral English proficiency for their TA duties. Such ITA screening tests often elicit a sample of spoken English, which is evaluated in terms of…

  4. Zertifikat Deutsch als Fremdsprache and the Oral Proficiency Interview: A Comparison of Test Scores and Examinations.

    ERIC Educational Resources Information Center

    Lalande, John F.; Schweckendiek, Jurgen

    1986-01-01

    Investigates what correlations might exist between an individual's score on the Zertifikat Deutsch als Fremdsprache and on the Oral Proficiency Interview. The tests themselves are briefly described. Results indicate that the two tests appear to correlate well in their evaluation of speaking skills. (SED)

  5. Testing Speaking Proficiency: The Oral Interview. An Update. Q&A.

    ERIC Educational Resources Information Center

    Lowe, Pardee, Jr.; Liskin-Gasparro, Judith E.

    The oral interview (OI) is a testing procedure that measures a wide range of speaking abilities in a foreign language. Although somewhat different versions are used in different testing situations, the OI always consists of a structured, face-to-face conversation on a variety of topics between a student and one or two testers. The resulting speech…

  6. Optimizing Oral Bioavailability in Drug Discovery: An Overview of Design and Testing Strategies and Formulation Options.

    PubMed

    Aungst, Bruce J

    2017-04-01

    For discovery teams working toward new, orally administered therapeutic agents, one requirement is to attain adequate systemic exposure after oral dosing, which is best accomplished when oral bioavailability is optimized. This report summarizes the bioavailability challenges currently faced in drug discovery, and the design and testing methods and strategies currently utilized to address the challenges. Profiling of discovery compounds usually includes separate assessments of solubility, permeability, and susceptibility to first-pass metabolism, which are the 3 most likely contributors to incomplete oral bioavailability. An initial assessment of absorption potential may be made computationally, and high throughput in vitro assays are typically performed to prioritize compounds for in vivo studies. The initial pharmacokinetic study is a critical decision point in compound evaluation, and the importance of the effect the dosing vehicle or formulation can have on oral bioavailability, especially for poorly water soluble compounds, is emphasized. Dosing vehicles and bioavailability-enabling formulations that can be used for discovery and preclinical studies are described. Optimizing oral bioavailability within a chemical series or for a lead compound requires identification of the barrier limiting bioavailability, and methods used for this purpose are outlined. Finally, a few key guidelines are offered for consideration when facing the challenges of optimizing oral bioavailability in drug discovery. Copyright © 2017 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

  7. Stability of methacholine chloride in bronchial provocation test solutions.

    PubMed

    MacDonald, N C; Whitmore, C K; Makoid, M C; Cobby, J

    1981-06-01

    The stability of methacholine chloride (5 mg/ml) in 0.9% sodium chloride solution was measured. A reliable colorimetric assay (530 nm) based on the formation of a hydroxamic acid-iron complex was used. At appropriate time intervals, samples were removed from solutions stored at 4, 20, 37, 60, or 80 degrees C and assayed. The degradation of methacholine chloride followed apparent first-order kinetics of methacholine chloride followed apparent first-order kinetics at all temperatures, with observed half-lives ranging from 29.3 days at 80 degrees C to 693 days 4 degrees C. Methacholine chloride in 0.9% sodium chloride solution does not degrade as rapidly as previously suggested. According to an Arrhenius plot, storage of such solutions at 30 or 4 degrees C would result in not more than 10% degradation over a period of approximately two or five months, respectively. Thus, it should be possible to prepare stock solutions of this deliquescent drug.

  8. Testing the applicability of a model of oral health-related quality of life.

    PubMed

    Santos, Camila Mello Dos; Celeste, Roger Keller; Hilgert, Juliana Balbinot; Hugo, Fernando Neves

    2015-09-01

    The aim of this study was to test Wilson & Cleary's conceptual model of the direct and mediated pathways between clinical and non-clinical variables in relation to oral health-related quality of life. A random sample of 578 older people was evaluated. Wilson & Cleary's conceptual model was tested using structural equations modeling including: biological variables, symptom status, functional health, oral health perceptions, oral health-related quality of life. Oral health-related quality of life was assessed with the Oral Health Impact Profile-14 (OHIP-14). In the final model, edentulism was negatively correlated to dissatisfaction of appearance of their dental prostheses (r = -0.25). Worse functional status was correlated with poor oral health perception (r = 0.24). Being aged over 68 (r = 0.25), being a female (r = 0.39) and living in rural areas (r = 0.15) had a direct effect on the edentulism. Age had a direct effect on OHIP-14 (r = -0.15). There was an indirect effect of sex on OHIP-14 via functional status (r = 0.12). The present findings partially support Wilson & Cleary's model framework.

  9. Deodorants: an experimental provocation study with isoeugenol.

    PubMed

    Bruze, Magnus; Johansen, Jeanne D; Andersen, Klaus Ejner; Frosch, Peter; Goossens, An; Lepoittevin, Jean-Pierre; Rastogi, Suresh C; White, Ian; Menné, Torkil

    2005-05-01

    Axillary dermatitis is common and overrepresented in people with contact allergy to fragrances. Many people suspect their deodorants to be the incriminating products. In order to investigate the significance of isoeugenol in deodorants for the development of axillary dermatitis when used by people with and without contact allergy to isoeugenol, patch tests with deodorants and ethanol solutions with isoeugenol, as well as repeated open application tests (ROAT) with roll-on deodorants with and without isoeugenol at various concentrations, were performed in 35 dermatitis patients, 10 without and 25 with contact allergy to isoeugenol. A positive ROAT was observed only in patients hypersensitive to isoeugenol (P<0.001) and only in the axilla to which the deodorants containing isoeugenol had been applied (P<0.001). Deodorants containing isoeugenol in the concentration range of 0.0063-0.2% used 2 times daily on healthy skin can thus elicit axillary dermatitis within a few weeks in people with contact allergy to isoeugenol.

  10. Hemodynamic effect of iloprost inhalation and oral sildenafil during acute vasoreactivity test in pulmonary arterial hypertension.

    PubMed

    Sompradeekul, Suree; Wattanasiriphakdee, Siriphan

    2015-02-01

    The vasoreactivity test is usually performed to identify pulmonary arterial hypertension (PAH) patients who may benefit from long-term calcium channel blocker (CCB). The first and most commonly used agent is intravenous epoprostenol. A few other agents such as intravenous adenosine and inhaled nitric oxide are also used. In Thailand, epoprostenol is not available and the others are costly. Therefore, inhaled iloprost or oral sildenafil may be alternatives to test vasoreactivity. To evaluate the hemodynamic effect and response rate of inhaled iloprost and oral sildenafil during acute vasoreactivity test in PAH patients. In this retrospective descriptive study, the authors recruited patients with idiopathic PAH (IPAH) or PAHassociated with connective tissue disease (PAH-CNT) seen at the Medicine department Siriraj Hospital between January 2005 and December 2011 for whom acute vasoreactivity test was indicated. All patients used 20 microgram of inhaled iloprost via Delphinus® nebulizer for the test. Hemodynamic parameters were recorded before and after iloprost administration. Eight of those patients subsequently had a repeated test using 100 mg of oral sildenafil. Fifteen patients had acute vasoreactivity testing. Eleven patients were IPAH and four were PAH-CNT Using ESC/ERS guidelines criteria for responsiveness to vasoreactivity test, the response rate was 13% (2 out of 15 patients) using inhaled iloprost. Hemodynamic change was seen as early as five minutes after the inhalation and the effect lasted up to 35 minutes. The response rate was 25% (2 out of 8 patients) using oral sildenafil. Hemodynamic change was seen as early as 30 minutes after sildenafil ingestion and lasted up to 480 minutes. Inhaled iloprost can be used for acute vasoreactivity test in Thailand. The hemodynamic parameters should be recorded immediately after iloprost inhalation. Oral sildenafil, however, is not a suitable agent for acute vasoreactivity test due to its extended effect.

  11. Deodorants: an experimental provocation study with hydroxycitronellal.

    PubMed

    Svedman, C; Bruze, M; Johansen, J D; Andersen, K E; Goossens, A; Frosch, P J; Lepoittevin, J-P; Rastogi, S; White, I R; Menné, T

    2003-04-01

    Axillary dermatitis is a common problem, particularly in individuals with contact allergy to fragrances. Many individuals suspect their deodorant to be the causal product of their fragrance allergy. It has been shown that deodorants containing cinnamic aldehyde (cinnamal) can elicit axillary dermatitis in patients sensitized to this substance. The aim of the present investigation was to evaluate the importance of hydroxycitronellal used in deodorants for the development of axillary dermatitis, when applied by individuals with and without contact allergy to this fragrance chemical. Patch tests with deodorants and ethanolic solutions containing hydroxycitronellal, as well as repeated open application tests (ROAT) with roll-on deodorants with and without hydroxycitronellal at different concentrations, were performed in 14 dermatitis patients, 7 with and 7 without contact allergy to hydroxycitronellal. A positive ROAT was noted only in the patients hypersensitive to hydroxycitronellal (P < 0.001) and only in the axilla to which the deodorants containing hydroxycitronellal had been applied (P < 0.001). Deodorants containing hydroxycitronellal in the concentration range of 0.032-0.32% used twice daily on healthy skin in individuals hypersensitive to hydroxycitronellal can elicit axillary dermatitis in a few weeks.

  12. Oral Calcium-loading Test in Rickets and in Neonatal Tetany: Effect of Vitamin D

    PubMed Central

    Barr, David G. D.; Forfar, John O.

    1969-01-01

    In an oral calcium-loading test performed on 10 infants with vitamin-D deficiency rickets and low fasting calcium levels, a comparison of results before and after therapy showed that vitamin D raised the serum calcium level at each stage of the test and altered the response so that a more rapid and substantial rise and fall in serum calcium occurred. The effects of vitamin D therapy on newborn infants with hypocalcaemic hyperphosphataemic tetany in another study suggests that these infants should be treated in this way to make them more responsive to oral calcium therapy. PMID:5792914

  13. Biorelevant in vitro performance testing of orally administered dosage forms-workshop report.

    PubMed

    Reppas, Christos; Friedel, Horst-Dieter; Barker, Amy R; Buhse, Lucinda F; Cecil, Todd L; Keitel, Susanne; Kraemer, Johannes; Morris, J Michael; Shah, Vinod P; Stickelmeyer, Mary P; Yomota, Chikako; Brown, Cynthia K

    2014-07-01

    Biorelevant in vitro performance testing of orally administered dosage forms has become an important tool for the assessment of drug product in vivo behavior. An in vitro performance test which mimics the intraluminal performance of an oral dosage form is termed biorelevant. Biorelevant tests have been utilized to decrease the number of in vivo studies required during the drug development process and to mitigate the risk related to in vivo bioequivalence studies. This report reviews the ability of current in vitro performance tests to predict in vivo performance and generate successful in vitro and in vivo correlations for oral dosage forms. It also summarizes efforts to improve the predictability of biorelevant tests. The report is based on the presentations at the 2013 workshop, Biorelevant In Vitro Performance Testing of Orally Administered Dosage Forms, in Washington, DC, sponsored by the FIP Dissolution/Drug Release Focus Group in partnership with the American Association of Pharmaceutical Scientists (AAPS) and a symposium at the AAPS 2012 Annual meeting on the same topic.

  14. The lupus band test in oral mucosa, conjunctiva and skin.

    PubMed

    Burge, S M; Frith, P A; Millard, P R; Wojnarowska, F

    1989-12-01

    The prevalence and clinical significance of subepithelial immunoglobulin and complement deposition (the lupus band) were examined in the uninvolved sun-protected skin of the forearm, the uninvolved sun-protected lip mucosa and sun-protected bulbar conjunctival mucosa in systemic lupus erythematosus (SLE) and chronic cutaneous lupus erythematosus (CCLE). In SLE, linear deposition of an immunoreactant at the BMZ was detected in 32% (6/19) of skin biopsies; 21% (4/19) of lip mucosal biopsies and 42% (5/12) of conjunctival biopsies. There was no significant difference in the sensitivity of the test at different sites in SLE and no correlation between a positive test in skin, lip or conjunctiva and clinical mucosal involvement. In CCLE, linear deposition of an immunoreactant at the BMZ was found in 3% (1/32) of skin biopsies; 3% (1/29) of lip mucosal biopsies and 50% (10/20) of conjunctiva and clinical mucosal involvement. In the conjunctiva, IgG was present in all but one of the biopsies and was the only immunoreactant in 90% (9/10) of positive CCLE biopsies and 60% (3/5) of positive SLE biopsies. In lupus erythematosus immunoreactants may be deposited in the basement membrane zone beneath non-keratinizing mucosal surfaces of the lip and the eye as well as the skin. In CCLE, the test may be positive in conjunctiva when skin and lip are negative.

  15. Programmable Bio-Nano-Chip based Cytologic Testing of Oral Potentially Malignant Disorders in Fanconi Anemia

    PubMed Central

    Floriano, Pierre; Abram, Tim; Taylor, Leander; Le, Cathy; Talavera, Humberto; Nguyen, Michael; Raja, Rameez; Gillenwater, Ann; McDevitt, John; Vigneswaran, Nadarajah

    2015-01-01

    Fanconi anemia (FA) is caused by mutations of DNA repair genes. The risk of oral squamous cell carcinoma (OSCC) among FA patients is 800-folds higher than in the general population. Early detection of OSCC, preferably at it precursor stage is critical in FA patients to improve their survival. In an ongoing clinical trial, we are evaluating the effectiveness of the programmable bio-nano-chip (p-BNC)-based oral cytology test in diagnosing oral potentially malignant disorders (OPMD) in non-FA patients. We used this test to compare the cytomorphometric and molecular biomarkers in OSCC cell lines derived from FA patients and non-FA patients and brush biopsy samples of a FA patient’s OPMD and normal mucosa of healthy volunteers. Our data showed that expression patterns of molecular biomarkers were not notably different between sporadic and FA OSCC cell lines. The p-BNC assay revealed significant differences in cytometric parameters and biomarker MCM2 expression between cytobrush samples of the FA patient and cytobrush samples of normal oral mucosa obtained from healthy volunteers. Microscopic examination of the FA patient’s OPMD confirmed the presence of dysplasia. Our pilot data suggests that p-BNC brush biopsy test recognizes dysplastic oral epithelial cells in a brush biopsy sample of a FA patient. PMID:25662766

  16. Programmable bio-nanochip-based cytologic testing of oral potentially malignant disorders in Fanconi anemia.

    PubMed

    Floriano, P N; Abram, T; Taylor, L; Le, C; Talavera, H; Nguyen, M; Raja, R; Gillenwater, A; McDevitt, J; Vigneswaran, N

    2015-07-01

    Fanconi anemia (FA) is caused by mutations of DNA repair genes. The risk of oral squamous cell carcinoma (OSCC) among FA patients is 800-folds higher than in the general population. Early detection of OSCC, preferably at it precursor stage, is critical in FA patients to improve their survival. In an ongoing clinical trial, we are evaluating the effectiveness of the programmable bio-nanochip (p-BNC)-based oral cytology test in diagnosing oral potentially malignant disorders (OPMD) in non-FA patients. We used this test to compare cytomorphometric and molecular biomarkers in OSCC cell lines derived from FA and non-FA patients to brush biopsy samples of a FA patient with OPMD and normal mucosa of healthy volunteers. Our data showed that expression patterns of molecular biomarkers were not notably different between sporadic and FA-OSCC cell lines. The p-BNC assay revealed significant differences in cytometric parameters and biomarker MCM2 expression between cytobrush samples of the FA patient and cytobrush samples of normal oral mucosa obtained from healthy volunteers. Microscopic examination of the FA patient's OPMD confirmed the presence of dysplasia. Our pilot data suggests that the p-BNC brush biopsy test recognized dysplastic oral epithelial cells in a brush biopsy sample of a FA patient. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  17. Acceptability of rapid oral fluid HIV testing among male injection drug users in Taiwan, 1997 and 2007.

    PubMed

    Lyu, Shu-Yu; Morisky, Donald E; Yeh, Ching-Ying; Twu, Shiing-Jer; Peng, Eugene Yu-Chang; Malow, Robert M

    2011-04-01

    Rapid oral fluid HIV testing (rapid oral testing) is in the process of being adapted in Taiwan and elsewhere given its advantages over prior HIV testing methods. To guide this process, we examined the acceptability of rapid oral testing at two time points (i.e., 1997 and 2007) among one of the highest risk populations, male injection drug users (IDUs). For this purpose, an anonymous self-administered survey was completed by HIV-negative IDUs involved in the criminal justice system in 1997 (N (1)=137 parolees) and 2007 (N (2)=106 prisoners). A social marketing model helped guide the design of our questionnaire to assess the acceptability of rapid oral testing. This included assessing a new product, across four marketing dimensions: product, price, promotion, and place. Results revealed that in both 1997 and 2007, over 90% indicated that rapid oral testing would be highly acceptable, particularly if the cost was under US$6, and that a pharmacy would be the most appropriate and accessible venue for selling the rapid oral testing kits. The vast majority of survey respondents believed that the cost of rapid oral testing should be federally subsidized and that television and newspaper advertisements would be the most effective media to advertise for rapid oral testing. Both the 1997 and 2007 surveys suggested that rapid oral HIV testing would be particularly accepted in Taiwan by IDUs after release from the criminal justice system.

  18. Comparison between E-test and CLSI broth microdilution method for antifungal susceptibility testing of Candida albicans oral isolates.

    PubMed

    Koga-Ito, Cristiane Yumi; Lyon, Juliana Pereira; Resende, Maria Aparecida de

    2008-01-01

    Thirty Candida albicans isolated from oral candidosis patients and 30 C. albicans isolated from control individuals were studied. In vitro susceptibility tests were performed for amphotericin B, fluconazole, 5-flucytosine and itraconazole through the Clinical and Laboratorial Standards Institute (CLSI) reference method and E test system. The results obtained were analyzed and compared. MIC values were similar for the strains isolated from oral candidosis patients and control individuals. The agreement rate for the two methods was 66.67% for amphotericin B, 53.33% for fluconazole, 65% for flucytosine and 45% for itraconazole. According to our data, E test method could be an alternative to trial routine susceptibility testing due to its simplicity. However, it can not be considered a substitute for the CLSI reference method.

  19. Short-Term Regulation of Lipocalin-2 but not RBP-4 During Oral Lipid Tolerance Test and Oral Glucose Tolerance Test.

    PubMed

    Schmid, A; Leszczak, S; Ober, I; Schäffler, A; Karrasch, T

    2016-02-01

    The postprandial regulation of lipocalin-2 and retinol binding protein-4 (RBP-4) by oral uptake of lipids and carbohydrates in healthy individuals has not yet been investigated. The regulation of lipocalin-2 and RBP-4 in 2 large cohorts of healthy volunteers during oral lipid tolerance test (OLTT; n=100) and oral glucose tolerance test (OGTT; n=100) was analyzed. One hundred healthy volunteers underwent OLTT and OGTT in an outpatient setting. Venous blood was drawn after 0, 2, 4, and 6 h in OLTT and after 0, 1, and 2 h in OGTT. In order to dissect carbohydrate-induced from lipid-induced effects, a novel OLTT solution completely free of carbohydrates and protein was applied. Subjects were characterized by anthropometric and laboratory parameters. Serum concentrations of lipocalin-2 and RBP-4 were measured by enzyme-linked immunosorbent assay (ELISA). Whereas RBP-4 levels remained unchanged during OGTT, lipocalin-2 concentrations significantly decreased during OGTT. During OLTT, RBP-4 levels were not influenced, whereas lipocalin-2 levels decreased significantly and stepwise. Fasting concentrations of RBP-4 were negatively correlated with BMI and waist-hip ratio, whereas lipocalin-2 levels were positively associated with BMI and waist-hip ratio. Female users of hormonal contraception had higher RBP-4 levels than females not on contraceptives. There is no significant short-term regulation of RBP-4 by orally ingested lipids or carbohydrates. Lipocalin-2 is downregulated after lipid and carbohydrate ingestion and this kind of regulation was not predicted by age, sex, triglycerides, glucose, or insulin levels.

  20. Measuring adult literacy students' reading skills using the Gray Oral Reading Test.

    PubMed

    Greenberg, Daphne; Pae, Hye Kyeong; Morris, Robin D; Calhoon, Mary Beth; Nanda, Alice O

    2009-12-01

    There are not enough reading tests standardized on adults who have very low literacy skills, and therefore tests standardized on children are frequently administered. This study addressed the complexities and problems of using a test normed on children to measure the reading comprehension skills of 193 adults who read at approximately third through fifth grade reading grade equivalency levels. Findings are reported from an analysis of the administration of Form A of the Gray Oral Reading Tests-Fourth Edition (Wiederholt & Bryant, 2001a, b). Results indicated that educators and researchers should be very cautious when interpreting test results of adults who have difficulty reading when children's norm-referenced tests are administered.

  1. Metabolic Profiling of the Response to an Oral Glucose Tolerance Test Detects Subtle Metabolic Changes

    PubMed Central

    Wopereis, Suzan; Rubingh, Carina M.; van Erk, Marjan J.; Verheij, Elwin R.; van Vliet, Trinette; Cnubben, Nicole H. P.; Smilde, Age K.; van der Greef, Jan; van Ommen, Ben; Hendriks, Henk F. J.

    2009-01-01

    Background The prevalence of overweight is increasing globally and has become a serious health problem. Low-grade chronic inflammation in overweight subjects is thought to play an important role in disease development. Novel tools to understand these processes are needed. Metabolic profiling is one such tool that can provide novel insights into the impact of treatments on metabolism. Methodology To study the metabolic changes induced by a mild anti-inflammatory drug intervention, plasma metabolic profiling was applied in overweight human volunteers with elevated levels of the inflammatory plasma marker C-reactive protein. Liquid and gas chromatography mass spectrometric methods were used to detect high and low abundant plasma metabolites both in fasted conditions and during an oral glucose tolerance test. This is based on the concept that the resilience of the system can be assessed after perturbing a homeostatic situation. Conclusions Metabolic changes were subtle and were only detected using metabolic profiling in combination with an oral glucose tolerance test. The repeated measurements during the oral glucose tolerance test increased statistical power, but the metabolic perturbation also revealed metabolites that respond differentially to the oral glucose tolerance test. Specifically, multiple metabolic intermediates of the glutathione synthesis pathway showed time-dependent suppression in response to the glucose challenge test. The fact that this is an insulin sensitive pathway suggests that inflammatory modulation may alter insulin signaling in overweight men. PMID:19242536

  2. 10 CFR 26.97 - Conducting an initial test for alcohol using a specimen of oral fluids.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 1 2014-01-01 2014-01-01 false Conducting an initial test for alcohol using a specimen of oral fluids. 26.97 Section 26.97 Energy NUCLEAR REGULATORY COMMISSION FITNESS FOR DUTY PROGRAMS Collecting Specimens for Testing § 26.97 Conducting an initial test for alcohol using a specimen of oral...

  3. 10 CFR 26.97 - Conducting an initial test for alcohol using a specimen of oral fluids.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 1 2012-01-01 2012-01-01 false Conducting an initial test for alcohol using a specimen of oral fluids. 26.97 Section 26.97 Energy NUCLEAR REGULATORY COMMISSION FITNESS FOR DUTY PROGRAMS Collecting Specimens for Testing § 26.97 Conducting an initial test for alcohol using a specimen of oral...

  4. 10 CFR 26.97 - Conducting an initial test for alcohol using a specimen of oral fluids.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 1 2013-01-01 2013-01-01 false Conducting an initial test for alcohol using a specimen of oral fluids. 26.97 Section 26.97 Energy NUCLEAR REGULATORY COMMISSION FITNESS FOR DUTY PROGRAMS Collecting Specimens for Testing § 26.97 Conducting an initial test for alcohol using a specimen of oral...

  5. 10 CFR 26.97 - Conducting an initial test for alcohol using a specimen of oral fluids.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 1 2010-01-01 2010-01-01 false Conducting an initial test for alcohol using a specimen of oral fluids. 26.97 Section 26.97 Energy NUCLEAR REGULATORY COMMISSION FITNESS FOR DUTY PROGRAMS Collecting Specimens for Testing § 26.97 Conducting an initial test for alcohol using a specimen of oral...

  6. 10 CFR 26.97 - Conducting an initial test for alcohol using a specimen of oral fluids.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 1 2011-01-01 2011-01-01 false Conducting an initial test for alcohol using a specimen of oral fluids. 26.97 Section 26.97 Energy NUCLEAR REGULATORY COMMISSION FITNESS FOR DUTY PROGRAMS Collecting Specimens for Testing § 26.97 Conducting an initial test for alcohol using a specimen of oral...

  7. An artificial oral environment for testing dental materials.

    PubMed

    DeLong, R; Douglas, W H

    1991-04-01

    Two servo-hydraulic actuators were combined to produce the force movement cycle of human mastication. A closed-loop method of control was used which functions in a manner similar to the human neuromuscular system. The horizontal closed-loop uses a linearly variable differential amplifier (LVDT) to monitor the position. The vertical closed-loop uses both an LVDT to monitor position and a load cell to monitor force with a "mode switch" being made between the two mechanisms of control. A function generator is used to produce a sine wave which is modified to produce the movement and force programs for the two servo-hydraulic actuators. An acrylic chamber was constructed which contains the test samples and maintains an environment similar to that which occurs in the mouth. Natural or artificial saliva maintained at 37 degrees C is continuously circulated through the chamber. The time to complete a single chewing cycle was decreased by eliminating that part of the cycle where no force is produced. This enables the chewing rate to be increased to four cycles per second. The wear produced in the artificial mouth was found to have a high correlation with clinical wear if 250,000 cycles in the artificial mouth are assumed to be equivalent to one year in the human mouth.

  8. [Skin tests for trophallergens and asthma].

    PubMed

    Delacourt, C

    2002-12-01

    The place of trophallergens in the allergy investigation of asthmatic children is controversial. Asthma is only rarely the isolated manifestation of food allergy. The clinical history is essential for research of the associated signs that reveal a food allergy. In the absence of these associated signs, the presence of a positive test for trophallergens only rarely reflects a true food allergy, of which the presence can only be assured by a double blind oral provocation test. In addition, in nurslings, the presence of a positive skin test to a trophallergen indicates atopy in the infant, but is only a mediocre predictive factor of eventual asthma, in the absence of an associated clinical allergy.

  9. Comparability of Student Performance Between Regular and Oral Administrations for a High-Stakes Mathematics Test

    ERIC Educational Resources Information Center

    Huynh, Huynh; Meyer, J. Patrick; Gallant, Dorinda J.

    2004-01-01

    This study examined the effect of oral administration accommodations on test structure and student performance on the mathematics portion of the South Carolina High School Exit Examination (HSEE). The examination was given at Grade 10 and was untimed. Three groups of students were studied. Two groups took the regular form. One group had recorded…

  10. Practical Issues in Field Based Testing of Oral Reading Fluency at Upper Elementary Grades

    ERIC Educational Resources Information Center

    Duesbery, Luke; Braun-Monegan, Jenelle; Werblow, Jacob; Braun, Drew

    2012-01-01

    In this series of studies, we explore the ideal frequency, duration, and relative effectiveness of measuring oral reading fluency. In study one, a sample of 389 fifth graders read out loud for 1 min and then took a traditional state-level standardized reading test. Results suggest administering three passages and using the median yields the…

  11. Practical Issues in Field Based Testing of Oral Reading Fluency at Upper Elementary Grades

    ERIC Educational Resources Information Center

    Duesbery, Luke; Braun-Monegan, Jenelle; Werblow, Jacob; Braun, Drew

    2012-01-01

    In this series of studies, we explore the ideal frequency, duration, and relative effectiveness of measuring oral reading fluency. In study one, a sample of 389 fifth graders read out loud for 1 min and then took a traditional state-level standardized reading test. Results suggest administering three passages and using the median yields the…

  12. Perceptions of Examiner Behavior Modulate Power Relations in Oral Performance Testing

    ERIC Educational Resources Information Center

    Plough, India C.; Bogart, Pamela S. H.

    2008-01-01

    To what extent are the discourse behaviors of examiners salient to participants of an oral performance test? This exploratory study employs a grounded ethnographic approach to investigate the perceptions of the verbal, paralinguistic and nonverbal discourse behaviors of an examiner in a one-on-one role-play task that is one of four tasks in an…

  13. Talking and Testing: Discourse Approaches to the Assessment of Oral Proficiency. Studies in Bilingualism, Volume 14.

    ERIC Educational Resources Information Center

    Young, Richard, Ed.; He, Agnes Weiyun, Ed.

    Papers on second language oral proficiency testing include: "Language Proficiency Interviews: A Discourse Approach" (Agnes Weiyun He, Richard Young); "Re-Analyzing the OPI: How Much Does It Look Like Natural Conversation?" (Marysia Johnson, Andrea Tyler); "Evaluating Learner Interactional Skills: Conversation at the Micro…

  14. The Relationship of Test Anxiety and Performance in Oral Comprehensive Exams.

    ERIC Educational Resources Information Center

    Barley, Zoe A.; And Others

    The relationship between test anxiety and performance on oral comprehensive examinations was studied, with special attention to the repressor phenomenon. Repressors are persons who report low anxiety, but are actually more stressed than are low anxious subjects, as evidenced on measures not relying on self-report. Subjects were 42 female graduate…

  15. 30 CFR 250.1508 - What must I do when MMS administers written or oral tests?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 2 2010-07-01 2010-07-01 false What must I do when MMS administers written or oral tests? 250.1508 Section 250.1508 Mineral Resources MINERALS MANAGEMENT SERVICE, DEPARTMENT OF THE INTERIOR OFFSHORE OIL AND GAS AND SULPHUR OPERATIONS IN THE OUTER CONTINENTAL SHELF Well Control...

  16. 30 CFR 250.1508 - What must I do when MMS administers written or oral tests?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 30 Mineral Resources 2 2011-07-01 2011-07-01 false What must I do when MMS administers written or oral tests? 250.1508 Section 250.1508 Mineral Resources BUREAU OF OCEAN ENERGY MANAGEMENT, REGULATION... CONTINENTAL SHELF Well Control and Production Safety Training § 250.1508 What must I do when MMS...

  17. The Relationship of Test Anxiety and Performance in Oral Comprehensive Exams.

    ERIC Educational Resources Information Center

    Barley, Zoe A.; And Others

    The relationship between test anxiety and performance on oral comprehensive examinations was studied, with special attention to the repressor phenomenon. Repressors are persons who report low anxiety, but are actually more stressed than are low anxious subjects, as evidenced on measures not relying on self-report. Subjects were 42 female graduate…

  18. Utility of 12-lead and signal-averaged Holter electrocardiograms after pilsicainide provocation for risk stratification in Brugada syndrome.

    PubMed

    Kakihara, Jun; Takagi, Masahiko; Hayashi, Yusuke; Tatsumi, Hiroaki; Doi, Atsushi; Yoshiyama, Minoru

    2017-03-31

    Non-invasive risk stratification for ventricular fibrillation (VF) in Brugada syndrome (BrS) has not been fully evaluated. The aim of this study was to assess the utility of signal-averaged Holter electrocardiogram (Holter SAECG) and 12-lead Holter electrocardiogram (Holter ECG) after a pilsicainide provocation test for non-invasive risk stratification in BrS. We enrolled 30 consecutive patients with BrS [divided into 2 groups: the VF group, those with a previous history of VF (n = 10); and the non-VF group, those without a history of VF (n = 20)] and 10 control subjects without type 1 ECG. We evaluated late potentials [LP: filtered QRS (f-QRS), RMS40, and LAS40] on the Holter SAECG for 4 h after the pilsicainide provocation and in the same patients on another day without performing the pilsicainide provocation. Furthermore, we measured QRS duration and QTc interval in leads V2 and V5, and J amplitude in lead V2 on the Holter ECG after the pilsicainide provocation. On the Holter SAECG, the f-QRS at 1 h and LAS40 at 3 h after the pilsicainide provocation were significantly larger in the VF group than in the non-VF group (f-QRS at 1 h: 113.9 ± 8.9 vs. 104.9 ± 8 ms; p = 0.01, LAS40 at 3 h: 45.4 ± 5.9 vs. 35.5 ± 7.4 ms; p < 0.001). The receiver-operating characteristic curve analysis for a single parameter of VF occurrence was determined [f-QRS at 1 h: area under the curve (AUC) 0.8, with sensitivity 80% and specificity 80%; and LAS40 at 3 h: AUC 0.87, with sensitivity 90% and specificity 75%]. On the Holter ECG, there were no significant differences in these parameters between the VF and non-VF groups. In conclusion, the LP after the pilsicainide provocation using Holter SAECG may be useful for risk stratification of VF episodes in patients with BrS.

  19. Stimulation of cortisol during mental task performance in a provocative virtual environment.

    PubMed

    Bullinger, Alex H; Hemmeter, Ullrich M; Stefani, Oliver; Angehrn, Isabelle; Mueller-Spahn, Franz; Bekiaris, Evangelos; Wiederhold, Brenda K; Sulzenbacher, Hubert; Mager, Ralph

    2005-09-01

    Fully immersive and stereoscopic Virtual Environments (VE) represent a powerful multimedia tool for laboratory-based simulations of distinct scenarios including scenarios for evaluating stressful situations resembling reality. Thus far, cortisol secretion as a neuroendocrine parameter of stress has not been evaluated within a Virtual Reality (VR)-based paradigm. In this study 94 healthy volunteers were subjected to a provocative VR-paradigm and a cognitive stress task. Provocative in this context means the VE was designed to provoke physiological reactions (cortisol secretion) within the respective users by purpose. It was tested (a) if a fully dynamic VE as opposed to a static VE can be regarded as a stressor and (b) if such a fully dynamic VE can modify an additional response to a cognitive stressor presented within the VE additionally. Furthermore, possible gender-related impacts on cortisol responses were assessed. A significant cortisol increase was observed only after the combined application of the fully dynamic VE and the cognitive stressor, but not after application of the dynamic VE or the cognitive stressor alone. Cortisol reactivity was greater for men than for women. We conclude that a fully dynamic VE does not affect cortisol secretion per se, but increases cortisol responses to a dual task paradigm that includes performance of a stressful mental task. This provides the basis for the application of VR-based technologies in neuroscientific research, including the assessment of the human Hypothalamus-Pituitary-Adrenal (HPA) axis regulation.

  20. Benign paroxysmal positioning vertigo: classic descriptions, origins of the provocative positioning technique, and conceptual developments.

    PubMed

    Lanska, D J; Remler, B

    1997-05-01

    The original description of benign paroxysmal positioning vertigo (BPPV) has been variously attributed to Bárány, Adler, and others. In addition, the proper eponymic designation for the provocative positioning test used to diagnose BPPV has been unclear, because authors use a variety of different terms, including Bárány, Nylén-Bárány, Nylén, Hallpike, Hallpike-Dix, and Dix-Hallpike to refer to the procedure in current use. Based on a review of the extant medical literature, Bárány was the first to describe the condition in detail, and Dix and Hallpike were the first to clearly describe both the currently used provocative positioning technique and the essential clinical manifestations of benign paroxysmal positioning vertigo elicited by that technique. Nevertheless, despite their important contributions, neither Bárány nor Dix and Hallpike understood the pathophysiology of BPPV nor did they appreciate that the positioning techniques they used actually demonstrated pathology in the semicircular canals rather than the utricle. The modern understanding of the pathophysiology of BPPV began with Schuknecht's proposal that the dysfunction resulted from the gravity-dependent movement of loose or fixed dense material within the posterior semicircular canal ("cupulolithiasis"). Although Schuknecht's formulations were not consistent with all clinical features of the disease, they led to the modern "canalolithiasis theory" and highly effective canalith repositioning or "liberatory" maneuvers for BPPV.

  1. Empathy Inhibits Aggression in Competition: The Role of Provocation, Emotion, and Gender.

    PubMed

    Stanger, Nicholas; Kavussanu, Maria; McIntyre, David; Ring, Christopher

    2016-02-01

    Although the empathy-aggression relationship has been well documented, research has yet to establish whether emotions mediate and gender moderates this relationship in athletes, under conditions of low and high provocation. In this experiment, we assigned team-sport athletes to either a high (n = 40) or a low (n = 40) empathy group, and asked them to compete in a reaction-time task against a (fictitious) opponent, under conditions of low and high provocation. Empathy reduced aggression (i.e., intensity of electrical shock administered to the opponent) at low provocation in men, and at both low and high provocation in women. Guilt mediated the effect of empathy on aggression at low provocation in men; anger did not mediate any effects of empathy on aggression. Our findings indicate that the inhibitory effect of empathy on aggression and the mediating role of guilt are moderated by provocation and gender.

  2. Ondansetron and promethazine have differential effects on hypothermic responses to lithium chloride administration and to provocative motion in rats.

    PubMed

    Guimaraes, Drielle D; Andrews, Paul L R; Rudd, John A; Braga, Valdir A; Nalivaiko, Eugene

    2015-01-01

    We recently reported that provocative motion (rotation in a home cage) causes hypothermic responses in rats, similar to the hypothermic responses associated with motion sickness in humans. Many stimuli inducing emesis in species with an emetic reflex also provoke hypothermia in the rat, therefore we hypothesized that a fall in body temperature may reflect a "nausea-like" state in these animals. As rats do not possess an emetic reflex, we employed a pharmacological approach to test this hypothesis. In humans, motion- and chemically-induced nausea have differential sensitivity to anti-emetics. We thus tested whether the hypothermia induced in rats by provocative motion (rotation at 0.7 Hz) and by the emetic LiCl (63 mg/kg i.p.) have a similar differential pharmacological sensitivity. Both provocations caused a comparable robust fall in core body temperature (-1.9 ± 0.3°C and -2.0 ± 0.2°C for chemical and motion provocations, respectively). LiCl(-)induced hypothermia was completely prevented by ondansetron (2mg/kg, i.p., a 5-HT3 receptor antagonist that reduces cancer chemotherapy-induced nausea and vomiting), but was insensitive to promethazine (10 mg/kg, i.p., a predominantly histamine-H1 and muscarinic receptor antagonist that is commonly used to treat motion sickness). Conversely, motion-induced hypothermia was unaffected by ondansetron but promethazine reduced the rate of temperature decline from 0.20 ± 0.02 to 0.11 ± 0.03°C/min (P < 0.05) with a trend to decrease the magnitude. We conclude that this differential pharmacological sensitivity of the hypothermic responses of vestibular vs. chemical etiology in rats mirrors the observations in other pre-clinical models and humans, and thus supports the idea that a "nausea-like" state in rodents is associated with disturbances in thermoregulation.

  3. Provocative questions in cancer epidemiology in a time of scientific innovation and budgetary constraints.

    PubMed

    Lam, Tram Kim; Schully, Sheri D; Rogers, Scott D; Benkeser, Rachel; Reid, Britt; Khoury, Muin J

    2013-04-01

    In a time of scientific and technological developments and budgetary constraints, the National Cancer Institute's (NCI) Provocative Questions Project offers a novel funding mechanism for cancer epidemiologists. We reviewed the purposes underlying the Provocative Questions Project, present information on the contributions of epidemiologic research to the current Provocative Questions portfolio, and outline opportunities that the cancer epidemiology community might capitalize on to advance a research agenda that spans a translational continuum from scientific discoveries to population health impact.

  4. Oral glucose tolerance test reduces arterial baroreflex sensitivity in older adults.

    PubMed

    Madden, Kenneth M; Tedder, Gale; Lockhart, Chris; Meneilly, Graydon S

    2008-03-01

    Although postprandial decreases in blood pressure are a common cause of syncope in the older adult population, the postprandial effects of the oral glucose tolerance test on blood pressure and the arterial baroreflex remain poorly characterized in older adults. Therefore, arterial blood pressure and the arterial baroreflex were studied in 19 healthy older adults (mean age 71.7 +/- 1.1 years) who were given a standardized oral glucose load (75 g) or an isovolumetric sham drink during 2 separate sessions. All measures were taken for 120 min after treatment. Baroreflex function was assessed by using the spontaneous baroreflex method (baroreflex sensitivity, BRS). Subjects demonstrated a decrease in BRS after oral glucose that was not seen in the placebo session (two-way analysis of variance, p = 0.04). There was no significant change in systolic, mean, or diastolic blood pressure; together with a drop in BRS, this resulted in a significant tachycardia post glucose (two-way analysis of variance, p < 0.001). We conclude that healthy older adults can successfully maintain blood pressure during an oral glucose tolerance test despite a decrease in arterial BRS. Decreased BRS resulted in a tachycardic response to glucose.

  5. Common drugs and treatments for cancer and age-related diseases: revitalizing answers to NCI's provocative questions.

    PubMed

    Blagosklonny, Mikhail V

    2012-12-01

    In 2011, The National Cancer Institute (NCI) has announced 24 provocative questions on cancer. Some of these questions have been already answered in "NCI's provocative questions on cancer: some answers to ignite discussion" (published in Oncotarget, 2011, 2: 1352.) The questions included "Why do many cancer cells die when suddenly deprived of a protein encoded by an oncogene?" "Can we extend patient survival by using approaches that keep tumors static?" "Why are some disseminated cancers cured by chemotherapy alone?" "Can we develop methods to rapidly test interventions for cancer treatment or prevention?" "Can we use our knowledge of aging to enhance prevention or treatment of cancer?" "What is the mechanism by which some drugs commonly and chronically used for other indications protect against cancer?" "How does obesity contribute to cancer risk?" I devoted a single subchapter to each the answer. As expected, the provocative questions were very diverse and numerous. Now I choose and combine, as a single problem, only three last questions, all related to common mechanisms and treatment of age-related diseases including obesity and cancer. Can we use common existing drugs for cancer prevention and treatment? Can we use some targeted "cancer-selective" agents for other diseases and … aging itself.

  6. Oral but not written test anxiety is related to social anxiety

    PubMed Central

    Laurin-Barantke, Lisa; Hoyer, Jürgen; Fehm, Lydia; Knappe, Susanne

    2016-01-01

    AIM To examine the associations of test anxiety (TA) in written vs oral exam situations with social anxiety (SA). METHODS A convenience sample of 204 students was recruited at the Technische Universität Dresden (TU Dresden, Germany) and contacted via e-mail asking to complete a cross-sectional online survey based on established questionnaires. The study protocol was approved by the ethics committee of the TU Dresden. Full data of n = 96 students were available for dependent t-tests and correlation analyses on the associations of SA and TA respectively with trigger events, cognitions, safety behaviors, physical symptoms and depersonalization. Analyses were run using SPSS. RESULTS Levels of TA were higher for fear in oral exams than for fear in written exams (M = 48.1, SD = 11.5 vs M = 43.7, SD = 10.1 P < 0.001). Oral TA and SA were positively correlated (Spearman’s r = 0.343, P < 0.001; Pearson’s r = 0.38, P < 0.001) contrasting written TA and SA (Spearman’s r = 0.17, P > 0.05; Pearson’s r = 0.223, P > 0.05). Compared to written TA, trigger events were more often reported for oral TA (18.2% vs 30.3%, P = 0.007); which was also accompanied more often by test-anxious cognitions (7.9% vs 8.5%, P = 0.001), safety behavior (8.9% vs 10.3%, P < 0.001) and physical symptoms (for all, P < 0.001). CONCLUSION Written, but not oral TA emerged being unrelated to SA and may rather not be considered as a typical facet of SA disorder. PMID:27679775

  7. Provocative dietary factors in geriatric hypertension: A surveillance study.

    PubMed

    Jagtap, Madhavi V; Deole, Yogesh S; Chandola, Harimohan; Ravishankar, B

    2012-10-01

    Hypertension is the most common psychosomatic disorder affecting 972 million people worldwide being more prevalent in old age. The present survey of hypertensive patients fulfilling the standard diagnostic criteria of WHO/ISH (2004) is carried out in geriatric age group from the Saurashtra region of Gujarat in India to observe the dietary pattern and provocative factors. Total 120 patients of 50 to 80 years of age having systolic blood pressure >140 mm Hg and ≤180 mm Hg and diastolic blood pressure >90 mm Hg and ≤110 mm Hg irrespective of gender and religion were selected for the present study. They were interviewed for list of provocative factors enlisted in Ayurveda. As observed, the study supported the facts described in Ayurveda that dietary etiological factors, such as excess intake of Lavana (salty), Amla (sour), Katu (pungent), Tikshna, Ushna (hot), Vidahi (producing burning sensation), Viruddha (incompatible), Snigdha (unctuous), Abhishyandi (leading to obstruction), Madhura (sweet), Guru (heavy to digest) dietary articles, Ajirnashana (taking diet before complete digestion of previous meal), Adhyashana (repeated eating at short intervals), will vitiate Rakta dhatu as well as Pitta dosha in the body leading to disorders like hypertension. Hypertension in old age is found to be a disease of Vata-Pitta dominant vitiation with the involvement of Rasa, Rakta, Meda as main Dushya (vitiated factors) and dietary factors can contribute to worsening of the disease. The etiological factors having role in the pathogenesis can also be applied for preventive guidelines for the management of hypertension.

  8. Provocative dietary factors in geriatric hypertension: A surveillance study

    PubMed Central

    Jagtap, Madhavi V.; Deole, Yogesh S.; Chandola, Harimohan; Ravishankar, B.

    2012-01-01

    Hypertension is the most common psychosomatic disorder affecting 972 million people worldwide being more prevalent in old age. The present survey of hypertensive patients fulfilling the standard diagnostic criteria of WHO/ISH (2004) is carried out in geriatric age group from the Saurashtra region of Gujarat in India to observe the dietary pattern and provocative factors. Total 120 patients of 50 to 80 years of age having systolic blood pressure >140 mm Hg and ≤180 mm Hg and diastolic blood pressure >90 mm Hg and ≤110 mm Hg irrespective of gender and religion were selected for the present study. They were interviewed for list of provocative factors enlisted in Ayurveda. As observed, the study supported the facts described in Ayurveda that dietary etiological factors, such as excess intake of Lavana (salty), Amla (sour), Katu (pungent), Tikshna, Ushna (hot), Vidahi (producing burning sensation), Viruddha (incompatible), Snigdha (unctuous), Abhishyandi (leading to obstruction), Madhura (sweet), Guru (heavy to digest) dietary articles, Ajirnashana (taking diet before complete digestion of previous meal), Adhyashana (repeated eating at short intervals), will vitiate Rakta dhatu as well as Pitta dosha in the body leading to disorders like hypertension. Hypertension in old age is found to be a disease of Vata-Pitta dominant vitiation with the involvement of Rasa, Rakta, Meda as main Dushya (vitiated factors) and dietary factors can contribute to worsening of the disease. The etiological factors having role in the pathogenesis can also be applied for preventive guidelines for the management of hypertension. PMID:23723671

  9. Cross-cultural Adaptation of the Oral Anticoagulation Knowledge Test to the Brazilian Portuguese.

    PubMed

    Praxedes, Marcus Fernando da Silva; Abreu, Mauro Henrique Nogueira Guimarães; Ribeiro, Daniel Dias; Marcolino, Milena Soriano; Paiva, Saul Martins de; Martins, Maria Auxiliadora Parreiras

    2017-05-01

    Patients' knowledge about oral anticoagulant therapy may favor the achievement of therapeutic results and the prevention of adverse pharmacotherapy-related events. Brazil lacks validated instruments for assessing the patient's knowledge about treatment with warfarin. This study aimed to perform the cross-cultural adaptation of the Oral Anticoagulation Knowledge (OAK) Test instrument from English into Portuguese. This is a methodological study developed in an anticoagulation clinic of a public university hospital. The study included initial translation, synthesis of translations, back-translation, review by the experts committee and pre-testing with 30 individuals. We obtained semantic equivalence through the analysis of the referential and general meaning of each item. The conceptual equivalence of the items sought to demonstrate the relevance and acceptability of the instrument. The process of cross-cultural adaptation produced the final version of the OAK Test in Brazilian Portuguese entitled "Teste de Conhecimento sobre Anticoagulação Oral". There was a suitable semantic and conceptual equivalence between the adapted version and the original version, as well as an excellent acceptability of this instrument.

  10. Assessment of psychometric properties of the Brazilian version of the oral anticoagulation knowledge test.

    PubMed

    Praxedes, Marcus Fernando da Silva; de Abreu, Mauro Henrique Nogueira Guimarães; Paiva, Saul Martins; Mambrini, Juliana Vaz de Melo; Marcolino, Milena Soriano; Martins, Maria Auxiliadora Parreiras

    2016-06-24

    The aim of this study was to evaluate the psychometric properties of the Brazilian version of the Oral Anticoagulation Knowledge (OAK) Test. This study, conducted in an anticoagulation clinic, included 201 Brazilian participants aged over 18 years, who had been using warfarin for more than two months. The reliability of the instrument was evaluated by assessing internal consistency (Kuder-Richardson coefficient) and reproducibility (test-retest reliability). The validity was evaluated by hypothesizing that there would be a positive correlation of moderate to strong intensity between the correctness levels of the OAK Test and time within therapeutic range (TTR) values, which is a measure used to evaluate the quality of oral anticoagulation. The instrument exhibited good psychometric properties. The total a Kuder-Richardson coefficient value was 0.818 and intraclass correlation coefficient was 0.967. The validity revealed a strong positive correlation between the values of the level of knowledge, as measured by the OAK Test and the TTR values (rs = 0.780). The instrument proved to be a reliable and valid tool for evaluating the knowledge of Brazilian patients on oral anticoagulation therapy with warfarin. This instrument may be incorporated into the practice of health care for substantiating the structuring of educational activities to ensure the improvement of knowledge about the use of warfarin, thereby increasing the effectiveness and safety of treatment.

  11. Acute oral toxicity testing: Scientific evidence and practicability should govern Three Rs activities.

    PubMed

    Buesen, Roland; Oberholz, Uwe; Sauer, Ursula G; Landsiedel, Robert

    2016-09-01

    Acute oral toxicity is determined for regulatory hazard classification or non-classification. The European Union Reference Laboratory for Alternatives to Animal Testing (EURL ECVAM) recommends the following modules for acute oral toxicity testing: a) the use of the in vitro 3T3 Neutral Red Uptake (NRU) test to identify substances not requiring classification and to estimate starting doses for in vivo acute oral toxicity studies; and b) the use of data from sub-acute toxicity studies to identify substances not requiring classification. However, the application of these modules in a regulatory context would require a predefined, validated and formally accepted testing strategy and data interpretation procedure, which are not available. Furthermore, the application of the 3T3 NRU assay for starting dose estimations could in fact increase the number of animals used. Finally, only very few substances exist for which data from sub-acute or other repeated dose studies are available, but data from acute studies are not. Therefore, in practice, the prediction of acute toxicity by using sub-acute toxicity data is generally irrelevant. It could even lead to a risk of overdosing in the range-finding study, which may result in the death of many or all of the animals used. 2016 FRAME.

  12. Oral vaccination of cattle with heat inactivated Mycobacterium bovis does not compromise bovine TB diagnostic tests.

    PubMed

    Jones, Gareth J; Steinbach, Sabine; Sevilla, Iker A; Garrido, Joseba M; Juste, Ramon; Vordermeier, H Martin

    2016-12-01

    In this study we investigated whether oral uptake of a heat inactivated M. bovis wildlife vaccine by domestic cattle induced systemic immune responses that compromised the use of tuberculin or defined antigens in diagnostic tests for bovine TB. Positive skin test and blood-based IFN-γ release assay (IGRA) results were observed in all calves vaccinated via the parenteral route (i.e. intramuscular). In contrast, no positive responses to tuberculin or defined antigens were observed in either the skin test or IGRA test when performed in calves vaccinated via the oral route. In conclusion, our results suggest that the heat inactivated M. bovis vaccine could be used to vaccinate wildlife in a baited form in conjunction with the following in cattle: (i) continuation of existing tuberculin skin testing or novel skin test formats based on defined antigens; and (ii) the use of IGRA tests utilizing tuberculin or defined antigens. Crown Copyright © 2016. Published by Elsevier B.V. All rights reserved.

  13. Apple pectin affects the efficacy of epigallocatechin gallate on oral sucrose tolerance test in adult mice.

    PubMed

    Tamura, M; Hori, S

    2011-11-01

    Epigallocatechin gallate (EGCg), a dietary polyphenol and a major tea catechin, is a known sucrase inhibitor. Since dietary pectin is known to modulate some of the functions of the gastrointestinal tract, we investigated whether it could specifically affect the efficacy of EGCg on an oral sucrose tolerance test in mice. Male Crj:CD-1 (ICR) mice (seven weeks old) were randomly divided into two groups and fed a 5 % apple pectin (PE) or 5 % cellulose (CE) diet (control diet) for 28 days. After the experimental diet period, all mice were fasted overnight. A volume of 0.2 mL EGCg (20 mg/mL) was orally administered to all the mice by stainless steel feeding needle via injection syringe and a sucrose tolerance test was performed. The blood glucose levels were measured in blood collected from the tail vein using the OneTouch® Ultra® blood glucose monitoring system. Blood glucose levels at 30 minutes and 60 minutes after sucrose loading in the PE group were significantly higher than initial blood glucose levels. However, blood glucose levels at 30 minutes, 60 minutes, and 120 minutes after sucrose loading in the CE group were not significantly higher than initial blood glucose levels. After laparotomy, plasma lipids were also measured. Plasma triglyceride concentrations were significantly greater in the PE group than in the CE (control) group. This demonstrates that dietary pectin can affect the efficacy of EGCg on the oral sucrose tolerance test in mice.

  14. Hypercoagulable states: an algorithmic approach to laboratory testing and update on monitoring of direct oral anticoagulants

    PubMed Central

    Nakashima, Megan O.

    2014-01-01

    Hypercoagulability can result from a variety of inherited and, more commonly, acquired conditions. Testing for the underlying cause of thrombosis in a patient is complicated both by the number and variety of clinical conditions that can cause hypercoagulability as well as the many potential assay interferences. Using an algorithmic approach to hypercoagulability testing provides the ability to tailor assay selection to the clinical scenario. It also reduces the number of unnecessary tests performed, saving cost and time, and preventing potential false results. New oral anticoagulants are powerful tools for managing hypercoagulable patients; however, their use introduces new challenges in terms of test interpretation and therapeutic monitoring. The coagulation laboratory plays an essential role in testing for and treating hypercoagulable states. The input of laboratory professionals is necessary to guide appropriate testing and synthesize interpretation of results. PMID:25025009

  15. Measuring Adult Literacy Students’ Reading Skills Using the Gray Oral Reading Test

    PubMed Central

    Greenberg, Daphne; Pae, Hye Kyeong; Morris, Robin D.; Calhoon, Mary Beth; Nanda, Alice O.

    2009-01-01

    There are not enough reading tests standardized on adults who have very low literacy skills, and therefore tests standardized on children are frequently administered. This study addressed the complexities and problems of using a test normed on children to measure the reading comprehension skills of 193 adults who read at approximately third through fifth grade reading grade equivalency levels. Findings are reported from an analysis of the administration of Form A of the Gray Oral Reading Tests – Fourth Edition (GORT-4; Wiederholt & Bryant, 2001). Results indicated that educators and researchers should be very cautious when interpreting test results of adults who have difficulty reading when children's norm-referenced tests are administered. PMID:19629705

  16. Violent offenders respond to provocations with high amygdala and striatal reactivity.

    PubMed

    da Cunha-Bang, Sofi; MacDonald Fisher, Patrick; Vadskjær Hjordt, Liv; Perfalk, Erik; Persson Skibsted, Anine; Bock, Camilla; Ohlhues Baandrup, Anders; Deen Christensen, Marie; Thomsen, Carsten; Sestoft, Dorte; Knudsen, Gitte M

    2017-03-08

    The ability to successfully suppress impulses and angry affect is fundamental to control aggressive reactions following provocations. The aim of this study was to examine neural responses to provocations and aggression using a laboratory model of reactive aggression. We used a novel functional magnetic resonance imaging point-subtraction aggression paradigm in 44 men, of whom 18 were incarcerated violent offenders and 26 were control non-offenders. We measured brain activation following provocations (monetary subtractions), while the subjects had the possibility to behave aggressively or pursue monetary rewards. The violent offenders behaved more aggressively than controls (aggression frequency 150 vs. 84, p = 0.03) and showed significantly higher brain reactivity to provocations within the amygdala and striatum, as well as reduced amygdala-prefrontal and striato-prefrontal connectivity. Amygdala reactivity to provocations was positively correlated with task-related behavior in the violent offenders. Across groups, striatal and prefrontal reactivity to provocations were positively associated with trait anger and trait aggression. These results suggest that violent individuals display abnormally high neural sensitivity to social provocations, a sensitivity related to aggressive behavior. These findings provide novel insight into the neural pathways that are sensitive to provocations, which is critical to more effectively shape interventions that aim to reduce pathological aggressive behavior.

  17. Power and Provocativeness: The Effects of Subtle Changes in Clothing on Perceptions of Working Women.

    PubMed

    Gurung, Regan A R; Punke, Elizabeth; Brickner, Michaella; Badalamenti, Vincenzio

    2017-05-19

    The current study investigates the effects of subtle changes in professional women's dress on women's perceptions of power and competence. We replicate and extend Howlett, Pine, Cahill, Orakcioglu, and Fletcher's (2015) research showing women in provocative clothing are rated as less competent. We used a larger sample, tested a second independent variable, and fine-tuned the design for higher face validity. Participants (N = 198, 170 women and 29 men) from a Midwestern university in the USA rated four photographs of professionally dressed women whose blouses varied in the number of buttons left undone and whether they wore a camisole. We found main effects of buttons (undone/done) and camisoles (on/off) for participants perceptions of intelligence, competence, powerfulness, and on a global rating score. Results also showed significant interaction effects between buttons and camisoles on ratings of powerfulness. The results have many implications for how women dress professionally.

  18. Can oral fluid cannabinoid testing monitor medication compliance and/or cannabis smoking during oral THC and oromucosal Sativex administration?

    PubMed Central

    Lee, Dayong; Karschner, Erin L.; Milman, Garry; Barnes, Allan J.; Goodwin, Robert S.; Huestis, Marilyn A.

    2012-01-01

    OBJECTIVES We characterize cannabinoid disposition in oral fluid (OF) after Dronabinol, synthetic oral Δ9-tetrahydrocannabinol (THC), and Sativex, a cannabis-extract oromucosal spray, and evaluate whether smoked cannabis relapse or Sativex compliance can be identified with OF cannabinoid monitoring. METHODS 5 and 15 mg synthetic oral THC, low (5.4 mg THC, 5.0 mg cannabidiol (CBD)) and high (16.2 mg THC, 15.0 mg CBD) dose Sativex, and placebo were administered in random order (n=14). Oral fluid specimens were collected for 10.5h after dosing and analyzed for THC, CBD, cannabinol (CBN), and 11-nor-9-carboxy-THC (THCCOOH). RESULTS After oral THC, OF THC concentrations decreased over time from baseline, reflecting residual THC excretion from previously self-administered smoked cannabis. CBD and CBN also were rarely detected. After Sativex, THC, CBD and CBN increased greatly, peaking at 0.25–1h. Median CBD/THC and CBN/THC ratios were 0.82–1.34 and 0.04–0.06, respectively, reflecting cannabinoids’ composition in Sativex. THCCOOH/THC ratios within 4.5h post Sativex were ≤1.6 pg/ng, always lower than after oral THC and placebo. THCCOOH/THC ratios increased throughout each dosing session. CONCLUSIONS Lack of measurable THC, CBD and CBN in OF following oral THC, and high OF CBD/THC ratios after Sativex distinguish oral and sublingual drug delivery routes from cannabis smoking. Low THCCOOH/THC ratios suggest recent Sativex and smoked cannabis exposure. These data indicate that OF cannabinoid monitoring can document compliance with Sativex pharmacotherapy, and identify relapse to smoked cannabis during oral THC medication but not Sativex treatment, unless samples were collected shortly after smoking. PMID:23146820

  19. Development of a biopolymer nanoparticle-based method of oral toxicity testing in aquatic invertebrates.

    PubMed

    Gott, Ryan C; Luo, Yangchao; Wang, Qin; Lamp, William O

    2014-06-01

    Aquatic toxicity testing generally focuses on the water absorption/dermal route of exposure to potential toxic chemicals, while much less work has been done on the oral route of exposure. This is due in part to the difficulties of applying traditional oral toxicity testing to aquatic environments, including the tendency for test chemicals to dissolve into water. The use of biopolymer nanoparticles to encapsulate test chemicals onto food to prevent dissolution is one solution presented herein. The biopolymers zein and chitosan were explored for their previously known nanoparticle-forming abilities. Nanoparticles containing the test chemical rhodamine B were formed, applied as films to coat food, and then fed to the test organism, the freshwater amphipod Hyalella azteca. In feeding trials both zein and chitosan nanoparticles showed a significantly lower release rate of rhodamine B into water than food dyed with rhodamine B without biopolymer nanoparticles. Zein nanoparticles also showed better retention ability than chitosan nanoparticles. Both kinds of nanoparticles showed no significant effect on the survival, growth, or feeding behavior of H. azteca. Thus these biopolymers may be an effective system to encapsulate and deliver chemicals to aquatic invertebrates without interfering with common toxicity assessment endpoints like survival and growth. Copyright © 2014 Elsevier Inc. All rights reserved.

  20. [METHODS OF INGESTION IN ORAL FOOD CHALLENGE TESTS USING WHOLE-EGG POWDER].

    PubMed

    Yanagida, Noriyuki; Sato, Sakura; Ebisawa, Motohiro

    2016-05-01

    Preparation of the food for an oral food challenge (OFC) test is complicated. We prospectively examined the results of an inpatient oral food challenge test involving the use of juice containing whole-egg powder (egg juice) prepared by NH Foods Ltd. and conducted in the Department of Pediatrics of Sagamihara National Hospital. We prospectively evaluated the results of an egg-juice (equivalent to half of an egg) OFC test conducted in Sagamihara National Hospital between September 2014 and April 2015 in 116 cases for diagnosis or tolerance acquisition. The OFC test positivity rate was 33%. Severity according to the anaphylaxis guidelines was grade 1 (mild; 42%), grade 2 (moderate; 53%), and grade 3 (severe; 5%) in the patients with positive test results. Among the 78 subjects with negative results for intakes at home, 92% had no symptoms, with the remaining 8% having mild symptoms but requiring no treatment. We could confirm later that all the patients could eat foods containing half of a chicken egg. For the subjects with negative egg-juice OFC test results, eating egg products equivalent to half of an egg at home seemed to be relatively safe.

  1. Comparing the OPI and the OPIc: The Effect of Test Method on Oral Proficiency Scores and Student Preference

    ERIC Educational Resources Information Center

    Thompson, Gregory L.; Cox, Troy L.; Knapp, Nieves

    2016-01-01

    While studies have been done to rate the validity and reliability of the Oral Proficiency Interview (OPI) and Oral Proficiency Interview-Computer (OPIc) independently, a limited amount of research has analyzed the interexam reliability of these tests, and studies have yet to be conducted comparing the results of Spanish language learners who take…

  2. Field-Based Video Pre-Test Counseling, Oral Testing, and Telephonic Post-Test Counseling: Implementation of an HIV Field Testing Package among High-Risk Indian Men

    ERIC Educational Resources Information Center

    Snyder, Hannah; Yeldandi, Vijay V.; Kumar, G. Prem; Liao, Chuanhong; Lakshmi, Vemu; Gandham, Sabitha R.; Muppudi, Uma; Oruganti, Ganesh; Schneider, John A.

    2012-01-01

    In India, men who have sex with men (MSM) and truck drivers are high-risk groups that often do not access HIV testing due to stigma and high mobility. This study evaluated a field testing package (FTP) that identified HIV positive participants through video pre-test counseling, OraQuick oral fluid HIV testing, and telephonic post-test counseling…

  3. Field-Based Video Pre-Test Counseling, Oral Testing, and Telephonic Post-Test Counseling: Implementation of an HIV Field Testing Package among High-Risk Indian Men

    ERIC Educational Resources Information Center

    Snyder, Hannah; Yeldandi, Vijay V.; Kumar, G. Prem; Liao, Chuanhong; Lakshmi, Vemu; Gandham, Sabitha R.; Muppudi, Uma; Oruganti, Ganesh; Schneider, John A.

    2012-01-01

    In India, men who have sex with men (MSM) and truck drivers are high-risk groups that often do not access HIV testing due to stigma and high mobility. This study evaluated a field testing package (FTP) that identified HIV positive participants through video pre-test counseling, OraQuick oral fluid HIV testing, and telephonic post-test counseling…

  4. Development of a candy-sucking test for evaluating oral function in elderly patients with dementia: A pilot study.

    PubMed

    Mori, Takahiro; Yoshikawa, Mineka; Maruyama, Mariko; Hiraoka, Aya; Nakamori, Masahiro; Yoshida, Mitsuyoshi; Tsuga, Kazuhiro

    2017-02-22

    To maintain oral intake in elderly patients with dementia, it is important to evaluate their oral function. However, these patients often have difficulties following instructions during oral function tests, especially with the progression of dementia. The task of sucking a lollipop candy is simple for elderly patients with mild or severe dementia. The present study aimed to develop a new oral function test - the "candy sucking test" (CST) - for elderly patients with dementia. We recruited 23 female elderly patients with dementia (mean age 89.0 ± 6.7 years). First, we determined the number of participants who were able to carry out this new oral function test, compared with other existing tests. Then, swallowing function was evaluated using videofluoroscopy for those who could carry out the CST. More participants were able to perform carry out CST than other function tests (P < 0.05). A significant correlation was observed between the CST value, evaluated as the difference in candy weight, and oral transit time (ρ = -0.62, P < 0.01). The CST could be useful as a new method for evaluating the oral function of elderly patients with dementia. Geriatr Gerontol Int 2017; ••: ••-••. © 2017 Japan Geriatrics Society.

  5. Roche DAT immunoassay: sensitivity and specificity testing for amphetamines, cocaine, and opiates in oral fluid.

    PubMed

    Crooks, C Richard; Brown, Sue

    2010-03-01

    Laboratory testing of oral fluid for drugs of abuse continues to expand in the workplace, legal, treatment, and health settings. In this study, we assessed recently developed homogeneous Roche DAT screening assays for amphetamines, cocaine metabolite [benzoylecgonine (BZE)], methamphetamines, and opiates in oral fluid. Precision and accuracy were assessed using control samples at +/-25% of cutoff. Sensitivity, specificity, and agreement compared to liquid chromatography-tandem mass spectrometry (LC-MS-MS) was assessed by analysis of oral fluid specimens collected from 994 subjects enrolled in a drug treatment or probation and parole drug-testing program. An additional 180 research specimens from Kroll Laboratories were analyzed for amphetamine and methamphetamine. Screening cutoff concentrations (ng/mL) were as follows: amphetamines, 40; cocaine metabolite, 3; methamphetamines, 40; and opiates, 10. LC-MS-MS analyses were performed with the following cutoff concentrations (ng/mL): amphetamine, 40; BZE, 2.0; methamphetamine, 40; and codeine or morphine, 10. The percent coefficient of variation ranged from 3.4% to 7.3%. Sensitivity and specificity of the Roche DAT assays compared to LC-MS-MS were > 94%, and agreement was > 96% for the four assays. The performance of the Roche DAT assays suggests these new homogeneous screening assays will be an attractive alternative to existing more labor-intensive enzyme immunoassays.

  6. Coagulation Testing in Acute Ischemic Stroke Patients Taking Non-Vitamin K Antagonist Oral Anticoagulants.

    PubMed

    Purrucker, Jan C; Haas, Kirsten; Rizos, Timolaos; Khan, Shujah; Poli, Sven; Kraft, Peter; Kleinschnitz, Christoph; Dziewas, Rainer; Binder, Andreas; Palm, Frederick; Jander, Sebastian; Soda, Hassan; Heuschmann, Peter U; Veltkamp, Roland

    2017-01-01

    In patients who present with acute ischemic stroke while on treatment with non-vitamin K antagonist oral anticoagulants (NOACs), coagulation testing is necessary to confirm the eligibility for thrombolytic therapy. We evaluated the current use of coagulation testing in routine clinical practice in patients who were on NOAC treatment at the time of acute ischemic stroke. Prospective multicenter observational RASUNOA registry (Registry of Acute Stroke Under New Oral Anticoagulants; February 2012-2015). Results of locally performed nonspecific (international normalized ratio, activated partial thromboplastin time, and thrombin time) and specific (antifactor Xa tests, hemoclot assay) coagulation tests were documented. The implications of test results for thrombolysis decision-making were explored. In the 290 patients enrolled, nonspecific coagulation tests were performed in ≥95% and specific coagulation tests in 26.9% of patients. Normal values of activated partial thromboplastin time and international normalized ratio did not reliably rule out peak drug levels at the time of the diagnostic tests (false-negative rates 11%-44% [95% confidence interval 1%-69%]). Twelve percent of patients apparently failed to take the prescribed NOAC prior to the acute event. Only 5.7% (9/159) of patients in the 4.5-hour time window received thrombolysis, and NOAC treatment was documented as main reason for not administering thrombolysis in 52.7% (79/150) of patients. NOAC treatment currently poses a significant barrier to thrombolysis in ischemic stroke. Because nonspecific coagulation test results within normal range have a high false-negative rate for detection of relevant drug concentrations, rapid drug-specific tests for thrombolysis decision-making should be established. URL: http://www.clinicaltrials.gov. Unique identifier: NCT01850797. © 2016 American Heart Association, Inc.

  7. Test Review: J. L. Wiederholt & B. R. Bryant. (2012). Gray Oral Reading Tests-Fifth Edition (GORT-5). Austin, TX: Pro-Ed.

    ERIC Educational Resources Information Center

    Hall, Anna H.; Tannebaum, Rory P.

    2013-01-01

    The first edition of the Gray Oral Reading Tests (GORT, 1963) was written by Dr. William S. Gray, a founding member and the first president of the International Reading Association. The GORT was designed to measure oral reading abilities (i.e., Rate, Accuracy, Fluency, and Comprehension) of students in Grades 2 through 12 due to the noteworthy…

  8. Test Review: J. L. Wiederholt & B. R. Bryant. (2012). Gray Oral Reading Tests-Fifth Edition (GORT-5). Austin, TX: Pro-Ed.

    ERIC Educational Resources Information Center

    Hall, Anna H.; Tannebaum, Rory P.

    2013-01-01

    The first edition of the Gray Oral Reading Tests (GORT, 1963) was written by Dr. William S. Gray, a founding member and the first president of the International Reading Association. The GORT was designed to measure oral reading abilities (i.e., Rate, Accuracy, Fluency, and Comprehension) of students in Grades 2 through 12 due to the noteworthy…

  9. [Direct oral anticoagulants: what is the exact assessment of coagulation tests and plasma levels by laboratory tests in clinical practice?].

    PubMed

    Gendron, Nicolas; Smadja, David M

    2016-01-01

    Direct oral anticoagulants (DAO), anti-IIa or anti-Xa, are intended to be widely used for the treatment and prevention of thrombotic disorders in venous thromboembolic disease and atrial fibrillation as an alternative of vitamin K antagonists (VKA). Despite predictable pharmacological properties, spontaneous or provoked hemorrhagic risks by DAO are major limitations. Thus, after few years of inconsistence concerning biological implication and in particular coagulation tests, it is now established that we need biology to evaluate hemorrhagic risk before surgery or in hemorrhagic cases.

  10. Oral fluid testing as an alternative to urine testing for drugs of abuse in inpatient forensic settings: giving patients choice.

    PubMed

    MacCall, C A; Ritchie, G; Sood, M

    2013-05-01

    The abuse of illicit substances is very common amongst forensic psychiatry populations and is known to be one of the most potent risk factors for interpersonal violence. Forensic psychiatry units hence strive to keep themselves as free as possible from illicit substances and in Scotland drugs of abuse have traditionally been screened for by means of urine testing. The aim of this study is to examine patients' preferences for drug testing methods and to compare the acceptability of urine testing versus oral fluid testing (OFT) within a secure hospital setting. Patients in three continuing care wards at the State Hospital, Carstairs were offered the choice of either urine or oral fluid testing. We developed protocols and recording forms and trained staff in the administration of the OFT. We recorded the sampling time for OFT and urine, and the views of patients and staff on the testing procedures over a six month period. Sixty-two samples were taken, with 53 (85%) opting for OFT and nine (15%) opting for urine sampling. The average time taken for OFT was 13 minutes, while the average time taken for urine sampling was 33 minutes. The majority of patients and staff rated oral fluid and urine testing as comfortable and easy. Patients recorded comments on 46 (87%) of OFT samples, only two of which were negative. In general they preferred the OFT because it was quicker and easier and they commented on it being more dignified and private. Patients recorded comments on five (55%) of urine samples, with one of the primary reasons for opting for urine sampling appearing to be a reluctance to try new things, though a few said they did not want to have anything in their mouths. Staff returned comments on 24 (45%) of OFT samples and one (11%) of urine samples. Comments on the OFT were overwhelmingly positive and pointed out the relative speed and ease of this sampling method. We concluded that the pilot study was successful. OFT was found to be generally preferred by patients

  11. Utility of point of care test devices for infectious disease testing of blood and oral fluid and application to rapid testing in the field

    NASA Astrophysics Data System (ADS)

    Lee, Stephen R.; Kardos, Keith W.; Yearwood, Graham D.; Guillon, Geraldine B.; Kurtz, Lisa A.; Mokkapati, Vijaya K.

    2008-04-01

    Rapid, point of care (POC) testing has been increasingly deployed as an aid in the diagnosis of infectious disease, due to its ability to deliver rapid, actionable results. In the case of HIV, a number of rapid test devices have been FDA approved and CLIA-waived in order to enable diagnosis of HIV infection outside of traditional laboratory settings. These settings include STD clinics, community outreach centers and mobile testing units, as well as identifying HIV infection among pregnant women and managing occupational exposure to infection. The OraQuick ® rapid test platform has been widely used to identify HIV in POC settings, due to its simplicity, ease of use and the ability to utilize oral fluid as an alternative specimen to blood. More recently, a rapid test for antibodies to hepatitis C virus (HCV) has been developed on the same test platform which uses serum, plasma, finger-stick blood, venous blood and oral fluid. Clinical testing using this POC test device has shown that performance is equivalent to state of the art, laboratory based tests. These devices may be suitable for rapid field testing of blood and other body fluids for the presence of infectious agents.

  12. Patients' perspectives on self-testing of oral anticoagulation therapy: content analysis of patients' internet blogs.

    PubMed

    Shah, Syed Ghulam Sarwar; Robinson, Ian

    2011-02-03

    Patients on oral anticoagulant therapy (OAT) require regular testing of the prothrombin time (PT) and the international normalised ratio (INR) to monitor their blood coagulation level to avoid complications of either over or under coagulation. PT/INR can be tested by a healthcare professional or by the patient. The latter mode of the testing is known as patient self-testing or home testing. The objective of this study was to elicit patients' perspectives and experiences regarding PT/INR self-testing using portable coagulometer devices. Internet blog text mining was used to collect 246 blog postings by 108 patients, mainly from the USA and the UK. The content of these qualitative data were analysed using XSight and NVivo software packages. The key themes in relation to self-testing of OAT identified were as follows: Patient benefits reported were time saved, personal control, choice, travel reduction, cheaper testing, and peace of mind. Equipment issues included high costs, reliability, quality, and learning how to use the device. PT/INR issues focused on the frequency of testing, INR fluctuations and individual target (therapeutic) INR level. Other themes noted were INR testing at laboratories, the interactions with healthcare professionals in managing and testing OAT and insurance companies' involvement in acquiring the self-testing equipment. Social issues included the pain and stress of taking and testing for OAT. Patients' blogs on PT/INR testing provide insightful information that can help in understanding the nature of the experiences and perspectives of patients on self-testing of OAT. The themes identified in this paper highlight the substantial complexities involved in self-testing programmes in the healthcare system. Thus, the issues elicited in this study are very valuable for all stakeholders involved in developing effective self-testing strategies in healthcare that are gaining considerable current momentum particularly for patients with chronic

  13. Patients' perspectives on self-testing of oral anticoagulation therapy: Content analysis of patients' internet blogs

    PubMed Central

    2011-01-01

    Background Patients on oral anticoagulant therapy (OAT) require regular testing of the prothrombin time (PT) and the international normalised ratio (INR) to monitor their blood coagulation level to avoid complications of either over or under coagulation. PT/INR can be tested by a healthcare professional or by the patient. The latter mode of the testing is known as patient self-testing or home testing. The objective of this study was to elicit patients' perspectives and experiences regarding PT/INR self-testing using portable coagulometer devices. Methods Internet blog text mining was used to collect 246 blog postings by 108 patients, mainly from the USA and the UK. The content of these qualitative data were analysed using XSight and NVivo software packages. Results The key themes in relation to self-testing of OAT identified were as follows: Patient benefits reported were time saved, personal control, choice, travel reduction, cheaper testing, and peace of mind. Equipment issues included high costs, reliability, quality, and learning how to use the device. PT/INR issues focused on the frequency of testing, INR fluctuations and individual target (therapeutic) INR level. Other themes noted were INR testing at laboratories, the interactions with healthcare professionals in managing and testing OAT and insurance companies' involvement in acquiring the self-testing equipment. Social issues included the pain and stress of taking and testing for OAT. Conclusions Patients' blogs on PT/INR testing provide insightful information that can help in understanding the nature of the experiences and perspectives of patients on self-testing of OAT. The themes identified in this paper highlight the substantial complexities involved in self-testing programmes in the healthcare system. Thus, the issues elicited in this study are very valuable for all stakeholders involved in developing effective self-testing strategies in healthcare that are gaining considerable current momentum

  14. Teens with heavy prenatal cocaine exposure respond to experimental social provocation with escape not aggression.

    PubMed

    Greenwald, M K; Chiodo, L M; Hannigan, J H; Sokol, R J; Janisse, J; Delaney-Black, V

    2011-01-01

    Preclinical data show that, compared to no exposure, prenatal cocaine exposure (PCE) has age-dependent effects on social interaction and aggression. The aim of this clinical study was to determine how heavy/persistent PCE--after controlling for other prenatal drug exposures, sex and postnatal factors--predicts behavioral sensitivity to provocation (i.e., reactive aggression) using a well-validated human laboratory model of aggression. African American teens (mean=14.2 years old) with histories of heavy/persistent PCE (maternal cocaine use ≥ 2 times/week during pregnancy, or positive maternal or infant urine/meconium test at delivery; n=86) or none/some exposure (NON: maternal cocaine use < 2 times/week during pregnancy; n=330) completed the Point Subtraction Aggression Paradigm. In this task, teens competed in a computer game against a fictitious opponent. There were three possible responses: (a) earn points, to exchange for money later; or (b) "aggress" against the fictitious opponent by subtracting their points; or (c) escape temporarily from point subtraction perpetrated by the fictitious opponent. The PCE group responded significantly more frequently on the escape option than the NON group, but did not differ in aggressive or money-earning responses. These data indicate that PCE-teens provoked with a social stressor exhibit a behavioral preference for escape (negative reinforcement) than for aggressive (retaliatory) or appetitive (point- or money-reinforced) responses. These findings are consistent with preclinical data showing that social provocation of adolescent or young adult offspring after PCE is associated with greater escape behavior, inferring greater submission, social withdrawal, or anxiety, as opposed to aggressive behavior.

  15. Hypersensitivity to RF fields emitted from CDMA cellular phones: a provocation study.

    PubMed

    Nam, Ki Chang; Lee, Ju Hyung; Noh, Hyung Wook; Cha, Eun Jong; Kim, Nam Hyun; Kim, Deok Won

    2009-12-01

    With the number of cellular phone users rapidly increasing, there is a considerable amount of public concern regarding the effects that electromagnetic fields (EMFs) from cellular phones have on health. People with self-attributed electromagnetic hypersensitivity (EHS) complain of subjective symptoms such as headaches, insomnia, and memory loss, and attribute these symptoms to radio frequency (RF) radiation from cellular phones and/or base stations. However, EHS is difficult to diagnose because it relies on a person's subjective judgment. Various provocation studies have been conducted on EHS caused by Global System for Mobile Communications (GSM) phones in which heart rate and blood pressure or subjective symptoms were investigated. However, there have been few sham-controlled provocation studies on EHS with Code Division Multiple Access (CDMA) phones where physiological parameters, subjective symptoms, and perception of RF radiation for EHS and non-EHS groups were simultaneously investigated. In this study, two volunteer groups of 18 self-reported EHS and 19 non-EHS persons were tested for both sham and real RF exposure from CDMA cellular phones with a 300 mW maximum exposure that lasted half an hour. We investigated not only the physiological parameters such as heart rate, respiration rate, and heart rate variability (HRV), but also various subjective symptoms and the perception of EMF. In conclusion, RF exposure did not have any effects on physiological parameters or subjective symptoms in either group. As for EMF perception, there was no evidence that the EHS group better perceived EMF than the non-EHS group.

  16. Failure of introduction of food allergens after negative oral food challenge tests in children.

    PubMed

    van der Valk, J P M; Gerth van Wijk, R; Vergouwe, Y; de Jong, N W

    2015-08-01

    One of the purposes to perform an oral food challenge (FC) test is to avoid unnecessary elimination of food allergens. In case of a negative FC test result, the food can be introduced. It is, however, unknown if patients act according to the outcome of the test. This study evaluates the rate of introduction of peanut, hazelnut, cow's milk or hen's egg allergens after a negative FC test. We investigated the introduction rate of children (0-18 years) with a negative FC test visiting the Department of Allergology, Erasmus Medical Centre Rotterdam from 2008 till 2013 and the factors that influence the rate of introduction. Patients were asked to complete a comprehensive questionnaire about their FC test. In total, 157 (38% girls, mean age during challenge 6.9 years) participated in the study. Of these FC tests, 104 (56%) were followed by a successful introduction, 30 (16%) by a partly introduction (traces or processed foods) and 52 (28%) by a failed introduction. Peanut and hazelnut showed a statistically significant lower successful introduction rate. Age, gender, symptoms during FC test, dietary advice and time period to introduction significantly influenced the rate of introduction. One fourth of the children with failure of introducing foods experienced symptoms during the introduction. More than one quarter of all children with a negative FC test result did not introduce the food. The FC test in its current form does not achieve its objective for this group of children.

  17. Oral rapid test: an alternative to traditional HIV screening in Chile

    PubMed Central

    Irarrazábal, Lisette Paola; Ferrer, Lilian; Cianelli, Rosina; Lara, Loreto; Reed, Reiley; Levy, Judith; Pérez, Carlos

    2016-01-01

    Objective To compare the sensitivity and specificity of an Oral Rapid Test (ORT) to that of the Enzyme-Linked Immunosorbent Assay (ELISA) for HIV testing in Santiago, Chile; to track the number of study participants returning for ELISA testing results; and to analyze the participants’ perceptions of the ORT compared to the ELISA. Methods A total of 497 people were recruited in Santiago, Chile: 153 had previously tested positive for HIV, and 344 were of unknown status. Participants were tested for HIV using both the ELISA and the ORT to examine and compare specificity and sensitivity. Qualitative data were collected from 22 participants to compare perceptions of the testing experience with ORT versus ELISA. Results The ELISA reported 184 (37%) of the 497 participants as being “positive” for HIV antibodies; the ORT showed 181 (36.4%) as being “reactive” for HIV. The ORT showed a sensitivity of 98.4% (95.7%–99.9%, 95% Confidence Interval) and specificity of 100%. The Kappa test produced K = 0.983 (P < 0.0001). Of the 344 participants whose HIV status was unknown at the start of the study, 55 failed to return for their ELISA results. Participants positively perceived ORT as having reduced both waiting time and anxiety over obtaining their test results. ORT oral swabbing appeared more practical and less invasive than drawing blood for the ELISA. Conclusions The ORT and ELISA were statistically equal in specificity and sensitivity. ORT provides quicker results, potentially ensuring that more people receive them, and does not require handling of or exposure to potentially hazardous blood products. PMID:23939368

  18. Guidance for Classifying Studies Conducted Using the OECD Test Guideline 223 (TG223) (Acute Avian Oral Sequential Dose Study)

    EPA Pesticide Factsheets

    Guidance based on comparison of results from the TG223 validation studies to results from avian acute oral studies previously submitted to EPA for two test chemicals following EPA's 850.2100 (public draft) guidelines.

  19. Critique on the use of the standardized avian acute oral toxicity test for first generation anticoagulant rodenticides

    USGS Publications Warehouse

    Vyas, Nimish B.; Rattner, Barnett A.

    2012-01-01

    Avian risk assessments for rodenticides are often driven by the results of standardized acute oral toxicity tests without regards to a toxicant's mode of action and time course of adverse effects. First generation anticoagulant rodenticides (FGARs) generally require multiple feedings over several days to achieve a threshold concentration in tissue and cause adverse effects. This exposure regimen is much different than that used in the standardized acute oral toxicity test methodology. Median lethal dose values derived from standardized acute oral toxicity tests underestimate the environmental hazard and risk of FGARs. Caution is warranted when FGAR toxicity, physiological effects, and pharmacokinetics derived from standardized acute oral toxicity testing are used for forensic confirmation of the cause of death in avian mortality incidents and when characterizing FGARs' risks to free-ranging birds.

  20. The effect of age and diet on the oral glucose tolerance test in ponies.

    PubMed

    Murphy, D; Reid, S W; Love, S

    1997-11-01

    To evaluate the effects of age and diet on the oral glucose tolerance test (OGTT) in healthy ponies, OGTTs were performed on 2 groups of British native breed ponies (Group A: 7 foals [6-9 months], Group B: 7 mature individuals [6-13 years]) when maintained on either a high fibre pelleted ration only (Groups A and B) or a hay only diet (Group B). Plasma glucose response, following oral glucose administration, for Group A (basal plasma glucose concentration [Glu0] 4.6 +/- 0.4 mmol/l (mean +/- s.d.) increasing to 11.5 +/- 1.3 mmol/l at 90 min) was significantly different (P < 0.05) from that observed for Group B (Glu0 of 4.3 +/- 0.2 mmol/l increasing to 6.8 +/- 1.3 mmol/l at 90 min), when fed the same diet. For Group B ponies, the plasma glucose response, following oral glucose administration, was significantly different (P < 0.05) when fed hay only (Glu0 4.6 +/- 0.4 mmol/l increasing to 9.6 +/- 2.1 mmol/l at 150 min) compared to when fed the high fibre pelleted ration. These results indicate that both age and diet have a significant effect on plasma glucose concentrations measured during an OGTT.

  1. Quantitative sensory testing for assessment of somatosensory function in human oral mucosa: a review.

    PubMed

    Zhou, Pin; Chen, Yaming; Zhang, Jinglu; Wang, Kelun; Svensson, Peter

    2017-09-20

    This narrative review provides an overview of the quantitative sensory testing (QST) to assess somatosensory function in human oral mucosa. A literature search was conducted in the PubMed database to identify studies in vivo on human oral mucosa using QST methods. A list of 149 articles was obtained and screened. A total of 36 relevant articles remained and were read in full text. Manual search of the reference lists identified eight additional relevant studies. A total of 44 articles were included for final assessment. The included studies were divided into six categories according to the study content and objective. In each category, there was a great variety of aims, methods, participants and outcome measures. The application of QST has nevertheless helped to monitor somatosensory function in experimental models of intraoral pain, effects of local anesthesia, after oral and maxillofacial surgery and after prosthodontic and orthodontic treatment. QST has been proved to be sufficiently stable and reliable, and valuable information has been obtained regarding somatosensory function in healthy volunteers, special populations and orofacial pain patients. However, as most of the studies were highly heterogeneous, the results are difficult to compare quantitatively. A standardized intraoral QST protocol is recommended and expected to help advance a mechanism-based assessment of neuropathies and other intraoral pain conditions.

  2. Pressure and tendon strain in the sixth extensor compartment of the wrist during simulated provocative maneuvers for diagnosing extensor carpi ulnaris tendinitis.

    PubMed

    Kataoka, Toshiyuki; Moritomo, Hisao; Omori, Shinsuke; Iida, Akio; Omokawa, Shohei; Suzuki, Daisuke; Fujimiya, Mineko; Wada, Takuro; Aoki, Mitsuhiro; Yoshikawa, Hideki

    2015-11-01

    Various provocative maneuvers for diagnosing extensor carpi ulnaris (ECU) tendinitis have been reported; however, it remains unclear which maneuver is the most sensitive to detect ECU tendinitis. To clarify this, we investigated and compared the extratendinous pressure and ECU tendon strain in the sixth extensor compartment of the wrist during various provocative maneuvers for diagnosing ECU tendinitis. Nine upper extremities from nine fresh-frozen cadavers were examined. We investigated extratendinous pressure in the ECU fibro-osseous tunnel of the distal ulna and ECU tendon strain during eight forearm positions-neutral rotation, pronation, supination, pronation with wrist flexion, supination with wrist flexion, supination with wrist extension, both hand and forearm supination, and supination with ECU full loading-to simulate provocative maneuvers reported to detect ECU tendinitis. Pressure was significantly higher during both hand and forearm supination (carpal supination test) and during supination with wrist extension (prayer's hand supination test) than during neutral rotation. The pressure during the carpal supination test was 3 times higher than that during the prayer's hand supination test and 27 times higher than that during the neutral position. Strain was significantly higher during the carpal supination test and during supination with ECU full loading (the ECU synergy test) than during other maneuvers. Both pressure and tendon strain increased most notably during the carpal supination test compared to the other maneuvers, which suggests that the carpal supination test is the most sensitive for the detection of ECU tendinitis.

  3. Factors Associated with Willingness to Accept Oral Fluid HIV Rapid Testing among Most-at-Risk Populations in China

    PubMed Central

    Xun, Huanmiao; Kang, Dianmin; Huang, Tao; Qian, Yuesheng; Li, Xiufang; Wilson, Erin C.; Yang, Shan; Jiang, Zhenxia; Gong, Cuihua; Tao, Xiaorun; Zhang, Xijiang; Wang, Guoyong; Song, Yapei; Xu, Zhijian; Marley, Gifty; Huai, Pengcheng; Ma, Wei

    2013-01-01

    Background The availability of oral fluid HIV rapid testing provides an approach that may have the potential to expand HIV testing in China, especially among most-a-risk populations. There are few investigations about the acceptability of oral fluid HIV testing among most-at-risk populations in China. Method A cross-sectional study with men who have sex with men (MSM), female sex workers (FSW) and voluntary counseling and testing (VCT) clients was conducted in three cities of Shandong province, China from 2011 to 2012. Data were collected by face-to-face questionnaire. Results About 71% of participants were willing to accept the oral fluid HIV rapid testing, and home HIV testing was independently associated with acceptability of the new testing method among MSM, FSW and VCT clients (AOR of 4.46, 3.19 and 5.74, respectively). Independent predictors of oral fluid HIV rapid testing acceptability among MSM were having ever taken an oral fluid HIV rapid test (AOR= 15.25), having ever taken an HIV test (AOR= 2.07), and education level (AOR= 1.74). Engagement in HIV-related risk behaviors (AOR= 1.68) was an independent predictor of acceptability for FSW. Having taken an HIV test (AOR= 2.85) was an independent predictor of acceptability for VCT clients. The primary concern about the oral fluid HIV testing was accuracy. The median price they would pay for the testing ranged from 4.8 to 8.1 U.S. dollars. Conclusion High acceptability of oral fluid HIV rapid testing was shown among most-at-risk populations. Findings provide support for oral rapid HIV testing as another HIV prevention tool, and provide a backdrop for the implementation of HIV home testing in the near future. Appropriate pricing and increased public education through awareness campaigns that address concerns about the accuracy and safety of the oral fluid HIV rapid testing may help increase acceptability and use among most-at-risk populations in China. PMID:24260432

  4. Heterogeneity in glucose response curves during an oral glucose tolerance test and associated cardiometabolic risk.

    PubMed

    Hulman, Adam; Simmons, Rebecca K; Vistisen, Dorte; Tabák, Adam G; Dekker, Jacqueline M; Alssema, Marjan; Rutters, Femke; Koopman, Anitra D M; Solomon, Thomas P J; Kirwan, John P; Hansen, Torben; Jonsson, Anna; Gjesing, Anette Prior; Eiberg, Hans; Astrup, Arne; Pedersen, Oluf; Sørensen, Thorkild I A; Witte, Daniel R; Færch, Kristine

    2017-02-01

    We aimed to examine heterogeneity in glucose response curves during an oral glucose tolerance test with multiple measurements and to compare cardiometabolic risk profiles between identified glucose response curve groups. We analyzed data from 1,267 individuals without diabetes from five studies in Denmark, the Netherlands and the USA. Each study included between 5 and 11 measurements at different time points during a 2-h oral glucose tolerance test, resulting in 9,602 plasma glucose measurements. Latent class trajectories with a cubic specification for time were fitted to identify different patterns of plasma glucose change during the oral glucose tolerance test. Cardiometabolic risk factor profiles were compared between the identified groups. Using latent class trajectory analysis, five glucose response curves were identified. Despite similar fasting and 2-h values, glucose peaks and peak times varied greatly between groups, ranging from 7-12 mmol/L, and 35-70 min. The group with the lowest and earliest plasma glucose peak had the lowest estimated cardiovascular risk, while the group with the most delayed plasma glucose peak and the highest 2-h value had the highest estimated risk. One group, with normal fasting and 2-h values, exhibited an unusual profile, with the highest glucose peak and the highest proportion of smokers and men. The heterogeneity in glucose response curves and the distinct cardiometabolic risk profiles may reflect different underlying physiologies. Our results warrant more detailed studies to identify the source of the heterogeneity across the different phenotypes and whether these differences play a role in the development of type 2 diabetes and cardiovascular disease.

  5. The "muffin test"--an alternative to the oral glucose tolerance test for detecting impaired glucose tolerance.

    PubMed

    Traub, Michael L; Jain, Akas; Maslow, Bat-Sheva; Pal, Lubna; Stein, Daniel T; Santoro, Nanette; Freeman, Ruth

    2012-01-01

    The aim of this study was to compare the effectiveness of the "muffin test" (MT) with that of the oral glucose tolerance test (OGTT) in diagnosing impaired glucose tolerance (IGT). This is a cross-sectional study in a single academic institution. The participants were 73 women aged 42 to 58 years, less than 36 months after menopause, recruited for the Kronos Early Estrogen Prevention Study Trial. After a 10-hour fasting blood draw, the participants were provided a muffin and a beverage. Two-hour glucose levels were assessed. A subset underwent metabolic testing consisting of an OGTT (n = 12) and a mixed-meal tolerance test (n = 10). The main outcome measures were the prevalence of IGT and 2-hour glucose measurements after each testing method. Two-hour glucose levels were linearly related to fasting values by multivariable linear regression. This association was exaggerated in overweight (body mass index, 25 kg/m2) women (coefficient, 1.43; P < 0.001). Two-hour OGTT and MT glucose levels were comparable (P > 0.05); 2-hour glucose levels after OGTT were slightly lower than after the mixed-meal tolerance test (P < 0.05). The prevalence of IGT was 11% (8 of 73). Fasting plasma glucose alone would have missed 63% of cases (five of eight cases). The MT demonstrated 100% sensitivity and specificity for diagnosing IGT compared with the gold standard OGTT. This small pilot study should be confirmed in a larger prospective group of participants.

  6. Neuropsychological assessment without upper limb involvement: a systematic review of oral versions of the Trail Making Test and Symbol-Digit Modalities Test.

    PubMed

    Jaywant, Abhishek; Barredo, Jennifer; Ahern, David C; Resnik, Linda

    2016-10-18

    The Trail Making Test (TMT) and written version of the Symbol Digit Modalities Test (SDMT) assess attention, processing speed, and executive functions but their utility is limited in populations with upper limb dysfunction. Oral versions of the TMT and SDMT exist, but a systematic review of their psychometric properties and clinical utility has not been conducted, which was the goal of this study. Searches were conducted in PubMed and PsycINFO, test manuals, and the reference lists of included articles. Four measures were identified: the SDMT-oral, oral TMT-A, oral TMT-B, and the Mental Alternation Test (MAT). Two investigators independently reviewed abstracts to identify peer-reviewed articles that reported on these measures in adult populations. From each article, one investigator extracted information on reliability, validity, responsiveness, minimum detectable change, normative data, and demographic influences. A second investigator verified the accuracy of the data in a random selection of 10% of papers. The quality of the evidence for each psychometric property was rated on a 4-point scale (unknown, poor, adequate, excellent). Results showed excellent evidence for the SDMT-oral, adequate evidence for the oral TMT-B and MAT, and adequate to poor evidence for the oral TMT-A. These findings inform the clinical assessment of attention, processing speed, and executive functions in individuals with upper limb disability.

  7. [Insulin response and NEFA behavior in volunteers with a flat response to oral glucose tolerance test].

    PubMed

    Viviani, G; Cordera, R; Maiello, M; De Micheli, A; Odetti, P; Corsi, L; Boeri, D; Prando, R

    1979-07-15

    The insulin response and the NEFA behaviour of 7 lean and 8 obese subjects with a flat response to an oral glucose tolerance test have been studied. A flat response has been defined as one in which the maximum glycemic increase and the area of increase does not exceed 32 mg% and 18 mg% respectively. The insulin response and the NEFA behaviour were similar both in lean and in obese subjects to controls with normal O.G.T.T. The glucose/I.R.I. ratios were increased. A possible physiopathological interpretation is proposed.

  8. Non-vitamin-K oral anticoagulants and laboratory testing: now and in the future

    PubMed Central

    Salmonson, Tomas; Dogné, Jean-Michel; Janssen, Heidi; Garcia Burgos, Juan; Blake, Paul

    2017-01-01

    In contrast to vitamin K antagonists, no routine coagulation monitoring is required in patients taking non-vitamin-K oral anticoagulants (NOACs). However, dosing must take into account factors such as patient age, renal function, and accompanying haemorrhagic risk. There has been considerable debate about when laboratory measurement might be appropriate and which tests should be used. A workshop at the European Medicines Agency recently discussed the evidence about laboratory measurement from formal studies, clinical experience, and the multiple perspectives on NOAC treatment, and considered how our knowledge might be further enhanced. PMID:28025213

  9. Diagnosis of food allergies: the impact of oral food challenge testing.

    PubMed

    Ito, Komei

    2013-01-01

    A diagnosis of food allergies should be made based on the observation of allergic symptoms following the intake of suspected foods and the presence of allergen-specific IgE antibodies. The oral food challenge (OFC) test is the most reliable clinical procedure for diagnosing food allergies. Specific IgE testing of allergen components as well as classical crude allergen extracts helps to make a more specific diagnosis of food allergies. The Japanese Society of Pediatric Allergy and Clinical Immunology issued the 'Japanese Pediatric Guideline for Food Allergy 2012' to provide information regarding the standardized diagnosis and management of food allergies. This review summarizes recent progress in the diagnosis of food allergies, focusing on the use of specific IgE tests and the OFC procedure in accordance with the Japanese guidelines.

  10. [Micronucleus test of human oral buccal epithelium: problems, progress and prospects].

    PubMed

    Kalaev, V N; Artiukhov, V G; Nechaeva, M S

    2014-01-01

    The articles by russian and foreign authors for the period from 2000 to 2012, devoted to the problems of application, analysis and interpretation of the results of micronucleus test in human buccal epithelium has been analyzed in the review. Nuclear abnormality founding in the cells of the oral mucosa has been described. The paper summarizes works devoted to the analysis of the influence of the micronucleus test methods (painting, taking scrapings) to its results. Modern opinions about the factors of different etiology (sex, age, genotype, psycho-physiological characteristics, immune status, diseases of different etiology, man-made pollution, climatic and geographical conditions, ionizing and nonionizing radiation, chemical compounds (drugs, dietary supplements, androgenic steroids, etc.), dental fillings, occupational exposures, alcohol, using tobacco blends) inducing the estimation of nuclear aberration has been summarized as a scheme. The problems and unresolved issues related to the peculiarities of micronucleus test has been noted.

  11. An evaluation of human immunodeficiency virus oral screening test awareness and preferences in the West region of Cameroon.

    PubMed

    Nkenfou, Celine N; Kembou, Japhette T; Djikeng, Appolinaire; Domkam, Irenee; Tchuinkam, Timoleon

    2015-01-01

    HIV serological diagnosis has evolved during the last decade to give rise to rapid testing using biological materials, such as blood or oral mucosal transudate (OMT). However, blood collection is not always welcomed, justifying the evaluation of OMT-based devices. In a cross sectional study carried out in May 2011 aimed at evaluating the level of awareness about OMT based HIV tests, questionnaires were administered to participants who consented to take part in the study. Eighty-five percent (n = 1520) of participants reported a lack of awareness of HIV oral screening before the study, and surprisingly, no association was found between the awareness of participants and their educational level (p = 0.768). There was also no association (p = 0.743) found between having had previous screening tests and awareness of oral testing. The percentage of participants who accepted the oral test before being informed about it was 31.3% (n = 1520). After sensitization, 76.3% (n = 1520)preferred oral screening for future tests (p = 0). These results reveal that if the OMT based test is affordable, its implementation as a screening tool in the general population could greatly increase participation in screening campaigns and is welcomed by those who want to self-test in a non-invasive way. This will create a better estimation of the national HIV prevalence. Its use could then have a significant public health impact on HIV prevention and clinical management.

  12. Oral Adherence Monitoring Using a Breath Test to Supplement Highly Active Antiretroviral Therapy

    PubMed Central

    Morey, Timothy E.; Booth, Matthew; Wasdo, Scott; Wishin, Judith; Quinn, Brian; Gonzalez, Daniel; Derendorf, Hartmut; McGorray, Susan P.; Simoni, Jane; Melker, Richard J.; Dennis, Donn M.

    2012-01-01

    A breath-based adherence system to document ingestion of oral medications (e.g., HAART) was investigated. Specifically, the food additive 2-butanol, which can be easily packaged with a drug, is converted via alcohol dehydrogenase to the volatile metabolite 2-butanone that rapidly appears in breath, indicating adherence. In healthy adults using a portable sensor and GC-MS, the following experiments were performed: yield of 2-butanone in breath following ingestion of 2-butanol, adherence system accuracy, and potential interference of the adherence system by food or misplacement of 2-butanol on the tongue. During feasibility testing, every subject exhaled 2-butanone with 6.6±1.5 min to peak concentrations of 548±235 ppb following ingestion of 2-butanol (40 mg). ROC areas at 5 and 10 min were 0.95 (0.86–1.00) and 3 1.00 (1.00–1.00). Food did not interfere. Tongue application resulted in large concentrations of 2-butanol, but not 2-butanone. A breath test to provide definitive evidence of oral medication adherence appears technically feasible. PMID:23001413

  13. Effect of oral anticoagulants on the outcome of faecal immunochemical test.

    PubMed

    Bujanda, L; Sarasqueta, C; Lanas, Á; Quintero, E; Cubiella, J; Hernandez, V; Morillas, J D; Perez-Fernández, T; Salas, D; Andreu, M; Carballo, F; Bessa, X; Portillo, I; Jover, R; Balaguer, F; Cosme, A; Castells, A

    2014-03-04

    We aimed to evaluate whether oral anticoagulants (OACs) alter faecal immunochemical test (FIT) performance in average-risk colorectal cancer (CRC) screening. Individuals aged 50-69 years were invited to receive one FIT sample (cutoff 75 ng ml(-1)) between November 2008 and June 2011. Faecal immunochemical test was positive in 9.3% (21 out of 224) of users of OAC and 6.2% (365 out of 5821) of non-users (P-trend=0.07). The positive predictive value (PPV) for advanced neoplasia (AN) in non-users was 50.4% vs 47.6% in users (odds ratio, 0.70; 95% CI, 0.3-1.8; P=0.5). The PPV for AN in OAC more antiplatelets (aspirin or clopidogrel) was 75% (odds ratio, 2; 95% CI, 0.4-10.8; P=0.4). Oral anticoagulant did not significantly modify the PPV for AN in this population-based colorectal screening program. The detection rate of advanced adenoma was higher in the combination OAC more antiplatelets.

  14. Effect of oral anticoagulants on the outcome of faecal immunochemical test

    PubMed Central

    Bujanda, L; Sarasqueta, C; Lanas, Á; Quintero, E; Cubiella, J; Hernandez, V; Morillas, J D; Perez-Fernández, T; Salas, D; Andreu, M; Carballo, F; Bessa, X; Portillo, I; Jover, R; Balaguer, F; Cosme, A; Castells, A

    2014-01-01

    Background: We aimed to evaluate whether oral anticoagulants (OACs) alter faecal immunochemical test (FIT) performance in average-risk colorectal cancer (CRC) screening. Methods: Individuals aged 50–69 years were invited to receive one FIT sample (cutoff 75 ng ml–1) between November 2008 and June 2011. Results: Faecal immunochemical test was positive in 9.3% (21 out of 224) of users of OAC and 6.2% (365 out of 5821) of non-users (P-trend=0.07). The positive predictive value (PPV) for advanced neoplasia (AN) in non-users was 50.4% vs 47.6% in users (odds ratio, 0.70; 95% CI, 0.3–1.8; P=0.5). The PPV for AN in OAC more antiplatelets (aspirin or clopidogrel) was 75% (odds ratio, 2; 95% CI, 0.4–10.8; P=0.4). Conclusions: Oral anticoagulant did not significantly modify the PPV for AN in this population-based colorectal screening program. The detection rate of advanced adenoma was higher in the combination OAC more antiplatelets. PMID:24496455

  15. Physical Examination of the Wrist: Useful Provocative Maneuvers.

    PubMed

    Kleinman, William B

    2015-07-01

    Chronic wrist pain resulting from partial interosseous ligament injury remains a diagnostic dilemma for many hand and orthopedic surgeons. Overuse of costly diagnostic studies including magnetic resonance imaging, computed tomography scans, and bone scans can be further frustrating to the clinician because of their inconsistent specificity and reliability in these cases. Physical diagnosis is an effective (and underused) means of establishing a working diagnosis of partial ligament injury to the wrist. Carefully performed provocative maneuvers can be used by the clinician to reproduce the precise character of a patient's problem, reliably establish a working diagnosis, and initiate a plan of treatment. Using precise physical examination techniques, the examiner introduces energy into the wrist in a manner that puts load on specific support ligaments of the carpus, leading to an accurate diagnosis. This article provides a broad spectrum of physical diagnostic tools to help the surgeon develop a working diagnosis of partial wrist ligament injuries in the face of chronic wrist pain and normal x-rays. Copyright © 2015 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  16. Introduction to provocative questions in left–right asymmetry

    PubMed Central

    Klar, Amar J. S.; Ramsdell, Ann F.

    2016-01-01

    Left–right asymmetry is a phenomenon that has a broad appeal—to anatomists, developmental biologists and evolutionary biologists—because it is a morphological feature of organisms that spans scales of size and levels of organization, from unicellular protists, to vertebrate organs, to social behaviour. Here, we highlight a number of important aspects of asymmetry that encompass several areas of biology—cell-level, physiological, genetic, anatomical and evolutionary components—and that are based on research conducted in diverse model systems, ranging from single cells to invertebrates to human developmental disorders. Together, the contributions in this issue reveal a heretofore-unsuspected variety in asymmetry mechanisms, including ancient chirality elements that could underlie a much more universal basis to asymmetry development, and provide much fodder for thought with far reaching implications in biomedical, developmental, evolutionary and synthetic biology. The new emerging theme of binary cell-fate choice, promoted by asymmetric cell division of a deterministic cell, has focused on investigating asymmetry mechanisms functioning at the single cell level. These include cytoskeleton and DNA chain asymmetry—mechanisms that are amplified and coordinated with those employed for the determination of the anterior–posterior and dorsal–ventral axes of the embryo. This article is part of the themed issue ‘Provocative questions in left–right asymmetry’. PMID:27821529

  17. Analytical evaluation of four on-site oral fluid drug testing devices.

    PubMed

    Vanstechelman, Sylvie; Isalberti, Cristina; Van der Linden, Trudy; Pil, Kristof; Legrand, Sara-Ann; Verstraete, Alain G

    2012-03-01

    The use of oral fluid (OF) as an alternative matrix for the detection of drugs of abuse has increased over the last decade, leading to the need for a rapid, simple, and reliable on-site OF testing device. Four on-site OF drug testing devices (Dräger DrugTest 5000, Cozart DDS, Mavand Rapid STAT, and Innovacon OrAlert) were evaluated on 408 volunteers at drug treatment centers. UPLC-MS-MS results were used as reference to determine sensitivity, specificity and accuracy for each device, applying Belgian legal confirmation cutoffs for benzoylecgonine, cocaine, and THC (10 ng/mL); morphine and 6-acetylmorphine (5 ng/mL); and amphetamine and 3,4-methylenedioxymethylamphetamine (25 ng/mL). Sensitivity for cocaine was 50%, 50%, 27%, and 11% for DrugTest, OrAlert, Rapid STAT, and DDS 806, respectively. For opiates, sensitivities were 84%, 73%, 77%, and 65%, respectively. For THC, the sensitivities were 81%, 23%, 43%, and 28%, respectively. For amphetamines, the sensitivities were 75%, 33%, 17%, and 67%, respectively. Specificity was >88% for opiates and THC, > 90% for amphetamines, and > 97% for cocaine. All tests showed good specificity. DrugTest had the highest sensitivity, although it was still low for some analytes.

  18. Ondansetron and promethazine have differential effects on hypothermic responses to lithium chloride administration and to provocative motion in rats

    PubMed Central

    Guimaraes, Drielle D; Andrews, Paul L R; Rudd, John A; Braga, Valdir A; Nalivaiko, Eugene

    2015-01-01

    We recently reported that provocative motion (rotation in a home cage) causes hypothermic responses in rats, similar to the hypothermic responses associated with motion sickness in humans. Many stimuli inducing emesis in species with an emetic reflex also provoke hypothermia in the rat, therefore we hypothesized that a fall in body temperature may reflect a “nausea-like” state in these animals. As rats do not possess an emetic reflex, we employed a pharmacological approach to test this hypothesis. In humans, motion- and chemically-induced nausea have differential sensitivity to anti-emetics. We thus tested whether the hypothermia induced in rats by provocative motion (rotation at 0.7 Hz) and by the emetic LiCl (63 mg/kg i.p.) have a similar differential pharmacological sensitivity. Both provocations caused a comparable robust fall in core body temperature (−1.9 ± 0.3°C and −2.0 ± 0.2°C for chemical and motion provocations, respectively). LiCl−induced hypothermia was completely prevented by ondansetron (2mg/kg, i.p., a 5-HT3 receptor antagonist that reduces cancer chemotherapy-induced nausea and vomiting), but was insensitive to promethazine (10 mg/kg, i.p., a predominantly histamine-H1 and muscarinic receptor antagonist that is commonly used to treat motion sickness). Conversely, motion-induced hypothermia was unaffected by ondansetron but promethazine reduced the rate of temperature decline from 0.20 ± 0.02 to 0.11 ± 0.03°C/min (P < 0.05) with a trend to decrease the magnitude. We conclude that this differential pharmacological sensitivity of the hypothermic responses of vestibular vs. chemical etiology in rats mirrors the observations in other pre-clinical models and humans, and thus supports the idea that a “nausea-like” state in rodents is associated with disturbances in thermoregulation. PMID:27227074

  19. ALLERGEN PROVOCATION AUGMENTS ENDOTOXIN-INDUCED NASAL INFLAMMATION IN ATOPIC ASTHMATICS

    EPA Science Inventory

    Background: Recent epidemiologic and in vivo studies have suggested that inhaled endotoxin plays an important role in asthma pathogenesis.
    Objective: The present study examines the effect of nasal allergen provocation on subsequent endotoxin challenges in subjects with atopi...

  20. The oral glucose tolerance test is frequently abnormal in patients with uncontrolled epilepsy.

    PubMed

    Vianna, J B M; Atallah, A N; Prado, G F; Valente, O; Duarte-Barros, M L; Vianna, E C S; Mello, L E A M

    2006-08-01

    The clinical efficacy of the ketogenic diet as therapy for patients with difficult-to-treat epilepsy prompted us to investigate the glucose metabolism of these patients under an oral overload of glucose, that is, in the oral glucose tolerance test (OGTT). Thirty patients (12 males, 18 females; age range: 17-59, mean: 35.1) with difficult-to-treat epilepsy, 23 patients with controlled epilepsy (11 males, 12 females; age range: 14-66, mean: 36.9), and 39 control subjects (18 males, 21 females; age range: 16-58, mean: 33.3) were evaluated with the OGTT. For patients with epilepsy, we also measured C-peptide and glycosylated hemoglobin in the fasting state. Glucose levels lower than 70 mg/dL at any point of the curve were considered to be abnormal. All subjects in the control group and the group with controlled epilepsy had a normal OGTT. In contrast, all 30 patients with difficult-to-treat epilepsy had at least one point on the OGTT curve below the normal range (P<0.001), most often 180 and 240 minutes after the oral glucose load (P<0.001). C-peptide levels were significantly lower in the group with difficult-to-treat epilepsy as compared with the group with controlled epilepsy. Fasting glycohemoglobin and insulin levels did not differ between the two patient groups. We suggest that undiagnosed metabolic disturbances in patients with difficult-to-treat epilepsy may somehow contribute to their refractoriness to conventional pharmacological therapy. We propose the hypothesis that calorie-restricted diets aimed at correcting OGTT curves may prove beneficial in treating patients with difficult-to-treat epilepsy. Our hypothesis generates a clear endpoint for the diet, and its demonstration would provide new standards for diet-based antiepileptic regimens. Accordingly, our results may help in understanding the positive consequences of ketogenic or calorie-restricted diets in persons with seizures.

  1. Effects of an oral glucose tolerance test on the myogenic response in healthy individuals.

    PubMed

    Lott, Mary E J; Hogeman, Cynthia; Herr, Michael; Gabbay, Robert; Sinoway, Lawrence I

    2007-01-01

    The myogenic response, the inherent ability of blood vessels to rapidly respond to changes in transmural pressure, is involved in local blood flow autoregulation. Animal studies suggest that both acute hyperglycemia and hyperinsulinemia may impair myogenic vasoconstriction. The purpose of this study was to examine the effects of an oral glucose load on brachial mean blood velocity (MBV) during increases in forearm transmural pressure in humans. Eight healthy men and women (38 +/- 5 yr) underwent an oral glucose tolerance test (OGTT). MBV (in cm/s; Doppler ultrasound) responses to a rise in forearm transmural pressure (arm tank suction, -50 mmHg) were studied before and every 30 min for 120 min during the OGTT. Before the start of the OGTT, MBV was lower than baseline values 30 and 60 s after the application of negative pressure. This suggests that myogenic constriction was present. During the OGTT, blood glucose rose from 88 +/- 2 to 120 +/- 6 mg/dl (P < 0.05) and insulin rose from 14 +/- 1 to 101 +/- 32 microU/ml (P < 0.05). Glucose loading attenuated the reduction in MBV with arm suction (Delta-0.73 +/- 0.14 vs. Delta-1.67 +/- 0.43 cm/s and Delta-1.07 +/- 0.14 vs. Delta-2.38 +/- 0.54 cm/s, respectively, during 30 and 60 s of suction postglucose compared with preglucose values; all P < 0.05). We observed no such time effect for myogenic responses during a sham OGTT. In an additional 5 subjects, glucose loading had no effect on brachial diameters with the application of negative pressure. Oral glucose loading leads to attenuated myogenic vasoconstriction in healthy individuals. The role that this diminished postglucose reactivity plays in mediating postprandial hypotension and/or orthostasis needs to be further explored.

  2. North Korea’s Provocation and Escalation Calculus: Dealing with the Kim Jong-un Regime

    DTIC Science & Technology

    2015-08-01

    level” provocations while minimizing risks of potential rapid conflict escalation remains a central dilemma as was demonstrated in the reaction to North...politician who is 3 comfortable manipulating the environment around him would figure greatly into how he would operate in a crisis. Will...and the United States can take to strengthen deterrence of “low-level” DPRK provocations while minimizing risks of potential rapid conflict escalation

  3. Initial Accuracy of HIV Rapid Test Kits Stored in Suboptimal Conditions and Validity of Delayed Reading of Oral Fluid Tests.

    PubMed

    Choko, Augustine T; Taegtmeyer, Miriam; MacPherson, Peter; Cocker, Derek; Khundi, McEwen; Thindwa, Deus; Sambakunsi, Rodrick S; Kumwenda, Moses K; Chiumya, Kondwani; Malema, Owen; Makombe, Simon D; Webb, Emily L; Corbett, Elizabeth L

    2016-01-01

    To evaluate the effect of storing commonly used rapid diagnostic tests above manufacturer-recommended temperature (at 37°C), and the accuracy of delayed reading of oral fluid kits with relevance to HIV self-testing programmes. A quality assurance study of OraQuick (OraSure), Determine HIV 1/2™ (Alere) and Uni-Gold™ (Recombigen®). Consecutive adults (≥18y) attending Ndirande Health Centre in urban Blantyre, Malawi in January to April 2012 underwent HIV testing with two of each of the three rapid diagnostic test kits stored for 28 days at either 18°C (optimally-stored) or at 37°C (pre-incubated). Used OraQuick test kits were stored in a laboratory for delayed day 1 and subsequent monthly re-reading was undertaken for one year. Of 378 individuals who underwent parallel testing, 5 (1.3%) were dropped from the final analysis due to discordant or missing reference standard results (optimally-stored Determine and Uni-Gold). Compared to the diagnostic reference standard, OraQuick had a sensitivity of 97.2% (95% CI: 93.6-99.6). There were 7 false negative results among all test kits stored at 37°C and three false negatives among optimally stored kits. Excellent agreement between pre-incubated tests and optimally-stored tests with Kappa values of 1.00 for Determine and Uni-Gold; and 0.97 (95% CI: 0.95; 1.00) for OraQuick were observed. There was high visual stability on re-reading of OraQuick, with only 1/375 pre-incubated and 1/371 optimally-stored OraQuick kits changing from the initial result over 12 months. Erroneous results observed during HIV testing in low income settings are likely to be due to factors other than suboptimal storage conditions. Re-reading returned OraQuick kits may offer a convenient and accurate quality assurance approach, including in HIV self-testing programmes.

  4. Interference of the new oral anticoagulant dabigatran with frequently used coagulation tests.

    PubMed

    Halbmayer, Walter-Michael; Weigel, Guenter; Quehenberger, Peter; Tomasits, Josef; Haushofer, Alexander C; Aspoeck, Gerold; Loacker, Lorin; Schnapka-Koepf, Mirjam; Goebel, Georg; Griesmacher, Andrea

    2012-01-01

    Dabigatran etexilate is a new oral anticoagulant for the therapy and prophylaxis of venous thromboembolism and stroke prevention in patients with atrial fibrillation. To investigate the extent of interactions of this new anticoagulant with frequently used coagulation assays, we completed a multicenter in vitro trial with Conformité Européenne(CE)-labeled dabigatran-spiked plasma samples. Lyophilized plasma samples with dabigatran concentrations ranging from 0.00 to 0.48 μg/mL were sent to the coagulation laboratories of six major Austrian hospitals for evaluation. Coagulation assays were performed under routine conditions using standard reagents and analyzer. Dabigatran led to a dose-dependent prolongation of the clotting times in coagulometric tests and influenced the majority of the parameters measured. Statistically significant interference could be observed with the prothrombin time (PT), activated partial thromboplastin time (aPTT) and PT/aPTT-based assays (extrinsic/intrinsic factors, APC-resistance test) as well as lupus anticoagulant testing. Even non-clotting tests, such as the colorimetric factor XIII activity assay and to a minor extent the amidolytic antithrombin activity assay (via factor IIa) were affected. This multicenter trial confirms and also adds to existing data, demonstrating that laboratories should expect to observe strong interferences of coagulation tests with increasing concentrations of dabigatran. This finding might become particularly important in the elderly and in patients with renal impairment as well as patients whose blood is drawn at peak levels of dabigatran.

  5. Biorelevant in-vitro performance testing of orally administered dosage forms.

    PubMed

    Reppas, Christos; Vertzoni, Maria

    2012-07-01

    This review focuses on the evolution and current status of biorelevant media and hydrodynamics, and discusses the usefulness of biorelevant performance testing in the evaluation of specific dosage form related lumenal processes. During the last 15 years our knowledge of the gastrointestinal environment (including the lower gut) has improved dramatically and biorelevant media composition and, to a lesser extent, biorelevant hydrodynamics, have been refined. Biorelevant dissolution/release testing is useful for the evaluation of formulation and food effects on plasma levels after administration of immediate release dosage forms containing low solubility compounds and after administration of extended release products. Lumenal disintegration times of immediate release dosage forms and the bile acid sequestering activity of resins in the lumen can also be successfully forecasted with biorelevant in vitro testing. Biorelevant in-vitro performance testing is an important tool for evaluating intralumenal dosage form performance. Since the formulation of new active pharmaceutical ingredients for oral delivery is more challenging than ever before, efforts to improve the predictability of biorelevant tests are expected to continue. © 2012 The Authors. JPP © 2012 Royal Pharmaceutical Society.

  6. Evaluation of the disintegration properties of commercial famotidine 20 mg orally disintegrating tablets using a simple new test and human sensory test.

    PubMed

    Harada, Tsutomu; Narazaki, Ryuichi; Nagira, Shinsuke; Ohwaki, Takayuki; Aoki, Shigeru; Iwamoto, Kiyoshi

    2006-08-01

    The purpose of this study was to demonstrate the usefulness and broad-applicability of a simple disintegration test method for orally disintegrating tablets (ODT). Eight types of commercial famotidine 20 mg orally disintegrating tablets with different physical properties (formulation, manufacturing method, tablet weight, shape, diameter, thickness, etc.), were used. Disintegration times of these tablets were evaluated employing human sensory test, conventional disintegration test, and the new proposed disintegration test. The human sensory test was performed in 5 healthy volunteers. In the conventional disintegration test, the disintegration apparatus described in the Japanese Pharmacopeia (JP 1(st)) was used. Our proposed new test which is characterized by a rotating shaft with a low weight (10, 15 g) and rotation speed (10, 25, 50 rpm) was evaluated using tablets with and without storage under severe conditions (60 degrees C/75%RH for 1 week). The disintegration times of famotidine 20 mg orally disintegrating tablets in human sensory test varied from 9 to 32 s. In contrast, disintegration times in the conventional test were prolonged to over 300 s. Disintegration times in the new proposed test were close to those in human sensory test. Especially, when the new test was conducted with 15 or 10 g weight and 25 rpm, the slope (human sensory test vs. new proposed test) was almost 1. We were able to demonstrate that the new proposed test was useful to estimate the actual human disintegration time.

  7. Direct oral anticoagulants and antiplatelet agents. Clinical relevance and options for laboratory testing.

    PubMed

    Sibbing, D; Spannagl, M

    2014-01-01

    Oral anticoagulants and platelet receptor blockers are widely used in clinical practice with the aim of reducing the risk of thrombotic complications in patients with cardiovascular diseases. Their regular intake and adequate antithrombotic action is vital and this is way numerous assays have been developed for laboratory testing and monitoring of these agents. Available assays can be stratified into pharmacokinetic and pharmacodynamic assays. Such assays are increasingly used in clinical routine and their daily use is triggered by the advent of the novel direct oral anticoagulants (DOACs) as an alternative for vitamin K antagonist (VKA) treatment, which are dabigatran, rivaroxaban and apixaban, and by the advent of prasugrel or ticagrelor as an alternative for clopidogrel with regard to platelet P2Y12 receptor inhibition. In this review the most important and most commonly used laboratory assays are summarized as well as their clinical implications with the focus on DOACs as an alternative for VKAs and the different P2Y12 receptor blockers for antiplatelet treatment.

  8. The Oral Trail Making Test: Effects of Age and Concurrent Validity†

    PubMed Central

    Mrazik, Marty; Millis, Scott; Drane, Daniel L.

    2010-01-01

    The oral version of the Trail Making Test (OTMT) is a neuropsychological measure that provides an assessment of sequential set-shifting without the motor and visual demands of the written TMT (WTMT). Originally purposed to serve as an oral analog of the WTMT, the OTMT provides a means to evaluate patients with physical restrictions. However, formal validity studies and available normative data remain sparse. In a sample of healthy adults (n = 81), a strong correlation was observed between OTMT-B and its written counterpart (r = .62), but the correlations were weak between OTMT-A and either written version of the TMT. OTMT-B was significantly correlated with age but not with education or gender, whereas OTMT-A was not significantly correlated with demographic factors. The WTMT to OTMT ratios observed in the current study were generally lower than previously reported and varied across age groups, suggesting that the recommended use of a uniform conversion factor to predict one performance based on the other should be cautiously undertaken. Normative data that have been stratified by age are provided as well as suggestions for using both versions of the TMT in tandem to better elucidate the nature of cognitive deficits and to aid in the localization of cerebral dysfunction. PMID:20197294

  9. High precision automated face localization in thermal images: oral cancer dataset as test case

    NASA Astrophysics Data System (ADS)

    Chakraborty, M.; Raman, S. K.; Mukhopadhyay, S.; Patsa, S.; Anjum, N.; Ray, J. G.

    2017-02-01

    Automated face detection is the pivotal step in computer vision aided facial medical diagnosis and biometrics. This paper presents an automatic, subject adaptive framework for accurate face detection in the long infrared spectrum on our database for oral cancer detection consisting of malignant, precancerous and normal subjects of varied age group. Previous works on oral cancer detection using Digital Infrared Thermal Imaging(DITI) reveals that patients and normal subjects differ significantly in their facial thermal distribution. Therefore, it is a challenging task to formulate a completely adaptive framework to veraciously localize face from such a subject specific modality. Our model consists of first extracting the most probable facial regions by minimum error thresholding followed by ingenious adaptive methods to leverage the horizontal and vertical projections of the segmented thermal image. Additionally, the model incorporates our domain knowledge of exploiting temperature difference between strategic locations of the face. To our best knowledge, this is the pioneering work on detecting faces in thermal facial images comprising both patients and normal subjects. Previous works on face detection have not specifically targeted automated medical diagnosis; face bounding box returned by those algorithms are thus loose and not apt for further medical automation. Our algorithm significantly outperforms contemporary face detection algorithms in terms of commonly used metrics for evaluating face detection accuracy. Since our method has been tested on challenging dataset consisting of both patients and normal subjects of diverse age groups, it can be seamlessly adapted in any DITI guided facial healthcare or biometric applications.

  10. Laboratory tests on the effectiveness of oral vaccination of young children against typhoid and paratyphoid A and B

    PubMed Central

    Vlădoianu, I. R.; Dimache, G.; Antohi, S.; Vlădoianu, Constanța; Zarma, Ortansa

    1965-01-01

    In Romania, pre-school children are excluded from subcutaneous inoculation with typhoid and paratyphoid A and B vaccine. The authors have therefore investigated the possibility of giving them an oral vaccine. Laboratory tests were carried out on 30 children from 3 to 7 years of age. Samples of blood serum were collected before and after vaccination and subsequently tested for (1) seroprotection in chick embryos, (2) seroprotection in white mice, (3) titration of the agglutinating antibodies, and (4) electrophoretic pattern. The results obtained showed that the oral administration of the vaccine can, under the conditions used in the test, afford a considerable degree of protection to young children. PMID:14290078

  11. Oral Fluency in the Context of Second/Foreign Language Testing: Understanding the Role of Task Structure and Formulaic Speech.

    ERIC Educational Resources Information Center

    Ejzenberg, Roseli

    A study was planned to generate a model for testing second language education that would incorporate task types to allow the display of fluency. It is argued that the display of oral fluency can be used as a selection criterion for inclusion of test items in multitask or portfolio assessment. The following three research questions were formulated:…

  12. Interpretive accuracy of the disk diffusion method for testing newer orally administered cephalosporins against Morganella morganii.

    PubMed Central

    Biedenbach, D J; Jones, R N; Erwin, M E

    1993-01-01

    Eight newer orally administered cephems (cefdinir, cefetamet, cefixime, cefpodoxime, cefprozil, ceftibuten, cefuroxime, and loracarbef) were tested against 100 clinical strains of Morganella morganii to determine the extent of serious interpretive very major (false-susceptible) errors when current criteria for the disk diffusion test are applied. Agar dilution MICs and disk diffusion tests were performed as recommended by the National Committee for Clinical Laboratory Standards (Villanova, Pa.) (NCCLS), and the methods were compared by regression analysis using the method of least squares and by error rate bounding. The following results are listed in the order of increasing error rates: cefdinir, loracarbef, and cefprozil, < or = 1% very major error; ceftibuten, 8% minor errors; cefuroxime, 21% minor errors; cefixime, cefpodoxime, and cefetamet, very major errors of 15, 24, and 36%, respectively. M. morganii produces unacceptable rates of test error with cefuroxime, cefixime, cefpodoxime, and cefetamet. The latter two cephalosporins currently have NCCLS table footnote warnings covering the problem observed with this organism. The inclusion of cefuroxime and cefixime in the NCCLS table footnote is strongly recommended. PMID:8253998

  13. Mycoprotein reduces glycemia and insulinemia when taken with an oral-glucose-tolerance test.

    PubMed

    Turnbull, W H; Ward, T

    1995-01-01

    This study investigated the effects of mycoprotein, a food produced by the continuous fermentation of Fusarium graminearum (Schwabe), on acute glycemia and insulinemia in normal healthy individuals. Subjects participated in two single-meal study periods in a crossover design. After an overnight fast, subjects were given milkshakes containing mycoprotein or a control substance, which were isoenergetic and nutrient balanced. Each milkshake contained 75 g carbohydrate, equivalent to a standard World Health Organization oral-glucose-tolerance test. Blood samples were taken fasting and at 30, 60, 90, and 120 min postprandially for the measurement of serum glucose and insulin. Glycemia was reduced postmeal after mycoprotein compared with the control and was statistically significant at 60 min (13% reduction). Insulinemia was reduced postmeal after mycoprotein compared with the control and was statistically significant at 30 min (19% reduction) and 60 min (36% reduction) postmeal. These results may be significant in the dietary treatment of diabetes.

  14. All Reading Tests Are Not Created Equal: A Comparison of the State of Texas Assessment of Academic Readiness (STAAR) and the Gray Oral Reading Test-4 (GORT-4)

    ERIC Educational Resources Information Center

    Johnson, Kary A.; Wilson, Celia M.; Williams-Rossi, Dara

    2013-01-01

    This exploratory study investigated how reading comprehension was conceptualized on the new high-stakes test, the 2011-2012 State of Texas Assessment of Academic Readiness (STAAR). Specifically, comprehension, rate, and accuracy scores on the Gray Oral Reading Test 4 (GORT-4) from a group of struggling, low-SES, Hispanic middle school students (n…

  15. Evaluation of JNJ-54717793 a Novel Brain Penetrant Selective Orexin 1 Receptor Antagonist in Two Rat Models of Panic Attack Provocation

    PubMed Central

    Bonaventure, Pascal; Dugovic, Christine; Shireman, Brock; Preville, Cathy; Yun, Sujin; Lord, Brian; Nepomuceno, Diane; Wennerholm, Michelle; Lovenberg, Timothy; Carruthers, Nicolas; Fitz, Stephanie D.; Shekhar, Anantha; Johnson, Philip L.

    2017-01-01

    Orexin neurons originating in the perifornical and lateral hypothalamic area are highly reactive to anxiogenic stimuli and have strong projections to anxiety and panic-associated circuitry. Recent studies support a role for the orexin system and in particular the orexin 1 receptor (OX1R) in coordinating an integrative stress response. However, no selective OX1R antagonist has been systematically tested in two preclinical models of using panicogenic stimuli that induce panic attack in the majority of people with panic disorder, namely an acute hypercapnia-panic provocation model and a model involving chronic inhibition of GABA synthesis in the perifornical hypothalamic area followed by intravenous sodium lactate infusion. Here we report on a novel brain penetrant, selective and high affinity OX1R antagonist JNJ-54717793 (1S,2R,4R)-7-([(3-fluoro-2-pyrimidin-2-ylphenyl)carbonyl]-N-[5-(trifluoromethyl)pyrazin-2-yl]-7-azabicyclo[2.2.1]heptan-2-amine). JNJ-54717793 is a high affinity/potent OX1R antagonist and has an excellent selectivity profile including 50 fold versus the OX2R. Ex vivo receptor binding studies demonstrated that after oral administration JNJ-54717793 crossed the blood brain barrier and occupied OX1Rs in the rat brain. While JNJ-54717793 had minimal effect on spontaneous sleep in rats and in wild-type mice, its administration in OX2R knockout mice, selectively promoted rapid eye movement sleep, demonstrating target engagement and specific OX1R blockade. JNJ-54717793 attenuated CO2 and sodium lactate induced panic-like behaviors and cardiovascular responses without altering baseline locomotor or autonomic activity. These data confirm that selective OX1R antagonism may represent a novel approach of treating anxiety disorders, with no apparent sedative effects. PMID:28649201

  16. Idiopathic environmental intolerance attributed to electromagnetic fields (formerly 'electromagnetic hypersensitivity'): An updated systematic review of provocation studies.

    PubMed

    Rubin, G James; Nieto-Hernandez, Rosa; Wessely, Simon

    2010-01-01

    Idiopathic Environmental Intolerance attributed to electromagnetic fields (IEI-EMF; formerly 'electromagetic hypersensitivity') is a medically unexplained illness in which subjective symptoms are reported following exposure to electrical devices. In an earlier systematic review, we reported data from 31 blind provocation studies which had exposed IEI-EMF volunteers to active or sham electromagnetic fields and assessed whether volunteers could detect these fields or whether they reported worse symptoms when exposed to them. In this article, we report an update to that review. An extensive literature search identified 15 new experiments. Including studies reported in our earlier review, 46 blind or double-blind provocation studies in all, involving 1175 IEI-EMF volunteers, have tested whether exposure to electromagnetic fields is responsible for triggering symptoms in IEI-EMF. No robust evidence could be found to support this theory. However, the studies included in the review did support the role of the nocebo effect in triggering acute symptoms in IEI-EMF sufferers. Despite the conviction of IEI-EMF sufferers that their symptoms are triggered by exposure to electromagnetic fields, repeated experiments have been unable to replicate this phenomenon under controlled conditions. A narrow focus by clinicians or policy makers on bioelectromagnetic mechanisms is therefore, unlikely to help IEI-EMF patients in the long-term.

  17. Evaluation of a Provocative Dyspnea Severity Score in Acute Heart Failure

    PubMed Central

    AbouEzzeddine, Omar F.; Lala, Anuradha; Khazanie, Prateeti P.; Shah, Ravi; Ho, Jennifer E.; Chen, Horng H.; Pang, Peter S.; McNulty, Steven E.; Anstrom, Kevin J.; Hernandez, Adrian F.; Redfield, Margaret M.

    2015-01-01

    Background The acute heart failure (AHF) Syndromes International Working Group proposed that dyspnea be assessed under standardized, incrementally provocative maneuvers and called for studies to assess the feasibility of this approach. We sought to assess the feasibility and statistical characteristics of a novel provocative dyspnea severity score (pDS) versus the traditional dyspnea visual analogue scale (DVAS) in an AHF trial. Methods At enrollment, 24, 48 and 72 hours, 230 ROSE-AHF patients completed a DVAS. Dyspnea was then assessed with five-point Likert dyspnea scales administered during four stages (A: upright-with O2, B: upright-without O2, C: supine-without O2 and D: exercise-without O2). Patients with moderate or less dyspnea were eligible for the next stage. Results At enrollment, oxygen withdrawal and supine provocation were highly feasible (≥97%), provoking more severe dyspnea (≥ 1 Likert point) in 24% and 42% of eligible patients respectively. Exercise provocation had low feasibility with 38% of eligible patients unable to exercise due to factors other than dyspnea. A pDS was constructed from Likert scales during the three feasible assessment conditions (A–C). Relative to DVAS, the distribution of the pDS was more skewed with a high “ceiling effect” at enrollment (23%) limiting sensitivity to change. Change in pDS was not related to decongestion or 60-day outcomes. Conclusions While oxygen withdrawal and supine provocation are feasible and elicit more severe dyspnea, exercise provocation had unacceptable feasibility in this AHF cohort. The statistical characteristics of a pDS based on feasible provocation measures do not support its potential as a robust dyspnea assessment tool in AHF. Clinical Trial Registration RED-ROSE; ClinicalTrials.gov identifier: NCT01132846 PMID:26856213

  18. Provocation of Symmetry/Ordering Symptoms in Anorexia nervosa: A Functional Neuroimaging Study

    PubMed Central

    Giampietro, Vincent; Uher, Rudolf; Mataix-Cols, David; Brammer, Michael J.; Williams, Steven C. R.; Treasure, Janet; Campbell, Iain C.

    2014-01-01

    Anorexia nervosa (AN), obsessive–compulsive disorder (OCD), and obsessive–compulsive personality disorder (OCPD) are often co-morbid; however, the aetiology of such co-morbidity has not been well investigated. This study examined brain activation in women with AN and in healthy control (HC) women during the provocation of symmetry/ordering-related anxiety. During provocation, patients with AN showed more anxiety compared to HCs, which was correlated with the severity of symmetry/ordering symptoms. Activation in the right parietal lobe and right prefrontal cortex (rPFC) in response to provocation was reduced in the AN group compared with the HC group. The reduced right parietal activation observed in the AN group is consistent with parietal lobe involvement in visuospatial cognition and with studies of OCD reporting an association between structural abnormalities in this region and the severity of ‘ordering’ symptoms. Reduced rPFC activation in response to symmetry/ordering provocation has similarities with some, but not all, data collected from patients with AN who were exposed to images of food and bodies. Furthermore, the combination of data from the AN and HC groups showed that rPFC activation during symptom provocation was inversely correlated with the severity of symmetry/ordering symptoms. These data suggest that individuals with AN have a diminished ability to cognitively deal with illness-associated symptoms of provocation. Furthermore, our data also suggest that symptom provocation can progressively overload attempts by the rPFC to exert cognitive control. These findings are discussed in the context of the current neurobiological models of AN. PMID:24844926

  19. A screening trial of Helicobacter pylori-specific antigen tests in saliva to identify an oral infection.

    PubMed

    Yee, Kuo Ching; Wei, M H; Yee, Hsian Ching; Everett, Karin D E; Yee, Hsian Pei; Hazeki-Talor, Noriko

    2013-01-01

    Helicobacter pylori infection places a heavy burden on medical and economic resources. Standard diagnosis requires the presence of established H. pylori gastric disease. A multicenter screening trial assessing 2 immunochromatographic H. pylori antigen oral tests was carried out with 201 participants. The analysis also included a urea breath test (UBT), a Campylobacter-like organism test, silver stain, culture, serology, and stool tests. The participants were grouped into UBT positive (UBT+) and UBT negative (UBT-) people, using conventional methods with congruent clusters based on p values from McNemar's paired χ2 analysis and 95% CI estimates. Both oral tests were also positive in 82% of the seropositive UBT- people. However, oral antigen and seroprevalence divided UBT- people into 2 statistically separate CI subgroups: the UBT- symptomatic (highly positive) group and the UBT- asymptomatic (mostly negative) group. 90.5% of all people whose oral tests were both negative were also UBT-. Saliva H. pylori antigen is an important indicator in UBT- asymptomatic patients. Currently, its clinical significance remains uncertain, but saliva may be a reservoir from where H. pylori is transmitted to the stomach. In symptomatic patients, it is strongly associated with stomach infection. Copyright © 2013 S. Karger AG, Basel.

  20. Factor structure of a conceptual model of oral health tested among 65-year olds in Norway and Sweden.

    PubMed

    Astrøm, Anne Nordrehaug; Ekbäck, Gunnar; Ordell, Sven

    2010-04-01

    No studies have tested oral health-related quality of life models in dentate older adults across different populations. To test the factor structure of oral health outcomes within Gilbert's conceptual model among 65-year olds in Sweden and Norway. It was hypothesized that responses to 14 observed indicators could be explained by three correlated factors, symptom status, functional limitations and oral disadvantages, that each observed oral health indicator would associate more strongly with the factor it is supposed to measure than with competing factors and that the proposed 3-factor structure would possess satisfactory cross-national stability with 65-year olds in Norway and Sweden. In 2007, 6078 Swedish- and 4062 Norwegian adults borne in 1942 completed mailed questionnaires including oral symptoms, functional limitations and the eight item Oral Impacts on Daily Performances inventory. Model generation analysis was restricted to the Norwegian study group and the model achieved was tested without modifications in Swedish 65-year olds. A modified 3-factor solution with cross-loadings, improved the fit to the data compared with a 2-factor- and the initially proposed 3-factor model among the Norwegian [comparative fit index (CFI) = 0.97] and Swedish (CFI = 0.98) participants. All factor loadings for the modified 3-factor model were in the expected direction and were statistically significant at CR > 1. Multiple group confirmatory factor analyses, with Norwegian and Swedish data simultaneously revealed acceptable fit for the unconstrained model (CFI = 0.97), whereas unconstrained and constrained models were statistically significant different in nested model comparison. Within construct validity of Gilbert's model was supported with Norwegian and Swedish 65-year olds, indicating that the 14-item questionnaire reflected three constructs; symptom status, functional limitation and oral disadvantage. Measurement invariance was confirmed at the level of factor structure

  1. Acute fructose administration decreases the glycemic response to an oral glucose tolerance test in normal adults.

    PubMed

    Moore, M C; Cherrington, A D; Mann, S L; Davis, S N

    2000-12-01

    In animal models, a small (catalytic) dose of fructose administered with glucose decreases the glycemic response to the glucose load. Therefore, we examined the effect of fructose on glucose tolerance in 11 healthy human volunteers (5 men and 6 women). Each subject underwent an oral glucose tolerance test (OGTT) on 2 separate occasions, at least 1 week apart. Each OGTT consisted of 75 g glucose with or without 7.5 g fructose (OGTT+F or OGTT-F), in random order. Arterialized blood samples were obtained from a heated dorsal hand vein twice before ingestion of the carbohydrate and every 15 min for 2 h afterward. The area under the curve (AUC) of the change in plasma glucose was 19% less in OGTT+F vs. OGTT-F (P: < 0.05). Glucose tolerance was improved by fructose in 9 subjects and worsened in 2. All 6 subjects with the largest glucose AUC during OGTT-F had a decreased response during OGTT+F (31 +/- 5% decrease). The insulin AUC did not differ between the 2 studies. Of the 9 subjects with improved glucose tolerance during the OGTT+F, 5 had smaller insulin AUC during the OGTT+F than the OGTT-F. Plasma glucagon concentrations declined similarly during OGTT-F and OGTT+F. The blood lactate response was about 50% greater during the OGTT+F (P: < 0.05). Neither nonesterified fatty acid nor triglyceride concentrations differed between the two OGTT. In conclusion, low dose fructose improves the glycemic response to an oral glucose load in normal adults without significantly enhancing the insulin or triglyceride response. Fructose appears most effective in those normal individuals who have the poorest glucose tolerance.

  2. Thermal effects of mobile phone RF fields on children: a provocation study.

    PubMed

    Lindholm, Harri; Alanko, Tommi; Rintamäki, Hannu; Kännälä, Sami; Toivonen, Tommi; Sistonen, Heli; Tiikkaja, Maria; Halonen, Janne; Mäkinen, Tero; Hietanen, Maila

    2011-12-01

    The aim of this study was to examine thermal and local blood flow responses in the head area of the preadolescent boys during exposure to radiofrequency (RF) electromagnetic fields produced by a GSM mobile phone. The design was a double-blinded sham-controlled study of 26 boys, aged 14-15 years. The SAR distribution was calculated and modelled in detail. The duration of the sham periods and exposures with GSM 900 phone was 15 min each, and the tests were carried out in a climatic chamber in controlled thermoneutral conditions. The ear canal temperatures were registered from both ear canals, and the skin temperatures at several sites of the head, trunk and extremities. The local cerebral blood flow was monitored by a near-infrared spectroscopy (NIRS), and the autonomic nervous system function by recordings of ECG and continuous blood pressure. During the short-term RF exposure, local cerebral blood flow did not change, the ear canal temperature did not increase significantly and autonomic nervous system was not interfered. The strengths of this study were the age of the population, multifactorial physiological monitoring and strictly controlled thermal environment. The limitations of the study were large inter-individual variation in the physiological responses, and short duration of the exposure. Longer provocation protocols, however, might cause in children distress related confounding physiological responses. Copyright © 2011 Elsevier Ltd. All rights reserved.

  3. The Novaco Anger Scale-Provocation Inventory (1994 version) in Dutch forensic psychiatric patients.

    PubMed

    Hornsveld, Ruud H J; Muris, Peter; Kraaimaat, Floris W

    2011-12-01

    We examined the psychometric properties of the Novaco Anger Scale-Provocation Inventory (NAS-PI, 1994 version) in Dutch violent forensic psychiatric patients and secondary vocational students. A confirmatory factor analysis of the subscale structure of the NAS was carried out, reliability was investigated, and relations were calculated between NAS-PI scores and other measures of personality traits and problem behaviors. The 3-subscale structure of the original NAS could not be confirmed. However, the internal consistency of the NAS and the PI was excellent, and the test-retest reliability of the NAS was good. The validity of the NAS and the PI was supported by a meaningful pattern of correlations with alternative measures of anger and personality traits. Forensic psychiatric outpatients displayed higher NAS scores than secondary vocational students, but inpatients scored even lower than this nonclinical control group. Our preliminary conclusion is that the NAS-PI is a valuable instrument for the assessment of anger in Dutch violent forensic psychiatric patients.

  4. Orally administered whole egg demonstrates antidepressant-like effects in the forced swimming test on rats.

    PubMed

    Nagasawa, Mao; Otsuka, Tsuyoshi; Ogino, Yumi; Yoshida, Junki; Tomonaga, Shozo; Yasuo, Shinobu; Furuse, Mitsuhiro

    2014-08-01

    Several studies have reported that vegetarian diets are associated with a higher prevalence of major depression. Therefore, we hypothesised that the consumption of animal products, especially eggs, may have positive effects on mental health, especially on major depression, because a previous study reported that egg consumption produces numerous beneficial effects in humans. The purpose of the present study was to evaluate the effects of chronic whole-egg treatment on depression-like behaviours in Wistar rats, a control strain, and Wistar Kyoto rats, an animal model of depression. In both the rats, either whole-egg solution (5 ml/kg) or distilled water (5 ml/kg) was orally administrated for 35 days. During these periods, the open-field test (OFT) was conducted on the 21st day, and a forced swimming test (FST) was enforced on the 27th and 28th days. On the 36th day, the plasma and brain were collected. Chronic whole-egg treatment did not affect line crossing in the OFT, whereas it reduced the total duration of immobility in the FST on both strains. Furthermore, interestingly, the results indicated the possibility that whole-egg treatment elevated the incorporation of tryptophan into the brain, and the tryptophan concentration in the prefrontal cortex was actually increased by the treatment. This study demonstrated that whole-egg treatment exerts an antidepressant-like effect in the FST. It is suggested that whole egg may be an excellent food for preventing and alleviating the conditions of major depression.

  5. Is There a Threshold Oral Glucose Tolerance Test Value for Predicting Adverse Pregnancy Outcome?

    PubMed

    Stuebe, Alison M; Landon, Mark B; Lai, Yinglei; Klebanoff, Mark; Ramin, Susan M; Wapner, Ronald J; Varner, Michael W; Rouse, Dwight J; Sciscione, Anthony; Catalano, Patrick; Saade, George; Sorokin, Yoram; Peaceman, Alan M

    2015-07-01

    This study aims to determine whether there is a threshold 3-hour oral glucose tolerance test (OGTT) value associated with accelerated risk of adverse pregnancy outcomes. In a secondary analysis of a cohort of women with untreated mild gestational glucose intolerance, we used generalized additive models with smoothing splines to explore nonlinear associations between each of the 3-hour OGTT values (fasting, 1-hour, 2-hour, and 3-hour) and adverse pregnancy outcomes, including the study's composite outcome (perinatal mortality, hypoglycemia, hyperbilirubinemia, neonatal hyperinsulinemia, and/or birth trauma), large for gestational age birth weight, small for gestational age birth weight, shoulder dystocia, neonatal hypoglycemia, gestational hypertension (gHTN), and preeclampsia. Among the 1,360 eligible women, each timed OGTT value was linearly associated with increased odds of composite adverse outcome. We found evidence of a departure from linearity only for the association between fasting glucose and gHTN/preeclampsia, with a stronger association for values of 85 to 94 mg/dL (p = 0.03). We found no evidence of departure from linearity for any other OGTT values and measured outcomes (all chi-square test p-values ≥ 0.05). In a population of untreated women with mild gestational glucose intolerance and fasting OGTT < 95 mg/dL, we found an increasing risk of gHTN with a fasting glucose between 85 and 94 mg/dL. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  6. Point of care HIV testing with oral fluid among returnee migrants in a rural area of Bangladesh

    PubMed Central

    Alam, Md Shah; Khan, Sharful I.; Reza, Masud; Shahriar, Ahmed; Sarker, Md Safiullah; Rahman, Anisur; Rahman, Mustafizur; Azim, Tasnim

    2016-01-01

    Objectives To determine HIV prevalence and assess the acceptability of HIV testing using oral fluid as a point of care (PoC) test method among returnee migrants in a rural area of Bangladesh. Design A cross-sectional study. Methods Matlab is a rural area southeast of Dhaka where icddr,b hosts a health and demographic surveillance system covering 225 826 people of whom 934 are returnee migrants. The sample size of 304 was proportionately distributed among randomly selected households. HIV antibodies in oral fluid were tested using OraQuick Rapid HIV 1/2 antibody test. To understand reasons of acceptability a short questionnaire was applied and 32 in-depth interviews were conducted. Results Of 304 returnee migrants approached, 97.4% accepted the test. The prevalence of HIV was 0.3% without a confirmatory blood test. Reasons for acceptance included easy accessibility of the test at the door-step which saved resources (i.e., time and money), comfortable test-procedure without any pain and fear, and receiving quick results with confidentiality. Some described knowing HIV status as a way to ‘get certified’ (of sexual fidelity) and to confront a prevailing silent stigma against migrants. Acceptability was moreover found to be grounded in icddr,b's institutional reputation and its close relationship with the local community. Conclusions The PoC oral fluid test for HIV has shown for the first time that assessment of HIV prevalence in rural-based returnee migrants is possible. Findings also suggest that PoC oral fluid test has the potential of increasing accessibility to HIV testing as it was found to be highly acceptable. PMID:26945144

  7. Oral Fluid Testing for Cocaine: Analytical Evaluation of Two Point-of-Collection Drug Screening Devices.

    PubMed

    Scherer, Juliana Nichterwitz; Fiorentin, Taís Regina; Sousa, Tanara Rosangela Vieira; Limberger, Renata Pereira; Pechansky, Flavio

    2017-06-01

    The use of point-of-collection testing (POCT) devices for drugs of abuse in oral fluid (OF) is an advantageous tool that has been used for different purposes-particularly traffic enforcement. However, even with the widespread report of cocaine consumption, the reliability of POCT devices has been reported in different magnitudes. This study evaluated the reliability of two POCT devices for the detection of cocaine in OF samples of 110 cocaine users: (i) the DDS2™ (cutoff = 30 ng/mL) and (ii) the Multi-Drugs Multi-Line-Twist Screen Test Device™ (MDML) (cutoff = 20 ng/mL). Results of the screening tests were compared with a Liquid Chromatography-Mass Spectrometry (LC-MS) assay. Sensitivity, specificity and accuracy of DDS2™ were 100, 77.77 and 80% when compared with LC-MS with a cutoff of 30 ng/mL, and 88.89, 89.15 and 89.09% with a cutoff of 10 ng/mL. The MDML™ device achieved sensitivity, specificity and accuracy of 100, 65.6 and 70.9% when compared with LC-MS with a cutoff of 20 ng/mL, and 92.6, 71.1 and 76.6% with a cutoff of 10 ng/mL. When compared with a 10 ng/mL cutoff, the DDS2™ achieved reliability parameters higher than 80%. On the other hand, the MDML™ device did not achieve the minimal recommendation of 80% for all parameters at the same time. Taking into consideration the reliability results showed here, the authors believe that the use of these POCT devices seems to be suitable for cocaine detection in forensic tests only if all positive specimens are further confirmed by a validated method. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  8. Sensitization to Food Additives in Patients with Allergy: A Study Based on Skin Test and Open Oral Challenge.

    PubMed

    Moghtaderi, Mozhgan; Hejrati, Zinatosadat; Dehghani, Zahra; Dehghani, Faranak; Kolahi, Niloofar

    2016-06-01

    There has been a great increase in the consumption of various food additives in recent years. The purpose of this study was to identify the incidence of sensitization to food additives by using skin prick test in patients with allergy and to determine the concordance rate between positive skin tests and oral challenge in hypersensitivity to additives. This cross-sectional study included 125 (female 71, male 54) patients aged 2-76 years with allergy and 100 healthy individuals. Skin tests were performed in both patient and control groups with 25 fresh food additives. Among patients with allergy, 22.4% showed positive skin test at least to one of the applied materials. Skin test was negative to all tested food additives in control group. Oral food challenge was done in 28 patients with positive skin test, in whom 9 patients showed reaction to culprit (Concordance rate=32.1%). The present study suggested that about one-third of allergic patients with positive reaction to food additives showed positive oral challenge; it may be considered the potential utility of skin test to identify the role of food additives in patients with allergy.

  9. Strong Correlation of Upper-Extremity Blood-Flow Volume With Grip Strength While in a Provocative Shoulder Position in Baseball Pitchers.

    PubMed

    Laudner, Kevin; Vazquez, Jose; Selkow, Noelle; Meister, Keith

    2017-07-01

    Baseball players, specifically pitchers, with symptomatic neurovascular occlusion often initially complain of arm fatigue and loss of ball control and velocity. As the compression continues complaints may manifest in dull pain, paresthesia, and decreased grip strength. To determine the correlation between upper-extremity blood-flow volume and grip strength among baseball pitchers. Cross-sectional. Athletic training room. 66 professional baseball pitchers (age 21.6 ± 2.0 y, height 186.9 ± 5.7 cm, mass 91.3 ± 10.9 kg) before the start of spring training. Diagnostic ultrasound was used to measure upper-extremity blood-flow volume with the throwing shoulder in a resting position and in a provocative position. Grip strength was measured with participants seated and their throwing-arm elbow flexed to 90°. Pearson product-moment correlation coefficients were used to determine the strength of the relationships between blood-flow volume in the 2 arm positions and grip strength (P < .05). No significant relationship was found between blood-flow volume in the resting position and grip strength (r = .03, P = .81); however, a strong positive correlation was found in the 2nd provocative position (r = .67, P = .001). This relationship indicates that as blood-flow volume tested in a provocative shoulder position decreases, so does grip strength. A strong positive relationship was found in pitchers, demonstrating that as upper-extremity blood-flow volume while in the provocative shoulder position decreases, so does grip strength.

  10. An Examination of Rater Performance on a Local Oral English Proficiency Test: A Mixed-Methods Approach

    ERIC Educational Resources Information Center

    Yan, Xun

    2014-01-01

    This paper reports on a mixed-methods approach to evaluate rater performance on a local oral English proficiency test. Three types of reliability estimates were reported to examine rater performance from different perspectives. Quantitative results were also triangulated with qualitative rater comments to arrive at a more representative picture of…

  11. The Effects of Different Lengths of Pretask Planning Time on L2 Learners' Oral Test Performance

    ERIC Educational Resources Information Center

    Li, Lanlan; Chen, Jiliang; Sun, Lan

    2015-01-01

    The effect of planning on second language (L2) learners' oral performance is a hotly debated topic in the field of second language acquisition. However, studies on the effect of different amounts of planning time have been quite limited, especially in a testing context. The present study investigated the effects of different lengths of…

  12. Rater Effects in ITA Testing: ESL Teachers' versus American Undergraduates' Judgments of Accentedness, Comprehensibility, and Oral Proficiency

    ERIC Educational Resources Information Center

    Hsieh, Ching-Ni

    2011-01-01

    Second language (L2) oral performance assessment always involves raters' subjective judgments and is thus subject to rater variability. The variability due to rater characteristics has important consequential impacts on decision-making processes, particularly in high-stakes testing situations (Bachman, Lynch, & Mason, 1995; A. Brown, 1995;…

  13. The Effects of Different Lengths of Pretask Planning Time on L2 Learners' Oral Test Performance

    ERIC Educational Resources Information Center

    Li, Lanlan; Chen, Jiliang; Sun, Lan

    2015-01-01

    The effect of planning on second language (L2) learners' oral performance is a hotly debated topic in the field of second language acquisition. However, studies on the effect of different amounts of planning time have been quite limited, especially in a testing context. The present study investigated the effects of different lengths of…

  14. Rater Effects in ITA Testing: ESL Teachers' versus American Undergraduates' Judgments of Accentedness, Comprehensibility, and Oral Proficiency

    ERIC Educational Resources Information Center

    Hsieh, Ching-Ni

    2011-01-01

    Second language (L2) oral performance assessment always involves raters' subjective judgments and is thus subject to rater variability. The variability due to rater characteristics has important consequential impacts on decision-making processes, particularly in high-stakes testing situations (Bachman, Lynch, & Mason, 1995; A. Brown, 1995;…

  15. Amantadine reduces glucagon and enhances insulin secretion throughout the oral glucose tolerance test: central plus peripheral nervous system mechanisms

    PubMed Central

    Lechin, Fuad; van der Dijs, Bertha; Pardey-Maldonado, Betty; Rivera, Jairo E; Lechin, Marcel E; Baez, Scarlet

    2009-01-01

    Objective The purpose of the trial was to examine the effects of amantadine, a N-methyl-D-aspartate (NMDA) antagonist, on the oral glucose tolerance test (OGTT) plus insulin, glucagon and neurotransmitters circulating levels. Previous findings showed that hyperinsulinism and type 2 diabetes are positively associated with neural sympathetic and adrenal sympathetic activities, respectively. These peripheral sympathetic branches depend on the pontine (A5-noradrenergic) and the rostral ventrolateral (C1-adrenergic) medullary nuclei. They are excited by glutamate axons which act at NMDA postsynaptic receptors. Research design and methods One OGTT plus placebo and one OGTT plus oral amantadine test were carried out two weeks apart in 15 caucasic normal voluntary humans. Noradrenaline, adrenaline, dopamine, plasma-free serotonin, platelet serotonin, glucose, glucagon, and insulin were measured throughout the 180-minute testing period. Results Maximal reductions of plasma glucose and glucagon plus exacerbated insulin rises were significantly greater throughout the oral glucose plus amantadine test than those registered throughout the oral glucose plus placebo challenge. The above findings were paralleled by greater than normal noradrenaline/adrenaline plasma ratio increases. In addition, maximal reductions of the platelet serotonin and plasma serotonin circulating values contrasted with the normal rises of these parameters, always registered during the glucose load plus placebo challenge. Conclusion This study supports the theory that amantadine might be a powerful antidiabetic tool and could be added to the therapeutic arsenal against type 2 diabetes. PMID:21437134

  16. Test of three bait types for oral immunization of dogs against rabies in Tunisia.

    PubMed

    Matter, H C; Kharmachi, H; Haddad, N; Ben Youssef, S; Sghaier, C; Ben Khelifa, R; Jemli, J; Mrabet, L; Meslin, F X; Wandeler, A I

    1995-06-01

    Chicken heads and two types of artificial bait were tested in Tunisia during two field trials in a waste disposal site carried out in 1988 and 1989 to compare their effectiveness as vehicles for the oral administration of antirabies vaccine to free-roaming dogs. Baits were made available for 36 hr and those that disappeared or were consumed were replaced on several occasions. In 1988, an artificial bait composed of fat and fishmeal (artificial bait type I) was tested. In the second trial, chicken heads and an artificial bait composed of polymerized fishmeal and wax (artificial bait type II) were compared. The vaccine containers were loaded with a topical marker (rhodamine B or methylene blue) to identify animals that had consumed baits. The artificial type I bait tested in 1988 was poorly accepted, but in the second trial, the number of chicken-head baits probably taken by dogs was more than seven times greater than the number of artificial type II baits taken. Thirteen dogs observed during the day showed topical marker staining. In both trials, most baits were taken during the night when dog activity in the waste disposal site was at its maximum. Artificial baits were characterized either by their lack of thermostability (type I, melting) or a certain attractiveness for cats (type II, fish flavor). Chicken heads fulfill established requirements for baits for vaccine delivery. They are well-accepted by free-roaming dogs, inexpensive, usually easily available at local markets, unattractive to humans, relatively easy to store in large quantities, and easy to handle.

  17. Identifying responsiveness to oral P2Y12 receptor blockers: platelet function assays and genetic tests.

    PubMed

    Valgimigli, Marco

    2013-12-01

    Some patients with acute coronary syndromes and/or who are undergoing percutaneous coronary interventions (PCI) remain at risk for cardiovascular events despite antiplatelet treatment with clopidogrel. This may be due, at least in part, to high residual on-treatment platelet reactivity (PR). Given the potential seriousness of an incomplete response to treatment, there is a need for a simple, rapid and reproducible point-of-care method to determine the patient's response to clopidogrel in order to tailor treatment in routine clinical practice. Among the available assays to measure the degree of platelet inhibition, the VerifyNow P2Y12 system is a simple test based on agglutination of fibrinogen-coated beads. Numerous studies have used this system to assess on-clopidogrel PR in an attempt to define a reliable cut-off for identifying patients at risk for a cardiovascular event. Despite substantial evidence to support a role for PR testing in routine clinical practice to stratify the risk of cardiovascular events in patients who undergo PCI, definitive clinical evidence is still lacking for the utility using PR data to tailor clopidogrel treatment. Issues include the risk profile of patients enrolled in studies, the timing of assessment of PR and the fact that PR has been shown to change over time. Genetic susceptibility may explain some of the variability in PR, and genetic testing could provide additional information for clinical decision-making. Nevertheless, until new evidence from well designed clinical studies is available, the implementation of current treatment guidelines and the administration of newer, more potent oral P2Y12 receptor blockers remains the standard-of-care.

  18. Oral versus Written Assessments: A Test of Student Performance and Attitudes

    ERIC Educational Resources Information Center

    Huxham, Mark; Campbell, Fiona; Westwood, Jenny

    2012-01-01

    Student performance in and attitudes towards oral and written assessments were compared using quantitative and qualitative methods. Two separate cohorts of students were examined. The first larger cohort of students (n = 99) was randomly divided into "oral" and "written" groups, and the marks that they achieved in the same…

  19. Oral allergy syndrome--the need of a multidisciplinary approach.

    PubMed

    Kelava, Nikolina; Lugović-Mihić, Liborija; Duvancić, Tomislav; Romić, Renata; Situm, Mirna

    2014-06-01

    Oral allergy syndrome (OAS) is one of the most common types of food allergy. The syndrome includes itching and swelling of the lips, palate and tongue, usually after consuming fresh fruits and vegetables. The underlying pathogenic mechanism is cross-reactivity between IgE antibodies specific to pollen, and antigens in food, such as fresh fruits, vegetables and nuts that are structurally similar to pollen. Both pollen and food antigens can bind to IgE and trigger type I immune reaction. Diagnosis is primarily based on the patient's history, and confirmed by skin tests, in vitro tests, and oral provocation tests. Differential diagnoses include many diseases (such as burning mouth syndrome, angioedema, hay fever, various other oral diseases, etc.), and for this reason a multidisciplinary approach is necessary, as different specialists need to be involved in the diagnostic procedure. Therapy includes avoiding, or thermal processing of, fruit and vegetables known to trigger a reaction, and antihistamine medications. If a more severe anaphylactic reaction develops, more aggressive therapy is required. The goal of this article is to present OAS, its etiopathogenesis, clinical picture, and symptoms, diagnostic approach and therapy for OAS.

  20. Estimation of parameters for the elimination of an orally administered test substance with unknown absorption.

    PubMed

    Vogt, Josef A; Denzer, Christian

    2013-04-01

    Assessment of the elimination of an oral test dose based on plasma concentration values requires correction for the effect of gastric release and absorption. Irregular uptake processes should be described 'model independently', which requires estimation of a large number of absorption parameters. To limit the associated computational effort a new approach is developed with a reduced number of unknown parameters. A marginalized and regularized absorption approach (MRA) is defined, which uses for the uptake just one parameter to control rigidity of the uptake curve. For validation, elimination and absorption were reproduced using published IVIVC data and a synthetic data set for comparison with approaches using a 'model-free'--staircase function or mechanistic models to describe absorption. MRA performed almost as accurate as well specified mechanistic models, which gave the best reproduction. MRA demonstrated a 50fold increase in computational efficiency compared to other approaches. The absorption estimated for the IVIVC study demonstrated an in vivo-in vitro correlation comparable to published values. The newly developed MRA approach can be used to efficiently and accurately estimate elimination and absorption with a restricted number of adaptive parameters and with automatic adjustment of the complexity of the uptake.

  1. Prevalence of diabetes in Catalonia (Spain): an oral glucose tolerance test-based population study.

    PubMed

    Castell, C; Tresserras, R; Serra, J; Goday, A; Lloveras, G; Salleras, L

    1999-01-01

    The goal of this study was to investigate the prevalence of diabetes mellitus and impaired glucose tolerance in the adult population of Catalonia and study their association with obesity, central obesity, hypertension and smoking habit. A random sample of 3839 subjects aged 30-89 years participated in this cross-sectional study: 2214 subjects underwent a health examination with oral glucose tolerance test (OGTT) and 1625 were interviewed by phone. Diabetes prevalence (known and unknown) in the 30-89-year-old population was 10.3%, (95% CI: 9.1-11.6). In this age group, the prevalence rates of known diabetes, unknown diabetes and impaired glucose tolerance were 6.4, 3.9 and 11.9% in men and 6.9, 3.4 and 11.9% in women. The age adjusted prevalence to the world population for the 30-64-year-old age group was 6.1% (7.1% in men and 5.2% in women).The factors significantly associated with diabetes were age, obesity, hypertension and family history of diabetes. The high ratio of previously known diabetic cases to newly discovered ones, specially in the oldest age group, suggests good levels of awareness and medical services. The prevalence in Catalonia is similar to that observed in other Mediterranean countries.

  2. A comparison of zinc sulfate and oxide absorption in humans using an oral zinc tolerance test

    SciTech Connect

    English-Westcott, J.L.; Hambidge, K.M.; Ellenbogen, L. Lederle Labs., Pearl River, NY )

    1991-03-15

    The objective of this study was to compare the absorption of zinc from zinc sulfate and zinc oxide, two compounds that are used frequently for zinc supplementation. Absorption of zinc was estimated by an oral zinc tolerance test. At three to five day intervals, each of 16 subjects received either 40 mg of zinc as sulfate, 40 mg of zinc as oxide or 80 ml of water alone. These were administered in a random order, at 0700 hours after a ten hour fast. Plasma zinc was measured at 0, 1, 2, 3, 4, 5, and 6 hours. The areas under the curve were compared in three ways: actual mean plasma zinc values, mean change from the baseline in plasma zinc values, and plasma zinc values after subtracting the control values. The peak plasma zinc, mean {plus minus} SD, occurred two hours after ingestion of the capsules. No increase in plasma zinc values occurred during the control treatment. No significant difference was observed between the response to zinc oxide and zinc sulfate, although both were significantly different from the control treatment. It is concluded that equivalent doses of zinc sulfate and zinc oxide can be used to administer zinc supplementation.

  3. A preliminary report on oral fat tolerance test in rhesus monkeys

    PubMed Central

    2014-01-01

    Background Oral fat tolerance test (OFTT) has been widely used to assess the postprandial lipemia in human beings, but there is few studies concerning OFTT in nonhuman primates. This study is designed to explore the feasibility of OFTT in rhesus monkeys. Methods In a cross-over study, a total of 8 adult female rhesus monkeys were fed with normal monkey diet (NND), high sugar high fat diet (HHD), and extremely high fat diet (EHD), respectively. Each monkey consumed NND, HHD and EHD respectively, each weighing 60 g. Serial blood samples were collected at 1, 2, 3, 4, 5, and 6 h after ingesting each kind of food. Triglyceride, cholesterol, glucose, and insulin at each time point were measured. The area under the curve of triglyceride (TG-AUC) and triglyceride peak response (TG-PR) were also calculated. Results All monkeys ingested 3 kinds of foods within 15 minutes. TG-AUC and TG-PR of HHD group were higher than those of the other two groups. Postprandial triglyceride levels at 2, 3, 4, and 5 hours in HHD group during OFTT were also higher than those in NND and EHD group. Conclusions HHD diet can be used in OFTT for nonhuman primates. PMID:24410972

  4. An integrated glucose-insulin model to describe oral glucose tolerance test data in healthy volunteers.

    PubMed

    Silber, Hanna E; Frey, Nicolas; Karlsson, Mats O

    2010-03-01

    The extension of the previously developed integrated models for glucose and insulin (IGI) to include the oral glucose tolerance test (OGTT) in healthy volunteers could be valuable to better understand the differences between healthy individuals and those with type 2 diabetes mellitus (T2DM). Data from an OGTT in 23 healthy volunteers were used. Analysis was based on the previously developed intravenous model with extensions for glucose absorption and incretin effect on insulin secretion. The need for additional structural components was evaluated. The model was evaluated by simulation and a bootstrap. Multiple glucose and insulin concentration peaks were observed in most individuals as well as hypoglycemic episodes in the second half of the experiment. The OGTT data were successfully described by the extended basic model. An additional control mechanism of insulin on glucose production improved the description of the data. The model showed good predictive properties, and parameters were estimated with good precision. In conclusion, a previously presented integrated model has been extended to describe glucose and insulin concentrations in healthy volunteers following an OGTT. The characterization of the differences between the healthy and diabetic stages in the IGI model could potentially be used to extrapolate drug effect from healthy volunteers to T2DM.

  5. Oral glucose tolerance test effects on endothelial inflammation markers in healthy subjects and diabetic patients.

    PubMed

    Derosa, G; D'Angelo, A; Salvadeo, S A T; Ferrari, I; Fogari, E; Gravina, A; Mereu, R; Palumbo, I; Maffioli, P; Randazzo, S; Cicero, A F G

    2010-01-01

    The aim of this study was to evaluate the effect of an oral glucose tolerance test (OGTT) on the level of endothelial dysfunction and vascular inflammation markers in healthy subjects (H) and diabetic overweight patients (D). We enrolled 256 healthy subjects and 274 type 2 diabetic patients. We evaluated blood glucose (BG), soluble intercellular adhesion molecule-1 (sICAM-1), interleukin-6 (IL-6), high-sensitivity C reactive protein (hsCRP), soluble vascular cell adhesion molecule-1 (sVCAM-1), soluble E-selectin (sE-selectin), and tumor necrosis factor-alpha (TNF-alpha) at baseline and after OGTT. We observed that BG, sICAM-1, IL-6, hs-CRP, sVCAM-1, sE-selectin, and TNF-alpha values were higher in D group than in H group. In a large sample of adult healthy subjects and type 2 diabetics we observed that both answer to an OGTT with a significant increase in biomarkers of systemic low-grade inflammation and endothelial dysfunction such as hsCRP, IL-6, TNF-alpha, sICAM-1, sVCAM-1, and sE-selectin. Type 2 diabetics experienced, however, a more significant increase in TNF-alpha, and sE-selectin.

  6. Validation of insulin sensitivity indices from oral glucose tolerance test parameters in obese children and adolescents.

    PubMed

    Yeckel, Catherine W; Weiss, Ram; Dziura, James; Taksali, Sara E; Dufour, Sylvie; Burgert, Tania S; Tamborlane, William V; Caprio, Sonia

    2004-03-01

    Given the extreme increase in prediabetes, type 2 diabetes, and the potential for metabolic syndrome in obese youth, identifying simplified indexes for assessing stimulated insulin sensitivity is critical. The purpose of this study was validation of two surrogate indexes of insulin sensitivity determined from the oral glucose tolerance test (OGTT): the composite whole body insulin sensitivity index (WBISI) and the insulin sensitivity index (ISI). An obese population (aged 8-18 yr) of normal and impaired glucose tolerance individuals was studied. One group (n = 38) performed both the euglycemic-hyperinsulinemic clamp and OGTT for comparison of insulin sensitivity measurements as well as (1)H-magnetic resonance spectroscopy estimates of intramyocellular lipid content. Another larger (n = 368) cohort participated only in an OGTT. Both the WBISI and ISI represented good estimates (r = 0.78 and 0.74; P < 0.0005) for clamp-derived insulin sensitivity (glucose disposed, M-value), respectively. In the large cohort, the surrogate indexes demonstrated the shift toward poorer function and increased risk profile as a function of insulin resistance. Additionally, the WBISI and ISI correlated with intramyocellular lipid content (r = -0.74 and -0.71; P < 0.0001), a tissue marker for insulin resistance. Insulin sensitivity can be estimated using plasma glucose and insulin responses derived from the OGTT in obese youth with normal and impaired glucose tolerance.

  7. A modified oral sugar test for evaluation of insulin and glucose dynamics in horses.

    PubMed

    Lindåse, Sanna; Nostell, Katarina; Bröjer, Johan

    2016-10-20

    An oral sugar test (OST) using Karo(®) Light Corn Syrup has been developed in the USA as a field test for the assessment of insulin dysregulation in horses but the syrup is not available in Scandinavian grocery stores. The aim of the study was to compare the results of a modified OST between horses with equine metabolic syndrome (EMS) and healthy horses using a Scandinavian commercially available glucose syrup (Dansukker glykossirap). In addition, the effect of breed and the repeatability of the test were evaluated. In the present study, clinically healthy horses (7 Shetland ponies, 8 Icelandic horses, 8 Standardbred horses) and 20 horses of various breeds with EMS underwent the modified OST test. The Icelandic horses and Shetland ponies underwent the OST twice. Insulin and glucose data from the OST were used to calculate peak insulin concentration (PeakINS), time to peak insulin concentration (T-peakINS), area under the curve for insulin (AUCINS) and glucose (AUCGLU) as well as whole body insulin sensitivity index (ISICOMP). Compared to the healthy group, the EMS group had 6-7 times higher geometric mean for PeakINS and AUCINS and 8 times lower geometric mean for ISICOMP. The EMS group had a delayed T-peakINS compared to the healthy group. There was no effect of breed in the group of healthy horses on PeakINS, T-peakINS, AUCINS, AUCGLU and ISICOMP. Coefficient of variation for repeated tests was 19.8, 19.0 and 17.6 % for PeakINS, AUCINS and ISICOMP respectively. The results of the present study demonstrate that the modified OST appears to be a practical and useful diagnostic tool for assessment of insulin dysregulation in the horse. However, to make it possible to establish the most appropriate sampling interval and to evaluate the accuracy of the modified OST, further studies in horses with a variable degree of insulin resistance are needed, where results from the modified OST are compared with quantitative measurements for IS.

  8. Tissue viability imaging (TiVi) in the assessment of divergent beam UV-B provocation.

    PubMed

    O'Doherty, Jim; Henricson, Joakim; Enfield, Joey; Nilsson, Gert E; Leahy, Martin J; Anderson, Chris D

    2011-03-01

    In routine clinical phototesting and in basic research, naked eye dermatological assessment is the "gold standard" for determining the patient's minimal erythemal dose (MED). In UV-B testing with a divergent, radially attenuating beam of characterised dosimetry, laser Doppler perfusion imaging has been previously used to give quantitative description of reactivity to doses above the MED in addition to a "single-dose" objective determination of the MED itself. In the present paper, the recently developed tissue viability imaging (TiVi) technology is presented for the first time as a reliable, easily applicable, high-resolution alternative to LDPI in the divergent beam testing concept. Data obtained after provocation with a range of doses was analysed in order to determine the reaction diameter, which can be related to the MED using field dosimetry. The dose-response features of exposure above the MED and the relationship between naked eye readings and the diameter were determined from the image data. TiVi data were obtained faster than LDPI data and at a higher spatial resolution of 100 μm instead of 1 mm. A tool was developed to centre over the erythema area of the acquired image. Response data could be plotted continuously against dose. Thresholding of processed images compared to naked eye "gold standard" readings showed that the normal skin value +4 standard deviations produced a good fit between both methods. A linear fitting method for the dose-response data provided a further method of determination of the reaction diameter (MED). Erythemal "volume under the surface (VUS)" for the reaction provided a new concept for visualising information. TiVi offers advantages over LDPI in the acquisition and analysis of data collected during divergent beam testing. An increased amount of data compared to traditional phototesting is easily and more objectively obtained which increases applicability in the clinical and research environment.

  9. Nonclinical safety of astilbin: A 4-week oral toxicity study in rats with genotoxicity, chromosomal aberration, and mammalian micronucleus tests.

    PubMed

    Gao, Yonglin; Li, Chunmei; Wang, Yunzhi; Liu, Yunguo; Li, Guisheng; Fan, Xiaochen; Li, Yanshen; Tian, Jingwei; Lee, Albert W

    2017-09-01

    Astilbin is an active flavonoid compound isolated from Rhizoma Smilacis Glabrae. It has been widely used as an anti-hepatic, anti-arthritic, and anti-renal injury agent. However, its safety has not yet been established. The objective of this study was to evaluate 4-week repeated oral toxicity and genotoxicity of astilbin. We examined oral toxicity in Sprague-Dawley rats after daily oral administration of astilbin at 50, 150, and 500 mg/kg for 4 weeks. Negative control animals received the same volume of the solvent. Astilbin administration did not lead to death, body weight gain, food consumption, or adverse events. There were no significant differences in toxicity between the astilbin and control group; we observed no toxic effects on hematological or urinalysis parameters, biochemical values, organ weight, or histopathological findings. We assessed the genotoxicity of astilbin with the Ames test (TA97a, TA98, TA100, TA102, and TA1535), chromosomal aberration assay (using Chinese hamster ovary cells), and mammalian micronucleus test (in mice). We found no genotoxicity in any tested strains. The no-observed-adverse-effect level (NOAEL) for astilbin in the 4-week repeated oral toxicity study in rats was greater than 500 mg/kg body weight/day, regardless of gender. Results also suggested that astilbin does not have genotoxicity potential. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. Validity of the estimates of oral cholera vaccine effectiveness derived from the test-negative design.

    PubMed

    Ali, Mohammad; You, Young Ae; Sur, Dipika; Kanungo, Suman; Kim, Deok Ryun; Deen, Jacqueline; Lopez, Anna Lena; Wierzba, Thomas F; Bhattacharya, Sujit K; Clemens, John D

    2016-01-20

    The test-negative design (TND) has emerged as a simple method for evaluating vaccine effectiveness (VE). Its utility for evaluating oral cholera vaccine (OCV) effectiveness is unknown. We examined this method's validity in assessing OCV effectiveness by comparing the results of TND analyses with those of conventional cohort analyses. Randomized controlled trials of OCV were conducted in Matlab (Bangladesh) and Kolkata (India), and an observational cohort design was used in Zanzibar (Tanzania). For all three studies, VE using the TND was estimated from the odds ratio (OR) relating vaccination status to fecal test status (Vibrio cholerae O1 positive or negative) among diarrheal patients enrolled during surveillance (VE= (1-OR)×100%). In cohort analyses of these studies, we employed the Cox proportional hazard model for estimating VE (=1-hazard ratio)×100%). OCV effectiveness estimates obtained using the TND (Matlab: 51%, 95% CI:37-62%; Kolkata: 67%, 95% CI:57-75%) were similar to the cohort analyses of these RCTs (Matlab: 52%, 95% CI:43-60% and Kolkata: 66%, 95% CI:55-74%). The TND VE estimate for the Zanzibar data was 94% (95% CI:84-98%) compared with 82% (95% CI:58-93%) in the cohort analysis. After adjusting for residual confounding in the cohort analysis of the Zanzibar study, using a bias indicator condition, we observed almost no difference in the two estimates. Our findings suggest that the TND is a valid approach for evaluating OCV effectiveness in routine vaccination programs. Copyright © 2015 Elsevier Ltd. All rights reserved.

  11. An elevated 1-h post- load glucose level during the oral glucose tolerance test detects prediabetes.

    PubMed

    Buysschaert, Martin; Bergman, Michael; Yanogo, Donald; Jagannathan, Ram; Buysschaert, Benoit; Preumont, Vanessa

    The objective of the study was to compare the diagnosis of dysglycemic states by conventional oral glucose tolerance test (OGTT) criteria (fasting and 2-h plasma glucose) with the 1-h post-load plasma glucose level. 34 individuals (mean age: 55±13years; BMI: 27.7±6.3kg/m(2)) at risk for prediabetes were administered a 75g OGTT. Individuals with normal glucose tolerance (NGT) or prediabetes were identified according to fasting and/or 2-h plasma glucose (PG) concentrations. Subsequently, subjects were divided in 2 groups: group 1 (n=21) with a 1-h PG<155mg/dl and group 2 (n=13) with a 1-h PG≥155mg/dl. HOMA was performed to assess β-cell function and insulin sensitivity. NGT or prediabetes based on conventional criteria correlated with the 1-h PGtest vs. 1-h PG<155mg/dl. The 1-h post-load plasma glucose value ≥155mg/dl is strongly associated with conventional criteria for (pre)diabetes and alterations of β-cell function. Copyright © 2016 Diabetes India. Published by Elsevier Ltd. All rights reserved.

  12. Exhaled breath condensate pH decreases following oral glucose tolerance test.

    PubMed

    Bikov, Andras; Pako, Judit; Montvai, David; Kovacs, Dorottya; Koller, Zsofia; Losonczy, Gyorgy; Horvath, Ildiko

    2015-12-15

    Exhaled breath condensate (EBC) pH is a widely measured non-invasive marker of airway acidity. However, some methodological aspects have not been thoroughly investigated. The aim of the study was to determine the effect of oral glucose tolerance test (OGTT) on EBC pH in attempt to better standardize its measurement. Seventeen healthy subjects (24  ±  2 years, 6 men, 11 women) participated in the study. EBC collection and capillary blood glucose measurements were performed before as well as 0, 30, 60 and 120 min after a standardized OGTT test. The rate of respiratory droplet dilution and pH were evaluated in EBC. Blood glucose significantly increased at 30 min and maintained elevation after 60 and 120 min following OGTT. Compared to baseline (7.99  ±  0.25) EBC pH significantly decreased immediately after OGTT (7.41  ±  0.47); this drop sustained over 30 (7.44  ±  0.72) and 60 min (7.62  ±  0.44) without a significant difference at 120 min (7.78  ±  0.26). No change was observed in the rate of respiratory droplet dilution. There was no relationship between blood glucose and EBC pH values. Sugar intake may significantly decrease EBC pH. This effect needs to be considered when performing EBC pH studies. Further experiments are also warranted to investigate the effect of diet on other exhaled biomarkers.

  13. Oral mucosal fixed drug eruption: characteristics and differential diagnosis.

    PubMed

    Özkaya, Esen

    2013-08-01

    Little is known about the characteristic features of oral mucosal fixed drug eruption (FDE). To present the clinical highlights and the differential diagnosis of oral mucosal FDE in a relatively large group of patients from Turkey. This was a methodological, retrospective, cross-sectional study of 61 patients with oral mucosal FDE. The causative drug was established mainly by oral provocation test. The age range of 61 patients (38 females, 23 males) was 7 to 62 years. Naproxen and cotrimoxazole were the main inducers. Fourteen patients (23%) had a solitary oral lesion predominantly located on the dorsum of the tongue, or on the hard palate, the former statistically significantly associated with cotrimoxazole. Bullous/erosive (n = 47), aphthous (n = 12), and erythematous (n = 2) morphology were observed. A considerable number of patients were referred with a prior clinical diagnosis of herpes simplex and Behçet's disease; some of them were already receiving long-term treatment with acyclovir and colchicine, respectively. The main limitation of the present study resides in its retrospective design. Isolated oral lesions, aphthous lesions, severe bullous/erosive lesions, and the absence of residual pigmentation are the main features that may cause difficulties in the differential diagnosis. It is important to differentiate dysmenorrhea-related monthly attacks of oral FDE in female patients caused by nonsteroidal anti-inflammatory drugs from menstruation-triggered attacks of herpes simplex infection, and isolated orogenital aphthous FDE from Behçet's disease, especially in countries with a high frequency of the disease in order to prevent irrelevant therapies. Copyright © 2012 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

  14. The Role of Witnessing Violence, Peer Provocation, Family Support, and Parenting Practices in the Aggressive Behavior of Rural Adolescents

    ERIC Educational Resources Information Center

    Mazefsky, Carla A.; Farrell, Albert D.

    2005-01-01

    This study examined the influence of witnessing violence, peer provocation, family support, and parenting practices (monitoring and discipline) on aggression. Participants were 1,196 ninth graders at nine schools in poor, predominantly agricultural, rural communities who completed measures of these variables. Witnessing violence, peer provocation,…

  15. Meal related glucose monitoring is a method of diagnosing glucose intolerance in pregnancies with high probability of gestational diabetes but normal glucose tolerance by oral glucose tolerance test.

    PubMed

    John, Mathew; Gopinath, Deepa

    2013-06-01

    Gestational diabetes mellitus diagnosed by classical oral glucose tolerance test can result in fetal complications like macrosomia and polyhydramnios. Guidelines exist on management of patients diagnose by abnormal oral glucose tolerance test with diet modification followed by insulin. Even patients with abnormal oral glucose tolerance test maintaining apparently normal blood sugars with diet are advised insulin if there is accelerated fetal growth. But patients with normal oral glucose tolerance test can present with macrosomia and polyhydramnios. These patients are labelled as not having gestational diabetes mellitus and are followed up with repeat oral glucose tolerance test. We hypothesise that these patients may have an altered placental threshold to glucose or abnormal sensitivity of fetal tissues to glucose. Meal related glucose monitoring in these patients can identify minor abnormalities in glucose disturbance and should be treated to targets similar to physiological levels of glucose in non pregnant adults.

  16. Effects of withholding feed on thyrotropin-releasing hormone stimulation test results and effects of combined testing on oral sugar test and thyrotropin-releasing hormone stimulation test results in horses.

    PubMed

    Restifo, Melissa M; Frank, Nicholas; Hermida, Pilar; Sanchez-Londoño, Alfredo

    2016-07-01

    OBJECTIVE To assess effects of withholding feed on thyrotropin-releasing hormone (TRH) stimulation test results used in diagnosis of pituitary pars intermedia dysfunction in horses and determine effects of combined testing on results of the TRH stimulation test and the oral sugar test (OST) used in diagnosis of equine metabolic syndrome. ANIMALS 30 adult horses. PROCEDURES All horses underwent TRH stimulation tests under fed and nonfed conditions, an OST alone, and an OST combined with TRH stimulation testing. For TRH stimulation tests, plasma ACTH concentrations were measured before (baseline) and 10 minutes after (poststimulation) IV TRH administration. For the OST, plasma glucose and insulin concentrations were measured before (baseline) and 60 and 90 minutes after oral corn syrup administration. For combined testing, the TRH stimulation test was initiated immediately after 60-minute posttreatment sample collection for the OST. Results were compared among methods by Wilcoxon matched-pairs, signed rank tests, paired t tests, and Bland-Altman analysis. RESULTS Feeding conditions did not affect median ACTH concentrations when TRH stimulation tests were performed alone. Median baseline ACTH concentration did not differ between TRH stimulation tests performed alone (under fed or nonfed conditions) and those combined with OSTs. Median poststimulation ACTH concentration was significantly lower for combined tests than for solitary TRH stimulation tests. Mean 60-minute plasma glucose concentration was significantly lower for solitary OSTs than for combined tests, but this difference could not be attributed to TRH administration. CONCLUSIONS AND CLINICAL RELEVANCE Combined testing in the manner described impacted ACTH concentrations during TRH stimulation tests and is not recommended at this time.

  17. Choice in HIV testing: the acceptability and anticipated use of a self-administered at-home oral HIV test among South Africans.

    PubMed

    Kelvin, Elizabeth A; Cheruvillil, Sonia; Christian, Stephanie; Mantell, Joanne E; Milford, Cecilia; Rambally-Greener, Letitia; Mosery, Nzwakie; Greener, Ross; Smit, Jennifer A

    2016-07-01

    Combination HIV prevention is being widely promoted by funders. This strategy aims to offer HIV prevention choices that can be selected and combined to decrease HIV risk in ways that fit with each individual's situation. Treatment as prevention and pre-exposure prophylaxis are two new evidence-based strategies to decrease HIV incidence, both of which require high HIV testing rates to be effective, and the Joint United Nations Programme on HIV/AIDS (UNAIDS) has set a goal of 90% of HIV-positive individuals knowing their status by 2030. However, HIV testing rates in many countries remain suboptimal. Just as no single HIV prevention method is ideal for all people in all situations, no single HIV testing modality is likely to be acceptable to everyone. By offering HIV testing choices, we may be able to increase testing rates. However, many low-resourced countries have been slow to take up new HIV testing options such as the self-administered at-home oral HIV test that is currently available in the United States. In this paper, we present findings from 20 in-depth interviews, conducted in 2010, documenting opinions about self-administered at-home oral HIV testing, a testing modality still largely unavailable in Africa. Participants were clients of three primary healthcare clinics in South Africa. Self-testing was seen as enabling confidentiality/privacy, saving time, and facilitating testing together with partners. However, concerns were raised about psychological distress when testing at home without a counsellor. Some suggested this concern could be minimised by having experienced clinic-based HIV testing and counselling before getting self-testing kits for home use. Thus, self-administered HIV testing could be an option added to the current testing modalities to address some important barriers to testing.

  18. Relationships of Early And Late Glycemic Responses With Gastric Emptying During An Oral Glucose Tolerance Test.

    PubMed

    Marathe, Chinmay S; Horowitz, Michael; Trahair, Laurence G; Wishart, Judith M; Bound, Michelle; Lange, Kylie; Rayner, Christopher K; Jones, Karen L

    2015-09-01

    The early glycemic response during a 75-g oral glucose tolerance test (OGTT) is directly related to the rate of gastric emptying (GE). There is little information about the effect of GE on the blood glucose at either 60 min (a predictor of diabetes) or 120 min (used diagnostically). This study aimed to evaluate the relationships between glycemic responses at 30, 60, and 120 min and GE following a 75-g OGTT in subjects with normal glucose tolerance (NGT), impaired glucose tolerance (IGT), and type 2 diabetes (T2D). Eighty-two subjects in the general community without diabetes (57 NGT, 25 IGT) and 16 with T2D consumed a 75-g glucose drink labeled with (99m)Tc-sulfur colloid. GE (by scintigraphy) and glycemia were measured from t = 0-120 min and relationships between blood glucose (absolute, change from baseline, and area under the curve) and GE at 30, 60, and 120 min determined. There were no differences in GE. There were relationships between the blood glucose at 30 min and GE (NGT: r = 0.40; P < .01; IGT: r = 0.49; P = .02; T2D: r = 0.62; P = .01). There was also a relationship between the blood glucose at 60 min and GE in IGT (r = 0.52; P = .02) and T2D (r = 0.77; P < .01), but not NGT (r = 0.16; P = .24). In NGT, there was an inverse relationship between blood glucose at 120 min and GE (r = -0.30; P = .02), but not in IGT (r = 0.05; P = .82) or T2D (r = 0.37; P = .16). GE is a determinant of the glycemic response to an OGTT in NGT, IGT, and T2D but these relationships differ and are time dependent.

  19. Oral glucose tolerance test for preoperative assessment of liver function in liver resection

    PubMed Central

    Rachapoodivenkata, Raghavendra Rao

    2017-01-01

    Backgrounds/Aims We intended to determine the role of the Oral glucose tolerance test (OGTT), in addition to volumetry, in preoperative assessment of patients undergoing liver resection. Methods This was a prospective study conducted at a tertiary care hospital, between February 2009 and February 2011. OGTT curve (parabolic/linear), linearity index (LI) and Parenchymal Hepatic Resection Rate (PHRR) were correlated with postoperative outcomes in terms of postoperative liver failure (PLF), by 50-50 criteria, morbidity, mortality and hospital stay. Results Of the 33 patients included in the study, 23 (69.7%) patients underwent major liver resections. Hepatocellular carcinoma (30.3%) was the leading indication. The overall postoperative morbidity rate was 72.7%, but major complications occurred in 3 (9.1%) patients only. There was no 90-day mortality. The 50-50 criteria were met by 3 patients undergoing major resection. Significant correlation was noted between the linear OGTT curve and the overall hospital stay (12.1 days vs. 9.6 days in parabolic; p=0.04). Patients with linear OGTT met the 50-50 criteria more often (18%) than those having a parabolic curve (4.5%; p=0.25). Although the OGTT was more often linear with occurrence of morbidity (41.7% vs 11.1%), major morbidity (66.7% vs 30%) and PLF by 50-50 criteria (66.7% vs 30%), it was not statistically significant. The linearity index was marginally lower (0.9 vs 1.2) in the presence of major morbidity and PLF by 50-50 criteria. Conclusions Linear OGTT affects the PLF and major morbidity, therein impacting the hospital stay. OGTT LI and PHRR can help predict postoperative outcome for a given extent of liver resection. PMID:28317039

  20. A Study on the Reliability of an On-Site Oral Fluid Drug Test in a Recreational Context

    PubMed Central

    Gentili, Stefano; Tittarelli, Roberta; Mannocchi, Giulio

    2016-01-01

    The reliability of DrugWipe 5A on site test for principal drugs of abuse (cannabis, amphetamines, cocaine, and opiates) detection in oral fluid was assessed by comparing the on-site results with headspace solid-phase microextraction (HS-SPME) gas chromatography-mass spectrometry (GC-MS) analysis on samples extracted by the device collection pad. Oral fluid samples were collected at recreational settings (e.g., discos, pubs, and music bars) of Rome metropolitan area. Eighty-three club goers underwent the on-site drug screening test with one device. Independently from the result obtained, a second device was used just to collect another oral fluid sample subsequently extracted and analyzed in the laboratory following HS-SPME procedure, gas chromatographic separation by a capillary column, and MS detection by electron impact ionization. DrugWipe 5A on-site test showed 54 samples (65.1%) positive to one or more drugs of abuse, whereas 75 samples (90.4%) tested positive for one or more substances following GC-MS assay. Comparing the obtained results, the device showed sensitivity, specificity, and accuracy around 80% for amphetamines class. Sensitivity (67 and 50%) was obtained for cocaine and opiates, while both sensitivity and accuracy were unsuccessful (29 and 53%, resp.) for cannabis, underlying the limitation of the device for this latter drug class. PMID:27610266

  1. Does short-term exposure to mobile phone base station signals increase symptoms in individuals who report sensitivity to electromagnetic fields? A double-blind randomized provocation study.

    PubMed

    Eltiti, Stacy; Wallace, Denise; Ridgewell, Anna; Zougkou, Konstantina; Russo, Riccardo; Sepulveda, Francisco; Mirshekar-Syahkal, Dariush; Rasor, Paul; Deeble, Roger; Fox, Elaine

    2007-11-01

    Individuals with idiopathic environmental illness with attribution to electromagnetic fields (IEI-EMF) believe they suffer negative health effects when exposed to electromagnetic fields from everyday objects such as mobile phone base stations. This study used both open provocation and double-blind tests to determine if sensitive and control individuals experience more negative health effects when exposed to base station-like signals compared with sham. Fifty-six self-reported sensitive and 120 control participants were tested in an open provocation test. Of these, 12 sensitive and 6 controls withdrew after the first session. The remainder completed a series of double-blind tests. Subjective measures of well-being and symptoms as well as physiological measures of blood volume pulse, heart rate, and skin conductance were obtained. During the open provocation, sensitive individuals reported lower levels of well-being in both the global system for mobile communication (GSM) and universal mobile telecommunications system (UMTS) compared with sham exposure, whereas controls reported more symptoms during the UMTS exposure. During double-blind tests the GSM signal did not have any effect on either group. Sensitive participants did report elevated levels of arousal during the UMTS condition, whereas the number or severity of symptoms experienced did not increase. Physiological measures did not differ across the three exposure conditions for either group. Short-term exposure to a typical GSM base station-like signal did not affect well-being or physiological functions in sensitive or control individuals. Sensitive individuals reported elevated levels of arousal when exposed to a UMTS signal. Further analysis, however, indicated that this difference was likely to be due to the effect of order of exposure rather than the exposure itself.

  2. Children's Emotion Regulation: Self-Report and Physiological Response to Peer Provocation

    ERIC Educational Resources Information Center

    Hessler, Danielle M.; Katz, Lynn Fainsilber

    2007-01-01

    The authors examined the notion that children's emotion regulation (ER) is a uniform skill by (a) investigating the concordance between self-report of ER and physiological measures and by (b) examining ER in a specific context (e.g., peer provocation) and context-free manner (e.g., during a semistructured interview of ER abilities). Seventy-two…

  3. Children's Emotion Regulation: Self-Report and Physiological Response to Peer Provocation

    ERIC Educational Resources Information Center

    Hessler, Danielle M.; Katz, Lynn Fainsilber

    2007-01-01

    The authors examined the notion that children's emotion regulation (ER) is a uniform skill by (a) investigating the concordance between self-report of ER and physiological measures and by (b) examining ER in a specific context (e.g., peer provocation) and context-free manner (e.g., during a semistructured interview of ER abilities). Seventy-two…

  4. The Novaco Anger Scale--Provocation Inventory (1994 Version) in Dutch Forensic Psychiatric Patients

    ERIC Educational Resources Information Center

    Hornsveld, Ruud H. J.; Muris, Peter; Kraaimaat, Floris W.

    2011-01-01

    We examined the psychometric properties of the Novaco Anger Scale--Provocation Inventory (NAS-PI, 1994 version) in Dutch violent forensic psychiatric patients and secondary vocational students. A confirmatory factor analysis of the subscale structure of the NAS was carried out, reliability was investigated, and relations were calculated between…

  5. Making Choices: Simultaneous Report and Provocative Statements, Tools for Appreciative Inquiry

    ERIC Educational Resources Information Center

    Nelson, Eric M.; Wright, Christine M.

    2011-01-01

    Many educators find that students do not participate actively in class, and are constantly seeking a variety of techniques to encourage student participation. The focus of this paper is to show how simultaneous report and provocative statements can be combined to foster appreciative inquiry, thereby, creating a learning environment with greater…

  6. Types of Aggression, Responsiveness to Provocation, and Callous-Unemotional Traits in Detained Adolescents

    ERIC Educational Resources Information Center

    Munoz, Luna C.; Frick, Paul J.; Kimonis, Eva R.; Aucoin, Katherine J.

    2008-01-01

    The present study investigated differences in the behavioral and psychophysiological responses to provocation and in the level of callous-unemotional traits in boys exhibiting different patterns of aggression. Eighty-five boys (ages 13-18) in a juvenile detention center played a competitive computer task against a hypothetical peer who provided…

  7. Popular Culture as Emotional Provocation: The Material Enactment of Queer Pedagogies in a High School Classroom

    ERIC Educational Resources Information Center

    Quinlivan, Kathleen

    2012-01-01

    Drawing on the notion of popular culture as a form of queer emotional provocation, in this paper I suggest that attending to the material enactment of queer pedagogies in context enables an understanding of the importance of attending more fully to the emotional ramifications of queer pedagogies. Working within the context of a research project…

  8. Nonspecific provocation of target organs in allergic diseases: EAACI-GA(2)LEN consensus report.

    PubMed

    Bonini, S; Rasi, G; Brusasco, V; Carlsen, K-H; Crimi, E; Popov, T; Schultze-Werninghaus, G; Gramiccioni, C; Bonini, M; Passali, D; Bachert, C; van Cauwenberge, P B; Bresciani, M; Bonini, S; Calonge, M; Montan, P G; Serapiao Dos Santos, M; Belfort, R; Lambiase, A; Sacchetti, M

    2007-06-01

    It is widely accepted that nonspecific tissue reactivity is a distinct pathophysiological hallmark of allergic diseases, influenced by genetic and environmental factors different from those involved in causing sensitization and allergen response of target organs. This consensus document aims at reviewing procedures currently used for nonspecific provocation of the bronchi, nose and eye and for measuring their responsiveness to nonspecific stimuli.

  9. Social provocation modulates decision making and feedback processing: Examining the trajectory of development in adolescent participants.

    PubMed

    Pincham, Hannah L; Wu, Claire; Killikelly, Clare; Vuillier, Laura; Fearon, R M Pasco

    2015-10-01

    Increasingly, research is turning to the ways in which social context impacts decision making and feedback processing in adolescents. The current study recorded electroencephalography to examine the trajectory of development across adolescence, with a focus on how social context impacts cognition and behaviour. To that end, younger (10-12 years) and older (14-16 years) adolescents played a modified Taylor Aggression Paradigm against two virtual opponents: a low-provoker and a high-provoker. During the task's decision phase (where participants select punishment for their opponent), we examined two event-related potentials: the N2 and the late positive potential (LPP). During the outcome phase (where participants experience win or loss feedback), we measured the feedback related negativity (FRN). Although N2 amplitudes did not vary with provocation, LPP amplitudes were enhanced under high provocation for the younger group, suggesting that emotional reactivity during the decision phase was heightened for early adolescents. During the outcome phase, the FRN was reduced following win outcomes under high provocation for both groups, suggesting that a highly provocative social opponent may influence the reward response. Collectively, the data argue that social context is an important factor modulating neural responses in adolescent behavioural and brain development.

  10. Individual Differences in Responses to Provocation and Frequent Victimization by Peers

    ERIC Educational Resources Information Center

    Champion, Kelly M.; Clay, Daniel L.

    2007-01-01

    This study examined associations between victimization by peers and intention to respond to provocative events as a function of anger arousal and motivation to improve the situation in a cross-sectional sample of school-age children (N = 506, 260 males, 246 females). Results demonstrated that more intense anger and more retaliatory motivation were…

  11. Exploratory Factor Analysis and Convergent Validity of the Dundee Provocation Inventory

    ERIC Educational Resources Information Center

    Alder, Lucy; Lindsay, William R.

    2007-01-01

    Background: The prevalence and consequences of anger and aggression in people with intellectual disability (ID) are of great concern. It is essential that appropriate assessment tools are developed to aid formulation of treatments and to evaluate progress and outcomes. Method: This study evaluates the "Dundee Provocation Inventory" (DPI), a…

  12. The Novaco Anger Scale--Provocation Inventory (1994 Version) in Dutch Forensic Psychiatric Patients

    ERIC Educational Resources Information Center

    Hornsveld, Ruud H. J.; Muris, Peter; Kraaimaat, Floris W.

    2011-01-01

    We examined the psychometric properties of the Novaco Anger Scale--Provocation Inventory (NAS-PI, 1994 version) in Dutch violent forensic psychiatric patients and secondary vocational students. A confirmatory factor analysis of the subscale structure of the NAS was carried out, reliability was investigated, and relations were calculated between…

  13. What's Really Said in the Teachers' Lounge: Provocative Ideas about Cultures and Classrooms.

    ERIC Educational Resources Information Center

    Kottler, Jeffrey A.

    This publication explores how teachers' cultural origins, as well as those of their students and colleagues, impact growth and learning, and how teachers can make classrooms more culturally responsive. The book is divided into two parts with a "bridge" chapter between them. Part 1, "Conceptual Provocations" includes five…

  14. Individual Differences in Responses to Provocation and Frequent Victimization by Peers

    ERIC Educational Resources Information Center

    Champion, Kelly M.; Clay, Daniel L.

    2007-01-01

    This study examined associations between victimization by peers and intention to respond to provocative events as a function of anger arousal and motivation to improve the situation in a cross-sectional sample of school-age children (N = 506, 260 males, 246 females). Results demonstrated that more intense anger and more retaliatory motivation were…

  15. The Photomontages of John Heartfield: A Provocative Teaching Tool for "Landeskunde."

    ERIC Educational Resources Information Center

    Mathieu, Gustave Bording

    1992-01-01

    A case is made for the use of the politically provocative photomontages of Heartfield (a.k.a. Berlin-born Helmut Herzfeld) in the German classroom. The interplay of language, art, culture, and history makes them especially useful as realia. A model for teaching them is presented, including a chronology and nine reproductions. (Author/LB)

  16. Measured Effects of Provocation and Emotional Mastery Techniques in Fostering Emotional Intelligence among Nigerian Adolescents

    ERIC Educational Resources Information Center

    Ogunyemi, Ajibola Olusoga

    2008-01-01

    Introduction: This study investigated the effects of provocation and emotional mastery programmes at fostering emotional intelligence of Nigerian adolescents. The study also aimed to establish whether gender will moderate the effects of the two techniques on emotional intelligence skills of adolescents. Method: The study employed a…

  17. Field-based video pre-test counseling, oral testing, and telephonic post-test counseling: implementation of an HIV field testing package among high-risk Indian men.

    PubMed

    Snyder, Hannah; Yeldandi, Vijay V; Prem Kumar, G; Liao, Chuanhong; Lakshmi, Vemu; Gandham, Sabitha R; Muppudi, Uma; Oruganti, Ganesh; Schneider, John A

    2012-08-01

    In India, men who have sex with men (MSM) and truck drivers are high-risk groups that often do not access HIV testing due to stigma and high mobility. This study evaluated a field testing package (FTP) that identified HIV positive participants through video pre-test counseling, OraQuick oral fluid HIV testing, and telephonic post-test counseling and then connected them to government facilities. A total of 598 MSM and truck drivers participated in the FTP and completed surveys covering sociodemographics, HIV testing history, risk behaviors, and opinions on the FTP. MSM and truck drivers equally preferred video counseling, although MSM who had been previously tested preferred traditional methods. Nearly all participants preferred oral testing. Rates of counseling completion and linkage to government centers were low, with one-third of newly identified positives completing follow-up. With increased public-private coordination, this FTP could identify many hard-to-reach preliminary positive individuals and connect them to government testing and care.

  18. Esophageal reflexes modulate frontoparietal response in neonates: Novel application of concurrent NIRS and provocative esophageal manometry.

    PubMed

    Jadcherla, Sudarshan R; Pakiraih, Joanna F; Hasenstab, Kathryn A; Dar, Irfaan; Gao, Xiaoyu; Bates, D Gregory; Kashou, Nasser H

    2014-07-01

    Central and peripheral neural regulation of swallowing and aerodigestive reflexes is unclear in human neonates. Functional near infrared spectroscopy (NIRS) is a noninvasive method to measure changes in oxyhemoglobin (HbO) and deoxyhemoglobin (HbD). Pharyngoesophageal manometry permits evaluation of aerodigestive reflexes. Modalities were combined to investigate feasibility and to test neonatal frontoparietal cortical changes during pharyngoesophageal (visceral) stimulation and/or swallowing. Ten neonates (45.6 ± 3.0 wk postmenstrual age, 4.1 ± 0.5 kg) underwent novel pharyngoesophageal manometry concurrent with NIRS. To examine esophagus-brain interactions, we analyzed cortical hemodynamic response (HDR) latency and durations during aerodigestive provocation and esophageal reflexes. Data are presented as means ± SE or percent. HDR rates were 8.84 times more likely with basal spontaneous deglutition compared with sham stimuli (P = 0.004). Of 182 visceral stimuli, 95% were analyzable for esophageal responses, 38% for HDR, and 36% for both. Of analyzable HDR (n = 70): 1) HbO concentration (μmol/l) baseline 1.5 ± 0.7 vs. 3.7 ± 0.7 poststimulus was significant (P = 0.02), 2) HbD concentration (μmol/l) between baseline 0.1 ± 0.4 vs. poststimulus -0.5 ± 0.4 was not significant (P = 0.73), and 3) hemispheric lateralization was 21% left only, 29% right only, and 50% bilateral. During concurrent esophageal and NIRS responses (n = 66): 1) peristaltic reflexes were present in 74% and HDR in 61% and 2) HDR was 4.75 times more likely with deglutition reflex vs. secondary peristaltic reflex (P = 0.016). Concurrent NIRS with visceral stimulation is feasible in neonates, and frontoparietal cortical activation is recognized. Deglutition contrasting with secondary peristalsis is related to cortical activation, thus implicating higher hierarchical aerodigestive protective functional neural networks.

  19. Esophageal reflexes modulate frontoparietal response in neonates: Novel application of concurrent NIRS and provocative esophageal manometry

    PubMed Central

    Pakiraih, Joanna F.; Hasenstab, Kathryn A.; Dar, Irfaan; Gao, Xiaoyu; Bates, D. Gregory; Kashou, Nasser H.

    2014-01-01

    Central and peripheral neural regulation of swallowing and aerodigestive reflexes is unclear in human neonates. Functional near infrared spectroscopy (NIRS) is a noninvasive method to measure changes in oxyhemoglobin (HbO) and deoxyhemoglobin (HbD). Pharyngoesophageal manometry permits evaluation of aerodigestive reflexes. Modalities were combined to investigate feasibility and to test neonatal frontoparietal cortical changes during pharyngoesophageal (visceral) stimulation and/or swallowing. Ten neonates (45.6 ± 3.0 wk postmenstrual age, 4.1 ± 0.5 kg) underwent novel pharyngoesophageal manometry concurrent with NIRS. To examine esophagus-brain interactions, we analyzed cortical hemodynamic response (HDR) latency and durations during aerodigestive provocation and esophageal reflexes. Data are presented as means ± SE or percent. HDR rates were 8.84 times more likely with basal spontaneous deglutition compared with sham stimuli (P = 0.004). Of 182 visceral stimuli, 95% were analyzable for esophageal responses, 38% for HDR, and 36% for both. Of analyzable HDR (n = 70): 1) HbO concentration (μmol/l) baseline 1.5 ± 0.7 vs. 3.7 ± 0.7 poststimulus was significant (P = 0.02), 2) HbD concentration (μmol/l) between baseline 0.1 ± 0.4 vs. poststimulus −0.5 ± 0.4 was not significant (P = 0.73), and 3) hemispheric lateralization was 21% left only, 29% right only, and 50% bilateral. During concurrent esophageal and NIRS responses (n = 66): 1) peristaltic reflexes were present in 74% and HDR in 61% and 2) HDR was 4.75 times more likely with deglutition reflex vs. secondary peristaltic reflex (P = 0.016). Concurrent NIRS with visceral stimulation is feasible in neonates, and frontoparietal cortical activation is recognized. Deglutition contrasting with secondary peristalsis is related to cortical activation, thus implicating higher hierarchical aerodigestive protective functional neural networks. PMID:24789204

  20. Alpha-9 nicotinic acetylcholine receptors mediate hypothermic responses elicited by provocative motion in mice.

    PubMed

    Tu, Longlong; Poppi, Lauren; Rudd, John; Cresswell, Ethan T; Smith, Doug W; Brichta, Alan; Nalivaiko, Eugene

    2017-03-14

    Hypothermic responses accompany motion sickness in humans and can be elicited by provocative motion in rats. We aimed to determine the potential role in these responses of the efferent cholinergic vestibular innervation. To this end, we used knockout (KO) mice lacking α9 cholinoreceptor subunit predominantly expressed in the vestibular hair cells and CBA strain as a wild-type (WT) control. In WT mice, circular horizontal motion (1Hz, 4cm radius, 20min) caused rapid and dramatic falls in core body temperature and surface head temperature associated with a transient rise in the tail temperature; these responses were substantially attenuated in KO mice; changes were (WT vs. KO): for the core body temperature-5.2±0.3 vs. -2.9±0.3°C; for the head skin temperature-3.3±0.2 vs. -1.7±0.2°C; for the tail skin temperature+3.9±1.1 vs+1.1±1.2°C. There was a close correlation in the time course of cooling the body and the surface of the head. KO mice also required 25% more time to complete a balance test. We conclude: i) that the integrity of cholinergic efferent vestibular system is essential for the full expression of motion-induced hypothermia in mice, and that the role of this system is likely facilitatory; ii) that the system is involvement in control of balance, but the involvement is not major; iii) that in mice, motion-induced body cooling is mediated via increased heat flow through vasodilated tail vasculature and (likely) via reduced thermogenesis. Our results support the idea that hypothermia is a biological correlate of a nausea-like state in animals.

  1. Calypte AWARE HIV-1/2 OMT antibody test using oral fluid: special challenges of rapid HIV testing in the developing world.

    PubMed

    Gottfried, Toby D; Mink, Ronald W; Phanuphak, Praphan

    2006-03-01

    The testing and counseling of persons at risk for infection with HIV and their subsequent treatment remains the primary tool to curb worldwide transmission of the virus. Rapid HIV tests address the need in the developing world for accurate, easy-to-use tests that do not require laboratory equipment or highly trained professionals for implementation or refrigeration for storage. Calypte Biomedical has recently developed the Calypte AWARE HIV-1/2 OMT antibody test using oral fluid samples. This test has demonstrated high sensitivity and specificity for specimens collected in target areas where increased testing is needed. The inexpensive dipstick format in combination with the use of an alternative fluid to blood provides an improved testing procedure for areas with limited resources.

  2. The influence of aortoseptal angulation on provocable left ventricular outflow tract obstruction in hypertrophic cardiomyopathy

    PubMed Central

    Critoph, Christopher Howell; Pantazis, Antonios; Tome Esteban, Maria Teresa; Salazar-Mendiguchía, Joel; Pagourelias, Efstathios D; Moon, James C; Elliott, Perry Mark

    2014-01-01

    Objectives Aortoseptal angulation (AoSA) can predict provocable left ventricular outflow tract obstruction (LVOTO) in patients with symptomatic hypertrophic cardiomyopathy (HCM). Lack of a standardised measurement technique in HCM without the need for complex three-dimensional (3D) imaging limits its usefulness in routine clinical practice. This study aimed to validate a simple measurement of AoSA using 2D echocardiography and cardiac MR (CMR) imaging as a predictor of LVOTO. Methods We retrospectively assessed 160 patients with non-obstructive HCM, referred for exercise stress echocardiography. AoSA was measured using resting 2D echocardiography in all patients, and CMR in 29. Twenty-five controls with normal echocardiograms were used for comparison. Results Patients with HCM had a reduced AoSA compared with controls (113°±12 vs 126°±6), p<0.0001. Sixty (38%) patients had provocable LVOTO, with smaller angles than non-obstructive patients (108°±12 vs 116°±12, p<0.0001). AoSA, degree of mitral valvular regurgitation and incomplete systolic anterior motion (SAM) were associated with peak left ventricular outflow tract gradient (r=0.508, p<0.0001). An angle ≤100° had 27% sensitivity, 91% specificity and 59% positive predictive value for predicting provocable LVOTO. When combined with SAM, specificity was 99% and positive predictive value 88%. Intraclass correlation coefficient of AoSA measured by two observers was 0.901 (p<0.0001). Bland-Altman analysis of echocardiographic AoSA showed good agreement with the CMR-derived angle. Conclusions Measurement of AoSA using echocardiography in HCM is easy, reproducible and comparable to CMR. Patients with provocable LVOTO have reduced angles compared with non-obstructive patients. AoSA is highly specific for provocable LVOTO and should prompt further evaluation in symptomatic patients without resting obstruction. PMID:25371813

  3. Provocative motion causes fall in brain temperature and affects sleep in rats.

    PubMed

    Del Vecchio, Flavia; Nalivaiko, Eugene; Cerri, Matteo; Luppi, Marco; Amici, Roberto

    2014-08-01

    Neural substrate of nausea is poorly understood, contrasting the wealth of knowledge about the emetic reflex. One of the reasons for this knowledge deficit is limited number and face validity of animal models of nausea. Our aim was to search for new physiological correlates of nausea in rats. Specifically, we addressed the question whether provocative motion (40-min rotation at 0.5 Hz) affects sleep architecture, brain temperature, heart rate (HR) and arterial pressure. Six adult male Sprague–Dawley rats were instrumented for recordings of EEG, nuchal electromyographic, hypothalamic temperature and arterial pressure. Provocative motion had the following effects: (1) total abolition of REM sleep during rotation and its substantial reduction during the first hour post-rotation (from 20 ± 3 to 5 ± 1.5%); (2) reduction in NREM sleep, both during rotation (from 57 ± 6 to 19 ± 5%) and during the first hour post-rotation (from 56 ± 3 to 41 ± 9%); (3) fall in the brain temperature (from 37.1 ± 0.1 to 36.0 ± 0.1 °C); and (4) reduction in HR (from 375 ± 6 to 327 ± 7 bpm); arterial pressure was not affected. Ondansetron, a 5-HT3 antagonist, had no major effect on all observed parameters during both baseline and provocative motion. We conclude that in rats, provocative motion causes prolonged arousing effects, however without evidence of sympathetic activation that usually accompanies heightened arousal. Motion induced fall in the brain temperature complements and extends our previous observations in rats and suggests that similar to humans, provocative motion triggers coordinated thermoregulatory response, leading to hypothermia in this species.

  4. The effect of low-oestrogen combined pill, progestogen-only pill and medroxyprogesterone acetate on oral glucose tolerance test.

    PubMed

    Kamau, R K; Maina, F W; Kigondu, C; Mati, J K

    1990-08-01

    The effect of a low-oestrogen combined pill, progestogen-only pill and medroxyprogesterone acetate on oral glucose tolerance test was studied in 29, 30 and 9 indigenous Kenyan women respectively. Glucose tolerance test was performed before treatment was started and then after 1,3 and 6 months in microgynon users. The mean areas under the glucose curves were also significantly elevated. Significant increase in blood glucose values were noted only at 30 minutes after 6 months of use of the progestogen-only oral contraceptive but the mean blood glucose values were higher than in the control after 1,3 and 6 months of use. However, the mean values of the areas under the glucose curves were significantly elevated after 1,3, and 6 months of use. Medroxyprogesterone acetate users showed significantly lower fasting blood glucose values at 60 and 90 minutes after 1 month of use, after which the blood glucose values returned to the pre-treatment values. The mean values of the glucose curve areas showed no significant change. It is concluded that both microgynon and minipill cause relative impairment of glucose tolerance test as early as after 1 month of use. Medroxyprogesterone acetate does not impair oral glucose tolerance for at least the first 6 months of use. The implications of these findings are discussed.

  5. Assessment of Oral Fluid HIV Test Performance in an HIV Pre-Exposure Prophylaxis Trial in Bangkok, Thailand

    PubMed Central

    Suntharasamai, Pravan; Martin, Michael; Choopanya, Kachit; Vanichseni, Suphak; Sangkum, Udomsak; Tararut, Pairote; Leelawiwat, Wanna; Anekvorapong, Rapeepan; Mock, Philip A.; Cherdtrakulkiat, Thitima; Leethochawalit, Manoj; Chiamwongpaet, Sithisat; Gvetadze, Roman J.; McNicholl, Janet M.; Paxton, Lynn A.; Kittimunkong, Somyot; Curlin, Marcel E.

    2015-01-01

    Background Rapid easy-to-use HIV tests offer opportunities to increase HIV testing among populations at risk of infection. We used the OraQuick Rapid HIV-1/2 antibody test (OraQuick) in the Bangkok Tenofovir Study, an HIV pre-exposure prophylaxis trial among people who inject drugs. Methods The Bangkok Tenofovir Study was a randomized, double-blind, placebo-controlled trial. We tested participants’ oral fluid for HIV using OraQuick monthly and blood using a nucleic-acid amplification test (NAAT) every 3 months. We used Kaplan-Meier methods to estimate the duration from a positive HIV NAAT until the mid-point between the last non-reactive and first reactive oral fluid test and proportional hazards to examine factors associated with the time until the test was reactive. Results We screened 3678 people for HIV using OraQuick. Among 447 with reactive results, 436 (97.5%) were confirmed HIV-infected, 10 (2.2%) HIV-uninfected, and one (0.2%) had indeterminate results. Two participants with non-reactive OraQuick results were, in fact, HIV-infected at screening yielding 99.5% sensitivity, 99.7% specificity, a 97.8% positive predictive value, and a 99.9% negative predictive value. Participants receiving tenofovir took longer to develop a reactive OraQuick (191.8 days) than participants receiving placebo (16.8 days) (p = 0.02) and participants infected with HIV CRF01_AE developed a reactive OraQuick earlier than participants infected with other subtypes (p = 0.04). Discussion The oral fluid HIV test performed well at screening, suggesting it can be used when rapid results and non-invasive tools are preferred. However, participants receiving tenofovir took longer to develop a reactive oral fluid test result than those receiving placebo. Thus, among people using pre-exposure prophylaxis, a blood-based HIV test may be an appropriate choice. Trial Registration ClinicalTrials.gov NCT00119106. PMID:26717405

  6. Assessment of Oral Fluid HIV Test Performance in an HIV Pre-Exposure Prophylaxis Trial in Bangkok, Thailand.

    PubMed

    Suntharasamai, Pravan; Martin, Michael; Choopanya, Kachit; Vanichseni, Suphak; Sangkum, Udomsak; Tararut, Pairote; Leelawiwat, Wanna; Anekvorapong, Rapeepan; Mock, Philip A; Cherdtrakulkiat, Thitima; Leethochawalit, Manoj; Chiamwongpaet, Sithisat; Gvetadze, Roman J; McNicholl, Janet M; Paxton, Lynn A; Kittimunkong, Somyot; Curlin, Marcel E

    2015-01-01

    Rapid easy-to-use HIV tests offer opportunities to increase HIV testing among populations at risk of infection. We used the OraQuick Rapid HIV-1/2 antibody test (OraQuick) in the Bangkok Tenofovir Study, an HIV pre-exposure prophylaxis trial among people who inject drugs. The Bangkok Tenofovir Study was a randomized, double-blind, placebo-controlled trial. We tested participants' oral fluid for HIV using OraQuick monthly and blood using a nucleic-acid amplification test (NAAT) every 3 months. We used Kaplan-Meier methods to estimate the duration from a positive HIV NAAT until the mid-point between the last non-reactive and first reactive oral fluid test and proportional hazards to examine factors associated with the time until the test was reactive. We screened 3678 people for HIV using OraQuick. Among 447 with reactive results, 436 (97.5%) were confirmed HIV-infected, 10 (2.2%) HIV-uninfected, and one (0.2%) had indeterminate results. Two participants with non-reactive OraQuick results were, in fact, HIV-infected at screening yielding 99.5% sensitivity, 99.7% specificity, a 97.8% positive predictive value, and a 99.9% negative predictive value. Participants receiving tenofovir took longer to develop a reactive OraQuick (191.8 days) than participants receiving placebo (16.8 days) (p = 0.02) and participants infected with HIV CRF01_AE developed a reactive OraQuick earlier than participants infected with other subtypes (p = 0.04). The oral fluid HIV test performed well at screening, suggesting it can be used when rapid results and non-invasive tools are preferred. However, participants receiving tenofovir took longer to develop a reactive oral fluid test result than those receiving placebo. Thus, among people using pre-exposure prophylaxis, a blood-based HIV test may be an appropriate choice. ClinicalTrials.gov NCT00119106.

  7. MAOA-uVNTR genotype predicts interindividual differences in experimental aggressiveness as a function of the degree of provocation.

    PubMed

    Kuepper, Yvonne; Grant, Phillip; Wielpuetz, Catrin; Hennig, Juergen

    2013-06-15

    The MAOA-uVNTR has been suggested to play a role regarding aggression, however, results are inconsistent. We aimed at further elucidating potential effects of the MAOA-uVNTR on aggressiveness with respect to potential modulators: sex, experimental vs. trait aggressiveness and type of aggressiveness (proactive vs. reactive aggressiveness). We tested 239 healthy young adults (88 men/151 women). Participants were genotyped for the MAOA-uVNTR and performed a modified version of a competitive reaction time task - a commonly used and well established tool to elicit and measure aggressiveness. Furthermore, they completed a self-report scale measuring trait aggressiveness. We found a main effect of MAOA-uVNTR on a measure of reactive aggressiveness for both men and women, whereby the low-activity alleles of the MAOA-uVNTR were associated with substantially increased aggressive reactions (p<.05). This effect was unique for reactive aggressiveness. Measures of proactive aggressiveness or self reports were not associated with the MAOA-uVNTR-genotype. Our data are in line with earlier studies and indicate the MAOA-uVNTR-genotype to be specifically associated with measures of reactive impulsive experimental aggressiveness in healthy men and women. Furthermore the association between the MAOA-uVNTR genotype and aggressive responses increases in a fashion linear to the degree of provocation. This indicates that the low-functional alleles of the MAOA-uVNTR are not associated with increased aggressive behavior per se, but rather with an increased aggressive reactivity to provocation.

  8. Difference Between Dormant Conduction Sites Revealed by Adenosine Triphosphate Provocation and Unipolar Pace-Capture Sites Along the Ablation Line After Pulmonary Vein Isolation.

    PubMed

    Kogawa, Rikitake; Okumura, Yasuo; Watanabe, Ichiro; Sonoda, Kazumasa; Sasaki, Naoko; Takahashi, Keiko; Iso, Kazuki; Nagashima, Koichi; Ohkubo, Kimie; Nakai, Toshiko; Kunimoto, Satoshi; Hirayama, Atsushi

    2016-01-01

    Dormant pulmonary vein (PV) conduction revealed by adenosine/adenosine triphosphate (ATP) provocation test and exit block to the left atrium by pacing from the PV side of the ablation line ("pace and ablate" method) are used to ensure durable pulmonary vein isolation (PVI). However, the mechanistic relation between ATP-provoked PV reconnection and the unexcitable gap along the ablation line is unclear.Forty-five patients with atrial fibrillation (AF) (paroxysmal: 31 patients, persistent: 14 patients; age: 61.1 ± 9.7 years) underwent extensive encircling PVI (EEPVI, 179 PVs). After completion of EEPVI, an ATP provocation test (30 mg, bolus injection) and unipolar pacing (output, 10 mA; pulse width, 2 ms) were performed along the previous EEPVI ablation line to identify excitable gaps. Dormant conduction was revealed in 29 (34 sites) of 179 PVs (16.2%) after EEP-VI (22/45 patients). Pace capture was revealed in 59 (89 sites) of 179 PVs (33.0%) after EEPVI (39/45 patients), and overlapping sites, ie, sites showing both dormant conduction and pace capture, were observed in 22 of 179 (12.3%) PVs (17/45 patients).Some of the ATP-provoked dormant PV reconnection sites were identical to the sites with excitable gaps revealed by pace capture, but most of the PV sites were differently distributed, suggesting that the main underling mechanism differs between these two forms of reconnection. These findings also suggest that performance of the ATP provocation test followed by the "pace and ablate" method can reduce the occurrence of chronic PV reconnections.

  9. The response to nasal allergen provocation with grass pollen is reduced in patients with chronic rhinosinusitis with nasal polyposis and grass sensitization.

    PubMed

    Calus, L; Devuyst, L; Van Zele, T; De Ruyck, N; Derycke, L; Bachert, C; Gevaert, P

    2016-04-01

    The majority of grass pollen-sensitized rhinitis patients develops allergic symptoms when exposed to the causal allergen and shows a positive nasal allergen provocation test (NAPT). Chronic rhinosinusitis with nasal polyposis (CRSwNP) patients, also characterized by eosinophilic inflammation and local IgE production, can suffer from comorbid inhalant allergy, but may show a different response to allergens. We aimed to explore the allergic response to grass pollen allergens by NAPT in grass pollen-sensitized CRSwNP patients. Twelve grass pollen-sensitized CRSwNP patients underwent NAPT with grass pollen and were compared with 12 grass pollen allergic rhinitis patients, 12 control patients and 12 CRSwNP patients without grass pollen sensitization. A positive NAPT was based on change in nasal airflow and symptoms. Further, VAS scores of different symptoms were noted before and after NAPT. Biomarkers such as total IgE, grass pollen-specific IgE and tryptase were measured in serum and nasal secretions. NAPT was positive in 6 of 12 of the grass pollen-sensitized CRSwNP patients, and another four patients developed allergic symptoms not fulfilling the criteria of positivity. In contrast, all patients with allergic rhinitis developed a positive provocation test, whereas in the control group one of the patients and in the non-sensitized CRSwNP group two of the patients developed a positive provocation test. These results show that allergen exposure induces an attenuated clinical response in patients with CRSwNP and sensitization to grass pollen as compared with grass pollen allergic rhinitis patients. © 2015 John Wiley & Sons Ltd.

  10. Oral Proficiency Testing in the Real World: Answers to Frequently Asked Questions

    ERIC Educational Resources Information Center

    Swender, Elvira

    2003-01-01

    The ACTFL Oral Proficiency Interview (OPI) is used to assess the ability of individuals to use language for real-world purposes. Today, OPIs are used by academic institutions, government agencies, and private corporations for many purposes: academic placement, student assessment, program evaluation, professional certification, hiring, and…

  11. Relationship of Oral Reading Fluency Probes on Students' Reading Achievement Test Scores

    ERIC Educational Resources Information Center

    Devena, Sarah

    2013-01-01

    Current emphasis on adequate academic progress monitored by standardized assessments has increased focus on student acquisition of required skills. Reading ability can be assessed through student achievement on Oral Reading Fluency (ORF) measures. This study investigated the effectiveness of using ORF measures to predict achievement on high stakes…

  12. Comparison of A1C to Oral Glucose Tolerance Test for the Diagnosis of Prediabetes in Overweight and Obese Youth.

    PubMed

    Khokhar, Aditi; Naraparaju, Gayathri; Friedman, Miriam; Perez-Colon, Sheila; Umpaichitra, Vatcharapan; Chin, Vivian L

    2017-07-01

    IN BRIEF This study reports performance of A1C against the oral glucose tolerance test (OGTT) in predicting prediabetes among overweight and obese African-American and Caribbean children. A retrospective chart review was completed for 230 children. Receiver operating characteristic curves were generated to find the predictive performances of different tests against the OGTT. A1C alone is a poor discriminator of prediabetes in our study population, with low sensitivity (70%) and specificity (48.8%). BMI z score, A1C, and homeostatic model assessment of insulin resistance are significant predictors of prediabetes and, when taken together, provide better discrimination for prediabetes.

  13. Deodorants: a clinical provocation study in fragrance-sensitive individuals.

    PubMed

    Johansen, J D; Rastogi, S C; Bruze, M; Andersen, K E; Frosch, P; Dreier, B; Lepoittevin, J P; White, I; Menné, T

    1998-10-01

    Deodorants are one of the most marketed types of cosmetics and are frequently reported as a cause of dermatitis, particularly among fragrance-sensitive persons. The aim of this study was to investigate the ability of deodorants, which had previously caused axillary dermatitis in fragrance-mix-sensitive eczema patients, to provoke reactions on repeated open application tests on the upper arm and in the axillae, and to relate the findings to the content of fragrance-mix constituents in those deodorants. 14 eczema patients performed a 7-day use test with 1 or 2 deodorants that had caused a rash within the last 12 months. 2 applications per day were made in the axilla and simultaneously on a 25 cm2 area on the upper arm. A total of 20 deodorants were tested among the 14 patients. Afterwards, the deodorants were subjected to quantitative chemical analysis identifying constituents of the fragrance mix. 12/20 (60%) deodorants elicited eczema on use testing in the axilla. 8/12 deodorants were positive in the axilla on day (D) 7 and 4 both in the axilla and on the upper arm. 2 of the 4 developed a reaction in the axilla before it developed on the upper arm. Chemical analysis revealed that 18/19 deodorants contained between 1 and 6 of the fragrance-mix constituents, on average 3 being found. The mean concentration of fragrance-mix constituents was generally higher in the deodorants causing a positive use test, as compared with those giving a negative reaction, indicating that the differences between the deodorants in terms of elicitation potential were more related to quantitative aspects of allergen content than of a qualitative nature. It is recommended that deodorants are tested in the axilla in the case of a negative use test on the upper arm and a strong clinical suspicion.

  14. Stakeholder Input and Test Design: A Case Study on Changing the Interlocutor Familiarity Facet of the Group Oral Discussion Test

    ERIC Educational Resources Information Center

    Ockey, Gary J.; Koyama, Dennis; Setoguchi, Eric

    2013-01-01

    Test takers should have a voice in testing practices (Mathew, 2004). However, when incorporating their input, systematic processes to ensure the validity of testing practices must be followed. Such processes allow for test development to be a more democratic process (Shohamy, 2001), without sacrificing the value of the resulting inferences made…

  15. Deodorants: an experimental provocation study with cinnamic aldehyde.

    PubMed

    Bruze, Magnus; Johansen, J D; Andersen, K E; Frosch, P; Lepoittevin, J-P; Rastogi, S; Wakelin, S; White, I; Menné, T

    2003-02-01

    Axillary dermatitis is common and overrepresented in individuals with contact allergy to fragrances. Many individuals suspect their deodorants to be the incriminating products. Our aim was to investigate the significance of cinnamic aldehyde in deodorants for the development of axillary dermatitis when used by individuals with and without contact allergy to cinnamic aldehyde. Patch tests with deodorants and ethanol solutions with cinnamic aldehyde, and repeated open application tests with roll-on deodorants without and with cinnamic aldehyde at different concentrations, were performed in 37 patients with dermatitis, 20 without and 17 with contact allergy to cinnamic aldehyde. A repeated open application test with positive findings was noted only in patients hypersensitive to cinnamic aldehyde (P <.001) and only in the axilla to which the deodorants containing cinnamic aldehyde had been applied (P <.001). Deodorants containing cinnamic aldehyde in the concentration range 0.01% to 0.32%, used twice daily on healthy skin, can elicit axillary dermatitis within a few weeks.

  16. The effect of fluid density and volume on the accuracy of test weighing in a simulated oral feeding situation.

    PubMed

    Dowling, Donna A; Madigan, Elizabeth; Siripul, Pulsuk

    2004-06-01

    For preterm infants and infants who have difficulty with oral feeding, excessive drooling during oral feedings can result in inaccurate assessment of intake. The drooled volume is typically estimated by visual and tactile assessment of the bib. Research, however, has demonstrated that visual assessment is inaccurate. The purpose of this study was to determine the accuracy of a scale that was used for the test weighing of milk that was drooled during a study of oral feeding for preterm infants. Additionally, the effect of weighing solutions with different densities on the accuracy of test weights was examined. Descriptive, comparative design. A simulated feeding situation was performed using 3 fluids (water, Enfamil(20), and Enfamil(24)) and 3 volume ranges (1 mL to 10 mL, 11 mL to 20 mL, and 21 mL to 30 mL). Data collection sessions were conducted for each of the 3 fluids using each range of volumes, for a total of 180 test weights. The research assistant performing the test weights was blinded to the preweight of the bib and the amount of fluid being applied to the bib. Differences between the actual volume applied to the bib and the volume estimated by the scale were very small, with 51% of the differences equaling 0 mL and 48% of the differences between -1 mL and 1 mL. There were significant differences in errors related to both the type of fluid (F = 25.7; df = 2; P < 0.001) and volume range (F = 12.7; df = 2; P < 0.001), as well as for the interaction between the 2 factors (F = 7.02; df = 4; P < 0.001). Water had significantly less mean error than either formula, and large volumes had significantly greater mean error than either small or medium volumes. Test weighing is an accurate method for measuring fluids of different densities and volumes in a simulation of drooling during oral feeding. The increased error with larger volumes of higher density solutions was not clinically significant. The study supports the need to consider both the accuracy of the scale

  17. THE DESIGN OF OBJECTIVE DIAGNOSTIC AND ATTAINMENT TESTS OF AN AURAL-ORAL COMMAND OF FRENCH.

    ERIC Educational Resources Information Center

    OSMAN, NEILE

    THE INCREASED EMPHASIS ON THE AUDIOLINGUAL SKILLS REQUIRES NEW APPROACHES IN TESTING. THESE SKILLS CAN BE SEPARATED INTO SEVERAL AREAS FOR WHICH GROUP AND INDIVIDUAL OBJECTIVE TESTS CAN BE CONSTRUCTED. EXAMPLES OF GROUP TESTS ARE AURAL WORD-RECOGNITION TESTS AND TESTS OF LISTENING COMPREHENSION. TESTS WHICH MUST BE ADMINISTERED INDIVIDUALLY ARE…

  18. Oral application of Escherichia coli bacteriophage: safety tests in healthy and diarrheal children from Bangladesh.

    PubMed

    Sarker, Shafiqul Alam; Berger, Bernard; Deng, Ying; Kieser, Silas; Foata, Francis; Moine, Deborah; Descombes, Patrick; Sultana, Shamima; Huq, Sayeeda; Bardhan, Pradip Kumar; Vuillet, Valérie; Praplan, Fabienne; Brüssow, Harald

    2017-01-01

    A T4-like coliphage cocktail was given with different oral doses to healthy Bangladeshi children in a placebo-controlled randomized phase I safety trial. Fecal phage detection was oral dose dependent suggesting passive gut transit of coliphages through the gut. No adverse effects of phage application were seen clinically and by clinical chemistry. Similar results were obtained for a commercial phage preparation (Coliproteus from Microgen/Russia). By 16S rRNA gene sequencing, only a low degree of fecal microbiota conservation was seen in healthy children from Bangladesh who were sampled over a time interval of 7 days suggesting a substantial temporal fluctuation of the fecal microbiota composition. Microbiota variability was not associated with the age of the children or the presence of phage in the stool. Stool microbiota composition of Bangladeshi children resembled that found in children of other regions of the world. Marked variability in fecal microbiota composition was also seen in 71 pediatric diarrhea patients receiving only oral rehydration therapy and in 38 patients receiving coliphage preparations or placebo when sampled 1.2 or 4 days apart respectively. Temporal stability of the gut microbiota should be assessed in case-control studies involving children before associating fecal microbiota composition with health or disease phenotypes. © 2016 Society for Applied Microbiology and John Wiley & Sons Ltd.

  19. Pre-Type 1 Diabetes Dysmetabolism: Maximal sensitivity achieved with Both Oral and Intravenous Glucose Tolerance Testing

    PubMed Central

    Barker, Jennifer M.; McFann, Kim; Harrison, Leonard C.; Fourlanos, Spiros; Krischer, Jeffrey; Cuthbertson, David; Chase, H. Peter; Eisenbarth, George S.; Group, the DPT-1 Study

    2007-01-01

    Objective To determine the relationship of intravenous (IVGTT) and oral (OGTT) glucose tolerance tests abnormalities to diabetes development in a high-risk pre-diabetic cohort and identify an optimal testing strategy for detecting pre-clinical diabetes. Study design Diabetes Prevention Trial Type 1 randomized subjects to oral (n=372) and parenteral (n=339) insulin prevention trials. Subjects were followed with IVGTTs and OGTTs. Factors associated with progression to diabetes were evaluated. Results Survival analysis revealed that higher quartiles of 2-hour glucose and lower quartiles of FPIR at baseline were associated with decreased diabetes-free survival. Cox proportional hazards modeling showed that baseline BMI, FPIR and 2-hour glucose levels were significantly associated with an increased hazard for diabetes. On testing performed within 6 months of diabetes diagnosis, 3% (1/32) had normal first phase insulin response (FPIR) and normal 2-hour glucose on OGTT. The sensitivities for impaired glucose tolerance (IGT) and low FPIR performed within 6 months of diabetes diagnosis were equivalent (76% vs. 73%). Conclusions Most (97%) subjects had abnormal IVGTTs and/or OGTTs prior to the development of diabetes. The highest sensitivity is achieved using both tests. PMID:17188609

  20. Thermal provocation to evaluate microvascular reactivity in human skin.

    PubMed

    Minson, Christopher T

    2010-10-01

    With increased interest in predictive medicine, development of a relatively noninvasive technique that can improve prediction of major clinical outcomes has gained considerable attention. Current tests that are the target of critical evaluation, such as flow-mediated vasodilation of the brachial artery and pulse-wave velocity, are specific to the larger conduit vessels. However, evidence is mounting that functional changes in the microcirculation may be an early sign of globalized microvascular dysfunction. Thus development of a test of microvascular reactivity that could be used to evaluate cardiovascular risk or response to treatment is an exciting area of innovation. This mini-review is focused on tests of microvascular reactivity to thermal stimuli in the cutaneous circulation. The skin may prove to be an ideal site for evaluation of microvascular dysfunction due to its ease of access and growing evidence that changes in skin vascular reactivity may precede overt clinical signs of disease. Evaluation of the skin blood flow response to locally applied heat has already demonstrated prognostic utility, and the response to local cooling holds promise in patients in whom cutaneous disorders are present. Whether either of these tests can be used to predict cardiovascular morbidity or mortality in a clinical setting requires further evaluation.

  1. Thermal provocation to evaluate microvascular reactivity in human skin

    PubMed Central

    2010-01-01

    With increased interest in predictive medicine, development of a relatively noninvasive technique that can improve prediction of major clinical outcomes has gained considerable attention. Current tests that are the target of critical evaluation, such as flow-mediated vasodilation of the brachial artery and pulse-wave velocity, are specific to the larger conduit vessels. However, evidence is mounting that functional changes in the microcirculation may be an early sign of globalized microvascular dysfunction. Thus development of a test of microvascular reactivity that could be used to evaluate cardiovascular risk or response to treatment is an exciting area of innovation. This mini-review is focused on tests of microvascular reactivity to thermal stimuli in the cutaneous circulation. The skin may prove to be an ideal site for evaluation of microvascular dysfunction due to its ease of access and growing evidence that changes in skin vascular reactivity may precede overt clinical signs of disease. Evaluation of the skin blood flow response to locally applied heat has already demonstrated prognostic utility, and the response to local cooling holds promise in patients in whom cutaneous disorders are present. Whether either of these tests can be used to predict cardiovascular morbidity or mortality in a clinical setting requires further evaluation. PMID:20507974

  2. [The effects of media violence on aggression: focus on the role of anger evoked by provocation].

    PubMed

    Yukawa, S; Endo, K; Yoshida, F

    2001-04-01

    This study investigated the effects of anger evoked by earlier provocation on cognition, emotion, and aggressive behavior after being exposed to media violence. Sixty male undergraduates participated in the experiment. Before viewing one of three videos (either highly violent, violent with high entertainment, or nonviolent), half of the subjects were provoked by a confederate posing as another subject. Subjects' heart rates and eyeblink rates were recorded while viewing the video. After viewing the video, subjects described their thoughts that occurred while watching the video and rated their affective reactions toward the video. Finally, subjects' aggressive behavior toward the confederate was measured. Results of covariance structure analysis suggested that (a) anger evoked by provocation and high level of violence in videos additively elicited negative cognition and affect, which further facilitated aggressive behavior, and (b) high level of entertainment in videos elicited positive cognition and affect, which alleviated negative cognition and affect.

  3. Experimental panic provocation in healthy man—a translational role in anti-panic drug development?

    PubMed Central

    Kellner, Michael

    2011-01-01

    Experimental neurochemical provocation of panic attacks in susceptible human subjects has considerably expanded our knowledge of the pathophysiology and psychopharmacology of panic disorder. Some panicogens also elicit short-lived panic-like states in healthy man. This offers the opportunity to assess the anti-panic action of drugs in proof-of-concept studies. However, from current data it is still unclear whether experimental panic in healthy man is a valid translational model. Most such studies in healthy volunteers have been performed using a cholecystokinin tetrapeptide (CCK-4) challenge. While CCK-4 panic was blocked by alprazolam pretreatment, escitalopram showed negative results in healthy man. Preliminary findings on novel investigational drugs and a few problematic results will be reviewed. Small sample sizes in many panic provocation studies, lack of dose-response aspects, and still-insufficient knowledge about the biological underpinning of experimental and spontaneous panic limit the interpretation of existing findings and should inspire further research. PMID:22275853

  4. Oral glucose-stimulated growth hormone (GH) test in adult GH deficiency patients and controls: Potential utility of a novel test.

    PubMed

    Pena-Bello, Lara; Seoane-Pillado, Teresa; Sangiao-Alvarellos, Susana; Outeiriño-Blanco, Elena; Varela-Rodriguez, Barbara; Juiz-Valiña, Paula; Cordido, María; Cordido, Fernando

    2017-06-09

    The diagnosis of adult GH deficiency requires confirmation with a GH stimulation test. Oral glucose (OG) administration affects GH secretion, initially decreasing and subsequently stimulating GH secretion. The aim of this study was to investigate the diagnostic efficacy and safety of a long OG test (LOGT) as a stimulus of GH secretion for the diagnosis of adult GH deficiency (AGHD). Prospective experimental cross-sectional study. The study was conducted at the Endocrinology department of the University Hospital of a Coruña, Spain. We included 60 (40 women) AGHD patients (15) and controls (45) paired 1:3, of similar age, sex and BMI. The area under the curve (AUC) and peak were calculated for GH. The Mann-Whitney test was used to compare the different groups. ROC curve analyses were used. p-Values<0.05 were considered as statistically significant. The intervention consisted of orally administering 75g oral glucose administration; GH was obtained every 30min for a total of 300min. Peak GH area under receiver operating characteristic curve (ROC-AUC) following LOGT. Peak GH (μg/L) levels were lower in the AGHD patients (0.26±0.09) than in the controls (4.00±0.45), p<0.001. After LOGT, with the ROC plot analysis the best peak GH cut-point was 1.0μg/L, with 100% sensitivity, 78% specificity, ROC-AUC of 0.9089 and 81.82% accuracy. There were no relevant adverse events during any of the LOGT. The LOGT could be a cheap, safe, convenient and effective test for the diagnosis of AGHD. Copyright © 2017 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

  5. Exogenous testosterone in a non-social provocation paradigm potentiates anger but not behavioral aggression.

    PubMed

    Panagiotidis, Despina; Clemens, Benjamin; Habel, Ute; Schneider, Frank; Schneider, Isabella; Wagels, Lisa; Votinov, Mikhail

    2017-09-19

    Animal studies suggest a causal link between testosterone and aggression. However, in human research the exact role of this hormone is still unclear, having been linked to dominance and approach behavior rather than to aggression per se. In a social context, the induction of aggression might be confounded with dominance or status changes, which potentially influence the association between aggression and testosterone. The objective of the current study was to investigate the influence of testosterone on non-social aggression in a double-blind, placebo-controlled experiment including 90 healthy male participants. To this end, we developed an innovative paradigm in which participants were provoked by a malfunctioning joystick restraining them from a promised reward. As measures for aggression throughout the task the joystick amplitude was recorded and anger was assessed via emotional self-ratings. Participants reacted to the provocation with a significant shift to more negative emotions and increased implicit aggressive behavior, reflected in the force exerted to pull the joystick following provocation. Importantly, the study demonstrated first evidence for a modulating influence of testosterone on non-social aggression in males: Self-rated anger was significantly elevated in the testosterone group compared to the placebo group as a function of provocation. Testosterone administration did not significantly influence the implicit aggressive response. These findings demonstrate a potentiating effect of testosterone on provocation-related anger in a non-social context. Furthermore, the results highlight the importance of disentangling different components of aggression and characterizing different influencing factors when inferring on hormonal effects. Copyright © 2017 Elsevier B.V. and ECNP. All rights reserved.

  6. The Effect of Mode of Response on a Semidirect Test of Oral Proficiency

    ERIC Educational Resources Information Center

    Kiddle, Thom; Kormos, Judit

    2011-01-01

    This article reports on a study conducted with 42 participants from a Chilean university, which aimed to determine the effect of mode of response on test performance and test-taker perception of test features by comparing a semidirect online version and a direct face-to-face version of a speaking test. Candidate performances on both test versions…

  7. Nickel sensitization and dietary nickel are a substantial cause of symptoms provocation in patients with chronic allergic-like dermatitis syndromes

    PubMed Central

    Soana, Roberto

    2015-01-01

    Data in literature seem to show that, in patients with contact allergic dermatitis, dietary nickel might be a cause of systemic dermatitis, but little information exists in literature about the role of nickel sensitization and dietary nickel in patients with allergic-like chronic dermatitis syndromes. The prevalence of nickel sensitization in patients with chronic allergic-like, non-IgE-mediated skin diseases, and the possible impact of dietary nickel on symptom provocation and persistence has been assessed in the present retrospective study on a case series of 1726 patients referred to our allergy unit for chronic allergic-like skin diseases. IgE-mediated pathogenesis and other differential diagnoses excluded, patients were patch tested. Nickel-positive patients underwent an elimination diet and double-blind placebo-controlled nickel challenge (DBPCNC) test. A total of 339 (20%) tested nickel-positive. Fifty-two patients (15%) recovered by avoiding sources of nickel contact and 29 (10%) dropped out. Out of the remaining nickel-sensitized patients, 277 (80%) achieved complete or near complete recovery with low-nickel content diet, and 185 of them (89%) were positive to DBPCNC. We conclude that nickel sensitization and dietary nickel seem to be the chief trigger for provocation and persistence of symptoms in an important part (∼11%) of patients with chronic allergic-like dermatitis syndromes. PMID:25747857

  8. Habitual Starvation and Provocative Behaviors: Two Potential Routes to Extreme Suicidal Behavior in Anorexia Nervosa

    PubMed Central

    Selby, Edward A.; Smith, April R.; Bulik, Cynthia M.; Olmsted, Marion P.; Thornton, Laura; McFarlane, Traci L.; Berrettini, Wade H.; Brandt, Harry A.; Crawford, Steve; Fichter, Manfred M.; Halmi, Katherine A.; Jacoby, Georg E.; Johnson, Craig L.; Jones, Ian; Kaplan, Allan S.; Mitchell, James E.; Nutzinger, Detlev O.; Strober, Michael; Treasure, Janet; Woodside, D. Blake; Kaye, Walter H.; Joiner, Thomas E.

    2016-01-01

    Anorexia nervosa (AN) is perhaps the most lethal mental disorder, in part due to starvation-related health problems, but especially because of high suicide rates. One potential reason for high suicide rates in AN may be that those affected face pain and provocation on many fronts, which may in turn reduce their fear of pain and thereby increase risk for death by suicide. The purpose of the following studies was to explore whether repetitive exposure to painful and destructive behaviors such as vomiting, laxative use, and non-suicidal self-injury (NSSI) was a mechanism that linked AN-binge-purging (ANBP) subtype, as opposed to AN-restricting subtype (ANR), to extreme suicidal behavior. Study 1 utilized a sample of 787 individuals diagnosed with one or the other subtype of AN, and structural equation modeling results supported provocative behaviors as a mechanism linking ANBP to suicidal behavior. A second, unexpected mechanism emerged linking ANR to suicidal behavior via restricting. Study 2, which used a sample of 249 AN patients, replicated these findings, including the second mechanism linking ANR to suicide attempts. Two potential routes to suicidal behavior in AN appear to have been identified: one route through repetitive experience with provocative behaviors for ANBP, and a second for exposure to pain through the starvation of restricting in ANR. PMID:20398895

  9. Habitual starvation and provocative behaviors: two potential routes to extreme suicidal behavior in anorexia nervosa.

    PubMed

    Selby, Edward A; Smith, April R; Bulik, Cynthia M; Olmsted, Marion P; Thornton, Laura; McFarlane, Traci L; Berrettini, Wade H; Brandt, Harry A; Crawford, Steve; Fichter, Manfred M; Halmi, Katherine A; Jacoby, Georg E; Johnson, Craig L; Jones, Ian; Kaplan, Allan S; Mitchell, James E; Nutzinger, Detlev O; Strober, Michael; Treasure, Janet; Woodside, D Blake; Kaye, Walter H; Joiner, Thomas E

    2010-07-01

    Anorexia nervosa (AN) is perhaps the most lethal mental disorder, in part due to starvation-related health problems, but especially because of high suicide rates. One potential reason for high suicide rates in AN may be that those affected face pain and provocation on many fronts, which may in turn reduce their fear of pain and thereby increase risk for death by suicide. The purpose of the following studies was to explore whether repetitive exposure to painful and destructive behaviors such as vomiting, laxative use, and non-suicidal self-injury (NSSI) was a mechanism that linked AN-binge-purging (ANBP) subtype, as opposed to AN-restricting subtype (ANR), to extreme suicidal behavior. Study 1 utilized a sample of 787 individuals diagnosed with one or the other subtype of AN, and structural equation modeling results supported provocative behaviors as a mechanism linking ANBP to suicidal behavior. A second, unexpected mechanism emerged linking ANR to suicidal behavior via restricting. Study 2, which used a sample of 249 AN patients, replicated these findings, including the second mechanism linking ANR to suicide attempts. Two potential routes to suicidal behavior in AN appear to have been identified: one route through repetitive experience with provocative behaviors for ANBP, and a second for exposure to pain through the starvation of restricting in ANR.

  10. Influence Of Novel Electrocardiographic Features Of Provocable Brugada ECG In Arrhythmogenic Cardiomyopathy And Its Exclusion By Lead AVR.

    PubMed

    Peters, Stefan

    2016-01-01

    In 19 patients (14 females, mean age 49.1 ± 11.3 years) with typical arrhythmogenic cardiomyopathy and provocable type I Brugada ECG pattern by ajmaline administration were analysed by novel electrocardiographic features as having "true" or "false" Brugada syndrome. Three patients turned out as having false Brugada syndrome, the diagnosis is pure arrhythmogenic cardiomyopathy. In 16 patients, however, true Brugada syndrome could be provoked. In these patients the diagnosis was arrhythmogenic cardiomyopathy associated by provocable Brugada syndrome.

  11. [Laboratory coagulation tests in patients treated by direct oral anticoagulants (DOACs)].

    PubMed

    Sié, Pierre

    2015-01-01

    Routine clotting time assays (Prothrombin Time/INR, activated Partial Thromboplastin Time [aPTT]) are prolonged at variable extent by direct oral anticoagulants (DOAC), according to the assay, the reagent and the type of DOAC. These assays are not reliable for monitoring the intensity of treatment and the measurement of the plasma level of the DOAC is usually not required. At high concentrations, DOAC interfere with the routine clotting assays, making them difficult to interpret. In critical situations such as major bleeding or urgent invasive procedure, the measurement of DOAC level and its kinetics are simple and useful to manage the patient. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  12. A novel protocol for the oral administration of test chemicals to adult zebrafish.

    PubMed

    Zang, Liqing; Morikane, Daizo; Shimada, Yasuhito; Tanaka, Toshio; Nishimura, Norihiro

    2011-12-01

    A novel protocol using gluten as a carrier material was developed to administer chemicals to adult zebrafish, per os (p.o.). To evaluate the capacity of gluten to retain chemicals, we prepared gluten granules containing eight types of chemicals with different Log P(ow) values and immersed them in water. Less than 5% of chemicals were eluted from gluten granules within 5 min, a standard feeding time for zebrafish. Although retention capability was dependent on the hydrophilicity and hydrophobicity of the chemicals, the gluten granules retained 62%-99% of the total amount of chemical, even after immersion in water for 60 min. Vital staining dyes, such as 4-Di-2-Asp and Nile red, administered p.o., were delivered into the gastrointestinal tract where they were digested and secreted. Subsequently, we conducted a pharmacokinetic study of oral administration of felbinac and confirmed that it was successfully delivered into the blood of zebrafish. This indicates that chemicals administered using gluten granules are satisfactorily absorbed from the digestive tract and delivered into the metabolic system. The absorption, distribution, and pharmacokinetics of chemicals given by oral administration were also compared with those of chemicals given by alternative administration routes such as intraperitoneal injection and exposure to chemical solution.

  13. Evaluation of a rapid oral fluid point-of-care test for MDMA.

    PubMed

    Wilson, Lisa; Jehanli, Ahmed; Hand, Chris; Cooper, Gail; Smith, Robert

    2007-03-01

    Cozart Bioscience Limited has developed novel lateral flow technology that allows the detection of drugs of abuse in biological fluids and suspect powders. This paper describes the application of this technology for the detection of 3,4-methylenedioxymethamphetamine (MDMA) in oral fluid. Samples (N = 370) were obtained from the analytical laboratory at Cozart Bioscience Limited following their routine analysis for drugs of abuse. Oral fluid samples were screened for the presence of MDMA and methamphetamine using the Cozart RapiScan System (CRS) and then confirmed for the presence of amphetamines (amphetamine, methamphetamine, MDA, MDMA, MDEA, and MBDB) by gas chromatography-mass spectrometry (GC-MS). In addition to the detection of MDMA and methamphetamine, the CRS cross-reacts with high levels of amphetamine to give a positive result. One hundred and twenty-one samples screened positive using the CRS. Six of these samples were confirmed negative for MDMA and methamphetamine, but contained very high levels of amphetamine. Employing a screening cutoff of 45 ng/mL for the CRS and a confirmation cutoff of 30 ng/mL for GC-MS, the sensitivity, specificity, and accuracy were 96.6, 96.8, and 96.8%, respectively. When applying the Substance Abuse and Mental Health Services Administration recommended confirmation cutoff for amphetamines of 50 ng/mL, the sensitivity, specificity, and accuracy increased marginally to 98.3, 96.9, and 97.3%, respectively.

  14. Single Oral Dose Toxicity Test of Blue Honeysuckle Concentrate in Mice

    PubMed Central

    Park, Sang-In; Choi, Seung-Hoon; Song, Chang-Hyun; Park, Soo-Jin; Shin, Yong-Kook; Han, Chang-Hyun; Lee, Young Joon; Ku, Sae-Kwang

    2015-01-01

    The objective of this study was to obtain single oral dose toxicity information for concentrated and lyophilized powder of blue honeysuckle (Lonicera caerulea L., Caprifoliaceae; BHcL) in female and male ICR mice to aid in the process of developing natural origin medicinal ingredients or foods following proximate analysis and phytochemical profile measurement. The proximate analysis revealed that BHcL had an energy value of 3.80 kcal/g and contained 0.93 g/g of carbohydrate, 0.41 g/g of sugar, 0.02 g/g of protein, and 0.20 mg/g of sodium. BHcL did not contain lipids, including saturated lipids, trans fats, or cholesterols. Further, BHcL contained 4.54% of betaine, 210.63 mg/g of total phenols, 159.30 mg/g of total flavonoids, and 133.57 mg/g of total anthocyanins. Following administration of a single oral BHcL treatment, there were no treatment-related mortalities, changes in body weight (bw) or organ weight, clinical signs, necropsy or histopathological findings up to 2,000 mg/kg bw, the limited dosage for rodents of both sexes. We concluded that BHcL is a practically non-toxic material in toxicity potency. PMID:25874034

  15. Effect of glycemia on plasma incretins and the incretin effect during oral glucose tolerance test.

    PubMed

    Salehi, Marzieh; Aulinger, Benedict; D'Alessio, David A

    2012-11-01

    The incretin effect, reflecting the enhancement of postprandial insulin secretion by factors including the intestinal hormones glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide, increases in proportion to meal size. However, it is unknown whether the incretin effect is dependent on ambient glucose. The goal of this study was to determine the effect of plasma glycemia on the incretin effect. Thirteen healthy subjects consumed 50 g oral glucose solution mixed with d-xylose during fixed hyperglycemia at 8 and 10.5 mmol/L, on 3 separate days, twice at lower glycemia (LOW) and once at higher values (HIGH). The relative increase in insulin release after glucose ingestion at fixed hyperglycemia, a surrogate for the incretin effect, was similar among all three studies. The GLP-1 response to oral glucose was significantly lower at higher plasma glycemia, as was the appearance of d-xylose after the meal. Between the two LOW studies, the reproducibility of insulin release in response to intravenous glucose alone and intravenous plus ingested glucose was similar. These findings indicate that the incretin contribution to postprandial insulin release is independent of glycemia in healthy individuals, despite differences in GLP-1 secretion. The incretin effect is a reproducible trait among humans with normal glucose tolerance.

  16. Development and assessment of the disposition index based on the oral glucose tolerance test in subjects with different glycaemic status.

    PubMed

    Santos, J L; Yévenes, I; Cataldo, L R; Morales, M; Galgani, J; Arancibia, C; Vega, J; Olmos, P; Flores, M; Valderas, J P; Pollak, F

    2016-06-01

    Insulin secretion and insulin sensitivity indexes are related by hyperbolic functions, allowing the calculation of the disposition index (DI) as the product of the acute insulin response (AIR) and the insulin sensitivity index (Si) from intravenous glucose tolerance test (IVGTT). Our objective was to develop an oral-DI based on the oral glucose tolerance test (OGTT) and to assess its association with glucose tolerance status. This research is structured in three studies. Study 1: OGTT were performed in 833 non-diabetic Chilean women (18-60 years) without family history of diabetes mellitus. Study 2: an independent group of n = 57 non-diabetic (18-46 years) without family history of diabetes mellitus carried out an OGTT and an abbreviated IVGTT. Study 3: a sample of 1674 Chilean adults (18-60 years) with different glycaemic status performed an OGTT. An adequate statistical fit for a rectangular hyperbola was found between the area under the curve of insulin-to-glucose ratio (AUCI/G-R) and the Matsuda ISI-COMP index (study 1). The oral-DI derived as AUCI/G-R × ISI-COMP was previously termed insulin-secretion-sensitivity index-2 (ISSI-2). ISSI-2 significantly correlated with DI from IVGTT (rho = 0.34; p = 0.009) (study 2). ISSI-2 shows important differences across groups of subjects with different glycaemic status (study 3). We have confirmed that ISSI-2 replicates the mathematical properties of DI, showing significant correlations with DI from the abbreviated MM-IVGTT. These results indicate that ISSI-2 constitutes a surrogate measure of insulin secretion relative to insulin sensitivity and emphasizes the pivotal role of impaired insulin secretion in the development of glucose homeostasis dysregulation.

  17. Uptake and Acceptability of Oral HIV Self-Testing among Community Pharmacy Clients in Kenya: A Feasibility Study

    PubMed Central

    Micheni, Murugi; Shangala, Jimmy; Hussein, Mohamed H.; Graham, Susan M.; Rinke de Wit, Tobias F.; Sanders, Eduard J.

    2017-01-01

    Background While HIV testing and counselling is a key entry point for treatment as prevention, over half of HIV-infected adults in Kenya are unaware they are infected. Offering HIV self-testing (HST) at community pharmacies may enhance detection of undiagnosed infections. We assessed the feasibility of pharmacy-based HST in Coastal Kenya. Methods Staff at five pharmacies, supported by on-site research assistants, recruited adult clients (≥18 years) seeking services indicative of HIV risk. Participants were offered oral HST kits (OraQuick®) at US$1 per test. Within one week of buying a test, participants were contacted for post-test data collection and counselling. The primary outcome was test uptake, defined as the proportion of invited clients who bought tests. Views of participating pharmacy staff were solicited in feedback sessions during and after the study. Results Between November 2015 and April 2016, 463 clients were invited to participate; 174 (38%) were enrolled; and 161 (35% [95% Confidence Interval (CI) 31–39%]) bought a test. Uptake was higher among clients seeking HIV testing compared to those seeking other services (84% vs. 11%, adjusted risk ratio 6.9 [95% CI 4.9–9.8]). Only 4% of non-testers (11/302) stated inability to pay as the reason they did not take up the test. All but one tester reported the process was easy (29%) or very easy (70%). Demand for HST kits persisted after the study and participating service providers expressed interest in continuing to offer the service. Conclusions Pharmacy HST is feasible in Kenya and may be in high demand. The uptake pattern observed suggests that a client-initiated approach is more feasible compared to pharmacy-initiated testing. Price is unlikely to be a barrier if set at about US$1 per test. Further implementation research is required to assess uptake, yield, and linkage to care on a larger scale. PMID:28125699

  18. Assessing oral literacy demand in genetic counseling dialogue: preliminary test of a conceptual framework.

    PubMed

    Roter, Debra L; Erby, Lori H; Larson, Susan; Ellington, Lee

    2007-10-01

    Health literacy deficits affect half the American patient population and are linked to poor health, ineffective disease management and high rates of hospitalization. Restricted literacy has also been linked with less satisfying medical visits and communication difficulties, particularly in terms of the interpersonal and informational aspects of care. Despite growing attention to these issues by researchers and policy makers, few studies have attempted to conceptualize and assess those aspects of dialogue that challenge persons with low literacy skills, i.e., the oral literacy demand within medical encounters. The current study uses videotapes and transcripts of 152 prenatal and cancer pretest genetic counseling sessions recorded with simulated clients to develop a conceptual framework to explore oral literacy demand and its consequences for medical interaction and related outcomes. Ninety-six prenatal and 81 cancer genetic counselors-broadly representative of the US National Society of Genetic Counselors-participated in the study. Key elements of the conceptual framework used to define oral literacy demand include: (1) use of unfamiliar technical terms; (2) general language complexity, reflected in the application of Microsoft Word grammar summary statistics to session transcripts; and, (3) structural characteristics of dialogue, including pacing, density, and interactivity. Genetic counselor outcomes include self-ratings of session satisfaction, informativeness, and development of rapport. The simulated clients rated their satisfaction with session communication, the counselor's effective use of nonverbal skills, and the counselor's affective demeanor during the session. Sessions with greater overall technical term use were longer and used more complex language reflected in readability indices and multi-syllabic vocabulary (measures averaging p<.05). Sessions with a high proportionate use of technical terms were characterized by shorter visits, high readability

  19. Effects of celiac superior mesenteric ganglionectomy on glucose homeostasis and hormonal changes during oral glucose tolerance testing in rats.

    PubMed

    Kumakura, Atsushi; Shikuma, Junpei; Ogihara, Norikazu; Eiki, Jun-ichi; Kanazawa, Masao; Notoya, Yōko; Kikuchi, Masatoshi; Odawara, Masato

    2013-01-01

    The liver plays an important role in maintaining glucose homeostasis in the body. In the prandial state, some of the glucose which is absorbed by the gastrointestinal tract is converted into glycogen and stored in the liver. In contrast, the liver produces glucose by glycogenolysis and gluconeogenesis while fasting. Thus, the liver contributes to maintaining blood glucose level within normoglycemic range. Glycogenesis and glycogenolysis are regulated by various mechanisms including hormones, the sympathetic and parasympathetic nervous systems and the hepatic glucose content. In this study, we examined a rat model in which the celiac superior mesenteric ganglion (CSMG) was resected. We attempted to elucidate how the celiac sympathetic nervous system is involved in regulating glucose homeostasis by assessing the effects of CSMG resection on glucose excursion during an oral glucose tolerance test, and by examining hepatic glycogen content and hepatic glycogen phosphorylase (GP) activity. On the oral glucose tolerance test, CSMG-resected rats demonstrated improved glucose tolerance and significantly increased GP activity compared with sham-operated rats, whereas there were no significant differences in insulin, glucagon or catecholamine levels between the 2 groups. These results suggest that the celiac sympathetic nervous system is involved in regulating the rate of glycogen consumption through GP activity. In conclusion, the examined rat model showed that the celiac sympathetic nervous system regulates hepatic glucose metabolism in conjunction with vagal nerve innervations and is a critical component in the maintenance of blood glucose homeostasis.

  20. Application of ORAL.screen saliva drug test for the screening of methamphetamine, MDMA, and MDEA incorporated in hair.

    PubMed

    Miki, Akihiro; Katagi, Munehiro; Shima, Noriaki; Tsuchihashi, Hitoshi

    2004-03-01

    By the use of a one-step immunoassay drug test for oral fluid, a convenient and fairly sensitive screening method has been devised for methamphetamine (MA), 3,4-methylenedioxymethamphetamine (MDMA), and 3,4-methylenedioxyethylamphetamine (MDEA) incorporated in hair. These drugs, in a 10-mg portion of hair, were extracted into 5M HCl/methanol (1:20, v/v), and the extract reconstituted in 100 micro L water was assayed with the saliva drug test ORAL.screen trade mark. The limits of detection were 0.5 ng/mg hair for d-MA, 0.8 ng/mg for dl-MDMA, and 1.0 ng/mg for dl-MDEA. The results are in good agreement with those of gas chromatography-mass spectrometry (GC-MS) determination. Although all positive results must be confirmed by either GC-MS or a specific alternative methodology, this method provided a simple screening, suitable for drug enforcement purposes, while requiring only a 10-mg hair specimen.

  1. Evidence that the oral glucose-tolerance test does not provide a uniform stimulus to pancreatic islets in pregnancy.

    PubMed

    de Leacy, E A; Cowley, D M

    1989-07-01

    Fifty consecutive pregnant patients referred for a glucose-tolerance test were classified on the basis of increasing (n = 20) or decreasing (n = 28) hematocrit after an oral 75-g glucose load. (The hematocrit did not change in the other two patients.) Patients with increasing hematocrit, a response previously seen in patients with the dumping syndrome, showed significantly flatter increases in glucose concentrations in plasma after the load. The mean decrease in the concentration of phosphate in plasma, measured as an index of glucose uptake by cells, was significantly less (P less than 0.05) 2 h after the load in the group with flatter glucose responses, suggesting that the flat response is ascribable to poor glucose absorption rather than to an exaggerated insulin response. These results indicate that the oral glucose-tolerance test stresses the pancreatic islets differently in different pregnant subjects, owing to individual variations in the gastrointestinal handling of the glucose load. Consequently, patients may give a "normal" result who might otherwise become hyperglycemic after normal meals. We suggest that alternative screening procedures be investigated to assess pregnant patients postprandially.

  2. New-onset diabetes after transplantation--role of oral glucose tolerance test for diagnosis and study of risk factors.

    PubMed

    Sahay, Manisha; Sahay, Rakesh K; Narayan, Girish

    2013-09-01

    To determine the role of the oral glucose tolerance test in the early detection of new-onset diabetes after transplantation (NODAT) and to compare the various risk factors and insulin kinetics in the transplant patients, we studied 41 live-related renal allograft recipients who were not diabetic before transplantation. Immunosuppression included triple drug therapy (cyclosporine, azathioprine and steroids) and rejection episodes were treated with methyl prednisolone (30 mg/kg IV × 3 days). All the study patients were subjected to an oral glucose tolerance test (OGTT) at Day 90 post-transplant and classified as having normal glucose tolerance (NGT), impaired fasting glucose (IFG), impaired glucose tolerance (IGT) and NODAT as per the World Health Organization guidelines. Insulin levels were also determined at 0, ½ hour, 1 hour and 2 hours during OGTT. NODAT was noted in 29.2% of the study patients, IFG in 4.8% of the study patients and NGT in 65.8% of the study patients. All the groups had normal fasting plasma glucose, but higher than normal insulin levels, suggesting insulin resistance. The patients with overt NODAT had, in addition, low fasting insulin (insulin secretory defect). OGTT may be used for the early detection of NODAT. Although insulin resistance is detected in the majority of post-transplant patients, NODAT also reveals also an insulin secretory defect.

  3. Evaluation of the main coagulation tests in the presence of hemolysis in healthy subjects and patients on oral anticoagulant therapy.

    PubMed

    D'Angelo, G; Villa, C; Tamborini, A; Villa, S

    2015-12-01

    Our study was designed to evaluate, on healthy subjects and patients on oral anticoagulant therapy vitamin K antagonist (OAT-vka), the possible interference caused by hemolysis on the main coagulation tests. To obtain hemolyzed samples, two methods were used: heat shock and mechanical system. The coagulation tests on hemolyzed samples were performed employing optical automated analyser BCSxp (Siemens Healthcare(®)). Moreover, the prothrombin time (PT) and activated partial thromboplastin time (aPTT) tests were also carried out manually using an electromechanical device (KC4 - Amelung). The PT test, on healthy subjects, in case of moderate hemolysis can be performed without significant interference on automatic instrument. On manual instrument, the PT test can be performed even in case of marked hemolysis. For patients on OAT-vka, the PT test in case of marked hemolysis can be performed both on automatic and manual instrument. For the aPTT test, it can be carried out manually, because also in case of marked hemolysis a statistically significant difference was not observed. For the fibrinogen test, a dramatic concentration decrease was already clear for weak hemolysis. A decreased function on antithrombin test was statistically significant for mild-moderate hemolysis. The D-dimer test showed increased values for mild hemolysis. The rejection of hemolyzed sample and/or the request of a second sample are not always the proper attitudes to take for performing clotting tests. The rational management of the hemolyzed samples decreases the employment of both nursing and technical staff significantly, the turnaround time and, consequently, does not lead to additional costs for each patient involved. © 2015 John Wiley & Sons Ltd.

  4. Measuring Adult Literacy Students' Reading Skills Using the Gray Oral Reading Test

    ERIC Educational Resources Information Center

    Greenberg, Daphne; Pae, Hye Kyeong; Morris, Robin D.; Calhoon, Mary Beth; Nanda, Alice O.

    2009-01-01

    There are not enough reading tests standardized on adults who have very low literacy skills, and therefore tests standardized on children are frequently administered. This study addressed the complexities and problems of using a test normed on children to measure the reading comprehension skills of 193 adults who read at approximately third…

  5. Oral Language Tests for Bilingual Students: An Evaluation of Language Dominance and Proficiency Instruments.

    ERIC Educational Resources Information Center

    Northwest Regional Educational Lab., Portland, OR.

    This publication represents the first attempt to address the problem of adequate evaluation processes for testing language dominance and proficiency in bilingual education. It is produced by individuals intimately acquainted with the fields of language testing and bilingual education. Issues in language testing as well as its history are…

  6. Measuring Adult Literacy Students' Reading Skills Using the Gray Oral Reading Test

    ERIC Educational Resources Information Center

    Greenberg, Daphne; Pae, Hye Kyeong; Morris, Robin D.; Calhoon, Mary Beth; Nanda, Alice O.

    2009-01-01

    There are not enough reading tests standardized on adults who have very low literacy skills, and therefore tests standardized on children are frequently administered. This study addressed the complexities and problems of using a test normed on children to measure the reading comprehension skills of 193 adults who read at approximately third…

  7. Assessment of incretins in oral glucose and lipid tolerance tests may be indicative in the diagnosis of metabolic syndrome aggravation.

    PubMed

    Kiec-Klimczak, M; Malczewska-Malec, M; Razny, U; Zdzienicka, A; Gruca, A; Goralska, J; Pach, D; Gilis-Januszewska, A; Dembinska-Kiec, A; Hubalewska-Dydejczyk, A

    2016-04-01

    Incretins stimulated by oral meals are claimed to be protective for the pancreatic beta cells, to increase insulin secretion, to inhibit glucagon release, slow gastric emptying (glucagon-like peptide-1) and suppress appetite. Recently it has however been suggested that glucagon-like peptide-1 (GLP-1) is putative early biomarker of metabolic consequences of the obesity associated proinflammatory state. The study was aimed to compare the release of incretins and some of early markers of inflammation at the fasting and postprandial period induced by functional oral glucose as well as lipid load in healthy controls and patients with metabolic syndrome (MS) to see if functional tests may be helpful in searching for the inflammatory status of patients. Fifty patients with MS and 20 healthy volunteers (C) participated in this study. The 3-hour oral glucose (OGTT) and the 8-hour oral lipid (OLTT) tolerance tests were performed. At fasting leptin and adiponectin, as well as every 30 minutes of OGTT and every 2 hours of OLTT blood concentration of GLP-1, glucose-dependent insulinotropic polypeptide (GIP), glucose, insulin, triglycerides, free fatty acids, glutathione peroxidase, interleukin-6, sE-selectin, monocyte chemoattractant protein-1 (MCP1) and visfatin were measured. At fasting and during both OGTT and OLTT the level of incretins did not differ between the MS and the C group. Both glucose and lipids reach food activated incretins secretion. Glucose was the main GLP-1 release activator, while the lipid load activated evidently GIP secretion. A significantly larger AUC-GIP after the lipid-rich meal over the carbohydrate meal was observed, while statistically bigger value of AUC-GLP-1 was noticed in OGTT than in OLTT (P < 0.001) within each of the investigated groups. In patients with the highest fasting plasma GIP concentration (3(rd) tertile), IL-6, MCP-1, sE-selectin and visfatin blood levels were increased and correlated with glutathione peroxydase, leptin

  8. Knowledge of HIV and willingness to conduct oral rapid HIV testing among dentists in Xi'an China.

    PubMed

    Wang, Lirong; Santella, Anthony J; Huang, Ruizhe; Kou, Lingling; You, Lijuan; Zhang, Xiaona; Wang, Shu; Wang, Jingyao; Gao, Longfei; Yin, Juan; Zhuang, Guihua

    2015-01-01

    China is considered a country of low HIV prevalence (780,000 people living with HIV), however, HIV infections among high-risk populations continue to grow at alarming rates. Voluntary Counseling and Testing services were first implemented in 2003, and oral rapid HIV testing (ORHT) began in 2012. Dentists, as oral health experts, would be well placed to conduct ORHT. We assessed willingness of dentists to undertake ORHT in their clinical practice. A cross-sectional, paper-based survey of dentists from the Xi'an region of China was conducted from April to June 2013. Dentists were recruited from Shaanxi Stomatological Association using a stratified sampling methodology. A 40-item survey was used to measure knowledge of HIV, attitudes toward people living with HIV and willingness to conduct ORHT. 477 dentists completed the survey with a mean HIV knowledge test score of 13.2/18 (SD 1.9). If made available in the dental setting, 276 (57.9%) preferred to use blood to diagnose HIV, only 190 (39.8%) preferred saliva or both. Four hundred and thirty-five (91.2%) thought that ORHT was needed in dental clinics. Female dentists felt more accepting of ORHT than males (93.8% vs. 87.8%; χ2=5.145; p<0.05). 42.6% of the participants who responded thought that lack of education on ORHT for dentists was the most urgent problem to solve for ORHT, 144 (31.3%) thought that lack of support for ORHT from patients was the most urgent problem. There was statistically significant difference among dental hospital, dentistry and department of dentistry (χ2=24.176; p<0.05). The majority of Chinese dentists thought that ORHT was needed in the dental setting. Providing opportunities for dentists and dental students to learn about HIV testing guidelines and practices is needed as well as feasibility and implementation science research.

  9. Knowledge of HIV and Willingness to Conduct Oral Rapid HIV Testing among Dentists in Xi’an China

    PubMed Central

    Huang, Ruizhe; Kou, Lingling; You, Lijuan; Zhang, Xiaona; Wang, Shu; Wang, Jingyao; Gao, Longfei; Yin, Juan; Zhuang, Guihua

    2015-01-01

    Introduction China is considered a country of low HIV prevalence (780,000 people living with HIV), however, HIV infections among high-risk populations continue to grow at alarming rates. Voluntary Counseling and Testing services were first implemented in 2003, and oral rapid HIV testing (ORHT) began in 2012. Dentists, as oral health experts, would be well placed to conduct ORHT. We assessed willingness of dentists to undertake ORHT in their clinical practice. Methods A cross-sectional, paper-based survey of dentists from the Xi’an region of China was conducted from April to June 2013. Dentists were recruited from Shaanxi Stomatological Association using a stratified sampling methodology. A 40-item survey was used to measure knowledge of HIV, attitudes toward people living with HIV and willingness to conduct ORHT. Results 477 dentists completed the survey with a mean HIV knowledge test score of 13.2/18 (SD 1.9). If made available in the dental setting, 276 (57.9%) preferred to use blood to diagnose HIV, only 190 (39.8%) preferred saliva or both. Four hundred and thirty-five (91.2%) thought that ORHT was needed in dental clinics. Female dentists felt more accepting of ORHT than males (93.8% vs. 87.8%; χ2=5.145; p<0.05). 42.6% of the participants who responded thought that lack of education on ORHT for dentists was the most urgent problem to solve for ORHT, 144 (31.3%) thought that lack of support for ORHT from patients was the most urgent problem. There was statistically significant difference among dental hospital, dentistry and department of dentistry (χ2=24.176; p<0.05). Conclusions The majority of Chinese dentists thought that ORHT was needed in the dental setting. Providing opportunities for dentists and dental students to learn about HIV testing guidelines and practices is needed as well as feasibility and implementation science research. PMID:25742600

  10. Macimorelin (AEZS-130)-stimulated growth hormone (GH) test: validation of a novel oral stimulation test for the diagnosis of adult GH deficiency.

    PubMed

    Garcia, J M; Swerdloff, R; Wang, C; Kyle, M; Kipnes, M; Biller, B M K; Cook, D; Yuen, K C J; Bonert, V; Dobs, A; Molitch, M E; Merriam, G R

    2013-06-01

    In the absence of panhypopituitarism and low serum IGF-I levels, the diagnosis of adult GH deficiency (AGHD) requires confirmation with a GH stimulation test. Macimorelin is a novel, orally active ghrelin mimetic that stimulates GH secretion. The objective of the study was to determine the diagnostic efficacy and safety of macimorelin in AGHD. This was a multicenter open-label study comparing the diagnostic accuracy of oral macimorelin with that of arginine+GHRH in AGHD patients and healthy, matched controls. After 43 AGHD patients and 10 controls were tested, the GHRH analog Geref Diagnostic [GHRH(1-29)NH2] became unavailable in the United States. The study was completed by testing 10 additional AGHD patients and 38 controls with macimorelin alone. Peak GH area under the receiver operating characteristic curve after macimorelin was measured. Fifty AGHD subjects and 48 controls were evaluated. Peak GH levels in AGHD patients and controls after macimorelin were 2.36 ± 5.69 and 17.71 ± 19.11 ng/mL, respectively (P < .0001). With macimorelin, the receiver operating characteristic analysis yielded an optimal GH cut point of 2.7 ng/mL, with 82% sensitivity, 92% specificity, and 13% misclassification rate. For subjects receiving both tests, macimorelin showed discrimination comparable with arginine+GHRH (area under the receiver operating characteristic curve 0.99 vs 0.94, respectively, P = .29). Obesity (body mass index > 30 kg/m(2)) was present in 58% of subjects, and peak GH levels were inversely associated with body mass index in controls (r = -0.37, P = .01). Using the separate cut points of 6.8 ng/mL for nonobese and 2.7 for obese subjects reduced the misclassification rate to 11%. Only 1 drug-related serious adverse event, an asymptomatic QT interval prolongation on the electrocardiogram, was reported. Oral macimorelin is safe, convenient, and effective in diagnosing AGHD with accuracy comparable with the arginine+GHRH test.

  11. Macimorelin (AEZS-130)-Stimulated Growth Hormone (GH) Test: Validation of a Novel Oral Stimulation Test for the Diagnosis of Adult GH Deficiency

    PubMed Central

    Swerdloff, R.; Wang, C.; Kyle, M.; Kipnes, M.; Biller, B. M. K.; Cook, D.; Yuen, K. C. J.; Bonert, V.; Dobs, A.; Molitch, M. E.; Merriam, G. R.

    2013-01-01

    Context: In the absence of panhypopituitarism and low serum IGF-I levels, the diagnosis of adult GH deficiency (AGHD) requires confirmation with a GH stimulation test. Macimorelin is a novel, orally active ghrelin mimetic that stimulates GH secretion. Objective: The objective of the study was to determine the diagnostic efficacy and safety of macimorelin in AGHD. Design: This was a multicenter open-label study comparing the diagnostic accuracy of oral macimorelin with that of arginine+GHRH in AGHD patients and healthy, matched controls. After 43 AGHD patients and 10 controls were tested, the GHRH analog Geref Diagnostic [GHRH(1–29)NH2] became unavailable in the United States. The study was completed by testing 10 additional AGHD patients and 38 controls with macimorelin alone. Main Outcome Measure: Peak GH area under the receiver operating characteristic curve after macimorelin was measured. Results: Fifty AGHD subjects and 48 controls were evaluated. Peak GH levels in AGHD patients and controls after macimorelin were 2.36 ± 5.69 and 17.71 ± 19.11 ng/mL, respectively (P < .0001). With macimorelin, the receiver operating characteristic analysis yielded an optimal GH cut point of 2.7 ng/mL, with 82% sensitivity, 92% specificity, and 13% misclassification rate. For subjects receiving both tests, macimorelin showed discrimination comparable with arginine+GHRH (area under the receiver operating characteristic curve 0.99 vs 0.94, respectively, P = .29). Obesity (body mass index > 30 kg/m2) was present in 58% of subjects, and peak GH levels were inversely associated with body mass index in controls (r = −0.37, P = .01). Using the separate cut points of 6.8 ng/mL for nonobese and 2.7 for obese subjects reduced the misclassification rate to 11%. Only 1 drug-related serious adverse event, an asymptomatic QT interval prolongation on the electrocardiogram, was reported. Conclusion: Oral macimorelin is safe, convenient, and effective in diagnosing AGHD with accuracy

  12. Testing of a palatable bait and compatible vaccine carrier for the oral vaccination of European badgers (Meles meles) against tuberculosis.

    PubMed

    Gowtage, Sonya; Williams, Gareth A; Henderson, Ray; Aylett, Paul; MacMorran, Duncan; Palmer, Si; Robertson, Andy; Lesellier, Sandrine; Carter, Stephen P; Chambers, Mark A

    2017-02-07

    The oral vaccination of wild badgers (Meles meles) with live Bacillus Calmette-Guérin (BCG) is one of the tools being considered for the control of bovine tuberculosis (caused by Mycobacterium bovis) in the UK. The design of a product for oral vaccination requires that numerous, and often competing, conditions are met. These include the need for a highly palatable, but physically stable bait that will meet regulatory requirements, and one which is also compatible with the vaccine formulation; in this case live BCG. In collaboration with two commercial bait companies we have developed a highly attractive and palatable bait recipe designed specifically for European badgers (Meles meles) that meets these requirements. The palatability of different batches of bait was evaluated against a standardised palatable control bait using captive badgers. The physical properties of the bait are described e.g. firmness and colour. The microbial load in the bait was assessed against European and US Pharmacopoeias. The bait was combined with an edible vaccine carrier made of hydrogenated peanut oil in which BCG vaccine was stable during bait manufacture and cold storage, demonstrating <0.5 log10 reduction in titre after 117weeks' storage at -20°C. BCG stability in bait was also evaluated at +4°C and under simulated environmental conditions (20°C, 98% Relative Humidity; RH). Finally, iophenoxic acid biomarkers were utilised as a surrogate for the BCG vaccine, to test variants of the vaccine-bait design for their ability to deliver biomarker to the gastrointestinal tract of individual animals. These data provide the first detailed description of a bait-vaccine delivery system developed specifically for the oral vaccination of badgers against Mycobacterium bovis using live BCG.

  13. Reliability and validity testing for the Child Oral Health Impact Profile-Reduced (COHIP-SF 19)

    PubMed Central

    Broder, Hillary L.; Wilson-Genderson, Maureen; Sischo, Lacey

    2012-01-01

    Objectives This study assessed the reliability and validity of the Child Oral Health Impact Profile–Short Form 19 (COHIP-SF 19) from the validated 34-item COHIP. Methods Participants included 205 pediatric, 107 orthodontic, and 863 patients with craniofacial anomalies (CFAs). Item level evaluations included examining content overlap, distributional properties, and use of the response set. Confirmatory factor analysis identified potential items for deletion. Scale reliability was assessed with Cronbach's alpha. Discriminant validity of the COHIP-SF 19 was evaluated as follows: among pediatric participants, scores were compared with varying amounts of decayed and filled surfaces (DFS) and presence of caries on permanent teeth; for orthodontic patients, scores were correlated with anterior tooth spacing/crowding; and for those with CFA, scores were compared with clinicians’ ratings of extent of defect (EOD) for nose and lip and/or speech hypernasality. Convergent validity was assessed by examining the partial Spearman correlation between the COHIP scores and a standard Global Health self-rating. Comparisons between the COHIP and the COHIP-SF 19 were completed across samples. Results The reduced questionnaire consists of 19 items: Oral Health (five items), Functional Well-Being (four items), and a combined subscale named Socio-Emotional Well-Being (10 items). Internal reliability is ≥0.82 for the three samples. Results demonstrate that the COHIP-SF 19 discriminates within and across treatment groups by EOD and within a community-based pediatric sample. The measure is associated with the Global Health rating (P < 0.05), thereby indicating convergent validity. Conclusions Reliability and validity testing demonstrate that the COHIP-SF 19 is a psychometrically sound instrument to measure oral health-related quality of life across school-aged pediatric populations. PMID:22536873

  14. The new oral anticoagulants and the future of haemostasis laboratory testing

    PubMed Central

    Favaloro, Emmanuel J; Lippi, Giuseppe

    2012-01-01

    The tests currently employed within most haemostasis laboratories to monitor anticoagulant therapy largely comprise the prothrombin time (PT)/ International Normalised Ratio (INR) and the activated partial thromboplastin time (APTT). These are respectively used to monitor Vitamin K antagonists (VKAs) such as warfarin, and unfractionated heparin. Additional tests that laboratories may also employ for assessing or monitoring unfractionated heparin include thrombin time (TT) and the anti-Xa assay, which can also be used to monitor low molecular weight heparin. Several new anti-thrombotic agents have recently emerged, or are in the final process of clinical evaluation. These novel drugs that include Dabigatran etexilate and Rivaroxaban would not theoretically require monitoring; however, testing is useful in specific situations. The tests currently used to monitor VKAs and heparin are typically either too sensitive or too insensitive to the new drugs to be used as ‘typically performed in laboratories’, and may thus require some methodological adjustments to increase or decrease their sensitivity. Alternately, different tests may be better employed in these assessments. Whatever the case, laboratories may soon be performing a reduced or possibly increased number of tests, the same kind of tests but perhaps differently, or conceivably different assay panels. Specific laboratory guidance on the choice of the appropriate test to be ordered according to the drug being administered, as well as on appropriate interpretation of test results, will also be necessary. The current report reviews the current state of play and provides a glimpse to the possible future of the coagulation laboratory. PMID:23092064

  15. Aggregated data from two double-blind base station provocation studies comparing individuals with idiopathic environmental intolerance with attribution to electromagnetic fields and controls.

    PubMed

    Eltiti, Stacy; Wallace, Denise; Russo, Riccardo; Fox, Elaine

    2015-02-01

    Data from two previous studies were aggregated to provide a statistically powerful test of whether exposure to electromagnetic fields (EMFs) produced by telecommunication base stations negatively affects well-being in individuals who report idiopathic environmental illness with attribution to electromagnetic fields (IEI-EMF) and control participants. A total of 102 IEI-EMF and 237 controls participated in open provocation trials and 88 IEI-EMF and 231 controls went on to complete double-blind trials in which they were exposed to EMFs from a base station emitting either a Global System for Mobile Communication and Universal Mobile Telecommunications System or a Terrestrial Trunked Radio Telecommunications System signal. Both experiments included a comparison sham condition. Visual analog and symptom scales measured subjective well-being. Results showed that IEI-EMF participants reported lower levels of well-being during real compared to sham exposure during open provocation, but not during double-blind trials. Additionally, participants reported lower levels of well-being during high compared to low load trials and this did not interact with radiofrequency-EMF exposure. These findings are consistent with a growing body of literature indicating there is no causal relationship between short-term exposure to EMFs and subjective well-being in members of the public whether or not they report perceived sensitivity to EMFs.

  16. Oral pathology.

    PubMed

    Niemiec, Brook A

    2008-05-01

    Oral disease is exceedingly common in small animal patients. In addition, there is a very wide variety of pathologies that are encountered within the oral cavity. These conditions often cause significant pain and/or localized and systemic infection; however, the majority of these conditions have little to no obvious clinical signs. Therefore, diagnosis is not typically made until late in the disease course. Knowledge of these diseases will better equip the practitioner to effectively treat them. This article covers the more common forms of oral pathology in the dog and cat, excluding periodontal disease, which is covered in its own chapter. The various pathologies are presented in graphic form, and the etiology, clinical signs, recommended diagnostic tests, and treatment options are discussed. Pathologies that are covered include: persistent deciduous teeth, fractured teeth, intrinsically stained teeth, feline tooth resorption, caries, oral neoplasia, eosinophilic granuloma complex, lymphoplasmacytic gingivostomatitis, enamel hypoplasia, and "missing" teeth.

  17. Investigation of the correlation between 100 gram oral glucose tolerance test results and maternal leptin levels during pregnancy

    PubMed Central

    Şengül, Özlem Baykara; Mungan, Tamer; Erdemoğlu, Evrim; İslamoğlu, Göksel; Kıyak, Nuran

    2009-01-01

    Objective To investigate the correlation between maternal leptin levels and 100 gram oral glucose test (OGTT) results as well as the correlation between leptin levels and the development of gestational diabetes mellitus (GDM) and glucose intolerance during pregnancy. Material and Method: 104 subjects with gestational weeks ranging from 24 to 32 weeks who had increased 50 gr OGTT values (>140) were included in this study. After the screening test, 100 gr OGTT was administered to the subjects. Sixty cases were selected from these subjects; twenty patients with one abnormal test result were identified as “glucose intolerant” group (Group 1), 20 patients with two abnormal test values were diagnosed with GDM (Group 2) and 20 patients with normal test results constituted the control group. The serum leptin levels of the groups were measured with enzyme linked immunosorbent assay (ELISA). Results The serum leptin level was 8.4±5.1 ng/ml for group 1, 9.1±5.3 ng/ml for group 2 and 6.3±4.6 ng/ml for the control group. Although serum leptin levels for group 1 and 2 was observed to be higher than the control group, the result was not statistically significant (p>0.05). This result did not change after adjusting for body mass index (BMI). Conclusion There is no statistically significant difference between leptin levels among three groups. PMID:24591860

  18. Toxicological assessment of enzyme-treated asparagus extract in rat acute and subchronic oral toxicity studies and genotoxicity tests.

    PubMed

    Ito, Tomohiro; Ono, Tomoko; Sato, Atsuya; Goto, Kazunori; Miura, Takehito; Wakame, Koji; Nishioka, Hiroshi; Maeda, Takahiro

    2014-03-01

    The safety of enzyme-treated asparagus extract (ETAS) developed as a novel anti-stress functional material was assessed in acute and subchronic studies and genotoxicity assays. In the acute oral dose toxicity study, all rats survived during the test period and ETAS did not influence clinical appearance, body weight gain and necropsy findings at a dosage of 2000mg/kg body weight. Thus, the 50% lethal dose (LD50) of ETAS was determined to be greater than 2000mg/kg. The 90-day subchronic study (500, 1000 and 2000mg/kg body weight, delivered by gavage) in rats reported no significant adverse effects in food consumption, body weight, mortality, urinalysis, hematology, biochemistry, necropsy, organ weight and histopathology. In the micronucleus test of mice, the incidence of micronuclei in ETAS-administered groups (500, 1000 and 2000mg/kg/day, injected twice) was equivalent to that of the negative control group, while the positive control group receiving mitomycin C showed a high incidence. The potential of ETAS to induce gene mutation was tested using four Salmonella typhimurium strains and Escherichia coli WP2uvrA. The test sample was not mutagenic to the test strains. These results support the safety of ETAS as food and dietary supplement. Copyright © 2014 Elsevier Inc. All rights reserved.

  19. Large Dataset of Acute Oral Toxicity Data Created for Testing in Silico Models (ASCCT meeting)

    EPA Science Inventory

    Acute toxicity data is a common requirement for substance registration in the US. Currently only data derived from animal tests are accepted by regulatory agencies, and the standard in vivo tests use lethality as the endpoint. Non-animal alternatives such as in silico models are ...

  20. Should oral gavage be abandoned in toxicity testing of endocrine disruptors?

    PubMed Central

    2014-01-01

    For decades, hazard assessments for environmental chemicals have used intra-gastric gavage to assess the effects of ‘oral’ exposures. It is now widely used – and in some cases required – by US federal agencies to assess potential toxicity of endocrine disrupting chemicals (EDCs). In this review we enumerate several reasons why gavage is not appropriate for the assessment of EDCs using bisphenol A (BPA) as a main example. First, whereas human dietary exposures interact with the oral mucosa, gavage exposures avoid these interactions, leading to dramatic differences in absorption, bioavailability and metabolism with implications for toxicokinetic assumptions and models. Additionally, there are well acknowledged complications associated with gavage, such as perforation of the esophagus that diminish its value in toxicological experiments. Finally, the gavage protocol itself can induce stress responses by the endocrine system and confound the assessment of EDCs. These serious flaws have not been taken into account in interpreting results of EDC research. We propose the exploration of alternatives to mimic human exposures when there are multiple exposure routes/sources and when exposures are chronic. We conclude that gavage may be preferred over other routes for some environmental chemicals in some circumstances, but it does not appropriately model human dietary exposures for many chemicals. Because it avoids exposure pathways, is stressful, and thus interferes with endocrine responses, gavage should be abandoned as the default route of administration for hazard assessments of EDCs. PMID:24961440

  1. Evaluation of suppression of growth hormone levels following a 75g oral glucose tolerance test.

    PubMed

    Nazaimoon, W M; Ng, M L; Satgunasingam, N; Khalid, B A

    1992-06-01

    Growth hormone (GH) levels were measured after a 75g oral glucose load (OGTT) in normal adults, patients with impaired glucose tolerance (IGT), insulin-dependent diabetes mellitus (IDDM) and acromegaly. Nadir GH levels at 2-hour post-OGTT in normal subjects ranged from 0.4 to 8.4 mIU/L, the 95% confidence interval being 0.4-4.4 mIU/L. In IGT and IDDM subjects basal fasting GH levels were not significantly different from normal and did not alter during OGTT. The high fasting GH level measured in one each of the IGT and IDDM patients was suppressible at 1-hour after glucose intake. In contrast, acromegalic patients had elevated fasting GH levels (11.8-178 mIU/L) although in 3 patients, the levels were mildly elevated and overlapped with normal. OGTT failed or only partially suppressed GH secretion in all acromegalics. Therefore, elevated fasting GH levels are not diagnostic and OGTT is required for accurate diagnosis and assessment of treatment of acromegalic patients.

  2. Simulation of oral glucose tolerance tests and the corresponding isoglycemic intravenous glucose infusion studies for calculation of the incretin effect.

    PubMed

    Kim, Myeungseon; Oh, Tae Jung; Lee, Jung Chan; Choi, Karam; Kim, Min Young; Kim, Hee Chan; Cho, Young Min; Kim, Sungwan

    2014-03-01

    The incretin effect, which is a unique stimulus of insulin secretion in response to oral ingestion of nutrients, is calculated by the difference in insulin secretory responses from an oral glucose tolerance test (OGTT) and a corresponding isoglycemic intravenous glucose infusion (IIGI) study. The OGTT model of this study, which is individualized by fitting the glucose profiles during an OGTT, was developed to predict the glucose profile during an IIGI study in the same subject. Also, the model predicts the insulin and incretin profiles during both studies. The incretin effect, estimated by simulation, was compared with that measured by physiologic studies from eight human subjects with normal glucose tolerance, and the result exhibited a good correlation (r > 0.8); the incretin effect from the simulation was 56.5% ± 10.6% while the one from the measured data was 52.5% ± 19.6%. In conclusion, the parameters of the OGTT model have been successfully estimated to predict the profiles of both OGTTs and IIGI studies. Therefore, with glucose data from the OGTT alone, this model could control and predict the physiologic responses, including insulin secretion during OGTTs and IIGI studies, which could eventually eliminate the need for complex and cumbersome IIGI studies in incretin research.

  3. Provocation 6

    ERIC Educational Resources Information Center

    Mathematics Teaching, 2009

    2009-01-01

    In this article, two old men make the link: real mathematics = functional mathematics. The two old men were referred to as Alpha and Beta. Alpha talks about the problem in so many schools, now, and that they have teachers who have either forgotten how to engage learners or who have never experienced the power. Beta speaks of a plague on teachers'…

  4. Provocation 6

    ERIC Educational Resources Information Center

    Mathematics Teaching, 2009

    2009-01-01

    In this article, two old men make the link: real mathematics = functional mathematics. The two old men were referred to as Alpha and Beta. Alpha talks about the problem in so many schools, now, and that they have teachers who have either forgotten how to engage learners or who have never experienced the power. Beta speaks of a plague on teachers'…

  5. Interdisciplinary Strategies for Treating Oral Aversions in Children.

    PubMed

    Edwards, Sarah; Davis, Ann McGrath; Ernst, Linda; Sitzmann, Brenda; Bruce, Amanda; Keeler, David; Almadhoun, Osama; Mousa, Hayat; Hyman, Paul

    2015-11-01

    Oral aversion is a frequent diagnosis in the pediatric population. For a minority of children, feeding challenges rise to the level of requiring clinical evaluation and intervention. Determining the best evaluation and treatment plan can be challenging, but there is a consensus that treatment for children with a severe oral aversion involves an interdisciplinary approach. Within the team model, multiple strategies have demonstrated effectiveness, including sensorimotor skill building, behavioral modification, hunger provocation, and sensory integration therapy. This tutorial reviews the diagnostic and treatment process for a child with oral aversion, including identification of an underlying etiology, the medical and behavioral evaluation, and formulation of a treatment plan.

  6. Oral challenge tests for soybean allergies in Japan: A summary of 142 cases.

    PubMed

    Sato, Miki; Shukuya, Akinori; Sato, Sakura; Komata, Takatsugu; Utsunomiya, Tomohiro; Imai, Takanori; Tomikawa, Morimitsu; Ebisawa, Motohiro

    2016-01-01

    Soybeans are one of causative foods for infantile onset allergies in Japan. This study aimed to analyze the results of soybean challenge tests that were conducted over approximately 7 years at our institution. Using the test data, we sought to identify the responses and clinical profiles of patients with soybean allergies, and to investigate the relationship between the responses and soybean sensitization status. Between July 2004 and May 2010, 142 cases (125 patients) underwent food challenge tests (100 g of silken tofu) for the diagnosis of soybean allergy or confirmation of their tolerance. The patients' characteristics, soybean sensitization status, and responses to the challenge tests were retrospectively evaluated. Among the subjects who underwent the soybean challenge test, the male/female ratio was 1.6 (87/55), and the mean age at the test was 2.8 ± 1.7 years. The positive rate for the challenge test was 38.7%. Induced symptoms were observed in the skin (81.8%), respiratory system (50.9%), and gastrointestinal system/mucosal membrane/anaphylaxis (12.7%). Intramuscular epinephrine was administered to all 7 patients who experienced an anaphylactic reaction. The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic efficiency of soybean-specific IgE titers were low for predicting the responses to the challenge test. Soybean allergies were diagnosed in only 18% of the subjects with positive sensitization to soybeans. Therefore, soybean-specific IgE titers are not an effective predictor of a positive response to the challenge test. Copyright © 2015 The Authors. Production and hosting by Elsevier B.V. All rights reserved.

  7. Anatomical and functional overlap within the insula and anterior cingulate cortex during interoception and phobic symptom provocation.

    PubMed

    Caseras, Xavier; Murphy, Kevin; Mataix-Cols, David; López-Solà, Marina; Soriano-Mas, Carles; Ortriz, Hector; Pujol, Jesus; Torrubia, Rafael

    2013-05-01

    The anterior insula and the dorsal anterior cingulate cortex (ACC) are regarded as key brain structures associated with the integration of perceived phobic characteristics of external stimuli and the perception of ones own body responses that leads to emotional feelings. To test to what extent the activity in these two brain structures anatomically and functionally overlap during phobic reactions and interoception, we submitted the same group of phobic participants (n = 29; either spider or blood-injection-injury (BII) phobics) and controls (n = 17) to both type of experimental paradigms. Results showed that there was a clear anatomical overlap in the Blood Oxygen Level-Dependent (BOLD) responses within the anterior insula and ACC elicited during phobic symptom provocation and during interoceptive awareness. The activity within these two brain structures also showed to be correlated in the spider phobia group, but not in the BII phobic participants. Our results seem to support the idea that the activity within these two brain areas would be associated with the integration of perceived stimuli characteristics and bodily responses that lead to what we label as "fear." However, that seems not to be the case in BII phobia, where more research is needed in order to clarify to what extent that could be associated with the idiosyncratic physiological response that these patients present in front of phobic stimuli (i.e., drop in heart rate and blood pressure).

  8. Correlation between amount of virus with altered nucleotide sequence and the monkey test for acceptability of oral poliovirus vaccine.

    PubMed Central

    Chumakov, K M; Powers, L B; Noonan, K E; Roninson, I B; Levenbook, I S

    1991-01-01

    Production of live attenuated oral poliomyelitis vaccine (OPV) requires rigorous neurovirulence safety testing of each vaccine lot, currently carried out in monkeys. It has been reported that a change from 472-U to 472-C in the type 3 OPV RNA is associated with an increased histologic lesion score produced upon intraspinal inoculation of the mutant virus in monkeys. We have developed a method, based on polymerase chain reaction, for measuring the relative abundance of these mutant sequences directly in vaccine preparations and used this method to evaluate the proportion of 472-C in 40 different lots of type 3 OPV. Six vaccine lots that had failed the intraspinal monkey neurovirulence test contained a higher proportion of 472-C than all other lots that had passed this test. OPV type 3 virus containing 472-C was rapidly selected during serial passages in African green monkey kidney cells that are used for manufacturing of the vaccine. We have also found that the wild-type poliovirus type 3 strain Leon/37, from which the vaccine strain was originally derived, contained a mixture of 472-U and 472-C sequences. No other mutations in OPV type 3 RNA have been detected by similar assays at position 2034, also associated with attenuation, or at several other positions reported to be altered in some vaccine preparations. Our results suggest that molecular diagnostics may provide a supplement or a potential alternative to animal testing of live attenuated vaccines. Images PMID:1846038

  9. Can migraine aura be provoked experimentally? A systematic review of potential methods for the provocation of migraine aura.

    PubMed

    Lindblad, Marianne; Hougaard, Anders; Amin, Faisal Mohammad; Ashina, Messoud

    2017-01-01

    Background The nature of the migraine aura and its role in migraine pathophysiology is incompletely understood. In particular, the mechanisms underlying aura initiation and the causal relation between aura and headache are unknown. The scientific investigation of aura in patients is only possible if aura can be triggered. This paper reviews potential methods for the experimental provocation of migraine aura. Methods We systematically searched PubMed for studies of experimental migraine provocation, including case reports of patients with aura and reports of the occurrence of aura following exposure to any kind of suspected trigger. Results We identified 21 provocation studies, using 13 different prospective provocation methods, and 34 case reports. In the prospective studies, aura were reported following the administration of intravenous and sublingual glyceryl trinitrate, visual stimulation, physical activity, calcitonin gene-related peptide infusion, chocolate ingestion, and the intravenous injection of insulin. In addition, carotid artery puncture has consistently been reported as a trigger of aura. Conclusions No safe and efficient method for aura provocation exists at present, but several approaches could prove useful for this purpose.

  10. Effect of natural seasonal pollen exposure and repeated nasal allergen provocations on elevation of exhaled nitric oxide.

    PubMed

    Bergmann-Hug, K; Wirth, R; Henseler, M; Helbling, A; Pichler, W J; Schnyder, B

    2009-11-01

    Exhaled nitric oxide (FENO) is a marker for allergic airway inflammation. We wondered whether in patients with intermittent allergic rhinitis only (i) natural pollen exposure and (ii) artificial pollen exposure by repeated nasal allergen provocations may lead to an elevation of FENO. In two prospective studies, we compared the FENO of nonatopic controls with the FENO of nonasthmatic individuals with mild intermittent rhinitis to tree and/or grass pollen. Study I: 13 atopic individuals and seven controls had measurements of FENO, blood eosinophils and eosinophilic cationic protein (ECP) before, during and after pollen season. Study II: 16 atopic individuals and 12 controls had nasal allergen provocations on four following days out of pollen season, with daily measurements of FENO before, 2 and 6 h after provocation, and determination of blood eosinophils, ECP and FEV1 at baseline, on days 5 and 10-12. Natural pollen exposure (study I) caused a significant elevation of FENO in allergic individuals. Nasal allergen provocations (study II) did not elicit a statistically significant rise neither of FENO nor of blood eosinophils between baseline and day 5. However, a subgroup of four individuals with a rise of blood eosinophils during nasal allergen provocations showed also a rise of FENO. We suppose that in allergic rhinitis a concomitant reaction of the bronchial system is dependent on a strong local inflammation leading to a generalized immune stimulation.

  11. Safety and predictors of adverse events during oral immunotherapy for milk allergy: severity of reaction at oral challenge, specific IgE and prick test.

    PubMed

    Vázquez-Ortiz, M; Alvaro-Lozano, M; Alsina, L; Garcia-Paba, M B; Piquer-Gibert, M; Giner-Muñoz, M T; Lozano, J; Domínguez-Sánchez, O; Jiménez, R; Días, M; Martín-Mateos, M A; Plaza-Martín, A M

    2013-01-01

    Strict avoidance is the only accepted management for cow's milk (CM) allergy. CM oral immunotherapy (CM-OIT) is under investigation. To evaluate long-term safety of CM-OIT. To identify clinical/immunological predictors of adverse events. Prospective longitudinal epidemiological intervention study. CM-allergic children aged 5-18 underwent a Spanish-approved CM-OIT protocol without premedication. Clinical data, skin prick test (SPT) and specific IgE (sIgE) at baseline and 1 year after OIT were registered. All dose-related reactions, treatments needed and cofactors involved were recorded. Through survival analysis, we studied the cumulative probability of reactions resolution over time and clinical/immunological risk factors of reactions persistence. 81 children were recruited. Mean follow-up was 25 months. 95% of children suffered reactions, 91% of which affected a single organ. Reactions were heterogeneously distributed: (a) 60 children (75%) had occasional symptoms which ceased over time. 86% of them reached complete desensitization (200 mL). (b) 20 children (25%) suffered frequent (78% of total reactions), more severe and unpredictable reactions, which persisted during follow-up or led to withdrawal (6 cases). Reactions persistence was associated with a higher frequency and severity. Kaplan-Meier estimate revealed a cumulative probability of reactions resolution of 25% at 3 months (95% CI: 1.9-4.1) and 50% (95% CI: 6.1-9.9) at 8 months based on all patients. Cox proportional hazards multivariate regression model identified 3 variables (CM-sIgE ≥ 50 KU L(-1) , CM-SPT ≥ 9 mm and Sampson's severity grades 2, 3 and 4 at baseline food challenge) as independent risk factors of reactions persistence. The combination of 2 or 3 of these factors involved hazard ratios to develop persistent reactions of 2.26 (95% CI: 1.14-4.46; P = 0.019) and 6.06 (95% CI: 2.7-13.7; P < 0.001), respectively. CM-OIT was insufficiently safe in 25% of children. The above-mentioned clinical

  12. TOEFL iBT Speaking Test Scores as Indicators of Oral Communicative Language Proficiency

    ERIC Educational Resources Information Center

    Bridgeman, Brent; Powers, Donald; Stone, Elizabeth; Mollaun, Pamela

    2012-01-01

    Scores assigned by trained raters and by an automated scoring system (SpeechRater[TM]) on the speaking section of the TOEFL iBT[TM] were validated against a communicative competence criterion. Specifically, a sample of 555 undergraduate students listened to speech samples from 184 examinees who took the Test of English as a Foreign Language…

  13. Critical Evaluation of Animal Alternative Tests for the Identification of Endocrine Active Substances, oral presentation

    EPA Science Inventory

    In the past 20 years, considerable progress in animal alternatives accompanied by advances in the toxicological sciences and new emphases on aquatic vertebrates has appeared. A significant amount of current research is targeted to evaluate alternative test methods that may reduce...

  14. Critical Evaluation of Animal Alternative Tests for the Identification of Endocrine Active Substances, oral presentation

    EPA Science Inventory

    In the past 20 years, considerable progress in animal alternatives accompanied by advances in the toxicological sciences and new emphases on aquatic vertebrates has appeared. A significant amount of current research is targeted to evaluate alternative test methods that may reduce...

  15. Diagnosis and treatment of an oral base-metal contact lesion following negative dermatologic patch tests.

    PubMed

    Lyzak, W A; Flaitz, C M; McGuckin, R S; Eichmiller, F; Brown, R S

    1994-08-01

    We report a confirmed case of intraoral contact mucositis secondary to nickel dental alloy hypersensitivity. The lesion resolved after removal of the offending prosthesis. The patient responded negatively to dermatologic patch tests, but a positive intraoral rechallenge confirmed the mucositis diagnosis. A nonreactive, gold alloy prosthesis was inserted for a successful result.

  16. SOME DIFFERENCES BETWEEN SILENT AND ORAL READING RESPONSES ON A STANDARDIZED READING TEST.

    ERIC Educational Resources Information Center

    LEIBERT, ROBERT E.

    A STUDY DESIGNED TO IDENTIFY SOME OF THE DIFFERENCES BETWEEN THE RESPONSES ON THE GATES ADVANCED PRIMARY READING TEST AND THE KINDS OF RESPONSES OBTAINED FROM AN INFORMAL READING INVENTORY (IRI) IS REPORTED. SUBJECTS WERE 65 THIRD-GRADE PUPILS IN WEST BABYLON, NEW YORK. PUPILS AT THE SAME INSTRUCTIONAL LEVEL SCORED HIGHER IN THE RECOGNITION TEST…

  17. TOEFL iBT Speaking Test Scores as Indicators of Oral Communicative Language Proficiency

    ERIC Educational Resources Information Center

    Bridgeman, Brent; Powers, Donald; Stone, Elizabeth; Mollaun, Pamela

    2012-01-01

    Scores assigned by trained raters and by an automated scoring system (SpeechRater[TM]) on the speaking section of the TOEFL iBT[TM] were validated against a communicative competence criterion. Specifically, a sample of 555 undergraduate students listened to speech samples from 184 examinees who took the Test of English as a Foreign Language…

  18. Pathophysiological studies in idiopathic hypercalciuria: use of an oral calcium tolerance test to characterize distinctive hypercalciuric subgroups.

    PubMed

    Broadus, A E; Dominguez, M; Bartter, F C

    1978-10-01

    Twenty-one unselected patients with recurrent nephrolithiasis and normocalcemic hypercalciuria with or without hypophosphatemia and 18 normal subjects were studied with an oral calcium tolerance test and for 3- to 5-day periods while consuming a low normal (400 mg) and high-normal (1000 mg) calcium intake. The oral calcium tolerance test consisted of the measurement of the calcemic, calciuric, and parathyroid (assessed by determinations of serum immunoreactive parathyroid hormone and nephrogenous cAMP) responses to acute 1000- or 350-mg doses of calcium. Nineteen patients displayed normal results for basal serum calcium, parathyroid function, and fasting calcium excretion, and striking calcemic (mean increase in serum calcium, 0.9 vs. 0.2 mg/dl in the normal subjects) and calciuric (mean increase in urinary calcium, 0.33 vs. 0.15 mg calcium/100 ml GF in the normal subjects) responses to the 1000-mg calcium tolerance test, associated with a mean 54% suppression in nephrogenous cAMP. These patients were operationally defined as having "absorptive" hypercalciuria. The variable occurrence of hypophosphatemia in this group suggested that the pathogenesis of "absorptive" hypercalciuria may be complex and/or multifactorial. There were strong positive correlations between the calciuric response to the calcium tolerance test and fractional isotopic calcium absorption (r = 0.75, P less than 0.00), the calcemic responses to the test (r = 0.71, P less than 0.001) and the calciuric responses noted on the 1000- vs. the 400-mg daily calcium intake (r = 0.78, P less than 0.001). Two patients displayed low or low normal basal serum calcium, increased parathyroid function, increased fasting calcium excretion, and a striking calciuric but minimal calcemic response to the 1000-mg calcium tolerance test, associated with a moderate suppression in nephrogenous cAMP. These patients were operationally defined as having "renal" hypercalciuria. Several lines of evidence indicated that the

  19. Standardized Simulated Events for Provocative Testing of Medical Care System Rescue Capabilities

    DTIC Science & Technology

    2005-01-01

    from the available literature.* Observed simulated event behavior. While an apneic event was initiated on room air and 100 percent O2, the PaO2 ...Pediatric Advanced Life Support. Hypoxia and hypotension were defined as SpO2 ឬ percent and systolic BPអ mm Hg, respectively, as these parameters...ETCO2 1 0 Cont. auscultation 1 0 Oxygenation SpO2 1 1 Cont. Tone/Beep 1 1 Alarm for SpO2 1 1 Perfusion SpO2 pleth 1 1 SpO2 HR 1 1

  20. Acute D-psicose administration decreases the glycemic responses to an oral maltodextrin tolerance test in normal adults.

    PubMed

    Iida, Tetsuo; Kishimoto, Yuka; Yoshikawa, Yuko; Hayashi, Noriko; Okuma, Kazuhiro; Tohi, Mikiko; Yagi, Kanako; Matsuo, Tatsuhiro; Izumori, Ken

    2008-12-01

    An examination was conducted to verify D-psicose suppressed the elevation of blood glucose and insulin concentration in a dose-dependent manner under the concurrent administration of maltodextrin and D-psicose to healthy humans. Twenty subjects aged 20-39 y, 11 males and 9 females were recruited. A load test of oral maltodextrin was conducted as a randomized single blind study. The subjects took one of five test beverages (7.5 g D-psicose alone, 75 g maltodextrin alone, 75 g maltodextrin +2.5, 5 or 7.5 g D-psicose). Blood was collected before an intake and at 30, 60, 90 and 120 min after an intake. Intervals of administration were at least 1 wk. The load test with 75 g maltodextrin showed significant suppressions of the elevation of blood glucose and insulin concentration under the doses of 5 g or more D-psicose with dose dependency. An independent administration of 7.5 g D-psicose had no influence on blood glucose or insulin concentration. D-Psicose is considered efficacious in the suppression of the elevation of blood glucose concentration after eating in humans.

  1. Automation of an in vitro cytotoxicity assay used to estimate starting doses in acute oral systemic toxicity tests.

    PubMed

    Bouhifd, Mounir; Bories, Gilles; Casado, Juan; Coecke, Sandra; Norlén, Hedvig; Parissis, Nicholaos; Rodrigues, Robim M; Whelan, Maurice P

    2012-06-01

    Application of High Throughput Screening (HTS) to the regulatory safety assessment of chemicals is still in its infancy but shows great promise in terms of facilitating better understanding of toxicological modes-of-action, reducing the reliance on animal testing, and allowing more data-poor chemicals to be assessed at a reasonable cost. To promote the uptake and acceptance of HTS approaches, we describe in a stepwise manner how a well known cytotoxicity assay can be automated to increase throughput while maintaining reliability. Results generated with selected reference chemicals compared very favourably with data obtained from a previous international validation study concerning the prediction of acute systemic toxicity in rodents. The automated assay was then included in a formal ECVAM validation study to determine if the assay could be used for binary classification of chemicals with respect to their acute oral toxicity, using a threshold equivalent to a dose of 2000 mg/kg b.w. in a rodent bioassay (LD50). This involved the blind-testing of 56 reference chemicals on the HTS platform to produce concentration-response and IC50 data. Finally, the assay was adapted to a format more suited to higher throughput testing without compromising the quality of the data obtained. Copyright © 2012 Elsevier Ltd. All rights reserved.

  2. New Insights into the Reliability of Automatic Dynamic Methods for Oral Bioaccessibility Testing: A Case Study for BGS102 soil.

    PubMed

    Cave, Mark R; Rosende, María; Mounteney, Ian; Gardner, Amanda; Miró, Manuel

    2016-09-06

    Dynamic flow-through extraction is attracting a great deal of attention for real-time monitoring of the bioaccessible fraction of metal species in environmental solid substrates compared to its batchwise manual counterparts. There is however a lack of studies on the harmonization and validation of in vitro dynamic methods for physiologically based extraction tests against in vivo bioavailability methods. This work is aimed at evaluating the reliability of dynamic flow-through extraction methods for estimation of oral bioaccessible fractions of Cu, Zn, Pb, Ni, Cr, and As under worst-case extraction conditions in the gastric compartment based on the BGS102 guidance soil using the in vivo validated Unified BARGE (UBM) test, commonly performed under batchwise mode. Good overall agreement between batch and dynamic UBM results was obtained for the tested elements, except for Pb, as a consequence of the slow leaching kinetics identified with the dynamic method and the contribution of readsorption phenomena in the course of the gastric digestion. Metal-soil phase associations and their relationship with gastric bioaccessible fractions were elucidated using the so-called Chemometric Identification of Substrates and Element Distributions method based on sequential extraction with a variety of chemicals of increasing acidity as applied to both static and dynamic bioaccessibility data.

  3. Psychophysiological responses to anger provocation among Asian Indian and White men.

    PubMed

    Suchday, Sonia; Larkin, Kevin T

    2004-01-01

    To examine cultural differences in response to anger provocation, affective, cognitive, behavioral, and cardiovascular responses to social confrontation, role plays were measured in 20 Indian male immigrants in the United States and 40 White men. Participants engaged in 2 interactions with a nonacquiescent male confederate and were instructed to suppress or express their anger in counterbalanced order. Following each role play, participants state anger, and resentful and reflective cognitions pertaining to anger were assessed. Participants' videotaped behavioral responses were assessed for problem-solving skills and negative and positive verbal and nonverbal behaviors. Blood pressure and heart rate (HR) responses were recorded throughout the session. Results revealed that Indian participants used more introspective strategies comprising of repression and rational coping self-statements to anger provocation than their White counterparts. White participants experienced significantly higher HR responses and showed more awareness of physiological sensation compared to the Indian participants, but only when asked to exhibit their anger. Indian participants had a faster diastolic blood pressure (DBP) recovery when allowed to engage in anger inhibition (which is a culturally determined mode of functioning) compared to when they had to exhibit anger before inhibiting it. White men showed a heightened cardiac response to anger expression, something not seen among Indian men. Indian men, in contrast, exhibited delayed DBP recovery from anger expression and increased introspective cognitive strategies when asked to engage in anger exhibition, a behavior not congruent with their culture of origin.

  4. Avoidant Responses to Interpersonal Provocation Are Associated with Increased Amygdala and Decreased Mentalizing Network Activity

    PubMed Central

    Krämer, Ulrike M.

    2017-01-01

    When intentionally pushed or insulted, one can either flee from the provoker or retaliate. The implementation of such fight-or-flight decisions is a central aspect in the genesis and evolution of aggression episodes, yet it is usually investigated only indirectly or in nonsocial situations. In the present fMRI study, we aimed to distinguish brain regions associated with aggressive and avoidant responses to interpersonal provocation in humans. Participants (thirty-six healthy young women) could either avoid or face a highly (HP) and a lowly (LP) provoking opponent in a competitive reaction time task: the fight-or-escape (FOE) paradigm. Subjects avoided the HP more often, but retaliated when facing her. Moreover, they chose to fight the HP more quickly, and showed increased heart rate (HR) right before confronting her. Orbitofrontal cortex (OFC) and sensorimotor cortex were more active when participants decided to fight, whereas the mentalizing network was engaged when deciding to avoid. Importantly, avoiding the HP relative to the LP was associated with both higher activation in the right basolateral amygdala and lower relative activity in several mentalizing regions [e.g., medial and inferior frontal gyrus (IFG), temporal-parietal junction (TPJ)]. These results suggest that avoidant responses to provocation might result from heightened threat anticipation and are associated with reduced perspective taking. Furthermore, our study helps to reconcile conflicting findings on the role of the mentalizing network, the amygdala, and the OFC in aggression. PMID:28660251

  5. Experimental provocation of 'ice-cream headache' by ice cubes and ice water.

    PubMed

    Mages, Stephan; Hensel, Ole; Zierz, Antonia Maria; Kraya, Torsten; Zierz, Stephan

    2017-04-01

    Background There are various studies on experimentally provoked 'ice-cream headache' or 'headache attributed to ingestion or inhalation of a cold stimulus' (HICS) using different provocation protocols. The aim of this study was to compare two provocation protocols. Methods Ice cubes pressed to the palate and fast ingestion of ice water were used to provoke HICS and clinical features were compared. Results The ice-water stimulus provoked HICS significantly more often than the ice-cube stimulus (9/77 vs. 39/77). Ice-water-provoked HICS had a significantly shorter latency (median 15 s, range 4-97 s vs. median 68 s, range 27-96 s). There was no difference in pain localisation. Character after ice-cube stimulation was predominantly described as pressing and after ice-water stimulation as stabbing. A second HICS followed in 10/39 (26%) of the headaches provoked by ice water. Lacrimation occurred significantly more often in volunteers with than in those without HICS. Discussion HICS provoked by ice water was more frequent, had a shorter latency, different pain character and higher pain intensity than HICS provoked by ice cubes. The finding of two subsequent HICS attacks in the same volunteers supports the notion that two types of HICS exist. Lacrimation during HICS indicates involvement of the trigeminal-autonomic reflex.

  6. Use of Provocative Angiography to Localize Site in Recurrent Gastrointestinal Bleeding

    SciTech Connect

    Johnston, Ciaran Tuite, David; Pritchard, Ruth; Reynolds, John; McEniff, Niall; Ryan, J. Mark

    2007-09-15

    Background. While the source of most cases of lower gastrointestinal bleeding may be diagnosed with modern radiological and endoscopic techniques, approximately 5% of patients remain who have negative endoscopic and radiological investigations.Clinical Problem. These patients require repeated hospital admissions and blood transfusions, and may proceed to exploratory laparotomy and intraoperative endoscopy. The personal and financial costs are significant. Method of Diagnosis and Decision Making. The technique of adding pharmacologic agents (anticoagulants, vasodilators, fibrinolytics) during standard angiographic protocols to induce a prohemorrhagic state is termed provocative angiography. It is best employed when significant bleeding would otherwise necessitate emergency surgery. Treatment. This practice frequently identifies a bleeding source (reported success rates range from 29 to 80%), which may then be treated at the same session. We report the case of a patient with chronic lower gastrointestinal hemorrhage with consistently negative endoscopic and radiological workup, who had an occult source of bleeding identified only after a provocative angiographic protocol was instituted, and who underwent succeeding therapeutic coil embolization of the bleeding vessel.

  7. Orally inhaled drug performance testing for product development, registration, and quality control.

    PubMed

    Lastow, Orest; Svensson, Mårten

    2014-12-01

    A DPI can be split into three different modules; device, formulation, process. These are developed in parallel, and together with the user they provide the performance of an inhalation product. During product development, these modules are evolving and changing, whereas the requirements on an inhalation product are always expressed in terms of the performance of the final commercial product. To do performance testing during development when the product is not finished presents many challenges and can be confusing and misleading. During development, the performance of the final product is typically being predicted by testing ever changing prototypes. This article describes methods and approaches to manage such development and to, during development, provide relevant predictions of the in vitro and in vivo performances of the final product.

  8. Caffeine ingestion before an oral glucose tolerance test impairs blood glucose management in men with type 2 diabetes.

    PubMed

    Robinson, Lindsay E; Savani, Sonali; Battram, Danielle S; McLaren, Drew H; Sathasivam, Premila; Graham, Terry E

    2004-10-01

    Caffeine ingestion negatively affects insulin sensitivity during an oral glucose tolerance test (OGTT) in lean and obese men, but this has not been studied in individuals with type 2 diabetes. We examined the effects of caffeine ingestion on insulin and glucose homeostasis in obese men with type 2 diabetes. Men (n = 12) with type 2 diabetes (age = 49 +/- 2 y, BMI = 32 +/- 1 kg/m(2)) underwent 2 trials, 1 wk apart, in a randomized, double-blind design. Each trial was conducted after withdrawal from caffeine, alcohol, exercise, and oral hypoglycemic agents for 48 h and an overnight fast. Subjects randomly ingested caffeine (5 mg/kg body weight) or placebo capsules and 1 h later began a 3 h 75 g OGTT. Caffeine increased (P < 0.05) serum insulin, proinsulin, and C-peptide concentrations during the OGTT relative to placebo. Insulin area under the curve was 25% greater (P < 0.05) after caffeine than after placebo ingestion. Despite this, blood glucose concentration was also increased (P < 0.01) in the caffeine trial. After caffeine ingestion, blood glucose remained elevated (P < 0.01) at 3 h postglucose load (8.9 +/- 0.7 mmol/L) compared with baseline (6.7 +/- 0.4 mmol/L). The insulin sensitivity index was lower (14%, P = 0.02) after caffeine than after placebo ingestion. Overall, despite elevated and prolonged proinsulin, C-peptide, and insulin responses after caffeine ingestion, blood glucose was also increased, suggesting an acute caffeine-induced impairment in blood glucose management in men with type 2 diabetes.

  9. Insulin resistance and lipid profile during an oral glucose tolerance test in women with and without gestational diabetes mellitus.

    PubMed

    Liang, Zx; Wu, Y; Zhu, Xy; Fang, Q; Chen, Dq

    2016-01-01

    We aimed to compare changes in insulin levels during an oral glucose tolerance test (OGTT) between women with normal glucose tolerance (NGT) during pregnancy and those with gestational diabetes mellitus (GDM). Overall, 105 pregnant women between 24 and 28 weeks' gestation, 50 with NGT and 55 with GDM according to NDDG standard, were enrolled into the study. The levels of fasting blood glucose, insulin, triglyceride (TG) and total cholesterol (TC) and the insulin levels, blood glucose levels at 1, 2 and 3 hours post oral glucose administration during an OGTT (5.8, 10.6, 9.2 and 8.1 mmol/L, respectively) were measured. Then, insulin resistance (IR) index was calculated. There was no significant difference in fasting, 3-h insulin levels and 3-h blood glucose levels between those with NGT and those with GDM (P > 0.05). However, 1-h and 2-h insulin levels, fasting and 1-h and 2-h blood glucose levels in women with GDM were significantly higher than those in the NGT group (P < 0.05). Fasting TC and TG levels in the GDM group were significantly higher than those with NGT (P = 0.031 and P = 0.025, respectively). Correlation analysis showed that TG and TC levels were positively correlated with homoeostasis model assessment-IR (HOMA-IR) (r = 0.67 and r = 0.78, respectively; P < 0.05). Our findings suggest that insulin sensitivity in women with GDM was significantly lower than that observed in those with NGT. Reducing IR and blood lipids in women with GDM could potentially improve maternal and foetal outcomes.

  10. Simple Urine Test to Evaluate Adherence to Oral 5-ASA in Teenagers With Ulcerative Colitis: Proof of Concept.

    PubMed

    Dijkstra, Alie; Touw, Daan J; van Rheenen, Patrick F

    2017-10-01

    5-Aminosalicylic acid (5-ASA) is an important maintenance drug for patients with ulcerative colitis. A proportion of the ingested dose is excreted in the urine. Measuring 5-ASA and its metabolites in urine requires mass spectrometry, which is not widely available for this purpose. Urinary 5-ASA can be measured by colorimetry using the serum salicylic acid assay and is a surrogate marker of recent 5-ASA ingestion. We evaluated whether measuring 5-ASA in first morning voids or in random spot urine samples correctly identifies teenagers with poor adherence to oral 5-ASA. Teenagers who were prescribed a current regimen including >40 mg · kg · day of 5-ASA were invited to collect their spot urine with various time lapses since their last presumed 5-ASA ingestion. Classification of adherence was based on a composite method that included a patient-reported adherence scale and 6-thioguanine levels in erythrocytes. Teenagers who were classified as "good adherers" had 66 of 69 (96%; 95% confidence interval 87%-99%) spot urine samples with detectable 5-ASA levels. "Poor adherers" had 30 of 45 (67%; 95% confidence interval 52%-79%) spot urine samples with undetectable 5-ASA levels. The "good adherers" with false-negative urine tests were on a once daily dosing regimen and had collected a spot urine sample shortly before the next dosage. Their first morning voids had detectable 5-ASA levels. Undetectable 5-ASA levels in the first morning void confirms short-term nonadherence to oral 5-ASA.

  11. Correspondence of continuous interstitial glucose measurement against arterialised and capillary glucose following an oral glucose tolerance test in healthy volunteers.

    PubMed

    Dye, Louise; Mansfield, Michael; Lasikiewicz, Nicola; Mahawish, Lena; Schnell, Rainer; Talbot, Duncan; Chauhan, Hitesh; Croden, Fiona; Lawton, Clare

    2010-01-01

    The aim of the present study was to validate the Glucoday continuous interstitial ambulatory glucose-monitoring device (AGD) against plasma glucose measured from arterialised venous (AV) and glucose from capillary whole blood (finger prick, FP) in non-diabetic subjects in response to an oral glucose tolerance test. Fifteen healthy overweight men (age 30-49 years, BMI 26-31 kg/m2) participated. Glucose levels were measured before, during and after consumption of an oral 75 g glucose load using twelve FP samples and forty-four 1 ml AV blood samples during 180 min. Interstitial glucose was measured via the AGD. Three venous samples for fasting insulin were taken to estimate insulin resistance. Profiles of AGD, AV and FP glucose were generated for each participant. Glucose values for each minute of the measurement period were interpolated using a locally weighted scatterplot smoother. Data were compared using Bland-Altman plots that showed good correspondence between all pairs of measurements. Concordance between the three methods was 0.8771 (Kendall's W, n 15, P < 0.001). Concordance was greater between AV and FP (W = 0.9696) than AGD and AV (W = 0.8770) or AGD and FP (W = 0.8764). Analysis of time to peak glucose indicated that AGD measures lagged approximately 15 min behind FP and AV measures. Percent body fat was significantly correlated with time to peak glucose levels for each measure, while BMI and estimated insulin resistance (homeostatic model assessment, HOMA) were not. In conclusion, AGD shows good correspondence with FP and AV glucose measures in response to a glucose load with a 15 min time lag. Taking this into account, AGD has potential application in nutrition and behaviour studies.

  12. Cephalothin is not a reliable surrogate marker for oral cephalosporins in susceptibility testing of Enterobacteriaceae causing urinary tract infection.

    PubMed

    López, Itziar Angulo; Montes, Jorge Calvo; Álvarez, Mar Justel; Mazarrasa, Carlos Fernández; Martínez-Martínez, Luis

    2016-12-01

    Vitek® 2 (bioMérieux) is a widely used commercial antimicrobial susceptibility test (AST) system. AST-N244 card includes cephalothin as first-generation cephalosporin. We compared the cephalothin susceptibility results obtained with Vitek® 2 AST-N244 to those obtained by broth microdilution (BMD) and disk diffusion (DD) for 212 urinary Enterobacteriaceae. We also evaluated the differences between cefazolin and cephalothin susceptibility results. The overall performance of Vitek® 2 for cephalothin testing was 74.5% and 76.4% category agreement compared to BMD and DD, respectively; 84.4% essential agreement; very major errors 15.2% and 11.1% compared to BMD and DD; major errors 0% compared to both methods; and minor errors 22.2% and 21.7% compared to BMD and DD. Regarding correlation between cephalothin and cefazolin, the differences observed were statistically significant (P<0.0001) for the 167 Escherichia coli included (39.5% cephalothin susceptible versus 92.2% cefazolin susceptible by BMD; 41.9% cephalothin susceptible versus 93.4% cefazolin susceptible by DD). Vitek® 2 should provide cefazolin instead of cephalothin as a surrogate marker for oral cephalosporins on the urinary AST-244 cards in order to follow the CLSI (2016) recommendations.

  13. The nondestructive testing research on porcelain-fused-to-metal (PFM) of oral cavity

    NASA Astrophysics Data System (ADS)

    Yang, Guo-biao; Zhang, Zhang; Ding, Yi

    2008-09-01

    PFM has the advantages of real color and anti-milled, widely be used in restoration of teeth destroyed, teeth incomplete and teeth beauty. However, due to the issue of brittleness of ceramics and its manufacturing technology, the case of lost ceramics, crack inside and interface separate often occurs in clinical. In this regard, it not only delay the restoration, but also greatly add the expense of restoration. Hence, a inspection method is required to develop, in order to judge whether there is flaw on the PFM teeth cover or inside or not both before and after restoration. This paper will adopt Scanning Acoustic Microscope and X-Ray Microscope Inspection to conduct the Nondestructive testing for PFM restoration. The results show that the above two methods are both feasible on flaw inspection. Especially, the combination of two methods could effectively inspect the flaw's depth and size on PFM cover or inside, this will provide widely application for clinical in the future.

  14. Pharmacokinetics and pharmacodynamics of oral mecamylamine - development of a nicotinic acetylcholine receptor antagonist cognitive challenge test using modelling and simulation.

    PubMed

    Alvarez-Jimenez, Ricardo; Baakman, Anne Catrien; Stevens, Jasper; Goulooze, Sebastiaan C; Hart, Ellen P; Rissmann, Robert; van Gerven, Joop Ma; Groeneveld, Geert Jan

    2017-02-01

    A pharmacologic challenge model with a nicotinic antagonist could be an important tool not only to understand the complex role of the nicotinic cholinergic system in cognition, but also to develop novel compounds acting on the nicotinic acetylcholine receptor. The objective was to develop a pharmacokinetic-pharmacodynamic (PKPD) model using nonlinear mixed effects (NLME) methods to quantitate the pharmacokinetics of three oral mecamylamine doses (10, 20 and 30 mg) and correlate the plasma concentrations to the pharmacodynamic effects on a cognitive and neurophysiologic battery of tests in healthy subjects. A one-compartment linear kinetic model best described the plasma concentrations of mecamylamine. Mecamylamine's estimated clearance was 0.28 ± 0.015 L min(-1). The peripheral volume of distribution (291 ± 5.15 L) was directly related to total body weight. Mecamylamine impaired the accuracy and increased the reaction time in tests evaluating short term working memory with a steep increase in the concentration-effect relationship at plasma concentrations below 100 μg L(-1). On the other hand, mecamylamine induced a decrease in performance of tests evaluating visual and fine motor coordination at higher plasma concentrations (EC50 97 μg L(-1)). Systolic and diastolic blood pressure decreased exponentially after a plasma mecamylamine concentration of 80 μg L(-1), a known effect previously poorly studied in healthy subjects. The developed mecamylamine PKPD model was used to quantify the effects of nicotinic blockade in a set of neurophysiological tests in humans with the goal to provide insight into the physiology and pharmacology of the nicotinic system in humans and the possibility to optimize future trials that use mecamylamine as a pharmacological challenge.

  15. A comparison of the oral and silent reading methods of standardized science test delivery on the performance level of fifth-grade African American students

    NASA Astrophysics Data System (ADS)

    Merenda, Gloria Louise

    This study compared two methods of standardized test administration, oral delivery using an audio tape and the standard silent reading by the student, on the performance level (test score) and science understanding (right answer/right reason) of urban fifth grade African American students. The effect of reading ability, special needs, and socioeconomic status were also examined as possible confounding variables. A randomized post-test only control group design was used with data for the sample (N = 106) collected from student files at two Detroit Public Schools, which included the Michigan Education Assessment Program (MEAP) reading and science scores. In addition, face-to-face interviews were completed with a small subsample to determine reasoning for selecting their answers. Six hypotheses were developed to determine if there were significant differences in science performance level and understanding in fifth grade urban African American students when the standardized science test, MEAP, Area Specific Portions, Physical Science and Earth/Space Science, were delivered orally, using the audio tape, and silently, which is the present standard delivery method. Significant differences in scores were found favoring the oral over the silent test group. A significant association was also found for reading and science MEAP scores, with students who had higher scores on the reading test achieving higher scores on the science test. Although socioeconomic status did not appear to result in differential outcomes among the students, a significant interaction was found between test administration type and socioeconomic status. The conclusion that was reached was that students who have difficulty in reading the printed material could benefit from having standardized tests administered orally (except for reading tests).

  16. Correlations of nasal responses to leukotriene D4 and histamine nasal provocation with quality of life in allergic rhinitis

    PubMed Central

    Zhu, Zheng; Xie, Yanqing; Guan, Weijie; Gao, Yi; Xia, Shu; Shi, Xu

    2016-01-01

    Background The symptoms of allergic rhinitis (AR) greatly affect the quality of life (QoL) in the patients with AR. The correlations of nasal response to leukotriene D4 (LTD4) and histamine nasal provocation with health related QoL in AR are not clear. Objective To evaluate the correlations of nasal response to LTD4 and histamine nasal challenge with QoL in AR. Methods Patients randomly underwent LTD4 and histamine nasal challenge tests, completed the rhinoconjunctivitis quality of life questionnaire (RQoLQ), and rating the symptom severity score (total symptom score 4, TSS4) in the previous week. The correlations between nasal challenge tests induced nasal responses and QoL in RQoLQ were analyzed. Results A total of 25 eligible AR patients enrolled and finished both LTD4 and histamine nasal challenge and completed the questionnaire of RQoLQ. Histamine nasal challenge induced sneezing, increased nasal resistant were correlated with most of the dimensions (general, practical, nasal, eye problems, and quality of sleep, p < 0.05), while LTD4 nasal challenge induced sneeze, increased nasal resistant only correlated with nasal and ocular problems. On the contrary, the severity of the sneeze assessed by TSS4, was not correlated with QoL, while the severity of rhinorrhea, congestion, and nasal pruritus were correlated with nasal and practical problems, and nasal congestion was also correlated with ocular problems (r = 0.60, p = 0.01). Conclusion LTD4 and histamine nasal challenge induced nasal responses were correlated with different clinical symptoms severity and QoL, which can be used as a good diagnosis and evaluation methods for the management of AR. PMID:27803885

  17. Point-of-care coagulation testing for assessment of the pharmacodynamic anticoagulant effect of direct oral anticoagulant.

    PubMed

    Mani, Helen; Herth, Natalie; Kasper, Alexander; Wendt, Thomas; Schuettfort, Gundolf; Weil, Yvonne; Pfeilschifter, Waltraud; Linnemann, Birgit; Herrmann, Eva; Lindhoff-Last, Edelgard

    2014-10-01

    This investigation was carried out with already available point-of-care testing (POCT) systems for coagulation parameters to evaluate the qualitative and semiquantitative determination of the time- and concentration-dependent anticoagulant effects of the direct oral anticoagulants rivaroxaban and dabigatran. The whole blood prothrombin time (PT), activated partial thromboplastin time (aPTT), and activated clotting time (ACT) were determined using the GEM PCL Plus coagulation system. Whole blood PT was also measured on the CoaguCheck XS instrument. In addition, PT and aPTT values were obtained in citrated plasma using the PT reagent Neoplastin Plus and the STA APTT reagent. Drug concentrations of rivaroxaban and dabigatran were determined with a chromogenic anti-Xa assay and the hemoclot assay, which are reported to have good agreement with liquid chromatography coupled with tandem mass spectrometry measurements. POCT was performed in 27 consecutive patients who received rivaroxaban 10, 15, or 20 mg once daily and in 15 patients receiving dabigatran 110 or 150 mg twice daily. Blood samples were collected predose and 2 hours after observed drug intake at steady state. Two hours after observed rivaroxaban administration, the whole blood PT measured on the GEM PCL Plus was prolonged by an average of 64.5% in comparison with predose levels. Less differentiation was observed for rivaroxaban when the PT was measured on the CoaguCheck XS instrument or in plasma (prolongation of 24.1% and 36.8%, respectively). After 2 hours observed dabigatran administration, the whole blood aPTT was comparable with plasma values and was prolonged by 23.5% in comparison with trough values. Significant concentration-dependent prolongations of the activated clotting time were observed to different extents for both direct anticoagulants. Direct oral anticoagulants display variable ex vivo effects on different POCT-assays. POCT for aPTT is sensitive to increased concentrations of dabigatran

  18. Severe selective magnesium malabsorption: tests of tolerance of oral magnesium supplements.

    PubMed

    Mettey, R; Guillard, O; Merle, P; Maillet-Picker, F

    1990-12-01

    Since his birth, we have been monitoring a 12-year-old boy suffering from selective severe magnesium malabsorption. Our essential problem is to prepare a form of galena with acceptable taste, tolerated by the digestive tract and well absorbed; also, the carrier compound must not cause short- or long-term side effects. An additional factor is the steadily increasing need for magnesium from 1 mmol/kg.d at 1 year to 14 mmol/kg.d at present age (345 mg/kg.d). The galena forms currently on sale were, with the exception of lactate and pyrollidone carboxylate, immediately rejected since they contain insufficient Mg2+. Following short trials resulting in diarrhoea, the other two preparations were also rejected. We then constituted - and also abandoned - our own galena compounds: aspartate (bitterness), aspartate + glycerophosphate (GLP) (bitterness), glutamate + GLP ('Chinese restaurant syndrome' and fear of the long term toxic effect of the glutamate), gluconate (excessive volume: 11/1 proportion with Mg2+). A recent test featuring GLP of Mg 40 g + cocoa butter 40 g + cocoa 10 g, brought about vomiting and diarrhoea, and was not adequately absorbed. The best tolerated formula is: Mg GLP 21.33 g; saccharose 6 g; aspartam 1 g; gelatin 0.5 g; citric acid, conserving agent, fruity aroma; water: qs 100 g. Such composition yields a caramel cream absorbed in five small portions, at a daily quantity of 375 g (80 g GLP Mg, 10 g Mg2+). Vitamin B6, which promotes intestinal absorption of magnesium, must be given separately in tablet form at a dose of 1 g/d, since it causes nausea if it is included in the Mg preparation.(ABSTRACT TRUNCATED AT 250 WORDS)

  19. A Preliminary Investigation of Second- and Fourth-Grade African American Students' Performance on the Gray Oral Reading Test-Fourth Edition

    ERIC Educational Resources Information Center

    Champion, Tempii B.; Rosa-Lugo, Linda I.; Rivers, Kenyatta O.; McCabe, Allyssa

    2010-01-01

    Purpose: Research has established that African American (AA) children are lagging behind other children in their reading skills. A number of factors have been proposed to account for the literacy gap; however no single factor has entirely explained this disparity. This investigation examined the appropriateness of the Gray Oral Reading Test-Fourth…

  20. The shape of the glucose response curve during an oral glucose tolerance test heralds biomarkers of type 2 diabetes risk in obese youth

    USDA-ARS?s Scientific Manuscript database

    The shape of the glucose response curve during an oral glucose tolerance test (OGTT), monophasic versus biphasic, identifies physiologically distinct groups of individuals with differences in insulin secretion and sensitivity. We aimed to verify the value of the OGTT-glucose response curve against m...

  1. Primary hyperparathyroidism with intermittent hypercalcaemia: serial observations and simple diagnosis by means of an oral calcium tolerance test.

    PubMed

    Broadus, A E; Horst, R L; Littledike, E T; Mahaffey, J E; Rasmussen, H

    1980-03-01

    Ten patients with subtle primary hyperparathyroidism and intermittent hypercalcaemia were followed serially for periods of 2--18 months (mean 10 months). Fasting serum calcium was elevated (greater than 10.6 mg/dl) in only 20% of determinations and fluctuated widely (9.1--11.2 mg/dl), yet the patients displayed a continuous, rather than episodic, basic disease process as defined by increases in nephrogenous cyclic AMP and serum iPTH. Identical findings were noted in short-term (2--3 successive days) studies in twelve patients. In response to a 1000 mg oral calcium tolerance test, twelve patients with primary hyperparathyroidism and intermittent hypercalcaemia (basal serum calcium 10.2 +/- 0.2 mg/dl, mean +/- SD) displayed: (1) hyperabsorption of calcium (mean calciuric response twice normal); (2) induced-hypercalcaemia (mean serum calcium 11.4 mg/dl, with a mean increase of 1.2 mg/dl versus 0.2 mg/cl in normal subjects); and (3) abnormal parathyroid suppressibility (nephrogenous cyclic AMP 2.66 +/- 0.57 nmol/100 ml GF versus 0.95 +/- 0.40 nmol/100 ml GF in normal subjects, mean +/- SD). The patients demonstrated striking hypercalciuria (452 +/- 123 mg/24 h) on a 1000 mg metabolic calcium diet. Serum levels of 1,25(OH)2D3, measured in ten patients, were markedly elevated at 90 +/- 20 pg/ml (mean +/- SD), and there was a strong positive correlation between the values for 1,25(OH)2D3 and the calciuric response to the calcium tolerance test (r = 0.75, P less than 0.001). These results (1) indicate that the calcium tolerance test is a simple and reliable technique for diagnosis of patients with primary hyperparathyroidism and intermittent hypercalcaemia, and (2) emphasize the important pathophysiologic features of this subtle clinical variant of primary hyperparathyroidism.

  2. Talking to Score: Impression Management in L2 Oral Assessment and the Co-Construction of a Test Discourse Genre

    ERIC Educational Resources Information Center

    Luk, Jasmine

    2010-01-01

    In recent years, the emphasis in second language (L2) oral proficiency assessment has shifted from linguistic accuracy to discourse strategies such as the ability to initiate, respond, and negotiate meaning. This has resulted in a growing interest in the discourse analysis of students' performance in different oral proficiency assessment formats.…

  3. Talking to Score: Impression Management in L2 Oral Assessment and the Co-Construction of a Test Discourse Genre

    ERIC Educational Resources Information Center

    Luk, Jasmine

    2010-01-01

    In recent years, the emphasis in second language (L2) oral proficiency assessment has shifted from linguistic accuracy to discourse strategies such as the ability to initiate, respond, and negotiate meaning. This has resulted in a growing interest in the discourse analysis of students' performance in different oral proficiency assessment formats.…

  4. A comparison of effectiveness between oral rapid testing and routine serum-based testing for HIV in an outpatient dental clinic in Yuxi Prefecture, China: a case-control study.

    PubMed

    Li, Shifu; Su, Shu; Li, Shunxiang; Gao, Liangmin; Cai, Ying; Fu, Jincui; Guo, Chunyuan; Lu, Wei; Cheng, Feng; Jing, Jun; Chen, Liang; Zhang, Lei

    2017-06-30

    To compare the outcomes of routine provider-initiated HIV testing and counselling (PITC) and oral rapid HIV testing for dental clinic outpatients in a hospital. We employed a case-control study design and recruited dental outpatients into routine serum-based and oral rapid testing groups. We compared the acceptance, completion and result notification rate between groups. A dental outpatient clinic in the Yuxi People's Hospital, Yunnan. A total of 758 and 816 dental outpatients were enrolled for routine and oral rapid testing, respectively. The percentage of participants willing to receive routine HIV testing was 28.1% (95% CI 24.9% to 31.3%) and 96.1% (95% CI 94.8% to 97.4%, χ2=186.4, p<0.001) for the rapid testing. Among accepted participants, the percentage of participants who received HIV testing was 26.8% (95% CI 20.9% to 32.7%) in the routine testing group and 100.0% in the oral rapid HIV testing group (χ2=77.5, p<0.001). About 93.0% of routine testers returned for the test results on the next day, whereas all rapid testers received their test results on the same day (χ2=34.6, p<0.001). These correspond to an overall completion rate of 7.0% (95% CI 5.2% to 8.8%) and 96.1% (95% CI 94.8% to 97.4%, p<0.001), respectively. Among the 545 patients who declined routine serum-based HIV testing, the main reasons included, an unnecessary hassle (254/545, 46.6%), having been previously tested (124/545, 22.8%) and self-perceived low risk of HIV infection (103/545, 18.9%). In contrast, only 32 individuals declined oral rapid testing, and having received a previous test was the primary reason. Three patients in the rapid testing group were later confirmed HIV-positive, yielding an HIV prevalence of 0.38%. Oral rapid HIV testing is a feasible and efficient approach in a clinical setting. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  5. Do TETRA (Airwave) Base Station Signals Have a Short-Term Impact on Health and Well-Being? A Randomized Double-Blind Provocation Study

    PubMed Central

    Wallace, Denise; Eltiti, Stacy; Ridgewell, Anna; Garner, Kelly; Russo, Riccardo; Sepulveda, Francisco; Walker, Stuart; Quinlan, Terence; Dudley, Sandra; Maung, Sithu; Deeble, Roger; Fox, Elaine

    2010-01-01

    Background “Airwave” is the new communication system currently being rolled out across the United Kingdom for the police and emergency services, based on the Terrestrial Trunked Radio Telecommunications System (TETRA). Some police officers have complained about skin rashes, nausea, headaches, and depression as a consequence of using their Airwave handsets. In addition, a small subgroup in the population self-report being sensitive to electromagnetic fields (EMFs) in general. Objectives We conducted a randomized double-blind provocation study to establish whether short-term exposure to a TETRA base station signal has an impact on the health and well-being of individuals with self-reported “electrosensitivity” and of participants who served as controls. Methods Fifty-one individuals with self-reported electrosensitivity and 132 age- and sex-matched controls participated in an open provocation test; 48 sensitive and 132 control participants went on to complete double-blind tests in a fully screened semianechoic chamber. Heart rate, skin conductance, and blood pressure readings provided objective indices of short-term physiological response. Visual analog scales and symptom scales provided subjective indices of well-being. Results We found no differences on any measure between TETRA and sham (no signal) under double-blind conditions for either controls or electrosensitive participants, and neither group could detect the presence of a TETRA signal at rates greater than chance (50%). When conditions were not double blind, however, the self-reported electrosensitive individuals did report feeling worse and experienced more severe symptoms during TETRA compared with sham. Conclusions Our findings suggest that the adverse symptoms experienced by electrosensitive individuals are due to the belief of harm from TETRA base stations rather than to the low-level EMF exposure itself. PMID:20075020

  6. Swab2know: An HIV-Testing Strategy Using Oral Fluid Samples and Online Communication of Test Results for Men Who Have Sex With Men in Belgium

    PubMed Central

    Fransen, Katrien; Apers, Ludwig; Kenyon, Chris; Albers, Laura; Vermoesen, Tine; Loos, Jasna; Florence, Eric

    2015-01-01

    Background As HIV remains a public health concern, increased testing among those at risk for HIV acquisition is important. Men who have sex with men (MSM) are the most important group for targeted HIV testing in Europe. Several new strategies have been developed and implemented to increase HIV-testing uptake in this group, among them the Swab2know project. Objective In this project, we aim to assess the acceptability and feasibility of outreach and online HIV testing using oral fluid samples as well as Web-based delivery of test results. Methods Sample collection happened between December 2012 and April 2014 via outreach and online sampling among MSM. Test results were communicated through a secured website. HIV tests were executed in the laboratory. Each reactive sample needed to be confirmed using state-of-the-art confirmation procedures on a blood sample. Close follow-up of participants who did not pick up their results, and those with reactive results, was included in the protocol. Participants were asked to provide feedback on the methodology using a short survey. Results During 17 months, 1071 tests were conducted on samples collected from 898 men. Over half of the samples (553/1071, 51.63%) were collected during 23 outreach sessions. During an 8-month period, 430 samples out of 1071 (40.15%) were collected from online sampling. Additionally, 88 samples out of 1071 (8.22%) were collected by two partner organizations during face-to-face consultations with MSM and male sex workers. Results of 983 out of 1071 tests (91.78%) had been collected from the website. The pickup rate was higher among participants who ordered their kit online (421/430, 97.9%) compared to those participating during outreach activities (559/641, 87.2%; P<.001). MSM participating during outreach activities versus online participants were more likely to have never been tested before (17.3% vs 10.0%; P=.001) and reported more sexual partners in the 6 months prior to participation in the

  7. Individual Differences in Automatic Emotion Regulation Interact with Primed Emotion Regulation during an Anger Provocation.

    PubMed

    Zhang, Jing; Lipp, Ottmar V; Hu, Ping

    2017-01-01

    The current study investigated the interactive effects of individual differences in automatic emotion regulation (AER) and primed emotion regulation strategy on skin conductance level (SCL) and heart rate during provoked anger. The study was a 2 × 2 [AER tendency (expression vs. control) × priming (expression vs. control)] between subject design. Participants were assigned to two groups according to their performance on an emotion regulation-IAT (differentiating automatic emotion control tendency and automatic emotion expression tendency). Then participants of the two groups were randomly assigned to two emotion regulation priming conditions (emotion control priming or emotion expression priming). Anger was provoked by blaming participants for slow performance during a subsequent backward subtraction task. In anger provocation, SCL of individuals with automatic emotion control tendencies in the control priming condition was lower than of those with automatic emotion control tendencies in the expression priming condition. However, SCL of individuals with automatic emotion expression tendencies did no differ in the automatic emotion control priming or the automatic emotion expression priming condition. Heart rate during anger provocation was higher in individuals with automatic emotion expression tendencies than in individuals with automatic emotion control tendencies regardless of priming condition. This pattern indicates an interactive effect of individual differences in AER and emotion regulation priming on SCL, which is an index of emotional arousal. Heart rate was only sensitive to the individual differences in AER, and did not reflect this interaction. This finding has implications for clinical studies of the use of emotion regulation strategy training suggesting that different practices are optimal for individuals who differ in AER tendencies.

  8. Neural and Behavioral Correlates of Alcohol-Induced Aggression Under Provocation.

    PubMed

    Gan, Gabriela; Sterzer, Philipp; Marxen, Michael; Zimmermann, Ulrich S; Smolka, Michael N

    2015-12-01

    Although alcohol consumption is linked to increased aggression, its neural correlates have not directly been studied in humans so far. Based on a comprehensive neurobiological model of alcohol-induced aggression, we hypothesized that alcohol-induced aggression would go along with increased amygdala and ventral striatum reactivity and impaired functioning of the prefrontal cortex (PFC) under alcohol. We measured neural and behavioral correlates of alcohol-induced aggression in a provoking vs non-provoking condition with a variant of the Taylor aggression paradigm (TAP) allowing to differentiate between reactive (provoked) and proactive (unprovoked) aggression. In a placebo-controlled cross-over design with moderate alcohol intoxication (~0.6 g/kg), 35 young healthy adults performed the TAP during functional magnetic resonance imaging (fMRI). Analyses revealed that provoking vs non-provoking conditions and alcohol vs placebo increased aggression and decreased brain responses in the anterior cingulate cortex/dorso-medial PFC (provokingprovocation interaction). However, investigation of inter-individual differences revealed (1) that pronounced alcohol-induced proactive aggression was linked to higher levels of aggression under placebo, and (2) that pronounced alcohol-induced reactive aggression was related to increased amygdala and ventral striatum reactivity under alcohol, providing evidence for their role in human alcohol-induced reactive aggression. Our findings suggest that in healthy young adults a liability for alcohol-induced aggression in a non-provoking context might depend on overall high levels of aggression, but on alcohol-induced increased striatal and amygdala reactivity when triggered by provocation.

  9. Exercise but not mannitol provocation increases urinary Clara cell protein (CC16) in elite swimmers.

    PubMed

    Romberg, Kerstin; Bjermer, Leif; Tufvesson, Ellen

    2011-01-01

    Elite swimmers have an increased risk of developing asthma, and exposure to chloramine is believed to be an important trigger factor. The aim of the present study was to explore pathophysiological mechanisms behind induced bronchoconstriction in swimmers exposed to chloramine, before and after swim exercise provocation as well as mannitol provocation. Urinary Clara cell protein (CC16) was used as a possible marker for epithelial stress. 101 elite aspiring swim athletes were investigated and urinary samples were collected before and 1 h after completed exercise and mannitol challenge. CC16, 11β-prostaglandin (PG)F(2α) and leukotriene E(4) (LTE(4)) were measured. Urinary levels of CC16 were clearly increased after exercise challenge, while no reaction was seen after mannitol challenge. Similar to CC16, the level of 11β-PGF(2α) was increased after exercise challenge, but not after mannitol challenge, while LTE(4) was reduced after exercise. There was no significant difference in urinary response between those with a negative compared to positive challenge, but a tendency of increased baseline levels of 11β-PGF(2α) and LTE(4) in individuals with a positive mannitol challenge. The uniform increase of CC16 after swim exercise indicates that CC16 is of importance in epithelial stress, and may as such be an important pathogenic factor behind asthma development in swimmers. The changes seen in urinary levels of 11β-PGF(2α) and LTE(4) indicate a pathophysiological role in both mannitol and exercise challenge. Copyright © 2010 Elsevier Ltd. All rights reserved.

  10. Provocative and inhibitory effects of a video-EEG neuropsychologic protocol in juvenile myoclonic epilepsy.

    PubMed

    Guaranha, Mirian Salvadori Bittar; da Silva Sousa, Patrícia; de Araújo-Filho, Gerardo Maria; Lin, Katia; Guilhoto, Laura Maria Figueiredo Ferreira; Caboclo, Luís Otávio Sales Ferreira; Yacubian, Elza Márcia Targas

    2009-11-01

    Studies suggest that higher cognitive functions could precipitate seizures in juvenile myoclonic epilepsy (JME). The present study aimed to analyze the effects of higher mental activity on epileptiform discharges and seizures in patients with JME and compare them to those of habitual methods of activation. Seventy-six patients with JME (41 female) underwent a video-EEG (electroencephalography) neuropsychologic protocol (VNPP) and habitual methods of activation for 4-6 h. Twenty-nine of the 76 (38.2%) presented provocative effect, and inhibition was seen in 28 of 31 (90.3%). A mixed effect was observed in 11 (35.5%), and 30 patients (39.5%) suffered no effect of VNPP. Action-programming tasks were more effective than thinking in provoking epileptiform discharges (23.7% and 11.0% of patients, respectively, p = 0.03). Inhibitory effect was observed equally in the various categories of tasks, except in mental calculation, which had a higher inhibitory rate. Habitual methods of activation were more effective than VNPP in provoking discharges. Anxiety disorders were diagnosed in 24 of 58 patients (41.4%); anxious patients had greater discharge indexes and no significant inhibitory effect on VNPP. Praxis exerted the most remarkable provocative effect, in accordance with the motor circuitry hyperexcitability hypothesis in JME. Inhibitory effect, which had no such task specificity, might be mediated by a widespread cortical-thalamic pathway, possibly involving the parietal cortex. The frequent inhibitory effect found under cortical activation conditions, influenced by the presence of anxiety, supports nonpharmacologic therapeutic interventions in JME.

  11. Individual Differences in Automatic Emotion Regulation Interact with Primed Emotion Regulation during an Anger Provocation

    PubMed Central

    Zhang, Jing; Lipp, Ottmar V.; Hu, Ping

    2017-01-01

    The current study investigated the interactive effects of individual differences in automatic emotion regulation (AER) and primed emotion regulation strategy on skin conductance level (SCL) and heart rate during provoked anger. The study was a 2 × 2 [AER tendency (expression vs. control) × priming (expression vs. control)] between subject design. Participants were assigned to two groups according to their performance on an emotion regulation-IAT (differentiating automatic emotion control tendency and automatic emotion expression tendency). Then participants of the two groups were randomly assigned to two emotion regulation priming conditions (emotion control priming or emotion expression priming). Anger was provoked by blaming participants for slow performance during a subsequent backward subtraction task. In anger provocation, SCL of individuals with automatic emotion control tendencies in the control priming condition was lower than of those with automatic emotion control tendencies in the expression priming condition. However, SCL of individuals with automatic emotion expression tendencies did no differ in the automatic emotion control priming or the automatic emotion expression priming condition. Heart rate during anger provocation was higher in individuals with automatic emotion expression tendencies than in individuals with automatic emotion control tendencies regardless of priming condition. This pattern indicates an interactive effect of individual differences in AER and emotion regulation priming on SCL, which is an index of emotional arousal. Heart rate was only sensitive to the individual differences in AER, and did not reflect this interaction. This finding has implications for clinical studies of the use of emotion regulation strategy training suggesting that different practices are optimal for individuals who differ in AER tendencies. PMID:28484412

  12. Provocative sacroiliac joint maneuvers and sacroiliac joint block are unreliable for diagnosing sacroiliac joint pain.

    PubMed

    Berthelot, Jean-Marie; Labat, Jean-Jacques; Le Goff, Benoît; Gouin, François; Maugars, Yves

    2006-01-01

    Mapping studies of pain elicited by injections into the sacroiliac joints (SIJs) suggest that sacroiliac joint syndrome (SIJS) may manifest as low back pain, sciatica, or trochanteric pain. Neither patient-reported symptoms nor provocative SIJ maneuvers are sensitive or specific for SIJS when SIJ block is used as the diagnostic gold standard. This has led to increasing diagnostic use of SIJ block, a procedure in which an anesthetic is injected into the joint under arthrographic guidance. However, several arguments cast doubt on the validity of SIJ block as a diagnostic gold standard. Thus, the effects of two consecutive blocks are identical in only 60% of cases, and the anesthetic diffuses out of the joint in 61% of cases, often coming into contact with the sheaths of the adjacent nerve trunks or roots, including the lumbosacral trunk (which may contribute to pain in the groin or thigh) and the L5 and S1 nerve roots. These data partly explain the limited specificity of SIJ block for the diagnosis of SIJS and the discordance between the pain elicited by the arthrography injection and the response to the block. The limitations of provocative maneuvers and SIJ blocks may stem in part from a contribution of extraarticular ligaments to the genesis of pain believed to originate within the SIJs. These ligaments inc