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Sample records for clinical subtype questionnaire

  1. Clinical REM sleep behavior disorder and motor subtypes in Parkinson's disease: a questionnaire-based study.

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    Aygun, Dursun; Turkel, Yakup; Onar, Musa Kazım; Sunter, Tevfik

    2014-04-01

    Studies documenting the association between rapid eye movement sleep behavior disorder (RBD) and motor subtypes in Parkinson's disease (PD) are rare. Our hypothesis is that RBD may be more severe in non-tremor dominant (NTD) patients with RBD than those tremor dominant (TD) with RBD. In this study, we investigated the association between motor subtypes and clinical RBD in PD. We evaluated 104 consecutive patients older than 18 years presenting with PD to the Neurology Clinic of the University Hospital for one year in this study. The clinical diagnosis of RBD was based on the minimal diagnostic criteria of International Classification of Sleep Disorders, revised. The Stavanger Sleepiness Questionnaire was used to rate the severity of clinical RBD. The patients were divided into two subgroups as TD and NTD. The patient and control groups were compared with each other for severity and frequency of clinical RBD, and the Unified Parkinson's Disease Rating Scale (UPDRS) and Hoehn-Yahr stage scores. The correlation between severity of clinical RBD and clinical severity of PD was analyzed in the patient groups. Of the patients, 45.2% (n=47) had the NTD subtype of PD and 54.8% (n=57) had the TD subtype of PD. There was no significant difference among the groups in terms of frequency and severity of clinical RBD. For the NTD patients, there was a weak positive correlation between severity of clinical RBD and clinical severity of PD. However, there was no correlation in the TD subgroup. In our study, frequency of clinical RBD was unrelated to motor subtypes of PD. However, in the present study, we found a weak correlation between clinical severity (UPDRS and the Hoehn-Yahr) of PD and severity of clinical RBD in the NTD subtype but not in the TD subtype. Copyright © 2014 Elsevier B.V. All rights reserved.

  2. Towards a brief definition of burnout syndrome by subtypes: Development of the "Burnout Clinical Subtypes Questionnaire" (BCSQ-12

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    Gili Margarita

    2011-09-01

    Full Text Available Abstract Background Burnout has traditionally been described by means of the dimensions of exhaustion, cynicism and lack of eficacy from the "Maslach Burnout Inventory-General Survey" (MBI-GS. The "Burnout Clinical Subtype Questionnaire" (BCSQ-12, comprising the dimensions of overload, lack of development and neglect, is proposed as a brief means of identifying the different ways this disorder is manifested. The aim of the study is to test the construct and criterial validity of the BCSQ-12. Method A cross-sectional design was used on a multi-occupational sample of randomly selected university employees (n = 826. An exploratory factor analysis (EFA was performed on half of the sample using the maximum likelihood (ML method with varimax orthogonal rotation, while confirmatory factor analysis (CFA was performed on the other half by means of the ML method. ROC curve analysis was preformed in order to assess the discriminatory capacity of BCSQ-12 when compared to MBI-GS. Cut-off points were proposed for the BCSQ-12 that optimized sensitivity and specificity. Multivariate binary logistic regression models were used to estimate effect size as an odds ratio (OR adjusted for sociodemographic and occupational variables. Contrasts for sex and occupation were made using Mann-Whitney U and Kruskall-Wallis tests on the dimensions of both models. Results EFA offered a solution containing 3 factors with eigenvalues > 1, explaining 73.22% of variance. CFA presented the following indices: χ2 = 112.04 (p 2/gl = 2.44, GFI = 0.958, AGFI = 0.929, RMSEA = 0.059, SRMR = 0.057, NFI = 0.958, NNFI = 0.963, IFI = 0.975, CFI = 0.974. The area under the ROC curve for 'overload' with respect to the 'exhaustion' was = 0.75 (95% CI = 0.71-0.79; it was = 0.80 (95% CI = 0.76-0.86 for 'lack of development' with respect to 'cynicism' and = 0.74 (95% CI = 0.70-0.78 for 'neglect' with respect to 'inefficacy'. The presence of 'overload' increased the likelihood of suffering from

  3. A newer and broader definition of burnout: Validation of the "Burnout Clinical Subtype Questionnaire (BCSQ-36"

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    García-Campayo Javier

    2010-06-01

    Full Text Available Abstract Background Burnout syndrome has been clinically characterised by a series of three subtypes: frenetic, underchallenged and worn-out, with reference to coping strategies for stress and frustration at work with different degrees of dedication. The aims of the study are to present an operating definition of these subtypes in order to assess their reliability and convergent validity with respect to a standard burnout criterion and to examine differences with regard to sex and the temporary nature of work contracts. Method An exploratory factor analysis was performed by the main component method on a range of items devised by experts. The sample was composed of 409 employees of the University of Zaragoza, Spain. The reliability of the scales was assessed with Cronbach's α, convergent validity in relation to the Maslach Burnout Inventory with Pearson's r, and differences with Student's t-test and the Mann-Whitney U test. Results The factorial validity and reliability of the scales were good. The subtypes presented relations of differing degrees with the criterion dimensions, which were greater when dedication to work was lower. The frenetic profile presented fewer relations with the criterion dimensions while the worn-out profile presented relations of the greatest magnitude. Sex was not influential in establishing differences. However, the temporary nature of work contracts was found to have an effect: temporary employees exhibited higher scores in the frenetic profile (p p = 0.018 and worn-out (p Conclusions The classical Maslach description of burnout does not include the frenetic profile; therefore, these patients are not recognised. The developed questionnaire may be a useful tool for the design and appraisal of specific preventive and treatment approaches based on the type of burnout experienced.

  4. A newer and broader definition of burnout: validation of the "Burnout Clinical Subtype Questionnaire (BCSQ-36)".

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    Montero-Marín, Jesús; García-Campayo, Javier

    2010-06-02

    Burnout syndrome has been clinically characterised by a series of three subtypes: frenetic, underchallenged, and worn-out, with reference to coping strategies for stress and frustration at work with different degrees of dedication. The aims of the study are to present an operating definition of these subtypes in order to assess their reliability and convergent validity with respect to a standard burnout criterion and to examine differences with regard to sex and the temporary nature of work contracts. An exploratory factor analysis was performed by the main component method on a range of items devised by experts. The sample was composed of 409 employees of the University of Zaragoza, Spain. The reliability of the scales was assessed with Cronbach's alpha, convergent validity in relation to the Maslach Burnout Inventory with Pearson's r, and differences with Student's t-test and the Mann-Whitney U test. The factorial validity and reliability of the scales were good. The subtypes presented relations of differing degrees with the criterion dimensions, which were greater when dedication to work was lower. The frenetic profile presented fewer relations with the criterion dimensions while the worn-out profile presented relations of the greatest magnitude. Sex was not influential in establishing differences. However, the temporary nature of work contracts was found to have an effect: temporary employees exhibited higher scores in the frenetic profile (p < 0.001), while permanent employees did so in the underchallenged (p = 0.018) and worn-out (p < 0.001) profiles. The classical Maslach description of burnout does not include the frenetic profile; therefore, these patients are not recognised. The developed questionnaire may be a useful tool for the design and appraisal of specific preventive and treatment approaches based on the type of burnout experienced.

  5. A newer and broader definition of burnout: Validation of the "Burnout Clinical Subtype Questionnaire (BCSQ-36)"

    OpenAIRE

    García-Campayo Javier; Montero-Marín Jesús

    2010-01-01

    Abstract Background Burnout syndrome has been clinically characterised by a series of three subtypes: frenetic, underchallenged and worn-out, with reference to coping strategies for stress and frustration at work with different degrees of dedication. The aims of the study are to present an operating definition of these subtypes in order to assess their reliability and convergent validity with respect to a standard burnout criterion and to examine differences with regard to sex and the tempora...

  6. Burnout syndrome among dental students: a short version of the "Burnout Clinical Subtype Questionnaire" adapted for students (BCSQ-12-SS).

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    Montero-Marin, Jesus; Monticelli, Francesca; Casas, Marina; Roman, Amparo; Tomas, Inmaculada; Gili, Margarita; Garcia-Campayo, Javier

    2011-12-12

    Burnout has been traditionally defined in relation to the dimensions of "exhaustion", "cynicism", and "inefficiency". More recently, the Burnout Clinical Subtype Questionnaire (BCSQ-12) further established three different subtypes of burnout: the "frenetic" subtype (related to "overload"), the "under-challenged" subtype (related to "lack of development"), and the "worn-out" subtype (related to "neglect"). However, to date, these definitions have not been applied to students. The aims of this research were (1) to adapt a Spanish version of the BCSQ-12 for use with students, (2) to test its factorial validity, internal consistency, convergent and discriminant validity, and (3) to assess potential socio-demographic and occupational risk factors associated with the development of the subtypes. We used a cross-sectional design on a sample of dental students (n = 314) from Santiago and Huesca universities (Spain). Participants completed the Burnout Clinical Subtype Questionnaire Student Survey (BCSQ-12-SS), the Maslach Burnout Inventory Student Survey (MBI-SS), and a series of socio-demographic and occupational questions formulated for the specific purpose of this study. Data were subjected to exploratory factor analysis (EFA) using the principal component method with varimax orthogonal rotation. To assess the relations with the criterion, we calculated the Pearson correlation coefficient (r), multiple correlation coefficient (R(y.123)), and the coefficient of determination (R(2)(y.123)). To assess the association between the subtypes and the socio-demographic variables, we examined the adjusted odds ratio (OR) obtained from multivariate logistic regression models. Factorial analyses supported the theoretical proposition of the BCSQ-12-SS, with α-values exceeding 0.80 for all dimensions. The "overload-exhaustion" relation was r = 0.59 (p burnout as established by the BCSQ-12-SS. As such, the BCSQ-12-SS can be used for the recognition of clinical profiles and for the

  7. Specific trauma subtypes improve the predictive validity of the Harvard Trauma Questionnaire in Iraqi refugees.

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    Arnetz, Bengt B; Broadbridge, Carissa L; Jamil, Hikmet; Lumley, Mark A; Pole, Nnamdi; Barkho, Evone; Fakhouri, Monty; Talia, Yousif Rofa; Arnetz, Judith E

    2014-12-01

    Trauma exposure contributes to poor mental health among refugees, and exposure often is measured using a cumulative index of items from the Harvard Trauma Questionnaire (HTQ). Few studies, however, have asked whether trauma subtypes derived from the HTQ could be superior to this cumulative index in predicting mental health outcomes. A community sample of recently arrived Iraqi refugees (N = 298) completed the HTQ and measures of posttraumatic stress disorder (PTSD) and depression symptoms. Principal components analysis of HTQ items revealed a 5-component subtype model of trauma that accounted for more item variance than a 1-component solution. These trauma subtypes also accounted for more variance in PTSD and depression symptoms (12 and 10%, respectively) than did the cumulative trauma index (7 and 3%, respectively). Trauma subtypes provided more information than cumulative trauma in the prediction of negative mental health outcomes. Therefore, use of these subtypes may enhance the utility of the HTQ when assessing at-risk populations.

  8. Transsexual subtypes : Clinical and theoretical significance

    NARCIS (Netherlands)

    Smith, YLS; van Goozen, SHM; Kuiper, AJ; Cohen-Kettenis, PT

    2005-01-01

    The present study was designed to investigate whether transsexuals can be validly subdivided into subtypes on the basis of sexual orientation, and whether differences between subtypes of transsexuals are similar for male-to-female (ME) and female-to-male transsexuals (FMs). Within a large transsexua

  9. Menstrual questionnaires for clinical and research use.

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    Matteson, Kristen A

    2017-04-01

    Patient-reported outcome measures (PROMs) have the potential to be extremely valuable in the clinical care delivery for women who report heavy menstrual bleeding (HMB). Increasingly, studies on HMB have incorporated PROMs to evaluate the impact of bleeding on quality of life. These measures have included semiquantitative charts and pictograms, questionnaires to assess symptoms and impact on quality of life, and health-related quality of life questionnaires. Recent systematic reviews have highlighted inconsistency of outcome measurement across studies on HMB as a challenge limiting the interpretability of the body of literature and the ability to generate consensus on the relative effectiveness of treatment options. Consequently, research initiatives and international collaborations are working to harmonize outcome measurement. Harmonizing the use of questionnaires in research and clinical care has the potential to improve patient-centered care delivery for women with HMB and improve the generation of patient-focused evidence-based guidelines for the evaluation and treatment of HMB. Copyright © 2016. Published by Elsevier Ltd.

  10. Clinical implications of the intrinsic molecular subtypes of breast cancer.

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    Prat, Aleix; Pineda, Estela; Adamo, Barbara; Galván, Patricia; Fernández, Aranzazu; Gaba, Lydia; Díez, Marc; Viladot, Margarita; Arance, Ana; Muñoz, Montserrat

    2015-11-01

    Gene-expression profiling has had a considerable impact on our understanding of breast cancer biology. During the last 15 years, 5 intrinsic molecular subtypes of breast cancer (Luminal A, Luminal B, HER2-enriched, Basal-like and Claudin-low) have been identified and intensively studied. In this review, we will focus on the current and future clinical implications of the intrinsic molecular subtypes beyond the current pathological-based classification endorsed by the 2013 St. Gallen Consensus Recommendations. Within hormone receptor-positive and HER2-negative early breast cancer, the Luminal A and B subtypes predict 10-year outcome regardless of systemic treatment administered as well as residual risk of distant recurrence after 5 years of endocrine therapy. Within clinically HER2-positive disease, the 4 main intrinsic subtypes can be identified and dominate the biological and clinical phenotype. From a clinical perspective, patients with HER2+/HER2-enriched disease seem to benefit the most from neoadjuvant trastuzumab, or dual HER2 blockade with trastuzumab/lapatinib, in combination with chemotherapy, and patients with HER2+/Luminal A disease seem to have a relative better outcome compared to the other subtypes. Finally, within triple-negative breast cancer (TNBC), the Basal-like disease predominates (70-80%) and, from a biological perspective, should be considered a cancer-type by itself. Importantly, the distinction between Basal-like versus non-Basal-like within TNBC might predict survival following (neo)adjvuvant multi-agent chemotherapy, bevacizumab benefit in the neoadjuvant setting (CALGB40603), and docetaxel vs. carboplatin benefit in first-line metastatic disease (TNT study). Overall, this data suggests that intrinsic molecular profiling provides clinically relevant information beyond current pathology-based classifications.

  11. Detecting exacerbations using the Clinical COPD Questionnaire

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    Trappenburg Jaap CA

    2010-09-01

    Full Text Available Abstract Background Early treatment of COPD exacerbations has shown to be important. Despite a non-negligible negative impact on health related quality of life, a large proportion of these episodes is not reported (no change in treatment. Little is known whether (low burden strategies are able to capture these unreported exacerbations. Methods The Clinical COPD Questionnaire (CCQ is a short questionnaire with great evaluative properties in measuring health status. The current explorative study evaluates the discriminative properties of weekly CCQ assessment in detecting exacerbations. Results In a multicentre prospective cohort study, 121 patients, age 67.4 ± 10.5 years, FEV1 47.7 ± 18.5% pred were followed for 6 weeks by daily diary card recording and weekly CCQ assessment. Weeks were retrospectively labeled as stable or exacerbation (onset weeks using the Anthonisen symptom diary-card algorithm. Change in CCQ total scores are significantly higher in exacerbation-onset weeks, 0.35 ± 0.69 compared to -0.04 ± 0.37 in stable weeks (p Conclusions Weekly CCQ assessment is a promising, low burden method to detect unreported exacerbations. Further research is needed to validate discriminative performance and practical implications of the CCQ in detecting exacerbations in daily care.

  12. Clinical investigation of set-shifting subtypes in anorexia nervosa.

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    Abbate-Daga, Giovanni; Buzzichelli, Sara; Marzola, Enrica; Amianto, Federico; Fassino, Secondo

    2014-11-30

    While evidence continues to accumulate on the relevance of cognitive inflexibility in anorexia nervosa (AN), its clinical correlates remain unclear. We aimed at examining the relationship between set-shifting and clinical variables (i.e., eating psychopathology, depression, and personality) in AN. Ninety-four individuals affected by AN and 59 healthy controls (HC) were recruited. All participants were assessed using: Eating Disorders Inventory-2 (EDI-2), Temperament and Character Inventory (TCI), Beck Depression Inventory (BDI), and Wisconsin Card Sorting Test (WCST). The AN group scored worse than HCs on set-shifting. According to their neuropsychological performances, AN patients were split into two groups corresponding to poor (N=30) and intact (N=64) set-shifting subtypes. Interoceptive awareness, impulse regulation, and maturity fears on the EDI-2 and depression on the BDI differed across all groups (HC, intact, and poor set-shifting subtype). Self-directedness on the TCI differed significantly among all groups. Cooperativeness and reward dependence differed instead only between HC and AN poor set-shifting subtype. After controlling for depression, only interoceptive awareness remained significant with reward dependence showing a trend towards statistical significance. These findings suggest that multiple clinical variables may be correlated with set-shifting performances in AN. The factors contributing to impaired cognitive inflexibility could be more complex than heretofore generally considered.

  13. Molecular Subtypes of Uterine Leiomyosarcoma and Correlation with Clinical Outcome

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    Joyce N. Barlin

    2015-02-01

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

  14. Bilateral vestibular hypofunction: Insights in etiologies, clinical subtypes and diagnostics

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    F. eLucieer

    2016-03-01

    Full Text Available Objective:To evaluate the different etiologies and clinical subtypes of bilateral vestibular hypofunction (BVH and the value of diagnostic tools in the diagnostic process of BVH.Materials and methods: A retrospective case review was performed on 154 patients diagnosed with BVH in a tertiary referral center, between 2013 and 2015. Inclusion criteria comprised 1 imbalance and/or oscillopsia during locomotion, and 2 summated slow phase velocity of nystagmus of less than 20 degrees per second during bithermal caloric tests.Results:The definite etiology of BVH was determined in 47% of the cases and the probable etiology in 22%. In 31%, the etiology of BVH remained idiopathic. BVH resulted from more than 20 different etiologies. In the idiopathic group, the percentage of migraine was significantly higher compared to the non-idiopathic group (50% versus 11%, p<0.001. Among all patients, 23.4% were known with autoimmune disorders in their medical history. All 4 clinical subtypes (recurrent vertigo with BVH, rapidly progressive BVH, slowly progressive BVH and slowly progressive BVH with ataxia were found in this population. Slowly progressive BVH with ataxia comprised only 4.5% of the cases. The head impulse test was abnormal in 94% of the cases. The torsion swing test was abnormal in 66%. Bilateral normal hearing to moderate hearing loss was found in 49%. Blood tests did not often contribute to the determination of the etiology of the disease. Abnormal cerebral imaging was found in 21 patients.Conclusion:BVH is a heterogeneous condition with various etiologies and clinical characteristics. Migraine seems to play a significant role in idiopathic BVH and auto-immunity could be a modulating factor in the development of BVH. The distribution of etiologies of BVH probably depends on the clinical setting. In the diagnostic process of BVH, the routine use of some blood tests can be reconsidered and a low-threshold use of audiometry and cerebral imaging is

  15. Irritable bowel syndrome subtypes: clinical and psychological features, body mass index and comorbidities

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    Cristiane Kibune-Nagasako

    2016-02-01

    Full Text Available Background: Irritable bowel syndrome (IBS is classified into subtypes according to bowel habit. Objective: To investigate whether there are differences in clinical features, comorbidities, anxiety, depression and body mass index (BMI among IBS subtypes. Methods: The study group included 113 consecutive patients (mean age: 48 ± 11 years; females: 94 with the diagnosis of IBS. All of them answered a structured questionnaire for demographic and clinical data and underwent upper endoscopy. Anxiety and depression were assessed by the Hospital Anxiety and Depression scale (HAD. Results: The distribution of subtypes was: IBS-diarrhea (IBS-D, 46%; IBS-constipation (IBS-C, 32%, and mixed IBS (IBS-M, 22%. IBS overlap with gastroesophageal reflux disease (GERD, functional dyspepsia, chronic headache and fibromyalgia occurred in 65.5%, 48.7%, 40.7% and 22.1% of patients, respectively. Anxiety and/or depression were found in 81.5%. Comparisons among subgroups showed that bloating was significantly associated with IBS-M compared to IBS-D (odds ratio-OR-5.6. Straining was more likely to be reported by IBS-M (OR 15.3 and IBS-C (OR 12.0 compared to IBS-D patients, while urgency was associated with both IBS-M (OR 19.7 and IBS-D (OR 14.2 compared to IBS-C. In addition, IBS-M patients were more likely to present GERD than IBS-D (OR 6.7 and higher scores for anxiety than IBS-C patients (OR 1.2. BMI values did not differ between IBS-D and IBS-C. Conclusion: IBS-M is characterized by symptoms frequently reported by both IBS-C (straining and IBS-D (urgency, higher levels of anxiety, and high prevalence of comorbidities. These features should be considered in the clinical management of this subgroup.

  16. Clinical Implications of DSM-IV Subtyping of Bipolar Disorders in Referred Children and Adolescents

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    Masi, Gabriele; Perugi, Giulio; Millepiedi, Stefania; Mucci, Maria; Pari, Cinzia; Pfanner, Chiara; Berloffa, Stefano; Toni, Cristina

    2007-01-01

    Objective: According to DSM-IV, bipolar disorders (BDs) include four subtypes, BD I, BD II, cyclothymic disorder, and BD not otherwise specified (NOS). We explore the clinical implications of this subtyping in a naturalistic sample of referred youths with BD I, BD II, and BD-NOS. Method: The sample consisted of 217 patients, 135 males and 82…

  17. Effect of HLA-B*27 and its subtypes on clinical manifestations and severity of ankylosing spondylitis in Iranian patients.

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    Sasan Fallahi

    2013-12-01

    Full Text Available The aim of this study was to assess the role of HLA-B*27 and it's subtypes in determining severity and clinical manifestations of ankylosing spondylitis (AS.A total of 163 AS patients were assessed for clinical manifestations and severity using structured questionnaires. HLA-B*27 screening and B*27 sub-typing were performed by PCR.One hundred twenty two patients (74.8% were B*27 positive. The male to female ratio, peripheral arthritis, steroid use, intense dorsal kyphosis and decrease of cervical slope had a significantly higher frequency in B*27 positive patients compared to B*27 negative ones (p=0.01, 0.001, 0.01, 0.04 and 0.04, respectively. However, the age of diagnosis was significantly lower in B*27 positive patients (p=0.005. Trend in uveitis and some severity markers including: BASMI and ASQoL were toward higher values in B*27 positive group with no significant difference. After controlling confounding variables, significant relationship was found only between B*27 and BASMI (p=0.01. B*27 subtypes in patients were included B*2705: 48.4%, B*2702: 42.6%, B*2704: 5.7% and B*2707: 3.3%. No significant differences were seen for severity markers and clinical manifestations between subtypes; although trend toward lower values of severity markers, less intense dorsal kyphosis and less decrease of cervical slope were observed in B*2704 and B*2707 versus other polymorphisms.Clinical features and severity of AS is influenced by HLA-B*27. Trend toward higher severity markers in B*2705 and B*2702 versus other polymorphisms might be subject of interest for evaluation in other ethnicities with concentration to other novel susceptibility genes co-inherited in each B*27 subtype.

  18. The dissociative subtype of posttraumatic stress disorder: rationale, clinical and neurobiological evidence, and implications.

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    Lanius, Ruth A; Brand, Bethany; Vermetten, Eric; Frewen, Paul A; Spiegel, David

    2012-08-01

    Clinical and neurobiological evidence for a dissociative subtype of posttraumatic stress disorder (PTSD) has recently been documented. A dissociative subtype of PTSD is being considered for inclusion in the forthcoming Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (DSM-5) to address the symptoms of depersonalization and derealization found among a subset of patients with PTSD. This article reviews research related to the dissociative subtype including antecedent, concurrent, and predictive validators as well as the rationale for recommending the dissociative subtype. The relevant literature pertaining to the dissociative subtype of PTSD was reviewed. Latent class analyses point toward a specific subtype of PTSD consisting of symptoms of depersonalization and derealization in both veteran and civilian samples of PTSD. Compared to individuals with PTSD, those with the dissociative subtype of PTSD also exhibit a different pattern of neurobiological response to symptom provocation as well as a differential response to current cognitive behavioral treatment designed for PTSD. We recommend that consideration be given to adding a dissociative subtype of PTSD in the revision of the DSM. This facilitates more accurate analysis of different phenotypes of PTSD, assist in treatment planning that is informed by considering the degree of patients' dissociativity, will improve treatment outcome, and will lead to much-needed research about the prevalence, symptomatology, neurobiology, and treatment of individuals with the dissociative subtype of PTSD. © 2012 Wiley Periodicals, Inc.

  19. Identification and prospective validation of clinically relevant chronic obstructive pulmonary disease (COPD) subtypes.

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    García Aymerich, Judith; Gomez, F. P.; Benet Mora, Marta; Farrero, E.; Basagaña, Xavier; Gayete, A.; Pare i Bardera, J. Carles; Freixa, X.; Ferrer, J.; Ferrer Monreal, Antonio; Roca Elias, Josep; Galdiz, J. P.; Sauleda, J. E.; Monso, E; Gea Guiral, Joaquim

    2010-01-01

    Background Chronic obstructive pulmonary disease (COPD) is increasingly considered a heterogeneous condition. It was hypothesised that COPD, as currently defined, includes different clinically relevant subtypes. Methods To identify and validate COPD subtypes, 342 subjects hospitalised for the first time because of a COPD exacerbation were recruited. Three months after discharge, when clinically stable, symptoms and quality of life, lung function, exercise capacity, nutritional status, biomark...

  20. Epidemiology of constipation (EPOC) study in the United States: relation of clinical subtypes to sociodemographic features.

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    Stewart, W F; Liberman, J N; Sandler, R S; Woods, M S; Stemhagen, A; Chee, E; Lipton, R B; Farup, C E

    1999-12-01

    Constipation is a common heterogeneous condition, possibly encompassing different clinical subtypes. Little is known about the comparative epidemiology of constipation subtypes. This study was conducted to estimate the prevalence of constipation subtypes and determine whether subtypes differ by sociodemographic factors. Between June and September 1997, a telephone interview was conducted with individuals about their bowel habits in the preceding 3 months. Survey data on 15 constipation-related symptoms were used to identify individuals who met prespecified symptom criteria for the following mutually exclusive subgroups: functional constipation, irritable bowel syndrome (IBS), outlet obstruction or delay (outlet), both IBS and outlet (IBS-outlet), and frequent laxative users (i.e., at least every other day). A total of 10,018 eligible individuals in the United States 18 yr of age or older completed the interview. Test-retest reliability of reporting symptoms was assessed in a separate national survey. The Spearman's correlation coefficient for reporting symptoms ranged from 0.54 to 0.83; all but three symptoms had correlations above 0.68. The overall prevalence of constipation was 14.7%. By subtype, prevalence was 4.6% for functional, 2.1% for IBS, 4.6% for outlet, and 3.4% for IBS-outlet. An additional 1.8% of respondents reported laxative use at least every other day. Outlet was the most common subtype among women, whereas functional constipation was the most common subtype among men. The gender ratio varied by subtype, with elevated ratios for outlet (F/M = 1.65) and IBS-outlet (F/M = 2.27) subtypes. The age pattern differed among each of the four subtypes. Prevalence of functional subtype decreased with increasing age. In contrast, outlet subtype did not seem to vary by age, and IBS (both men and women) and IBS-outlet (women only) subtypes increased to age 35 yr and declined thereafter. Prevalence of functional constipation increased with increasing education

  1. Delirium clinical motor subtypes: a narrative review of the literature and insights from neurobiology.

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    FitzGerald, James M

    2017-04-10

    Clinical motor subtypes have been long recognised in delirium and, despite a growing body of research, a lack of clarity exists regarding the importance of these motor subtypes. The aims of this review are to (1) examine how the concept of motor subtypes has evolved, (2) explore their relationship to the clinical context, (3) discuss the relationship between the phenomenology of delirium and motor activity, (4) discuss the application of neurobiology to the theory of delirium motor subtypes, and (5) identify methodological issues and provide solutions for further studies. The following databases were searched: PubMed, PsychInfo, EBSCO, Medline, BioMed central and Science Direct. Inclusion criteria specified peer-reviewed research assessing delirium motor subtypes published between 1990 and 2016. Sixty-one studies met the inclusion criteria. The majority of studies (n = 50) were found to use validated psychometric tools, while the remainder (n = 11) used clinical criteria. The majority of studies (n = 45) were conducted in the medical setting, while the remainder were in the ICU/post-operative setting (n = 17). Although host sensitivities (e.g. frailty) and exogenous factors (e.g. medication exposure) may determine the type of motor disturbance, it remains unclear to what extent motor subtypes are influenced by other features of delirium. The use of more specialised tools (e.g. delirium motor subtyping scale), may enable researchers to develop an approach to delirium that has a greater nosological consistency. Future studies investigating delirium motor subtypes may benefit from enhanced theoretical considerations of the dysfunctional neural substrate of the delirious state.

  2. Millon Clinical Multiaxial Inventory-III Subtypes of Opioid Dependence: Validity and Matching to Behavioral Therapies

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    Ball, Samuel A.; Nich, Charla; Rounsaville, Bruce J.; Eagan, Dorothy; Carroll, Kathleen M.

    2004-01-01

    The concurrent and predictive validity of 2 different methods of Millon Clinical Multiaxial Inventory-III subtyping (protocol sorting, cluster analysis) was evaluated in 125 recently detoxified opioid-dependent outpatients in a 12-week randomized clinical trial. Participants received naltrexone and relapse prevention group counseling and were…

  3. Clinical subtypes and genetic heterogeneity: of lumping and splitting in Parkinson disease.

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    von Coelln, Rainer; Shulman, Lisa M

    2016-12-01

    Recent studies on clinical, genetic and pathological heterogeneity of Parkinson disease have renewed the old debate whether we should think of Parkinson disease as one disease with variations, or as a group of independent diseases that happen to present with similar phenotypes. Here, we provide an overview of where the debate is coming from, and how recent findings in clinical subtyping, genetics and clinico-pathological correlation have shaped this controversy over the last few years. New and innovative clinical diagnostic criteria for Parkinson disease have been proposed and await validation. Studies using functional imaging or wearable biosensors, as well as biomarker studies, provide new support for the validity of the traditional clinical subtypes of Parkinson disease (tremor-dominant versus akinetic-rigid or postural instability/gait difficulty). A recent cluster analysis (as unbiased data-driven approach to subtyping) included a wide spectrum of nonmotor variables, and showed correlation of the proposed subtypes with disease progression in a longitudinal analysis. New genetic factors contributing to Parkinson disease susceptibility continue to be identified, including rare mutations causing monogenetic disease, common variants with small effect size and risk factors (like mutations in the gene for glucocerebrosidase) that fall in between the two other categories. Recent studies show some limited correlation between genetic factors and clinical heterogeneity. Despite some variations in patterns of pathology, Lewy bodies are still the hallmark of Parkinson disease, including the vast majority of genetic subgroups. Evidence of clinical, genetic and pathological heterogeneity of Parkinson disease continues to emerge, but clearly defined subtypes that hold up in more than one of these domains remain elusive. For research to identify such subtypes, splitting is likely the way forward; until then, for clinical practice, lumping remains the more pragmatic approach.

  4. Clinical trial participants' experiences of completing questionnaires: a qualitative study.

    Science.gov (United States)

    Holmberg, Christine; Karner, Julia J; Rappenecker, Julia; Witt, Claudia M

    2014-03-24

    To improve clinical study developments for elderly populations, we aim to understand how they transfer their experiences into validated, standardised self-completed study measurement instruments. We analysed how women (mean 78±8 years of age) participating in a randomised controlled trial (RCT) cognised study instruments used to evaluate outcomes of the intervention. The interview study was nested in an RCT on chronic neck pain using common measurement instruments situated in an elderly community in Berlin, Germany, which comprised of units for independent and assisted-living options. The sample (n=20 women) was selected from the RCT sample (n=117, 95% women, mean age 76 (SD±8) years). Interview participants were selected using a purposive sampling list based on the RCT outcomes. We asked participants about their experiences completing the RCT questionnaires. Interviews were analysed thematically, then compared with the questionnaires. Interviewees had difficulties in translating complex experiences into a single value on a scale and understanding the relationship of the questionnaires to study aims. Interviewees considered important for the trial that their actual experiences were understood by trial organisers. This information was not transferrable by means of the questionnaires. To rectify these difficulties, interviewees used strategies such as adding notes, adding response categories or skipping an item. Elderly interview participants understood the importance of completing questionnaires for trial success. This led to strategies of completing the questionnaires that resulted in 'missing' or ambiguous data. To improve data collection in elderly populations, educational materials addressing the differential logics should be developed and tested. Pilot testing validated instruments using cognitive interviews may be particularly important in such populations. Finally, when the target of an intervention is a subjective experience, it seems important to create a

  5. Clinical trial participants’ experiences of completing questionnaires: a qualitative study

    Science.gov (United States)

    Holmberg, Christine; Karner, Julia J; Rappenecker, Julia; Witt, Claudia M

    2014-01-01

    Objectives To improve clinical study developments for elderly populations, we aim to understand how they transfer their experiences into validated, standardised self-completed study measurement instruments. We analysed how women (mean 78±8 years of age) participating in a randomised controlled trial (RCT) cognised study instruments used to evaluate outcomes of the intervention. Setting The interview study was nested in an RCT on chronic neck pain using common measurement instruments situated in an elderly community in Berlin, Germany, which comprised of units for independent and assisted-living options. Participants The sample (n=20 women) was selected from the RCT sample (n=117, 95% women, mean age 76 (SD±8) years). Interview participants were selected using a purposive sampling list based on the RCT outcomes. Outcomes We asked participants about their experiences completing the RCT questionnaires. Interviews were analysed thematically, then compared with the questionnaires. Results Interviewees had difficulties in translating complex experiences into a single value on a scale and understanding the relationship of the questionnaires to study aims. Interviewees considered important for the trial that their actual experiences were understood by trial organisers. This information was not transferrable by means of the questionnaires. To rectify these difficulties, interviewees used strategies such as adding notes, adding response categories or skipping an item. Conclusions Elderly interview participants understood the importance of completing questionnaires for trial success. This led to strategies of completing the questionnaires that resulted in ‘missing’ or ambiguous data. To improve data collection in elderly populations, educational materials addressing the differential logics should be developed and tested. Pilot testing validated instruments using cognitive interviews may be particularly important in such populations. Finally, when the target of an

  6. Clinical manifestations of geriatric depression in a memory clinic: toward a proposed subtyping of geriatric depression.

    Science.gov (United States)

    Dillon, Carol; Machnicki, Gerardo; Serrano, Cecilia M; Rojas, Galeno; Vazquez, Gustavo; Allegri, Ricardo F

    2011-11-01

    As the older population increases so does the number of older psychiatric patients. Elderly psychiatric patients manifest certain specific and unique characteristics. Different subtypes of depressive syndromes exist in late-life depression, and many of these are associated with cognitive impairment. A total of 109 depressive patients and 30 normal subjects matched by age and educational level were evaluated using a neuropsychiatric interview and an extensive neuropsychological battery. Depressive patients were classified into four different groups by SCAN 2.1 (schedules for clinical assessment in Neuropsychiatry): major depression disorder (n: 34), dysthymia disorder (n: 29), subsyndromal depression (n: 28), and depression due to mild dementia of Alzheimer's type (n: 18). We found significant associations (pdepressive status and demographic or clinical factors that include marital status (OR: 3.4, CI: 1.2-9.6), level of daily activity (OR: 5.3, CI: 2-14), heart disease (OR: 12.5, CI: 1.6-96.3), and high blood cholesterol levels (p:.032). Neuropsychological differences were observed among the four depressive groups and also between depressive patients and controls. Significant differences were observed in daily life activities and caregivers' burden between depressive patients and normal subjects. Geriatric depression is associated with heart disease, high cholesterol blood levels, marital status, and daily inactivity. Different subtypes of geriatric depression have particular clinical features, such as cognitive profiles, daily life activities, and caregivers' burden, that can help to differentiate among them. The cohort referred to a memory clinic with memory complaints is a biased sample, and the results cannot be generalized to other non-memory symptomatic cohorts. Copyright © 2011 Elsevier B.V. All rights reserved.

  7. Characterization of rheumatoid arthritis subtypes using symptom profiles, clinical chemistry and metabolomics measurements.

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    Herman A van Wietmarschen

    Full Text Available OBJECTIVE: The aim is to characterize subgroups or phenotypes of rheumatoid arthritis (RA patients using a systems biology approach. The discovery of subtypes of rheumatoid arthritis patients is an essential research area for the improvement of response to therapy and the development of personalized medicine strategies. METHODS: In this study, 39 RA patients are phenotyped using clinical chemistry measurements, urine and plasma metabolomics analysis and symptom profiles. In addition, a Chinese medicine expert classified each RA patient as a Cold or Heat type according to Chinese medicine theory. Multivariate data analysis techniques are employed to detect and validate biochemical and symptom relationships with the classification. RESULTS: The questionnaire items 'Red joints', 'Swollen joints', 'Warm joints' suggest differences in the level of inflammation between the groups although c-reactive protein (CRP and rheumatoid factor (RHF levels were equal. Multivariate analysis of the urine metabolomics data revealed that the levels of 11 acylcarnitines were lower in the Cold RA than in the Heat RA patients, suggesting differences in muscle breakdown. Additionally, higher dehydroepiandrosterone sulfate (DHEAS levels in Heat patients compared to Cold patients were found suggesting that the Cold RA group has a more suppressed hypothalamic-pituitary-adrenal (HPA axis function. CONCLUSION: Significant and relevant biochemical differences are found between Cold and Heat RA patients. Differences in immune function, HPA axis involvement and muscle breakdown point towards opportunities to tailor disease management strategies to each of the subgroups RA patient.

  8. Clinical, electrophysiological subtypes and antiganglioside antibodies in childhood Guillain-Barré syndrome

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    Meena A Kannan

    2011-01-01

    Full Text Available Background: Guillain-Barré syndrome (GBS has been the most common cause of flaccid paralysis in children after the decline in the incidence of poliomyelitis. There are not any published data from the Indian subcontinent documenting electrophysiological patterns and antiganglioside antibodies in pediatric GBS. Materials and Methods: The study population included children with GBS referred for electrodiagnostic evaluation and also children with GBS admitted to our institute between August 2006 and July 2007. Nerve conduction studies were done to determine GBS subtypes and serum antiganglioside antibodies were measured using enzyme-linked immunosorbent assay (ELISA. Clinical and electrophysiological features were correlated with antiganglioside antibody results. Results: Of the 43 (male to female ratio = 2.1:1 children studied, 97.6% had motor weakness, 76.7% had cranial nerve palsies, 13.9% had autonomic disturbances and respiratory paralysis was found in 9.3% children. Antecedent illness was recorded in 69.8% children. The GBS subtype distribution was as follows: acute inflammatory demyelinating polyradiculoneuropathy (AIDP in 21 (48.8%, acute motor axonal neuropathy (AMAN in 19 (44.2%, and 3 (6.9% children were unclassified. The severity of illness was similar in both AMAN and AIDP subtypes and the recovery in both the subtypes was complete without any significant difference in the duration of recovery. Preceding diarrheal illness was more common in AMAN subtype as compared to AIDP subtype (57.9% vs. 4.7%, P = 0.007. Sensory symptoms were more common in AIDP subtype than in AMAN subtype (66.6% vs. 21%, P = 0.03}. The commonest ganglioside antibody was IgM GM2. Anti GM3 antibodies were exclusively seen in children with AMAN and IgG GD1b was significantly associated with (36.7 vs. 4%; P = 0.007 AMAN subtype. IgG GT1b was identified in 50% of patients with AIDP as compared to 22.7% in patients with AMAN. Conclusion: In this study, AMAN subtype

  9. White matter hyperintensities and medial temporal lobe atrophy in clinical subtypes of mild cognitive impairment: the DESCRIPA study

    OpenAIRE

    Pol, van de, Jaco; Verhey, F.; Frisoni, G.B.; Tsolaki, M; Papapostolou, P.; Nobili, F.; Wahlund, L. O.; Minthon, L.; Frolich, L.; Hampel, H.; Soininen, H.; Knol, D.L.; Barkhof, F; Scheltens, P.; Visser, P.J.

    2009-01-01

    Abstract Clinical subtypes of mild cognitive impairment (MCI) may represent different underlying aetiologies. In a European, multi-center, memory-clinic based study (DESCRIPA) of non-demented subjects we investigated whether MCI subtypes have different brain correlates on MRI and whether the relation between subtypes and brain pathology is modified by age. Using visual rating scales medial temporal lobe atrophy (MTA) (0-4) and white matter hyperintensities (WMH) (0-30) were assesse...

  10. The Clinical Utility of Personality Subtypes in Patients with Anorexia Nervosa

    Science.gov (United States)

    Wildes, Jennifer E.; Marcus, Marsha D.; Crosby, Ross D.; Ringham, Rebecca M.; Dapelo, Marcela Marin; Gaskill, Jill A.; Forbush, Kelsie T.

    2011-01-01

    Objective: Elucidation of clinically relevant subtypes has been proposed as a means of advancing treatment research, but classifying anorexia nervosa (AN) patients into restricting and binge-eating/purging types has demonstrated limited predictive validity. This study aimed to evaluate whether an approach to classifying eating disorder patients on…

  11. The Clinical Utility of Personality Subtypes in Patients with Anorexia Nervosa

    Science.gov (United States)

    Wildes, Jennifer E.; Marcus, Marsha D.; Crosby, Ross D.; Ringham, Rebecca M.; Dapelo, Marcela Marin; Gaskill, Jill A.; Forbush, Kelsie T.

    2011-01-01

    Objective: Elucidation of clinically relevant subtypes has been proposed as a means of advancing treatment research, but classifying anorexia nervosa (AN) patients into restricting and binge-eating/purging types has demonstrated limited predictive validity. This study aimed to evaluate whether an approach to classifying eating disorder patients on…

  12. Prediction consistency and clinical presentations of breast cancer molecular subtypes for Han Chinese population

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    Huang Chi-Cheng

    2012-09-01

    Full Text Available Abstract Background Breast cancer is a heterogeneous disease in terms of transcriptional aberrations; moreover, microarray gene expression profiles had defined 5 molecular subtypes based on certain intrinsic genes. This study aimed to evaluate the prediction consistency of breast cancer molecular subtypes from 3 distinct intrinsic gene sets (Sørlie 500, Hu 306 and PAM50 as well as clinical presentations of each molecualr subtype in Han Chinese population. Methods In all, 169 breast cancer samples (44 from Taiwan and 125 from China of Han Chinese population were gathered, and the gene expression features corresponding to 3 distinct intrinsic gene sets (Sørlie 500, Hu 306 and PAM50 were retrieved for molecular subtype prediction. Results For Sørlie 500 and Hu 306 intrinsic gene set, mean-centring of genes and distance-weighted discrimination (DWD remarkably reduced the number of unclassified cases. Regarding pairwise agreement, the highest predictive consistency was found between Hu 306 and PAM50. In all, 150 and 126 samples were assigned into identical subtypes by both Hu 306 and PAM50 genes, under mean-centring and DWD. Luminal B tended to show a higher nuclear grade and have more HER2 over-expression status than luminal A did. No basal-like breast tumours were ER positive, and most HER2-enriched breast tumours showed HER2 over-expression, whereas, only two-thirds of ER negativity/HER2 over-expression tumros were predicted as HER2-enriched molecular subtype. For 44 Taiwanese breast cancers with survival data, a better prognosis of luminal A than luminal B subtype in ER-postive breast cancers and a better prognosis of basal-like than HER2-enriched subtype in ER-negative breast cancers was observed. Conclusions We suggest that the intrinsic signature Hu 306 or PAM50 be used for breast cancers in the Han Chinese population during molecular subtyping. For the prognostic value and decision making based on intrinsic subtypes, further prospective

  13. Ovarian cancer cell line panel (OCCP: clinical importance of in vitro morphological subtypes.

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    Corine M Beaufort

    Full Text Available Epithelial ovarian cancer is a highly heterogeneous disease and remains the most lethal gynaecological malignancy in the Western world. Therapeutic approaches need to account for inter-patient and intra-tumoural heterogeneity and detailed characterization of in vitro models representing the different histological and molecular ovarian cancer subtypes is critical to enable reliable preclinical testing. There are approximately 100 publicly available ovarian cancer cell lines but their cellular and molecular characteristics are largely undescribed. We have characterized 39 ovarian cancer cell lines under uniform conditions for growth characteristics, mRNA/microRNA expression, exon sequencing, drug response for clinically-relevant therapeutics and collated all available information on the original clinical features and site of origin. We tested for statistical associations between the cellular and molecular features of the lines and clinical features. Of the 39 ovarian cancer cell lines, 14 were assigned as high-grade serous, four serous-type, one low-grade serous and 20 non-serous type. Three morphological subtypes: Epithelial (n = 21, Round (n = 7 and Spindle (n = 12 were identified that showed distinct biological and molecular characteristics, including overexpression of cell movement and migration-associated genes in the Spindle subtype. Comparison with the original clinical data showed association of the spindle-like tumours with metastasis, advanced stage, suboptimal debulking and poor prognosis. In addition, the expression profiles of Spindle, Round and Epithelial morphologies clustered with the previously described C1-stromal, C5-mesenchymal and C4 ovarian subtype expression profiles respectively. Comprehensive profiling of 39 ovarian cancer cell lines under controlled, uniform conditions demonstrates clinically relevant cellular and genomic characteristics. This data provides a rational basis for selecting models to develop

  14. Locus heterogeneity for Waardenburg syndrome is predictive of clinical subtypes

    Energy Technology Data Exchange (ETDEWEB)

    Farrer, L.A.; Hoth, C. [Boston Univ. School of Medicine, MA (United States); Arnos, K.S. [Galludet Univ., Washington, DC (United States); Asher, J.H. Jr.; Friedman, T.B. [Michigan State Univ., East Lansing, MI (United States); Grundfast, K.M.; Lalwani, A.K. [National Institute on Deafness and Other Communication Disorders, Bethesda, MD (United States); Greenberg, J. [Univ. of Cape Town (South Africa); Diehl, S.R. [and others

    1994-10-01

    Waardenburg syndrome (WS) is a dominantly inherited and clinically variable syndrome of deafness, pigmentary changes, and distinctive facial features. Clinically, WS type I (WS1) is differentiated from WS type II (WS2) by the high frequency of dystopia canthorum in the family. In some families, WS is caused by mutations in the PAX3 gene on chromosome 2q. We have typed microsatellite markers within and flanking PAX3 in 41 WS1 kindreds and 26 WS2 kindreds in order to estimate the proportion of families with probable mutations in PAX3 and to study the relationship between phenotypic and genotypic heterogeneity. Evaluation of heterogeneity in location scores obtained by multilocus analysis indicated that WS is linked to PAX3 in 60% of all WS families and in 100% of WS1 families. None of the WS2 families were linked. In those families in which equivocal lod scores (between -2 and +1) were found, PAX3 mutations have been identified in 5 of the 15 WS1 families but in none of the 4 WS2 families. Although preliminary studies do not suggest any association between the phenotype and the molecular pathology in 20 families with known PAX3 mutations and in four patients with chromosomal abnormalities in the vicinity of PAX3, the presence of dystopia in multiple family members is a reliable indicator for identifying families likely to have a defect in PAX3. 59 refs., 3 figs., 5 tabs.

  15. The Asthma Control Questionnaire as a clinical trial endpoint

    DEFF Research Database (Denmark)

    Barnes, P J; Casale, T B; Dahl, Ronald;

    2014-01-01

    The goal of asthma treatment is to control the disease according to guidelines issued by bodies such as the Global Initiative for Asthma. Effective control is dependent upon evaluation of symptoms, initiation of appropriate treatment and minimization of the progressive adverse effects...... of the disease and its therapies. Although individual outcome measures have been shown to correlate with asthma control, composite endpoints are preferred to enable more accurate and robust monitoring of the health of the individual patient. A number of validated instruments are utilized to capture...... these component endpoints; however, there is no consensus on the optimal instrument for use in clinical trials. The Asthma Control Questionnaire (ACQ) has been shown to be a valid, reliable instrument that allows accurate and reproducible assessment of asthma control that compares favourably with other commonly...

  16. Clinical Features in Juvenile-Onset Ankylosing Spondylitis Patients Carrying Different B27 Subtypes

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    Yikun Mou

    2015-01-01

    Full Text Available Background. Ankylosing spondylitis (AS is a common rheumatic disease and is characterized by inflammation of the axial skeleton. HLA-B27 is strongly associated with AS. Juvenile-onset AS (JAS with disease onset before 16 years of age differs from adult-onset AS (AAS in many respects. Objective. To compare the clinical features in JAS with different B27 subtypes and analyze the differences between JAS and AAS. Methods. 145 JAS and 360 AAS patients were included. The demographic data, clinical manifestations, laboratory markers, Bath AS indices, and B27 subtypes were recorded. Results. Peripheral arthritis, enthesitis, BASDAI, ESR, and CRP were significantly higher in JAS patients with HLA-B*2704 than those with B27-negative. Enthesitis and ESR were significantly higher in patients with HLA-B*2705 than those with B27-negative. The onset age of HLA-B*2715 group was much earlier than the other groups. The peripheral arthritis, enthesitis, and hip joint involvement in JAS with HLA-B*2704 were significantly higher than those in AAS with HLA-B*2704. Conclusion. JAS with different B27 subtypes had similar features in most of manifestations; JAS and AAS patients with the same subtype could have distinctive courses. Early diagnosis, hip detection, and control of systemic active inflammation in JAS patients will be helpful for improving the prognosis.

  17. Macrocephaly as a clinical indicator of genetic subtypes in autism.

    Science.gov (United States)

    Klein, Steven; Sharifi-Hannauer, Pantea; Martinez-Agosto, Julian A

    2013-02-01

    An association between autism and macrocephaly has been previously described. A subset of cases with extreme macrocephaly (>3 standard deviation [SD], 99.7th percentile) have been correlated to mutations in the gene phosphatase and tensin homolog (PTEN). However, the phenotypic and genetic characterization of the remaining cases remains unclear. We report the phenotypic classification and genetic testing evaluation of a cohort of 33 patients with autism and macrocephaly. Within our cohort, we confirm the association of PTEN mutations and extreme macrocephaly (>3 SD, 99.7th percentile) and identify mutations in 22% of cases, including three novel PTEN mutations. In addition, we define three phenotypic subgroups: (a) those cases associated with somatic overgrowth, (b) those with disproportionate macrocephaly, and (c) those with relative macrocephaly. We have devised a novel way to segregate patients into these subgroups that will aide in the stratification of autism macrocephaly cases. Within these subgroups, we further expand the genetic etiologies for autism cases with macrocephaly by describing two novel suspected pathogenic copy number variants located at 6q23.2 and 10q24.32. These findings demonstrate the phenotypic heterogeneity of autism cases associated with macrocephaly and their genetic etiologies. The clinical yield from PTEN mutation analysis is 22% and 9% from chromosomal microarray (CMA) testing within this cohort. The identification of three distinct phenotypic subgroups within macrocephaly autism patients may allow for the identification of their respective distinct genetic etiologies that to date have remained elusive.

  18. GliomaPredict: a clinically useful tool for assigning glioma patients to specific molecular subtypes

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    Fine Howard A

    2010-07-01

    Full Text Available Abstract Background Advances in generating genome-wide gene expression data have accelerated the development of molecular-based tumor classification systems. Tools that allow the translation of such molecular classification schemas from research into clinical applications are still missing in the emerging era of personalized medicine. Results We developed GliomaPredict as a computational tool that allows the fast and reliable classification of glioma patients into one of six previously published stratified subtypes based on sets of extensively validated classifiers derived from hundreds of glioma transcriptomic profiles. Our tool utilizes a principle component analysis (PCA-based approach to generate a visual representation of the analyses, quantifies the confidence of the underlying subtype assessment and presents results as a printable PDF file. GliomaPredict tool is implemented as a plugin application for the widely-used GenePattern framework. Conclusions GliomaPredict provides a user-friendly, clinically applicable novel platform for instantly assigning gene expression-based subtype in patients with gliomas thereby aiding in clinical trial design and therapeutic decision-making. Implemented as a user-friendly diagnostic tool, we expect that in time GliomaPredict, and tools like it, will become routinely used in translational/clinical research and in the clinical care of patients with gliomas.

  19. Hepatitis C virus (HCV genotype 1 subtype identification in new HCV drug development and future clinical practice.

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    Stéphane Chevaliez

    Full Text Available BACKGROUND: With the development of new specific inhibitors of hepatitis C virus (HCV enzymes and functions that may yield different antiviral responses and resistance profiles according to the HCV subtype, correct HCV genotype 1 subtype identification is mandatory in clinical trials for stratification and interpretation purposes and will likely become necessary in future clinical practice. The goal of this study was to identify the appropriate molecular tool(s for accurate HCV genotype 1 subtype determination. METHODOLOGY/PRINCIPAL FINDINGS: A large cohort of 500 treatment-naïve patients eligible for HCV drug trials and infected with either subtype 1a or 1b was studied. Methods based on the sole analysis of the 5' non-coding region (5'NCR by sequence analysis or reverse hybridization failed to correctly identify HCV subtype 1a in 22.8%-29.5% of cases, and HCV subtype 1b in 9.5%-8.7% of cases. Natural polymorphisms at positions 107, 204 and/or 243 were responsible for mis-subtyping with these methods. A real-time PCR method using genotype- and subtype-specific primers and probes located in both the 5'NCR and the NS5B-coding region failed to correctly identify HCV genotype 1 subtype in approximately 10% of cases. The second-generation line probe assay, a reverse hybridization assay that uses probes targeting both the 5'NCR and core-coding region, correctly identified HCV subtypes 1a and 1b in more than 99% of cases. CONCLUSIONS/SIGNIFICANCE: In the context of new HCV drug development, HCV genotyping methods based on the exclusive analysis of the 5'NCR should be avoided. The second-generation line probe assay is currently the best commercial assay for determination of HCV genotype 1 subtypes 1a and 1b in clinical trials and practice.

  20. [Subtype distribution of Blastocystis isolates and evaluation of clinical symptoms detected in Aydin province, Turkey].

    Science.gov (United States)

    Ertuğ, Sema; Malatyalı, Erdoğan; Ertabaklar, Hatice; Özlem Çalışkan, Serçin; Bozdoğan, Bülent

    2015-01-01

    The pathogenic potential and genetic diversity of Blastocystis are poorly understood despite being one of the most frequent intestinal parasites in routine fecal examination all around the world as well as Turkey. There are numerous defined subtypes (ST) of Blastocystis which infect animals and nine of them were isolated from human fecal samples. Blastocystis is an anaerobic parasite and generally recognized as nonpathogenic microorganism that colonizes the colon. However recent studies have indicated that the genotypes may be related with the pathogenicity and clinical symptoms of the infection. The aims of this study were to investigate the subtypes of Blastocystis isolates obtained from stool samples submitted to the parasitology laboratory of Adnan Menderes University, Faculty of Medicine, and to evaluate the clinical symptoms of infected cases. A total of 61 cases (40 male, 21 female; age range: 5-69 years, mean age: 35 ± 19.1 years) were included in the study. Stool samples that were positive for Blastocystis cysts in direct microscopic examination, were inoculated in Jones medium and incubated at 37°C for 72 hours for the growth of parasite. Genomic DNAs were isolated from Jones medium directly or frozen samples with a commercial kit (DNAzol, Invitrogen, USA). The subtypes of Blastocystis were detected by polymerase chain reaction (PCR) using ST-specific primers and the symptoms of patients were evaluated retrospectively. Forty-four (72.1%) out of 61 isolates were subtyped by PCR, while 17 (27.9%) could not be typed. The distribution of Blastocystis subtypes were found as follows; ST3 in 17 (38.6%), ST2 in 13 (29.5%), ST1 in 9 (20.5%), ST1 + ST3 in 4 (9.1%), and ST1 + ST2 in one (2.3%) of the samples. The most common symptoms among Blastocystis infected cases were abdominal pain (n= 24, 39.4%), pruritus (n= 22, 36.1%), diarrhea (n= 4, 6.6%) and constipation (n= 2, 3.3%), respectively. This is the first study investigating the genotypes of Blastocystis in

  1. CSF Proteomics Identifies Specific and Shared Pathways for Multiple Sclerosis Clinical Subtypes.

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    Timucin Avsar

    Full Text Available Multiple sclerosis (MS is an immune-mediated, neuro-inflammatory, demyelinating and neurodegenerative disease of the central nervous system (CNS with a heterogeneous clinical presentation and course. There is a remarkable phenotypic heterogeneity in MS, and the molecular mechanisms underlying it remain unknown. We aimed to investigate further the etiopathogenesis related molecular pathways in subclinical types of MS using proteomic and bioinformatics approaches in cerebrospinal fluids of patients with clinically isolated syndrome, relapsing remitting MS and progressive MS (n=179. Comparison of disease groups with controls revealed a total of 151 proteins that are differentially expressed in clinically different MS subtypes. KEGG analysis using PANOGA tool revealed the disease related pathways including aldosterone-regulated sodium reabsorption (p=8.02x10-5 which is important in the immune cell migration, renin-angiotensin (p=6.88x10-5 system that induces Th17 dependent immunity, notch signaling (p=1.83x10-10 pathway indicating the activated remyelination and vitamin digestion and absorption pathways (p=1.73x10-5. An emerging theme from our studies is that whilst all MS clinical forms share common biological pathways, there are also clinical subtypes specific and pathophysiology related pathways which may have further therapeutic implications.

  2. Colon cancer molecular subtypes identified by expression profiling and associated to stroma, mucinous type and different clinical behavior

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    Perez Villamil Beatriz

    2012-06-01

    Full Text Available Abstract Background Colon cancer patients with the same stage show diverse clinical behavior due to tumor heterogeneity. We aimed to discover distinct classes of tumors based on microarray expression patterns, to analyze whether the molecular classification correlated with the histopathological stages or other clinical parameters and to study differences in the survival. Methods Hierarchical clustering was performed for class discovery in 88 colon tumors (stages I to IV. Pathways analysis and correlations between clinical parameters and our classification were analyzed. Tumor subtypes were validated using an external set of 78 patients. A 167 gene signature associated to the main subtype was generated using the 3-Nearest-Neighbor method. Coincidences with other prognostic predictors were assesed. Results Hierarchical clustering identified four robust tumor subtypes with biologically and clinically distinct behavior. Stromal components (p BRAF mutations. Tumor subtypes were validated using an external set of 78 patients. A 167 gene signature associated to the Low-stroma-subtype distinguished low risk patients from high risk patients in the external cohort (Dukes B and C:HR = 8.56(2.53-29.01; Dukes B,C and D:HR = 1.87(1.07-3.25. Eight different reported survival gene signatures segregated our tumors into two groups the Low-stroma-subtype and the other tumor subtypes. Conclusions We have identified novel molecular subtypes in colon cancer with distinct biological and clinical behavior that are established from the initiation of the tumor. Tumor microenvironment is important for the classification and for the malignant power of the tumor. Differential gene sets and biological pathways characterize each tumor subtype reflecting underlying mechanisms of carcinogenesis that may be used for the selection of targeted therapeutic procedures. This classification may contribute to an improvement in the management of the patients with CRC and to a

  3. Gender related differences in demographic and clinical manifestations in patients suffering from various subtypes of schizophrenia

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    Gorana Sulejmanpašić Arslanagić

    2011-12-01

    Full Text Available Introduction: Schizophrenia is devastating neuropsychiatric disorder that has no clearly identified etiology. The subtypes of schizophrenia are distinguished by the prevalent symptomatology. The aim of this study was to determine gender related differences in demographic and clinical manifestations in patients suffering from various subtypes of schizophrenia.Methods: A longitudinal, prospective,original,clinical investigation first in our local area, with application of Structured Clinical Interview for DSM IV Axis I Disorders (SCID I was used in this work. The study included 121 patients during five years period. Patients were recruited as consecutive admissions to the Psychiatric clinic, from all parts of Bosnia and Herzegovina, mostly Sarajevo region.Results: The study was conducted on a group of schizophrenic patients which consisted of 52.1% male and 47.9% female patients. Average duration of the episode was about a month. Majority of patients (male were in the group of disorganized (hebephrenic schizophrenia. The duration of current psychotic episode was similar in all three groups regarding subtypes of schizophrenia. Psychotic episodes appear equally in both gender (higher in disorganized group with a statistically significant difference between all groups (p<0.001.Conclusions: Male group patients showed tendency to be younger than women. Most of the schizophrenic individuals start to suffer from this disease between age of 20 and 39 years. Male group patients suffered mostly of disorganized (hebephrenic type of schizophrenia. Duration of psychotic episode was proportionally the same in both groups while in male group the highest number of episodes was found in group of disorganized schizophrenia.

  4. Histopathological characterization of the oral lichenoid disease subtypes and the relation with the clinical data.

    Science.gov (United States)

    Alberdi-Navarro, J; Marichalar-Mendia, X; Lartitegui-Sebastián, M-J; Gainza-Cirauqui, M-L; Echebarria-Goikouria, M-A; Aguirre-Urizar, J-M

    2017-05-01

    The aim of the study was to analyze the histopathological characteristics of samples with a diagnosis of oral lichenoid disease (OLD) and their link with the location and the type of clinical lesion, and the clinicopathological subtypes. Retrospective study on 85 consecutive patients diagnosed with OLD (58 women and 27 men, mean age of 57.7 years). Clinical and histopathological characterization of each case (modified WHO criteria). Collection of the clinical and histopathological data of the lesions. Descriptive and comparative statistical analysis of the results. The 78.8% of the cases were considered clinically typical while the 21.2% were considered compatible. Histologically, 52.9% were classified as typical and 47.1% as compatible. Biopsies from "plaque-like" lesions presented hyperkeratosis (p>0.001) and epithelial dysplasia (p=0.06) more frequently. Furthermore, acute inflammation was more evident in erosive-ulcerative lesions (p=0.001). Differences regarding the location of the biopsy were statistically non-significant. However, 42.9% of the tongue biopsies showed epithelial dysplasia. The histopathological aspect of this disorder is not specific and does not allow us to differentiate between the main subtypes. Therefore, the main reasons to perform a biopsy in this disorder are to define the differential diagnosis and to rule out epithelial dysplasia or a carcinoma. The final histopathological result may be subject to the type of lesion that is biopsied.

  5. Differential clinical effects of different mutation subtypes in CALR-mutant myeloproliferative neoplasms

    Science.gov (United States)

    Pietra, D; Rumi, E; Ferretti, V V; Buduo, C A Di; Milanesi, C; Cavalloni, C; Sant'Antonio, E; Abbonante, V; Moccia, F; Casetti, I C; Bellini, M; Renna, M C; Roncoroni, E; Fugazza, E; Astori, C; Boveri, E; Rosti, V; Barosi, G; Balduini, A; Cazzola, M

    2016-01-01

    A quarter of patients with essential thrombocythemia or primary myelofibrosis carry a driver mutation of CALR, the calreticulin gene. A 52-bp deletion (type 1) and a 5-bp insertion (type 2 mutation) are the most frequent variants. These indels might differentially impair the calcium binding activity of mutant calreticulin. We studied the relationship between mutation subtype and biological/clinical features of the disease. Thirty-two different types of CALR variants were identified in 311 patients. Based on their predicted effect on calreticulin C-terminal, mutations were classified as: (i) type 1-like (65%); (ii) type 2-like (32%); and (iii) other types (3%). Corresponding CALR mutants had significantly different estimated isoelectric points. Patients with type 1 mutation, but not those with type 2, showed abnormal cytosolic calcium signals in cultured megakaryocytes. Type 1-like mutations were mainly associated with a myelofibrosis phenotype and a significantly higher risk of myelofibrotic transformation in essential thrombocythemia. Type 2-like CALR mutations were preferentially associated with an essential thrombocythemia phenotype, low risk of thrombosis despite very-high platelet counts and indolent clinical course. Thus, mutation subtype contributes to determining clinical phenotype and outcomes in CALR-mutant myeloproliferative neoplasms. CALR variants that markedly impair the calcium binding activity of mutant calreticulin are mainly associated with a myelofibrosis phenotype. PMID:26449662

  6. Toddler Autism Screening Questionnaire: Development and Potential Clinical Validity

    Science.gov (United States)

    Tsai, Wen-Che; Soong, Wei-Tsuen; Shyu, Yea-Ing Lotus

    2012-01-01

    No feasible screening instrument is available for early detection of children with autism in Taiwan. The existing instruments may not be appropriate for use in Taiwan due to different health care systems and child-rearing cultures. The purpose of this study was to develop and test a screening questionnaire for generic autism. The initial 18-item…

  7. Clinical evidence for three distinct gastric cancer subtypes: time for a new approach.

    Directory of Open Access Journals (Sweden)

    Alessandro Bittoni

    Full Text Available BACKGROUND: Recently, a new classification for gastric cancer (GC has been proposed, based on Lauren's histology and on anatomic tumour location, identifying three subtypes of disease: type 1 (proximal non diffuse GC, type 2 (diffuse GC and type 3 (distal non diffuse GC. Aim of our analysis was to compare clinical outcome according to different GC subtypes (1,2,3 in metastatic GC patients receiving first-line chemotherapy. PATIENTS AND METHODS: Advanced GC pts treated with a first-line combination chemotherapy were included in our analysis. Pts were divided in three subgroups (type 1, type 2 and type 3 as previously defined. RESULTS: A total of 248 advanced GC pts were included: 45.2% belonged to type 2, 43.6% to type 3 and 11.2% to type 1. Patients received a fluoropyrimidine-based chemotherapy doublet or three drugs regimens including a platinum derivate and a fluoropyrimidine with the addition of an anthracycline, a taxane or mytomicin C. RR was higher in type 1 pts (RR = 46.1% and type 3 (34,3% compared to type 2 (20,4%, (p = 0.015. Type 2 presented a shorter PFS, median PFS = 4.2 months, compared to type 1, mPFS = 7.2 months, and type 3, mPFS = 5.9 months (p = 0.011 and also a shorter OS (p = 0.022. CONCLUSIONS: Our analysis suggests that GC subtypes may be important predictors of benefit from chemotherapy in advanced GC patients. Future clinical trials should take in account these differences for a better stratification of patients.

  8. Generation of an algorithm based on minimal gene sets to clinically subtype triple negative breast cancer patients.

    Science.gov (United States)

    Ring, Brian Z; Hout, David R; Morris, Stephan W; Lawrence, Kasey; Schweitzer, Brock L; Bailey, Daniel B; Lehmann, Brian D; Pietenpol, Jennifer A; Seitz, Robert S

    2016-02-23

    Recently, a gene expression algorithm, TNBCtype, was developed that can divide triple-negative breast cancer (TNBC) into molecularly-defined subtypes. The algorithm has potential to provide predictive value for TNBC subtype-specific response to various treatments. TNBCtype used in a retrospective analysis of neoadjuvant clinical trial data of TNBC patients demonstrated that TNBC subtype and pathological complete response to neoadjuvant chemotherapy were significantly associated. Herein we describe an expression algorithm reduced to 101 genes with the power to subtype TNBC tumors similar to the original 2188-gene expression algorithm and predict patient outcomes. The new classification model was built using the same expression data sets used for the original TNBCtype algorithm. Gene set enrichment followed by shrunken centroid analysis were used for feature reduction, then elastic-net regularized linear modeling was used to identify genes for a centroid model classifying all subtypes, comprised of 101 genes. The predictive capability of both this new "lean" algorithm and the original 2188-gene model were applied to an independent clinical trial cohort of 139 TNBC patients treated initially with neoadjuvant doxorubicin/cyclophosphamide and then randomized to receive either paclitaxel or ixabepilone to determine association of pathologic complete response within the subtypes. The new 101-gene expression model reproduced the classification provided by the 2188-gene algorithm and was highly concordant in the same set of seven TNBC cohorts used to generate the TNBCtype algorithm (87%), as well as in the independent clinical trial cohort (88%), when cases with significant correlations to multiple subtypes were excluded. Clinical responses to both neoadjuvant treatment arms, found BL2 to be significantly associated with poor response (Odds Ratio (OR) =0.12, p=0.03 for the 2188-gene model; OR = 0.23, p sets can recapitulate the TNBC subtypes identified by the original 2188

  9. GFAP mutations, age at onset, and clinical subtypes in Alexander disease.

    Science.gov (United States)

    Prust, M; Wang, J; Morizono, H; Messing, A; Brenner, M; Gordon, E; Hartka, T; Sokohl, A; Schiffmann, R; Gordish-Dressman, H; Albin, R; Amartino, H; Brockman, K; Dinopoulos, A; Dotti, M T; Fain, D; Fernandez, R; Ferreira, J; Fleming, J; Gill, D; Griebel, M; Heilstedt, H; Kaplan, P; Lewis, D; Nakagawa, M; Pedersen, R; Reddy, A; Sawaishi, Y; Schneider, M; Sherr, E; Takiyama, Y; Wakabayashi, K; Gorospe, J R; Vanderver, A

    2011-09-27

    To characterize Alexander disease (AxD) phenotypes and determine correlations with age at onset (AAO) and genetic mutation. AxD is an astrogliopathy usually characterized on MRI by leukodystrophy and caused by glial fibrillary acidic protein (GFAP) mutations. We present 30 new cases of AxD and reviewed 185 previously reported cases. We conducted Wilcoxon rank sum tests to identify variables scaling with AAO, survival analysis to identify predictors of mortality, and χ(2) tests to assess the effects of common GFAP mutations. Finally, we performed latent class analysis (LCA) to statistically define AxD subtypes. LCA identified 2 classes of AxD. Type I is characterized by early onset, seizures, macrocephaly, motor delay, encephalopathy, failure to thrive, paroxysmal deterioration, and typical MRI features. Type II is characterized by later onset, autonomic dysfunction, ocular movement abnormalities, bulbar symptoms, and atypical MRI features. Survival analysis predicted a nearly 2-fold increase in mortality among patients with type I AxD relative to those with type II. R79 and R239 GFAP mutations were most common (16.6% and 20.3% of all cases, respectively). These common mutations predicted distinct clinical outcomes, with R239 predicting the most aggressive course. AAO and the GFAP mutation site are important clinical predictors in AxD, with clear correlations to defined patterns of phenotypic expression. We propose revised AxD subtypes, type I and type II, based on analysis of statistically defined patient groups.

  10. Schizophrenia dissection by five anxiety and depressive subtype comorbidities: Clinical implications and evolutionary perspective.

    Science.gov (United States)

    Veras, André B; Cougo, Simone; Meira, Fernanda; Peixoto, Clayton; Barros, Jorge A; Nardi, Antonio E; Malaspina, Dolores; Poyurovsky, Michael; Kahn, Jeffrey P

    2017-07-26

    Twenty patients with DSM5 schizophrenia were comprehensively and formally assessed by an experienced psychiatrist. All subjects were assessed for: positive and negative psychotic symptoms; social anxiety; panic anxiety; obsessive compulsive disorder, atypical depression; major depression; suicide risk; and global assessment of functioning. Different profiles of clinical presentation and symptom evolution emerged for patients with schizophrenia who had co-morbid depression (15%), OCD (15%), panic or limited symptom attacks (55%) and social anxiety (5%). At least eighty percent of the sample had one or more of these co-morbidities. Summing up, the data support our previous finding that panic is highly prevalent in Schizophrenia with Auditory Hallucinations (>73% here, versus 100% before), and panic was paroxysmally concurrent with voice onset. Moreover, characteristic clinical findings may help point clinicians to five specific co-morbidity psychosis subtypes. Moreover, co-morbidity dissection of psychotic diagnoses recalls and parallels the historical psychopharmacologic dissection of non-psychotic anxiety and depressive subtypes diagnoses. Larger studies should further test and explore these preliminary findings. Copyright © 2017. Published by Elsevier B.V.

  11. Subtypes of chronic urticaria in patients attending allergy clinics in Venezuela.

    Science.gov (United States)

    Sánchez-Borges, M; Caballero-Fonseca, F; Capriles-Hulett, A

    2014-11-01

    Chronic urticaria (CU) is one of the most puzzling clinical entities confronted by the medical profession. It is a common motive for consultation, and in a sizable proportion of patients no identifiable cause is evident. Since there are relatively few publications regarding CU in developing countries, we performed a prospective 3-year study on the demographic and clinical features of patients with CU. Four hundred and twenty-three subjects were studied, 52 children and 371 adults, 295 females (69.7%), with a mean age of 38.4 ± 17.8 years. More often, wheals and angioedema (AE) were present on the head, upper and lower limbs and the trunk. AE was present in 162 patients (38.4%). The most frequent subtypes were chronic spontaneous urticaria, aspirin-exacerbated cutaneous disease, dermographic urticaria, and combinations of various subtypes. A better understanding of the characteristics of patients suffering CU is helpful for clinicians dealing with this ailment, and provides guidance for new investigations on its pathogenesis, which will hopefully result in a better management of this vexing condition.

  12. The OnyCOE-t™ questionnaire: responsiveness and clinical meaningfulness of a patient-reported outcomes questionnaire for toenail onychomycosis

    OpenAIRE

    Kianifard Farid; Raut Monika; Mathias Susan D; Potter Lori P; Tavakkol Amir

    2006-01-01

    Abstract Background This research was conducted to confirm the validity and reliability and to assess the responsiveness and clinical meaningfulness of the OnyCOE-t™, a questionnaire specifically designed to measure patient-reported outcomes (PRO) associated with toenail onychomycosis. Methods 504 patients with toenail onychomycosis randomized to receive 12 weeks of terbinafine 250 mg/day with or without target toenail debridement in the IRON-CLAD® trial completed the OnyCOE-t™ at baseline, w...

  13. The clinical usefulness of the new LPE specifier for subtyping adolescents with conduct disorder in the DSM 5.

    Science.gov (United States)

    Jambroes, Tijs; Jansen, Lucres M C; Vermeiren, Robert R J M; Doreleijers, Theo A H; Colins, Olivier F; Popma, Arne

    2016-08-01

    In DSM 5, conduct disorder (CD) has been expanded with a new specifier 'with Limited Prosocial Emotions' (LPE) in addition to the age-of-onset (AoO) subtyping, and is thought to identify a severe antisocial subgroup of CD. However, research in clinical practice has been scarce. Therefore, the current study will examine differences in clinical symptoms between subtypes of CD, based on both subtyping schemes. Subsequently, it will investigate whether the LPE specifier explains unique variance in aggression, added to the AoO subtyping. A sample of 145 adolescents with CD (51 % male, mean age 15.0) from a closed treatment institution participated in this study. CD diagnoses and AoO subtype were assessed using a structured diagnostic interview. The LPE specifier was assessed using the callous-unemotional dimension of the Youth Psychopathy Traits Inventory (YPI). Self-reported proactive and reactive aggression, rule-breaking behavior and internalizing problems within the subtypes were compared. Youth with childhood-onset CD and LPE showed significantly more aggression than adolescent-onset CD without LPE (proactive aggression: F = 3.1, p LPE specifier uniquely explained 7 % of the variance in reactive aggression, additionally to the AoO subtyping. For proactive aggression, the interaction between AoO and the LPE added 4.5 % to the explained variance. Although the LPE specifier may help to identify a more aggressive subtype of CD in adolescents, the incremental utility seems to be limited. Therefore, clinical relevance of the LPE specifier in high-risk adolescent samples still needs to be investigated thoroughly.

  14. [Differential personality features in adult ADHD subtypes].

    Science.gov (United States)

    Martínez Ortega, Yolanda; Bosch Munsó, Rosa; Gomà-i-Freixanet, Montserrat; Valero Ventura, Sergi; Ramos-Quiroga, Josep Antoni; Nogueira, Mariana; Casas Brugué, Miguel

    2010-05-01

    Attention Deficit/Hyperactivity Disorder (ADHD) and personality traits are relatively stable from childhood and across life span. The purpose of this study was to identify differential and discriminative personality traits between clinical subtypes of ADHD in adults. The Zuckerman-Kuhlman Personality Questionnaire (ZKPQ) and the Millon Multiaxial Clinical Inventory-II (MCMI-II) were administered to a sample of 146 adults with ADHD. Activity and Aggression-Hostility dimensions from the ZKPQ allowed us to properly classify 75.8% of the inattentive and combined subtypes. Data indicates that ADHD is not a homogeneous entity, but rather, there are significant differences in personality characteristics among clinical subtypes. The results have theoretical implications about the connection between ADHD and personality, and clinical implications regarding diagnosis and treatment designs better tailored to the characteristics of each subtype.

  15. Bipolar disorder subtypes in children and adolescents: demographic and clinical characteristics from an Australian sample.

    Science.gov (United States)

    Hirneth, Stephen J; Hazell, Philip L; Hanstock, Tanya L; Lewin, Terry J

    2015-04-01

    Bipolar disorder (BD) phenomenology in children and adolescents remains contentious. The study investigated Australian children and adolescents with bipolar I disorder (BD-I), bipolar II disorder (BD-II), or BD not otherwise specified (BD-NOS). Index episode demographics, symptomatology, functioning and diagnostic data were compared for 88 participants (63 female) aged 8-18 years (M=14.8, SD=2.5) meeting DSM-IV-TR criteria for BD-I (n=24), BD-II (n=13) or BD-NOS (n=51). BD-I had higher rates of previous episodes, psychotropic medication (compared to BD-II but not BD-NOS), rates of inpatient admissions (compared to BD-NOS), and number of inpatient admissions (compared to BD-II). BD-II had lower rates of lifetime depression and anxiety disorders, higher frequency of hypomania, shorter duration of illness, and fewer previous episodes. BD-NOS had younger age of onset, chronic course, irritability and mixed presentation. All BD subtypes had high rates of self-harm (69.3%), suicidal ideation (73.9%), suicide attempts (36.4%), psychiatric admission (55.7%), and psychosis (36.4%). There were relatively small numbers of BD-I and BD-II. Diagnoses were based on retrospective recall. All BD subtypes had high levels of acuity and clinical risk. In accord with previous results, BD-I and BD-II participants' phenomenology was consistent with classical descriptions of these subtypes. BD-NOS participants were younger, with less euphoric mania but otherwise phenomenologically on a continuum with BD-I, suggesting that child and adolescent BD-NOS may be an early and less differentiated phase of illness of BD-I or BD-II and hence a target for early intervention. Copyright © 2014 Elsevier B.V. All rights reserved.

  16. Clinical and socioeconomic impact of different types and subtypes of seasonal influenza viruses in children during influenza seasons 2007/2008 and 2008/2009

    Directory of Open Access Journals (Sweden)

    Giacchino Raffaella

    2011-10-01

    Full Text Available Abstract Background There are few and debated data regarding possible differences in the clinical presentations of influenza A/H1N1, A/H3N2 and B viruses in children. This study evaluates the clinical presentation and socio-economic impact of laboratory-confirmed influenza A/H1N1, A/H3N2 or B infection in children attending an Emergency Room because of influenza-like illness. Methods Among the 4,726 children involved, 662 had influenza A (143 A/H1N1 and 519 A/H3N2 and 239 influenza B infection detected by means of real-time polymerase chain reaction. Upon enrolment, systematic recordings were made of the patients' demographic characteristics and medical history using standardised written questionnaires. The medical history of the children was re-evaluated 5-7 days after enrolment and until the resolution of their illness by means of interviews and a clinical examination by trained investigators using standardised questionnaires. During this evaluation, information was also obtained regarding illnesses and related morbidity among households. Results Children infected with influenza A/H1N1 were significantly younger (mean age, 2.3 yrs than children infected with influenza A/H3N2 (mean age, 4.7 yrs; p Conclusions Disease due to influenza A/H3N2 viral subtype is significantly more severe than that due to influenza A/H1N1 subtype and influenza B virus, which indicates that the characteristics of the different viral types and subtypes should be adequately considered by health authorities when planning preventive and therapeutic measures.

  17. The OnyCOE-t™ questionnaire: responsiveness and clinical meaningfulness of a patient-reported outcomes questionnaire for toenail onychomycosis

    Science.gov (United States)

    Potter, Lori P; Mathias, Susan D; Raut, Monika; Kianifard, Farid; Tavakkol, Amir

    2006-01-01

    Background This research was conducted to confirm the validity and reliability and to assess the responsiveness and clinical meaningfulness of the OnyCOE-t™, a questionnaire specifically designed to measure patient-reported outcomes (PRO) associated with toenail onychomycosis. Methods 504 patients with toenail onychomycosis randomized to receive 12 weeks of terbinafine 250 mg/day with or without target toenail debridement in the IRON-CLAD® trial completed the OnyCOE-t™ at baseline, weeks 6, 12, 24, and 48. The OnyCOE-t™ is composed of 6 multi-item scales and 1 single-item scale. These include a 7-item Toenail Symptom assessment, which comprises both Symptom Frequency and Symptom Bothersomeness scales; an 8-item Appearance Problems scale; a 7-item Physical Activities Problems scale; a 1-item Overall Problem scale; a 7-item Stigma scale; and a 3-item Treatment Satisfaction scale. In total, 33 toenail onychomycosis-specific items are included in the OnyCOE-t™. Clinical data, in particular the percent clearing of mycotic involvement in the target toenail, and OnyCOE-t™ responses were used to evaluate the questionnaire's reliability, validity, responsiveness, and the minimally clinical important difference (MCID). Results The OnyCOE-t™ was shown to be reliable and valid. Construct validity and known groups validity were acceptable. Internal consistency reliability of multi-item scales was demonstrated by Cronbach's alpha > .84. Responsiveness was good, with the Treatment Satisfaction, Symptom Frequency, Overall Problem, and Appearance Problem scales demonstrating the most responsiveness (Guyatt's statistic of 1.72, 1.31, 1.13, and 1.11, respectively). MCID was evaluated for three different clinical measures, and indicated that approximately an 8.5-point change (on a 0 to 100 scale) was clinically meaningful based on a 25% improvement in target nail clearing. Conclusion The OnyCOE-t™ questionnaire is a unique, toenail-specific PRO questionnaire that can be

  18. The OnyCOE-t™ questionnaire: responsiveness and clinical meaningfulness of a patient-reported outcomes questionnaire for toenail onychomycosis

    Directory of Open Access Journals (Sweden)

    Kianifard Farid

    2006-08-01

    Full Text Available Abstract Background This research was conducted to confirm the validity and reliability and to assess the responsiveness and clinical meaningfulness of the OnyCOE-t™, a questionnaire specifically designed to measure patient-reported outcomes (PRO associated with toenail onychomycosis. Methods 504 patients with toenail onychomycosis randomized to receive 12 weeks of terbinafine 250 mg/day with or without target toenail debridement in the IRON-CLAD® trial completed the OnyCOE-t™ at baseline, weeks 6, 12, 24, and 48. The OnyCOE-t™ is composed of 6 multi-item scales and 1 single-item scale. These include a 7-item Toenail Symptom assessment, which comprises both Symptom Frequency and Symptom Bothersomeness scales; an 8-item Appearance Problems scale; a 7-item Physical Activities Problems scale; a 1-item Overall Problem scale; a 7-item Stigma scale; and a 3-item Treatment Satisfaction scale. In total, 33 toenail onychomycosis-specific items are included in the OnyCOE-t™. Clinical data, in particular the percent clearing of mycotic involvement in the target toenail, and OnyCOE-t™ responses were used to evaluate the questionnaire's reliability, validity, responsiveness, and the minimally clinical important difference (MCID. Results The OnyCOE-t™ was shown to be reliable and valid. Construct validity and known groups validity were acceptable. Internal consistency reliability of multi-item scales was demonstrated by Cronbach's alpha > .84. Responsiveness was good, with the Treatment Satisfaction, Symptom Frequency, Overall Problem, and Appearance Problem scales demonstrating the most responsiveness (Guyatt's statistic of 1.72, 1.31, 1.13, and 1.11, respectively. MCID was evaluated for three different clinical measures, and indicated that approximately an 8.5-point change (on a 0 to 100 scale was clinically meaningful based on a 25% improvement in target nail clearing. Conclusion The OnyCOE-t™ questionnaire is a unique, toenail-specific PRO

  19. Blastocystis and urticaria: Examination of subtypes and morphotypes in an unusual clinical manifestation.

    Science.gov (United States)

    Casero, Rodolfo Daniel; Mongi, Florencia; Sánchez, Angie; Ramírez, Juan David

    2015-08-01

    Blastocystis is a human common enteric protist that may colonize a large variety of non-human hosts linked to symptoms and diseases such as abdominal pain, constipation, diarrhea, urticaria, flatulence and irritable bowel syndrome (IBS). Blastocystis exhibits remarkable genetic diversity and multiple subtypes (STs) within the genus with no absolute associations with clinical symptomatology. Here we analyzed fecal samples from Argentinean patients (n=270) belonging to symptomatic (urticaria and non-specific gastrointestinal symptoms, n=39) and asymptomatic control (n=28). Those patients infected with Blastocystis (n=67) were submitted for morphological analysis, DNA extraction, 18S PCR, sequencing and STs identification according to DNA barcoding. Blastocystis vacuolar forms were the predominant morphotype (75%), ameboid-like forms were evidenced in 1.5% of samples. Blastocystis ST3 was detected in 71.6% (n=48), of which 71.4%, (n=35) and 28.6% (n=14) belonged to symptomatic and asymptomatic respectively. Other subtypes identified were ST1 (14.9%), ST6 (7.5%) and ST2 (5.9%). Blastocystis 18S barcoding evidenced in non-urticaria symptomatic patients and asymptomatic control group the presence of allele 134 (ST3) (p<0.0001), while allele 34 (ST3) was detected in 85.7% (18/21) of symptomatic uricaria as compared with control group (1/21) (p<0.0001). The presence of a particular allele (a34) significantly associated with urticaria patients was detected and the clinical implications of these findings are herein discussed.

  20. Therapeutic strategies in male breast cancer: clinical implications of chromosome 17 gene alterations and molecular subtypes.

    Science.gov (United States)

    Schildhaus, Hans-Ulrich; Schroeder, Lars; Merkelbach-Bruse, Sabine; Binot, Elke; Büttner, Reinhard; Kuhn, Walther; Rudlowski, Christian

    2013-12-01

    Male breast cancer (MBC) is a rare disease. To date, therapy is mainly based on studies and clinical experiences with breast cancer in women. Only little is known about molecular typing of MBC, particularly with regard to potential biological predictors for adjuvant therapy. In female breast cancer tumors with chromosome 17 centromere (CEP17) duplication, HER2 and/or Topoisomerase II alpha (Topo II-α) gene alterations have been suggested to be associated with poor prognosis and increased sensitivity to anthracycline-containing regimens. In a well characterized cohort of 96 primary invasive MBC, we studied CEP17, HER2 and Topo II-α alterations by fluorescence in-situ hybridization (FISH), and expression of hormone receptors (HR), HER2 and Ki67 by immunohistochemistry to define molecular subtypes. Tumor characteristics and follow-up data were available and correlated with molecular findings. HER2 amplification and Topo II-α amplification/deletion were exceptionally rare in MBC (6.3% and 3.1%, respectively). CEP17 polysomy were found in 9.4% of tumors. HER2, Topo II-α and CEP17 gene alterations were not correlated to patients outcome. 96.9% of our cases were HR positive. Triple negative tumors were found in only 3.1% of the cases. In nodal negative tumors luminal A subtypes were significantly associated with better overall survival. Our results provide evidence for a predominant male breast cancer phenotype, characterized by HR expression and a lack of HER2/Topo II-α alterations and CEP17 duplicates. Therefore, the impact of anthracycline sensitivity linked to HER2/Topo II-α alterations as found in female breast cancer has low clinical significance for this specific male breast cancer phenotype. Copyright © 2013 Elsevier Ltd. All rights reserved.

  1. Relationships between a Dissociative Subtype of PTSD and Clinical Characteristics in Patients with Substance Use Disorders.

    Science.gov (United States)

    Mergler, Michaela; Driessen, Martin; Lüdecke, Christel; Ohlmeier, Martin; Chodzinski, Claudia; Weirich, Steffen; Schläfke, Detlef; Wedekind, Dirk; Havemann-Reinecke, Ursula; Renner, Walter; Schäfer, Ingo

    2017-01-01

    The increasing support for a dissociative subtype of post-traumatic stress disorder (PTSD-D) has led to its inclusion in DSM-5. We examined relationships between PTSD-D and relevant variables in patients with substance use disorders (SUD). The sample comprised N = 459 patients with SUD. The International Diagnostic Checklist and the Posttraumatic Diagnostic Scale were used to diagnose PTSD. In addition, participants completed the Childhood Trauma Questionnaire and the Dissociative Experiences Scale. The course of SUD was assessed by means of the European Addiction Severity Index. One-fourth of participants fulfilled a diagnosis of PTSD (25.3%). Patients with PTSD-D (N = 32, 27.6% of all patients with PTSD) reported significantly more current depressive symptoms, more current suicidal thoughts, more lifetime anxiety/tension, and more suicide attempts. The PTSD-D group also showed a significantly higher need for treatment due to drug problems, higher current use of opiates/analgesics, and a higher number of lifetime drug overdoses. In a regression model, symptoms of depression in the last month and lifetime suicide attempts significantly predicted PTSD-D. These findings suggest that PTSD-D is related to additional psychopathology and to a more severe course of substance-related problems in patients with SUD, indicating that this group also has additional treatment needs.

  2. Clinical Validation of the Trait and State Versions of the Food Craving Questionnaire

    Science.gov (United States)

    Moreno, Silvia; Rodriguez, Sonia; Fernandez, Mari Carmen; Tamez, Jeannine; Cepeda-Benito, Antonio

    2008-01-01

    This is the first study to evaluate the psychometric properties of the Food Craving Questionnaire-Trait (FCQ-T), and Food Craving Questionnaire-State (FCQ-S) measures using a clinically heterogeneous sample of eating disorder patients (N = 177) recruited from seven different outpatient eating disorder treatment centers in Spain. Confirmatory…

  3. Genome-wide association study of clinically defined gout identifies multiple risk loci and its association with clinical subtypes

    Science.gov (United States)

    Matsuo, Hirotaka; Yamamoto, Ken; Nakaoka, Hirofumi; Nakayama, Akiyoshi; Sakiyama, Masayuki; Chiba, Toshinori; Takahashi, Atsushi; Nakamura, Takahiro; Nakashima, Hiroshi; Takada, Yuzo; Danjoh, Inaho; Shimizu, Seiko; Abe, Junko; Kawamura, Yusuke; Terashige, Sho; Ogata, Hiraku; Tatsukawa, Seishiro; Yin, Guang; Okada, Rieko; Morita, Emi; Naito, Mariko; Tokumasu, Atsumi; Onoue, Hiroyuki; Iwaya, Keiichi; Ito, Toshimitsu; Takada, Tappei; Inoue, Katsuhisa; Kato, Yukio; Nakamura, Yukio; Sakurai, Yutaka; Suzuki, Hiroshi; Kanai, Yoshikatsu; Hosoya, Tatsuo; Hamajima, Nobuyuki; Inoue, Ituro; Kubo, Michiaki; Ichida, Kimiyoshi; Ooyama, Hiroshi; Shimizu, Toru; Shinomiya, Nariyoshi

    2016-01-01

    Objective Gout, caused by hyperuricaemia, is a multifactorial disease. Although genome-wide association studies (GWASs) of gout have been reported, they included self-reported gout cases in which clinical information was insufficient. Therefore, the relationship between genetic variation and clinical subtypes of gout remains unclear. Here, we first performed a GWAS of clinically defined gout cases only. Methods A GWAS was conducted with 945 patients with clinically defined gout and 1213 controls in a Japanese male population, followed by replication study of 1048 clinically defined cases and 1334 controls. Results Five gout susceptibility loci were identified at the genome-wide significance level (p<5.0×10−8), which contained well-known urate transporter genes (ABCG2 and SLC2A9) and additional genes: rs1260326 (p=1.9×10−12; OR=1.36) of GCKR (a gene for glucose and lipid metabolism), rs2188380 (p=1.6×10−23; OR=1.75) of MYL2-CUX2 (genes associated with cholesterol and diabetes mellitus) and rs4073582 (p=6.4×10−9; OR=1.66) of CNIH-2 (a gene for regulation of glutamate signalling). The latter two are identified as novel gout loci. Furthermore, among the identified single-nucleotide polymorphisms (SNPs), we demonstrated that the SNPs of ABCG2 and SLC2A9 were differentially associated with types of gout and clinical parameters underlying specific subtypes (renal underexcretion type and renal overload type). The effect of the risk allele of each SNP on clinical parameters showed significant linear relationships with the ratio of the case–control ORs for two distinct types of gout (r=0.96 [p=4.8×10−4] for urate clearance and r=0.96 [p=5.0×10−4] for urinary urate excretion). Conclusions Our findings provide clues to better understand the pathogenesis of gout and will be useful for development of companion diagnostics. PMID:25646370

  4. A Study of the Effectiveness of Information Design Principles Applied to Clinical Research Questionnaires.

    Science.gov (United States)

    Zimmerman, Beverly B.; Schultz, Jessica R.

    2000-01-01

    Investigates the effectiveness of information design principles and feedback-based usability testing in developing clinical questionnaires. Finds that a form developed using information design principles collected significantly more data than did a control form. (SR)

  5. Cutaneous and Mucosal Lichen Planus: A Comprehensive Review of Clinical Subtypes, Risk Factors, Diagnosis, and Prognosis

    Directory of Open Access Journals (Sweden)

    Farzam Gorouhi

    2014-01-01

    Full Text Available Lichen planus (LP is a chronic inflammatory disorder that most often affects middle-aged adults. LP can involve the skin or mucous membranes including the oral, vulvovaginal, esophageal, laryngeal, and conjunctival mucosa. It has different variants based on the morphology of the lesions and the site of involvement. The literature suggests that certain presentations of the disease such as esophageal or ophthalmological involvement are underdiagnosed. The burden of the disease is higher in some variants including hypertrophic LP and erosive oral LP, which may have a more chronic pattern. LP can significantly affect the quality of life of patients as well. Drugs or contact allergens can cause lichenoid reactions as the main differential diagnosis of LP. LP is a T-cell mediated immunologic disease but the responsible antigen remains unidentified. In this paper, we review the history, epidemiology, and clinical subtypes of LP. We also review the histopathologic aspects of the disease, differential diagnoses, immunopathogenesis, and the clinical and genetic correlations.

  6. Clinical Spectrum, Risk Factors, and Behavioral Abnormalities among Dementia Subtypes in a North Indian Population: A Hospital-Based Study

    Directory of Open Access Journals (Sweden)

    Suman Kushwaha

    2017-07-01

    Full Text Available Background: As variability in the clinical profile of dementia subtypes had been reported with regional differences across the world, we conducted a retrospective hospital-based study in a North Indian population. Methods: We retrieved patient records from 2007 to 2014 for details of clinical evaluation, diagnosis, neuroimaging, biochemical investigations, and follow-up of 1,876 patients with dementia (PwD, and the data were analyzed using descriptive statistics. Results: Of the total PwD, Alzheimer disease (AD accounted for 30% followed by vascular dementia (VaD 26%, mixed dementia (MD 21%, Parkinson-related dementia 11%, frontotemporal dementia (FTD 7%, and infective dementia 5%. Of all PwD excluding the infective group (n = 1,777, 63% were men, 39% were from rural areas, 87% had behavioral abnormalities along with cognitive deficits, and 73% had impaired ADLs. Among dementia subtypes, a positive family history, cardiovascular and metabolic risk factors, and behavioral abnormalities were found to be distributed. However, there existed a predominance of specific behavioral pattern in each subtype. The mean duration of follow-up varied from 2.9 ± 2.3 (VaD to 3.6 ± 2.1 (AD and greater than 30% were found to be stable on treatment (except in dementia with Lewy body. Conclusions: This large hospital-based study provides a distribution pattern and clinical spectrum of dementia subtypes in a North Indian population.

  7. Evaluation of complementary-alternative medicine (CAM) questionnaire development for Indonesian clinical psychologists: A pilot study.

    Science.gov (United States)

    Liem, Andrian; Newcombe, Peter A; Pohlman, Annie

    2017-08-01

    This study aimed to evaluate questionnaire development to measure the knowledge of Complementary-Alternative Medicine (CAM), attitudes towards CAM, CAM experiences, and CAM educational needs of clinical psychologists in Indonesia. A 26-item questionnaire was developed through an extensive literature search. Data was obtained from provisional psychologists from the Master of Professional Clinical Psychology programs at two established public universities in urban areas of Indonesia. To validate the questionnaire, panel reviews by executive members of the Indonesian Clinical Psychology Association (ICPA), experts in health psychology, and experts in public health and CAM provided their professional judgements. The self-reporting questionnaire consisted of four scales including: knowledge of CAM (6 items), attitudes towards CAM (10 items), CAM experiences (4 items), and CAM educational needs (6 items). All scales, except CAM Experiences, were assessed on a 7-point Likert scale. Sixty provisional psychologists were eligible to complete the questionnaire with a response rate of 73% (N=44). The results showed that the CAM questionnaire was reliable (Cronbach's coefficient alpha range=0.62-0.96; item-total correlation range=0.14-0.92) and demonstrated content validity. Following further psychometric evaluation, the CAM questionnaire may provide the evidence-based information to inform the education and practice of Indonesian clinical psychologists. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. Serum Level of Vascular Endothelial Growth Factor in Patients with Different Clinical SubtypeS of Oral Lichen Planus

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    Maryam Mardani

    2012-12-01

    Full Text Available Background: Oral lichen planus is a chronic inflammatory disease with a poorly understood etiology. The role of angiogenesis in the development of different chronic inflammatory diseases is of great concern. Vascular endothelial growth factor (VEGF is an important regulator of angiogenesis. We aimed to evaluate the serum level of VEGF in patients with oral lichen planus compared with normal individuals and consider its clinical significance.Methods: In this case-control study, 36 serum samples from patients diagnosed with oral lichen planus admitted to the Oral Medicine Department of the School of Dentistry at Shiraz University of Medical Sciences (14 men, 22 women, mean [±SD] age: 38.8 [±6.07] years and 23 serum samples from healthy individuals (9 men, 14 women, mean [±SD] age: 38.7 [±4.9] years were collected. VEGF concentration was measured using the ELISA method. The Mann-Whitney test was used for statistical analysis.Results: The serum VEGF level was significantly higher in patients with oral lichen planus compared with the healthy controls (112.97 [±63.2] vs. 66.21 [±56.2] ngr/ml, P<0.001. A similar difference was also observed between the two types of oral lichen planus, being more pronounced in the erosive form (P<0.001.Conclusion: Serum VEGF can be used as a useful and suitable marker to scrutinize the disease activity.

  9. Blastocystis subtypes in cancer patients: Analysis of possible risk factors and clinical characteristics.

    Science.gov (United States)

    Yersal, Ozlem; Malatyali, Erdogan; Ertabaklar, Hatice; Oktay, Esin; Barutca, Sabri; Ertug, Sema

    2016-12-01

    The aim of the present study was to examine the frequency and genetic diversity of Blastocystis in cancer patients of a Medical Oncology Department in Aydın, Turkey. Patients' stool samples were examined between January 2013 and February 2014 by both microscopy and culture methods. Culture positive samples were subjected to DNA isolation and Sequence Tagged Site (STS)-PCR analysis. Possible etiological factors and clinical features of Blastocystis infection were also analyzed and compared between Blastocystis infected and non-infected subgroups. Blastocystis was detected in 15 (6.5%) of 232 stool samples by microscopy and in 25 (10.8%) by culture methods. Out of 25 culture positive isolates, the most prevalent subtype was ST3 (59%), followed by ST1 (23%) and ST2 (18%). Blastocystis frequency was higher in the male patients than the females (19% vs. 6.5%, pBlastocystis was more frequent in patients with lung cancer than the other cancer types (χ(2)=18, pBlastocystis in cancer patients should be further examined, particularly as relates to treatment, microbiota and cancer type. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  10. Criterion Validity of the Mood and Feelings Questionnaire for Depressive Episodes in Clinic and Non-Clinic Subjects

    Science.gov (United States)

    Daviss, W. Burleson; Birmaher, Boris; Melhem, Nadine A.; Axelson, David A.; Michaels, Shana M.; Brent, David A.

    2006-01-01

    Background: Previous measures of pediatric depression have shown inconsistent validity in groups with differing demographics, comorbid diagnoses, and clinic or non-clinic origins. The current study re-examines the criterion validity of child- and parent-versions of the Mood and Feelings Questionnaire (MFQ-C, MFQ-P) in a heterogeneous sample of…

  11. Clinical Differences between Subtypes of Atrial Fibrillation and Flutter: Cross-Sectional Registry of 407 Patients

    Directory of Open Access Journals (Sweden)

    Eduardo Dytz Almeida

    2015-01-01

    Full Text Available Introduction: Atrial fibrillation and atrial flutter account for one third of hospitalizations due to arrhythmias, determining great social and economic impacts. In Brazil, data on hospital care of these patients is scarce. Objective: To investigate the arrhythmia subtype of atrial fibrillation and flutter patients in the emergency setting and compare the clinical profile, thromboembolic risk and anticoagulants use. Methods: Cross-sectional retrospective study, with data collection from medical records of every patient treated for atrial fibrillation and flutter in the emergency department of Instituto de Cardiologia do Rio Grande do Sul during the first trimester of 2012. Results: We included 407 patients (356 had atrial fibrillation and 51 had flutter. Patients with paroxysmal atrial fibrillation were in average 5 years younger than those with persistent atrial fibrillation. Compared to paroxysmal atrial fibrillation patients, those with persistent atrial fibrillation and flutter had larger atrial diameter (48.6 ± 7.2 vs. 47.2 ± 6.2 vs. 42.3 ± 6.4; p < 0.01 and lower left ventricular ejection fraction (66.8 ± 11 vs. 53.9 ± 17 vs. 57.4 ± 16; p < 0.01. The prevalence of stroke and heart failure was higher in persistent atrial fibrillation and flutter patients. Those with paroxysmal atrial fibrillation and flutter had higher prevalence of CHADS2 score of zero when compared to those with persistent atrial fibrillation (27.8% vs. 18% vs. 4.9%; p < 0.01. The prevalence of anticoagulation in patients with CHA2DS2-Vasc ≤ 2 was 40%. Conclusions: The population in our registry was similar in its comorbidities and demographic profile to those of North American and European registries. Despite the high thromboembolic risk, the use of anticoagulants was low, revealing difficulties for incorporating guideline recommendations. Public health strategies should be adopted in order to improve these rates.

  12. Clinical Differences between Subtypes of Atrial Fibrillation and Flutter: Cross-Sectional Registry of 407 Patients

    Science.gov (United States)

    Almeida, Eduardo Dytz; Guimarães, Raphael Boesche; Stephan, Laura Siga; Medeiros, Alexandre Kreling; Foltz, Katia; Santanna, Roberto Tofani; Pires, Leonardo Martins; Kruse, Marcelo Lapa; de Lima, Gustavo Glotz; Leiria, Tiago Luiz Luz

    2015-01-01

    Introduction Atrial fibrillation and atrial flutter account for one third of hospitalizations due to arrhythmias, determining great social and economic impacts. In Brazil, data on hospital care of these patients is scarce. Objective To investigate the arrhythmia subtype of atrial fibrillation and flutter patients in the emergency setting and compare the clinical profile, thromboembolic risk and anticoagulants use. Methods Cross-sectional retrospective study, with data collection from medical records of every patient treated for atrial fibrillation and flutter in the emergency department of Instituto de Cardiologia do Rio Grande do Sul during the first trimester of 2012. Results We included 407 patients (356 had atrial fibrillation and 51 had flutter). Patients with paroxysmal atrial fibrillation were in average 5 years younger than those with persistent atrial fibrillation. Compared to paroxysmal atrial fibrillation patients, those with persistent atrial fibrillation and flutter had larger atrial diameter (48.6 ± 7.2 vs. 47.2 ± 6.2 vs. 42.3 ± 6.4; p < 0.01) and lower left ventricular ejection fraction (66.8 ± 11 vs. 53.9 ± 17 vs. 57.4 ± 16; p < 0.01). The prevalence of stroke and heart failure was higher in persistent atrial fibrillation and flutter patients. Those with paroxysmal atrial fibrillation and flutter had higher prevalence of CHADS2 score of zero when compared to those with persistent atrial fibrillation (27.8% vs. 18% vs. 4.9%; p < 0.01). The prevalence of anticoagulation in patients with CHA2DS2-Vasc ≤ 2 was 40%. Conclusions The population in our registry was similar in its comorbidities and demographic profile to those of North American and European registries. Despite the high thromboembolic risk, the use of anticoagulants was low, revealing difficulties for incorporating guideline recommendations. Public health strategies should be adopted in order to improve these rates. PMID:26016782

  13. Severity and patterns of blood-nerve barrier breakdown in patients with chronic inflammatory demyelinating polyradiculoneuropathy: correlations with clinical subtypes.

    Directory of Open Access Journals (Sweden)

    Fumitaka Shimizu

    Full Text Available OBJECTIVE: Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP is currently classified into clinical subtypes, including typical and atypical forms (multifocal acquired demyelinating sensory and motor neuropathy (MADSAM and distal acquired demyelinating symmetric neuropathy (DADS. The aim of this study was to elucidate the patterns and severity of breakdown of the blood-nerve barrier (BNB in each CIDP subtype. METHODS: We evaluated the effects of sera obtained from patients with typical CIDP, MADSAM and DADS and control subjects on the expression levels of tight junction proteins and transendothelial electrical resistance (TEER value in human peripheral nerve microvascular endothelial cells (PnMECs. RESULTS: The sera obtained from the patients with the three clinical phenotypes of CIDP decreased the amount of claudin-5 protein levels and TEER values in the PnMECs. In addition, the sera obtained from typical CIDP patients more prominently reduced claudin-5 protein levels and TEER values in the PnMECs than did that obtained from the MADSAM and DADS patients. Furthermore, the severity of BNB disruption after exposure to the sera was associated with higher Hughes grade, lower MRC score, more pronounced slowing of motor nerve conduction in the median nerve and higher frequency of abnormal temporal dispersion. CONCLUSIONS: Sera derived from typical CIDP patients destroy the BNB more severely than those from MADSAM or DADS patients. The extent of BNB disruption in the setting of CIDP is associated with clinical disability and demyelination in the nerve trunk. These observations may explain the phenotypical differences between CIDP subtypes.

  14. The effect of question wording in questionnaire surveys on placebo use in clinical practice.

    Science.gov (United States)

    Babel, Przemyslaw

    2012-12-01

    To identify factors that contribute to the high variability of the rates of use of placebo interventions reported in questionnaire surveys, the author investigated the effect of the explicit use of the word "placebo" in questionnaire surveys on placebo use in clinical practice on the results obtained. 190 primary care physicians in Poland were divided randomly into two groups. The groups received a questionnaire in which either the word placebo or the term "nonspecific methods of treatment" was used. The respondents who were asked explicitly about the use of placebo interventions declared that they never used placebo interventions significantly more often than participants asked about the use of nonspecific treatment methods. Moreover, the former reported significantly rarer use of placebo interventions than the latter. The study demonstrates that differences in the wording of questions in questionnaire surveys on placebo use can create statistically significant differences in results.

  15. Pre-registration nursing student's quality of practice learning: Clinical learning environment inventory (actual) questionnaire.

    Science.gov (United States)

    Shivers, Eleanor; Hasson, Felicity; Slater, Paul

    2017-08-01

    Clinical learning is a vital component of nurse education and assessing student's experiences can provide useful insights for development. Whilst most research in this area has focused on the acute setting little attention has been given to all pre-registration nurses' experience across the clinical placements arenas. To examine of pre-registration nursing students (first, second and third year) assessment of their actual experiences of their most recent clinical learning clinical learning experience. A cross sectional survey involving a descriptive online anonymous questionnaire based on the clinical learning environment inventory tool. One higher education institution in the United Kingdom. Nursing students (n=147) enrolled in an undergraduate nursing degree. This questionnaire included demographic questions and the Clinical Learning Environment Inventory (CLEI) a 42 item tool measuring student's satisfaction with clinical placement. SPPS version 22 was employed to analyse data with descriptive and inferential statistics. Overall students were satisfied with their clinical learning experience across all placement areas. This was linked to the 6 constructs of the clinical learning environment inventory; personalization, innovation, individualization, task orientation, involvement, satisfaction. Significant differences in student experience were noted between age groups and student year but there was no difference noted between placement type, age and gender. Nursing students had a positive perception of their clinical learning experience, although there remains room for improvement. Enabling a greater understanding of students' perspective on the quality of clinical education is important for nursing education and future research. Copyright © 2017. Published by Elsevier Ltd.

  16. Translation and cross-cultural adaptation of the Clinical Competence Questionnaire for use in Brazil.

    Science.gov (United States)

    Kwiatkoski, Danielle Ritter; Mantovani, Maria de Fátima; Pereira, Evani Marques; Bortolato-Major, Carina; Mattei, Ângela Taís; Peres, Aida Maris

    2017-06-05

    translating and transculturally adapting the Clinical Competence Questionnaire to Brazilian senior undergraduate Nursing students, as well as measuring psychometric properties of the questionnaire. a methodological study carried out in six steps: translation of the Clinical Competence Questionnaire instrument, consensus of the translations, back-translation, analysis by an expert committee, pre-testing and then presentation of the cross-cultural adaptation process to the developers. Psychometric properties were measured using Cronbach's alpha, intraclass correlation coefficient and content validity index. the instrument was translated, transculturally adapted and its final version consisted of 48 items. Cronbach's alpha coefficient was 0.90, and the agreement index of the items was 99% for students and 98% for evaluators. the Clinical Competence Questionnaire was translated and adapted to Brazilian students, and the psychometric properties of the Portuguese version of the questionnaire presented satisfactory internal consistency regarding the studied sample. traduzir e adaptar transculturalmente o Clinical Competence Questionnaire aos estudantes brasileiros concluintes da graduação em enfermagem, bem como mensurar as propriedades psicométricas do questionário. estudo metodológico realizado em seis etapas: tradução do instrumento Clinical Competence Questionnaire, consenso das traduções, retrotradução, análise pelo comitê de especialistas, pré-teste e apresentação do processo de adaptação transcultural para os desenvolvedores. As propriedades psicométricas foram mensuradas utilizando-se o alfa de Cronbach, coeficiente de correlação intraclasse e índice de validade de conteúdo. o instrumento foi traduzido, adaptado transculturalmente e sua versão final foi constituída de 48 itens. O coeficiente alfa de Cronbach foi de 0,90, e o índice de concordância dos itens foi de 99% para os estudantes e de 98% para os avaliadores. o Clinical Competence

  17. A comparison of 2 screening questionnaires for clinical assessment of canine cognitive dysfunction

    DEFF Research Database (Denmark)

    Schütt, Trine; Toft, Nils; Berendt, Mette

    2015-01-01

    on the basis of very different strategies. The study population consisted of 50 dogs more than 8years of age. The dogs were evaluated clinically, and the 2 questionnaires were given in a face-to-face interview with the owners. The study found a significant correlation (r= 0.83, P

  18. The ENDOCARE questionnaire guides European endometriosis clinics to improve the patient-centeredness of their care

    NARCIS (Netherlands)

    Dancet, E.A.; Apers, S.; Kluivers, K.B.; Kremer, J.A.M.; Sermeus, W.; Devriendt, C.; Nelen, W.L.D.M.; D'Hooghe, T.M.

    2012-01-01

    STUDY QUESTION: How patient-centered are two included specialized endometriosis clinics relative to each other and how can they improve the patient-centeredness of their care? SUMMARY ANSWER: The validated ENDOCARE questionnaire (ECQ) reliably concluded that the adjusted overall patient-centeredness

  19. Psychometric Properties of the Penn State Worry Questionnaire for Children in a Large Clinical Sample

    Science.gov (United States)

    Pestle, Sarah L.; Chorpita, Bruce F.; Schiffman, Jason

    2008-01-01

    The Penn State Worry Questionnaire for Children (PSWQ-C; Chorpita, Tracey, Brown, Collica, & Barlow, 1997) is a 14-item self-report measure of worry in children and adolescents. Although the PSWQ-C has demonstrated favorable psychometric properties in small clinical and large community samples, this study represents the first psychometric…

  20. Psychometric Properties of the Penn State Worry Questionnaire for Children in a Large Clinical Sample

    Science.gov (United States)

    Pestle, Sarah L.; Chorpita, Bruce F.; Schiffman, Jason

    2008-01-01

    The Penn State Worry Questionnaire for Children (PSWQ-C; Chorpita, Tracey, Brown, Collica, & Barlow, 1997) is a 14-item self-report measure of worry in children and adolescents. Although the PSWQ-C has demonstrated favorable psychometric properties in small clinical and large community samples, this study represents the first psychometric…

  1. Making clinical academic careers more attractive: views from questionnaire surveys of senior UK doctors

    OpenAIRE

    Lambert, TW; Smith, F; Goldacre, MG

    2015-01-01

    Objectives To report on doctors’ reasons, as expressed to our research group, for choosing academic careers, and on factors that would make a career in clinical academic medicine more attractive to them. Design Postal, email and web questionnaires Participants 6936 UK-trained doctors who graduated in 1996, 1999 and 2000 Main Outcome Measures Open-ended comments about a career in clinical academic medicine. Results Of doctors who provided reasons for pursuing a ...

  2. Clinic-based screening for domestic violence: use of a child safety questionnaire

    Directory of Open Access Journals (Sweden)

    Sisk Doris J

    2004-06-01

    Full Text Available Abstract Background Domestic violence affects many women during their lifetime. Children living in homes where they are or have been exposed to violence are at increased risk for adverse outcomes. The American Academy of Pediatrics, the American Academy of Family Practice, and the American College of Obstetrics/Gynecology have recently joined in recommending routine screening of all families for the presence of domestic violence. We present our experience with an office-based domestic violence screening questionnaire. Methods A series of four child safety questionnaires (designed for parents of infant, preschool-age, school-age, and adolescent patients, which included specific questions about domestic violence, was given to all mothers presenting to a university out-patient general pediatric clinic. The questionnaires, offered in both English and Spanish, were reviewed for the presence of domestic violence exposure, usually at the time of the clinic visit. The number of women who reported either current or past exposure to domestic violence as disclosed by this active screening process was compared to the number discovered prior to the use of these questionnaires. Results Prior to the use of active screening with a child safety questionnaire, five cases of domestic violence were identified in our clinic population of approximately 5000 children over a 3 month period. Active screening of this population with a parent questionnaire resulted in the identification of 69 cases of current domestic violence exposure (2% of those screened during each of 2 years of screening. Use of the child safety questionnaire was associated with a significantly increased odds of detecting current domestic violence (OR = 3.6, 95% CI [1.4, 9.1], P = 0.007, with 72% [26–84%] of the cases identified being attributable to the use of the questionnaire. Of children screened, 2% were currently exposed to domestic violence, and 13% had been exposed to past domestic violence

  3. Characterization of Rheumatoid Arthritis Subtypes Using Symptom Profiles, Clinical Chemistry and Metabolomics Measurements

    NARCIS (Netherlands)

    Wietmarschen, H.A. van; Dai, W.; Kooij, A.J. van der; Reijmers, T.H.; Schroën, Y.; Wang, M.; Xu, Z.; Wang, X.; Kong, H.; Xu, G.; Hankemeier, T.; Meulman, J.J.; Greef, J. van der

    2012-01-01

    Objective: The aim is to characterize subgroups or phenotypes of rheumatoid arthritis (RA) patients using a systems biology approach. The discovery of subtypes of rheumatoid arthritis patients is an essential research area for the improvement of response to therapy and the development of personalize

  4. Ethnic Comparison of Clinical Characteristics and Ischemic Stroke Subtypes Among Young Adult Patients With Stroke in Hawaii.

    Science.gov (United States)

    Nakagawa, Kazuma; Ito, Cherisse S; King, Sage L

    2017-01-01

    Native Hawaiians and other Pacific Islanders (NHOPI) with ischemic stroke have younger age of stroke onset compared with whites. However, ethnic differences in stroke subtypes in this population have been inadequately studied. Consecutive young adult patients (aged ≤55 years) who were hospitalized for ischemic stroke between 2006 and 2012 at a tertiary center in Honolulu were studied. Clinical characteristics and stroke subtypes based on pathophysiological TOAST classification (Trial of Org 10172) of NHOPI and Asians were compared with whites. A total of 427 consecutive young adult (mean age, 46.7±7.8 years) patients (NHOPI 45%, Asians 38%, and whites 17%) were studied. NHOPI had a higher prevalence of hypertension, diabetes mellitus, prosthetic valve, higher body mass index, hemoglobin A1c, and lower high-density lipoprotein than whites (all P<0.05). Stroke subtype distribution was not different between the ethnic groups. Specifically, the prevalence of small-vessel disease was similar between NHOPI (26.6%), whites (28.4%), and Asians (24.8%). In the univariate analyses, the use of intravenous tissue-type plasminogen activator was lower among NHOPI (4.7%; P=0.01) and Asians (3.1%; P=0.002) than among whites (12.5%). In the multivariable model, NHOPI (odds ratio, 0.35; 95% confidence interval, 0.12-0.98) and Asians (odds ratio, 0.23; 95% confidence interval, 0.07-0.74) were less likely to be treated with intravenous tissue-type plasminogen activator than whites. NHOPI have greater cardiovascular risk factors than whites, but there were no differences in stroke subtypes between the ethnic groups. Furthermore, NHOPI and Asians may be less likely to be treated with intravenous tissue-type plasminogen activator than whites. © 2016 American Heart Association, Inc.

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

    OpenAIRE

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

    1995-01-01

    Serotonergic neurotransmission represents a complex mechanism involving pre- and post-synaptic events and distinct 5-HT receptor subtypes. Serotonin (5-HT) receptors have been classified into several categories, and they are termed as 5-HT1, 5-HT2, 5-HT3, 5-HT4, 5-HT5, 5-HT6 and 5-HT7 type receptors. 5-HT1 receptors have been further subdivided into 5-HT1A, 5-HT1B, 5-HT1D, 5-HT1E and 5-HT1F. 5-HT2 receptors have been divided into 5-HT2A, 5-HT2B and 5-HT2C receptors. All 5-HT2 receptor subtype...

  6. Clinical Profiles of Respiratory Syncytial Virus Subtypes A AND B Among Children Hospitalized with Bronchiolitis.

    Science.gov (United States)

    Laham, Federico R; Mansbach, Jonathan M; Piedra, Pedro A; Hasegawa, Kohei; Sullivan, Ashley F; Espinola, Janice A; Camargo, Carlos A

    2017-08-01

    In this analysis of a prospective, multicenter study of children hospitalized with bronchiolitis, 925 had respiratory syncytial virus (RSV)-A and 649 had RSV-B. Overall, bronchiolitis severity did not differ by RSV subtype. However, among children with RSV-only bronchiolitis, those children with RSV-A had higher risk of intensive care treatment (odds ratio, 1.31; 95% confidence interval, 1.00-1.71; P = 0.048) when compared with those having RSV-B.

  7. Psychosocial Aspects of Hereditary Cancer (PAHC) questionnaire: development and testing of a screening questionnaire for use in clinical cancer genetics

    NARCIS (Netherlands)

    Eijzenga, W.; Bleiker, E.M.A.; Hahn, D.E.E.; Kluijt, I.; Sidharta, G.N.; Gundy, C.; Aaronson, N.K.

    2014-01-01

    Background: Up to three-quarters of individuals who undergo cancer genetic counseling and testing report psychosocial problems specifically related to that setting. The objectives of this study were to develop and evaluate the screening properties of a questionnaire designed to assess specific psych

  8. Clinical features of human salmonellosis caused by bovine-associated subtypes in New York.

    Science.gov (United States)

    Cummings, Kevin J; Warnick, Lorin D; Gröhn, Yrjö T; Hoelzer, Karin; Root, Timothy P; Siler, Julie D; McGuire, Suzanne M; Wright, Emily M; Zansky, Shelley M; Wiedmann, Martin

    2012-09-01

    The objective of this study was to identify patient symptoms and case outcomes that were more likely to occur as a result of Salmonella infections caused by bovine-associated subtypes (isolates that matched contemporary bovine isolates from New York by serovar and pulsed-field gel electrophoresis pattern), as compared to salmonellosis caused by non-bovine-associated subtypes. Data were collected in 34 counties of New York that comprise the Foodborne Diseases Active Surveillance Network (FoodNet) catchment area of the Centers for Disease Control and Prevention Emerging Infections Program. Patients with specimen collection dates between March 1, 2008 and March 1, 2010 were included. Symptoms and outcomes of 40 cases infected with bovine-associated Salmonella subtypes were compared to those of 379 control-cases infected with Salmonella isolates that were not bovine-associated. Cases were significantly more likely to have invasive salmonellosis (odds ratio, 3.8; p-value=0.02), after adjusting for age group, gender, and race. In addition, there was a marginal association between case status and the presence of blood in the stool (p-value=0.1) while ill. These findings might have implications for patient management, as a history of consuming undercooked foods of bovine origin or having direct contact with cattle in the few days prior to illness could be useful for suggesting a more proactive diagnostic approach as well as close monitoring for the need to implement more aggressive therapy.

  9. Translation of the Nursing Clinical Facilitators Questionnaire (NCFQ) to Norwegian language.

    Science.gov (United States)

    Råholm, Maj-Britt; Thorkildsen, Kari; Löfmark, Anna

    2010-07-01

    The translation and adaptation of English instruments to be used with populations speaking other languages is an important and complex process which is attracting increased attention in nursing and health-related research. The aim of this article is to describe the translation process of the Nursing Clinical Facilitators Questionnaire (NCFQ) for testing in Norway. The instrument is a 28-item-questionnaire with a Likert-type (1-5) scale ranging from the descriptions "strongly agree (1) to strongly disagree (5)". The aim of the instrument is to measure the efficiency of, and satisfaction with the supervision received from the nurse students' perspective. The NCFQ questionnaire was translated in six phases. The translation process was conducted systematically by applying the three methods described in the literature: the methods of forward-translation, back-translation and comparison followed by an empirical study (pilot test). The methods were chosen to test the quality of translation, establish semantic equivalence of the translated instrument and to estimate the cross-cultural relevance of the instrument. The translation process has given prerequisites to use the NCFQ questionnaire in a larger study and a possibility to compare different models for supervision of nursing students in the clinical part of their education.

  10. Pain detection by clinical questionnaire in patients referred for temporomandibular disorders in a Chilean hospital.

    Directory of Open Access Journals (Sweden)

    Tomás Maturana

    2015-10-01

    Full Text Available Aim: To determine pain frequency by means of a clinical screening questionnaire in patients with temporomandibular disorders (TMD referred to the general Hospital of Valdivia (HBV between September and December 2014. Material and method: A descriptive study, which included patients referred to the TMD Unit of the dental service at HBV between September and December 2014, was carried out. A clinical screening questionnaire was applied by an examiner in order to detect painful Temporomandibular Joint Disorders. The variables age, sex, wait time, and presence of related TMD pain were measured. Results: 101 patients were surveyed; 88.17% (84 patients were women. Average age was 33.5 (11-70 years; 66% of patients had mandibular pain or stiffness upon awakening; 80% informed pain related to painful TMD. Conclusion: Most surveyed patients were women. Pain was highly frequent in the surveyed population; its main location was in temporal areas.

  11. [Self evaluation questionnaires for clinical psychodiagnosis in school-age children].

    Science.gov (United States)

    Littmann, E

    1989-11-01

    A survey of the literature is given on methodological problems associated with, and results of, the clinical diagnosis of personality in school age with questionnaires for self-evaluation. Further is given an outline of a number of major personality inventories used in (german) practice. Finally are presented the results of validation and standardisation gained with two children's inventories (PF/SF) for the multidimensional registration of psychic and social features of behaviorally disturbed children.

  12. Centrally necrotizing breast carcinoma: a rare histological subtype, which was cause of misdiagnosis in an evident clinical local recurrence

    Directory of Open Access Journals (Sweden)

    Hernanz Fernando

    2012-08-01

    Full Text Available Abstract Centrally necrotizing carcinoma is a rare subtype of breast carcinoma, which is characterized by an extensive central necrotic zone accounting for at least 70% of the cross-sectional area of the neoplasm. This central necrotic zone, in turn, is surrounded by a narrow rim of proliferative viable tumor cells. We report an unusual clinical situation in which a patient whose evident breast mass suggested an ipsilateral local recurrence and for which numerous attempts to confirm the histological diagnosis had failed. The patient was treated with a radical mastectomy based on clinical suspicion of breast cancer recurrence after an undesirable delay. In this case, the narrow rim of viable malignant tissue had a thickness of 0.5 to 8 mm, and the centrally necrotizing carcinoma had a central zone with a predominance of fibrosis. The special features of this case led to a misdiagnosis and to an evident clinical local recurrence.

  13. First clinical isolates of Cronobacter spp. (Enterobacter sakazakii) in Argentina: characterization and subtyping by pulsed-field gel electrophoresis.

    Science.gov (United States)

    Asato, Valeria C; Vilches, Viviana E; Pineda, María G; Casanueva, Enrique; Cane, Alejandro; Moroni, Mirian P; Brengi, Silvina P; Pichel, Mariana G

    2013-01-01

    Cronobacter species are opportunistic pathogens associated with severe infections in neonates and immunocompromised infants. From January 2009 through September 2010, two cases of neonatal infections associated with Cronobacter malonaticus and one case associated with Cronobacter sakazakii, two of them fatal, were reported in the same hospital. These are the first clinical isolates of Cronobacter spp. in Argentina. The objective of this work was to characterize and subtype clinical isolates of Cronobacter spp. in neonate patients, as well as to establish the genetic relationship between these isolates and the foodborne isolates previously identified in the country. Pulsed-field gel electrophoresis analysis showed a genetic relationship between the C. malonaticus isolates from two patients. Different results were found when the pulsed-field gel electrophoresis patterns of clinical isolates were compared with those deposited in the National Database of Cronobacter spp.

  14. Cultural adaptation and validation of the Portuguese version of the Nursing Clinical Facilitators Questionnaire

    Science.gov (United States)

    Frederico-Ferreira, Maria Manuela; Camarneiro, Ana Paula Forte; Loureiro, Cândida Rosalinda Exposto da Costa; Ventura, Maria Clara Amado Apóstolo

    2016-01-01

    ABSTRACT Objective: to perform the cultural adaptation to Portuguese of the Nursing Clinical Facilitators Questionnaire (NCFQ), which was designed by the Centre for Learning and Teaching at the University of Technology of Sydney, and to validate this instrument. Methods: this methodological study involved the cultural adaptation of the questionnaire by using translation, back-translation, semantic comparison, idiomatic and conceptual equivalence, and validation through validity and reliability analyses and used a sample of 767 students in their second year of the Nursing Program. Results: construct validity had a two-factor solution according to the varimax rotation method. In addition, there was a high overall internal consistency for the questionnaire (Cronbach's alpha of 0.977) and for the factors found (0.966 and 0.952, respectively). Conclusion: the Portuguese version has good psychometric characteristics; therefore, it is adequate to obtain reliable information on the perception of nursing students concerning the type of supervision that is provided in clinical practice, and this version is adequate to improve teaching practices. PMID:27533275

  15. Pretreatment HIV Drug Resistance and HIV-1 Subtype C Are Independently Associated With Virologic Failure: Results From the Multinational PEARLS (ACTG A5175) Clinical Trial

    Science.gov (United States)

    Kantor, Rami; Smeaton, Laura; Vardhanabhuti, Saran; Hudelson, Sarah E.; Wallis, Carol L.; Tripathy, Srikanth; Morgado, Mariza G.; Saravanan, Shanmugham; Balakrishnan, Pachamuthu; Reitsma, Marissa; Hart, Stephen; Mellors, John W.; Halvas, Elias; Grinsztejn, Beatriz; Hosseinipour, Mina C.; Kumwenda, Johnstone; La Rosa, Alberto; Lalloo, Umesh G.; Lama, Javier R.; Rassool, Mohammed; Santos, Breno R.; Supparatpinyo, Khuanchai; Hakim, James; Flanigan, Timothy; Kumarasamy, Nagalingeswaran; Campbell, Thomas B.; Eshleman, Susan H.

    2015-01-01

    Background. Evaluation of pretreatment HIV genotyping is needed globally to guide treatment programs. We examined the association of pretreatment (baseline) drug resistance and subtype with virologic failure in a multinational, randomized clinical trial that evaluated 3 antiretroviral treatment (ART) regimens and included resource-limited setting sites. Methods. Pol genotyping was performed in a nested case-cohort study including 270 randomly sampled participants (subcohort), and 218 additional participants failing ART (case group). Failure was defined as confirmed viral load (VL) >1000 copies/mL. Cox proportional hazards models estimated resistance–failure association. Results. In the representative subcohort (261/270 participants with genotypes; 44% women; median age, 35 years; median CD4 cell count, 151 cells/µL; median VL, 5.0 log10 copies/mL; 58% non-B subtypes), baseline resistance occurred in 4.2%, evenly distributed among treatment arms and subtypes. In the subcohort and case groups combined (466/488 participants with genotypes), used to examine the association between resistance and treatment failure, baseline resistance occurred in 7.1% (9.4% with failure, 4.3% without). Baseline resistance was significantly associated with shorter time to virologic failure (hazard ratio [HR], 2.03; P = .035), and after adjusting for sex, treatment arm, sex–treatment arm interaction, pretreatment CD4 cell count, baseline VL, and subtype, was still independently associated (HR, 2.1; P = .05). Compared with subtype B, subtype C infection was associated with higher failure risk (HR, 1.57; 95% confidence interval [CI], 1.04–2.35), whereas non-B/C subtype infection was associated with longer time to failure (HR, 0.47; 95% CI, .22–.98). Conclusions. In this global clinical trial, pretreatment resistance and HIV-1 subtype were independently associated with virologic failure. Pretreatment genotyping should be considered whenever feasible. Clinical Trials

  16. The Adolescent Substance Abuse Goal Commitment (ASAGC) Questionnaire: An Examination of Clinical Utility and Psychometric Properties.

    Science.gov (United States)

    Kaminer, Yifrah; Ohannessian, Christine McCauley; McKay, James R; Burke, Rebecca H

    2016-02-01

    Commitment to change is an innovative potential mediator or mechanism of behavior change that has not been examined in adolescents with substance use disorders (SUD). The Adolescent Substance Abuse Goal Commitment (ASAGC) questionnaire is a 16-item measure developed to assess an individual's commitment to his/her stated treatment goal. The objectives of this study are to explore the research and clinical utility of the commitment construct as measured by the ASAGC. During sessions 3 and 9 of a 10-week SUD treatment, therapists completed the ASAGC for 170 13-18 year-old adolescents. An exploratory factor analysis was conducted on the ATAGC items. Concurrent validity with related constructs, self-efficacy and motivation for change, was examined as well. At both sessions, the factor analysis resulted in two scales--Commitment to Recovery and Commitment to Harm Reduction. The ASAGC scales were found to demonstrate a high level of internal consistency (alpha coefficients ranged from .92 to .96 over time). In contrast to the Commitment to Harm Reduction scale, the Commitment to Recovery scale consistently correlated with scales from the Situational Confidence Questionnaire assessing self-efficacy, evidencing concurrent validity. Similarly, the Commitment to Recovery scale was related to the Problem Recognition Questionnaire, providing further evidence of the validity of the ASAGC. The ASAGC is a reliable and valid clinical research instrument for the assessment of adolescents' commitment to their substance abuse treatment goal. Clinical researchers may take advantage of the clinical utility of the ASAGC including its ability to differentiate between commitment to abstinence versus commitment to harm reduction.

  17. Stability and discriminative power of the Young Schema-Questionnaire in a Dutch clinical versus non-clinical population.

    Science.gov (United States)

    Rijkeboer, Marleen M; van den Bergh, Huub; van den Bout, Jan

    2005-06-01

    In this study the temporal stability and general discriminative and classifying ability of the Young Schema-Questionnaire (YSQ) was examined in a clinical and non-clinical sample. To be able to cross-validate on the variables, two parallel subtests, drawn from the YSQ item pool, were utilized. Results suggest adequate rank order stability. However, mean scores tended to drop systematically over time, most likely caused by transient error. Therefore, to assess progress in therapy, the alternate utilization of the parallel parts is advised. Findings from discriminant analysis suggest high sensitivity of the YSQ and its subscales in predicting the presence or absence of psychopathology.

  18. [Peripheral blood T lymphocyte subtypes in multiple sclerosis--dependance of clinical course and duration of the disease].

    Science.gov (United States)

    Vojinović, S; Vojinović, K; Kamenov, B; Vojinović, D; Gocić-Stanković, D

    1994-01-01

    Multiple sclerosis is a disease mediated by immunological mechanisms, with characteristics of an autoimmune prosses. We registered changes in distribution of immunophenotipisation markers CD2, CD3, CD4, CD8, CD56 and DR, by indirect immunoflourescence assay, on immune cells of peripheral blood. We tested 20 patients with clinically definite category of illness, in exacerbation, and 10 healthy individuals. Multiple sclerosis patients had changes in distribution of T cell subtypes in exacerbation, which correlated with clinical course and duration of the disease. Relapsing-remitting course of disease is followed by decrease of activated T lymphocytes and fluctuation of CD4+ T lymphocytes, while there are no changes in studied markers at patients with progressive course. Duration of the disease over 10 years is followed by decreases of CD4+ and CD8+ T lymphocytes, independent of course of the disease.

  19. Comparison of clinically diagnosed asthma with parental assessment of children's asthma in a questionnaire

    DEFF Research Database (Denmark)

    Hederos, C.A.; Hasselgren, M.; Hedlin, G.;

    2007-01-01

    Epidemiological evaluations of the prevalence of asthma are usually based on written questionnaires (WQs) in combination with validation by clinical investigation. In the present investigation, we compared parental assessment of asthma among their preschool children in response to a WQ...... with the corresponding medical records in the same region. An International Study of Asthma and Allergies in Childhood (ISAAC)-based WQ was answered by 75% of the parents of 6295 children aged 1-6 yr. Clinically diagnosed asthma, recorded in connection with admissions to the hospital or a visit to any of the outpatient...... clinics in the same region, were analysed in parallel. Finally, a complementary WQ was sent to the parents of children identified as asthmatic by either or both of this approaches. In response to the WQ 5.9% were claimed to suffer from asthma diagnosed by a doctor. According to the medical records...

  20. Evaluating clinical teachers with the Maastricht clinical teaching questionnaire : How much 'teacher' is in student ratings?

    NARCIS (Netherlands)

    Boerboom, Tobias B. B.; Mainhard, Tim; Dolmans, Diana H. J. M.; Scherpbier, Albert J. J. A.; Van Beukelen, Peter; Jaarsma, A. D. (Debbie) C.

    2012-01-01

    Background: Students are a popular source of data to evaluate the performance of clinical teachers. Instruments to obtain student evaluations must have proven validity. One aspect of validity that often remains underexposed is the possibility of effects of between-student differences and teacher and

  1. Development and validation of a self-efficacy questionnaire (SE-12) measuring the clinical communication skills of health care professionals

    DEFF Research Database (Denmark)

    Axboe, Mette K; Christensen, Kaj S; Kofoed, Poul-Erik

    2016-01-01

    . We consider the questionnaire useful for self-evaluation of clinical communication skills; the SE-12 is user-friendly and can be administered as an electronic questionnaire. However, future research should explore potential needs for adjustments to reduce the identified ceiling effect. Keyword...... Communication skills training Self-efficacy Self-assessment Calgary-Cambridge Guide Questionnaire Validity Reliability......Background The outcome of communication training is widely measured by self-efficacy ratings, and different questionnaires have been used. Nevertheless, none of these questionnaires have been formally validated through systematic measurement of assessment properties. Consequently, we decided...

  2. [Pharmacists' Behavior in Clinical Practice: Results from a Questionnaire Survey of Pharmacy Students].

    Science.gov (United States)

    Nakada, Akiko; Akagawa, Keiko; Yamamoto, Hitomi; Kato, Yasuhisa; Yamamoto, Toshinori

    2016-01-01

    A questionnaire survey was performed to obtain pharmacy students' impressions of pharmacists' behavior, to classify these based on professionalism, and to analyze the relationship between these experiences and students' satisfaction with their clinical practice in Japan. The questionnaire was answered by 327 5th-year pharmacy school students upon completing clinical practice at community pharmacies from 2011 to 2012. They rated their satisfaction with their clinical practice using a 6-point Likert scale, and provided descriptions of their experience such as, "This health provider is professional", or "What a great person he/she is as a health provider". We counted the words and then categorized the responses into 10 traits, as defined by the American Pharmaceutical Association Academy of Students of Pharmacy-American Association of Colleges of Pharmacy, Council of Deans Task Force on Professionalism 1999, using text mining. We analyzed the relationship between their experiences with respectful persons, and satisfaction, using the Mann-Whitney U-test (significance level<0.05). Most students (337 of 364, 92.6%) reported experiences with respectful health providers. These students experienced significantly more satisfaction than did other students (p<0.001). We analyzed 343 sentences written by 261 students, using text mining analysis after excluding unsuitable responses. The word most used was "patient" (121 times). Many students noted their impression that the pharmacists had answered patients' questions. Of the 10 trait categories, "professional knowledge and skills" was mentioned most often (151 students).

  3. Zika virus infection and Guillain-Barré syndrome: a review focused on clinical and electrophysiological subtypes.

    Science.gov (United States)

    Uncini, Antonino; Shahrizaila, Nortina; Kuwabara, Satoshi

    2017-03-01

    In 2016, we have seen a rapid emergence of Zika virus-associated Guillain-Barré syndrome (GBS) since its first description in a French-Polynesian patient in 2014. Current evidence estimates the incidence of GBS at 24 cases per 100 000 persons infected by Zika virus. This will result in a sharp rise in the number of GBS cases worldwide with the anticipated global spread of Zika virus. A better understanding of the pathogenesis of Zika-associated GBS is crucial to prepare us for the current epidemic. In this review, we evaluate the existing literature on GBS in association with Zika and other flavivirus to better define its clinical subtypes and electrophysiological characteristics, demonstrating a demyelinating subtype of GBS in most cases. We also recommend measures that will help reduce the gaps in knowledge that currently exist. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  4. The Portuguese version of the RhinoQOL Questionnaire: validation and clinical application,

    Directory of Open Access Journals (Sweden)

    Rui Cerejeira

    2015-12-01

    Full Text Available ABSTRACT INTRODUCTION: Rhinosinusitis constitutes an important health problem, with significant interference in personal, professional, and social functioning. This study presents the validation process of the Portuguese version of the RhinoQOL, to be used as a routine procedure in the assessment of patients with chronic rhinosinusitis. OBJECTIVE: To demonstrate that the Portuguese version of the RhinoQOL is as valid as the English version to measure symptoms and health-related quality of life in chronic rhinosinusitis. METHODS: The Portuguese version of the RhinoQOL was administered consecutively to 58 patients with chronic rhinosinusitis with and without nasal polyps, assessed for endoscopic sinus surgery. A follow-up survey was completed three months after surgery. Statistical analysis was performed to determine its psychometric properties. RESULTS: Face and content validity were confirmed by similar internal consistency as the original questionnaire for each sub-scale, and strong correlation between individual items and total score. The questionnaire was easy and quick to administer (5.5 min. At three months, there was a significant decrease from baseline for all sub-scale scores, indicating clinical improvement, with an effect size considered as large. CONCLUSION: This study provides a questionnaire that is equivalent to the original English version, with good responsiveness to change, which can be especially valuable to measure the outcome of surgery.

  5. Identification of subtypes in subjects with mild-to-moderate airflow limitation and its clinical and socioeconomic implications

    Directory of Open Access Journals (Sweden)

    Lee JH

    2017-04-01

    Full Text Available Jin Hwa Lee,1 Chin Kook Rhee,2 Kyungjoo Kim,2 Jee-Ae Kim,3 Sang Hyun Kim,4 Kwang Ha Yoo,5 Woo Jin Kim,6 Yong Bum Park,7 Hye Yun Park,8 Ki-Suck Jung9 1Division of Pulmonary and Critical Care Medicine, Department of Medicine, School of Medicine, EwhaWomans University, 2Department of Internal Medicine, Seoul St Mary’s Hospital, The Catholic University of Korea, Seoul, 3Pharmaceutical Policy Evaluation Research Team, Research Institution, Health Insurance Review and Assessment Service, 4Big Data Division, Health Insurance Review and Assessment Service, Wonju, 5Department of Internal Medicine, Konkuk University College of Medicine, Seoul, 6Department of Internal Medicine and Environmental Health Center, Kangwon National University Hospital, Chuncheon, 7Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Hallym University Kangdong Sacred Heart Hospital, 8Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 9Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Hallym University Medical Center, Hallym University College of Medicine, Anyang, South Korea Purpose: The purpose of this study was to identify subtypes in patients with mild-to-moderate airflow limitation and to appreciate their clinical and socioeconomic implications.Methods: Subjects who were aged ≥20 years and had forced expiratory volume in 1 second (FEV1 ≥60% predicted and FEV1/forced vital capacity <0.7 were selected from the fourth Korea National Health and Nutrition Examination Survey (KNHANES in 2007–2012. The data were merged to the National Health Insurance reimbursement database during the same period. k-Means clustering was performed to explore subtypes. For clustering analysis, six key input variables – age, body mass index (BMI, FEV1% predicted, the presence or absence of self-reported wheezing

  6. Prevalence of the different Axis I clinical subtypes in a sample of patients with orofacial pain and temporomandibular disorders in the Andalusian Healthcare Service

    Science.gov (United States)

    Blanco-Aguilera, Antonio; Blanco-Aguilera, Elena; Serrano-del-Rosal, Rafael; Biedma-Velázquez, Lourdes; Rodríguez-Torronteras, Alejandro; Segura-Saint-Gerons, Rafael

    2016-01-01

    Background The main objective of this paper is to analyze the prevalence of each of the different clinical subtypes of temporomandibular disorders (TMD) in a sample of patients with this pathology. In addition, a second objective was to analyze their distribution according to gender. Material and Methods To this end, the results of 1603 patients who went to the Unit of Temporomandibular Disorders in the Córdoba Healthcare District because they suffered from this pathology were analyzed. In order to diagnose them, the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) were applied, analyzing the different Axis I subtypes (myopathy, discopathy and arthropathy) and obtaining the combined Axis I for each patient and the relation of all these variables according to gender. The null-hypothesis test confirmed the lack of connection between the gender variable and the different subtypes in the clinical analysis, and between the former and the combined Axis I of the RDC/TMD. Results The prevalence was high for the muscle disorders subtype in general, showing an 88.7% prevalence, while the presence of discopathies or arthropathies was much lower. Among discopathies, the most frequent ones were disc displacements with reduction, with 39.7% and 42.8% for the left and right temporomandibular joints (TMJ), respectively, while the prevalence of arthropathies was 26.3% for the right TMJ and 32.9% for the left TMJ. The bivariate analysis on the connection with gender reveals a p≥ 0.05 value for the muscle and arthralgia subtypes. Conclusions The patients seen at the TMD Unit where mostly middle-aged women whose main clinical axis subtype was the muscle disorder subtype. For their part, both discopathies and arthropathies, although present, are much less prevalent. Key words:RDCTMD, axis I, orofacial pain, temporomandibular disorders, gender. PMID:26615508

  7. [Questionnaire investigation of incidence of Trichophyton tonsurans infection in dermatology clinics in the Kanto area].

    Science.gov (United States)

    Hiruma, Masataro; Shiraki, Yumi; Nihei, Nozomi; Hirose, Nobuyoshi; Suganami, Morio

    2005-01-01

    We conducted a questionnaire investigation to learn the incidence of T. tonsurans infection. Subjects of this investigation were 1,060 dermatologists in 1,060 dermatology clinics in the Kanto area to whom questionnaires were mailed. We asked each dermatologist whether he/she had experienced T. tonsurans infection cases (including suspected cases) and if so, we further asked; a. time of onset, b. number of cases, c. sexuality of the patient, d. club that the subject had joined (judo club, wrestling club or other), e. age of the subject, and f. number of cases suspected of having familial infection, the response rate was 47.5% (504 of the 1060 doctors), and 25.8% (130 of the 504) had handled T. tonsurans infection cases. The total number of patients was 707 (657 males and 50 females), with 400 (56.6%) of those in the 18 high-ranking clinics. The number of cases had increased rapidly from around 2002; 72.9% of the patients were students in high schools and universities and in 8 cases familial infection was suspected. 96.5% of the patients were in a judo or wrestling club. Our investigation revealed that this infectious disease had spread more than we had expected. It is important to develop more reliable infection control measures and to determine the actual conditions of this infection using mycological examinations.

  8. Subtypes of physical frailty: Latent class analysis and associations with clinical characteristics and outcomes

    Science.gov (United States)

    Liu, Li-Kuo; Guo, Chao-Yu; Lee, Wei-Ju; Chen, Liang-Yu; Hwang, An-Chun; Lin, Ming-Hsien; Peng, Li-Ning; Chen, Liang-Kung; Liang, Kung-Yee

    2017-01-01

    Frailty is a well-recognized geriatric syndrome with various definitions and conceptual frameworks. This study aimed to use latent class analysis to discover potential subtypes of pre-frail and frail older people. Data from the I-Lan Longitudinal Aging Study (ILAS), a community-based cohort study was used for analysis. Latent class analysis was applied to characterize classes or subgroups with different frailty phenotypes among ILAS participants targeting older adults aged 65 and above, capable of completing a 6-meter walk, without severe major or life threatening diseases, and not institutionalized. Latent class analysis identified three distinct subgroups with different frailty phenotypes: non-mobility-type (weight loss and exhaustion), mobility-type frailty (slowness and weakness), and low physical activity. Comparing these groups with the robust group, people with mobility-type frailty had poorer body composition, worse bone health, poorer cognitive function, lower survival (hazard ratio: 6.82, p = 0.019), and poorer overall health outcomes (hazard ratio: 1.67, p = 0.040). People in the non-mobility-type group had poorer bone health and more metabolic serum abnormalities. In conclusion, mobility-type frailty was a better predictor of adverse outcomes. However, further investigation is needed to evaluate how these phenotypic subgroups may help in predicting prognosis or in developing interventions. PMID:28397814

  9. Questionnaire-based survey on distribution and clinical incidence of canine babesiosis in France.

    Science.gov (United States)

    Halos, Lénaïg; Lebert, Isabelle; Chao, Isabelle; Vourc'h, Gwenaël; Ducrot, Christian; Abrial, David; Ravier, Jean-François; Guillot, Jacques

    2013-02-28

    The causative agent of canine babesiosis is the protozoan Babesia canis, transmitted by the tick Dermacentor reticulatus within France. While the parasite can be found everywhere in France however cases of infection are associated with distinct geographical foci. The aim of the study was to evaluate the clinical occurrence of canine babesiosis diagnosed in veterinary clinics in order to propose an updated map of the disease distribution in France. Questionnaires were sent via email to all canine veterinary clinics in continental France. Information collected included the number of babesiosis cases diagnosed in 2010, the number of veterinary practitioners and the location of the clinic. The total number of dogs and practitioners per administrative department were used to define the reference population. The annual incidence rate of canine babesiosis per department was calculated as the ratio between the number of babesiosis cases reported by the clinics and the total number of dogs in the clinics of the same department. Data were geo-referenced for map construction (Quantum GIS version 1.7.4). The overall annual incidence rate of clinical babesiosis among the surveyed population was 1.07% (CI95 1.05-1.09) with geographical variations between departments, ranging from 0.01% to 16.05%. Four enzootic areas were identified: South-West, Center, East and Paris area. The South-West region should be considered as a hyper-enzootic area with the higher incidence rates. Our results confirmed the burden of canine babesiosis in France. In the context of tick-borne disease emergence in Europe, the risk for canine babesiosis may become more significant in other European countries in the coming years.

  10. Differences in the Genetic Susceptibility to Age-Related Macular Degeneration Clinical Subtypes

    Science.gov (United States)

    Shen, Ling; Hoffmann, Thomas J.; Melles, Ronald B.; Sakoda, Lori C.; Kvale, Mark N.; Banda, Yambazi; Schaefer, Catherine; Risch, Neil; Jorgenson, Eric

    2015-01-01

    Purpose We compared across age-related macular degeneration (AMD) subtypes the effect of AMD risk variants, their predictive power, and heritability. Methods The prevalence of AMD was estimated among active non-Hispanic white Kaiser Permanente Northern California members who were at least 65 years of age as of June 2013. The genetic analysis included 5,170 overall AMD cases ascertained from electronic health records (EHR), including 1,239 choroidal neovascularization (CNV) cases and 1,060 nonexudative AMD cases without CNV, and 23,130 controls of non-Hispanic white ancestry from the Kaiser Permanente Genetic Epidemiology Research on Adult Health and Aging (GERA) cohort. Imputation was based on the 1000 Genomes Project reference panel. Results The narrow-sense heritability due to common autosomal single nucleotide polymorphisms (SNPs) was 0.37 for overall AMD, 0.19 for AMD unspecified, 0.20 for nonexudative AMD, and 0.60 for CNV. For the 19 previously reported AMD risk loci, the area under the receiver operating characteristic (ROC) curve was 0.675 for overall AMD, 0.640 for AMD unspecified, 0.678 for nonexudative AMD, and 0.766 for CNV. The individual effects on the risk of AMD for 18 of the 19 SNPs were in a consistent direction with those previously reported, including a protective effect of the APOE ε4 allele. Conversely, the risk of AMD was significantly increased in carriers of the ε2 allele. Conclusions These findings provide an independent confirmation of many of the previously identified AMD risk loci, and support a potentially greater role of genetic factors in the development of CNV. The replication of established associations validates the use of EHR in genetic studies of ophthalmologic traits. PMID:26176866

  11. Adult attention-deficit/hyperactivity disorder: Associations between subtype and lifetime substance use – a clinical study. [version 1; referees: 2 approved, 1 approved with reservations

    Directory of Open Access Journals (Sweden)

    Michael Liebrenz

    2015-07-01

    Full Text Available ADHD is the one of the most prevalent childhood disorders and has been associated with impairments persisting into adulthood. Specifically, childhood ADHD is an independent clinical risk factor for the development of later substance use disorders (SUD. Moreover, adults who meet diagnostic criteria for ADHD have shown high rates of comorbid SUDs. Few studies, however, have reported on the relationship between ADHD subtypes and SUD in adult samples. The purpose of this study was to characterize a clinical sample of adults with ADHD and to identify possible associations between ADHD subtypes, lifetime substance use, and if ADHD subtypes may be preferentially associated with specific substances of abuse. We recruited 413 adult ADHD patients, performed an evaluation of their ADHD and conducted an interview on their use of psychotropic substances. Complete data was obtained for 349 patients. Lifetime substance abuse or dependence was 26% and occasional use was 57% in this sample. The inattentive subtype was significantly less likely to abuse or be dependent on cocaine than the combined subtype. Our findings underscore the high rate of comorbidity between substance use and ADHD in adults. The more frequent abuse/dependence of cocaine by adult patients with hyperactive-impulsive symptoms should be kept in mind when treating this patient group.

  12. Adult attention-deficit/hyperactivity disorder: Associations between subtype and lifetime substance use – a clinical study [version 2; referees: 2 approved, 1 approved with reservations

    Directory of Open Access Journals (Sweden)

    Michael Liebrenz

    2016-10-01

    Full Text Available ADHD is the one of the most prevalent childhood disorders and has been associated with impairments persisting into adulthood. Specifically, childhood ADHD is an independent clinical risk factor for the development of later substance use disorders (SUD. Moreover, adults who meet diagnostic criteria for ADHD have shown high rates of comorbid SUDs. Few studies, however, have reported on the relationship between ADHD subtypes and SUD in adult samples. The purpose of this study was to characterize a clinical sample of adults with ADHD and to identify possible associations between ADHD subtypes, lifetime substance use, and if ADHD subtypes may be preferentially associated with specific substances of abuse. We recruited 413 adult ADHD patients, performed an evaluation of their ADHD and conducted an interview on their use of psychotropic substances. Complete data was obtained for 349 patients. Lifetime substance abuse or dependence was 26% and occasional use was 57% in this sample. The inattentive subtype was significantly less likely to abuse or be dependent on cocaine than the combined subtype. Our findings underscore the high rate of comorbidity between substance use and ADHD in adults. The more frequent abuse/dependence of cocaine by adult patients with hyperactive-impulsive symptoms should be kept in mind when treating this patient group.

  13. Integrated Genomic Analysis Identifies Clinically Relevant Subtypes of Glioblastoma Characterized by Abnormalities in PDGFRA, IDH1, EGFR, and NF1

    Energy Technology Data Exchange (ETDEWEB)

    Verhaak, Roel GW; Hoadley, Katherine A; Purdom, Elizabeth; Wang, Victoria; Qi, Yuan; Wilkerson, Matthew D; Miller, C Ryan; Ding, Li; Golub, Todd; Mesirov, Jill P; Alexe, Gabriele; Lawrence, Michael; O' Kelly, Michael; Tamayo, Pablo; Weir, Barbara A; Gabriel, Stacey; Winckler, Wendy; Gupta, Supriya; Jakkula, Lakshmi; Feiler, Heidi S; Hodgson, J Graeme; James, C David; Sarkaria, Jann N; Brennan, Cameron; Kahn, Ari; Spellman, Paul T; Wilson, Richard K; Speed, Terence P; Gray, Joe W; Meyerson, Matthew; Getz, Gad; Perou, Charles M; Hayes, D Neil; Network, The Cancer Genome Atlas Research

    2009-09-03

    The Cancer Genome Atlas Network recently cataloged recurrent genomic abnormalities in glioblastoma multiforme (GBM). We describe a robust gene expression-based molecular classification of GBM into Proneural, Neural, Classical, and Mesenchymal subtypes and integrate multidimensional genomic data to establish patterns of somatic mutations and DNA copy number. Aberrations and gene expression of EGFR, NF1, and PDGFRA/IDH1 each define the Classical, Mesenchymal, and Proneural subtypes, respectively. Gene signatures of normal brain cell types show a strong relationship between subtypes and different neural lineages. Additionally, response to aggressive therapy differs by subtype, with the greatest benefit in the Classical subtype and no benefit in the Proneural subtype. We provide a framework that unifies transcriptomic and genomic dimensions for GBM molecular stratification with important implications for future studies.

  14. Different subtypes of epithelioid sarcoma and their clinical implication: long-term multi-institutional experience with a rare sarcoma.

    Science.gov (United States)

    Kim, Chan; Yoo, Kwai Han; Kim, Min Hwan; Chon, Hong Jae; Lee, Soon Il; Lee, Hyo Jin; Koh, Sujin; Lee, Ha Yeon; Lee, Hye Ran; Kim, Kyung Sik; Choi, Young Deuk; Rha, Sun Young; Lee, Su Jin; Kim, Hyo Song

    2017-03-01

    Epithelioid sarcoma (ES) is a very rare soft-tissue sarcoma with a high tendency of recurrence and metastasis. We analyzed clinical features of ES and aimed to identify the potential role of radio- and chemotherapy in ES. Fifty-five patients diagnosed with ES between 1997 and 2014 were enrolled from seven tertiary hospitals in Korean Cancer Research Group. The clinical variables were retrospectively reviewed and analyzed. Forty-six (84%) patients underwent surgical resection of ES, and among them, 27 experienced recurrence. In these patients, resection margin status and adjuvant radiotherapy were independent prognostic factors for longer recurrence-free survival (RFS), while adjuvant chemotherapy did not influence RFS. Twenty-two (40%) patients received palliative chemotherapy for metastatic or recurrent ES, and in these patients, palliative chemotherapy was the only independent prognostic factor for longer overall survival. Intriguingly, the clinical benefit of radio- and chemotherapy was observable only in proximal ES, but not in extremity ES, indicating that subtypes of ES might respond to radio- or chemotherapy differently. Proximal ES seems to benefits more from active anticancer treatment than conventional extremity ES. The aggressive characteristics of proximal ES could be overcome with an optimal multimodal treatment.

  15. ELISA subtypization of anti-ENA autoantibodies in clinical management of autoimmune diseases in Bosnia and Herzegovina.

    Science.gov (United States)

    Subasic, Djemo; Karamehic, Jasenko; Gavrankapetanovic, Faris; Hodzic, Harun; Kasumovic, Mersija; Delic-Sarac, Marina; Prljaca-Zecevic, Lamija

    2009-01-01

    The basis of autoimmune diseases such as SLE (Systemic Lupus Eritematodes), Sjogren's syndrome, scleroderma, dermatomyositis and polymiositis is the creation of auto-antibodies to the following specific extractable nuclear antigens (ENA):Jo-1, Ssl-70, SS-A, SS-B, Sm and Sm/RNPs. Some of these antigens are in fact enzymes (Jo-1-histidil-tRNA synthetase, Scl-70-topoisomerase) which are inhibited by specific autoantibodies--this leads to disturbance in the metabolism of DNA and protein biosynthesis. During 2009, we analyzed total of 87 serum samples of patients suspected for autoimmune disorder using ANA-IFA and ELISA-ENA-6 methods. After establishing IFA-ANA positivity (83.9%), all serum specimens; ANA positive and negative, were subtypized by ELISA ENA-6 test. Analysis showed the highest incidence of anti-SS-A (56%), and incidence of anti-SS-B (29.8%), anti-Sm/ RNP (11.5%), anti-Jo-1 (2.3%) and anti-Scl-70 (1,1%) auto-antibodies. Also, 78.5% of IFA-ANA negative serum specimens showed high level of positivity (212.50 and 277.0 IU/ml) to SS-A (78.5%) and SS-B (21.4%) antigenes using ELISA-ENA-6 subtypization. Following these results, we conclude that it is necessary to introduce Western blot confirmation testing. After comparing with other clinical findings, we diagnosed the following autoimmune diseases: SLE, Sjogren's syndrome and dermatomiosytis.

  16. Early visual processing is affected by clinical subtype in patients with unilateral spatial neglect: A magnetoencephalography study.

    Directory of Open Access Journals (Sweden)

    Katsuhiro eMizuno

    2013-07-01

    Full Text Available OBJECTIVE: To determine whether visual evoked fields (VEFs elicited by right and left hemifield stimulation differ in patients with unilateral spatial neglect that results from cerebrovascular accident.METHODS: Pattern-reversal stimulation of the right and left hemifield was performed in three patients with left unilateral spatial neglect. Magnetoencephalography was recorded using a 160-channel system, and VEFs were quantified in the 400 ms after each stimulus. The presence or absence of VEF components at around 100 ms (P100m component and 145 ms (N145m component after stimulus onset was determined. The source of the VEF was determined using a single equivalent current dipole model for spherical volume conduction. All patients were evaluated using the behavioral inattention test (BIT.RESULTS: In response to right hemifield stimulation, the P100m and N145m components of the VEF were evident in all three patients. In response to left hemifield stimulation, both components were evident in Patient 3, whereas only the P100m component was evident in Patient 1 and only the N145m component was evident in Patient 2. Patient 1 exhibited impairments on the line bisection and cancellation tasks of the BIT, Patient 2 exhibited impairments on the copying, drawing and cancellation tasks of the BIT, and Patient 3 exhibited impairments on the cancellation task of the BIT.CONCLUSIONS: These results demonstrate that early VEFs are disrupted in patients with unilateral spatial neglect and support the concept that deficits in visual processing differ according to the clinical subtype of unilateral spatial neglect and the lesion location. This study also demonstrates the feasibility of using magnetoencephalography to explore subtypes of neglect.

  17. Clinical Insight Into Latent Variables of Psychiatric Questionnaires for Mood Symptom Self-Assessment

    Science.gov (United States)

    Saunders, Kate; Bilderbeck, Amy; Palmius, Niclas; Goodwin, Guy; De Vos, Maarten

    2017-01-01

    Background We recently described a new questionnaire to monitor mood called mood zoom (MZ). MZ comprises 6 items assessing mood symptoms on a 7-point Likert scale; we had previously used standard principal component analysis (PCA) to tentatively understand its properties, but the presence of multiple nonzero loadings obstructed the interpretation of its latent variables. Objective The aim of this study was to rigorously investigate the internal properties and latent variables of MZ using an algorithmic approach which may lead to more interpretable results than PCA. Additionally, we explored three other widely used psychiatric questionnaires to investigate latent variable structure similarities with MZ: (1) Altman self-rating mania scale (ASRM), assessing mania; (2) quick inventory of depressive symptomatology (QIDS) self-report, assessing depression; and (3) generalized anxiety disorder (7-item) (GAD-7), assessing anxiety. Methods We elicited responses from 131 participants: 48 bipolar disorder (BD), 32 borderline personality disorder (BPD), and 51 healthy controls (HC), collected longitudinally (median [interquartile range, IQR]: 363 [276] days). Participants were requested to complete ASRM, QIDS, and GAD-7 weekly (all 3 questionnaires were completed on the Web) and MZ daily (using a custom-based smartphone app). We applied sparse PCA (SPCA) to determine the latent variables for the four questionnaires, where a small subset of the original items contributes toward each latent variable. Results We found that MZ had great consistency across the three cohorts studied. Three main principal components were derived using SPCA, which can be tentatively interpreted as (1) anxiety and sadness, (2) positive affect, and (3) irritability. The MZ principal component comprising anxiety and sadness explains most of the variance in BD and BPD, whereas the positive affect of MZ explains most of the variance in HC. The latent variables in ASRM were identical for the patient groups

  18. HIV-1 subtype distribution trends and evidence of transmission clusters among incident cases in a rural clinical cohort in southwest Uganda, 2004-2010.

    Science.gov (United States)

    Kapaata, Anne; Lyagoba, Frederick; Ssemwanga, Deogratius; Magambo, Brian; Nanyonjo, Maria; Levin, Jonathan; Mayanja, Billy N; Mugasa, Claire; Parry, Chris M; Kaleebu, Pontiano

    2013-03-01

    The high diversity of HIV-1 has been shown to affect disease progression, transmission, and response to antiretroviral therapy and may influence HIV vaccine design. We describe the distribution trends of HIV-1 subtypes over a 7-year period among incident cases in a rural clinical cohort in Southwest Uganda and identify transmission clusters. Viral RNA was extracted from cryopreserved plasma samples from 94 participants who seroconverted and enrolled between 2004 and 2010. Partial gag (p24) and env (gp41) genes were directly sequenced to identify subtypes and transmission clusters with more than 95% bootstrap values. Direct sequencing of the partial pol gene and use of individual participant sexual life histories were also used to confirm these transmission clusters. The overall gag/env subtype distribution was A 28% (n=26), C 1% (n=1), and D 45% (n=42) and 27% (n=25) were intergene unique recombinant forms. The proportions of subtype A, D, or recombinants showed no significant increasing or decreasing trend over this time period (p=0.51). Phylogenetic analysis of the three genes confirmed 13 transmission clusters of which seven clusters were confirmed sexual partners using individual participants' sexual life histories. Subtype D has remained the predominant subtype in this population. From 2004 to 2010, there was no change in the proportions of these subtypes. Phylogenetic analysis and participants' sexual life histories revealed several transmission clusters. The high proportion of transmission clusters observed suggests continued high-risk sexual behavior and mixing in some individuals and possibly super transmitters in this presumed low-risk cohort, but also indicates that many transmissions occur in early HIV infection. This calls for early and targeted effective prevention and treatment intervention in this population.

  19. Different disease subtypes with distinct clinical expression in familial Mediterranean fever: results of a cluster analysis.

    Science.gov (United States)

    Akar, Servet; Solmaz, Dilek; Kasifoglu, Timucin; Bilge, Sule Yasar; Sari, Ismail; Gumus, Zeynep Zehra; Tunca, Mehmet

    2016-02-01

    The aim of this study was to evaluate whether there are clinical subgroups that may have different prognoses among FMF patients. The cumulative clinical features of a large group of FMF patients [1168 patients, 593 (50.8%) male, mean age 35.3 years (s.d. 12.4)] were studied. To analyse our data and identify groups of FMF patients with similar clinical characteristics, a two-step cluster analysis using log-likelihood distance measures was performed. For clustering the FMF patients, we evaluated the following variables: gender, current age, age at symptom onset, age at diagnosis, presence of major clinical features, variables related with therapy and family history for FMF, renal failure and carriage of M694V. Three distinct groups of FMF patients were identified. Cluster 1 was characterized by a high prevalence of arthritis, pleuritis, erysipelas-like erythema (ELE) and febrile myalgia. The dosage of colchicine and the frequency of amyloidosis were lower in cluster 1. Patients in cluster 2 had an earlier age of disease onset and diagnosis. M694V carriage and amyloidosis prevalence were the highest in cluster 2. This group of patients was using the highest dose of colchicine. Patients in cluster 3 had the lowest prevalence of arthritis, ELE and febrile myalgia. The frequencies of M694V carriage and amyloidosis were lower in cluster 3 than the overall FMF patients. Non-response to colchicine was also slightly lower in cluster 3. Patients with FMF can be clustered into distinct patterns of clinical and genetic manifestations and these patterns may have different prognostic significance. © The Author 2015. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  20. Clinical similarities among bradykinin-mediated and mast cell-mediated subtypes of non-hereditary angioedema : a retrospective study

    NARCIS (Netherlands)

    Schulkes, Karlijn J G; van den Elzen, Mignon T.; Hack, Erik C.; Otten, Henderikus G; Bruijnzeel-Koomen, Carla A.F.M.; Knulst, André C.

    2015-01-01

    BACKGROUND: Non-hereditary angioedema (non-HAE) is characterized by local swelling due to self-limiting, subcutaneous or submucosal extravasation of fluid, and can be divided into three subtypes. These subtypes are believed to have different pathophysiological backgrounds and are referred to in rece

  1. The Clinical Utility of the Proposed DSM-5 Callous-Unemotional Subtype of Conduct Disorder in Young Girls

    Science.gov (United States)

    Pardini, Dustin; Stepp, Stephanie; Hipwell, Alison; Stouthamer-Loeber, Magda; Loeber, Rolf

    2012-01-01

    Objective: A callous-unemotional (CU) subtype of conduct disorder (CD) has been proposed as an addition to the fifth edition of the "Diagnostic and Statistic Manual of Mental Disorders (DSM-5)." This study tested the hypothesis that young girls with the CU subtype of CD would exhibit more severe antisocial behavior and less severe internalizing…

  2. The Clinical Utility of the Proposed DSM-5 Callous-Unemotional Subtype of Conduct Disorder in Young Girls

    Science.gov (United States)

    Pardini, Dustin; Stepp, Stephanie; Hipwell, Alison; Stouthamer-Loeber, Magda; Loeber, Rolf

    2012-01-01

    Objective: A callous-unemotional (CU) subtype of conduct disorder (CD) has been proposed as an addition to the fifth edition of the "Diagnostic and Statistic Manual of Mental Disorders (DSM-5)." This study tested the hypothesis that young girls with the CU subtype of CD would exhibit more severe antisocial behavior and less severe internalizing…

  3. Distributed Subtyping

    OpenAIRE

    Baehni, Sébastien; Barreto, Joao; Guerraoui, Rachid

    2006-01-01

    One of the most frequent operations in object-oriented programs is the "instanceof" test, also called the "subtyping" test or the "type inclusion" test. This test determines if a given object is an instance of some type. Surprisingly, despite a lot of research on distributed object-oriented languages and systems, almost no work has been devoted to the implementation of this test in a distributed environment. This paper presents the first algorithm to implement the "subtyping" test on an obje...

  4. An investigation of the subtype diversity of clinical isolates of Irish Clostridium difficile ribotypes 027 and 078 by repetitive-extragenic palindromic PCR.

    LENUS (Irish Health Repository)

    Solomon, K

    2011-08-01

    A repetitive-extragenic palindromic PCR (rep-PCR) subtyping method (DiversiLab) in conjunction with ribotyping, toxinotyping and antimicrobial-susceptibility testing was used to detect subtypes within Clostridium difficile ribotypes 027 and 078. Clinical isolates of ribotypes 027 (toxinotype III) (n = 30) and 078 (toxinotype V) (n = 23) were provided by health-care facilities across the Republic of Ireland over 2 months in 2006 and 1 month in 2009. Ribotype 027 isolates were significantly more related to each other (9 different subtype profiles) when compared to ribotype 078 isolates (14 different profiles) (P = 0.001; cut-off >90 % similarity). Almost half of ribotype 078 isolates (45.5 %) showed no relationship to each other. The clonality of ribotype 027 isolates suggests effective adaptation to the human niche, whereas the considerable genetic diversity within ribotype 078 isolates suggests that they may have originated from a variety of sources. Subtyping correlated well with antimicrobial susceptibility, in particular clindamycin susceptibility for ribotype 027, but diverse antimicrobial-susceptibility profiles were seen in ribotype 078 isolates, even within a single health-care facility. Between 2006 and 2009, a change in the predominant subtype of ribotype 027 was seen, with the recent clone representing half of all ribotype 027 isolates studied. This strain exhibited 89 % similarity to a rep-PCR profile of the North American NAP-1 strain.

  5. Assessing preoperative anxiety using a questionnaire and clinical rating: a prospective observational study.

    Science.gov (United States)

    Laufenberg-Feldmann, Rita; Kappis, Bernd

    2013-12-01

    Preoperative anxiety and need for information can be detected during preoperative consultation via structured and standardised screening by the Amsterdam Preoperative Anxiety and Information Scale (APAIS) questionnaire. To identify the prevalence of preoperative anxiety and need for information, with regard to influencing factors such as age, sex, previous operation and grade of surgery, and to examine the level of agreement between patients' self-rating and physicians' ratings. Prospective observational study. Department of Anaesthesiology, University Medical Centre of the Johannes Gutenberg University Mainz, Germany. Two hundred seventeen patients scheduled for elective surgery. The patients completed questionnaires prior to the interaction with the anaesthesiologist. Physicians were blinded to the patients' ratings and provided their subjective ratings about patients' anxiety and need for information immediately after seeing the patient. Degree of anxiety and need for information, agreement of patients' self-reports and physician's rating. 18.9% of patients were classified as 'anxiety cases' (31.8% in women and 10.6% in men). The grade of the intended surgery but no other investigated factor was related to patients' anxiety. Age (older patients) was correlated with information requirement (r = 0.21, P = 0.002). Analysis of agreement showed only weak correlations between patients' self-reports and physicians' ratings, demonstrated in low weighted Kappa-coefficients (0.12 to 0.32). The APAIS is a useful instrument to assess the level of patients' preoperative anxiety and the need for information. Given the relationship between preoperative anxiety and postoperative outcome, it seems justified to incorporate this approach into the preoperative consultation. German Clinical Trials Register DRKS00003084.

  6. Development, validation and clinical assessment of a short questionnaire to assess disease-related knowledge in inflammatory bowel disease patients.

    LENUS (Irish Health Repository)

    Keegan, Denise

    2013-02-01

    Only two inflammatory bowel disease (IBD) knowledge scales are available, both primarily aimed at evaluating the effectiveness of clinical education programs. The aim of this study was to develop and validate a short knowledge questionnaire for clinical and academic research purposes.

  7. Assessment Procedures for Narcissistic Personality Disorder: A Comparison of the Personality Diagnostic Questionnaire-4 and Best-Estimate Clinical Judgments

    Science.gov (United States)

    Miller, Joshua D.; Campbell, W. Keith; Pilkonis, Paul A.; Morse, Jennifer Q.

    2008-01-01

    This study examined the degree of correspondence between two assessments for narcissistic personality disorder (NPD) in a mixed clinical and community sample--one using a self-report measure (Personality Diagnostic Questionnaire-4) and the other using clinical judgments derived from an assessment based on the longitudinal, expert, all data (LEAD)…

  8. Assessing decentering: validation, psychometric properties, and clinical usefulness of the Experiences Questionnaire in a Spanish sample.

    Science.gov (United States)

    Soler, Joaquim; Franquesa, Alba; Feliu-Soler, Albert; Cebolla, Ausias; García-Campayo, Javier; Tejedor, Rosa; Demarzo, Marcelo; Baños, Rosa; Pascual, Juan Carlos; Portella, Maria J

    2014-11-01

    Decentering is defined as the ability to observe one's thoughts and feelings in a detached manner. The Experiences Questionnaire (EQ) is a self-report instrument that originally assessed decentering and rumination. The purpose of this study was to evaluate the psychometric properties of the Spanish version of EQ-Decentering and to explore its clinical usefulness. The 11-item EQ-Decentering subscale was translated into Spanish and psychometric properties were examined in a sample of 921 adult individuals, 231 with psychiatric disorders and 690 without. The subsample of nonpsychiatric participants was also split according to their previous meditative experience (meditative participants, n=341; and nonmeditative participants, n=349). Additionally, differences among these three subgroups were explored to determine clinical validity of the scale. Finally, EQ-Decentering was administered twice in a group of borderline personality disorder, before and after a 10-week mindfulness intervention. Confirmatory factor analysis indicated acceptable model fit, sbχ(2)=243.8836 (p.46; and divergent validity: r<-.35). The scale detected changes in decentering after a 10-session intervention in mindfulness (t=-4.692, p<.00001). Differences among groups were significant (F=134.8, p<.000001), where psychiatric participants showed the lowest scores compared to nonpsychiatric meditative and nonmeditative participants. The Spanish version of the EQ-Decentering is a valid and reliable instrument to assess decentering either in clinical and nonclinical samples. In addition, the findings show that EQ-Decentering seems an adequate outcome instrument to detect changes after mindfulness-based interventions.

  9. Differentiated expression of somatostatin receptor subtypes in experimental models and clinical neuroblastoma.

    Science.gov (United States)

    Georgantzi, Kleopatra; Tsolakis, Apostolos V; Stridsberg, Mats; Jakobson, Ake; Christofferson, Rolf; Janson, Eva Tiensuu

    2011-04-01

    Neuroblastoma (NB) is a solid tumor of childhood originating from the adrenal medulla or sympathetic nervous system. Somatostatin (SS) is an important regulator of neural and neuroendocrine function, its actions being mediated through five specific membrane receptors. The aim of this study was to investigate the expression of the different somatostatin receptors (SSTRs) in NB tumor cells that may form targets for future therapeutic development. Tumor specimens from 11 children with stage II-IV disease were collected before and/or after chemotherapy. Experimental tumors derived from five human NB cell lines were grown subcutaneously in nude mice. Expression of SSRTs, the neuroendocrine marker chromogranin A (CgA) and SS was detected by immunohistochemistry using specific antibodies. SSTR2 was detected in 90%, SSTR5 in 79%, SSTR1 in 74%, SSTR3 in 68% whereas SSTR4 was expressed in 21% of the clinical tumors. The experimental tumors expressed SSTRs in a high but variable frequency. All clinical tumors showed immunoreactivity for CgA but not for SS. The frequent expression of SSTRs indicates that treatment with unlabeled or radiolabeled SS analogs should be further explored in NB. Copyright © 2010 Wiley-Liss, Inc.

  10. Cultural adaptation and validation of the Portuguese version of the Nursing Clinical Facilitators Questionnaire.

    Science.gov (United States)

    Frederico-Ferreira, Maria Manuela; Camarneiro, Ana Paula Forte; Loureiro, Cândida Rosalinda Exposto da Costa; Ventura, Maria Clara Amado Apóstolo

    2016-08-15

    to perform the cultural adaptation to Portuguese of the Nursing Clinical Facilitators Questionnaire (NCFQ), which was designed by the Centre for Learning and Teaching at the University of Technology of Sydney, and to validate this instrument. this methodological study involved the cultural adaptation of the questionnaire by using translation, back-translation, semantic comparison, idiomatic and conceptual equivalence, and validation through validity and reliability analyses and used a sample of 767 students in their second year of the Nursing Program. construct validity had a two-factor solution according to the varimax rotation method. In addition, there was a high overall internal consistency for the questionnaire (Cronbach's alpha of 0.977) and for the factors found (0.966 and 0.952, respectively). the Portuguese version has good psychometric characteristics; therefore, it is adequate to obtain reliable information on the perception of nursing students concerning the type of supervision that is provided in clinical practice, and this version is adequate to improve teaching practices. realizar a adaptação cultural para a língua portuguesa do Nursing Clinical Facilitators Questionnaire (NCFQ) concebido pelo Centre for Learning and Teaching, University of Technology de Sydney e proceder à validação do instrumento. estudo metodológico de adaptação cultural do questionário através de tradução, retroversão, comparação semântica, idiomática e equivalência conceitual, seguido de validação em uma amostra de 767 estudantes do 2º ano do Curso de Licenciatura em Enfermagem, por meio de análise da validade e confiabilidade. a validade de constructo apresenta uma solução bifatorial após rotação varimax. A consistência interna global do questionário é elevada (alfa de Cronbach 0,977), assim como dos fatores encontrados (respectivamente, 0,966 e 0,952). a versão portuguesa apresenta boas características psicométricas, sendo um instrumento v

  11. The common p.R114W HNF4A mutation causes a distinct clinical subtype of monogenic diabetes

    Science.gov (United States)

    Laver, Thomas W; Colclough, Kevin; Shepherd, Maggie; Patel, Kashyap; Houghton, Jayne AL; Dusatkova, Petra; Pruhova, Stepanka; Morris, Andrew D; Palmer, Colin N; McCarthy, Mark I; Ellard, Sian; Hattersley, Andrew T; Weedon, Michael N

    2016-01-01

    HNF4A mutations cause increased birth weight, transient neonatal hypoglycaemia and maturity onset diabetes of the young (MODY). The most frequently reported HNF4A mutation is p.R114W (previously p.R127W) but functional studies have shown inconsistent results, there is lack of co-segregation in some pedigrees and an unexpectedly high frequency in public variant databases. We confirm that p.R114W is a pathogenic mutation with an odds ratio of 30.4 (95% CI: 9.79 – 125, P=2x10-21) for diabetes in our MODY cohort compared to controls. p.R114W heterozygotes do not have the increased birth weight of patients with other HNF4A mutations (3476g vs. 4147g, P=0.0004) and fewer patients responded to sulfonylurea treatment (48% vs. 73%, P=0.038). p.R114W has reduced penetrance; only 54% of heterozygotes developed diabetes by age 30 compared to 71% for other HNF4A mutations. We re-define p.R114W as a pathogenic mutation causing a distinct clinical subtype of HNF4A MODY with reduced penetrance, reduced sensitivity to sulfonylurea treatment and no effect on birth weight. This has implications for diabetes treatment, management of pregnancy and predictive testing of at-risk relatives. The increasing availability of large-scale sequence data is likely to reveal similar examples of rare, low-penetrance MODY mutations. PMID:27486234

  12. JAK2 or CALR mutation status defines subtypes of essential thrombocythemia with substantially different clinical course and outcomes.

    Science.gov (United States)

    Rumi, Elisa; Pietra, Daniela; Ferretti, Virginia; Klampfl, Thorsten; Harutyunyan, Ashot S; Milosevic, Jelena D; Them, Nicole C C; Berg, Tiina; Elena, Chiara; Casetti, Ilaria C; Milanesi, Chiara; Sant'antonio, Emanuela; Bellini, Marta; Fugazza, Elena; Renna, Maria C; Boveri, Emanuela; Astori, Cesare; Pascutto, Cristiana; Kralovics, Robert; Cazzola, Mario

    2014-03-06

    Patients with essential thrombocythemia may carry JAK2 (V617F), an MPL substitution, or a calreticulin gene (CALR) mutation. We studied biologic and clinical features of essential thrombocythemia according to JAK2 or CALR mutation status and in relation to those of polycythemia vera. The mutant allele burden was lower in JAK2-mutated than in CALR-mutated essential thrombocythemia. Patients with JAK2 (V617F) were older, had a higher hemoglobin level and white blood cell count, and lower platelet count and serum erythropoietin than those with CALR mutation. Hematologic parameters of patients with JAK2-mutated essential thrombocythemia or polycythemia vera were related to the mutant allele burden. While no polycythemic transformation was observed in CALR-mutated patients, the cumulative risk was 29% at 15 years in those with JAK2-mutated essential thrombocythemia. There was no significant difference in myelofibrotic transformation between the 2 subtypes of essential thrombocythemia. Patients with JAK2-mutated essential thrombocythemia and those with polycythemia vera had a similar risk of thrombosis, which was twice that of patients with the CALR mutation. These observations are consistent with the notion that JAK2-mutated essential thrombocythemia and polycythemia vera represent different phenotypes of a single myeloproliferative neoplasm, whereas CALR-mutated essential thrombocythemia is a distinct disease entity.

  13. The Common p.R114W HNF4A Mutation Causes a Distinct Clinical Subtype of Monogenic Diabetes.

    Science.gov (United States)

    Laver, Thomas W; Colclough, Kevin; Shepherd, Maggie; Patel, Kashyap; Houghton, Jayne A L; Dusatkova, Petra; Pruhova, Stepanka; Morris, Andrew D; Palmer, Colin N; McCarthy, Mark I; Ellard, Sian; Hattersley, Andrew T; Weedon, Michael N

    2016-10-01

    HNF4A mutations cause increased birth weight, transient neonatal hypoglycemia, and maturity onset diabetes of the young (MODY). The most frequently reported HNF4A mutation is p.R114W (previously p.R127W), but functional studies have shown inconsistent results; there is a lack of cosegregation in some pedigrees and an unexpectedly high frequency in public variant databases. We confirm that p.R114W is a pathogenic mutation with an odds ratio of 30.4 (95% CI 9.79-125, P = 2 × 10(-21)) for diabetes in our MODY cohort compared with control subjects. p.R114W heterozygotes did not have the increased birth weight of patients with other HNF4A mutations (3,476 g vs. 4,147 g, P = 0.0004), and fewer patients responded to sulfonylurea treatment (48% vs. 73%, P = 0.038). p.R114W has reduced penetrance; only 54% of heterozygotes developed diabetes by age 30 years compared with 71% for other HNF4A mutations. We redefine p.R114W as a pathogenic mutation that causes a distinct clinical subtype of HNF4A MODY with reduced penetrance, reduced sensitivity to sulfonylurea treatment, and no effect on birth weight. This has implications for diabetes treatment, management of pregnancy, and predictive testing of at-risk relatives. The increasing availability of large-scale sequence data is likely to reveal similar examples of rare, low-penetrance MODY mutations.

  14. Do HIV-1 non-B subtypes differentially impact resistance mutations and clinical disease progression in treated populations? Evidence from a systematic review

    Directory of Open Access Journals (Sweden)

    Madhavi Bhargava

    2014-07-01

    Full Text Available There are 31 million adults living with HIV-1 non-B subtypes globally, and about 10 million are on antiretroviral therapy (ART. Global evidence to guide clinical practice on ART response in HIV-1 non-B subtypes remains limited. We systematically searched 11 databases for the period 1996 to 2013 for evidence. Outcomes documented included time to development of AIDS and/or death, resistance mutations, opportunistic infections, and changes in CD4 cell counts and viral load. A lack of consistent reporting of all clinical end points precluded a meta-analysis. In sum, genetic diversity that precipitated differences in disease progression in ART-naïve populations was minimized in ART-experienced populations, although variability in resistance mutations persisted across non-B subtypes. To improve the quality of patient care in global settings, recording HIV genotypes at baseline and at virologic failure with targeted non-B subtype-based point-of-care resistance assays and timely phasing out of resistance-inducing ART regimens is recommended.

  15. [Stroke in young adults: incidence and clinical picture in 280 patients according to their aetiological subtype].

    Science.gov (United States)

    Arboix, Adrià; Massons, Joan; García-Eroles, Luís; Oliveres, Montserrat

    2016-03-04

    To assess the clinical features and incidence rate of stroke in young adults (less than 55 years of age). Hospital-based descriptive study of 280 young inpatients consecutively admitted for stroke over a period of 24 years. We conducted a comparison with the remaining 4,312 patients admitted for stroke. Stroke in young adults represented 6.1% of all strokes, 5.7% of transient ischaemic attacks, 5.8% of cerebral infarctions and 8.4% of brain haemorrhages. However, reported minimal frequency of cardioembolic (2.1%) and atherothrombotic (3.4%) infarctions, accounted for 5.9% of lacunar and for 10.7% of essential infarctions and showed a maximum frequency in those infarctions of unusual aetiology (36%). Factors independently associated with stroke in young adults were cigarette smoking (OR 4.23; 95% CI 3.02-5.93; P=.000), unusual aetiology (OR 4.97; 95% CI 3.15-7.84; P=.000), headache (OR 4.57; 95% CI 2.59-8.07; P=.000), alcohol abuse (OR 3.93; 95% CI 2.46-6.29; P=.000), oral contraceptives (OR 14.07; 95% CI 2.37-83.40; P=.004), atrial fibrillation (OR 0.15; 95% CI 0.08-0.28; P=.000), arterial hypertension (OR 0.43; 95% CI 0.33-0.57; P=.000), COPD (OR 0.20; 95% CI 0.09-0.44; P=.000), atherothrombotic infarction (OR 0.51; 95% CI 0.34-0.77; P=.001), female sex (OR 0.71; 95% CI 0.52-0.97; P=.029), diabetes mellitus (OR 0.66; 95% CI 0.46-0.98; P=.030), ischaemic heart disease (OR 0.56; 95% CI 0.33-0.95; P=.032) and intermittent claudication (OR 0.48; 95% CI 0.24-0.94; P=.033). Stroke in young adults is infrequent (6.1% of the total), but represents the highest frequency of cerebral infarcts of unusual aetiology (36%). We conclude that stroke in younger patients presents its own and differentiated clinical profile. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

  16. Smartphone use and acceptability among clinical medical students: a questionnaire-based study.

    Science.gov (United States)

    Robinson, Tim; Cronin, Thomas; Ibrahim, Haider; Jinks, Mark; Molitor, Timothy; Newman, Joshua; Shapiro, Jonathan

    2013-06-01

    Smartphones are becoming increasingly common in both personal and professional spheres. These devices have many features which can be successfully harnessed in healthcare, including rapid access to information, instant communication and improved organisation. In particular, the smartphone's potential as an educational tool is an area which is starting to gain recognition, with a number of institutions providing the device to medical students. However, before more universities follow suit, a better understanding of students' ownership, usage and attitudes relating to smartphones is required. We therefore distributed a questionnaire to clinical medical students at the University of Birmingham, UK, which aimed to fill these gaps in knowledge. Data were obtained from 361 participants, representing a response rate of 32%. Fifty-nine per cent of students owned a smartphone; 37% of these reported using the device to support their learning. Generally students were positive towards the concept of smartphones as future educational aids, with 84% believing the devices would be useful or very useful. However, 64% thought smartphones would be too costly to implement and 62% felt such technology was not in the medical school's interest. Themes which emerged upon analysis of free text supported general findings, with students also mentioning issues such as potential for unprofessional behaviour and dependence upon smartphones. In conclusion, it appears most medical students believe a smartphone would be a useful addition to their education, although financial barriers must be overcome before the device is more universally accepted.

  17. Development and Psychometric Properties of the Nursing Critical Thinking in Clinical Practice Questionnaire.

    Science.gov (United States)

    Zuriguel-Pérez, Esperanza; Falcó-Pegueroles, Anna; Roldán-Merino, Juan; Agustino-Rodriguez, Sandra; Gómez-Martín, Maria Del Carmen; Lluch-Canut, Maria Teresa

    2017-08-01

    A complex healthcare environment, with greater need for care based on the patient and evidence-based practice, are factors that have contributed to the increased need for critical thinking in professional competence. At the theoretical level, Alfaro-LeFevre () put forward a model of critical thinking made up of four components. And although these explain the construct, instruments for their empirical measurement are lacking. The purpose of the study was to develop and validate the psychometric properties of an instrument, the Nursing Critical Thinking in Clinical Practice Questionnaire (N-CT-4 Practice), designed to evaluate the critical thinking abilities of nurses in the clinical setting. A cross-sectional survey design was used. A pool of items was generated for evaluation by a panel of experts who considered their validity for the new instrument, which was finally made up of 109 items. Following this, validation was carried out using a sample of 339 nurses at a hospital in Barcelona, Spain. Reliability was determined by means of internal consistency and test-retest stability over time, although the validity of the construct was assessed by means of confirmatory factor analysis. The content validity index of the N-CT-4 Practice was .85. Cronbach's alpha coefficient for the whole instrument was .96. The intraclass correlation coefficient was .77. Confirmatory factor analysis showed that the instrument was in line with the four-dimensional model proposed by Alfaro-LeFevre (). The psychometric properties of theN-CT-4 Practice uphold its potential for use in measuring critical thinking and in future research related with the examination of critical thinking. © 2017 The Authors Worldviews on Evidence-Based Nursing published by Wiley Periodicals, Inc. on behalf of Sigma Theta Tau International The Honor Society of Nursing.

  18. Clinical and imaging description of the Maron subtypes of hypertrophic cardiomyopathy.

    Science.gov (United States)

    Reant, Patricia; Donal, Erwan; Schnell, Frederic; Reynaud, Amelie; Daudin, Magalie; Pillois, Xavier; Dijos, Marina; Landelle, Mathieu; Peyrou, Jerome; Cornolle, Claire; Laurent, François; Montaudon, Michel; Roudaut, Raymond; Lafitte, Stephane

    2015-01-01

    Longitudinal strain analysis enables early detection of left ventricular (LV) contraction abnormalities in patients with preserved ejection fraction. Hypertrophic cardiomyopathy (HCM) is associated with low values of regional and global longitudinal myocardial deformations. In addition to contraction abnormalities, LV regional strain abnormalities are partially related to the degree of hypertrophy. This study sought to describe global longitudinal strain (GLS) in HCM patients as categorized using the Maron's classification. Complete echocardiography examinations, including GLS analysis, were performed in consecutive HCM patients followed up in two French HCM-clinics. A total of 271 patients (mean age 49 ± 16yrs; 71 % male) were evaluated. In this population, the most frequently classified hypertrophy pattern was Type II (47 %), following the Maron's classification. Type III was characterized by a higher degree of LV hypertrophy in terms of mass and maximal wall thickness, and was more frequently obstructive at rest, with lower GLS values (-15.3 ± 3.9 %, p = 0.016), higher E/E' ratio (13.4 ± 6.7, p < 0.001), and a more frequently inadequate blood pressure response to exercise (30 %, p = 0.04) compared to other patterns. The variable that correlated best with GLS was LV mass index (r = 0.49, p < 0.01), while GLS did not significantly correlate with left ventricular outflow tract obstruction. This study demonstrated that the Type III HCM pattern presented with lower GLS, which was partially related to higher LV mass index, more elevated LV filling pressures, and a more frequently inadequate blood pressure response to exercise, in comparison with other patterns categorized using the Maron's classification.

  19. Screening for developmental delay in the setting of a community pediatric clinic: a prospective assessment of parent-report questionnaires.

    Science.gov (United States)

    Rydz, David; Srour, Myriam; Oskoui, Maryam; Marget, Nancy; Shiller, Mitchell; Birnbaum, Rena; Majnemer, Annette; Shevell, Michael I

    2006-10-01

    Our goal for this study was to prospectively test whether parent-completed questionnaires can be effectively used in the setting of a busy ambulatory pediatric clinic to accurately screen for developmental impairments. Specific objectives included (1) assessing the feasibility of using parent-report instruments in the setting of a community pediatric clinic, (2) evaluating the accuracy of 2 available screening tests (the Ages and Stages Questionnaire and Child Development Inventory), and (3) ascertaining if the pediatrician's clinical judgment could be used as a potential modifier. Subjects were recruited from the patient population of a community clinic providing primary ambulatory pediatric care. Subjects without previous developmental delay or concerns noted were contacted at the time of their routine 18-month-old visit. Those subjects who agreed to participate were randomly assigned to 1 of 2 groups and completed either the Ages and Stages Questionnaire or Child Development Inventory. The child's pediatrician also completed a brief questionnaire regarding his or her opinion of the child's development. Those children for whom concerns were identified by either questionnaire underwent additional detailed testing by the Battelle Development Inventory, the "gold standard" for the purposes of this study. An equal number of children scoring within the norms of the screening measures also underwent testing with the Battelle Development Inventory. Of the 356 parents contacted, 317 parents (90%) agreed to participate. Most parents correctly completed the Ages and Stages Questionnaire (81%) and the Child Development Inventory (75%). Predictive values were calculated for the Ages and Stages Questionnaire and the Child Development Inventory (sensitivity: 0.67 and 0.50; specificity: 0.39 and 0.86; positive predictive value: 34% and 50%; negative predictive value: 71% and 86%, respectively). Incorporating the physician's opinion regarding the developmental status of the

  20. Development of a questionnaire to assess the factors associated with clinical learning of nursing students: A Delphi study

    Directory of Open Access Journals (Sweden)

    M Emami Maybodi

    2015-03-01

    Full Text Available Introduction : Inhibiting factors in clinical learning of nursing students cause a huge gap between the optimum and the current situation in performance of the graduates . Due to the lack of a comprehensive and reliable tool for the identification of these factors in Iran , this study aimed to develop a scale to assess the related items to nursing students’ clinical learning.   Methods : This descriptive study used Delphi approach to assess factors associated with clinical learning of nursing students in nursing schools of Yazd province in 2013 . The expert panel includes all registrars in nursing faculties, nursing clinical tutors, nursing personnel involved in education and years three and four nursing students. In the first round of Delphi, data collection tool was a structured questionnaire with 82 item s and an open question for additional suggestions.   Sampling method in those with responsibility was purposive, due to their limited number, and in other groups was random. Sample size was 48 of whom 41 agreed to participate in the study. According to the Delphi process, scope and scale of items were studied by 41 members of the panel t o reach over than 75% consensus. The collected data were analyzed by SPSS V 17.0 software using various analytic tests .   Results : Consensus on the questionnaire items was obtained during the two- round Delphi, and in the final questionnaire, the percentage of agreement between expert panel reached 79.85 %. Panel members came to agreement on factors associated with clinical learning questionnaire consisted 89 items in seven domains of educational planning (79.94% , evaluation (76.21%, resources and regulation of clinical environment (81.17%, professional communications (81.25%, clinical instructor (82/62, clinical instructor teaching methods (81.25% and student learning (81.91% .   Conclusion : The clinical learning factors questionnaire for nursing students, with 79.85% consensus of the expert panel

  1. Five-year prognosis after mild to moderate ischemic stroke by stroke subtype: a multi-clinic registry study.

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    Yumei Lv

    Full Text Available BACKGROUND AND PURPOSE: Mild to moderate ischemic stroke is a common presentation in the outpatient setting. Among the various subtypes of stroke, lacunar infarction (LI is generally very common. Currently, little is known about the long-term prognosis and factors associated with the prognosis between LI and non-LI. This study aims to compare the risk of death and acute cardiovascular events between patients with LI and non-LI, and identify potential risk factors associated with these outcomes. METHODS: A total of 710 first-ever ischemic stroke patients (LI: 474, non-LI: 263 from 18 clinics were recruited consecutively from 2003 to 2004. They were prospectively followed-up until the end of 2008. Hazard ratios and 95% confidence intervals were calculated using multivariable Cox proportional hazards regression. RESULTS: After a 5-year follow up, 54 deaths and 96 acute cardiovascular events occurred. Recurrent stroke was the most common cause of death (19 cases, 35.18% and new acute cardiovascular events (75 cases, 78.13%. There were no significant differences between patients with LI and non-LI in their risks of death, new cardiovascular events, and recurrent stroke after adjusting for age, sex, hypertension, diabetes, cardiac diseases, body mass index, dyslipidemia, smoking, alcohol consumption, ADL dependence, and depressive symptoms. Among the modifiable risk factors, diabetes, hypertension, ADL dependency, and symptoms of depression were independent predictors of poor outcomes in patients with LI. In non-LI patients, however, no modifiable risk factors were detected for poor outcomes. CONCLUSION: Long-term outcomes did not differ significantly between LI and non-LI patients. Detecting and managing vascular risk factors and depression as well as functional rehabilitation may improve the prognoses of LI patients.

  2. Assessment Procedures for Narcissistic Personality Disorder: A Comparison of the Personality Diagnostic Questionnaire-4 and Best-Estimate Clinical Judgments

    OpenAIRE

    Miller, Joshua D.; Campbell, W. Keith; Pilkonis, Paul A.; Morse, Jennifer Q

    2008-01-01

    This study examined the degree of correspondence between two assessments for narcissistic personality disorder (NPD) in a mixed clinical and community sample—one using a self-report measure (Personality Diagnostic Questionnaire-4) and the other using clinical judgments derived from an assessment based on the longitudinal, expert, all data (LEAD) methodology. NPD scores demonstrated moderate convergence for the total scores but weak convergence for the individual criteria. The authors also exa...

  3. Subtyping Stuttering II

    Science.gov (United States)

    Seery, Carol Hubbard; Watkins, Ruth V.; Mangelsdorf, Sarah C.; Shigeto, Aya

    2007-01-01

    This paper is the second in a series of two articles exploring subtypes of stuttering, and it addresses the question of whether and how language ability and temperament variables may be relevant to the study of subtypes within the larger population of children who stutter. Despite observations of varied profiles among young children who stutter, efforts to identify and characterize subtypes of stuttering have had limited influence on theoretical or clinical understanding of the disorder. This manuscript briefly highlights research on language and temperament in young children who stutter, and considers whether the results can provide guidance for efforts to more effectively investigate and elucidate subtypes in childhood stuttering. Issues from the literature that appear relevant to research on stuttering subtypes include: (a) the question of whether stuttering is best characterized as categorical or continuous; (b) interpretation of individual differences in skills and profiles; and (c) the fact that, during the preschool years, the interaction among domains such as language and temperament are changing very rapidly, resulting in large differences in developmental profiles within relatively brief chronological age periods. PMID:17825669

  4. Adverse Reactions to Foods and Food Allergy: Development and Reproducibility of a Questionnaire for Clinical Diagnosis

    Directory of Open Access Journals (Sweden)

    Nilza R. S. Lyra

    2013-01-01

    Full Text Available Objective. To develop a questionnaire as a screening tool for adverse reactions to foods in children and to assess the technical reproducibility by test-retest. Methods. Reproducibility of the questionnaire was performed by the literature review, preparing the preliminary questionnaire, peer review, pretest, and retest analysis. The study of the test-retest reproducibility was cross-sectional and descriptive. Kappa coefficient was used to study the reproducibility of the questionnaire. The sample consisted of 125 2–4 year-old children from 15 daycare centers in Recife, Brazil, and interviews with parents or caregivers were used to collect data. Results. From the total children, sixty-three were boys (50.4%, forty-six were two years old (36.8%, forty-seven were three years old (37.6%, and thirty-two were four years old (25.6%. Forty caregivers reported that their child had health problems with food. Most frequently reported offending foods were milk, peanuts, shrimp, and chocolate. Nine questions showed a good Kappa index (≥0,6. Conclusions. The questionnaire used needs to be resized and reshaped on the basis of the issues with good internal consistency and reproducibility. The use of a validated and reproducible questionnaire in the children represents an important contribution towards assessing an eventual rise in overt food allergy.

  5. Structure-Based Prediction of Subtype Selectivity of Histamine H3 Receptor Selective Antagonists in Clinical Trials

    DEFF Research Database (Denmark)

    Kim, Soo-Kyung; Fristrup, Peter; Abrol, Ravinder

    2011-01-01

    applications, including treatment of Alzheimer’s disease, attention deficit hyperactivity disorder (ADHD), epilepsy, and obesity.(1) However, many of these drug candidates cause undesired side effects through the cross-reactivity with other histamine receptor subtypes. In order to develop improved selectivity......–5–6 and the aliphatic ring located in TMs 2–3–7. These 3D structures for all four HRs should help guide the rational design of novel drugs for the subtype selective antagonists and agonists with reduced side effects....

  6. [Multicenter Clinical Study of Vibrant Soundbridge in Japan: Analysis of Subjective Questionnaires].

    Science.gov (United States)

    Kumakawa, Kozo; Kanzaki, Sho; Usami, Shin-ichi; Iwasaki, Satoshi; Yamanaka, Noboru; Doi, Katsumi; Naito, Yasushi; Gyo, Kiyofumi; Tono, Tetsuya; Takahashi, Haruo; Kanda, Yukihiko

    2015-11-01

    The Vibrant Soundbridge (VSB) is an active middle ear implant with the Floating Mass Transducer (FMT). We performed a multicenter study to study the efficacy of the VSB by means of "the 10 Questionnaire on Hearing 2002" and "the APHAB questionnaire" at 13 hospitals between 2011 and 2013. In all, 23 patients with mixed or conductive hearing loss received VSB implantation by the round window placement technique. These individuals were generally unable to use, or gained little from conventional hearing aids or bone conduction hearing aids. Two questionnaires were administrated before the surgery and 20 weeks after the VSB implantation. Scores on every item of "the 10 Questionnaire on Hearing 2002" showed significant improvement under noise after VSB implantation. On the APHAB, the scores for Ease of Communication, Reverberation, and Background subscales improved significantly after the VSB implantation, while the score for the Aversiveness subscale alone failed to show a positive improvement from the inexperience to the new sound. Analysis of the responses to these subjective questionnaires revealed better results after VSB implantation as compared to the preoperative data. In conclusion, RW vibroplasty with the use of VSB provided subjective benefit in patients with conductive and mixed hearing loss.

  7. The Portuguese version of the Outcome Questionnaire (OQ-45): Normative data, reliability, and clinical significance cut-offs scores.

    Science.gov (United States)

    Machado, Paulo P P; Fassnacht, Daniel B

    2015-12-01

    The Outcome Questionnaire (OQ-45) is one of the most extensively used standardized self-report instruments to monitor psychotherapy outcomes. The questionnaire is designed specifically for the assessment of change during psychotherapy treatments. Therefore, it is crucial to provide norms and clinical cut-off values for clinicians and researchers. The current study aims at providing study provides norms, reliability indices, and clinical cut-off values for the Portuguese version of the scale. Data from two large non-clinical samples (high school/university, N = 1,669; community, N = 879) and one clinical sample (n = 201) were used to investigate psychometric properties and derive normative data for all OQ-45 subscales and the total score. Significant and substantial differences were found for all subscales between the clinical and non-clinical sample. The Portuguese version also showed adequate reliabilities (internal consistency, test-retest), which were comparable to the original version. To assess individual clinical change, clinical cut-off values and reliable change indices were calculated allowing clinicians and researchers to monitor and evaluate clients' individual change. The Portuguese version of the OQ-45 is a reliable instrument with comparable Portuguese norms and cut-off scores to those from the original version. This allows clinicians and researchers to use this instrument for evaluating change and outcome in psychotherapy. This study provides norms for non-clinical and clinical Portuguese samples and investigates the reliability (internal consistency and test-retest) of the OQ-45. Cut-off values and reliable change index are provided allowing clinicians to evaluate clinical change and clients' response to treatment, monitoring the quality of mental health care services. These can be used, in routine clinical practice, as benchmarks for treatment progress and to empirically base clinical decisions such as continuation of treatment or considering

  8. The Latvian version of the Childhood Health Assessment Questionnaire (CHAQ) and the Child Health Questionnaire (CHQ).

    Science.gov (United States)

    Rumba, I; Ruperto, N; Bikis, E; Remberga, S; Saulite, I; Plotkina, N; Viksna, A; Krauca, M; Breca, I; Vikmanis, U

    2001-01-01

    We report herein the results of the cross-cultural adaptation and validation into the Latvian language of the parent's version of two health related quality of life instruments. The Childhood Health Assessment Questionnaire (CHAQ) is a disease specific health instrument that measures functional ability in daily living activities in children with juvenile idiopathic arthritis (JIA). The Child Health Questionnaire (CHQ) is a generic health instrument designed to capture the physical and psychosocial well-being of children independently from the underlying disease. The Latvian CHAQ CHQ were fully validated with 1 forward and 1 backward translations. A total of 141 subjects were enrolled: 80 patients with JIA (16% systemic onset, 32.5% polyarticular onset, 19% extended oligoarticular subtype, and 32.5% persistent oligoarticular subtype) and 61 healthy children. The CHAQ clinically discriminated between healthy subjects and JIA patients, with the systemic, polyarticular and extended oligoarticular subtypes having a higher degree of disability, pain, and a lower overall well-being when compared to their healthy peers. Also the CHQ clinically discriminated between healthy subjects and JIA patients, with the systemic onset, polyarticular onset and extended oligoarticular subtypes having a lower physical and psychosocial well-being when compared to their healthy peers. In conclusion the Latvian version of the CHAQ-CHQ is a reliable, and valid tool for the functional, physical and psychosocial assessment of children with JIA.

  9. Acute effects of outdoor air pollution on emergency department visits due to five clinical subtypes of coronary heart diseases in shanghai, china.

    Science.gov (United States)

    Xie, Juan; He, Mingzhen; Zhu, Weiying

    2014-01-01

    Air pollution can be a contributing cause to the development and exacerbation of coronary heart disease (CHD), but there is little knowledge about the acute effects of air pollution on different clinical subtypes of CHD. We conducted a time-series study to investigate the association of air pollution (particulate matter with an aerodynamic diameter emergency department (ED) visits due to five different subtypes of CHD in Shanghai, China, from 2010 to 2012. We applied an over-dispersed Poisson generalized addictive model to analyze the associations after controlling for the seasonality, day of the week, and weather conditions. We identified a total of 47 523 ED visits for CHD. A 10-µg/m(3) increase in the present-day concentrations of PM10, SO2, and NO2 was associated with respective increases of 1.10% (95% confidence interval [CI] 0.33%-1.87%), 0.90% (95% CI -0.14%-1.93%), and 1.44% (95% CI 0.63%-2.26%) for total ED visits for CHD. These associations varied greatly by clinical type, with strong effects on sudden cardiac death, moderate effects on acute myocardial infarction and angina, weak effects on ischemic cardiomyopathy, and no effect on occult CHD. The associations were stronger among people aged 65 years or more than in younger individuals and in the cool season versus the warm one. Outdoor air pollution may have different effects of air pollution on 5 subtypes of CHD. Our results might be useful for the primary prevention of various subtypes of CHD exacerbated by air pollution.

  10. [Performance of the Self-Reporting Questionnaire as a psychiatric screening questionnaire: a comparative study with Structured Clinical Interview for DSM-IV-TR].

    Science.gov (United States)

    Gonçalves, Daniel Maffasioli; Stein, Airton Tetelbon; Kapczinski, Flavio

    2008-02-01

    The SRQ (Self-Reporting Questionnaire) is a psychiatric screening tool that originally included 30 questions. The Brazilian version of SRQ-20 (a version that includes the 20 items for non-psychotic mental disorders) was validated in the early 1980s. The objective of the present study was to validate the Brazilian version of SRQ-20 and the 5 items for alcohol-related disorders as compared to the SCID-IV-TR (Structured Clinical Interview for DSM-IV-TR) as the gold standard. The study was conducted in Santa Cruz do Sul, a small town in southern Brazil, with 485 subjects (54.8% females, mean age 40.04 years). The 5 items for alcohol-related disorders showed low sensitivity (66%). The optimum cutoff value for SRQ-20 was 7/8, with 86.33% sensitivity and 89.31% specificity. The discriminant power of SRQ-20 for psychiatric screening was 0.9, and Cronbach's alpha was 0.86.

  11. Questionnaire vs clinical surveys: The right choice?-A cross-sectional comparative study

    Directory of Open Access Journals (Sweden)

    Aswini Y Balappanavar

    2011-01-01

    Conclusions: Self-assessment questionnaires were of low value in evaluating dental, periodontal health status and treatment needs in the study subjects. Findings reflect a low level of awareness that may influence care-seeking behavior and socioeconomic status has a clear role to play in dental health perception.

  12. Clinical Assessment of Affective Instability: Comparing EMA Indices, Questionnaire Reports, and Retrospective Recall

    Science.gov (United States)

    Solhan, Marika B.; Trull, Timothy J.; Jahng, Seungmin; Wood, Phillip K.

    2009-01-01

    Traditional self-report measures of psychopathology may be influenced by a variety of recall biases. Ecological momentary assessment (EMA) reduces these biases by assessing individuals' experiences as they occur in their natural environments. This study examines the discrepancy between trait questionnaire, retrospective report, and EMA measures of…

  13. Chorea as a clinical feature of the basophilic inclusion body disease subtype of fused-in-sarcoma-associated frontotemporal lobar degeneration.

    Science.gov (United States)

    Kawakami, Ito; Kobayashi, Zen; Arai, Tetsuaki; Yokota, Osamu; Nonaka, Takashi; Aoki, Naoya; Niizato, Kazuhiro; Oshima, Kenichi; Higashi, Shinji; Katsuse, Omi; Hosokawa, Masato; Hasegawa, Masato; Akiyama, Haruhiko

    2016-04-04

    Choreoathetoid involuntary movements are rarely reported in patients with frontotemporal lobar degeneration (FTLD), suggesting their exclusion as a supportive feature in clinical diagnostic criteria for FTLD. Here, we identified three cases of the behavioral variant of frontotemporal dementia (bvFTD) that display chorea with fused in sarcoma (FUS)-positive inclusions (FTLD-FUS) and the basophilic inclusion body disease (BIBD) subtype. We determined the behavioral and cognitive features in this group that were distinct from other FTLD-FUS cases. We also reviewed the clinical records of 72 FTLD cases, and clarified additional clinical features that are predictive of the BIBD pathology. Symptom onset in the three patients with chorea was at 44.0 years of age (±12.0 years), and occurred in the absence of a family history of dementia. The cases were consistent with a clinical form of FTD known as bvFTD, as well as reduced neurological muscle tone in addition to chorea. The three patients showed no or mild parkinsonism, which by contrast, increased substantially in the other FTLD cases until a later stage of disease. The three patients exhibited severe caudate atrophy, which has previously been reported as a histological feature distinguishing FTLD-FUS from FTLD-tau or FTLD-TAR DNA-binding protein 43. Thus, our findings suggest that the clinical feature of choreoathetosis in bvFTD might be associated with FTLD-FUS, and in particular, with the BIBD subtype.

  14. Shortened questionnaires to assess anxiety and depression during in-hospital rehabilitation: clinical validation and cutoff scores

    Directory of Open Access Journals (Sweden)

    Bertolotti G

    2016-10-01

    Full Text Available Giorgio Bertolotti,1 Loretta Moroni,1 Roberto Burro,2 Antonio Spanevello,3 Roberto FE Pedretti,4 Giandomenico Giorgetti5 1Psychology Unit, Salvatore Maugeri Foundation, IRCCS, Scientific Institute, Tradate, 2Department of Human Sciences – University of Verona, Verona, 3Department of Cardiology, 4Division of Pulmonary Disease, 5Department of Neuromotor Rehabilitation, Salvatore Maugeri Foundation, IRCCS, Scientific Institute of Tradate, Italy Background: A postacute phase needs reliable routine screening instruments in order to identify the patients to be referred for a clinical interview with a psychologist. The aim of this study was to estimate the clinical cutoff scores of the anxiety and depression questionnaires and their clinical validity using a gold standard. Methods: The study involved 177 patients with pulmonary, cardiac, or neurological disease undergoing in-hospital rehabilitation. Receiver operating characteristic curves were used to determine the best concordance between questionnaire’s scores and the gold standards. Results: There was a significant difference (P<0.001 between clinically anxious and depressed patients and nonclinical subjects. The receiver operating characteristic curve for anxiety indicated that the best area under the curve for State Anxiety Inventory is obtained with a cutoff point of 21 for males and 25 for females; for depression scores, the highest area under the curve for Depression Questionnaire-Reduced Form is obtained with a cutoff point of six for males and eight for females. Conclusion: Using appropriate cutoff values, the State Anxiety Inventory and Depression Questionnaire-Reduced Form allow psychologists to optimize early clinical intervention strategies selecting patients with significant needs. Keywords: anxiety, depression, questionnaire, sensitivity and specificity, rehabilitation

  15. Clinical symptoms and performance on the continuous performance test in children with attention deficit hyperactivity disorder between subtypes: a natural follow-up study for 6 months

    Directory of Open Access Journals (Sweden)

    Chiang Yuan-Lin

    2011-04-01

    Full Text Available Abstract Background The aims of this study were to determine the time course of improvements in attention deficit hyperactivity disorder (ADHD clinical symptoms and neurocognitive function in a realistic clinical setting, and the differences in ADHD symptom improvement using different classifications of ADHD subtypes. Methods The Child Behavior Checklist (CBCL was completed by parents of ADHD children at the initial visit. The computerized Continuous Performance Test (CPT, Swanson, Nolan, and Pelham, and Version IV Scale for ADHD (SNAP-IV, and ADHD Rating Scale (ADHD-RS were performed at baseline, one month, three months, and six months later, respectively. Patient care including drug therapy was performed at the discretion of the psychiatrist. The ADHD patients were divided into DSM-IV subtypes (Inattentive, Hyperactive-impulsive and Combined type, and were additionally categorized into aggressive and non-aggressive subtypes by aggression scale in CBCL for comparisons. Results There were 50 ADHD patients with a mean age of 7.84 ± 1.64 years; 15 of them were inattentive type, 11 were hyperactive-impulsive type, and 24 were combined type. In addition, 28 of the ADHD patients were grouped into aggressive and 22 into non-aggressive subtypes. There were significant improvements in clinical symptoms of hyperactivity and inattention, and impulsivity performance in CPT during the 6-month treatment. The clinical hyperactive symptoms were significantly different between ADHD patients sub-grouping both by DSM-IV and aggression. Non-aggressive patients had significantly greater changes in distraction and impulsivity performances in CPT from baseline to month 6 than aggressive patients. Conclusions We found that ADHD symptoms, which included impulsive performances in CPT and clinical inattention and hyperactivity dimensions, had improved significantly over 6 months under pragmatic treatments. The non-aggressive ADHD patients might have a higher potential

  16. Evaluating immunologic response and clinical deterioration in treatment-naïve patients initiating first-line therapies infected with HIV-1 CRF01_AE and subtype B

    Science.gov (United States)

    Oyomopito, Rebecca A.; Li, Patrick CK.; Sungkanuparph, Somnuek; Phanuphak, Praphan; Tee, Kok Keng; Sirisanthana, Thira; Kantipong, Pacharee; Oka, Shinichi; Lee, Chris KC.; Kamarulzaman, Adeeba; Choi, Jun Yong; Sohn, Annette H.; Law, Matthew; Chen, Yi-Ming A.

    2012-01-01

    Background HIV-1 group M viruses diverge 25%–35% in envelope, important for viral attachment during infection, and 10–15% in the pol region, under selection pressure from common antiretrovirals. In Asia, subtypes B and CRF01_AE are common genotypes. Our objectives were to determine whether clinical, immunologic or virologic treatment responses differed by genotype in treatment-naïve patients initiating first-line therapy. Methods Prospectively collected, longitudinal data from patients in Thailand, Hong Kong, Malaysia, Japan, Taiwan and South Korea were provided for analysis. Covariates included demographics, hepatitis B and C coinfections, baseline CD4 T lymphocyte count and plasma HIV-1 RNA levels. Clinical deterioration (a new diagnosis of CDC category B/AIDS-defining illness or death) was assessed by proportional hazards models. Surrogate endpoints were 12-month change in CD4 cell count and virologic suppression post-therapy, evaluated by linear and logistic regression, respectively. Results Of 1105 patients, 1036 (93.8%) infected with CRF01_AE or subtype B were eligible for inclusion in clinical deterioration analyses and contributed 1546.7 person-years of follow-up (median:413 days, IQR:169–672 days). Patients >40 years demonstrated smaller immunological increases (p=0.002) and higher risk of clinical deterioration (HR=2.17; p=0.008). Patients with baseline CD4 cell counts >200 cells/μL had lower risk of clinical deterioration (HR=0.373; p=0.003). A total of 532 patients (48.1% of eligible) had CD4 counts available at baseline and 12 months post-therapy for inclusion in immunolgic analyses. Patients infected with subtype B had larger increases in CD4 counts at 12 months (p=0.024). A total of 530 patients (48.0% of eligible) were included in virologic analyses with no differences in response found between genotypes. Conclusions Results suggest that patients infected with CRF01_AE have reduced immunologic response to therapy at 12 months, compared to

  17. Clinical Characteristics of Adults with Asperger's Syndrome Assessed with Self-Report Questionnaires

    Science.gov (United States)

    Kanai, Chieko; Iwanami, Akira; Ota, Haruhisa; Yamasue, Hidenori; Matsushima, Eisuke; Yokoi, Hideki; Shinohara, Kazuyuki; Kato, Nobumasa

    2011-01-01

    Diagnosis of Asperger's Syndrome (AS) in adults is difficult, and clinical sample-based studies that systematically illustrate the clinical characteristics of adult AS patients are needed so that appropriate treatment can be provided. Here we examined the clinical characteristics of AS in 112 adults (median age, 28.0 years [range, 18-52]; 71 men…

  18. A questionnaire study regarding local anesthesia in dentistry and safety measures in dental clinics among dental students

    OpenAIRE

    オオケ, ハナコ; クドウ, マサル; シンヤ, ノボル; Hanako, OHKE; Masaru, KUDO; Noboru, SHINYA

    2005-01-01

    This reports the results of a questionnaire study of dental students on the awareness of "local anesthesia" and "use of patient monitoring systems" in dental clinics. Subjects participated in the present study included 96 sixth year dental students (D6) and 93 first year dental students (D1). The results indicate that the majority of respondents including both D6 and D1 support the notion that a "dentist" is the most suitable person to perform local anesthesia in dental treatment. With respec...

  19. MDM2 and HIF1alpha expression levels in different histologic subtypes of malignant pleural mesothelioma: correlation with pathological and clinical data.

    Science.gov (United States)

    Pasello, Giulia; Urso, Loredana; Mencoboni, Manlio; Grosso, Federica; Ceresoli, Giovanni Luca; Lunardi, Francesca; Vuljan, Stefania Edith; Bertorelle, Roberta; Sacchetto, Valeria; Ciminale, Vincenzo; Rea, Federico; Favaretto, Adolfo; Conte, PierFranco; Calabrese, Fiorella

    2015-12-08

    Malignant pleural mesothelioma (MPM) is an aggressive tumor with poor prognosis and limited treatment options. Sarcomatoid/biphasic mesotheliomas are characterized by more aggressive behaviour and a poorer prognosis compared with the epithelioid subtype. To date prognostic and tailored therapeutic biomarkers are lacking. The present study analyzed the expression levels of MDM2 and HIF1alpha in different histologic subtypes from chemonaive MPM patients. Diagnostic biopsies of MPM patients from four Italian cancer centers were centrally collected and analyzed. MDM2 and HIF1alpha expression levels were investigated through immunohistochemistry and RT-qPCR. Pathological assessment of necrosis, inflammation and proliferation index was also performed. Molecular markers, pathological features and clinical characteristics were correlated to overall survival (OS) and progression free survival (PFS). Sixty MPM patients were included in the study (32 epithelioid and 28 non-epithelioid). Higher levels of MDM2 (p sarcomatoid/biphasic subtypes. Higher levels of inflammation were significantly associated with epithelioid subtype (p = 0.044). MDM2 expression levels were correlated with HIF1alpha levels (p = 0.0001), necrosis (p = 0.008) and proliferation index (p = 0.009). Univariate analysis showed a significant correlation of non-epithelioid histology (p = 0.04), high levels of necrosis (p = 0.037) and proliferation index (p = 0.0002) with shorter PFS. Sarcomatoid/biphasic and epithelioid mesotheliomas showed different MDM2 and HIF1alpha expression levels and were characterized by different levels of necrosis, proliferation and inflammation. Further studies are warranted to confirm a prognostic and predictive role of such markers and features.

  20. MDM2 and HIF1alpha expression levels in different histologic subtypes of malignant pleural mesothelioma: correlation with pathological and clinical data

    Science.gov (United States)

    Mencoboni, Manlio; Grosso, Federica; Ceresoli, Giovanni Luca; Lunardi, Francesca; Vuljan, Stefania Edith; Bertorelle, Roberta; Sacchetto, Valeria; Ciminale, Vincenzo; Rea, Federico; Favaretto, Adolfo; Conte, PierFranco; Calabrese, Fiorella

    2015-01-01

    Malignant pleural mesothelioma (MPM) is an aggressive tumor with poor prognosis and limited treatment options. Sarcomatoid/biphasic mesotheliomas are characterized by more aggressive behaviour and a poorer prognosis compared with the epithelioid subtype. To date prognostic and tailored therapeutic biomarkers are lacking. The present study analyzed the expression levels of MDM2 and HIF1alpha in different histologic subtypes from chemonaive MPM patients. Diagnostic biopsies of MPM patients from four Italian cancer centers were centrally collected and analyzed. MDM2 and HIF1alpha expression levels were investigated through immunohistochemistry and RT-qPCR. Pathological assessment of necrosis, inflammation and proliferation index was also performed. Molecular markers, pathological features and clinical characteristics were correlated to overall survival (OS) and progression free survival (PFS). Sixty MPM patients were included in the study (32 epithelioid and 28 non-epithelioid). Higher levels of MDM2 (p < 0.001), HIF1alpha (p = 0.013), necrosis (p = 0.013) and proliferation index (p < 0.001) were seen mainly in sarcomatoid/biphasic subtypes. Higher levels of inflammation were significantly associated with epithelioid subtype (p = 0.044). MDM2 expression levels were correlated with HIF1alpha levels (p = 0.0001), necrosis (p = 0.008) and proliferation index (p = 0.009). Univariate analysis showed a significant correlation of non-epithelioid histology (p = 0.04), high levels of necrosis (p = 0.037) and proliferation index (p = 0.0002) with shorter PFS. Sarcomatoid/biphasic and epithelioid mesotheliomas showed different MDM2 and HIF1alpha expression levels and were characterized by different levels of necrosis, proliferation and inflammation. Further studies are warranted to confirm a prognostic and predictive role of such markers and features. PMID:26544728

  1. Structure-Based Prediction of Subtype Selectivity of Histamine H3 Receptor Selective Antagonists in Clinical Trials

    DEFF Research Database (Denmark)

    Kim, Soo-Kyung; Fristrup, Peter; Abrol, Ravinder

    2011-01-01

    applications, including treatment of Alzheimer’s disease, attention deficit hyperactivity disorder (ADHD), epilepsy, and obesity.(1) However, many of these drug candidates cause undesired side effects through the cross-reactivity with other histamine receptor subtypes. In order to develop improved selectivity...... and antagonists. We find that E2065.46 contributes most in binding H3 selective agonists (5, 6, 7) in agreement with experimental mutation studies. We also find that conserved E5.46/S5.43 in both of hH3HR and hH4HR are involved in H3/ H4 subtype selectivity. In addition, we find that M3786.55 in hH3HR provides...

  2. Associations between body mass index and molecular subtypes as well as other clinical characteristics of breast cancer in Chinese women.

    Science.gov (United States)

    Chen, Fei-Yu; Ou, Hui-Ying; Wang, Shou-Man; Wu, Yu-Hui; Yan, Guo-Jiao; Tang, Li-Li

    2013-01-01

    Several studies have shown a positive association between body mass index (BMI) and the development of hormone receptor-positive breast cancer in postmenopausal women; however, the associations between BMI groups and molecular subtypes have yet to be well defined in premenopausal breast cancer patients. A total of 2465 female breast cancer patients diagnosed at our institution were recruited for this study. Clinicopathologic information (including age, body height and weight, as well as tumor subtypes and stages) was collected; analyses of these characteristics and the associations between them were performed. A total of 1951 cases were included in the study. The mean age was 47.3 years, the majority of patients were of normal weight, premenopausal, had stage 2 cancer, and did not present with positive nodes. The prevalence of the luminal A, luminal B, human epidermal growth factor receptor 2+, and triple-negative subtypes were 57.8%, 11.6%, 6.1%, and 24.5%, respectively. There were significant differences in the clinicopathologic features among BMI groups in premenopausal patients. The case-only odds ratio (OR) analysis revealed that normal weight patients tended to have luminal B cancer (OR = 1.4, P = 0.206), and overweight and obese patients tended to have triple-negative cancer in premenopausal patients (OR = 2.8, OR = 3.7, respectively; P < 0.001). IN CHINESE WOMEN, BREAST CANCER CAME WITH THESE CHARACTERISTICS: young mean age (premenopause), luminal A subtype, and the majority of them were within a normal weight range. In premenopausal patients, underweight patients tended to have luminal A, lower human epidermal growth factor receptor 2+ expression, stage 1 and no positive node cancer. However, overweight and obese patients tended to have a triple-negative, stage 3, and lymph node metastatic cancer.

  3. Associations between body mass index and molecular subtypes as well as other clinical characteristics of breast cancer in Chinese women

    Directory of Open Access Journals (Sweden)

    Chen FY

    2013-03-01

    Full Text Available Fei-Yu Chen, Hui-Ying Ou, Shou-Man Wang, Yu-Hui Wu, Guo-Jiao Yan, Li-Li Tang Department of Breast Surgery, Xiangya Hospital, Central South University, Changsha City, Hunan Province, People's Republic of China Background: Several studies have shown a positive association between body mass index (BMI and the development of hormone receptor-positive breast cancer in postmenopausal women; however, the associations between BMI groups and molecular subtypes have yet to be well defined in premenopausal breast cancer patients. Methods: A total of 2465 female breast cancer patients diagnosed at our institution were recruited for this study. Clinicopathologic information (including age, body height and weight, as well as tumor subtypes and stages was collected; analyses of these characteristics and the associations between them were performed. Results: A total of 1951 cases were included in the study. The mean age was 47.3 years, the majority of patients were of normal weight, premenopausal, had stage 2 cancer, and did not present with positive nodes. The prevalence of the luminal A, luminal B, human epidermal growth factor receptor 2+, and triple-negative subtypes were 57.8%, 11.6%, 6.1%, and 24.5%, respectively. There were significant differences in the clinicopathologic features among BMI groups in premenopausal patients. The case-only odds ratio (OR analysis revealed that normal weight patients tended to have luminal B cancer (OR = 1.4, P = 0.206, and overweight and obese patients tended to have triple-negative cancer in premenopausal patients (OR = 2.8, OR = 3.7, respectively; P < 0.001. Conclusion: In Chinese women, breast cancer came with these characteristics: young mean age (premenopause, luminal A subtype, and the majority of them were within a normal weight range. In premenopausal patients, underweight patients tended to have luminal A, lower human epidermal growth factor receptor 2+ expression, stage 1 and no positive node cancer. However

  4. Prognoses of MDS subtypes RARS, RCMD and RCMD-RS are comparable but cytogenetics separates a subgroup with inferior clinical course.

    Science.gov (United States)

    Bacher, Ulrike; Kern, Wolfgang; Alpermann, Tamara; Schnittger, Susanne; Haferlach, Claudia; Haferlach, Torsten

    2012-07-01

    In 2008, the WHO combined the former categories RCMD (refractory cytopenia with multilineage dysplasia) and RCMD-RS (ring sideroblasts ≥ 15%). We studied the clinical impact and genetic background of RARS, RCMD, and RCMD-RS in 1082 patients. Good karyotypes (IPSS) were similarly frequent in RARS, RCMD, and RCMD-RS. 2-year overall survival (OS) rates were similar in RARS, RCMD, and RCMD-RS (85.9%/89.0%/91.7%; n.s.). The 2-year OS rate was better in good than intermediate or poor karyotypes (pcytogenetic criteria for these MDS subtypes.

  5. Assessing the quality of clinical teachers: a systematic review of content and quality of questionnaires for assessing clinical teachers.

    NARCIS (Netherlands)

    Fluit, C.R.M.G.; Bolhuis, S.; Grol, R.P.T.M.; Laan, R.F.J.M.; Wensing, M.J.P.

    2010-01-01

    BACKGROUND: Learning in a clinical environment differs from formal educational settings and provides specific challenges for clinicians who are teachers. Instruments that reflect these challenges are needed to identify the strengths and weaknesses of clinical teachers. OBJECTIVE: To systematically r

  6. The Reflux Disease Questionnaire: a measure for assessment of treatment response in clinical trials

    Directory of Open Access Journals (Sweden)

    Junghard Ola

    2008-04-01

    Full Text Available Abstract Background Critical needs for treatment trials in gastroesophageal reflux disease (GERD include assessing response to treatment, evaluating symptom severity, and translation of symptom questionnaires into multiple languages. We evaluated the previously validated Reflux Disease Questionnaire (RDQ for internal consistency, reliability, responsiveness to change during treatment and the concordance between RDQ and specialty physician assessment of symptom severity, after translation into Swedish and Norwegian. Methods Performance of the RDQ after translation into Swedish and Norwegian was evaluated in 439 patients with presumed GERD in a randomized, double-blind trial of active treatment with a proton pump inhibitor. Results The responsiveness was excellent across three RDQ indicators. Mean change scores in patients on active treatment were large, also reflected in effect sizes that ranged from a low of 1.05 (dyspepsia to a high of 2.05 (heartburn and standardized response means 0.99 (dyspepsia and 1.52 (heartburn. A good positive correlation between physician severity ratings and RDQ scale scores was seen. The internal consistency reliability using alpha coefficients of the scales, regardless of language, ranged from 0.67 to 0.89. Conclusion The results provide strong evidence that the RDQ is amenable to translation and represents a viable instrument for assessing response to treatment, and symptom severity.

  7. Validation of the Marijuana Effect Expectancies Questionnaire (MEEQ in a Non-Clinical French-Speaking Adolescent Sample

    Directory of Open Access Journals (Sweden)

    Emilie Schmits

    2016-02-01

    Full Text Available Teenagers commonly use cannabis. Expectancies related to the effects of cannabis play an important role in its consumption and are frequently measured with the Marijuana Effect Expectancies Questionnaire (MEEQ. This study aims to assess the psychometric properties (factor structure, internal consistency reliability, criterion validity of the French MEEQ. A sample of 1,343 non-clinical teenagers (14–18 years were recruited to answer a self-report questionnaire; 877 of them responded twice (one-year interval. A four-factor structure was obtained: Cognitive Impairment and Negative, Relaxation and Social Facilitation, Perceptual Enhancement and Craving and Negative Behavioral Effect Expectancies. It is concluded that the French MEEQ constitutes an appropriate tool to measure cannabis effect expectancies among adolescents.

  8. The Attachment and Clinical Issues Questionnaire: a new methodology for science and practice in criminology and forensics.

    Science.gov (United States)

    Lindberg, Marc A; Fugett, April; Lounder, Lindsay

    2014-10-01

    Most modern theories suggest that interpersonal relationships are of central importance in the development of criminal behavior. We tested the parent attachment scales of a new research and clinical measure, the Attachment and Clinical Issues Questionnaire (ACIQ). It is a 29-scale battery assessing attachments to mother, father, partner, and peers, which also includes several related clinical scales. Sixty-one (18-20 years of age) male offenders from a maximum security detention center and 131 contrasts completed the ACIQ. ANOVA demonstrated that mother and father attachments displayed different patterns. The attachment scales also predicted the numbers of crimes within the population of juvenile offenders. Thus, the parent attachment scales of the ACIQ showed promise as an instrument to test dynamic systems approaches to developmental models of criminal behavior.

  9. Has the internet overtaken other traditional sources of health information? Questionnaire survey of patients attending ENT outpatient clinics.

    Science.gov (United States)

    Rokade, A; Kapoor, P K D; Rao, S; Rokade, V; Reddy, K T V; Kumar, B N

    2002-12-01

    The aim of this study was to find out whether patients attending ENT clinics obtain health information about their medical condition and to assess satisfaction with the sources of health information, including the internet. Three hundred and thirty patients attending ENT outpatient clinics at District General Hospitals in Wigan and Warrington during June 2001 were asked to complete detailed questionnaires. Fifty-seven per cent of patients attempted to obtain health information before their visit to the specialist clinic. Forty-five per cent of patients had access to the internet, but only 13% used it to obtain health information. General practitioners were the source of health information for 64%, but the NHS-Direct help line was only used by 16%. Patients also trusted the health information provided by their GPs the most. In the twenty-first century, patients turn to their GP as the main source of health information.

  10. Development of the clinical learning evaluation questionnaire for undergraduate clinical education: Factor structure, validity, and reliability study

    NARCIS (Netherlands)

    A.I. Alhaqwi (Ali I); J. Kuntze (Jeroen); H.T. van der Molen (Henk)

    2014-01-01

    textabstractBackground: Teaching and learning of clinical skills for undergraduate medical students usually takes place during the clinical clerkship. Therefore, it is of vital importance to ensure the effectiveness of the rotations within this clerkship. The aims of this study were to develop an in

  11. Refining Video Game Use Questionnaires for Research and Clinical Application: Detection of Problematic Response Sets

    Science.gov (United States)

    Faust, Kyle A.; Faust, David; Baker, Aaron M.; Meyer, Joseph F.

    2012-01-01

    Even when relatively infrequent, deviant response sets, such as defensive and careless responding, can have remarkably robust effects on individual and group data and thereby distort clinical evaluations and research outcomes. Given such potential adverse impacts and the widespread use of self-report measures when appraising addictions and…

  12. Doctors who considered but did not pursue specific clinical specialties as careers: questionnaire surveys.

    Science.gov (United States)

    Goldacre, Michael J; Goldacre, Raph; Lambert, Trevor W

    2012-04-01

    To report doctors' rejection of specialties as long-term careers and reasons for rejection. Postal questionnaires. United Kingdom. Graduates of 2002, 2005 and 2008 from all UK medical schools, surveyed one year after qualification. Current specialty choice; any choice that had been seriously considered but not pursued (termed 'rejected' choices) with reasons for rejection. 2573 of 9155 respondents (28%) had seriously considered but then not pursued a specialty choice. By comparison with positive choices, general practice was under-represented among rejected choices: it was the actual choice of 27% of respondents and the rejected choice of only 6% of those who had rejected a specialty. Consideration of 'job content' was important in not pursuing general practice (cited by 78% of those who considered but rejected a career in general practice), psychiatry (72%), radiology (69%) and pathology (68%). The surgical specialties were the current choice of 20% of respondents and had been considered but rejected by 32% of doctors who rejected a specialty. Issues of work-life balance were the single most common factor, particularly for women, in not pursuing the surgical specialties, emergency medicine, the medical hospital specialties, paediatrics, and obstetrics and gynaecology. Competition for posts, difficult examinations, stressful working conditions, and poor training were mentioned but were mainly minority concerns. There is considerable diversity between doctors in their reasons for finding specialties attractive or unattractive. This underlines the importance of recruitment strategies to medical school that recognize diversity of students' interests and aptitudes.

  13. [Prevalence and clinical characteristics of the IBS subtypes according to the Rome III criteria in patients from a clinical, multicentric trial. A report from the Mexican IBS Working Group].

    Science.gov (United States)

    Schmulson, M; Vargas, J A; López-Colombo, A; Remes-Troche, J M; López-Alvarenga, J C

    2010-01-01

    In Mexico the prevalence of irritable bowel síndrome (IBS) using Rome II criteria varies between 16 and 35%. To analyze the relative frequency of the IBS subtypes according to the Rome III criteria. A multicentric study in 1677 IBS-Rome III patients that consulted private medical clinics. They all answered a structured interview by their physicians to determine the IBS subtype and to evaluate their symptoms intensity (Likert Scales). Patients self-evaluated their symptoms as well by using 10 cm visual analog scales for each one. Women represented 76.8% of the patients for a F:M ratio of 3.3:1. The relative frequencies of the IBS subtypes were IBS-M: 48.4%, IBS-E: 43.0%, IBS-D: 5.6% and IBS-U: 2.8% with females predominating among all. However, IBS-D included 1.7 to 2.4 times more men than any of the other subtypes. The IBS-M reported a higher frequency and intensity of halitosis and vomiting and a higher intensity of burping; while those with IBS-E reported a higher frequency and intensity of straining and the IBS-D more urgency for a bowel movement, fecal incontinence and mucous in the stools. In IBS-Rome III patients in Mexico, IBS-M is the most common subtype and is more commonly associated with dyspeptic symptoms while the IBS-E reported more outlet symptoms and the IBS-D fecal incontinence. There is a higher female predominance amongst all, however men are more likely to be in IBS-D.

  14. The Mexican version of the Childhood Health Assessment Questionnaire (CHAQ) and the Child Health Questionnaire (CHQ).

    Science.gov (United States)

    Duarte, C; Ruperto, N; Goycochea, M V; Maldonado, R; Beristain, R; De Inocencio, J; Burgos-Vargas, R

    2001-01-01

    We report herein the results of the cross-cultural adaptation and validation into the Mexican language of the parent's version of two health related quality of life instruments. The Childhood Health Assessment Questionnaire (CHAQ) is a disease specific health instrument that measures functional ability in daily living activities in children with juvenile idiopathic arthritis (JIA). The Child Health Questionnaire (CHQ) is a generic health instrument designed to capture the physical and psychosocial well-being of children independently from the underlying disease. The Mexican CHAQ was already published and therefore it was revalidated while the Mexican CHQ was derived from the European Spanish version with changing of the few words whose use is different in the 2 countries. A total of 182 subjects were enrolled: 89 patients with JIA (26% systemic onset, 47% polyarticular onset, 13.5% extended oligoarticular subtype, and 13.5% persistent oligoarticular subtype) and 93 healthy children. The CHAQ clinically discriminated between healthy subjects and JIA patients, with the systemic onset, and polyarticular onset subtypes having a higher degree of disability, pain, and a lower overall well-being when compared to their healthy peers. Also the CHQ clinically discriminated between healthy subjects and JIA patients, with the systemic onset, and polyarticular onset having a lower physical and psychosocial well-being when compared to their healthy peers. In conclusion the Mexican version of the CHAQ-CHQ is a reliable, and valid tool for the functional, physical and psychosocial assessment of children with JIA.

  15. A First Look at the Structured Clinical Interview for "DSM-IV" Personality Disorders Screening Questionnaire: More Than Just a Screener?

    Science.gov (United States)

    Piedmont, Ralph L.; Sherman, Martin F.; Sherman, Nancy C.; Williams, Joseph E. G.

    2003-01-01

    This study examined the psychometrics of the Structured Clinical Interview for DSM-IV Personality Disorders Personality Questionnaire (SCID-IIP) self-report personality questionnaire. The responses to the instrument were found reliable and evidenced good self-other convergence. Correlations with external criteria showed the SCID-IIP to contain…

  16. An imprinted non-coding genomic cluster at 14q32 defines clinically relevant molecular subtypes in osteosarcoma across multiple independent datasets.

    Science.gov (United States)

    Hill, Katherine E; Kelly, Andrew D; Kuijjer, Marieke L; Barry, William; Rattani, Ahmed; Garbutt, Cassandra C; Kissick, Haydn; Janeway, Katherine; Perez-Atayde, Antonio; Goldsmith, Jeffrey; Gebhardt, Mark C; Arredouani, Mohamed S; Cote, Greg; Hornicek, Francis; Choy, Edwin; Duan, Zhenfeng; Quackenbush, John; Haibe-Kains, Benjamin; Spentzos, Dimitrios

    2017-05-15

    A microRNA (miRNA) collection on the imprinted 14q32 MEG3 region has been associated with outcome in osteosarcoma. We assessed the clinical utility of this miRNA set and their association with methylation status. We integrated coding and non-coding RNA data from three independent annotated clinical osteosarcoma cohorts (n = 65, n = 27, and n = 25) and miRNA and methylation data from one in vitro (19 cell lines) and one clinical (NCI Therapeutically Applicable Research to Generate Effective Treatments (TARGET) osteosarcoma dataset, n = 80) dataset. We used time-dependent receiver operating characteristic (tdROC) analysis to evaluate the clinical value of candidate miRNA profiles and machine learning approaches to compare the coding and non-coding transcriptional programs of high- and low-risk osteosarcoma tumors and high- versus low-aggressiveness cell lines. In the cell line and TARGET datasets, we also studied the methylation patterns of the MEG3 imprinting control region on 14q32 and their association with miRNA expression and tumor aggressiveness. In the tdROC analysis, miRNA sets on 14q32 showed strong discriminatory power for recurrence and survival in the three clinical datasets. High- or low-risk tumor classification was robust to using different microRNA sets or classification methods. Machine learning approaches showed that genome-wide miRNA profiles and miRNA regulatory networks were quite different between the two outcome groups and mRNA profiles categorized the samples in a manner concordant with the miRNAs, suggesting potential molecular subtypes. Further, miRNA expression patterns were reproducible in comparing high-aggressiveness versus low-aggressiveness cell lines. Methylation patterns in the MEG3 differentially methylated region (DMR) also distinguished high-aggressiveness from low-aggressiveness cell lines and were associated with expression of several 14q32 miRNAs in both the cell lines and the large TARGET clinical dataset

  17. THE RUSSIAN VERSION OF THE CHILDHOOD HEALTH ASSESSMENT QUESTIONNAIRES(CHAQ AND THE CHILD HEALTH QUESTIONNAIRES (CAQ

    Directory of Open Access Journals (Sweden)

    N N Kuzmina

    2002-01-01

    Full Text Available We report herein the results of the cross-cultural adaptation and validation into the Russian language of the parent’s version of two health related quality of life instruments. The Childhood Health Assessment Questionnaire (CHAQ is a disease specific health instrument that measures functional ability in daily living activities in children with juvenile chronic arthritis (JCA. The Child Health Questionnaire (CHQ is a generic health instrument designed to capture the physical and psychosocial well-being of children independently from the underlying disease. The Russian CHAQ-CHQ were fully validated with 3 forward and 3 backward translations. A total of 146 subjects were enrolled: 86 patients with JCA (23% systemic onset, 39% polyarticular onset, 15% extended oligoarlicular subtype, and 23% persistent oligoarticular subtype and 60 healthy children. The CHAQ clinically discriminated between healthy subjects and JCA patients, with the systemic, polyarticular and extended oligoarticular subtypes having a higher degree of disability, pain, and a lower overall wellbeing when compared to their healthy peers. Also the CHQ clinically discriminated between healthy subjects and JCA patients, with the systemic onset, polyarticular onset and extended oligoarticular subtypes having a lower physical and psychosocial well-being when compared to their healthy peers. In conclusion the Russian version of the CHAQ-CHQ is a reliable, and valid tool for the functional, physical and psychosocial assessment of children with JCA.

  18. Intravenous Laser Blood Irradiation Increases Efficacy of Etanercept in Selected Subtypes of Juvenile Idiopathic Arthritis: An Innovative Clinical Research Approach

    Directory of Open Access Journals (Sweden)

    Dragos Andrei Chiran

    2013-01-01

    Full Text Available This single-blind, placebo-controlled study assesses the efficacy of synergic administration of intravenous laser blood irradiation (ILBI and etanercept in selected subtypes of juvenile idiopathic arthritis (JIA. Etanercept is a tumor necrosis factor alpha blocking agent with recognized importance in JIA. Laser radiation has immunomodulatory effects in animal and human studies. Fourteen patients (Group I received ILBI and 9 patients (Group II received placebo laser. ILBI was performed in addition to ongoing JIA medication, including etanercept. ILBI was administrated in 3 sets of 5 consecutive daily sessions, with a 7-week interval between every set of sessions. Evaluation was performed using ACR (American College of Rheumatology Pediatric Criteria (ACR Pedi at study enrollment and at 10 and 20 weeks, respectively. After 10 weeks, 85.7% of the patients in Group I fulfilled Pedi 30 criteria, compared to only 55.6% of the patients in Group II. After 20 weeks, all patients in both groups had a Pedi 30 response. In Group I, 92.8% of the subjects met the Pedi 50 response, compared to only 55.6% in the placebo group. One patient in Group I responded best, fulfilling Pedi 70 criteria. If applied synergistically, ILBI and etanercept would have an increased efficacy in promoting JIA remission.

  19. Analysis of Prevalence and Clinical Features of Ameloblastoma and its Histopathological Subtypes in Southeast Myanmar and Lower Northern Thailand Populations: A 13-Year Retrospective Study

    Science.gov (United States)

    2017-01-01

    Introduction Prevalence of ameloblastomas has been established worldwide but collective data of ameloblastoma in Southeast Asian countries has not been well analyzed. Aim Aim of this study was to report analysis and comparison of the prevalence and demographic data of clinical features of ameloblastoma and its histopathological variants in Southeast Myanmar and lower Northern Thailand populations. Materials and Methods A retrospective study on ameloblastoma was performed based on the availability of oral biopsy specimens in Faculty of Dentistry, Naresuan University, Phitsanulok, Thailand, between January 2002 and August 2015. The collected data were subjected to descriptive statistical analyses with the SPSS version 17.0 statistical software package (SPSS Inc., Chicago, USA). Pearson’s chi square (χ2) test and t-test were employed. The critical level of significance was set at pameloblastoma with male:female ratio of 1.14:1. The mean age of the patients was 31.3±15.6 years. The predominance anatomical distribution was observed in the mandible (86.7%). Posterior body-ramus-angle region was the most common site. Almost all cases were asyptomatic and most common clinical manifestation was swelling of affected region. Multilocular radiolucency was observed in 70% of cases, whereas 30% were unilocular. Three subtypes of ameloblastomas were diagnosed: unicystic ameloblastoma (20%), conventional solid/multicystic ameloblastoma (70%), and desmoplastic ameloblastoma (10%). The most common histologic pattern was the plexiform type (57.2%) followed by follicular type (23.8%). Conclusion Prevalence of ameloblastoma in Southeast Myanmar and lower Northern Thailand populations correspond with data from other geographic areas of Thailand and other Asian countries. However, some demographic and histopathological profiles are different, with plexiform ameloblastoma being the most common subtype in this study. PMID:28274056

  20. Subtype-independent near full-length HIV-1 genome sequencing and assembly to be used in large molecular epidemiological studies and clinical management

    Directory of Open Access Journals (Sweden)

    Sebastian Grossmann

    2015-06-01

    Full Text Available Introduction: HIV-1 near full-length genome (HIV-NFLG sequencing from plasma is an attractive multidimensional tool to apply in large-scale population-based molecular epidemiological studies. It also enables genotypic resistance testing (GRT for all drug target sites allowing effective intervention strategies for control and prevention in high-risk population groups. Thus, the main objective of this study was to develop a simplified subtype-independent, cost- and labour-efficient HIV-NFLG protocol that can be used in clinical management as well as in molecular epidemiological studies. Methods: Plasma samples (n=30 were obtained from HIV-1B (n=10, HIV-1C (n=10, CRF01_AE (n=5 and CRF01_AG (n=5 infected individuals with minimum viral load >1120 copies/ml. The amplification was performed with two large amplicons of 5.5 kb and 3.7 kb, sequenced with 17 primers to obtain HIV-NFLG. GRT was validated against ViroSeqTM HIV-1 Genotyping System. Results: After excluding four plasma samples with low-quality RNA, a total of 26 samples were attempted. Among them, NFLG was obtained from 24 (92% samples with the lowest viral load being 3000 copies/ml. High (>99% concordance was observed between HIV-NFLG and ViroSeqTM when determining the drug resistance mutations (DRMs. The N384I connection mutation was additionally detected by NFLG in two samples. Conclusions: Our high efficiency subtype-independent HIV-NFLG is a simple and promising approach to be used in large-scale molecular epidemiological studies. It will facilitate the understanding of the HIV-1 pandemic population dynamics and outline effective intervention strategies. Furthermore, it can potentially be applicable in clinical management of drug resistance by evaluating DRMs against all available antiretrovirals in a single assay.

  1. Personality and clinical features analysis in children with different subtypes of attention deficit hyperactivity disorder%注意缺陷多动障碍患儿的个性及各亚型临床特点分析

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    段桂琴; 姚梅玲; 靳彦琴; 陈社菊

    2013-01-01

    目的:探讨注意缺陷多动障碍(ADHD)儿童不同亚型的个性和注意力缺陷多动的临床特征.方法:采用视听整合持续操作测验(IVA-CPT)和艾森克个性问卷(EPQ)对278例ADHD儿童的3个亚型(ADHD-Ⅰ、ADHD-HI和ADHD-C)进行个性特征和注意力缺陷多动特征分析.结果:ADHD患儿N维度量表T分在3个亚型间差异有统计学意义(P<0.05),ADHD-C型患儿得分高于ADHD-Ⅰ型.个性构成分析发现,ADHD-C型患儿情绪不稳定的个性构成人数大于ADHD-Ⅰ型和ADHD-HI型,差异有统计学意义(P<0.05).ADHD-C型的综合控制力商数、综合注意力商数、听觉和视觉注意力商数、听觉和视觉谨慎商数、听觉一致性商数、听觉注意集中商数、听觉和视觉警醒商数、视觉毅力商数与ADHD-Ⅰ型和/或ADHD-HI型比较其差异均有统计学意义(P<0.05).结论:ADHD-C型患儿情绪不稳定、敏感多疑、缺乏自尊自信的个性特征明显,并存在反应控制力和持续性注意力的损害,应根据不同亚型患儿的临床特点制定更有针对性的心理治疗方案.%Objective:To investigate personality and attention hyperactivity clinical features in children with different clinical subtypes of attention deficit hyperactivity disorder (ADHD).Methods:A total of 278 children with different clinical subtypes of ADHD children (ADHD-Ⅰ,ADHD-HI and ADHD-C) were analyzed for personality traits and inattention hyperactivity clinical features by using Integrated Visual and Auditory Continuous Performance Test (IVA-CPT) and Eysenck Personality Questionnaire (EPQ).Results:There was a statistically significant difference in dimension scale T points for 3 subtypes ADHD children (P < 0.05),children of ADHD-C score was higher than that of ADHD-Ⅰ.The proportion of instability in ADHD-C children was higher than that of ADHD-Ⅰ and ADHD-HI,respectively (P < 0.01,P < 0.05).There were significant differences in Full Scale Response Quotient

  2. Association of HLA-A*02:06 and HLA-DRB1*04:05 with clinical subtypes of juvenile idiopathic arthritis.

    Science.gov (United States)

    Yanagimachi, Masakatsu; Miyamae, Takako; Naruto, Takuya; Hara, Takuma; Kikuchi, Masako; Hara, Ryoki; Imagawa, Tomoyuki; Mori, Masaaki; Kaneko, Tetsuji; Goto, Hiroaki; Morita, Satoshi; Mizuki, Nobuhisa; Kimura, Akinori; Yokota, Shumpei

    2011-03-01

    Juvenile idiopathic arthritis (JIA) is one of the most common forms of pediatric chronic arthritis. JIA is a clinically heterogeneous disease. Therefore, the genetic background of JIA may also be heterogeneous. The aim of this study was to investigate associations between human leukocyte antigen (HLA) and susceptibility to JIA and/or uveitis, which is one of the most devastating complications of JIA. A total of 106 Japanese articular JIA patients (67 with polyarthritis and 39 with oligoarthritis) and 678 healthy controls were genotyped for HLA-A, -B and -DRB1 by PCR-sequence-specific oligonucleotide probe methodology. HLA-A(*)02:06 was the risk factor for JIA accompanied by uveitis after adjustment for clinical factors (corrected P-value < 0.001, odds ratio (OR) 11.7, 95% confidence interval (CI) 3.2-43.0). On the other hand, HLA-DRB1(*)04:05 was associated with polyarticular JIA (corrected P-value < 0.001, OR 2.9, 95% CI 1.7-4.8). We found an association of HLA-A(*)02:06 with susceptibility to JIA accompanied by uveitis, which might be considered a separate clinical JIA entity. We also found an association between HLA-DRB1(*)04:05 and polyarticular JIA. Thus, clinical subtypes of JIA can be classified by the presence of the specific HLA alleles, HLA-A(*)02:06 and DRB1(*)04:05.

  3. Evaluation of a Clinical Decision Support System for Dyslipidemia Treatment (HTE-DLPR by QoE questionnaire

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    Alberto Zamora

    2017-01-01

    Full Text Available Introduction: Clinical decision support systems (CDSS are computer systems designed to assist clinicians with patient-related decision making, such as diagnosis and treatment. CDSS have shown to improve both patient outcomes and cost of care.Methods: A multi-center observational prospective study was conducted. Ten physicians agreed to participate. Seventy-seven patients with high or very high cardiovascular risk were included. After using CDSS for dyslipidemia (HTE-DLPR for a 3 months period, participants were asked to evaluate their experience with HTE-DLPR using a quality of experience questionnaire (QoE tool for mHealth applications.Results: Total score on the QoE was 3.89 out of 5. The highest scores were received for precision, ease of use and content quality. The lowest scores were given to security, appearance and performance. Physicians were in strong agreement with the 1st HTEDLPR recommendation in 86.1% and the system’s use was described as comfortablein 85% of cases. Users positively evaluated the development of a new version of HTEDLPR in the future receiving a total score of 4.25 out of 5.Conclusions: A CDSS for dyslipidemia (HTE-DLP has been positively evaluated by physicians using QoE questionnaire.

  4. Clinical questionnaire study of oral health care and symptoms in diabetic vs. non-diabetic predialysis chronic kidney disease patients.

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    Vesterinen, Maarit; Ruokonen, Hellevi; Furuholm, Jussi; Honkanen, Eero; Meurman, Jukka H

    2012-04-01

    This paper aims to study oral symptoms (burning mouth sensation, xerostomia, dysphagia, and dysgeusia) and background characteristics among chronic kidney disease (CKD) patients. The hypothesis was that patients experience oral discomfort and show interest towards dental care differently depending on the origin of their kidney disease. One hundred thirty-eight CKD patients at predialysis stage (94 men, 44 women, mean age 54 years) at the Helsinki University Central Hospital participated in the study. The patients were divided into a diabetic nephropathy group and a group of patients with other kidney diseases. The patients had a clinical oral examination and filled in a structured questionnaire. The data were analyzed and compared between the groups (SPSS for Windows version 15.0). T test was used for parameters normally distributed while binomial data were analyzed with cross-tabulations and chi-square test. Contrary to our study hypothesis, no statistically significant differences were seen in the questionnaire study between the diabetic vs. non-diabetic CKD patients in any other study parameter except in the use of medication (10 ± 2.3 vs. 8 ± 3.1 drugs daily, p diabetic, 48.2% in non-diabetic patients). No difference was seen in the frequency of oral discomfort among the different groups of predialysis patients investigated. Clinicians should be aware of nephropathy patients who frequently suffer from oral discomfort, particularly xerostomia.

  5. The psychometric properties of the Finnish Young Schema Questionnaire in chronic pain patients and a non-clinical sample.

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    Saariaho, Tom; Saariaho, Anita; Karila, Irma; Joukamaa, Matti

    2009-03-01

    We investigated the latent factor structure of the Finnish Young Schema Questionnaire (YSQ-S2-extended; short form) in samples of chronic pain patients (n=271) and controls (n=331) with confirmatory factor analysis (CFA). The data in the total sample supported the 18-factor structure as hypothesized by Young, J. E., Klosko, J., & Weishaar, M. E. (2003). Schema therapy: A practitioner's guide. New York: Guilford Press. The diagonally weighted least squares estimation method gave repeatable parameter estimates in successive confirmatory factor analyses (CFA). The internal consistency of the YSQ-S2-extended was adequate to high in both samples and the groups showed equal goodness-of-fit statistics in CFA. This study consisted of the oldest population so far (mean age 47 years) and supported the use of the Finnish version of the YSQ-S2-extended in clinical practice.

  6. Knowledge and perception regarding clinical trials among doctors of government medical colleges: A questionnaire-based study

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    Supriyo Choudhury

    2016-01-01

    Full Text Available Aims: By virtue of being a specialized field by itself, the science of clinical trials (CTs may not be well understood by doctors who are not specifically trained in it. A lack of knowledge may translate to a negative perception toward CT. With the idea of getting a situational snapshot, we estimated the knowledge and perception of CTs among doctors from government medical colleges of West Bengal who are not trained on CT in their postgraduate curriculum. Several determinants of knowledge and perception regarding CT were also evaluated. Methods: We have quantified the knowledge and perception of CTs by a structured validated questionnaire. Development and validation of the questionnaire was performed prior to the study. Results: Among 133 participants, 7.5% received focused training on CT and 16.5% participated in CTs as investigators. Majority of the doctors were unfamiliar with the basic terminologies such as, “adverse event” and “good clinical practice.” Encouragingly, 93.3% doctors advised that a detailed discussion of CT methodology should be incorporated in the under graduate medical science curriculum. They had an overall positive attitude toward CTs conducted in India, with a mean score that is 72.6% of the maximum positive score. However, a large number of the doctors were skeptical about the primary motivation and operations of pharmaceutical industry sponsored CTs, with 45% of them believing that patients are exploited in these sponsored CTs. Conclusion: Participant doctors had a basic knowledge of CT methodology. The study has revealed specific areas of deficient knowledge, which might be emphasized while designing focused training on CT methodology.

  7. HIV-1 LTR subtype and perinatal transmission.

    Science.gov (United States)

    Blackard, J T; Renjifo, B; Fawzi, W; Hertzmark, E; Msamanga, G; Mwakagile, D; Hunter, D; Spiegelman, D; Sharghi, N; Kagoma, C; Essex, M

    2001-09-01

    Multiple subtypes of HIV-1 have been identified; however, there is little data on the relative transmissibility of viruses belonging to different subtypes. A matched case-control study addressed whether viruses with different long terminal repeat (LTR) subtypes were transmitted equally from mother to infant. The LTR subtype was determined for 45 matched cases and controls who participated in a clinical trial in Tanzania. HIV-1 subtypes A, C, and D and intersubtype recombinant sequences were identified. Exact matched logistic regression analysis showed that viruses containing subtype A or intersubtype recombinant LTRs were 3.2 and 4.8 times more likely to be transmitted from mother to infant than viruses with subtype D LTRs. Viruses containing subtype C LTRs were 6.1 times more likely to be transmitted than those with subtype D LTRs. These differences in transmission were independent of maternal CD4 at enrollment. Thus, it appears that HIV-1 subtype may be associated with differing rates of perinatal transmission in Tanzania. Copyright 2001 Academic Press.

  8. The effect of adding gender item to Berlin Questionnaire in determining obstructive sleep apnea in sleep clinics

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    Melike Yuceege

    2015-01-01

    Full Text Available Background and Aim: We aimed to validate the Turkish version of Berlin Questionnaire (BQ and developped a BQ-gender (BQ-G form by adding gender component. We aimed to compare the two forms in defining patients with moderate to severe obstructive sleep apnea (OSA in sleep clinics. Methods: Four hundred and eighty five consecutive patients, refered to our sleep clinic for snoring, witnessed apnea and/or excessive daytime sleepiness were enrolled to the study. All patients underwent in-laboratory polysomnography (PSG. Patients with sleep efficiency less than 40% and total sleep time less than 4 hours, chronic anxiolitic/sedative drug usage, respiratory tract infection within past two weeks were excluded from the study. All the patients fulfilled BQ. The test and retest for BQ were applied in 15-day interval in 30 patients. Results: Totally 433 patients were enrolled to the study (285 male, 148 female.The mean age of the patients was 47,5 ± 10.5 (21-79. 180 patients (41.6% had apnea-hypopnea index (AHI ≤ 15, while 253 patients (58,4% had AHI > 15. The κ value was 48–94 and the the truth value was 69-94% for the test-retest procedure. Sensitivity, specificity, negative predictive value (NPV, positive predictive value (PPV, and area under the curve AUC were 84.2%, 31.7%, 48.7%, 63.4%, and 0.579 in order for BQ and 79.9 %, 51.7%, 63.2% , 69.6%, and 0.652 for BQ-G. Conclusion: The results showed that BQ-G is relatively better than BQ in determining moderate to severe OSA in sleep clinics where most of the patients are sleep apneic but both of the tests were found to have insufficient validities in defining moderate to severe OSA in sleep clinics.

  9. Evaluation of Mother-Child Agreement and Factorial Structures of the SCARED Questionnaire in an Italian Clinical Sample

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    Scaini, Simona; Ogliari, Anna; De Carolis, Ludovica; Bellodi, Laura; Di Serio, Clelia; Brombin, Chiara

    2017-01-01

    Background: A great part of the literature has confirmed the importance of both child and parents reports as source of factual information, especially for childhood emotional syndromes. In our study we aimed at: (i) calculating mother-child agreement and (ii) evaluating factorial structure of the Screen for Child Anxiety Related Emotional Disorders (SCARED) questionnaire in an Italian clinical sample. The novelty of this contribution is two-fold: first, from a clinical point of view, we investigated the parent-child agreement level and examined separately the factorial structures of both parent and child versions of the SCARED for the first time in an Italian clinical sample. Second, unlike previous studies, we used statistical approaches specifically suited to account for the ordinal nature of the collected variables. Method: In a clinical sample of 171 children and adolescents aged 8–18 and their mothers we evaluated inter-rater agreement using weighted kappa indices to assess agreement for each item belonging to a certain SCARED subscale. Exploratory factor analysis for ordinal data was then performed on the polychoric correlation matrix calculated on SCARED items. Differences in the numbers of symptoms reported by children and parents were evaluated as well. Results and Conclusions: Our results reveal moderate to strong mother-child agreement. A significant age effect is present. Two different factorial solutions emerged for parent and child SCARED versions (a 5 factor structure for parents and a 6 factor solution in the child version, including a new factor “Worry about Parents”). This study confirmed the importance of evaluating both child and parent reports in assessment protocols for anxiety disorders. Our findings could help clinicians to determine which information, and from which rater, must be accounted for in evaluating treatment decisions. Moreover, we find that patients characteristics, such as gender and age, should be taken into account when

  10. Two Different Serum MiRNA Signatures Correlate with the Clinical Outcome and Histological Subtype in Pleural Malignant Mesothelioma Patients.

    Science.gov (United States)

    Lamberti, Monica; Capasso, Rosanna; Lombardi, Angela; Di Domenico, Marina; Fiorelli, Alfonso; Feola, Antonia; Perna, Alessandra F; Santini, Mario; Caraglia, Michele; Ingrosso, Diego

    2015-01-01

    Pleural malignant mesothelioma (MPM) is a detrimental neoplasm affecting pleural sheets and determining a high rate of mortality. In this study, we have enrolled 14 consecutive patients (13 males and 1 female) with MPM (mean age: 70.3 ± 4.6 years). We have collected serum for the determination of a miRNA profiling using a low-density microarray real time PCR system in the serum of patients and comparing it with that one of 10 control counterparts affected by not-cancer-related pleural effusions. In the patients 5 miRNAs were up-regulated (miR101, miR25, miR26b, miR335 and miR433), 2 miRNA were downregulated (miR191, miR223) and two miRNAs were expressed exclusively in patients (miR29a and miR516). Based upon the changes in the expression of the above mentioned miRNAs we detected two distinctive miRNA signatures predicting histotype and survival in these patients: I) patients with more than 3/9 upregulated miRNAs or 3/9 upregulated miRNAs and miR516 not recordable or unchanged (signature A); II) patients with at least 3/9 downregulated or unchanged miRNAs and/or miR29a downregulated (signature B). Based upon these criteria, 5 patients were stratified in signature A and the remaining 9 in signature B. Patients with signature A had a significant shorter median survival than those with signature B (7 months vs. 17 months, 95% CI: 0.098-1.72, p = 0.0021), had a sarcomatoid or mixed histological MPM subtype and were diagnosed in stage II (3/5) and stage III (2/5). In conclusion, we suggest that miRNA signature A is predictive of sarcomatoid histotype and of worse prognosis in MPM.

  11. Two Different Serum MiRNA Signatures Correlate with the Clinical Outcome and Histological Subtype in Pleural Malignant Mesothelioma Patients.

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    Monica Lamberti

    Full Text Available Pleural malignant mesothelioma (MPM is a detrimental neoplasm affecting pleural sheets and determining a high rate of mortality. In this study, we have enrolled 14 consecutive patients (13 males and 1 female with MPM (mean age: 70.3 ± 4.6 years. We have collected serum for the determination of a miRNA profiling using a low-density microarray real time PCR system in the serum of patients and comparing it with that one of 10 control counterparts affected by not-cancer-related pleural effusions. In the patients 5 miRNAs were up-regulated (miR101, miR25, miR26b, miR335 and miR433, 2 miRNA were downregulated (miR191, miR223 and two miRNAs were expressed exclusively in patients (miR29a and miR516. Based upon the changes in the expression of the above mentioned miRNAs we detected two distinctive miRNA signatures predicting histotype and survival in these patients: I patients with more than 3/9 upregulated miRNAs or 3/9 upregulated miRNAs and miR516 not recordable or unchanged (signature A; II patients with at least 3/9 downregulated or unchanged miRNAs and/or miR29a downregulated (signature B. Based upon these criteria, 5 patients were stratified in signature A and the remaining 9 in signature B. Patients with signature A had a significant shorter median survival than those with signature B (7 months vs. 17 months, 95% CI: 0.098-1.72, p = 0.0021, had a sarcomatoid or mixed histological MPM subtype and were diagnosed in stage II (3/5 and stage III (2/5. In conclusion, we suggest that miRNA signature A is predictive of sarcomatoid histotype and of worse prognosis in MPM.

  12. Eating Disorder Examination Questionnaire (EDE-Q) and Clinical Impairment Assessment (CIA): clinical norms and functional impairment in male and female adults with eating disorders.

    Science.gov (United States)

    Dahlgren, Camilla Lindvall; Stedal, Kristin; Rø, Øyvind

    2017-05-01

    The aim of the current study was to collect clinical normative data for the Clinical Impairment Assessment questionnaire (CIA) and the Eating Disorder Examination Questionnaire (EDE-Q) from adult patients with eating disorders (EDs). This study also examined unique contributions of eating disorder (ED) symptoms on levels of ED-related impairment. A sample of 667 patients, 620 females and 47 males, was recruited from six specialist centres across Norway. The majority of the sample (40.3%) was diagnosed with eating disorder not otherwise specified (EDNOS), 34.5% had bulimia nervosa (BN), and 25.2% were diagnosed with anorexia nervosa (AN). There were significant differences for global EDE-Q and CIA scores between females and males. In the female sample, significant differences were found on several EDE-Q sub-scales between the AN and BN group, and between the AN and EDNOS group. No significant differences were found between the diagnostic groups on the CIA. In the male sample, no significant differences were found between diagnostic groups on the EDE-Q or CIA. A multiple regression analysis revealed that 46.8% of the variance in impairment as measured by the CIA was accounted for by ED symptoms. Body mass index, Eating Concern, Shape/Weight Concern, and binge eating served as significant, unique predictors of impairment. The results from the present study contribute to the interpretation of EDE-Q and CIA scores in ED samples.

  13. Statistical support for subtypes in posttraumatic stress disorder: the how and why of subtype analysis.

    Science.gov (United States)

    Dalenberg, Constance J; Glaser, Dale; Alhassoon, Omar M

    2012-08-01

    A number of researchers have argued for the existence of different subtypes of posttraumatic stress disorder (PTSD). In the current paper we present criteria by which to assess these putative subtypes, clarify potential pitfalls of the statistical methods employed to determine them, and propose alternative methods for such determinations. Specifically, three PTSD subtypes are examined: (1) complex PTSD, (2) externalizing/internalizing PTSD, and (3) dissociative/nondissociative PTSD. In addition, three criteria are proposed for subtype evaluation, these are the need for (1) reliability and clarity of definition, (2) distinctions between subtypes either structurally or by mechanism, and (3) clinical meaningfulness. Common statistical evidence for subtyping, such as statistical mean difference and cluster analysis, are presented and evaluated. Finally, more robust statistical methods are suggested for future research on PTSD subtyping. © 2012 Wiley Periodicals, Inc.

  14. Validation of the MEDFICTS dietary questionnaire: A clinical tool to assess adherence to American Heart Association dietary fat intake guidelines

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    Bindeman Jody

    2003-06-01

    Full Text Available Abstract Background Dietary assessment tools are often too long, difficult to quantify, expensive to process, and largely used for research purposes. A rapid and accurate assessment of dietary fat intake is critically important in clinical decision-making regarding dietary advice for coronary risk reduction. We assessed the validity of the MEDFICTS (MF questionnaire, a brief instrument developed to assess fat intake according to the American Heart Association (AHA dietary "steps". Methods We surveyed 164 active-duty US Army personnel without known coronary artery disease at their intake interview for a primary prevention cardiac intervention trial using the Block food frequency (FFQ and MF questionnaires. Both surveys were completed on the same intake visit and independently scored. Correlations between each tools' assessment of fat intake, the agreement in AHA step categorization of dietary quality with each tool, and the test characteristics of the MF using the FFQ as the gold standard were assessed. Results Subjects consumed a mean of 36.0 ± 13.0% of their total calories as fat, which included saturated fat consumption of 13.0 ± 0.4%. The majority of subjects (125/164; 76.2% had a high fat (worse than AHA Step 1 diet. There were significant correlations between the MF and the FFQ for the intake of total fat (r = 0.52, P 70 [high fat diet] was negligible (kappa statistic = 0.036. The MF was accurate at the extremes of fat intake, but could not reliably identify the 3 AHA dietary classifications. Alternative MF cutpoints of 50 (high fat diet were highly sensitive (96%, but had low specificity (46% for a high fat diet. ROC curve analysis identified that a MF score cutoff of 38 provided optimal sensitivity 75% and specificity 72%, and had modest agreement (kappa = 0.39, P Conclusions The MEDFICTS questionnaire is most suitable as a tool to identify high fat diets, rather than discriminate AHA Step 1 and Step 2 diets. Currently recommended

  15. Value of STOP-Bang questionnaire in screening patients with obstructive sleep apnea hypopnea syndrome in sleep disordered breathing clinic

    Institute of Scientific and Technical Information of China (English)

    Luo Jinmei; Huang Rong; Zhong Xu; Xiao Yi; Zhou Jiong

    2014-01-01

    Background Obstructive sleep apnea hypopnea syndrome (OSAHS) is the most common sleep-disordered breathing and is still underdiagnosed.This study was designed to evaluate the value of the STOP-Bang questionnaire (SBQ) in screening OSAHS in sleep-disordered breathing clinics in order to extend it into the general Chinese population.Methods Two hundred and twelve patients undergoing overnight polysomnography (PSG) in the sleep-disordered breathing clinic of Pecking Union Medical College Hospital between May 2011 and January 2012 were prospectively included and were asked to fill in the SBQ.A score of 3 or more of the SBQ indicated a high risk of OSAHS.We analyzed the sensitivities and specificities of SBQ in screening OSAHS.Logistic regression analysis was used to evaluate the probabilities of the severity of OSAHS based upon the apnea hypopnea index (AHI).Results The patients at high risk of OSAHS had higher AHI,higher oxygen desaturation index (ODI),lower pulse oxygen saturation (LSpO2) during sleep time and less sleep time in stage N3.SBQ scores were positively correlated with AHI,ODI and the ratio of SpO2 lower than 90%,and negatively correlated with LSpO2 during sleep.The sensitivities of the SBQ with AHI ≥5/h,AHI ≥15/h,AHI ≥30/h as cut-offs were 94.9%,96.5%,and 97.7%,respectively,and the specificities were 50.0%,28.6%,and 17.9%,respectively.The Logistic regression analysis showed the probability of severe OSAHS increased and the probability of normal subjects decreased with increasing SBQ score.Conclusions The STOP-Bang questionnaire has excellent sensitivity in screening OSAHS patients and can predict the severity of OSAHS.More studies will be required to determine the value of SBQ in the general Chinese population.

  16. Preanesthesia Questionnaire

    Science.gov (United States)

    ... Brochures and Resources Videos AANA / Patients Pre-Anesthesia Questionnaire Page Content The information you supply below assists ... complementary or alternative medicines)______________________________________________________ _______________________________________________________________ Prior Operations ... Pre-Anesthesia Questionnaire Please answer the following questions. These responses will ...

  17. Complementary and Alternative Medicine use Among Patients with Acne Vulgaris or Melasma in Dermatology Clinic: a Questionnaire Survey

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    Çiçek Durusoy

    2010-03-01

    Full Text Available Aims: To determine the prevalence rate and types of complementary and alternative medicine (CAM use among patients diagnosed with acne vulgaris (AV or melasma, and to identify the factors influencing the use of CAM.Method: This study included 73 patients who attended dermatology outpatient clinic in Alanya Başkent University and diagnosed with AV or melasma. Each patient was asked to answer a questionnaire consisting of sociodemografic information and negative impact of their disease on their psychological and physical health status and work/friendship relations, their history of using CAM methods. Results: Of the study patients, 54 were diagnosed with AV and 19 with melasma. The proportion of CAM use was 52,1%in total; 57.4 %of AV and 36,8%of melasma patients had used CAM. Females with regard to the males, those having problems in work/friendship relations with regard to those who have not, were using CAM in high proportion. All CAM users have applied phytotherapy, and 63,2 %of the patients have learned these methods from family members and/or friends.Conclusion: Our results show that CAM use is common in patients with AV and melasma. Since the CAM methods have the potential of influencing the outcomes of the disease by interacting with the medical treatment modalities, dermatologists should enquire about CAM use as it may by.

  18. Functional Activities Questionnaire items that best discriminate and predict progression from clinically normal to mild cognitive impairment

    Science.gov (United States)

    Marshall, Gad A.; Zoller, Amy S.; Lorius, Natacha; Amariglio, Rebecca E.; Locascio, Joseph J.; Johnson, Keith A.; Sperling, Reisa A.; Rentz, Dorene M.

    2015-01-01

    Background Impairment in instrumental activities of daily living (IADL) emerges in the transition from mild cognitive impairment (MCI) to Alzheimer’s disease (AD) dementia. Some IADL scales are sensitive to early deficits in MCI, but none have been validated for detecting subtle functional changes in clinically normal (CN) elderly at risk for AD. Methods Data from 624 subjects participating in the Alzheimer’s Disease Neuroimaging Initiative and 524 subjects participating in the Massachusetts Alzheimer’s Disease Research Center, which are two large cohorts including CN elderly and MCI subjects, were used to determine which Functional Activities Questionnaire items best discriminate between and predict progression from CN to MCI. Results We found that “Remembering appointments” and “assembling tax records” best discriminated between CN and MCI subjects, while worse performance on “paying attention and understanding a TV program”, “paying bills/balancing checkbook”, and “heating water and turning off the stove” predicted greater hazard of progressing from a diagnosis of CN to MCI. Conclusions These results demonstrate that certain questions are especially sensitive in detecting the earliest functional changes in CN elderly at risk for AD. As the field moves toward earlier intervention in preclinical AD, it is important to determine which IADL changes can be detected at that stage and track decline over time. PMID:26017560

  19. Questionnaires used to assess barriers of clinical guideline use among physicians are not comprehensive, reliable, or valid: a scoping review.

    Science.gov (United States)

    Willson, Melina L; Vernooij, Robin W M; Gagliardi, Anna R

    2017-06-01

    This study described the number and characteristics of questionnaires used to assess barriers of guideline use among physicians. A scoping review was conducted. MEDLINE and EMBASE were searched from 2005 to June 2016. English-language studies that administered a questionnaire to assess barriers of guideline use among practicing physicians were eligible. Summary statistics were used to report study and questionnaire characteristics. Questionnaire content was assessed with a checklist of 57 known barriers. Each of the 178 included studies administered a unique questionnaire. The number of questionnaires increased yearly from 2005 to 2015. Few were pilot-tested (50, 28.1%) or tested for psychometric properties (3, 1.7%). Two were based on theory. None probed for the full range of known barriers. Ten included a free-text option. The majority assessed professional barriers (177, 99.4%) but few of the 14 factors within this domain. Questionnaire characteristics did not change over time. Organizations administered questionnaires that were not reliable or valid and did not comprehensively assess barriers and may have selected interventions unlikely to promote guideline use. Research is needed to construct a questionnaire that is practical, adaptable, and robust and leads to the selection of interventions that support guideline use. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  20. [Subtypes of cocaine addicts with and without associated problematic alcohol use: towards a neuropsychology of personality applied to clinical practice].

    Science.gov (United States)

    Pedrero Pérez, Eduardo J; Ruiz Sánchez de León, José M

    2012-01-01

    It is important to know which personality factors are associated with addiction so to distinguish addicts that require specialized treatment from those who do not, and to identify those addicts who achieve abstinence from those who continue their substance use despite the negative consequences. Cloninger's model includes biological and psychosocial variables that can be characterized in neuropsychological terms. Two samples were analyzed: individuals who had begun cocaine addiction treatment (n=183) and a non-clinical population sample (n = 183), matched for sex, age and educational level. Alcohol abuse/dependence was monitored as an independent variable. Significant differences and large effect size were found between addicts and non-clinical population in Novelty Seeking and Self-Directedness, and to a lesser extent, in Harm Avoidance. These differences increase when problematic use of alcohol is added. According to the profile of traits, clusters of addicts were established and differences were obtained in variables such as functional/dysfunctional impulsivity, dysexecutive symptoms and perceived stress. Six clusters were identified, some of minor severity, the most severely problematic clusters being characterized by higher levels of dysfunctional impulsivity, more dysexecutive symptoms and higher levels of perceived stress. Self-Directedness seems to reflect the deficit of prefrontal systems in the regulation of behavior, as well as in emotion and impulse control. It is proposed that evaluation of the personality is more useful than the mere assessment of symptoms for classifying addicts, determining their needs and designing a therapeutic itinerary.

  1. Personality profiles in Eating Disorders: further evidence of the clinical utility of examining subtypes based on temperament.

    Science.gov (United States)

    Turner, Brianna J; Claes, Laurence; Wilderjans, Tom F; Pauwels, Els; Dierckx, Eva; Chapman, Alexander L; Schoevaerts, Katrien

    2014-09-30

    Despite recent modifications to the DSM-V diagnostic criteria for Eating Disorders (ED; American Psychiatric Association, 2013), sources of variability in the clinical presentation of ED patients remain poorly understood. Consistent with previous research that has used underlying personality dimensions to identify distinct subgroups of ED patients, the present study examined (1) whether we could identify clinically meaningful subgroups of patients based on temperamental factors including Behavioral Inhibition (BIS), Behavioral Activation (BAS) and Effortful Control (EC), and (2) whether the identified subgroups would also differ with respect to ED, Axis-I and Axis-II psychopathology. One hundred and forty five ED inpatients participated in this study. Results of a k-means analysis identified three distinct groups of patients: an Overcontrolled/Inhibited group (n=53), an Undercontrolled/Dysregulated group (n=58) and a Resilient group (n=34). Further, group comparisons revealed that patients in the Undercontrolled/Dysregulated group demonstrated more severe symptoms of bulimia, hostility and Cluster B Personality Disorders compared to the other groups, while patients in the Resilient group demonstrated the least severe psychopathology. These findings have important implications for understanding how individual differences in personality may impact patterns of ED symptoms and co-occurring psychopathology in patients with ED.

  2. Monitoring outcomes of arthritis and longitudinal data collection in routine care using a patient questionnaire that incorporates a clinical note on one piece of paper.

    Science.gov (United States)

    Yazici, Yusuf

    2007-08-01

    Patient questionnaires are the quantitative tools available to rheumatologists to monitor their patients' health status and responses to therapy. The Health Assessment Questionnaire (HAQ) and its derivatives have been shown to be the most significant predictors of functional and work disability, costs, joint replacement surgery, and mortality; generally at higher levels of significance than joint counts, radiographs, and laboratory tests. Every encounter of a patient with a rheumatologist provides an opportunity to collect data. Yet patient questionnaires, which can be used in all rheumatic diseases, including osteoarthritis, systemic lupus erythematosus, fibromyalgia, scleroderma, and ankylosing spondylitis, are not included in routine care by most rheumatologists. Questionnaires can be adapted to include a simple subjective-objective-assessment-plan (SOAP) clinical encounter note that helps with data entry and also provides all the necessary information for clinical decision making in one sheet of paper. Data that are feasible to collect in clinical care provide the optimal approach to assessing quantitatively how patients are doing. If data are not collected and recorded, that opportunity, on that day, is lost forever. Rheumatologists would find it valuable to adapt questionnaires to the care they provide for all their patients, to document and improve the care they provide, and add quantitative data to standard clinical care.

  3. Short-term stability of subtypes in the irritable bowel syndrome

    DEFF Research Database (Denmark)

    Engsbro, A L; Simren, M; Bytzer, P

    2012-01-01

    In irritable bowel syndrome (IBS) subtyping is used in research and clinical practice. Knowledge of subtype stability is needed for proper design of trials and treatment strategies.......In irritable bowel syndrome (IBS) subtyping is used in research and clinical practice. Knowledge of subtype stability is needed for proper design of trials and treatment strategies....

  4. Absence of an orphan mitochondrial protein, c19orf12, causes a distinct clinical subtype of neurodegeneration with brain iron accumulation.

    Science.gov (United States)

    Hartig, Monika B; Iuso, Arcangela; Haack, Tobias; Kmiec, Tomasz; Jurkiewicz, Elzbieta; Heim, Katharina; Roeber, Sigrun; Tarabin, Victoria; Dusi, Sabrina; Krajewska-Walasek, Malgorzata; Jozwiak, Sergiusz; Hempel, Maja; Winkelmann, Juliane; Elstner, Matthias; Oexle, Konrad; Klopstock, Thomas; Mueller-Felber, Wolfgang; Gasser, Thomas; Trenkwalder, Claudia; Tiranti, Valeria; Kretzschmar, Hans; Schmitz, Gerd; Strom, Tim M; Meitinger, Thomas; Prokisch, Holger

    2011-10-07

    The disease classification neurodegeneration with brain iron accumulation (NBIA) comprises a clinically and genetically heterogeneous group of progressive neurodegenerative disorders characterized by brain iron deposits in the basal ganglia. For about half of the cases, the molecular basis is currently unknown. We used homozygosity mapping followed by candidate gene sequencing to identify a homozygous 11 bp deletion in the orphan gene C19orf12. Mutation screening of 23 ideopathic NBIA index cases revealed two mutated alleles in 18 of them, and one loss-of-function mutation is the most prevalent. We also identified compound heterozygous missense mutations in a case initially diagnosed with Parkinson disease at age 49. Psychiatric signs, optic atrophy, and motor axonal neuropathy were common findings. Compared to the most prevalent NBIA subtype, pantothenate kinase associated neurodegeneration (PKAN), individuals with two C19orf12 mutations were older at age of onset and the disease progressed more slowly. A polyclonal antibody against the predicted membrane spanning protein showed a mitochondrial localization. A histopathological examination in a single autopsy case detected Lewy bodies, tangles, spheroids, and tau pathology. The mitochondrial localization together with the immunohistopathological findings suggests a pathomechanistic overlap with common forms of neurodegenerative disorders.

  5. Clinical Utility of Subtyping Binge Eating Disorder by History of Anorexia or Bulimia Nervosa in a Treatment Sample

    Science.gov (United States)

    Utzinger, Linsey M.; Mitchell, James E.; Cao, Li; Crosby, Ross D.; Crow, Scott J.; Wonderlich, Stephen A.; Peterson, Carol B.

    2016-01-01

    Objective This study examined whether having a history of anorexia nervosa (AN) or bulimia nervosa (BN) is associated with response to treatment in adults with binge eating disorder (BED). Method Data from 189 adults diagnosed with BED who were randomly assigned to one of three group cognitive-behavioral (CBT) treatments were analyzed to compare those with and without a history of AN/BN. Results A total of 16% of the sample had a history of AN/BN. The BED subgroup with a history of AN/BN presented with higher rates of mood disorders and greater eating-related symptom severity at baseline. Participants with a history of AN/BN also had higher global eating disorder (ED) symptoms at end of treatment (EOT), and more frequent objective binge-eating episodes at EOT and 12-month follow-up. Discussion These findings suggest that in adults with BED, a history of AN/BN is predictive of greater eating-related symptom severity following group-based CBT and poorer short- and long-term binge-eating outcomes. These findings suggest that considering ED history in the treatment of adults with BED may be clinically useful. PMID:25959549

  6. Clinical utility of subtyping binge eating disorder by history of anorexia or bulimia nervosa in a treatment sample.

    Science.gov (United States)

    Utzinger, Linsey M; Mitchell, James E; Cao, Li; Crosby, Ross D; Crow, Scott J; Wonderlich, Stephen A; Peterson, Carol B

    2015-09-01

    This study examined whether having a history of anorexia nervosa (AN) or bulimia nervosa (BN) is associated with response to treatment in adults with binge eating disorder (BED). Data from 189 adults diagnosed with BED who were randomly assigned to one of three group cognitive-behavioral (CBT) treatments were analyzed to compare those with and without a history of AN/BN. A total of 16% of the sample had a history of AN/BN. The BED subgroup with a history of AN/BN presented with higher rates of mood disorders and greater eating-related symptom severity at baseline. Participants with a history of AN/BN also had higher global eating disorder (ED) symptoms at end of treatment (EOT), and more frequent objective binge-eating episodes at EOT and 12-month follow-up. These findings suggest that in adults with BED, a history of AN/BN is predictive of greater eating-related symptom severity following group-based CBT and poorer short- and long-term binge-eating outcomes. These findings suggest that considering ED history in the treatment of adults with BED may be clinically useful. © 2015 Wiley Periodicals, Inc.

  7. The clinical value of human leukocyte antigen HLA-DRB1 subtypes associated to Graves' disease in Romanian population.

    Science.gov (United States)

    Martin, Sorina; Dutescu, Monica Irina; Sirbu, Anca; Barbu, Carmen; Albu, Alice; Florea, Suzana; Fica, Simona

    2014-01-01

    The aim of this study was to identify the primary susceptibility HLA-DRB1 alleles associated with GD in Romanian population and to seek whether specific HLA-DRB1 haplotypes are associated with differences in the clinical presentation of GD at diagnosis. Molecular typing of HLA-DRB1 alleles was performed in 77 Romanian Caucasian GD patients and 445 racially matched controls. In GD patients, age, presence of eye disease, goiter grade, autoantibody status and titer, TSH, FT4, FT3, TT3 levels were recorded at diagnosis. The allelic frequencies of HLA-DRB1*03 (41.55% vs. 17.75%, p < 0.0001, χ(2) = 20.81) and DRB1*11 (42.85% vs. 30.56%, p = 0.045, χ(2) = 3.98)were higher, whereas those of HLA-DRB1*01(3.89% vs. 16.40%, p = 0.007, χ(2) = 7.281) and DRB1*15 (10.38% vs. 21.34%, p = 0.038, χ(2) = 4.309)were lower in GD patients than in controls. FT4/TT3 ratio (p = 0.015) and anti-thyroglobulin antibodies (p = 0.024) were higher in *03/11 patients compared to *X/X, *11/Z, *03/Y patients (where X is any other allele than *03 and *11, Y is any other allele than *11, Z is any other allele than *03). In conclusion, HLA-DRB1*03 and DRB1*11 may be the primary susceptibility HLA-DRB1 alleles associated with GD in Romanian population, whereas HLA-DRB1*01 and DRB1*15 seem to be protective. At diagnosis, HLA-DRB1*03/11 GD patients had higher FT4/TT3 ratio and anti-thyroglobulin antibody levels.

  8. Burnout and psychiatric morbidity among medical students entering clinical training: a three year prospective questionnaire and interview-based study

    Directory of Open Access Journals (Sweden)

    Runeson Bo

    2007-04-01

    Full Text Available Abstract Background Mental distress among medical students is often reported. Burnout has not been studied frequently and studies using interviewer-rated diagnoses as outcomes are rarely employed. The objective of this prospective study of medical students was to examine clinically significant psychiatric morbidity and burnout at 3rd year of medical school, considering personality and study conditions measured at 1st year. Methods Questionnaires were sent to 127 first year medical students who were then followed-up at 3rd year of medical school. Eighty-one of 3rd year respondents participated in a diagnostic interview. Personality (HP5-i and Performance-based self-esteem (PBSE-scale were assessed at first year, Study conditions (HESI, Burnout (OLBI, Depression (MDI at 1st and 3rd years. Diagnostic interviews (MINI were used at 3rd year to assess psychiatric morbidity. High and low burnout at 3rd year was defined by cluster analysis. Logistic regressions were used to identify predictors of high burnout and psychiatric morbidity, controlling for gender. Results 98 (77% responded on both occasions, 80 (63% of these were interviewed. High burnout was predicted by Impulsivity trait, Depressive symptoms at 1st year and Financial concerns at 1st year. When controlling for 3rd year study conditions, Impulsivity and concurrent Workload remained. Of the interviewed sample 21 (27% had a psychiatric diagnosis, 6 of whom had sought help. Unadjusted analyses showed that psychiatric morbidity was predicted by high Performance-based self-esteem, Disengagement and Depression at 1st year, only the later remained significant in the adjusted analysis. Conclusion Psychiatric morbidity is common in medical students but few seek help. Burnout has individual as well as environmental explanations and to avoid it, organisational as well as individual interventions may be needed. Early signs of depressive symptoms in medical students may be important to address. Students

  9. Enamelin (Enam) is essential for amelogenesis: ENU-induced mouse mutants as models for different clinical subtypes of human amelogenesis imperfecta (AI).

    Science.gov (United States)

    Masuya, Hiroshi; Shimizu, Kunihiko; Sezutsu, Hideki; Sakuraba, Yoshiyuki; Nagano, Junko; Shimizu, Aya; Fujimoto, Naomi; Kawai, Akiko; Miura, Ikuo; Kaneda, Hideki; Kobayashi, Kimio; Ishijima, Junko; Maeda, Takahide; Gondo, Yoichi; Noda, Tetsuo; Wakana, Shigeharu; Shiroishi, Toshihiko

    2005-03-01

    Amelogenesis imperfecta (AI) is a group of commonly inherited defects of dental enamel formation, which exhibits marked genetic and clinical heterogeneity. The genetic basis of this heterogeneity is still poorly understood. Enamelin, the affected gene product in one form of AI (AIH2), is an extracellular matrix protein that is one of the components of enamel. We isolated three ENU-induced dominant mouse mutations, M100395, M100514 and M100521, which caused AI-like phenotypes in the incisors and molars of the affected individuals. Linkage analyses mapped each of the three mutations to a region of chromosome 5 that contained the genes encoding enamelin (Enam) and ameloblastin (Ambn). Sequence analysis revealed that each mutation was a single-base substitution in Enam. M100395 (Enam(Rgsc395)) and M100514 (Enam(Rgsc514)) were putative missense mutations that caused S to I and E to G substitutions at positions 55 and 57 of the translated protein, respectively. Enam(Rgsc395) and Enam(Rgsc514) heterozygotes showed severe breakage of the enamel surface, a phenotype that resembled local hypoplastic AI. The M100521 mutation (Enam(Rgsc521)) was a T to A substitution at the splicing donor site in intron 4. This mutation resulted in a frameshift that gave rise to a premature stop codon. The transcript of the Enam(Rgsc521) mutant allele was degraded, indicating that Enam(Rgsc521) is a loss-of-function mutation. Enam(Rgsc521) heterozygotes showed a hypomaturation-type AI phenotype in the incisors, possibly due to haploinsufficiency of Enam. Enam(Rgsc521) homozygotes showed complete loss of enamel on the incisors and the molars. Thus, we report here that the Enam gene is essential for amelogenesis, and that mice with different point mutations at Enam may provide good animal models to study the different clinical subtypes of AI.

  10. Within-Farm Changes in Dairy Farm-Associated Salmonella Subtypes and Comparison to Human Clinical Isolates in Michigan, 2000-2001 and 2009.

    Science.gov (United States)

    Habing, Greg G; Manning, Shannon; Bolin, Carole; Cui, Yuehua; Rudrik, James; Dietrich, Stephen; Kaneene, John B

    2015-09-01

    Temporal changes in the distribution of Salmonella subtypes in livestock populations may have important impacts on human health. The first objective of this research was to determine the within-farm changes in the population of subtypes of Salmonella on Michigan dairy farms that were sampled longitudinally in 2000-2001 and again in 2009. The second objective was to determine the yearly frequency (2001 through 2012) of reported human illnesses in Michigan associated with the same subtypes. Comparable sampling techniques were used to collect fecal and environmental samples from the same 18 Michigan dairy farms in 2000-2001 and 2009. Serotypes, multilocus sequence types (STs), and pulsed-field gel electrophoresis (PFGE) banding patterns were identified for isolates from 6 farms where >1 Salmonella isolate was recovered in both 2000-2001 and 2009. The distribution of STs was significantly different between time frames (P Salmonella were due to recovery of MDR subtypes of S. enterica serotypes Senftenberg and Typhimurium in 2000-2001 and genetically distinct, pansusceptible subtypes of the same serotypes in 2009. The annual frequency of human illnesses between 2001 and 2012 with a PFGE pattern matching a bovine strain decreased for patterns recovered from dairy farms in 2000-2001 and increased for patterns recovered in 2009. These data suggest important changes in the population of Salmonella on dairy farms and in the frequency of human illnesses associated with cattle-derived subtypes.

  11. ADHD-hyperactive/impulsive subtype in adults

    Directory of Open Access Journals (Sweden)

    Stephen V. Faraone

    2010-01-01

    Full Text Available This is the first study to evaluate ADHD-hyperactive/impulsive subtype in a large clinical sample of adults with ADHD. The Quality of Life, Effectiveness, Safety and Tolerability (QuEST study included 725 adults who received clinician diagnoses of any ADHD subtype. Cross-sectional baseline data from 691 patients diagnosed with the hyperactive/impulsive (HI, inattentive (IA and combined subtypes were used to compare the groups on the clinician administered ADHD-RS, clinical features and health-related quality of life. A consistent pattern of differences was found between the ADHD-I and combined subtypes, with the combined subtype being more likely to be diagnosed in childhood, more severe symptom severity and lower HRQL. Twenty-three patients out of the total sample of 691 patients (3% received a clinician diagnosis of ADHD - hyperactive/impulsive subtype. Review of the ratings on the ADHD-RS-IV demonstrated, however, that this group had ratings of inattention comparable to the inattentive group. There were no significant differences found between the ADHD-HI and the other subtypes in symptom severity, functioning or quality of life. The hyperactive/impulsive subtype group identified by clinicians in this study was not significantly different from the rest of the sample. By contrast, significant differences were found between the inattentive and combined types. This suggests that in adults, hyperactivity declines and inattention remains significant, making the hyperactive/impulsive subtype as defined by childhood criteria a very rare condition and raising questions as to the validity of the HI subtype in adults.

  12. 不同亚型骨肉瘤的临床和影像表现分析%The clinical and radiological features of different subtypes of osteosarcoma

    Institute of Scientific and Technical Information of China (English)

    陈其春; 郑穗生; 王龙胜

    2014-01-01

    目的:探讨骨肉瘤不同亚型的临床和影像学表现,提高对骨肉瘤亚型的认识。方法回顾分析经病理证实的6种亚型11例骨肉瘤的临床及影像学表现。结果本组11例患者中毛细血管扩张型3例,表现为膨胀性、溶骨性骨质破坏,病灶内多发囊变,呈分房状,其内常见液-液平。皮质旁型2例,表现为骨表面的高密度肿块伴瘤骨形成。骨膜型2例,表现为骨表面密度不均的肿块,可见放射状分布的肿瘤骨,骨膜反应明显,髓腔未受累。小细胞型2例,呈溶骨性骨质破坏,骨皮质虫噬状破坏,骨膜反应及软组织肿块形成。颌骨型1例,表现为以颌骨为中心的软组织肿块,伴肿瘤骨形成。多中心型1例,表现为多发病灶,主病灶呈典型骨肉瘤表现,周围伴多发子灶形成。结论骨肉瘤亚型具有一定的临床和影像特点,有助于诊断。%Objective To assess the clinical and radiological features of osteosarcoma(OS),and to improve the knowledge of differ-ent types of OS.Methods Eleven cases of the six subtypes OS confirmed pathologically were retrospectively analysed,and the clinical and radiological features were reviewed.Results Among 11 cases of OS in our study,3 cases were of telangiectatic types.The findings of imaging showed that significant expansile,osteolytic destruction,multiple cystic changes like housing allocation could be found in the lesion.It con-tained multiple fluid levels.Two cases of parosteal OS showed as a high density mass with tumor bone formation adjacent to the bone.Two ca-ses were of periosteal types.Common radiographic findings included a uneven density soft-tissue mass with radial-like tumor bone on the bone surface,periosteal reaction.Intramedullary extension of periosteal OS was still considered rare.Two cases of small cell OS had permeative lytic bone destruction,periosteal reaction and soft-tissue mass formation.Cortical bone often

  13. Validation of the Marijuana Effect Expectancies Questionnaire (MEEQ) in a Non-Clinical French-Speaking Adolescent Sample

    National Research Council Canada - National Science Library

    Emilie Schmits; Etienne Quertemont; Eric Guillem; Cécile Mathys

    2016-01-01

    Teenagers commonly use cannabis. Expectancies related to the effects of cannabis play an important role in its consumption and are frequently measured with the Marijuana Effect Expectancies Questionnaire (MEEQ...

  14. Validity of the Children's Social Behavior Questionnaire (CSBQ) in Children with Intellectual Disability : Comparing the CSBQ with ADI-R, ADOS, and Clinical DSM-IV-TR Classification

    NARCIS (Netherlands)

    de Bildt, Annelies; Mulder, Erik J.; Hoekstra, Pieter J.; van Lang, Natasja D. J.; Minderaa, Ruud B.; Hartman, Catharina A.

    2009-01-01

    The Children's Social Behavior Questionnaire (CSBQ) was compared with the Autism Diagnostic Interview-Revised (ADI-R), Autism Diagnostic Observation Schedule (ADOS), and clinical classification in children with mild and moderate intellectual disability (ID), to investigate its criterion related vali

  15. Relation of the International Restless Legs Syndrome Study Group rating scale with the Clinical Global Impression severity scale, the restless legs syndrome 6-item questionnaire, and the restless legs syndrome-quality of life questionnaire.

    Science.gov (United States)

    Allen, Richard; Oertel, Wolfgang; Walters, Arthur; Benes, Heike; Schollmayer, Erwin; Grieger, Frank; Moran, Kimberly; Kohnen, Ralf

    2013-12-01

    The SP790 study (ClinicalTrials.gov, NCT00136045) showed benefits of rotigotine over placebo in improving symptom severity of restless legs syndrome (RLS), also known as Willis-Ekbom disease, on the International Restless Legs Syndrome Study Group rating scale (IRLS), Clinical Global Impression item 1 (CGI-1), RLS 6-item questionnaire (RLS-6), and the RLS-quality of life questionnaire (RLS-QoL) in patients with moderate to severe idiopathic RLS. To provide clinical context for the IRLS and to guide the choice of assessment scales for RLS studies, our post hoc analysis of SP790 data evaluated associations between the IRLS and the CGI-1, IRLS and RLS-6, and the IRLS and RLS-QoL. Scale associations were analyzed at baseline and at the end of maintenance (EoM) using data from the safety set (rotigotine and placebo groups combined [n=458]). Changes from baseline to EoM in IRLS score vs comparator scale scores also were analyzed. There was a trend towards increasing IRLS severity category with increasing CGI-1, RLS-6, and RLS-QoL score. Pearson product moment correlation coefficients showed correlations between IRLS and comparator scale scores at baseline and EoM as well as correlations for change from baseline to EoM. Correlations between the IRLS and comparator scales were substantial. These data indicate that the IRLS is clinically meaningful. The IRLS and CGI-1 are generally sufficient to evaluate the overall severity and impact of RLS symptoms in clinical trials. Copyright © 2013 Elsevier B.V. All rights reserved.

  16. Classifying anatomical subtypes of subjective memory impairment.

    Science.gov (United States)

    Jung, Na-Yeon; Seo, Sang Won; Yoo, Heejin; Yang, Jin-Ju; Park, Seongbeom; Kim, Yeo Jin; Lee, Juyoun; Lee, Jin San; Jang, Young Kyoung; Lee, Jong Min; Kim, Sung Tae; Kim, Seonwoo; Kim, Eun-Joo; Na, Duk L; Kim, Hee Jin

    2016-12-01

    We aimed to categorize subjective memory impairment (SMI) individuals based on their patterns of cortical thickness and to propose simple models that can classify each subtype. We recruited 613 SMI individuals and 613 age- and gender-matched normal controls. Using hierarchical agglomerative cluster analysis, SMI individuals were divided into 3 subtypes: temporal atrophy (12.9%), minimal atrophy (52.4%), and diffuse atrophy (34.6%). Individuals in the temporal atrophy (Alzheimer's disease-like atrophy) subtype were older, had more vascular risk factors, and scored the lowest on neuropsychological tests. Combination of these factors classified the temporal atrophy subtype with 73.2% accuracy. On the other hand, individuals with the minimal atrophy (non-neurodegenerative) subtype were younger, were more likely to be female, and had depression. Combination of these factors discriminated the minimal atrophy subtype with 76.0% accuracy. We suggest that SMI can be largely categorized into 3 anatomical subtypes that have distinct clinical features. Our models may help physicians decide next steps when encountering SMI patients and may also be used in clinical trials.

  17. The Millon Clinical Multiaxial Inventory-III (MCMI-III) and the Personality Disorder Questionnaire-4+(PDQ-4+) in a Mixed Italian Psychiatric Sample

    OpenAIRE

    Bottesi, G; Novara, C.; Ghisi, M; Ferracuti, S; Lang, M.; Sanavio, E; Zennaro, A.

    2013-01-01

    Self-report questionnaires play a crucial role in the assessment of Personality Disorders (PDs); in such a context, the Millon Clinical Multiaxial Inventory-III (MCMI-III) and the Personality Disorder Questionnaire-4+ (PDQ-4+) are frequently adopted. The aim of this preliminary study was to examine the association between the MCMI-III and the PDQ-4+ in a mixed Italian psychiatric sample. All the correlations between the MCMI-III personality scales and the correspondent PDQ-4+ scales were posi...

  18. Sensory subtypes and associated outcomes in children with autism spectrum disorders.

    Science.gov (United States)

    Ausderau, Karla K; Sideris, John; Little, Lauren M; Furlong, Melissa; Bulluck, John C; Baranek, Grace T

    2016-12-01

    Sensory features are prevalent and heterogeneous across children with ASD and these features have been associated with child outcomes. Identification of clinically defined sensory subtypes may enhance our understanding of unique phenotypes that have implications for etiology, prognosis, and intervention. This longitudinal study used a national online survey aimed to identify associations of previously validated sensory subtypes to specific child and family characteristics and functional outcomes [vineland adaptive behavior scale-II (VABS) and parenting stress index short form (PSI)]. The sensory experiences questionnaire-3.0 was collected from caregivers with children with ASD, ages 2-12, at two time points (Time 1, n = 1307, Time 2, n = 884), 1 year apart. Functional outcomes assessments were collected at the second time point. A latent profile transition analysis (LPTA) was used to test associations, and results indicated that the attenuated-preoccupied subtype presented with the significantly lowest levels of VABS adaptive behavior composite scores compared to the other three sensory subtypes. Both the VABS maladaptive behavior index and the total PSI score were significantly highest in the extreme-mixed subtype. These results underscore the clinical utility of this subtyping approach for differentiating characteristics and functional outcomes associated with clinically defined sensory phenotypes. These findings may have implications for better understanding etiology, prognosis, and more precise targets for interventions designed to ameliorate sensory difficulties, and ultimately mitigate negative developmental consequences and parenting stress. Autism Res 2016, 9: 1316-1327. © 2016 International Society for Autism Research, Wiley Periodicals, Inc. © 2016 International Society for Autism Research, Wiley Periodicals, Inc.

  19. [The Spanish adapted version of the Children's Communication Checklist identifies disorders of pragmatic use of language and differentiates between clinical subtypes].

    Science.gov (United States)

    Crespo-Eguilaz, N; Magallon, S; Sanchez-Carpintero, R; Narbona, J

    2016-01-01

    The Children's Communication Checklist (CCC) by Bishop is a useful scale for evaluation of pragmatic verbal abilities in school children. The aim of the study is to ascertain the validity and reliability of the CCC in Spanish. Answers to the CCC items by parents of 360 children with normal intelligence were analyzed. There were five groups: 160 control children; 68 children with attention deficit hyperactivity disorder, 77 with procedural non-verbal disorder, 25 children with social communication disorder and 30 with autism spectrum disorder. Investigations included: factorial analysis in order to cluster checklist items, reliability analyses of the proposed scales and discriminant analysis to check whether the scale correctly classifies children with pragmatic verbal abilities. Seven factors were obtained (Kaiser-Meyer-Olkin: 0.852) with moderate similarity with those of the original scale: social relationships, interests, and five more that can be grouped into pragmatic verbal ability (conversational abilities, coherence-comprehension, empathy nonverbal communication and appropriateness). All factors are significantly correlated with each other in the control group, and the five that compose pragmatic verbal ability correlate with each other in the clinical groups (Pearson r). The scales have good reliability (Cronbach's alpha: 0.914). The questionnaire correctly classifies 98.9% of grouped cases with and without pragmatic disorder and 78% of subjects in their appropriate clinical group. Besides, the questionnaire allows to differentiate the pathologies according to the presence and intensity of the symptoms. This Spanish version of the CCC is highly valid and reliable. The proposed statistics can be used as normative-reference values.

  20. Assessment of completion of early medical abortion using a text questionnaire on mobile phones compared to a self-administered paper questionnaire among women attending four clinics, Cape Town, South Africa.

    Science.gov (United States)

    Constant, Deborah; de Tolly, Katherine; Harries, Jane; Myer, Landon

    2015-02-01

    In-clinic follow-up to assess completion of medical abortion is no longer a requirement according to World Health Organization guidance, provided adequate counselling is given. However, timely recognition of ongoing pregnancy, complications or incomplete abortion, which require treatment, is important. As part of a larger trial, this study aimed to establish whether women having a medical abortion could self-assess whether their abortion was complete using an automated, interactive questionnaire on their mobile phones. All 469 participants received standard abortion care and all returnees filled in a self-assessment on paper at clinic follow-up 2-3 weeks later. The 234 women allocated to receive the phone messages were also asked to do a mobile phone assessment at home ten days post-misoprostol. Completion of the mobile assessment was tracked by computer and all completed assessments, paper and mobile, were compared to providers' assessments at clinic follow-up. Of the 226 women able to access the mobile phone assessment, 176 (78%) completed it; 161 of them (93%) reported it was easy to do so. Neither mobile nor paper self-assessments predicted all cases needing additional treatment at follow-up. Prediction of complete procedures was good; 71% of mobile assessments and 91% of paper assessments were accurate. We conclude that an interactive questionnaire assessing completion of medical abortion on mobile phones is feasible in the South African setting; however, it should be done later than day 10 and combined with an appropriate pregnancy test to accurately detect incomplete procedures. Copyright © 2015 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

  1. A psychometric evaluation of the behavioral inhibition questionnaire in a non-clinical sample of Dutch children and adolescents.

    NARCIS (Netherlands)

    S.M.L. Broeren (Suzanne); P.E.H.M. Muris (Peter)

    2010-01-01

    textabstractThe Behavioral Inhibition Questionnaire (BIQ) is a parent-rating scale for measuring temperamental characteristics referring to shyness, fearfulness, and withdrawal in young, preschool children. The present study evaluated the psychometric properties of the BIQ in a Dutch community sampl

  2. A psychometric evaluation of the behavioral inhibition questionnaire in a non-clinical sample of Dutch children and adolescents.

    NARCIS (Netherlands)

    S.M.L. Broeren (Suzanne); P.E.H.M. Muris (Peter)

    2010-01-01

    textabstractThe Behavioral Inhibition Questionnaire (BIQ) is a parent-rating scale for measuring temperamental characteristics referring to shyness, fearfulness, and withdrawal in young, preschool children. The present study evaluated the psychometric properties of the BIQ in a Dutch community sampl

  3. A Psychometric Evaluation of the Behavioral Inhibition Questionnaire in a Non-Clinical Sample of Dutch Children and Adolescents

    Science.gov (United States)

    Broeren, Suzanne; Muris, Peter

    2010-01-01

    The Behavioral Inhibition Questionnaire (BIQ) is a parent-rating scale for measuring temperamental characteristics referring to shyness, fearfulness, and withdrawal in young, preschool children. The present study evaluated the psychometric properties of the BIQ in a Dutch community sample of children with a broad age range. For this purpose, the…

  4. Characteristics of nickel-allergic dermatitis patients seen in private dermatology clinics in Denmark: a questionnaire study

    DEFF Research Database (Denmark)

    Thyssen, Jacob Pontoppidan; Hald, Marianne; Avnstorp, Christian

    2009-01-01

    . During 2006 to 2007, 634 patients with dermatitis aged 17-91 years were patch-tested and completed a questionnaire including a question about the occurrence of dermatitis following skin contact with ear-rings or ear-pins, watches, buttons or metal clasps (i.e. metal dermatitis). chi2 tests were applied...

  5. Factor structure of the General Health Questionnaire-28 (GHQ-28 from infertile women attending the Yazd Research and Clinical Center for Infertility

    Directory of Open Access Journals (Sweden)

    Zahra Shayan

    2015-12-01

    Full Text Available Background: Nowadays, infertility problems have become a social concern, and are associated with multiple psychological and social problems. Also, it affects the interpersonal communication between the individual, familial, and social characteristics. Since women are exposed to stressors of physical, mental, social factors, and treatment of infertility, providing a psychometric screening tool is necessary for disorders of this group. Objective: The aim of this study was to determine the factor structure of the general health questionnaire-28 to discover mental disorders in infertile women. Materials and Methods: In this study, 220 infertile women undergoing treatment of infertility were selected from the Yazd Research and Clinical Center for Infertility with convenience sampling in 2011. After completing the general health questionnaire by the project manager, validity and, reliability of the questionnaire were calculated by confirmatory factor structure and Cronbach's alpha, respectively. Results: Four factors, including anxiety and insomnia, social dysfunction, depression, and physical symptoms were extracted from the factor structure. 50.12% of the total variance was explained by four factors. The reliability coefficient of the questionnaire was obtained 0.90. Conclusion: Analysis of the factor structure and reliability of General Health Questionnaire-28 showed that it is suitable as a screening instrument for assessing general health of infertile women.

  6. The causative gene and clinical features of various subtypes of spinocerebellar ataxia%脊髓小脑共济失调各亚型致病基因及临床表现

    Institute of Scientific and Technical Information of China (English)

    宋建萍; 杨丹; 陈涛; 李海江; 李方方

    2016-01-01

    脊髓小脑共济失调(SCAs)是一种严重致残、致死的神经系统遗传变性疾病,具有高度的临床异质性和遗传异质性.根据致病基因定位的不同,分为不同的亚型.SCAs通常以进行性共济失调为主要临床特征,临床诊断的难点在于各个亚型的临床表现之间相互重叠,因此将各型特有的临床表现、致病基因进行系统综述,有助于通过常见的临床表现对各亚型进行临床初诊,也使基因检测更具有针对性.%Spinocerebellar ataxia (SCAs) is a series of degenerative diseases of the nervous system that lead to disability and death,and has high clinical and genetic heterogeneity.According to different loci of the causative genes,SCAs can be divided into different subtypes.In general,progressive ataxia is the main clinical features of SCAs.The difficulty of clinical diagnosis is the overlapping of the clinical manifestations between various subtypes.Thus,systematically reviewing the unique clinical manifestations and causative genes of the subtypes of SCAs here will be beneficial to the initial clinical diagnosis and to targeting the gene sequencing accurately.

  7. "Blue flags", development of a short clinical questionnaire on work-related psychosocial risk factors - a validation study in primary care.

    Science.gov (United States)

    Post Sennehed, Charlotte; Gard, Gunvor; Holmberg, Sara; Stigmar, Kjerstin; Forsbrand, Malin; Grahn, Birgitta

    2017-07-24

    Working conditions substantially influence health, work ability and sick leave. Useful instruments to help clinicians pay attention to working conditions are lacking in primary care (PC). The aim of this study was to test the validity of a short "Blue flags" questionnaire, which focuses on work-related psychosocial risk factors and any potential need for contacts and/or actions at the workplace. From the original"The General Nordic Questionnaire" (QPSNordic) the research group identified five content areas with a total of 51 items which were considered to be most relevant focusing on work-related psychosocial risk factors. Fourteen items were selected from the identified QPSNordic content areas and organised in a short questionnaire "Blue flags". These 14 items were validated towards the 51 QPSNordic items. Content validity was reviewed by a professional panel and a patient panel. Structural and concurrent validity were also tested within a randomised clinical trial. The two panels (n = 111) considered the 14 psychosocial items to be relevant. A four-factor model was extracted with an explained variance of 25.2%, 14.9%, 10.9% and 8.3% respectively. All 14 items showed satisfactory loadings on all factors. Concerning concurrent validity the overall correlation was very strong rs = 0.87 (p development of the "Blue flags" questionnaire. In summary, the overall validity is considered acceptable. Testing in clinical contexts and in other patient populations is recommended to ensure predictive validity and usefulness.

  8. Clinical features of psoriatic arthritis in Korean patients with psoriasis: a cross-sectional observational study of 196 patients with psoriasis using psoriatic arthritis screening questionnaires.

    Science.gov (United States)

    Shin, Dongyun; Kim, Hee Joo; Kim, Dae Suk; Kim, Soo Min; Park, Jin Su; Park, Yong-Beom; Lee, Min-Geol

    2016-02-01

    The prevalence and clinical features of psoriatic arthritis (PsA) in psoriasis patients vary widely in different countries, and studies on Korean population are rarely reported. The aim of this study was to investigate the clinical features of PsA in a Korean population of patients with psoriasis by using psoriatic arthritis screening questionnaires. A cross-sectional observational study was conducted, and consecutive psoriatic patients were evaluated for PsA by using two kinds of psoriatic arthritis screening questionnaires: Psoriatic Arthritis Screening and Evaluation tool (PASE) and Psoriasis Epidemiology Screening Tool (PEST). Psoriatic patients with higher score in screening questionnaires were referred to rheumatologist for confirmative diagnosis of PsA. Among 196 psoriasis patients screened by PASE and PEST, total prevalence of PsA was 11.2 % (n = 22/196) with 59.1 % of the cases being newly diagnosed. Compared with patients without PsA, patients with PsA had more extensive psoriasis, higher frequency of pustular and inverse type of psoriasis, and lower frequency of plaque type of psoriasis. Spondylitis was the most common manifestation pattern, followed by polyarthritis, oligoarthritis, predominant distal interphalangeal arthritis, and arthritis mutilans. Our findings are consistent with a low prevalence of PsA among patients with psoriasis in Asia. We also confirm a spondylitis as the most common pattern of PsA in Korea. PsA screening questionnaires can be a simple and useful tool to screen PsA in patients with psoriasis.

  9. 门诊帕金森病患者快速眼球运动睡眠期行为障碍在不同运动亚型间的比较%A comparative study on clinical rapid eye movement sleep behavior disorder and motor subtypes in outpatients with Parkinson's disease

    Institute of Scientific and Technical Information of China (English)

    武冬冬; 苏闻; 李淑华; 何婧; 马欣昕; 刘慧菁; 金莹; 金丽莹; 崔艺耀

    2016-01-01

    Objective To investigate the incidence and severity of clinical rapid eye movement sleep behavior disorder (RBD) in Parkinson's disease (PD),and the association with motor subtypes.Methods We recruited 187 patients with PD (Hoehn-Yahr stage Ⅰ-Ⅲ) from outpatient department in Beijing Hospital.The general information of the patients was collected and the Unified Parkinson's Disease Rating Scale (UPDRS) scores were caculated.The patients were divided into two subgroups as tremor dominant (TD) and non-tremor dominant (NTD).One hundred matched healthy controls (HC) were enrolled.We used the minimal diagnostic criteria of parasomnias described in the International Classification of Sleep Disorders-Revised to diagnose clinical RBD.The Stavanger Sleepiness Questionnaire (SSQ) was used to rate the severity of clinical RBD.The PD group and HC group were compared with incidence of clinical RBD.The TD subgroup and NTD subgroup were compared with each other for severity and incidence of clinical RBD,the UPDRS scores and disease duration.The correlation between severity of clinical RBD and clinical severity of PD was analyzed in the patient groups.Results The incidence of clinical RBD in PD and HC groups was 46.5% (87/187) and 5.0% (5/100).The difference between two groups was significant (x2 =1.537,P =0.000).Of the patients,36.4% (68/187) had the NTD subtype of PD.There were no significant differences in the incidence and severity of clinical RBD between NTD subtype and TD subtype.For the NTD patients,there was positive correlation between severity of clinical RBD (SSQ scores) and clinical severity (UPDRS scores and the Hoehn-Yahr stage) of PD (r =0.266,P =0.028;r =0.263,P =0.030).Conclusion In our study,incidence of clinical RBD is unrelated to motor subtypes of PD.There is a positive correlation between clinical severity of PD and severity of clinical RBD in the NTD subtype but not in the TD subtype.%目的 探讨帕金森病患者中快速眼球运动睡眠期行

  10. Development and validation of a self-efficacy questionnaire (SE-12) measuring the clinical communication skills of health care professionals

    DEFF Research Database (Denmark)

    Axboe, Mette K; Christensen, Kaj S; Kofoed, Poul-Erik;

    2016-01-01

    adjustments, the SE-12 questionnaire demonstrated evidence of content validity. An explorative factor analysis indicated unidimensionality with highly correlated items. A Cronbach’s α of 0.95 and a Loevinger’s H coefficient of 0.71 provided evidence of statistical reliability and scalability. The test...... of the theoretical approach applied in the communication course, statements from former course participants, teachers, and experts in the field. The questionnaire was initially validated through face-to-face interviews with 9 staff members following a test-retest including 195 participants. Results After minor......-retest reliability had a value of 0.71 when evaluated using intra-class correlation. Expected relations with other variables were partially confirmed in two of three hypotheses, but a ceiling effect was present in 9 of 12 items. Conclusions The SE-12 scale should be regarded a reliable and partially valid instrument...

  11. Cross sectional questionnaire-based internet study: Self-perception and clinical course of drug allergy in Greece

    Directory of Open Access Journals (Sweden)

    Michael P. Makris

    2017-01-01

    Conclusions: Allergic reactions to drugs are adverse events difficult to define and diagnose. A remarkable proportion of presumed as hypersensitivity reactions are not referred to allergists; therefore these patients may be either re-exposed to potentially noxious drugs, or needlessly avoid whole classes of drugs as b-lactams for more costly or less appropriate treatments. Internet-based questionnaires may contribute to awareness programs concerning drug allergy and help improve proper referral.

  12. Molecular subtypes and imaging phenotypes of breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Nariya [Dept. of Radiology, Seoul National University Hospital, Seoul (Korea, Republic of)

    2016-08-15

    During the last 15 years, traditional breast cancer classifications based on histopathology have been reorganized into the luminal A, luminal B, human epidermal growth factor receptor 2 (HER2), and basal-like subtypes based on gene expression profiling. Each molecular subtype has shown varying risk for progression, response to treatment, and survival outcomes. Research linking the imaging phenotype with the molecular subtype has revealed that non-calcified, relatively circumscribed masses with posterior acoustic enhancement are common in the basal-like subtype, spiculated masses with a poorly circumscribed margin and posterior acoustic shadowing in the luminal subtype, and pleomorphic calcifications in the HER2-enriched subtype. Understanding the clinical implications of the molecular subtypes and imaging phenotypes could help radiologists guide precision medicine, tailoring medical treatment to patients and their tumor characteristics.

  13. Molecular Identification and Subtype Analysis of Blastocystis.

    Science.gov (United States)

    Stensvold, C Rune; Clark, C Graham

    2016-11-18

    Several typing methods have been used in studies aiming to unravel the molecular epidemiology of Blastocystis, which is one of the most common intestinal parasites in human and many non-human hosts. Such studies have the potential to add to knowledge on Blastocystis transmission, host specificity, phylogeography, and clinical and public health significance, but rely on robust, standardized methods by which data can be generated and compared directly between studies. One of the most used methods is "barcoding,", which involves single-round PCR amplification and sequencing of partial small subunit ribosomal RNA genes of the parasites. Recently, a publicly available online facility was developed for quick and standardized identification of subtypes (ribosomal lineages) and subtype alleles (variation within subtypes) based on sequence data obtained by barcoding PCR. Moreover, a modified barcoding approach is now available using nested PCR, which enables detection of mixed subtype infections. © 2016 by John Wiley & Sons, Inc. Copyright © 2016 John Wiley & Sons, Inc.

  14. Validity of the Children's Social Behavior Questionnaire (CSBQ) in children with intellectual disability: comparing the CSBQ with ADI-R, ADOS, and clinical DSM-IV-TR classification.

    Science.gov (United States)

    de Bildt, Annelies; Mulder, Erik J; Hoekstra, Pieter J; van Lang, Natasja D J; Minderaa, Ruud B; Hartman, Catharina A

    2009-10-01

    The Children's Social Behavior Questionnaire (CSBQ) was compared with the Autism Diagnostic Interview-Revised (ADI-R), Autism Diagnostic Observation Schedule (ADOS), and clinical classification in children with mild and moderate intellectual disability (ID), to investigate its criterion related validity. The contribution of the CSBQ to a classification of Autism Spectrum Disorder (ASD) was most specific for the subscales 'contact' and 'stereotyped', with high coherence with all three classification methods. The CSBQ may be used as a signaling, screening, or describing instrument for children with ASD and ID, as it complements other methods by adding unique information about the clinical presentation.

  15. Development of a questionnaire to assess the factors associated with clinical learning of nursing students: A Delphi study

    OpenAIRE

    M Emami Maybodi; M. Mirzaei; T Farajkhoda; Soltani-Arabshahi, K

    2015-01-01

    Introduction : Inhibiting factors in clinical learning of nursing students cause a huge gap between the optimum and the current situation in performance of the graduates . Due to the lack of a comprehensive and reliable tool for the identification of these factors in Iran , this study aimed to develop a scale to assess the related items to nursing students’ clinical learning.   Methods : This descriptive study used Delphi approach to assess factors associated with clinical learning of nursing...

  16. 汪氏失眠综合问卷(WIIQ)的临床应用解读%The interpretation of clinical application to Wang integrated insomnia questionnair

    Institute of Scientific and Technical Information of China (English)

    唐常荣; 董徐斌; Birling Yoann; 冯帆; 田辰辰; 汪卫东

    2016-01-01

    汪氏失眠综合问卷(WIIQ)由中国中医科学院广安门医院汪卫东教授及其团队根据几十年的临床经验与研究编制而成,问卷涵盖失眠患者的睡眠习惯、失眠特点和原因、人格特点等,系统把握患者失眠的发病过程,对于临床治疗起到针对性的指导作用,提高临床诊疗效率。本文就汪氏失眠综合问卷(WIIQ)的临床应用进行解读,为开展临床失眠评估与治疗提供参考。%Wang integrated insomnia questionnair (WIIQ)was compiled from decades of clinical experience and re-search by professor Wang Weidong and his team.The questionnair cover sleep hygiene、insomnia features and account、personality traits etc,system grasp the pathogenesis of insomnia,provide specific guidance for clinical treatment,which can improve the efficiency of clinical diagnosis and treatment.This article mainly to interprete the clinical application of WIIQ,provide reference for clinical evaluation and treatment of insomnia.

  17. Comparative pathogenesis of a subtype A with a subtype B avian pneumovirus in turkeys.

    Science.gov (United States)

    Van de Zande, S; Nauwynck, H; De Jonghe, S; Pensaert, M

    1999-06-01

    This paper describes a study in which the pathogenesis of avian pneumovirus strains, isolated in Belgium, and belonging to the two subtypes A and B, were compared in 2-week-old turkeys. After oculonasal inoculation, animals were either observed for clinical signs or killed for pathological and virological examination. Virus titration and immunofluorescence were performed on the conjunctivae, turbinates, sinuses, upper and lower part of the trachea, lungs and air sacs. No differences were seen between the two subtypes concerning respiratory signs, or macroscopic and microscopic lesions in the respiratory tract. Slight variations were found in site and extent of virus replication. First, only subtype A was able to invade the lower parts of the respiratory tract (bronchi), whereas viral antigens were not detected in the lungs with subtype B. Secondly, the subtype A strain infected two times more epithelial cells at all levels of the upper respiratory tract compared to subtype B. Thirdly, the amount of virus produced at different sites along the respiratory tract was lower in subtype B-inoculated turkeys than in subtype A-inoculated ones.

  18. Clinical Characterization of Adults with Asperger's Syndrome Assessed by Self-Report Questionnaires Based on Depression, Anxiety, and Personality

    Science.gov (United States)

    Kanai, Chieko; Iwanami, Akira; Hashimoto, Ryuichiro; Ota, Haruhisa; Tani, Masayuki; Yamada, Takashi; Kato, Nobumasa

    2011-01-01

    Diagnosing Asperger's syndrome (AS) in adults is difficult and efficient indicators for a precise diagnosis are important in the clinical setting. We examined the clinical characteristics of AS in 129 adults (median age, 32.0 years [range, 19-57]; 102 men and 27 women; AS group (n = 64; median age, 32.0 years [range, 19-50]; 50 men and 14 women),…

  19. Presence of avian pneumovirus subtypes A and B in Japan.

    Science.gov (United States)

    Mase, Masaji; Yamaguchi, Shigeo; Tsukamoto, Kenji; Imada, Tadao; Imai, Kunitoshi; Nakamura, Kikuyasu

    2003-01-01

    Four avian pneumovirus (APV) isolates from chickens clinically diagnosed with swollen head syndrome were genetically characterized as to the subtypes of the virus in Japan. The results of reverse transcriptase-polymerase chain reactions based on subtype-specific primers and direct sequence analysis of G genes indicated subtypes A and B but not C or D of APV were present in Japan. Several routes or sources are conceivable for APV to invade into Japan.

  20. Prevalence and correlates of psychopathology in children and adolescents evaluated with the strengths and difficulties questionnaire dysregulation profile in a clinical setting.

    Science.gov (United States)

    Carballo, Juan José; Serrano-Drozdowskyj, Elena; García Nieto, Rebeca; Díaz de Neira-Hernando, Mónica; Pérez-Fominaya, Margarita; Molina-Pizarro, Cristian Antonio; De León-Martínez, Victoria; Baca-García, Enrique

    2014-01-01

    The clinical presentation of children and adolescents referred to mental health services is frequently complicated by comorbid and severe affective and behavioral dysregulation. This dysregulation phenotype seems to be an indicator of overall psychopathology, symptom severity and functional impairment. Currently, this phenotype is assessed by the Child Behavior Checklist. However, the widely used Strengths and Difficulties Questionnaire (SDQ) has been recently validated to screen the Dysregulation Profile (SDQ-DP) in clinical settings. The objective of this study was to determine the prevalence and demographic, psychosocial and clinical correlates of the SDQ-DP phenotype in a Spanish clinical sample. In a clinical sample of 623 consecutively referred children and adolescents (4-17 years old), we compared clinical and sociodemographic correlates between subjects who met the SDQ-DP criteria (DP) and those who did not (NO_DP). Sociodemographic data, parent-rated SDQ, Children's Global Assessment Scale, Clinical Global Impression, family Apgar scale and clinical diagnoses were collected by experienced child and adolescent psychiatrists. Overall in our sample, 175 subjects (28.1%) met the SDQ-DP criteria (DP group). Compared with the NO_DP group, the DP subjects had significantly higher scores on internalizing and externalizing psychopathology, problems with peers and overall problems as well as significantly lower scores on prosocial behavior. Clinical diagnoses assigned revealed that DP subjects showed significantly greater psychiatric comorbidity. DP subjects also showed significantly worse family functioning and increased symptom severity and significantly lower scores on psychosocial functioning. A high prevalence of children and adolescents with the dysregulated profile, assessed by the SDQ-DP, was found in our clinical setting. The SDQ-DP may serve as an index of overall psychological severity and functional impairment. In addition, it may indicate family

  1. Usefulness of the Spanish version of the mood disorder questionnaire for screening bipolar disorder in routine clinical practice in outpatients with major depression

    Directory of Open Access Journals (Sweden)

    Montes José

    2008-05-01

    Full Text Available Abstract Background According to some studies, almost 40% of depressive patients – half of them previously undetected – are diagnosed of bipolar II disorder when systematically assessed for hypomania. Thus, instruments for bipolar disorder screening are needed. The Mood Disorder Questionnaire (MDQ is a self-reported questionnaire validated in Spanish in stable patients with a previously known diagnosis. The purpose of this study is to evaluate in the daily clinical practice the usefulness of the Spanish version of the MDQ in depressive patients. Methods Patients (n = 87 meeting DSM-IV-TR criteria for a major depressive episode, not previously known as bipolar were included. The affective module of the Structured Clinical Interview (SCID was used as gold standard. Results MDQ screened 24.1% of depressive patients as bipolar, vs. 12.6% according to SCID. For a cut-off point score of 7 positive answers, sensitivity was 72.7% (95% CI = 63.3 – 82.1 and specificity 82.9% (95% CI = 74.9–90.9. Likelihood ratio of positive and negative tests were 4,252 y 0,329 respectively. Limitations The small sample size reduced the power of the study to 62%. Conclusion Sensitivity and specificity of the MDQ were high for screening bipolar disorder in patients with major depression, and similar to the figures obtained in stable patients. This study confirms that MDQ is a useful instrument in the daily clinical assessment of depressive patients.

  2. Bifactor analysis and construct validity of the five facet mindfulness questionnaire (FFMQ) in non-clinical Spanish samples.

    Science.gov (United States)

    Aguado, Jaume; Luciano, Juan V; Cebolla, Ausias; Serrano-Blanco, Antoni; Soler, Joaquim; García-Campayo, Javier

    2015-01-01

    The objective of the present study was to examine the dimensionality, reliability, and construct validity of the Five Facet Mindfulness Questionnaire (FFMQ) in three Spanish samples using structural equation modeling (SEM). Pooling the FFMQ data from 3 Spanish samples (n = 1191), we estimated the fit of two competing models (correlated five-factor vs. bifactor) via confirmatory factor analysis. The factorial invariance of the best fitting model across meditative practice was also addressed. The pattern of relationships between the FFMQ latent dimensions and anxiety, depression, and distress was analyzed using SEM. FFMQ reliability was examined by computing the omega and omega hierarchical coefficients. The bifactor model, which accounted for the covariance among FFMQ items with regard to one general factor (mindfulness) and five orthogonal factors (observing, describing, acting with awareness, non-judgment, and non-reactivity), fit the FFMQ structure better than the correlated five-factor model. The relationships between the latent variables and their manifest indicators were not invariant across the meditative experience. Observing items had significant loadings on the general mindfulness factor, but only in the meditator sub-sample. The SEM analysis revealed significant links between mindfulness and symptoms of depression and stress. When the general factor was partialled out, the acting with awareness facet did not show adequate reliability. The FFMQ shows a robust bifactor structure among Spanish individuals. Nevertheless, the Observing subscale does not seem to be adequate for assessing mindfulness in individuals without meditative experience.

  3. Bifactor analysis and construct validity of the Five Facet Mindfulness Questionnaire (FFMQ in non-clinical Spanish samples

    Directory of Open Access Journals (Sweden)

    Jaume eAguado

    2015-04-01

    Full Text Available The objective of the present study was to examine the dimensionality, reliability, and construct validity of the Five Facet Mindfulness Questionnaire (FFMQ in three Spanish samples using structural equation modelling (SEM. Pooling the FFMQ data from 3 Spanish samples (n= 1191, we estimated the fit of two competing models (correlated five-factor vs. bifactor via confirmatory factor analysis. The factorial invariance of the best fitting model across meditative practice was also addressed. The pattern of relationships between the FFMQ latent dimensions and anxiety, depression, and distress was analysed using SEM. FFMQ reliability was examined by computing the omega and omega hierarchical coefficients. The bifactor model, which accounted for the covariance among FFMQ items with regard to one general factor (mindfulness and five orthogonal factors (observing, describing, acting with awareness, non-judgment, and non-reactivity, fit the FFMQ structure better than the correlated five-factor model. The relationships between the latent variables and their manifest indicators were not invariant across the meditative experience. Observing items had significant loadings on the general mindfulness factor, but only in the meditator sub-sample. The SEM analysis revealed significant links between mindfulness and symptoms of depression and stress. When the general factor was partialled out, the acting with awareness facet did not show adequate reliability. The FFMQ shows a robust bifactor structure among Spanish individuals. Nevertheless, the Observing subscale does not seem to be adequate for assessing mindfulness in individuals without meditative experience.

  4. Variability of Delirium Motor Subtype Scale-Defined Delirium Motor Subtypes in Elderly Adults with Hip Fracture: A Longitudinal Study.

    Science.gov (United States)

    Scholtens, Rikie M; van Munster, Barbara C; Adamis, Dimitrios; de Jonghe, Annemarieke; Meagher, David J; de Rooij, Sophia E J A

    2017-02-01

    To examine changes in motor subtype profile in individuals with delirium. Observational, longitudinal study; substudy of a multicenter, randomized controlled trial. Departments of surgery and orthopedics, Academic Medical Center and Tergooi Hospital, the Netherlands. Elderly adults acutely admitted for hip fracture surgery who developed delirium according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, for 2 days or longer (n = 76, aged 86.4 ± 6.1, 68.4% female). Delirium Motor Subtype Scale (DMSS), Delirium Rating Scale R98 (DRS-R98), comorbidity, and function. Median delirium duration was 3 days (interquartile range 2.0 days). At first assessment, the hyperactive motor subtype was most common (44.7%), followed by hypoactive motor subtype (28.9%), mixed motor subtype (19.7%), and no motor subtype (6.6%). Participants with no motor subtype had lower DRS-R98 scores than those with the other subtypes (P delirium duration or severity were not associated with change in motor subtype. Motor subtype profile was variable in the majority of participants, although changes that occurred were often related to changes from or to no motor subtype, suggesting evolving or resolving delirium. Changes appeared not be associated with demographic or clinical characteristics, suggesting that evidence from cross-sectional studies of motor subtypes could be applied to many individuals with delirium. Further longitudinal studies should be performed to clarify the stability of motor subtypes in different clinical populations. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

  5. Low penetrance breast cancer susceptibility loci are associated with specific breast tumor subtypes

    DEFF Research Database (Denmark)

    Broeks, Annegien; Schmidt, Marjanka K; Sherman, Mark E

    2011-01-01

    Breast cancers demonstrate substantial biological, clinical and etiological heterogeneity. We investigated breast cancer risk associations of eight susceptibility loci identified in GWAS and two putative susceptibility loci in candidate genes in relation to specific breast tumor subtypes. Subtype...

  6. [Possibilities and problems in the development of forensic nursing in Japan: a questionnaire survey of clinical nurses].

    Science.gov (United States)

    Kodama, Hiromi; Tsuntematsu, Kayoko; Yanai, Keiko

    2012-09-01

    Forensic nursing scientifically obtains and preserves the criminal damage from victims of domestic violence, child abuse, elder abuse, sexual violence and other related forms of violence. This was developed in North America in the 1980s, and has carried out appropriate nursing care while protecting the human rights of victims. Serious crime in Japan has been increasing, and it would seem that forensic nursing opportunities should expand as well. However, in Japan, there hasn't been much discussion about forensic nursing. Theorizing that support for clinical forensic nursing should be recognized and relevant, we carried out a survey of 581 clinical nurses to investigate the development of forensic nursing in Japan. 93 clinical nurses (16.0%) had a low level of familiarity with forensic nursing; however, 324 nurses (56.3%) had encountered patients who had suffered violence. 264 nurses (45.4%) had a feeling of wanting to be involved in forensic nursing, but were not confident with the knowledge and technology, while 144 nurses (24.8%) were concerned about the larger responsibility they would have. 400 nurses (68.8%) hoped to receive specialized knowledge and technical education. It is necessary to establish an education system for forensic nursing in accordance with the educational status-quo while considering the present state of forensic nursing education.

  7. Distinct subtypes of knee osteoarthritis: Data from the Osteoarthritis Initiative

    NARCIS (Netherlands)

    J.H. Waarsing (Jan); S.M. Bierma-Zeinstra (Sita); H.H. Weinans (Harrie)

    2015-01-01

    textabstractObjective. OA is suspected to be a collection of distinct subtypes, each with different aetiology and clinical characteristics. We aimed to explore the existence of different subtypes of knee OA, using cluster analysis of the data of the OA Initiative. Methods. We used latent class

  8. Distinct subtypes of knee osteoarthritis : data from the Osteoarthritis Initiative

    NARCIS (Netherlands)

    Waarsing, Jan H; Bierma-Zeinstra, Sita M A; Weinans, Harrie

    OBJECTIVE: OA is suspected to be a collection of distinct subtypes, each with different aetiology and clinical characteristics. We aimed to explore the existence of different subtypes of knee OA, using cluster analysis of the data of the OA Initiative. METHODS: We used latent class cluster analysis

  9. Distinct subtypes of knee osteoarthritis : data from the Osteoarthritis Initiative

    NARCIS (Netherlands)

    Waarsing, Jan H; Bierma-Zeinstra, Sita M A; Weinans, Harrie

    2015-01-01

    OBJECTIVE: OA is suspected to be a collection of distinct subtypes, each with different aetiology and clinical characteristics. We aimed to explore the existence of different subtypes of knee OA, using cluster analysis of the data of the OA Initiative. METHODS: We used latent class cluster analysis

  10. Are licensed canine parvovirus (CPV2 and CPV2b) vaccines able to elicit protection against CPV2c subtype in puppies?: A systematic review of controlled clinical trials.

    Science.gov (United States)

    Hernández-Blanco, Beatriz; Catala-López, Ferrán

    2015-10-22

    Severe gastroenteritis caused by canine parvovirus type 2 (CPV2) is a serious life-threatening disease in puppies less than 4-months of age. The emergence of new variants has provoked some concern about the cross-protection elicited by licensed canine parvovirus modified-live type 2 (CPV2) and type 2b (CPV2b) vaccines against the most recent subtype CPV2c. A systematic review was carried out to assess the efficacy of commercial vaccines. We conducted a literature search of Pub Med/MEDLINE from January 1990 to May 2014. This was supplemented by hand-searching of related citations and searches in Google/Google Scholar. Controlled clinical trials in which vaccinated puppies were challenged with CPV2c virus were evaluated. Reporting of outcome measures and results for vaccine efficacy were critically appraised through a variety of clinical signs, serological tests, virus shedding and the ability to overcome maternally derived antibodies (MDA) titres. Six controlled clinical trials were included in the review. In most cases, the results of the selected studies reported benefits in terms of clinical signs, serological tests and virus shedding. However, MDA interference was not considered or evaluated in 5 of the selected trials. No accurate definitions of baseline healthy status and/or clinical outcomes were provided. Methods of randomization, allocation concealment and blinding were usually poorly reported. As a result of the limited number of included studies matching the inclusion criteria, the small sample sizes, short follow-up and the methodological limitations observed, it was not possible to reach a final conclusion regarding the cross-protection of licensed CPV2 and CPV2b vaccines against the subtype 2c in puppies. Further and specifically designed trials are required in order to elucidate whether cross-protection is acquired from licensed CPV vaccines.

  11. Pathological Gambling Subtypes

    Science.gov (United States)

    Vachon, David D.; Bagby, R. Michael

    2009-01-01

    Although pathological gambling (PG) is regarded in the 4th edition of the "Diagnostic and Statistical Manual of Mental Disorders" (American Psychiatric Association, 1994) as a unitary diagnostic construct, it is likely composed of distinct subtypes. In the current report, the authors used cluster analyses of personality traits with a…

  12. Psychometric properties of the Dresden Body Image Questionnaire: A multiple-group confirmatory factor analysis across sex and age in a Dutch non-clinical sample

    Science.gov (United States)

    Scheffers, Mia; van Duijn, Marijtje A. J.; Bosscher, Ruud J.; Wiersma, Durk; Schoevers, Robert A.; van Busschbach, Jooske T.

    2017-01-01

    Background Body image has implications for psychosocial functioning and quality of life and its disturbance is reported in a broad range of psychiatric disorders. In view of the lack of instruments in Dutch measuring body image as a broad concept, we set out to make an instrument available that reflects the multidimensional character of this construct by including more dimensions than physical appearance. The Dresden Körperbildfragebogen (DBIQ, Dresden Body Image Questionnaire) particularly served this purpose. The DBIQ consists of 35 items and five subscales: body acceptance, sexual fulfillment, physical contact, vitality, and self-aggrandizement. The main objective of the present study was to evaluate the psychometric properties of the Dutch translation of the Dresden Body Image Questionnaire (DBIQ-NL) in a non-clinical sample. Methods The psychometric properties of the DBIQ-NL were examined in a non-clinical sample of 988 respondents aged between 18 and 65. We investigated the subscales' internal consistency and test-retest reliability. In order to establish construct validity we evaluated the association with a related construct, body cathexis, and with indices of self-esteem and psychological wellbeing. The factor structure of the DBIQ-NL was examined via confirmatory factor analysis (CFA). The equivalence of the measurement model across sex and age was evaluated by multiplegroup confirmatory factor analyses. Results Confirmatory factor analyses showed a structure in accordance with the original scale, where model fit was improved significantly by moving one item to another subscale. Multiple group confirmatory factor analysis across sex and age demonstrated partial strong invariance. Internal consistency was good with little overlap between the subscales. Temporal reliability and construct validity were satisfactory. Conclusion Results indicate that the DBIQ-NL is a reliable and valid instrument for non-clinical subjects. This provides a sound basis for

  13. SUBTYPES OF JUVENILE SYSTEMIC SCLERODERMA

    Directory of Open Access Journals (Sweden)

    M N Slarovoitova

    2001-01-01

    Full Text Available Aim: to allot clinical forms of juvenile systemic scleroderma (JSSD. Material and methods: investigation and dynamic observation of 60 patients aged 14-54 (mean age 25.1 ±7.2 with onset of disease in child's and adolescent’s ages from 1 to 16 years old ( in average 11. 4±3.8 year old and disease duration from 1 to 39 years (in average 13.1 ±7.9. Results: 55% of patients demonstrated JSSD subtype with focal cutaneous lesion of different localization. The possibility of overlap-syndrome development in JSSD patients with onset in adolescent age typical for SSD-rheumatoid arthritis, SSD-polymvositis should be underlined. Conclusion: knowledge of different clinical forms and courses of the disease, modern diagnostics and early beginning of differential JSSD treatment will enable us to improve the prognosis and disease outcome.

  14. {sup 18}F-FDG PET/CT in the early prediction of pathological response in aggressive subtypes of breast cancer: review of the literature and recommendations for use in clinical trials

    Energy Technology Data Exchange (ETDEWEB)

    Groheux, David [Saint-Louis Hospital, Department of Nuclear Medicine, Paris Cedex 10 (France); INSERM/CNRS UMR944/7212, University Paris-Diderot, PRES Paris Cite, Paris (France); Mankoff, David [University of Pennsylvania Perelman School of Medicine, Department of Radiology, Philadelphia (United States); Espie, Marc [INSERM/CNRS UMR944/7212, University Paris-Diderot, PRES Paris Cite, Paris (France); Saint-Louis Hospital, Department of Medical Oncology, Breast Diseases Centre, Paris (France); Hindie, Elif [University of Bordeaux, Department of Nuclear Medicine, Haut-Leveque Hospital, Bordeaux (France)

    2016-05-15

    Early assessment of response to neoadjuvant chemotherapy (NAC) might be helpful in avoiding the toxicity of ineffective chemotherapy and allowing refinement of treatment. We conducted a review of the literature regarding the applicability of {sup 18}F-FDG PET/CT to the prediction of an early pathological response in different subgroups of breast cancer. Clinical research in this field has intensified in the last few years. Early studies by various groups have shown the potential of {sup 18}F-FDG PET/CT in the early assessment of response to NAC. However, interim PET/CT in breast cancer has not yet gained wide acceptance compared to its use in other settings such as lymphomas. This is in part due to a lack of consensus that early evaluation of response can be used to direct change in therapy in the neoadjuvant breast cancer setting, and only limited data showing that response-adaptive therapy leads to improved outcomes. However, one major element that has hampered the use of {sup 18}F-FDG PET/CT in directing neoadjuvant therapy is its evaluation in populations with mixed subtypes of breast cancer. However, major improvements have occurred in recent years. Pilot studies have highlighted the need for considering breast cancer subtype and the type of treatment, and have offered criteria for the use of PET/CT for the early prediction of response in specific settings. {sup 18}F-FDG PET/CT has considerable potential for the early prediction of pathological complete response to NAC in aggressive subtypes such as triple-negative or HER2-positive breast cancers. The results of a multicentre trial that used early metabolic response on {sup 18}F-FDG PET/CT as a means to select poor responders to adapt neoadjuvant treatment have recently been published. Other trials are ongoing or being planned. (orig.)

  15. Clinical analysis of 670 cases in two trials of the European Organization for the Research and Treatment of Cancer Lymphoma Cooperative Group subtyped according to the Revised European-American Classification of Lymphoid Neoplasms: a comparison with the Working Formulation.

    Science.gov (United States)

    Pittaluga, S; Bijnens, L; Teodorovic, I; Hagenbeek, A; Meerwaldt, J H; Somers, R; Thomas, J; Noordijk, E M; De Wolf-Peeters, C

    1996-05-15

    In the Working Formulation (WF), non-Hodgkin's lymphomas (NHL) are grouped according to their clinical behavior. These disorders are listed as entities defined by morphology, phenotype, and cytogenetics in the proposed Revised European-American Classification of Lymphoid Neoplasms (REAL), the clinical relevance of which is still debated. We analyzed 670 NHL cases included in two randomized clinical trials (EORTC 20855 WF-intermediate/high-grade and 20856 WF-low-grade malignancy) with histologic material available for review. Based on hematoxylin-eosin-stained sections, 77% of cases could be subtyped. Immunophenotyping was considered to be mandatory only in diagnosing T-cell lymphoma and anaplastic large-cell lymphoma. Of 522 cases subtyped, 11% were mantle cell lymphoma (MCL), 5% were marginal zone B-cell lymphoma (MZBCL), 46% were follicle center lymphoma, and 32% were diffuse large B-cell lymphoma. Statistical analysis and comparisons between classifications were made only within each trial and treatment group. MCL and MZBCL were characterized by a shorter median survival (3.4 and 4.1 years, respectively) in comparison with low- and intermediate-grade WF groups (> 9.3 and 5.8 years, respectively). In terms of progression-free survival, MCL showed a behavior similar to the low-grade group, with frequent relapses. Follicle center cell lymphomas behaved as low-grade lymphomas as defined by the WF and diffuse large B-cell lymphomas as the WF-intermediate grade group. Because several NHL entities have a clinical behavior of their own, their recognition by the REAL classification offers clinicians additional information that is not obtained when the WF is used.

  16. Development of an abbreviated version of the delirium motor subtyping scale (DMSS-4)

    NARCIS (Netherlands)

    Meagher, D; Adamis, D; Leonard, M; Trzepacz, P; Grover, S; Jabbar, F; Meehan, K; O'Connor, M; Cronin, C; Reynolds, P; Fitzgerald, J; O'Regan, N; Timmons, S; Slor, C; de Jonghe, J; de Jonghe, A; van Munster, B C; de Rooij, S E; Maclullich, A

    2014-01-01

    BACKGROUND: Delirium is a common neuropsychiatric syndrome with considerable heterogeneity in clinical profile. Identification of clinical subtypes can allow for more targeted clinical and research efforts. We sought to develop a brief method for clinical subtyping in clinical and research settings.

  17. Identification of Multiple Subtypes of Campylobacter jejuni in Chicken Meat and the Impact on Source Attribution

    Directory of Open Access Journals (Sweden)

    John A. Hudson

    2013-09-01

    Full Text Available Most source attribution studies for Campylobacter use subtyping data based on single isolates from foods and environmental sources in an attempt to draw epidemiological inferences. It has been suggested that subtyping only one Campylobacter isolate per chicken carcass incurs a risk of failing to recognise the presence of clinically relevant, but numerically infrequent, subtypes. To investigate this, between 21 and 25 Campylobacter jejuni isolates from each of ten retail chicken carcasses were subtyped by pulsed-field gel electrophoresis (PFGE using the two restriction enzymes SmaI and KpnI. Among the 227 isolates, thirteen subtypes were identified, the most frequently occurring subtype being isolated from three carcasses. Six carcasses carried a single subtype, three carcasses carried two subtypes each and one carcass carried three subtypes. Some subtypes carried by an individual carcass were shown to be potentially clonally related. Comparison of C. jejuni subtypes from chickens with isolate subtypes from human clinical cases (n = 1248 revealed seven of the thirteen chicken subtypes were indistinguishable from human cases. None of the numerically minor chicken subtypes were identified in the human data. Therefore, typing only one Campylobacter isolate from individual chicken carcasses may be adequate to inform Campylobacter source attribution.

  18. Nursing students' experiences of the clinical learning environment in nursing homes: a questionnaire study using the CLES+T evaluation scale.

    Science.gov (United States)

    Carlson, Elisabeth; Idvall, Ewa

    2014-07-01

    One major challenge facing the health care systems worldwide is the growing demand for registered nurses able to provide qualified nursing care for a vulnerable population. Positive learning experiences during clinical practice influence not only learning outcomes, but also how students reason in relation to future career choices. To investigate student nurses' experiences of the clinical learning environment during clinical practice in nursing homes, and to compare perceptions among student nurses with or without prior work experience as health care assistants in elderly care. A cross-sectional study was designed, utilising the Swedish version of the CLES+T evaluation scale. 260 student nurses (response rate 76%) who had completed a five week long clinical placement in nursing homes returned the questionnaire during the data collection period in 2011-2012. Data were analysed using descriptive statistics. Mann-Whitney U-test was used to examine differences in relation to students with or without prior experience of elderly care. Overall, the clinical learning environment was evaluated in a predominantly positive way. The sub-dimension Supervisory relationship displayed the highest mean value, and the lowest score was calculated for the sub-dimension Leadership style of the ward manager. Statistical significant differences between sub-groups were displayed for four out of 34 items. The supervisory relationship had the greatest impact on how student nurses experienced the clinical learning environment in nursing homes. It is therefore, of utmost importance that collaborative activities, between educational and nursing home settings, supporting the work of preceptors are established and maintained. Copyright © 2014 Elsevier Ltd. All rights reserved.

  19. Clinical utility of the Chinese Strengths and Weaknesses of ADHD-Symptoms and Normal-behaviors questionnaire (SWAN when compared with DISC-IV

    Directory of Open Access Journals (Sweden)

    Chan GFC

    2014-08-01

    Full Text Available Grace Fong-Chun Chan,1 Kelly Yee-Ching Lai,2 Ernest Siu-Luen Luk,3 Se-Fong Hung,2 Patrick Wing-Leung Leung4 1Department of Psychiatry, Alice Ho Miu Ling Nethersole Hospital, 2Department of Psychiatry, The Chinese University of Hong Kong, 3Private practice, 4Clinical and Health Psychology Centre, Department of Psychology, The Chinese University of Hong Kong, Hong Kong Special Administrative Region Background: Attention-deficit/hyperactivity disorder (ADHD is a common and impairing child and adolescent psychiatric disorder. Early identification and prompt treatment are essential. Rating scales are commonly used by clinicians and researchers to assess ADHD children. Objective: In the current study, we aimed to examine the clinical utility of the Chinese version of the Strengths and Weaknesses of ADHD Symptoms and Normal Behaviors (SWAN questionnaire. We validated its subscale scores against the Diagnostic Interview Schedule for Children Version IV (DISC-IV and looked into its ability to identify ADHD in a psychiatric clinic setting. We also tested age and gender effects on SWAN scores. Specific subscale cutoff scores of SWAN were subsequently determined.Method: A total of 290 children aged 6–12 years old studying in local mainstream primary schools were recruited from a clinic setting and interviewed with the parent version of DISC-IV. Their parents and teachers completed the corresponding version of SWAN.Results: Both parent and teacher versions of SWAN were found to have good concurrent validity with DISC-IV. It could identify ADHD well in a clinic sample. Gender-specific cutoff scores were determined. Sensitivities and specificities were found to be satisfactory. SWAN was also found to perform equally well in identifying ADHD in those with and without comorbid Autistic Spectrum Disorder.Conclusion: SWAN was proven to be a useful tool to aid the assessment of ADHD in a clinic sample. Keywords: ADHD, SWAN, DISC-IV, validity

  20. Burnout Subtypes and Absence of Self-Compassion in Primary Healthcare Professionals: A Cross-Sectional Study.

    Science.gov (United States)

    Montero-Marin, Jesus; Zubiaga, Fernando; Cereceda, Maria; Piva Demarzo, Marcelo Marcos; Trenc, Patricia; Garcia-Campayo, Javier

    2016-01-01

    Primary healthcare professionals report high levels of distress and burnout. A new model of burnout has been developed to differentiate three clinical subtypes: 'frenetic', 'underchallenged' and 'worn-out'. The aim of this study was to confirm the validity and reliability of the burnout subtype model in Spanish primary healthcare professionals, and to assess the explanatory power of the self-compassion construct as a possible protective factor. The study employed a cross-sectional design. A sample of n = 440 Spanish primary healthcare professionals (214 general practitioners, 184 nurses, 42 medical residents) completed the Burnout Clinical Subtype Questionnaire (BCSQ-36), the Maslach Burnout Inventory General Survey (MBI-GS), the Self-Compassion Scale (SCS), the Utrecht Work Engagement Scale (UWES) and the Positive and Negative Affect Schedule (PANAS). The factor structure of the BCSQ-36 was estimated using confirmatory factor analysis (CFA) by the unweighted least squares method from polychoric correlations. Internal consistency (R) was assessed by squaring the correlation between the latent true variable and the observed variables. The relationships between the BCSQ-36 and the other constructs were analysed using Spearman's r and multiple linear regression models. The structure of the BCSQ-36 fit the data well, with adequate CFA indices for all the burnout subtypes. Reliability was adequate for all the scales and sub-scales (R≥0.75). Self-judgement was the self-compassion factor that explained the frenetic subtype (Beta = 0.36; pSpanish primary healthcare professionals. The negative self-compassion dimensions seem to play a relevant role in explaining the burnout profiles in this population, and they should be considered when designing specific treatments and interventions tailored to the specific vulnerability of each subtype.

  1. Cardiac potassium channel subtypes

    DEFF Research Database (Denmark)

    Schmitt, Nicole; Grunnet, Morten; Olesen, Søren-Peter

    2014-01-01

    that they could constitute targets for new pharmacological treatment of atrial fibrillation. The interplay between the different K(+) channel subtypes in both atria and ventricle is dynamic, and a significant up- and downregulation occurs in disease states such as atrial fibrillation or heart failure......About 10 distinct potassium channels in the heart are involved in shaping the action potential. Some of the K(+) channels are primarily responsible for early repolarization, whereas others drive late repolarization and still others are open throughout the cardiac cycle. Three main K(+) channels...... drive the late repolarization of the ventricle with some redundancy, and in atria this repolarization reserve is supplemented by the fairly atrial-specific KV1.5, Kir3, KCa, and K2P channels. The role of the latter two subtypes in atria is currently being clarified, and several findings indicate...

  2. ESSENCE-Q – a first clinical validation study of a new screening questionnaire for young children with suspected neurodevelopmental problems in south Japan

    Directory of Open Access Journals (Sweden)

    Hatakenaka Y

    2016-07-01

    Full Text Available Yuhei Hatakenaka,1,2 Elisabeth Fernell,2 Masahiko Sakaguchi,3 Hitoshi Ninomiya,3 Ichiro Fukunaga,1 Christopher Gillberg2 1Kochi Gillberg Neuropsychiatry Centre, Kochi Prefectural Medical and Welfare Centre, Kochi, Japan; 2Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; 3Integrated Centre for Advanced Medical Technologies, Kochi University Medical School, Kochi, Japan Background: Early identification of autism spectrum disorder, intellectual developmental disorder, attention-deficit/hyperactivity disorder, and other neurodevelopmental disorders/problems is crucial, yet diagnosis is often delayed for years under the often misguided “wait-and-see” paradigm. The early symptomatic syndromes eliciting neurodevelopmental clinical examinations-questionnaire (ESSENCE-Q is a brief (12-item screening questionnaire developed specifically for the purpose of speeding up the identification process of a wide variety of neurodevelopmental problems. The aims were to 1 estimate the reliability of the ESSENCE-Q, 2 evaluate the clinical cutoff levels suggested by the author of the ESSENCE-Q, and 3 propose optimal cutoff levels based on receiver operating characteristic analysis.Methods: The ESSENCE-Q was used for 1 year by a psychiatrist in Kochi, Japan, assessing children under the age of 6 years referred for developmental problems. The children were also clinically assessed with regard to whether or not they met criteria for a developmental disorder (diagnosis positive and diagnosis negative groups. We contrasted the results of the ESSENCE-Q and those of clinical diagnostic assessments in 130 cases.Results: Cronbach’s alpha was 0.82, sensitivity was 0.94 (95% confidence interval [CI]: [0.88, 0.98], and specificity 0.53 (95% CI: [0.28, 0.77], which are reasonable psychometrics for a first-step screening tool. Based on receiver operating characteristic analysis, we recommended an optimal cutoff level of yes

  3. ESSENCE-Q – a first clinical validation study of a new screening questionnaire for young children with suspected neurodevelopmental problems in south Japan

    Science.gov (United States)

    Hatakenaka, Yuhei; Fernell, Elisabeth; Sakaguchi, Masahiko; Ninomiya, Hitoshi; Fukunaga, Ichiro; Gillberg, Christopher

    2016-01-01

    Background Early identification of autism spectrum disorder, intellectual developmental disorder, attention-deficit/hyperactivity disorder, and other neurodevelopmental disorders/problems is crucial, yet diagnosis is often delayed for years under the often misguided “wait-and-see” paradigm. The early symptomatic syndromes eliciting neurodevelopmental clinical examinations-questionnaire (ESSENCE-Q) is a brief (12-item) screening questionnaire developed specifically for the purpose of speeding up the identification process of a wide variety of neurodevelopmental problems. The aims were to 1) estimate the reliability of the ESSENCE-Q, 2) evaluate the clinical cutoff levels suggested by the author of the ESSENCE-Q, and 3) propose optimal cutoff levels based on receiver operating characteristic analysis. Methods The ESSENCE-Q was used for 1 year by a psychiatrist in Kochi, Japan, assessing children under the age of 6 years referred for developmental problems. The children were also clinically assessed with regard to whether or not they met criteria for a developmental disorder (diagnosis positive and diagnosis negative groups). We contrasted the results of the ESSENCE-Q and those of clinical diagnostic assessments in 130 cases. Results Cronbach’s alpha was 0.82, sensitivity was 0.94 (95% confidence interval [CI]: [0.88, 0.98]), and specificity 0.53 (95% CI: [0.28, 0.77]), which are reasonable psychometrics for a first-step screening tool. Based on receiver operating characteristic analysis, we recommended an optimal cutoff level of yes ≥2 or maybe/a little ≥3 on the ESSENCE-Q (0.87 (95% CI: [0.79, 0.92]) sensitivity and 0.77 (95% CI: [0.50, 0.93]) specificity). Conclusion and implication The ESSENCE-Q can be a good instrument for use as a screening tool for aiding in the process of early identification of neurodevelopmental disorders in clinical settings. To establish the broader validity and reliability of the ESSENCE-Q, case–control studies and general

  4. Relationship between the plasma levels of neurodegenerative proteins and motor subtypes of Parkinson's disease.

    Science.gov (United States)

    Ding, Jian; Zhang, Jiejin; Wang, Xixi; Zhang, Li; Jiang, Siming; Yuan, Yongsheng; Li, Junyi; Zhu, Lin; Zhang, Kezhong

    2017-03-01

    The aim of our study is to examine the plasma levels of the four kinds of neurodegenerative proteins in plasma: α-syn, T-tau, P-tau181, and Aβ-42 in Parkinson's disease (PD) and to evaluate the relationship between their plasma levels and PD motor subtypes. 84 patients with PD were enrolled in our study, and finally, 73 of them were classified into the tremor-dominant subtype (TD) and the postural instability gait difficulty subtype (PIGD). Their motor performance was evaluated by a series of clinical assessments: Freezing of Gait Questionnaire (FOGQ), Timed Up and Go (TUGs), Tinetti balance, and Tinetti gait. Plasma levels of these proteins were measured by enzyme-linked immunosorbent assay (ELISA). The plasma level of α-syn was significantly higher in PD patients when compared to controls (p = 0.004), and significantly higher in the PIGD group when compared to the TD group (p = 0.03). While the plasma level of Aβ-42 was significantly lower in PD patients than in controls (p = 0.002), and significantly lower in the PIGD group than in the TD group (p = 0.05). In PD patients, the plasma level of α-syn (r = -0.355, p score, even after performing multiple linear regression (p = 0.002). While the plasma level of Aβ-42 (r = -0.261, p score and remained correlate when performed multiple linear regression (p = 0.005). The patients with PIGD subtype are characterized with a lower level of plasma Aβ-42 and a higher plasma level of α-syn, which may be used as biomarkers for diagnosis and progression of the subtypes of PD.

  5. [Team approaches to critical bleeding (massive bleeding and transfusion) - chairmen's introductory remarks. Questionnaire survey on current status of hospital clinical laboratories evaluating critical hemorrhage].

    Science.gov (United States)

    Kino, Shuichi; Suwabe, Akira

    2014-12-01

    In 2007, "the Guidelines for Actions against Intraoperative Critical Hemorrhage" were established by the Japanese Society of Anaesthesiologists and the Japanese Society of Blood transfusion and Cell Therapy. The documentation of in-hospital procedures for critical hemorrhage, especially about how to select RBC units, has widely standardized hospital practice. Patients with intraoperative critical hemorrhage sometimes suffer from massive blood loss. In this situation, some patients develop coagulopathy. To treat them, we need to evaluate their coagulation status based on laboratory test results. So, we performed a nationwide questionnaire survey on the current status of hospital clinical laboratories evaluating critical hemorrhage. From the results of this survey, it was recommended that central hospital laboratories should try to reduce the turn-around time required to test for coagulation parameters as much as possible for appropriate substitution therapy. (Review).

  6. Robust Identification of Alzheimer’s Disease subtypes based on cortical atrophy patterns

    Science.gov (United States)

    Park, Jong-Yun; Na, Han Kyu; Kim, Sungsoo; Kim, Hyunwook; Kim, Hee Jin; Seo, Sang Won; Na, Duk L.; Han, Cheol E.; Seong, Joon-Kyung; Weiner, Michael; Aisen, Paul; Petersen, Ronald; Jack, Clifford R.; Jagust, William; Trojanowki, John Q.; Toga, Arthur W.; Beckett, Laurel; Green, Robert C.; Saykin, Andrew J.; Morris, John; Shaw, Leslie M.; Liu, Enchi; Montine, Tom; Thomas, Ronald G.; Donohue, Michael; Walter, Sarah; Gessert, Devon; Sather, Tamie; Jiminez, Gus; Harvey, Danielle; Bernstein, Matthew; Fox, Nick; Thompson, Paul; Schuff, Norbert; DeCarli, Charles; Borowski, Bret; Gunter, Jeff; Senjem, Matt; Vemuri, Prashanthi; Jones, David; Kantarci, Kejal; Ward, Chad; Koeppe, Robert A.; Foster, Norm; Reiman, Eric M.; Chen, Kewei; Mathis, Chet; Landau, Susan; Cairns, Nigel J.; Householder, Erin; Taylor Reinwald, Lisa; Lee, Virginia; Korecka, Magdalena; Figurski, Michal; Crawford, Karen; Neu, Scott; Foroud, Tatiana M.; Potkin, Steven G.; Shen, Li; Kelley, Faber; Kim, Sungeun; Nho, Kwangsik; Kachaturian, Zaven; Frank, Richard; Snyder, Peter J.; Molchan, Susan; Kaye, Jeffrey; Quinn, Joseph; Lind, Betty; Carter, Raina; Dolen, Sara; Schneider, Lon S.; Pawluczyk, Sonia; Beccera, Mauricio; Teodoro, Liberty; Spann, Bryan M.; Brewer, James; Vanderswag, Helen; Fleisher, Adam; Heidebrink, Judith L.; Lord, Joanne L.; Mason, Sara S.; Albers, Colleen S.; Knopman, David; Johnson, Kris; Doody, Rachelle S.; Villanueva Meyer, Javier; Chowdhury, Munir; Rountree, Susan; Dang, Mimi; Stern, Yaakov; Honig, Lawrence S.; Bell, Karen L.; Ances, Beau; Carroll, Maria; Leon, Sue; Mintun, Mark A.; Schneider, Stacy; Oliver, Angela; Marson, Daniel; Griffith, Randall; Clark, David; Geldmacher, David; Brockington, John; Roberson, Erik; Grossman, Hillel; Mitsis, Effie; de Toledo-Morrell, Leyla; Shah, Raj C.; Duara, Ranjan; Varon, Daniel; Greig, Maria T.; Roberts, Peggy; Albert, Marilyn; Onyike, Chiadi; D’Agostino II, Daniel; Kielb, Stephanie; Galvin, James E.; Pogorelec, Dana M.; Cerbone, Brittany; Michel, Christina A.; Rusinek, Henry; de Leon, Mony J.; Glodzik, Lidia; De Santi, Susan; Doraiswamy, P. Murali; Petrella, Jeffrey R.; Wong, Terence Z.; Arnold, Steven E.; Karlawish, Jason H.; Wolk, David; Smith, Charles D.; Jicha, Greg; Hardy, Peter; Sinha, Partha; Oates, Elizabeth; Conrad, Gary; Lopez, Oscar L.; Oakley, MaryAnn; Simpson, Donna M.; Porsteinsson, Anton P.; Goldstein, Bonnie S.; Martin, Kim; Makino, Kelly M.; Ismail, M. Saleem; Brand, Connie; Mulnard, Ruth A.; Thai, Gaby; Mc Adams Ortiz, Catherine; Womack, Kyle; Mathews, Dana; Quiceno, Mary; Diaz Arrastia, Ramon; King, Richard; Weiner, Myron; Martin Cook, Kristen; DeVous, Michael; Levey, Allan I.; Lah, James J.; Cellar, Janet S.; Burns, Jeffrey M.; Anderson, Heather S.; Swerdlow, Russell H.; Apostolova, Liana; Tingus, Kathleen; Woo, Ellen; Silverman, Daniel H. S.; Lu, Po H.; Bartzokis, George; Graff Radford, Neill R.; Parfitt, Francine; Kendall, Tracy; Johnson, Heather; Farlow, Martin R.; Marie Hake, Ann; Matthews, Brandy R.; Herring, Scott; Hunt, Cynthia; van Dyck, Christopher H.; Carson, Richard E.; MacAvoy, Martha G.; Chertkow, Howard; Bergman, Howard; Hosein, Chris; Black, Sandra; Stefanovic, Bojana; Caldwell, Curtis; Robin Hsiung, Ging Yuek; Feldman, Howard; Mudge, Benita; Assaly, Michele; Trost, Dick; Bernick, Charles; Munic, Donna; Kerwin, Diana; Marsel Mesulam, Marek; Lipowski, Kristine; Kuo Wu, Chuang; Johnson, Nancy; Sadowsky, Carl; Martinez, Walter; Villena, Teresa; Scott Turner, Raymond; Johnson, Kathleen; Reynolds, Brigid; Sperling, Reisa A.; Johnson, Keith A.; Marshall, Gad; Frey, Meghan; Yesavage, Jerome; Taylor, Joy L.; Lane, Barton; Rosen, Allyson; Tinklenberg, Jared; Sabbagh, Marwan N.; Belden, Christine M.; Jacobson, Sandra A.; Sirrel, Sherye A.; Kowall, Neil; Killiany, Ronald; Budson, Andrew E.; Norbash, Alexander; Lynn Johnson, Patricia; Obisesan, Thomas O.; Wolday, Saba; Allard, Joanne; Lerner, Alan; Ogrocki, Paula; Hudson, Leon; Fletcher, Evan; Carmichael, Owen; Olichney, John; Kittur, Smita; Borrie, Michael; Lee, T. Y.; Bartha, Rob; Johnson, Sterling; Asthana, Sanjay; Carlsson, Cynthia M.; Preda, Adrian; Nguyen, Dana; Tariot, Pierre; Reeder, Stephanie; Bates, Vernice; Capote, Horacio; Rainka, Michelle; Scharre, Douglas W.; Kataki, Maria; Adeli, Anahita; Zimmerman, Earl A.; Celmins, Dzintra; Brown, Alice D.; Pearlson, Godfrey D.; Blank, Karen; Anderson, Karen; Santulli, Robert B.; Kitzmiller, Tamar J.; Schwartz, Eben S.; Sink, Kaycee M.; Williamson, Jeff D.; Garg, Pradeep; Watkins, Franklin; Ott, Brian R.; Querfurth, Henry; Tremont, Geoffrey; Salloway, Stephen; Malloy, Paul; Correia, Stephen; Rosen, Howard J.; Miller, Bruce L.; Mintzer, Jacobo; Spicer, Kenneth; Bachman, David; Finger, Elizabether; Pasternak, Stephen; Rachinsky, Irina; Rogers, John; Kertesz, Andrew; Pomara, Nunzio; Hernando, Raymundo; Sarrael, Antero; Schultz, Susan K.; Boles Ponto, Laura L.; Shim, Hyungsub; Smith, Karen Elizabeth; Relkin, Norman; Chaing, Gloria; Raudin, Lisa; Smith, Amanda; Fargher, Kristin; Raj, Balebail Ashok

    2017-01-01

    Accumulating evidence suggests that Alzheimer’s disease (AD) is heterogenous and can be classified into several subtypes. Here, we propose a robust subtyping method for AD based on cortical atrophy patterns and graph theory. We calculated similarities between subjects in their atrophy patterns throughout the whole brain, and clustered subjects with similar atrophy patterns using the Louvain method for modular organization extraction. We applied our method to AD patients recruited at Samsung Medical Center and externally validated our method by using the AD Neuroimaging Initiative (ADNI) dataset. Our method categorized very mild AD into three clinically distinct subtypes with high reproducibility (>90%); the parietal-predominant (P), medial temporal-predominant (MT), and diffuse (D) atrophy subtype. The P subtype showed the worst clinical presentation throughout the cognitive domains, while the MT and D subtypes exhibited relatively mild presentation. The MT subtype revealed more impaired language and executive function compared to the D subtype. PMID:28276464

  7. Robust Identification of Alzheimer's Disease subtypes based on cortical atrophy patterns.

    Science.gov (United States)

    Park, Jong-Yun; Na, Han Kyu; Kim, Sungsoo; Kim, Hyunwook; Kim, Hee Jin; Seo, Sang Won; Na, Duk L; Han, Cheol E; Seong, Joon-Kyung

    2017-03-09

    Accumulating evidence suggests that Alzheimer's disease (AD) is heterogenous and can be classified into several subtypes. Here, we propose a robust subtyping method for AD based on cortical atrophy patterns and graph theory. We calculated similarities between subjects in their atrophy patterns throughout the whole brain, and clustered subjects with similar atrophy patterns using the Louvain method for modular organization extraction. We applied our method to AD patients recruited at Samsung Medical Center and externally validated our method by using the AD Neuroimaging Initiative (ADNI) dataset. Our method categorized very mild AD into three clinically distinct subtypes with high reproducibility (>90%); the parietal-predominant (P), medial temporal-predominant (MT), and diffuse (D) atrophy subtype. The P subtype showed the worst clinical presentation throughout the cognitive domains, while the MT and D subtypes exhibited relatively mild presentation. The MT subtype revealed more impaired language and executive function compared to the D subtype.

  8. Robust Identification of Alzheimer’s Disease subtypes based on cortical atrophy patterns

    Science.gov (United States)

    Park, Jong-Yun; Na, Han Kyu; Kim, Sungsoo; Kim, Hyunwook; Kim, Hee Jin; Seo, Sang Won; Na, Duk L.; Han, Cheol E.; Seong, Joon-Kyung; Weiner, Michael; Aisen, Paul; Petersen, Ronald; Jack, Clifford R.; Jagust, William; Trojanowki, John Q.; Toga, Arthur W.; Beckett, Laurel; Green, Robert C.; Saykin, Andrew J.; Morris, John; Shaw, Leslie M.; Liu, Enchi; Montine, Tom; Thomas, Ronald G.; Donohue, Michael; Walter, Sarah; Gessert, Devon; Sather, Tamie; Jiminez, Gus; Harvey, Danielle; Bernstein, Matthew; Fox, Nick; Thompson, Paul; Schuff, Norbert; Decarli, Charles; Borowski, Bret; Gunter, Jeff; Senjem, Matt; Vemuri, Prashanthi; Jones, David; Kantarci, Kejal; Ward, Chad; Koeppe, Robert A.; Foster, Norm; Reiman, Eric M.; Chen, Kewei; Mathis, Chet; Landau, Susan; Cairns, Nigel J.; Householder, Erin; Taylor Reinwald, Lisa; Lee, Virginia; Korecka, Magdalena; Figurski, Michal; Crawford, Karen; Neu, Scott; Foroud, Tatiana M.; Potkin, Steven G.; Shen, Li; Kelley, Faber; Kim, Sungeun; Nho, Kwangsik; Kachaturian, Zaven; Frank, Richard; Snyder, Peter J.; Molchan, Susan; Kaye, Jeffrey; Quinn, Joseph; Lind, Betty; Carter, Raina; Dolen, Sara; Schneider, Lon S.; Pawluczyk, Sonia; Beccera, Mauricio; Teodoro, Liberty; Spann, Bryan M.; Brewer, James; Vanderswag, Helen; Fleisher, Adam; Heidebrink, Judith L.; Lord, Joanne L.; Mason, Sara S.; Albers, Colleen S.; Knopman, David; Johnson, Kris; Doody, Rachelle S.; Villanueva Meyer, Javier; Chowdhury, Munir; Rountree, Susan; Dang, Mimi; Stern, Yaakov; Honig, Lawrence S.; Bell, Karen L.; Ances, Beau; Carroll, Maria; Leon, Sue; Mintun, Mark A.; Schneider, Stacy; Oliver, Angela; Marson, Daniel; Griffith, Randall; Clark, David; Geldmacher, David; Brockington, John; Roberson, Erik; Grossman, Hillel; Mitsis, Effie; de Toledo-Morrell, Leyla; Shah, Raj C.; Duara, Ranjan; Varon, Daniel; Greig, Maria T.; Roberts, Peggy; Albert, Marilyn; Onyike, Chiadi; D'Agostino, Daniel, II; Kielb, Stephanie; Galvin, James E.; Pogorelec, Dana M.; Cerbone, Brittany; Michel, Christina A.; Rusinek, Henry; de Leon, Mony J.; Glodzik, Lidia; de Santi, Susan; Doraiswamy, P. Murali; Petrella, Jeffrey R.; Wong, Terence Z.; Arnold, Steven E.; Karlawish, Jason H.; Wolk, David; Smith, Charles D.; Jicha, Greg; Hardy, Peter; Sinha, Partha; Oates, Elizabeth; Conrad, Gary; Lopez, Oscar L.; Oakley, Maryann; Simpson, Donna M.; Porsteinsson, Anton P.; Goldstein, Bonnie S.; Martin, Kim; Makino, Kelly M.; Ismail, M. Saleem; Brand, Connie; Mulnard, Ruth A.; Thai, Gaby; Mc Adams Ortiz, Catherine; Womack, Kyle; Mathews, Dana; Quiceno, Mary; Diaz Arrastia, Ramon; King, Richard; Weiner, Myron; Martin Cook, Kristen; Devous, Michael; Levey, Allan I.; Lah, James J.; Cellar, Janet S.; Burns, Jeffrey M.; Anderson, Heather S.; Swerdlow, Russell H.; Apostolova, Liana; Tingus, Kathleen; Woo, Ellen; Silverman, Daniel H. S.; Lu, Po H.; Bartzokis, George; Graff Radford, Neill R.; Parfitt, Francine; Kendall, Tracy; Johnson, Heather; Farlow, Martin R.; Marie Hake, Ann; Matthews, Brandy R.; Herring, Scott; Hunt, Cynthia; van Dyck, Christopher H.; Carson, Richard E.; Macavoy, Martha G.; Chertkow, Howard; Bergman, Howard; Hosein, Chris; Black, Sandra; Stefanovic, Bojana; Caldwell, Curtis; Robin Hsiung, Ging Yuek; Feldman, Howard; Mudge, Benita; Assaly, Michele; Trost, Dick; Bernick, Charles; Munic, Donna; Kerwin, Diana; Marsel Mesulam, Marek; Lipowski, Kristine; Kuo Wu, Chuang; Johnson, Nancy; Sadowsky, Carl; Martinez, Walter; Villena, Teresa; Scott Turner, Raymond; Johnson, Kathleen; Reynolds, Brigid; Sperling, Reisa A.; Johnson, Keith A.; Marshall, Gad; Frey, Meghan; Yesavage, Jerome; Taylor, Joy L.; Lane, Barton; Rosen, Allyson; Tinklenberg, Jared; Sabbagh, Marwan N.; Belden, Christine M.; Jacobson, Sandra A.; Sirrel, Sherye A.; Kowall, Neil; Killiany, Ronald; Budson, Andrew E.; Norbash, Alexander; Lynn Johnson, Patricia; Obisesan, Thomas O.; Wolday, Saba; Allard, Joanne; Lerner, Alan; Ogrocki, Paula; Hudson, Leon; Fletcher, Evan; Carmichael, Owen; Olichney, John; Kittur, Smita; Borrie, Michael; Lee, T. Y.; Bartha, Rob; Johnson, Sterling; Asthana, Sanjay; Carlsson, Cynthia M.; Preda, Adrian; Nguyen, Dana; Tariot, Pierre; Reeder, Stephanie; Bates, Vernice; Capote, Horacio; Rainka, Michelle; Scharre, Douglas W.; Kataki, Maria; Adeli, Anahita; Zimmerman, Earl A.; Celmins, Dzintra; Brown, Alice D.; Pearlson, Godfrey D.; Blank, Karen; Anderson, Karen; Santulli, Robert B.; Kitzmiller, Tamar J.; Schwartz, Eben S.; Sink, Kaycee M.; Williamson, Jeff D.; Garg, Pradeep; Watkins, Franklin; Ott, Brian R.; Querfurth, Henry; Tremont, Geoffrey; Salloway, Stephen; Malloy, Paul; Correia, Stephen; Rosen, Howard J.; Miller, Bruce L.; Mintzer, Jacobo; Spicer, Kenneth; Bachman, David; Finger, Elizabether; Pasternak, Stephen; Rachinsky, Irina; Rogers, John; Kertesz, Andrew; Pomara, Nunzio; Hernando, Raymundo; Sarrael, Antero; Schultz, Susan K.; Boles Ponto, Laura L.; Shim, Hyungsub; Smith, Karen Elizabeth; Relkin, Norman; Chaing, Gloria; Raudin, Lisa; Smith, Amanda; Fargher, Kristin; Raj, Balebail Ashok

    2017-03-01

    Accumulating evidence suggests that Alzheimer’s disease (AD) is heterogenous and can be classified into several subtypes. Here, we propose a robust subtyping method for AD based on cortical atrophy patterns and graph theory. We calculated similarities between subjects in their atrophy patterns throughout the whole brain, and clustered subjects with similar atrophy patterns using the Louvain method for modular organization extraction. We applied our method to AD patients recruited at Samsung Medical Center and externally validated our method by using the AD Neuroimaging Initiative (ADNI) dataset. Our method categorized very mild AD into three clinically distinct subtypes with high reproducibility (>90%) the parietal-predominant (P), medial temporal-predominant (MT), and diffuse (D) atrophy subtype. The P subtype showed the worst clinical presentation throughout the cognitive domains, while the MT and D subtypes exhibited relatively mild presentation. The MT subtype revealed more impaired language and executive function compared to the D subtype.

  9. 一个Bw亚型家系的血型分子机制及临床输血分析%Molecular basis and clinical transfusion of a family with Bw subtype of ABO blood group system

    Institute of Scientific and Technical Information of China (English)

    邓刚; 黄丹丹; 郭雯玉; 许德义; 杜勇; 马幼丽; 张哲

    2013-01-01

    Objective To study a family with Bw subtype of ABO blood group system,and to review safety issues in relation with clinical transfusion.Methods The molecular basis for the blood type was studied with serological assay,polymerase chain reaction-sequence specific primer (PCR-SSP) and DNA sequencing,TA clone and haplotype analysis in one blood donor whose ABO blood group were difficultly typed and her family.The bioinformatics analysis was carried out by biological analysis software to investigate the change of structure and function of enzymes influenced by the change amino acid.A retrospective survey was carried out to investigate what is the actual position that the donor blood was used in the clinical transfusion.Results Three members from the family were found to have a Bw subtype.A substitution of nucleotide C by T at position 721 in exon 7 was discovered,which resulted in replacement of amino acid Arg to Trp.Review of clinical record suggested that there has been no significant abnormality association with past three blood transfusions.Conclusion A 721C>T mutation of the ABO gene probably underlies the Bw subtype.Further research is needed for understanding the clinical significance of this subtype in the blood transfusion.%目的 对1个Bw亚型血型家系的分子机制进行研究,并探讨该亚型的临床输血情况.方法 对1名ABO血型正反定型不符的无偿献血者及其家人的血型进行血清学鉴定,并应用聚合酶链反应-序列特异性引物法、ABO基因直接测序、TA克隆单倍型分析及相关软件对该突变引起的酶结构及功能变化进行分析等方法,同时对该献血者以往3次所献的血样的临床输血情况进行回顾.结果 在该家系中发现了3例较为罕见的Bw亚型.该亚型是由于ABO基因第7外显子存在721C/T杂合,导致R241W氨基酸改变所致.临床回顾提示3次输血均未发现明显异常.结论 ABO基因721C>T突变是导致Bw亚型的分子遗传基础之一,

  10. Concurrent and prognostic utility of subtyping anorexia nervosa along dietary and negative affect dimensions.

    Science.gov (United States)

    Forbush, Kelsie T; Hagan, Kelsey E; Salk, Rachel H; Wildes, Jennifer E

    2017-03-01

    Bulimia nervosa can be reliably classified into subtypes based on dimensions of dietary restraint and negative affect. Community and clinical studies have shown that dietary-negative affect subtypes have greater test-retest reliability and concurrent and predictive validity compared to subtypes based on the Diagnostic and Statistical Manual of Mental Disorders (DSM). Although dietary-negative affect subtypes have shown utility for characterizing eating disorders that involve binge eating, this framework may have broader implications for understanding restrictive eating disorders.

  11. Review to better understand the macroscopic subtypes and histogenesis of intrahepatic cholangiocarcinoma

    Institute of Scientific and Technical Information of China (English)

    Yuichi; Sanada; Yujo; Kawashita; Satomi; Okada; Takashi; Azuma; Shigetoshi; Matsuo

    2014-01-01

    Intrahepatic cholangiocarcinoma is macroscopically classified into three subtypes, mass-forming-type, periductal infiltrating-type, and intraductal growth-type. Each subtype should be preoperatively differentiated to perform the valid surgical resection. Recent researches have revealed the clinical, radiologic, pathobiological characteristics of each subtype. We reviewed recently published studies covering various aspects of intrahepatic cholangiocarcinoma(ICC), focusing especially on the macroscopic subtypes and stem cell features to better understand the pathophysiology of ICC and to establish the valid therapeutic strategy.

  12. Comparison of Patient Health History Questionnaires Used in General Internal and Family Medicine, Integrative Medicine, and Complementary and Alternative Medicine Clinics.

    Science.gov (United States)

    Laube, Justin G R; Shapiro, Martin F

    2017-05-01

    Health history questionnaires (HHQs) are a set of self-administered questions completed by patients prior to a clinical encounter. Despite widespread use, minimal research has evaluated the content of HHQs used in general internal medicine and family medicine (GIM/FM), integrative medicine, and complementary and alternative medicine (CAM; chiropractic, naturopathic, and Traditional Chinese Medicine [TCM]) clinics. Integrative medicine and CAM claim greater emphasis on well-being than does GIM/FM. This study investigated whether integrative medicine and CAM clinics' HHQs include more well-being content and otherwise differ from GIM/FM HHQs. HHQs were obtained from GIM/FM (n = 9), integrative medicine (n = 11), naturopathic medicine (n = 5), chiropractic (n = 4), and TCM (n = 7) clinics in California. HHQs were coded for presence of medical history (chief complaint, past medical history, social history, family history, surgeries, hospitalizations, medications, allergies, review of systems), health maintenance procedures (immunization, screenings), and well-being components (nutrition, exercise, stress, sleep, spirituality). In HHQs of GIM/FM clinics, the average number of well-being components was 1.4 (standard deviation [SD], 1.4) compared with 4.0 (SD, 1.1) for integrative medicine (p medicine (p = 0.04), 2.0 (SD, 1.4) for chiropractic (p = 0.54), and 2.0 (SD, 1.5) for TCM (p = 0.47). In HHQs of GIM/FM clinics, the average number of medical history components was 6.4 (SD, 1.9) compared with 8.3 (SD, 1.2) for integrative medicine (p = 0.01), 9.0 (SD, 0) for naturopathic medicine (p = 0.01), 7.1 (SD, 2.8) for chiropractic (p = 0.58), and 7.1 (SD, 1.7) for TCM (p = 0.41). Integrative and naturopathic medicine HHQs included significantly more well-being and medical history components than did GIM/FM HHQs. Further investigation is warranted to determine the optimal HHQ content to support the clinical and preventive

  13. 强直性脊柱炎 HLA-B27亚型及其首发临床表现特征%HLA-B27 subtypes of ankylosing spondylitis and their first clinical manifestation

    Institute of Scientific and Technical Information of China (English)

    祁军; 张萍萍; 林智明; 魏秋静; 古洁若

    2015-01-01

    Objective This study aimed to investigate the HLA-B27 subtypes of ankylosing spondylitis (AS)and their initial symptoms.Methods This study included 476 patients with AS.Direct sequencing was used to identify the HLA -B27 genotype.Clinical initial symptoms were compared among patients with various HLA -B27 subtypes.Results Of the 476 AS patients,437(91.8%)were HLA-B27-positive.The most prevalent subtypes were HLA -B*2704(90%)and HLA-B*2705(8.6%).In the HLA-B*2704-and 2705-positive patients,axial joint was the most common first affected site followed by peripheral joint and then the both sites at the same time.However,there was no significant difference in incidence of the first affected sites such as axial joint ,peripheral joint,hip joint,ax-ial joint +peripheral joint,axial joint +hip joint and peripheral joint +hip joint between the subtypes (P >0.05).Compared with HLA-B*2704-positive patients,HLA-B*2705-patients demonstrated a significant increase in the incidence of uveitis (P =0.041). Conclusion Specific HLA-B27 subtypes are positively associated with particular initial symptoms .AS patients with HLA-B*2705 has a higher risk of uveitis than AS patients with HLA -B*2704 does.%目的:探讨强直性脊柱炎(ankylosing spondylitis,AS)HLA-B27亚型及其首发临床特征。方法476例 AS 患者,测定其 HLA-B27基因型。比较不同 HLA-B27亚型 AS 患者首发临床表现的差异。结果476例 AS 患者中,HLA-B27阳性的患者437例。最常见的 HLA-B27亚型是 HLA-B*2704(90%)和 HLA-B*2705(8.6%)。 HLA-B*2704和 HLA-B*2705阳性患者中,最常见首发受累部位是中轴关节,其次为外周关节,继之是中轴关节和外周关节同时发病者。 HLA-B*2704与 HLA-B*2705亚型 AS 患者首发受累部位发生率比较,首发受累的部位如中轴关节、外周关节、髋关节、中轴关节+外周关节、中轴关节+髋关节和外周关节+髋关节等

  14. [Questionnaires in sexual medicine].

    Science.gov (United States)

    Giuliano, F

    2013-07-01

    Screening, diagnosis and assessment of the management of male and female sexual dysfunctions have been greatly improved by the scientific development of self-administered questionnaires. Their use became the rule in clinical trials and epidemiological surveys. Nevertheless, their routine use has not yet become part of daily urological practice. Even if these tools replace neither the patient interview and medical history and the psychological and social context of the sexual behavior, nor clinical examination, they are of great assistance for determining management and are also highly reliable. Medical literature was reviewed and combined with expert opinion of the author. We present here several questionnaires which have been validated in their French version with the methodology for the calculation of the scores. The International Index of Erectile Function (15 items) and two abbreviated versions, the Erectile Function domain (six items) and the Sexual Health Inventory for Men (five questions) are mainly of use for patients with erectile dysfunction. They provide a robust classification of the severity of the condition. The Premature Ejaculation Profile (four questions) is used for patients with premature ejaculation. It describes premature ejaculation with the following criteria: time to ejaculation, control over ejaculation, the level of distress. The Male Health Sexual Questionnaire (25 questions) provides with a wider and more comprehensive approach to male sexuality of male sexuality including: erection, ejaculation, desire and satisfaction. This questionnaire is particularly useful to investigate ejaculatory disorders. Lastly, the Female Sexual Function Index (19 questions) is the tool of choice for female sexuality with questions regarding desire, arousal, lubrication, orgasm, satisfaction and pain. Validated, user-friendly questionnaires are available in French language for the diagnosis and the follow-up of sexual dysfunctions in both men and women

  15. Patient Acceptable Symptom State in Self-Report Questionnaires and Composite Clinical Disease Index for Assessing Rheumatoid Arthritis Activity: Identification of Cut-Off Points for Routine Care

    Directory of Open Access Journals (Sweden)

    Fausto Salaffi

    2015-01-01

    Full Text Available Objective. To provide information on the value of Patient Acceptable Symptom State (PASS in rheumatoid arthritis (RA by the identification of PASS thresholds for patient-reported outcomes (PROs composite scores. Methods. The characteristics of RA patients with affirmative and negative assignment to PASS were compared. Contributors to physician response were estimated by logistic regression models and PASS thresholds by the 75th percentile and receiver-operating characteristic (ROC curve methods. Results. 303 RA patients completed the study. All PROs were different between the PASS (+ and PASS (− groups (p<0.0001. The thresholds with the 75th percentile approach were 2.0 for the RA Impact of Disease (RAID score, 2.5 for the PRO-CLinical ARthritis Activity (PRO-CLARA index, and 1.0 for the Recent-Onset Arthritis Disability (ROAD questionnaire. The cut-off values for Clinical Disease Activity Index (CDAI were in the moderate range of disease activity. Assessing the size of the logistic regression coefficients, the strongest predictors of PASS were the disease activity (p=0.0007 and functional state level (0.006. Conclusion. PASS thresholds were relatively high and many patients in PASS had moderate disease activity states according to CDAI. Factors such as disease activity and physical function may influence a negative PASS.

  16. Internalizing and Externalizing Subtypes in Female Sexual Assault Survivors: Implications for the Understanding of Complex PTSD

    Science.gov (United States)

    Miller, Mark W.; Resick, Patricia A.

    2007-01-01

    This study replicated and extended findings of internalizing and externalizing subtypes of posttraumatic psychopathology (Miller, M. W., Greif, J. L., & Smith, A. A. (2003). Multidimensional Personality Questionnaire profiles of veterans with traumatic combat exposure: Internalizing and externalizing subtypes. "Psychological Assessment, 15",…

  17. Clinical Correlates of Patients With Rapid-Cycling Bipolar Disorder and a Recent History of Substance Use Disorder: A Subtype Comparison From Baseline Data of 2 Randomized, Placebo-Controlled Trials

    Science.gov (United States)

    Gao, Keming; Verduin, Marcia L.; Kemp, David E.; Tolliver, Bryan K.; Ganocy, Stephen J.; Elhaj, Omar; Bilali, Sarah; Brady, Kathleen T.; Findling, Robert L.; Calabrese, Joseph R.

    2014-01-01

    Objective To compare clinical variables in patients with rapid-cycling bipolar I or II disorder and a recent history of substance use disorder (SUD). Method Cross-sectional data from 2 studies of patients with rapid-cycling bipolar I disorder or rapid-cycling bipolar II disorder and a recent history of SUD were used to retrospectively assess the differences in clinical variables between the subtypes. The studies were conducted from November 1997 to February 2007 at University Hospitals Case Medical Center, Case Western Reserve University School of Medicine, Cleveland, Ohio. Extensive clinical interview and the Mini-International Neuropsychiatric Interview were used to ascertain DSM-IV diagnoses of rapid-cycling bipolar disorder, SUDs, and other Axis I disorders and to collect clinical variables. The Addiction Severity Index (ASI), Global Assessment Scale (GAS), and the Medical Outcomes Study 36-ltem Short-Form Health Survey were used to measure the severity of impairment at the initial assessment. One-way analysis of variance or χ2 was used for significance tests. A Bonferroni adjustment was applied for multiple comparisons. Results Of 245 patients with rapid-cycling bipolar disorder (rapid-cycling bipolar I disorder, N = 191; rapid-cycling bipolar II disorder, N = 54) and a recent history of SUD, the demographics were similar. A significantly higher rate of panic disorder was observed in patients with rapid-cycling bipolar I disorder than in those with rapid-cycling bipolar II disorder (odds ratio = 3.72, 95% CI = 1.66 to 8.32, p = .008). A significantly higher psychiatric composite score on the ASI was also found in patients with rapid-cycling bipolar I disorder than in those with rapid-cycling bipolar II disorder even after Bonferroni adjustment (p = .0007). There were no significant differences between the subtypes in the rates of previous hospitalization or suicide attempt, early childhood verbal, physical, or sexual abuse, lifetime substance abuse or

  18. VTEC O157 subtypes associated with the most severe clinical symptoms in humans constitute a minor part of VTEC 0157 isolates from Danish Cattle

    DEFF Research Database (Denmark)

    Roldgaard, Bemt Bjørn; Scheutz, Flemming; Boel, Jeppe;

    2004-01-01

    -positive VTEC 0 157 isolates (63 of bovine origin and 86 from human clinical cases) isolated between 1987 and 2001. All were analysed by vtx-PCR-RFLP and phage typing. The vtx-PCR-RFLP showed that isolates carrying the vtx2 gene was more than four times as prevalent among the human clinical isolates (55...

  19. Development of an abbreviated version of the delirium motor subtyping scale (DMSS-4).

    Science.gov (United States)

    Meagher, D; Adamis, D; Leonard, M; Trzepacz, P; Grover, S; Jabbar, F; Meehan, K; O'Connor, M; Cronin, C; Reynolds, P; Fitzgerald, J; O'Regan, N; Timmons, S; Slor, C; de Jonghe, J; de Jonghe, A; van Munster, B C; de Rooij, S E; Maclullich, A

    2014-04-01

    Delirium is a common neuropsychiatric syndrome with considerable heterogeneity in clinical profile. Identification of clinical subtypes can allow for more targeted clinical and research efforts. We sought to develop a brief method for clinical subtyping in clinical and research settings. A multi-site database, including motor symptom assessments conducted in 487 patients from palliative care, adult and old age consultation-liaison psychiatry services was used to document motor activity disturbances as per the Delirium Motor Checklist (DMC). Latent class analysis (LCA) was used to identify the class structure underpinning DMC data and also items for a brief subtyping scale. The concordance of the abbreviated scale was then compared with the original Delirium Motor Subtype Scale (DMSS) in 375 patients having delirium as per the American Psychiatric Association's Diagnostic and Statistical Manual (4th edition) criteria. Latent class analysis identified four classes that corresponded closely with the four recognized motor subtypes of delirium. Further, LCA of items (n = 15) that loaded >60% to the model identified four features that reliably identified the classes/subtypes, and these were combined as a brief motor subtyping scale (DMSS-4). There was good concordance for subtype attribution between the original DMSS and the DMSS-4 (κ = 0.63). The DMSS-4 allows for rapid assessment of clinical subtypes in delirium and has high concordance with the longer and well-validated DMSS. More consistent clinical subtyping in delirium can facilitate better delirium management and more focused research effort.

  20. HIV-1 subtypes in Yugoslavia.

    Science.gov (United States)

    Stanojevic, Maja; Papa, Anna; Papadimitriou, Evagelia; Zerjav, Sonja; Jevtovic, Djordje; Salemovic, Dubravka; Jovanovic, Tanja; Antoniadis, Antonis

    2002-05-01

    To gain insight concerning the genetic diversity of HIV-1 viruses associated with the HIV-1 epidemic in Yugoslavia, 45 specimens from HIV-1-infected individuals were classified into subtypes by sequence-based phylogenetic analysis of the polymerase (pol) region of the viral genome. Forty-one of 45 specimens (91.2%) were identified as pol subtype B, 2 of 45 as subtype C (4.4%), 1 of 45 as CRF01_AE (2.2%), and 1 as CRF02_AG recombinant (2.2%). Nucleotide divergence among subtype B sequences was 4.8%. Results of this study show that among HIV-1-infected patients in Yugoslavia subtype B predominates (91.5%), whereas non-B subtypes are present at a low percentage, mostly related to travel abroad.

  1. Uterine Artery Embolisation for Symptomatic Adenomyosis with Polyzene F-Coated Hydrogel Microspheres: Three-Year Clinical Follow-Up Using UFS–QoL Questionnaire

    Energy Technology Data Exchange (ETDEWEB)

    Nijenhuis, R. J., E-mail: nijenhuis@maastrichtuniversity.nl; Smeets, A. J., E-mail: a.smeets@elisabeth.nl; Morpurgo, M., E-mail: m.morpurgo@elisabeth.nl [St. Elisabeth Ziekenhuis, Department of Radiology (Netherlands); Boekkooi, P. F., E-mail: f.boekkooi@elisabeth.nl; Reuwer, P. J. H. M., E-mail: p.reuwer@elisabeth.nl; Smink, M., E-mail: m.smink@elisabeth.nl [St. Elisabeth Ziekenhuis, Department of Obstetrics and Gynecology (Netherlands); Rooij, W. J. van, E-mail: wjjvanrooij@gmail.com; Lohle, P. N. M., E-mail: radiol@eztilburg.nl, E-mail: paullohle@gmail.com [St. Elisabeth Ziekenhuis, Department of Radiology (Netherlands)

    2015-02-15

    PurposeThis study was designed to assess midterm outcome of uterine artery embolisation (UAE) for women with therapy-resistant adenomyosis using polyzene F-coated hydrogel microspheres.MethodsBetween September 2006 and January 2010, 29 consecutive women with adenomyosis (15 in combination with fibroids) were treated with UAE using polyzene F-coated hydrogel microspheres. Junction zone thickness was assessed with MRI at baseline and 3 months. Women filled out the uterine fibroid symptom and quality of life questionnaire at baseline, 3 months and after a mean clinical follow-up of 37 months (median 35, range 29–64 months).ResultsAt baseline, symptom severity score of 29 women was mean 67 (median 72, range 23–100). At 3 months, this score decreased to mean 22 (median 15, range 0–66) and mean 15 (median 17, range 0–34) at final follow-up. At final follow-up of mean 37 months (median 35, range 29–64 months), 22 of 29 (76 %) patients were asymptomatic. Of these 22 women, 3 underwent a second UAE at 6, 7, and 14 months. The remaining seven patients clinically improved but still had symptoms; one underwent a hysterectomy. There was no difference in outcome between women with pure adenomyosis and women with additional fibroids. The junction zone of 4 women with additional therapy was significantly thicker compared with the remaining 25 patients.ConclusionsIn women with therapy resistant adenomyosis, UAE using polyzene F-coated hydrogel microspheres resulted in 3 years preservation of the uterus in 28 of 29 (97 %) with good clinical outcome in the vast majority of patients. Initial thickness of the junction zone is related to additional therapy.

  2. Validation of the post sleep questionnaire for assessing subjects with restless legs syndrome: results from two double-blind, multicenter, placebo-controlled clinical trials

    Directory of Open Access Journals (Sweden)

    Bharmal Murtuza

    2011-04-01

    Full Text Available Abstract Background Because of the subjective nature of Restless Legs Syndrome (RLS symptoms and the impact of these symptoms on sleep, patient-reported outcomes (PROs play a prominent role as study endpoints in clinical trials investigating RLS treatments. The objective of this study was to validate a new measure, the Post Sleep Questionnaire (PSQ, to assess sleep dysfunction in subjects with moderate-to-severe RLS symptoms. Methods Pooled data were analyzed from two 12-week, randomized, placebo-controlled trials of gabapentin enacarbil (N = 540. At baseline and Week 12, subjects completed the PSQ and other validated health surveys: IRLS Rating Scale, Clinical Global Impression of Improvement (CGI-I, Profile of Mood States (POMS, Medical Outcomes Study Scale-Sleep (MOS-Sleep, and RLS-Quality of Life (RLSQoL. Pooled data were used post hoc to examine the convergent, divergent, known-group validity and the responsiveness of the PSQ. Results Convergent validity was demonstrated by significant correlations between baseline PSQ items and total scores of IRLS, POMS, RLSQoL, and the MOS-Sleep Scale (p ≤ 0.007 each. Divergent validity was demonstrated through the lack of significant correlations between PSQ items and demographic characteristics. Correlations (p Conclusions Although these analyses were potentially limited by the use of clinical trial data and not prospective data from a study conducted solely for validation purposes, the PSQ demonstrated robust psychometric properties and is a valid instrument for assessing sleep and sleep improvements in subjects with moderate-to-severe RLS symptoms. Trial Registration This study analyzed data from two registered trials, NCT00298623 and NCT00365352.

  3. Neural network subtyping of depression.

    Science.gov (United States)

    Florio, T M; Parker, G; Austin, M P; Hickie, I; Mitchell, P; Wilhelm, K

    1998-10-01

    To examine the applicability of a neural network classification strategy to examine the independent contribution of psychomotor disturbance (PMD) and endogeneity symptoms to the DSM-III-R definition of melancholia. We studied 407 depressed patients with the clinical dataset comprising 17 endogeneity symptoms and the 18-item CORE measure of behaviourally rated PMD. A multilayer perception neural network was used to fit non-linear models of varying complexity. A linear discriminant function analysis was also used to generate a model for comparison with the non-linear models. Models (linear and non-linear) using PMD items only and endogeneity symptoms only had similar rates of successful classification, while non-linear models combining both PMD and symptoms scores achieved the best classifications. Our current non-linear model was superior to a linear analysis, a finding which may have wider application to psychiatric classification. Our non-linear analysis of depressive subtypes supports the binary view that melancholic and non-melancholic depression are separate clinical disorders rather than different forms of the same entity. This study illustrates how non-linear modelling with neural networks is a potentially fruitful approach to the study of the diagnostic taxonomy of psychiatric disorders and to clinical decision-making.

  4. Measuring Subtypes of Emotion Regulation: From Broad Behavioural Skills to Idiosyncratic Meaning-making.

    Science.gov (United States)

    Pascual-Leone, Antonio; Gillespie, Nicole M; Orr, Emily S; Harrington, Shawn J

    2016-05-01

    The current paper introduces the notion of clinically relevant subtypes of emotion regulation behaviours. A new measure of emotion regulation, the Complexity of Emotional Regulation Scale (CERS), was established as psychometrically sound. It was positively correlated with a measure of emotional awareness (r = 0.28, p self-criticism (r = -0.28, p emotion regulation. Participants in the clinical sample more often identified an intention to soothe but did not follow through as compared with the non-clinical group, F(1, 198) = 4.662, p questionnaire format. Copyright © 2015 John Wiley & Sons, Ltd. Emotion regulation should be thought of as being on a continuum of complexity, where strategies range from general ('one size fits all') action to specific ('personal and idiosyncratic') meaning. The best emotion regulation strategy depends on a client's presenting difficulty and level of distress. Copyright © 2015 John Wiley & Sons, Ltd.

  5. High resolution microfluidic single cell transcriptional profiling reveals clinically relevant subtypes among human stem cell populations commonly utilized in cell-based therapies

    Directory of Open Access Journals (Sweden)

    Robert C. Rennert

    2016-03-01

    Full Text Available Stem cell therapies can promote neural repair and regeneration, yet controversy regarding optimal cell source and mechanism of action has slowed clinical translation, potentially due to undefined cellular heterogeneity. Single cell resolution is needed to identify clinically relevant subpopulations with the highest therapeutic relevance. We combine single cell microfluidic analysis with advanced computational modeling to study for the first time two common sources for cell-based therapies, human NSCs and MSCs. This methodology has the potential to logically inform cell source decisions for any clinical application.

  6. Development and validation of a quantitative PCR assay using multiplexed hydrolysis probes for detection and quantification of Theileria orientalis isolates and differentiation of clinically relevant subtypes.

    Science.gov (United States)

    Bogema, D R; Deutscher, A T; Fell, S; Collins, D; Eamens, G J; Jenkins, C

    2015-03-01

    Theileria orientalis is an emerging pathogen of cattle in Asia, Australia, and New Zealand. This organism is a vector-borne hemoprotozoan that causes clinical disease characterized by anemia, abortion, and death, as well as persistent subclinical infections. Molecular methods of diagnosis are preferred due to their sensitivity and utility in differentiating between pathogenic and apathogenic genotypes. Conventional PCR (cPCR) assays for T. orientalis detection and typing are laborious and do not provide an estimate of parasite load. Current real-time PCR assays cannot differentiate between clinically relevant and benign genotypes or are only semiquantitative without a defined clinical threshold. Here, we developed and validated a hydrolysis probe quantitative PCR (qPCR) assay which universally detects and quantifies T. orientalis and identifies the clinically associated Ikeda and Chitose genotypes (UIC assay). Comparison of the UIC assay results with previously validated universal and genotype-specific cPCR results demonstrated that qPCR detects and differentiates T. orientalis with high sensitivity and specificiy. Comparison of quantitative results based on percent parasitemia, determined via blood film analysis and packed cell volume (PCV) revealed significant positive and negative correlations, respectively. One-way analysis of variance (ANOVA) indicated that blood samples from animals with clinical signs of disease contained statistically higher concentrations of T. orientalis DNA than animals with subclinical infections. We propose clinical thresholds to assist in classifying high-, moderate-, and low-level infections and describe how parasite load and the presence of the Ikeda and Chitose genotypes relate to disease.

  7. Irritable bowel syndrome subtypes defined by Rome II and Rome III criteria are similar.

    Science.gov (United States)

    Dorn, Spencer D; Morris, Carolyn B; Hu, Yuming; Toner, Brenda B; Diamant, Nicholas; Whitehead, William E; Bangdiwala, Shrikant I; Drossman, Douglas A

    2009-03-01

    The implications of the Rome III recommendations to change the irritable bowel syndrome (IBS) subtype criteria for stool pattern are unknown. (1) Determine the level of agreement between Rome II and Rome III subtypes and (2) compare the behaviors of Rome II and Rome III subtypes over time. Female patients (n=148) with Rome II defined IBS were prospectively tracked over 5 consecutive 3-month periods. At baseline, bowel habit reports on questionnaires were used to subclassify patients into Rome II and Rome III subtypes. Over the subsequent 15 months, bowel habit reports on diary cards were used to subclassify patients based on previously derived surrogate criteria into Rome II and Rome III IBS subtypes. The level of agreement between Rome II and Rome III subtype assignments was quite high (86.5%; kappa 0.79). The behavior of Rome II and Rome III subtypes over time was also similar in terms of subtype prevalence, subtype stability, and the proportion of subjects who met criteria for alternating irritable bowel syndrome. Rome II and Rome III IBS subtypes are in high agreement and behave similarly over time. Therefore, studies that used Rome II subtype criteria and studies that will use Rome III criteria will define comparable populations.

  8. Validez del cuestionario cardiovascular MONICA comparado con la historia clínica Validity of the MONICA cardiovascular questionnaire compared with clinical records

    Directory of Open Access Journals (Sweden)

    José M. Baena-Díez

    2009-12-01

    Determinants in Cardiovascular Disease (MONICA compared with clinical records. Methods: A descriptive, prospective, multicenter study was performed within the framework of the Peripheral Arterial Disease Study (PERART in 3,329 persons aged >50 years old. The sample was selected by simple random sampling in 32 primary health care centers. The diagnoses included were acute myocardial infarction, angina pectoris, cerebrovascular disease, hypertension, diabetes mellitus, and hypercholesterolemia. Treatment variables were also considered (antihypertensive, lipid-lowering and hypoglycemic agents or insulin, as well as antiplatelet or anticoagulant agents. The sensitivity, specificity, predictive values, and kappa index were computed to test the validity of the MONICA questionnaire. Results: The mean age was 65 years (SD 8.9 and 54.8% were women. The sensitivity of the questionnaire was >90% for all the variables apart from angina pectoris (89.9% and cerebrovascular disease (86.5%. Specificity was also >90%, except for angina pectoris (88.3% and hypercholesterolemia (77.5%. The positive predictive value was >90% for all the treatments; >80% for angina pectoris, acute myocardial infarction and hypertension; 79.4% for cerebrovascular disease; 79.1% for hypercholesterolemia and 73.4% for diabetes mellitus. The negative predictive value was >90% for all the variables. The kappa indexes were >0.80 for all the variables apart from hypercholesterolemia (0.69 and diabetes mellitus (0.79. Conclusions: The MONICA cardiovascular questionnaire is valid in the assessment of cardiovascular disease, risk factors and treatments in patients aged >50 years old.

  9. Quality of life in patients with different constipation subtypes based on the Rome III criteria.

    Science.gov (United States)

    Ruiz-López, M C; Coss-Adame, E

    2015-01-01

    Functional constipation and irritable bowel syndrome with constipation are highly prevalent and affect the quality of life of those who suffer from them. To evaluate quality of life in patients with functional constipation and irritable bowel disease in accordance with the Rome III criteria, using the PAC-QOL and SF-36 questionnaires. A cross-sectional study was conducted using self-administered questionnaires. The PAC-QOL, SF-36, and Rome III constipation module questionnaires were applied to patients that complained of constipation at the outpatient clinic of a tertiary care hospital. The constipation subtypes were: functional constipation (no pain), irritable bowel syndrome with constipation (pain and/or discomfort ≥3 days/month), and unclassifiable constipation (pain ≤2 days/month). Data were summarized in proportions, and group comparisons were made between the scores of each of the areas of the PAC-QOL and SF-36 questionnaires using parametric tests (Student's t test and ANOVA). A total of 43 PAC-QOL surveys were analyzed, resulting in cases of irritable bowel syndrome with constipation (14%), functional constipation (37%), and unclassifiable constipation (49%). There were statistically significant differences (P<.05) in Physical discomfort (irritable bowel syndrome with constipation vs. functional constipation and unclassifiable constipation vs. irritable bowel syndrome with constipation), Worries and concerns (irritable bowel syndrome with constipation vs. functional constipation), and Treatment satisfaction (irritable bowel syndrome with constipation vs. functional constipation and unclassifiable constipation vs. irritable bowel syndrome with constipation). A total of 93 SF-36 questionnaires were analyzed, describing cases of irritable bowel syndrome with constipation (23%), functional constipation (27%), and unclassifiable constipation (51%). Lower physical energy was found in relation to irritable bowel syndrome with constipation vs. functional

  10. Reproducibility of histological subtyping of malignant pleural mesothelioma.

    Science.gov (United States)

    Brčić, Luka; Jakopović, Marko; Brčić, Iva; Klarić, Vlasta; Milošević, Milan; Sepac, Ana; Samaržija, Miroslav; Seiwerth, Sven

    2014-12-01

    Malignant pleural mesothelioma (MPM) has a very poor prognosis. Although clinical stage is currently the only reliable prognostic factor, histologic subtyping reportedly also affects prognosis. Some studies propose reclassification of pleomorphic epithelioid as biphasic or sarcomatoid MPM. This study assessed prognostic significance and interobserver agreement in MPM subtyping of small biopsy specimens. We analyzed biopsy specimens, and clinical and survival data from records of 108 patients who were diagnosed between 2000 and 2010 at the Institute of Pathology University of Zagreb School of Medicine, of whom 98 had epithelioid MPM, six biphasic MPM, and four sarcomatoid MPM. Among epithelioid subtypes, 44 (44.9 %) were solid, 19 (19.4 %) tubulopapillary, 18 (18.4 %) acinar, six (6.1 %) adenomatoid, five (5.1 %) pleomorphic, four (4.1 %) trabecular, and two (2.0 %) micropapillary subtype. Interobserver reliability for histological diagnosis was found to be κ = 0.72 (P sarcomatoid mesothelioma (4.0 [IQR 1.3-6.8] months; P = 0.270). We found strong reproducibility of MPM subtyping with good interobserver agreement. Furthermore, our results indicate that pleomorphic subtype to be a predictor of poor prognosis and support classifying it with sarcomatoid or biphasic MPM, as patients with the pleomorphic, biphasic, or sarcomatoid subtype show similarly poor overall survival.

  11. Non motor subtypes and Parkinson's disease.

    Science.gov (United States)

    Sauerbier, Anna; Jenner, Peter; Todorova, Antoniya; Chaudhuri, K Ray

    2016-01-01

    Non motor symptoms (NMS) represent a significant burden in Parkinson's disease (PD) with numerous studies highlighting the importance of NMS both in "pre-motor" phase of PD as well as throughout the course of disease. In part this has led the international Parkinson and Movement Disorder Society (IPMDS) task force to attempt a re-definition of PD incorporating NMS and not base the diagnosis solely on motor symptoms. While motor subtypes within PD have been recognized and researched, recent clinical and neurobiological research suggests the existence of discrete non motor subtypes in PD, particularly in untreated (drug naïve) and early PD patients. Several independent observers have reported specific "clusters of NMS dominant PD" using a data driven approach in early and untreated PD patients while others have reported on the burden of NMS in untreated PD and specific NMS dominant phenotypes in untreated or treated PD using observational case series based data. In this review we report on specific NMS dominant phenotypes of PD as described in the literature using clinical observational studies and address pathophysiological concepts. A proposal for several NMS subtypes are reported combining clinical reports with, where possible, evidence base supporting probable biomarkers.

  12. Transcriptome classification reveals molecular subtypes in psoriasis

    Directory of Open Access Journals (Sweden)

    Ainali Chrysanthi

    2012-09-01

    Full Text Available Abstract Background Psoriasis is an immune-mediated disease characterised by chronically elevated pro-inflammatory cytokine levels, leading to aberrant keratinocyte proliferation and differentiation. Although certain clinical phenotypes, such as plaque psoriasis, are well defined, it is currently unclear whether there are molecular subtypes that might impact on prognosis or treatment outcomes. Results We present a pipeline for patient stratification through a comprehensive analysis of gene expression in paired lesional and non-lesional psoriatic tissue samples, compared with controls, to establish differences in RNA expression patterns across all tissue types. Ensembles of decision tree predictors were employed to cluster psoriatic samples on the basis of gene expression patterns and reveal gene expression signatures that best discriminate molecular disease subtypes. This multi-stage procedure was applied to several published psoriasis studies and a comparison of gene expression patterns across datasets was performed. Conclusion Overall, classification of psoriasis gene expression patterns revealed distinct molecular sub-groups within the clinical phenotype of plaque psoriasis. Enrichment for TGFb and ErbB signaling pathways, noted in one of the two psoriasis subgroups, suggested that this group may be more amenable to therapies targeting these pathways. Our study highlights the potential biological relevance of using ensemble decision tree predictors to determine molecular disease subtypes, in what may initially appear to be a homogenous clinical group. The R code used in this paper is available upon request.

  13. Questionnaire survey on the clinical characteristics of 2 408 outpatients with tinnitus%门诊耳鸣患者2408例问卷调查

    Institute of Scientific and Technical Information of China (English)

    韩朝; 田亮; 丛宁; 黄一波; 杨娟梅

    2013-01-01

    Objective To explore the clinical characteristics of tinnitus in otolaryngological outpatients. Methods Tinnitus questionnaire survey was performed in 2 408 otolaryngological outpatients treated from Dec. 2009 to Jul. 2010. The data obtained were analyzed by statistical software. Results All outpatients were aged from 6 to 95 years, averagely (47.02 ± 17. 05) years. There were 996 cases with tinnitus(41. 36% ) , including 388(38. 96% ) male cases and 608(61. 04% )female cases. The difference of tinnitus incidence between male and female was significant(P = 0.001 9). Except for 4 cases aged less than 12 years, the remaining 992 tinnitus patients were divided into four groups according to the effect of tinnitus on life: no affection(149 cases, 15. 02%) , mild affection(480 cases, 48. 39%) , moderate affection(329 cases,33.16% ) ,severe affection(34 cases,3.43% ). The relationship between the degree of the different affection to life and doctors' office visiting was significantly correlated(P 2个月者,有效8例、无效6例.结论 耳鸣的发生率在耳鼻喉科门诊患者中所占比例极高,其中尤以女性多见.双侧耳鸣持续时间更长.随着治疗时间的延长,有效率有增加趋势.

  14. Penn State Worry Questionnaire

    DEFF Research Database (Denmark)

    Esbjørn, Barbara Hoff; Reinholdt-Dunne, Marie Louise; Caspersen, Ida Dyhr

    2013-01-01

    and valid assessment tools are essential to identify at-risk children. The present study investigates (i) the factor structure of the Penn State Worry Questionnaire for Children (PSWQ-C) using a large Danish community sample (N¿=¿933), and (ii) its treatment sensitivity in clinically anxious children (N......¿=¿30) treated with cognitive behavioral therapy. Results from the community sample replicated previous findings supporting the strong psychometric properties of the PSWQ-C, and yielded Danish norms and clinical cut-offs for the measure. Clinically anxious children with a generalized anxiety disorder...... (GAD; N¿=¿10) diagnosis reported significantly higher levels of worry than anxious children without GAD (N¿=¿20). At post treatment, worry levels in children with GAD but not in anxious children without GAD were normalized. Findings regarding worry in the community sample are discussed in light...

  15. Common Molecular Subtypes Among Asian Hepatocellular Carcinoma and Cholangiocarcinoma

    DEFF Research Database (Denmark)

    Chaisaingmongkol, Jittiporn; Budhu, Anuradha; Dang, Hien

    2017-01-01

    Intrahepatic cholangiocarcinoma (ICC) and hepatocellular carcinoma (HCC) are clinically disparate primary liver cancers with etiological and biological heterogeneity. We identified common molecular subtypes linked to similar prognosis among 199 Thai ICC and HCC patients through systems integration...... of genomics, transcriptomics, and metabolomics. While ICC and HCC share recurrently mutated genes, including TP53, ARID1A, and ARID2, mitotic checkpoint anomalies distinguish the C1 subtype with key drivers PLK1 and ECT2, whereas the C2 subtype is linked to obesity, T cell infiltration, and bile acid...

  16. Questionnaires for assessment of female sexual dysfunction

    DEFF Research Database (Denmark)

    Giraldi, Annamaria; Rellini, Alessandra; Pfaus, James G;

    2011-01-01

    There are many methods to evaluate female sexual function and dysfunction (FSD) in clinical and research settings, including questionnaires, structured interviews, and detailed case histories. Of these, questionnaires have become an easy first choice to screen individuals into different categories...

  17. Ischemic stroke subtype is associated with outcome in thrombolyzed patients

    DEFF Research Database (Denmark)

    Schmitz, Marie Louise; Simonsen, Claus Ziegler; Svendsen, M L

    2017-01-01

    OBJECTIVES: The impact of ischemic stroke subtype on clinical outcome in patients treated with intravenous tissue-type plasminogen activator (IV-tPA) is sparsely examined. We studied the association between stroke subtype and clinical outcome in magnetic resonance imaging (MRI)-evaluated patients...... treated with IV-tPA. MATERIAL AND METHODS: We conducted a single-center retrospective analysis of MRI-selected stroke patients treated with IV-tPA between 2004 and 2010. The Trial of ORG 10172 in Acute Stroke Treatment criteria were used to establish the stroke subtype by 3 months. The outcomes...... of interest were a 3-month modified Rankin Scale score of 0-1 (favorable outcome), and early neurological improvement defined as complete remission of neurological deficit or improvement of ≥4 on the National Institute of Health Stroke Scale at 24 h. The outcomes among stroke subtypes were compared...

  18. Among diffuse large B-cell lymphomas, T-cell-rich/histiocyte-rich BCL and CD30+anaplastic B-cell subtypes exhibit distinct clinical features

    NARCIS (Netherlands)

    Maes, B; Anastasopoulou, A; Kluin-Nelemans, JC; Teodorovic, [No Value; Achten, R; Carbone, A; De Wolf-Peeters, C

    2001-01-01

    Background: The EORTC clinical trial 20901, activated in 1990, was designed to treat non-Hodgkin's lymphomas (NHL) of intermediate/high-grade malignancy according to the Working Formulation. Established in 1994, the R.E.A.L. Classification on NHL has now replaced all former classifications. Patients

  19. Psychopathy subtypes and psychopathic violence

    OpenAIRE

    Koshkina Ekaterina Nikolaevna

    2015-01-01

    This article analyses two main subtypes of psychopathy and its characteristic traits that allow to differ them from each other. Following that, the existence of more specific subtypes of psychopathy and sociopathy is argued on the basis of the recent researches. Also, the inclination of psychopaths and sociopaths to various kinds of violence is examined.

  20. Penn State Worry Questionnaire

    DEFF Research Database (Denmark)

    Esbjørn, Barbara Hoff; Reinholdt-Dunne, Marie Louise; Caspersen, Ida Dyhr

    2013-01-01

    Anxiety disorders are among the most prevalent psychiatric disturbances in childhood. Nonetheless, they often go unrecognized and untreated, which puts the child at risk for developing additional difficulties, such as academic difficulties, depression, and substance abuse. Further knowledge...... and valid assessment tools are essential to identify at-risk children. The present study investigates (i) the factor structure of the Penn State Worry Questionnaire for Children (PSWQ-C) using a large Danish community sample (N¿=¿933), and (ii) its treatment sensitivity in clinically anxious children (N...

  1. The clinically-tested S1P receptor agonists, FTY720 and BAF312, demonstrate subtype-specific bradycardia (S1P₁ and hypertension (S1P₃ in rat.

    Directory of Open Access Journals (Sweden)

    Ryan M Fryer

    Full Text Available Sphingosine-1-phospate (S1P and S1P receptor agonists elicit mechanism-based effects on cardiovascular function in vivo. Indeed, FTY720 (non-selective S1P(X receptor agonist produces modest hypertension in patients (2-3 mmHg in 1-yr trial as well as acute bradycardia independent of changes in blood pressure. However, the precise receptor subtypes responsible is controversial, likely dependent upon the cardiovascular response in question (e.g. bradycardia, hypertension, and perhaps even species-dependent since functional differences in rodent, rabbit, and human have been suggested. Thus, we characterized the S1P receptor subtype specificity for each compound in vitro and, in vivo, the cardiovascular effects of FTY720 and the more selective S1P₁,₅ agonist, BAF312, were tested during acute i.v. infusion in anesthetized rats and after oral administration for 10 days in telemetry-instrumented conscious rats. Acute i.v. infusion of FTY720 (0.1, 0.3, 1.0 mg/kg/20 min or BAF312 (0.5, 1.5, 5.0 mg/kg/20 min elicited acute bradycardia in anesthetized rats demonstrating an S1P₁ mediated mechanism-of-action. However, while FTY720 (0.5, 1.5, 5.0 mg/kg/d elicited dose-dependent hypertension after multiple days of oral administration in rat at clinically relevant plasma concentrations (24-hr mean blood pressure = 8.4, 12.8, 16.2 mmHg above baseline vs. 3 mmHg in vehicle controls, BAF312 (0.3, 3.0, 30.0 mg/kg/d had no significant effect on blood pressure at any dose tested suggesting that hypertension produced by FTY720 is mediated S1P₃ receptors. In summary, in vitro selectivity results in combination with studies performed in anesthetized and conscious rats administered two clinically tested S1P agonists, FTY720 or BAF312, suggest that S1P₁ receptors mediate bradycardia while hypertension is mediated by S1P₃ receptor activation.

  2. Subtyping Obsessive-Compulsive Disorder: Neuropsychological Correlates

    Directory of Open Access Journals (Sweden)

    Catherine L. Harris

    2003-01-01

    Full Text Available We administered neuropsychological measures considered sensitive to prefrontal dysfunction (both orbitofrontal and dorsolateral prefrontal neocortex to obsessive-compulsive disorder (OCD patients and control subjects. OCD subjects exhibited performance deficits, in comparison to community controls, on three measures sensitive to orbitofrontal neocortex dysfunction. Contrary to expectation, OCD patients also exhibited performance deficits on measures sensitive to dorsolateral prefrontal neocortex dysfunction. However, distinct neurocognitive profiles emerged when we examined the impact of comorbid schizotypal personality features on neuropsychological test performance. Primary OCD patients displayed impaired performance on measures sensitive to orbitofrontal dysfunction; however, they did not differ from control subjects on tests of dorsolateral function. OCD subjects presenting with schizotypal personality features performed poorly not only on tests sensitive to orbitofrontal dysfunction, but also on tests sensitive to dorsolateral dysfunction. Findings suggest that OCD can be subdivided into clinical subtypes, and distinct prefrontal subsystems may be differentially involved in these subtypes.

  3. Proteomic maps of breast cancer subtypes

    DEFF Research Database (Denmark)

    Tyanova, Stefka; Albrechtsen, Reidar; Kronqvist, Pauliina;

    2016-01-01

    Systems-wide profiling of breast cancer has almost always entailed RNA and DNA analysis by microarray and sequencing techniques. Marked developments in proteomic technologies now enable very deep profiling of clinical samples, with high identification and quantification accuracy. We analysed 40...... oestrogen receptor positive (luminal), Her2 positive and triple negative breast tumours and reached a quantitative depth of >10,000 proteins. These proteomic profiles identified functional differences between breast cancer subtypes, related to energy metabolism, cell growth, mRNA translation and cell......-cell communication. Furthermore, we derived a signature of 19 proteins, which differ between the breast cancer subtypes, through support vector machine (SVM)-based classification and feature selection. Remarkably, only three proteins of the signature were associated with gene copy number variations and eleven were...

  4. Psychometric Properties of the Physical Activity Questionnaire for Older Children in Italy: Testing the Validity among a General and Clinical Pediatric Population.

    Directory of Open Access Journals (Sweden)

    Erica Gobbi

    Full Text Available The purpose of this research was to assess an Italian version of the Physical Activity Questionnaire for Older Children (PAQ-C-It. Three separate studies were conducted, whereby testing general psychometric properties, construct validity, concurrent validity and the factor structure of the PAQ-C-It among general and clinical pediatric population. Study 1 (n = 1170 examined the psychometric properties, internal consistency, factor structure (exploratory factor analysis, EFA and construct validity with enjoyment perception during physical activity. Study 2 (n = 59 reported on reliability, construct validity with enjoyment and BMI, and on cross-sectional concurrent validity with objectively measured MVPA (tri-axial accelerometry over the span of seven consecutive days. Study 3 (n = 58 examined the PAQ-C-It reliability, construct validity with BMI and VO2max as the objective measurement among a population of children with congenital heart defects (CHD. In study 2 and 3, the factor structure of the PAQ-C-It was then re-examined with an EFA. The PAQ-C-It showed acceptable to good reliability (alpha .70 to .83. Results on construct validity showed moderate but significant association with enjoyment perception (r = .30 and .36, with BMI (r = -.30 and -.79 for CHD simple form, and with the VO2max (r = .55 for CHD simple form. Significant concurrent validity with the objectively measured MVPA was reported (rho = .30, p < .05. Findings of the EFA suggested a two-factor structure for the PAQ-C-It, with items 2, 3, and 4 contributing little to the total score. This study supports the PAQ-C-It as an appropriate instrument to assess the MVPA levels of Italian children, including children with simple forms of CHD. Support is given to the possible instrument effectiveness on a large international perspective in order to level out data gathering across the globe.

  5. Examination of psychosocial predictors of Chinese hospital pharmacists' intention to provide clinical pharmacy services using the theory of planned behaviour: a cross-sectional questionnaire study

    Science.gov (United States)

    He, Yuan; Yang, Fan; Mu, Dongqin; Xing, Yuan; Li, Xin

    2016-01-01

    Objectives Main study aim was as follows: (1) to explore the usefulness of the theory of planned behaviour (TPB) model in predicting Chinese hospital pharmacists' intention to provide clinical pharmacy services (CPSs), including auxiliary CPSs and core CPSs; (2) to identify the main factors affecting the Chinese hospital pharmacists' intention to provide core CPSs based on TPB quantitatively. Design Cross-sectional questionnaire study. Setting The study was conducted in 22 general hospitals in seven cities located in the eastern and western part of China. Participants 416 hospital pharmacists (292 (70.2%) female) entered and completed the study. Primary and secondary outcome measures Quantitative responses with hospital pharmacists' intention, attitude, subjective norms (SNs) and perceived behavioural control (PBC) over provision of CPSs and their past behaviour (PB)-related CPSs. Results The structural equation model analysis found that attitude (p=0.0079, β=0.12), SN (p=0.038, β=0.10) and the pharmacists' intention to provide auxiliary CPSs (p=0.0001, β=0.63) significantly predicted of their intention to provide core CPSs, accounting for 54.0% of its variance. Attitude (p=0.0001, β=0.35), PBC (p=0.0182, β=0.12) and PB (p=0.0009, β=0.15) are significant predictors of pharmacists' intention, accounting for 21% of the variance in pharmacists' intention to provide auxiliary CPSs. Conclusions The TPB with the addition of PB is a useful framework for predicting pharmacists' intention to provide CPSs in Chinese hospital care context. Strategies to improve hospital pharmacists' intention to provide CPSs should focus on helping the individuals related medical care see the value of CPSs, altering their perception of social pressure towards core CPSs and the removal of obstacles that impede the translation of intentions into behaviour. PMID:27707835

  6. Examination of psychosocial predictors of Chinese hospital pharmacists' intention to provide clinical pharmacy services using the theory of planned behaviour: a cross-sectional questionnaire study.

    Science.gov (United States)

    He, Yuan; Yang, Fan; Mu, Dongqin; Xing, Yuan; Li, Xin

    2016-10-05

    Main study aim was as follows: (1) to explore the usefulness of the theory of planned behaviour (TPB) model in predicting Chinese hospital pharmacists' intention to provide clinical pharmacy services (CPSs), including auxiliary CPSs and core CPSs; (2) to identify the main factors affecting the Chinese hospital pharmacists' intention to provide core CPSs based on TPB quantitatively. Cross-sectional questionnaire study. The study was conducted in 22 general hospitals in seven cities located in the eastern and western part of China. 416 hospital pharmacists (292 (70.2%) female) entered and completed the study. Quantitative responses with hospital pharmacists' intention, attitude, subjective norms (SNs) and perceived behavioural control (PBC) over provision of CPSs and their past behaviour (PB)-related CPSs. The structural equation model analysis found that attitude (p=0.0079, β=0.12), SN (p=0.038, β=0.10) and the pharmacists' intention to provide auxiliary CPSs (p=0.0001, β=0.63) significantly predicted of their intention to provide core CPSs, accounting for 54.0% of its variance. Attitude (p=0.0001, β=0.35), PBC (p=0.0182, β=0.12) and PB (p=0.0009, β=0.15) are significant predictors of pharmacists' intention, accounting for 21% of the variance in pharmacists' intention to provide auxiliary CPSs. The TPB with the addition of PB is a useful framework for predicting pharmacists' intention to provide CPSs in Chinese hospital care context. Strategies to improve hospital pharmacists' intention to provide CPSs should focus on helping the individuals related medical care see the value of CPSs, altering their perception of social pressure towards core CPSs and the removal of obstacles that impede the translation of intentions into behaviour. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  7. Psychometric Properties of the Physical Activity Questionnaire for Older Children in Italy: Testing the Validity among a General and Clinical Pediatric Population.

    Science.gov (United States)

    Gobbi, Erica; Elliot, Catherine; Varnier, Maurizio; Carraro, Attilio

    2016-01-01

    The purpose of this research was to assess an Italian version of the Physical Activity Questionnaire for Older Children (PAQ-C-It). Three separate studies were conducted, whereby testing general psychometric properties, construct validity, concurrent validity and the factor structure of the PAQ-C-It among general and clinical pediatric population. Study 1 (n = 1170) examined the psychometric properties, internal consistency, factor structure (exploratory factor analysis, EFA) and construct validity with enjoyment perception during physical activity. Study 2 (n = 59) reported on reliability, construct validity with enjoyment and BMI, and on cross-sectional concurrent validity with objectively measured MVPA (tri-axial accelerometry) over the span of seven consecutive days. Study 3 (n = 58) examined the PAQ-C-It reliability, construct validity with BMI and VO2max as the objective measurement among a population of children with congenital heart defects (CHD). In study 2 and 3, the factor structure of the PAQ-C-It was then re-examined with an EFA. The PAQ-C-It showed acceptable to good reliability (alpha .70 to .83). Results on construct validity showed moderate but significant association with enjoyment perception (r = .30 and .36), with BMI (r = -.30 and -.79 for CHD simple form), and with the VO2max (r = .55 for CHD simple form). Significant concurrent validity with the objectively measured MVPA was reported (rho = .30, p PAQ-C-It, with items 2, 3, and 4 contributing little to the total score. This study supports the PAQ-C-It as an appropriate instrument to assess the MVPA levels of Italian children, including children with simple forms of CHD. Support is given to the possible instrument effectiveness on a large international perspective in order to level out data gathering across the globe.

  8. Clinical resistance to vicriviroc through adaptive V3 loop mutations in HIV-1 subtype D gp120 that alter interactions with the N-terminus and ECL2 of CCR5.

    Science.gov (United States)

    Ogert, Robert A; Hou, Yan; Ba, Lei; Wojcik, Lisa; Qiu, Ping; Murgolo, Nicholas; Duca, Jose; Dunkle, Lisa M; Ralston, Robert; Howe, John A

    2010-04-25

    The HIV-1 CCR5 co-receptor is a member of the chemokine receptor family of G-protein coupled receptors; for which a number of small molecule antagonists, such as vicriviroc (VCV), have been developed to inhibit HIV-1 R5-tropic replication. In this study, we analyzed an HIV-1 subtype D envelope gene from a clinical trial subject who developed complete resistance to VCV. The HIV-1 resistant envelope has six predominant amino acid changes in the V3 loop, together with one change in the C4 domain of gp120, which are fully responsible for the resistance phenotype. V3 loop mutations Q315E and R321G are essential for resistance to VCV, whereas E328K and G429R in C4 contribute significantly to the infectivity of the resistant variant. Collectively, these amino acid changes influenced the interaction of gp120 with both the N-terminus and ECL2 region of CCR5.

  9. Assessment of psychosocial problems in children with type 1 diabetes and their families: the added value of using standardised questionnaires in addition to clinical estimations of nurses and paediatricians

    NARCIS (Netherlands)

    Boogerd, E.A.; Damhuis, A.M.; Velden, J.A.M. van der; Steeghs, M.C.C.H.; Noordam, C.; Verhaak, C.M.; Vermaes, I.P.

    2015-01-01

    AIMS AND OBJECTIVES: To investigate the assessment of psychosocial problems in children with type 1 diabetes by means of clinical estimations made by nurses and paediatricians and by using standardised questionnaires. BACKGROUND: Although children with type 1 diabetes and their parents show increase

  10. Assessment of psychosocial problems in children with type 1 diabetes and their families: The added value of using standardised questionnaires in addition to clinical estimations of nurses and paediatricians

    NARCIS (Netherlands)

    Boogerd, E.A.; Damhuis, A.M.A.; Alfen-van der Velden, A.A.E.M. van; Steeghs, M.C.C.H.; Noordam, C.; Verhaak, C.M.; Vermaes, I.P.R.

    2015-01-01

    Aims and objectives: To investigate the assessment of psychosocial problems in children with type 1 diabetes by means of clinical estimations made by nurses and paediatricians and by using standardised questionnaires. Background Although children with type 1 diabetes and their parents show increased

  11. Burnout Subtypes and Absence of Self-Compassion in Primary Healthcare Professionals: A Cross-Sectional Study

    Science.gov (United States)

    Montero-Marin, Jesus; Zubiaga, Fernando; Cereceda, Maria; Piva Demarzo, Marcelo Marcos; Trenc, Patricia; Garcia-Campayo, Javier

    2016-01-01

    Background Primary healthcare professionals report high levels of distress and burnout. A new model of burnout has been developed to differentiate three clinical subtypes: ‘frenetic’, ‘underchallenged’ and ‘worn-out’. The aim of this study was to confirm the validity and reliability of the burnout subtype model in Spanish primary healthcare professionals, and to assess the explanatory power of the self-compassion construct as a possible protective factor. Method The study employed a cross-sectional design. A sample of n = 440 Spanish primary healthcare professionals (214 general practitioners, 184 nurses, 42 medical residents) completed the Burnout Clinical Subtype Questionnaire (BCSQ-36), the Maslach Burnout Inventory General Survey (MBI-GS), the Self-Compassion Scale (SCS), the Utrecht Work Engagement Scale (UWES) and the Positive and Negative Affect Schedule (PANAS). The factor structure of the BCSQ-36 was estimated using confirmatory factor analysis (CFA) by the unweighted least squares method from polychoric correlations. Internal consistency (R) was assessed by squaring the correlation between the latent true variable and the observed variables. The relationships between the BCSQ-36 and the other constructs were analysed using Spearman’s r and multiple linear regression models. Results The structure of the BCSQ-36 fit the data well, with adequate CFA indices for all the burnout subtypes. Reliability was adequate for all the scales and sub-scales (R≥0.75). Self-judgement was the self-compassion factor that explained the frenetic subtype (Beta = 0.36; p<0.001); isolation explained the underchallenged (Beta = 0.16; p = 0.010); and over-identification the worn-out (Beta = 0.25; p = 0.001). Other significant associations were observed between the different burnout subtypes and the dimensions of the MBI-GS, UWES and PANAS. Conclusions The typological definition of burnout through the BCSQ-36 showed good structure and appropriate internal consistence

  12. Burnout Subtypes and Absence of Self-Compassion in Primary Healthcare Professionals: A Cross-Sectional Study.

    Directory of Open Access Journals (Sweden)

    Jesus Montero-Marin

    Full Text Available Primary healthcare professionals report high levels of distress and burnout. A new model of burnout has been developed to differentiate three clinical subtypes: 'frenetic', 'underchallenged' and 'worn-out'. The aim of this study was to confirm the validity and reliability of the burnout subtype model in Spanish primary healthcare professionals, and to assess the explanatory power of the self-compassion construct as a possible protective factor.The study employed a cross-sectional design. A sample of n = 440 Spanish primary healthcare professionals (214 general practitioners, 184 nurses, 42 medical residents completed the Burnout Clinical Subtype Questionnaire (BCSQ-36, the Maslach Burnout Inventory General Survey (MBI-GS, the Self-Compassion Scale (SCS, the Utrecht Work Engagement Scale (UWES and the Positive and Negative Affect Schedule (PANAS. The factor structure of the BCSQ-36 was estimated using confirmatory factor analysis (CFA by the unweighted least squares method from polychoric correlations. Internal consistency (R was assessed by squaring the correlation between the latent true variable and the observed variables. The relationships between the BCSQ-36 and the other constructs were analysed using Spearman's r and multiple linear regression models.The structure of the BCSQ-36 fit the data well, with adequate CFA indices for all the burnout subtypes. Reliability was adequate for all the scales and sub-scales (R≥0.75. Self-judgement was the self-compassion factor that explained the frenetic subtype (Beta = 0.36; p<0.001; isolation explained the underchallenged (Beta = 0.16; p = 0.010; and over-identification the worn-out (Beta = 0.25; p = 0.001. Other significant associations were observed between the different burnout subtypes and the dimensions of the MBI-GS, UWES and PANAS.The typological definition of burnout through the BCSQ-36 showed good structure and appropriate internal consistence in Spanish primary healthcare professionals

  13. Does change in self-reported mindfulness mediate the clinical benefits of mindfulness training? A controlled study using the French translation of the Five Facet Mindfulness Questionnaire

    OpenAIRE

    Heeren, Alexandre; Deplus, Sandrine; Peschard, Virginie; Nef, François; Kotsou, Ilios; Dierickx, Christophe; Mondillon, Laurie; Robinaugh, Donald J.; Philippot, Pierre

    2015-01-01

    Mindfulness training improves mental health and psychological functioning. Although several questionnaires have been developed to measure mindfulness, the Five Facet Mindfulness Questionnaire (FFMQ) is currently one of the most widely used scales. However, uncertainty remains about wheth- er the effects of mindfulness training can be unambiguously attributed to change in self-reported mindfulness. The present study was designed to answer three major questions: First, relative to a wait-list g...

  14. A Bayesian semiparametric factor analysis model for subtype identification.

    Science.gov (United States)

    Sun, Jiehuan; Warren, Joshua L; Zhao, Hongyu

    2017-04-25

    Disease subtype identification (clustering) is an important problem in biomedical research. Gene expression profiles are commonly utilized to infer disease subtypes, which often lead to biologically meaningful insights into disease. Despite many successes, existing clustering methods may not perform well when genes are highly correlated and many uninformative genes are included for clustering due to the high dimensionality. In this article, we introduce a novel subtype identification method in the Bayesian setting based on gene expression profiles. This method, called BCSub, adopts an innovative semiparametric Bayesian factor analysis model to reduce the dimension of the data to a few factor scores for clustering. Specifically, the factor scores are assumed to follow the Dirichlet process mixture model in order to induce clustering. Through extensive simulation studies, we show that BCSub has improved performance over commonly used clustering methods. When applied to two gene expression datasets, our model is able to identify subtypes that are clinically more relevant than those identified from the existing methods.

  15. Clinical Evaluation of a Single-Tube Multiple RT-PCR Assay for the Detection of 13 Common Virus Types/Subtypes Associated with Acute Respiratory Infection.

    Directory of Open Access Journals (Sweden)

    Dan Zhang

    Full Text Available Respiratory viruses are among the most important causes of human morbidity and mortality worldwide, especially for infants and young children. In the past years, a few commercial multiplex RT-PCR assays have been used to detect respiratory viruses in spite of the high cost. In the present study, an improved single-tube multiplex reverse transcription PCR assay for simultaneous detection of 13 respiratory viruses was evaluated and compared with a previously reported two-tube assay as the reference method using clinical nasopharyngeal aspirates samples. Of 310 prospectively tested respiratory specimens selected from children hospitalized with acute respiratory illness, 226 (72.90%, 226/310 and 214 (69.03%, 214/310 positive for one or more viruses were identified by the single-tube and the two-tube assays, respectively, with combined test results showing good concordance (Kappa value = 0.874. Individually, the single-tube assay for adenovirus (Adv, human metapneumovirus (HMPV, human rhinovirus (HRV, parainfluenza virus type 1 (PIV1, parainfluenza virus type 3 (PIV3 and parainfluenza virus type 4 (PIV4 showed the significantly superior sensitivities to those of the two-tube assay. No false positives were found. In conclusion, our results demonstrates the one-tube assay revealed significant improvements over the two-tube assay in terms of the better sensitivity, more accurate quality control, less nonspecific amplification, more cost-effective and shorter turn-around time and will be a valuable tool for routine surveillance of respiratory virus infection in China.

  16. Molecular subtypes of glioblastoma are relevant to lower grade glioma.

    Directory of Open Access Journals (Sweden)

    Xiaowei Guan

    Full Text Available Gliomas are the most common primary malignant brain tumors in adults with great heterogeneity in histopathology and clinical course. The intent was to evaluate the relevance of known glioblastoma (GBM expression and methylation based subtypes to grade II and III gliomas (ie. lower grade gliomas.Gene expression array, single nucleotide polymorphism (SNP array and clinical data were obtained for 228 GBMs and 176 grade II/II gliomas (GII/III from the publically available Rembrandt dataset. Two additional datasets with IDH1 mutation status were utilized as validation datasets (one publicly available dataset and one newly generated dataset from MD Anderson. Unsupervised clustering was performed and compared to gene expression subtypes assigned using the Verhaak et al 840-gene classifier. The glioma-CpG Island Methylator Phenotype (G-CIMP was assigned using prediction models by Fine et al.Unsupervised clustering by gene expression aligned with the Verhaak 840-gene subtype group assignments. GII/IIIs were preferentially assigned to the proneural subtype with IDH1 mutation and G-CIMP. GBMs were evenly distributed among the four subtypes. Proneural, IDH1 mutant, G-CIMP GII/III s had significantly better survival than other molecular subtypes. Only 6% of GBMs were proneural and had either IDH1 mutation or G-CIMP but these tumors had significantly better survival than other GBMs. Copy number changes in chromosomes 1p and 19q were associated with GII/IIIs, while these changes in CDKN2A, PTEN and EGFR were more commonly associated with GBMs.GBM gene-expression and methylation based subtypes are relevant for GII/III s and associate with overall survival differences. A better understanding of the association between these subtypes and GII/IIIs could further knowledge regarding prognosis and mechanisms of glioma progression.

  17. Is PIGD a legitimate motor subtype in Parkinson disease?

    Science.gov (United States)

    Kotagal, Vikas

    2016-06-01

    Parkinson disease is a chronic progressive syndrome with a broad array of clinical features. Different investigators have suggested the heterogeneous motor manifestations of early Parkinson disease can be conceptualized through a taxonomy of clinical subtypes including tremor-predominant and postural instability and gait difficulty-predominant subtypes. Although it is theoretically valuable to distinguish subtypes of Parkinson disease, the reality is that few patients fit these discrete categories well and many transition from exhibiting elements of one subtype to elements of another. In the time since the initial description of the postural instability and gait difficulty-predominant subtype, Parkinson disease clinical research has blossomed in many ways - including an increased emphasis on the role of medical comorbidities and extranigral pathologies in Parkinson disease as markers of prognostic significance. By conceptualizing the pathogenesis of an expansive disease process in the limited terms of categorical motor subtypes, we run the risk of overlooking or misclassifying clinically significant pathogenic risk factors that lead to the development of motor milestones such as falls and related axial motor disability. Given its critical influence on quality of life and overall prognosis, we are in need of a model of postural instability and gait difficulty-predominant features in Parkinson disease that emphasizes the overlooked pathological influence of aging and medical comorbidities on the development of axial motor burden and postural instability and gait difficulty-predominant features. This Point of View proposes thinking of postural instability and gait difficulties in Parkinson disease not as a discrete subtype, but rather as multidimensional continuum influenced by several overlapping age-related pathologies.

  18. The Survey Questionnaire

    Science.gov (United States)

    Ritter, Lois A. Ed.; Sue, Valerie M., Ed.

    2007-01-01

    Internet-based surveys are still relatively new, and researchers are just beginning to articulate best practices for questionnaire design. Online questionnaire design has generally been guided by the principles applying to other self-administered instruments, such as paper-based questionnaires. Web-based questionnaires, however, have the potential…

  19. Impact of HIV-1 subtype and antiretroviral therapy on protease and reverse transcriptase genotype: results of a global collaboration.

    Directory of Open Access Journals (Sweden)

    Rami Kantor

    2005-04-01

    Full Text Available The genetic differences among HIV-1 subtypes may be critical to clinical management and drug resistance surveillance as antiretroviral treatment is expanded to regions of the world where diverse non-subtype-B viruses predominate.To assess the impact of HIV-1 subtype and antiretroviral treatment on the distribution of mutations in protease and reverse transcriptase, a binomial response model using subtype and treatment as explanatory variables was used to analyze a large compiled dataset of non-subtype-B HIV-1 sequences. Non-subtype-B sequences from 3,686 persons with well characterized antiretroviral treatment histories were analyzed in comparison to subtype B sequences from 4,769 persons. The non-subtype-B sequences included 461 with subtype A, 1,185 with C, 331 with D, 245 with F, 293 with G, 513 with CRF01_AE, and 618 with CRF02_AG. Each of the 55 known subtype B drug-resistance mutations occurred in at least one non-B isolate, and 44 (80% of these mutations were significantly associated with antiretroviral treatment in at least one non-B subtype. Conversely, of 67 mutations found to be associated with antiretroviral therapy in at least one non-B subtype, 61 were also associated with antiretroviral therapy in subtype B isolates.Global surveillance and genotypic assessment of drug resistance should focus primarily on the known subtype B drug-resistance mutations.

  20. Impact of HIV-1 subtype and antiretroviral therapy on protease and reverse transcriptase genotype: results of a global collaboration.

    Directory of Open Access Journals (Sweden)

    Rami Kantor

    2005-04-01

    Full Text Available BACKGROUND: The genetic differences among HIV-1 subtypes may be critical to clinical management and drug resistance surveillance as antiretroviral treatment is expanded to regions of the world where diverse non-subtype-B viruses predominate. METHODS AND FINDINGS: To assess the impact of HIV-1 subtype and antiretroviral treatment on the distribution of mutations in protease and reverse transcriptase, a binomial response model using subtype and treatment as explanatory variables was used to analyze a large compiled dataset of non-subtype-B HIV-1 sequences. Non-subtype-B sequences from 3,686 persons with well characterized antiretroviral treatment histories were analyzed in comparison to subtype B sequences from 4,769 persons. The non-subtype-B sequences included 461 with subtype A, 1,185 with C, 331 with D, 245 with F, 293 with G, 513 with CRF01_AE, and 618 with CRF02_AG. Each of the 55 known subtype B drug-resistance mutations occurred in at least one non-B isolate, and 44 (80% of these mutations were significantly associated with antiretroviral treatment in at least one non-B subtype. Conversely, of 67 mutations found to be associated with antiretroviral therapy in at least one non-B subtype, 61 were also associated with antiretroviral therapy in subtype B isolates. CONCLUSION: Global surveillance and genotypic assessment of drug resistance should focus primarily on the known subtype B drug-resistance mutations.

  1. HIV-1 subtype distribution and its demographic determinants in newly diagnosed patients in Europe suggest highly compartmentalized epidemics

    Directory of Open Access Journals (Sweden)

    Abecasis Ana B

    2013-01-01

    Full Text Available Abstract Background Understanding HIV-1 subtype distribution and epidemiology can assist preventive measures and clinical decisions. Sequence variation may affect antiviral drug resistance development, disease progression, evolutionary rates and transmission routes. Results We investigated the subtype distribution of HIV-1 in Europe and Israel in a representative sample of patients diagnosed between 2002 and 2005 and related it to the demographic data available. 2793 PRO-RT sequences were subtyped either with the REGA Subtyping tool or by a manual procedure that included phylogenetic tree and recombination analysis. The most prevalent subtypes/CRFs in our dataset were subtype B (66.1%, followed by sub-subtype A1 (6.9%, subtype C (6.8% and CRF02_AG (4.7%. Substantial differences in the proportion of new diagnoses with distinct subtypes were found between European countries: the lowest proportion of subtype B was found in Israel (27.9% and Portugal (39.2%, while the highest was observed in Poland (96.2% and Slovenia (93.6%. Other subtypes were significantly more diagnosed in immigrant populations. Subtype B was significantly more diagnosed in men than in women and in MSM > IDUs > heterosexuals. Furthermore, the subtype distribution according to continent of origin of the patients suggests they acquired their infection there or in Europe from compatriots. Conclusions The association of subtype with demographic parameters suggests highly compartmentalized epidemics, determined by social and behavioural characteristics of the patients.

  2. Utility of neurophysiological criteria in Guillain Barre΄ syndrome: Subtype spectrum from a tertiary referral hospital in India

    OpenAIRE

    Alexander, M.; A T Prabhakar; S Aaron; M. Thomas; Mathew, V; Patil, A. K.

    2011-01-01

    Background: The Guillain Barre′ syndrome (GBS) is a heterogeneous disease with various subtypes, the prevalence of which would depend on the geographic region. Recognition of these subtypes is of clinical importance since each subtype has an independent pathogenesis and different type of pathology and prognosis. Objectives: To study the various subtypes of GBS using the various published electrophysiological criteria. Design: Retrospective descriptive study. Materials and Methods: In a tertia...

  3. Prognosis of metastatic breast cancer subtypes: the hormone receptor/HER2-positive subtype is associated with the most favorable outcome.

    Science.gov (United States)

    Lobbezoo, Dorien J A; van Kampen, Roel J W; Voogd, Adri C; Dercksen, M Wouter; van den Berkmortel, Franchette; Smilde, Tineke J; van de Wouw, Agnes J; Peters, Frank P J; van Riel, Johanna M G H; Peters, Natascha A J B; de Boer, Maaike; Borm, George F; Tjan-Heijnen, Vivianne C G

    2013-10-01

    Contrary to the situation in early breast cancer, little is known about the prognostic relevance of the hormone receptor (HR) and human epidermal growth factor receptor 2 (HER2) in metastatic breast cancer. The objectives of this study were to present survival estimates and to determine the prognostic impact of breast cancer subtypes based on HR and HER2 status in a recent cohort of metastatic breast cancer patients, which is representative of current clinical practice. Patients diagnosed with metastatic breast cancer between 2007 and 2009 were included. Information regarding patient and tumor characteristics and treatment was collected. Patients were categorized in four subtypes based on the HR and HER2 status of the primary tumor: HR positive (+)/HER2 negative (-), HR+/HER2+, HR-/HER2+ and triple negative (TN). Survival was estimated using the Kaplan-Meier method. Cox proportional hazards model was used to determine the prognostic impact of breast cancer subtype, adjusted for possible confounders. Median follow-up was 21.8 months for the 815 metastatic breast cancer patients included; 66 % of patients had the HR+/HER2- subtype, 8 % the HR-/HER2+ subtype, 15 % the TN subtype and 11 % the HR+/HER2+ subtype. The longest survival was observed for the HR+/HER2+ subtype (median 34.4 months), compared to 24.8 months for the HR+/HER2- subtype, 19.8 months for the HR-/HER2+ subtype and 8.8 months for the TN subtype (P < 0.0001). In the multivariate analysis, subtype was an independent prognostic factor, as were initial site of metastases and metastatic-free interval. The HR+/HER2+ subtype was associated with the longest survival after diagnosis of distant metastases.

  4. Overall survival and local recurrence of 406 completely resected stage IIIa-N2 non-small cell lung cancer patients: questionnaire survey of the Japan Clinical Oncology Group to plan for clinical trials.

    Science.gov (United States)

    Ichinose, Y; Kato, H; Koike, T; Tsuchiya, R; Fujisawa, T; Shimizu, N; Watanabe, Y; Mitsudomi, T; Yoshimura, M

    2001-10-01

    the group of completely resected stage IIIA-N2 non-small cell lung cancer patients (NSCLC) is considered to be heterogeneous in various aspects including survival and the recurrent pattern. In the present study, we attempted to clarify the factors which separate these patients into high and low risk groups based on the survival and local recurrence. a questionnaire survey on the survival and local recurrence of non-small cell lung cancer patients with pathological stage IIIA-N2 disease who underwent a complete resection from January 1992 to December 1993 was performed by the Japan Clinical Oncology Group as of July 1999. The information on the survival of 406 patients and that of local recurrence in 332 of them was available. the 5-year survival of the 406 patients was 31.0%. In a univariate analysis, the age, clinical and pathological T status, number of N2 stations, pathological N1 disease, operative modality and postoperative radiotherapy were all found to be important prognostic factors. Clinical N2 disease marginally influenced the survival (P=0.07). In a multivariate analysis of these variables including clinical N2 disease, the survival was significantly worse in the case of multiple N2 stations (hazard ratio=1.741), the presence of pathological N1 disease (1.403), pathological T2 or 3 disease (1.399) and an age older than 65 (1.327). The rate of freedom from any local recurrence at the bronchial stump, or in the hilar, mediastinal or supraclavicular lymph nodes at 5 years was 64%. In a univariate analysis of the freedom from local recurrence, the clinical N status, pathological T status, pathological N1 disease and number of N2 stations were all found to be important prognostic factors. A multivariate analysis revealed the freedom from local recurrence to be adversely influenced by multiple N2 stations (hazard ratio=2.05), and the presence of either clinical N1 or 2 (1.733) disease. The 5-year survival and the rate of freedom from local recurrence at 5

  5. Duration of cross-protection between subtypes A and B avian pneumovirus in turkeys.

    Science.gov (United States)

    Van de Zande, S; Nauwynck, H; Naylor, C; Pensaert, M

    2000-07-29

    The degree and duration of clinical and virological cross-protection between avian pneumovirus subtypes A and B were examined in two-week-old pneumovirus antibody-free turkeys. The turkeys were inoculated with either a virulent subtype A (Belgian isolate A/T6/96), a virulent subtype B (Belgian isolate B/T9/96), an attenuated subtype A or an attenuated subtype B, and challenged homologously and heterologously with virulent avian pneumovirus two, five and 11 weeks after inoculation. Birds inoculated with virulent A or B virus showed typical respiratory signs from three to seven days after inoculation. After challenge, no clinical signs were observed in any of the groups, and no virus was isolated from the turkeys that had been initially inoculated with a virulent strain. Virulent virus was recovered from the birds that had been initially inoculated with attenuated subtypes and challenged five and/or 11 weeks later with a heterologous virulent strain. Birds challenged after five weeks showed a serological booster reaction only when they had been inoculated initially with a virulent or attenuated subtype B and challenged with subtype A. Seroconversion was observed in all the groups challenged after 11 weeks except when they had been inoculated initially with attenuated subtype B and challenged with subtype B.

  6. 桥本甲状腺炎甲状腺细针穿刺两种细胞学亚型临床特点比较%Patients with Hashimoto's thyroiditis confirmed by fine-needle aspiration cytology:comparison of clinical features of two subtypes

    Institute of Scientific and Technical Information of China (English)

    刘丽; 高燕明; 卢桂芝; 袁振芳; 高莹; 惠岩; 郭晓蕙; 唐素恩; 高妍

    2010-01-01

    Three hundred and ninety-seven patients of Hashimoto's thyroiditis(HT)confirmed by fine-needle aspiration cytology(FNAC)were investigated retrospectively.Between oxyphil cell subtype(OC,n=181)and lymphocytic cell subtype(LC,n=186),there were no significant differences in clinical manifestation and levels of thyroglobulin antibody(TgAb)and thyroid peroxidase antibody(TPOAb).However,compared with lymphocytic cell subtype,the patients with oxyphil cell subtype had the tendency to develop hypothyroidism,suggesting advanced stage of Hashimoto's thyroiditis.%回顾性分析397例经甲状腺细针穿刺细胞学(FNAC)确诊桥本甲状腺炎患者的临床特点.发现嗜酸细胞型(n=181)及淋巴细胞型(n=186)桥本甲状腺炎临床表现、抗甲状腺自身抗体(甲状腺球蛋白抗体、甲状腺过氧化物酶抗体)水平无差异.嗜酸细胞型较淋巴细胞型更倾向进展为甲状腺功能减退,可能为疾病进程中晚期阶段.

  7. Distinguishing subtypes of extrinsic motivation among people with mild to borderline intellectual disability.

    Science.gov (United States)

    Frielink, N; Schuengel, C; Embregts, P

    2017-07-01

    According to self-determination theory, motivation is ordered in types, including amotivation, extrinsic motivation and intrinsic motivation. Self-determination theory defines four subtypes of extrinsic motivation: external motivation, introjected motivation, identified motivation and integrated motivation. Although it has been argued theoretically that the different types of motivation are universally applicable, Reid et al. () proposed a dichotomy of broad subtypes of extrinsic motivation for people with intellectual disability (ID) due to their cognitive limitations. The current study challenges this proposal by testing whether the four subtypes of extrinsic motivation can be differentiated among people with ID as well. The subtypes of extrinsic motivation were measured using two adapted versions of the Self-Regulation Questionnaire, one regarding exercise and one regarding support. In total, 186 adults with mild to borderline ID participated in the study. Results supported the distinction between the four subtypes of extrinsic motivation regarding both exercise and support. In addition, the correlation coefficients supported a quasi-simplex pattern of correlations among the subtypes, indicating that adjacent subtypes were more closely related than non-adjacent subtypes. Moreover, the study showed sufficient Cronbach's alphas and test-retest reliabilities for early stage research. Overall, the results of the current study provide initial evidence for the universality of the four subtypes of extrinsic motivation across populations with and without ID. © 2017 The Authors. Journal of Intellectual Disability Research published by MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disibilities and John Wiley & Sons Ltd.

  8. Sensory subtypes and anxiety in older children and adolescents with autism spectrum disorder.

    Science.gov (United States)

    Uljarević, Mirko; Lane, Alison; Kelly, Amanda; Leekam, Susan

    2016-10-01

    This study aimed to identify sensory subtypes in older children and adolescents with Autism Spectrum Disorders (ASD) and examine the relationship of sensory subtypes with anxiety levels in this group. Mothers of 57 children and adolescents with ASD aged 11-17 years (Mean age = 14 years. 2.4 months, SD = 1.81) completed the short sensory profile and Spence anxiety scales. Model-based cluster analysis was applied to sensory profile scores to identify sensory subtypes. Three sensory subtypes, sensory adaptive (N = 19), sensory moderate (N = 29) and sensory severe (N = 9) were identified. The results indicated that the differences between the subtypes were well characterised by the severity of sensory symptoms and were not attributable to sensory modality or varying types of sensory-related behaviors. Children and adolescents from the adaptive subtype had significantly lower anxiety scores when compared with other two subtypes. There were no differences between subtypes based on chronological age, expressive language, or severity of autism diagnostic features as measured by the social communication questionnaire (SCQ total score). This is the first study to identify the existence of sensory subtypes among older children and adolescents with ASD and explore their association with anxiety levels. Autism Res 2016, 9: 1073-1078. © 2016 International Society for Autism Research, Wiley Periodicals, Inc.

  9. Clinical subtypes of obsessive-compulsive disorder based on the presence of checking and washing compulsions Subtipos clínicos do transtorno obsessivo-compulsivo com base na presença de compulsões de checagem e lavagem

    Directory of Open Access Journals (Sweden)

    Leonardo F Fontenelle

    2005-09-01

    Full Text Available OBJECTIVE: We aimed at examining the utility of checking and washing compulsions as markers of valid subtypes of obsessive-compulsive disorder (OCD. METHODS: One hundred and six patients with obsessive-compulsive disorder were evaluated with a socio-demographic and clinical questionnaire, the Structured Clinical Interview for DSM-IV, the Yale-Brown Obsessive-Compulsive Scale, the Clinical Global Impression, the Beck Depression Inventory, the Hamilton Rating Scale for Depression, and the Global Assessment of Functioning. These individuals were allocated in one of four subgroups [checkers (OCD-Ch; n = 20, washers (OCD-Wa; n = 13, checkers and washers (OCD-CW; n = 48, and non-checkers and non-washers (OCD non-CW = 25] on the basis of the presence and the clinical relevance of checking and/or washing compulsive behaviors across their lifetime. Socio-demographic and clinical variables were compared and contrasted between the groups by means of ANOVA followed by post-hoc Least Significant Difference or Dunnett's tests for continuous variables and chi-square tests followed by partitioned chi-square tests for categorical variables. RESULTS: OCD-Ch and OCD-Wa did not differ on most demographic and clinical features, the only exception being the number of different types of obsessions, which were significantly higher in the former group. The OCD-CW group was more likely to exhibit an insidious onset of obsessive-compulsive symptoms, to manifest itself as a mixed subtype of obsessive-compulsive disorder and to display obsessions with contamination themes. On the other hand, the OCD non-CW group was more likely to exhibit an acute onset, a shorter duration of illness, obsessions with religious themes, an episodic course, and less severe obsessive-compulsive symptoms. CONCLUSIONS: In our sample, the probing of the presence of checking and/or washing compulsions has provided significant empirical support to establish valid subtypes of obsessive

  10. Subtype distribution of Blastocystis isolates in Sebha, Libya.

    Science.gov (United States)

    Abdulsalam, Awatif M; Ithoi, Init; Al-Mekhlafi, Hesham M; Al-Mekhlafi, Abdulsalam M; Ahmed, Abdulhamid; Surin, Johari

    2013-01-01

    Blastocystis is a genetically diverse and a common intestinal parasite of humans with a controversial pathogenic potential. This study was carried out to identify the Blastocystis subtypes and their association with demographic and socioeconomic factors among outpatients living in Sebha city, Libya. Blastocystis in stool samples were cultured followed by isolation, PCR amplification of a partial SSU rDNA gene, cloning, and sequencing. The DNA sequences of isolated clones showed 98.3% to 100% identity with the reference Blastocystis isolates from the Genbank. Multiple sequence alignment showed polymorphism from one to seven base substitution and/or insertion/deletion in several groups of non-identical nucleotides clones. Phylogenetic analysis revealed three assemblage subtypes (ST) with ST1 as the most prevalent (51.1%) followed by ST2 (24.4%), ST3 (17.8%) and mixed infections of two concurrent subtypes (6.7%). ST1 infection was significantly associated with female (P = 0.009) and low educational level (P = 0.034). ST2 was also significantly associated with low educational level (P= 0.008) and ST3 with diarrhoea (P = 0.008). Phylogenetic analysis of Libyan Blastocystis isolates identified three different subtypes; with ST1 being the predominant subtype and its infection was significantly associated with female gender and low educational level. More extensive studies are needed in order to relate each Blastocystis subtype with clinical symptoms and potential transmission sources in this community.

  11. 不同分子亚型乳腺癌首发肝转移患者的临床特征和预后%Clinical features and prognosis of patients with first-episode liver metastasis of different molecular subtypes of breast cancer

    Institute of Scientific and Technical Information of China (English)

    2016-01-01

    Objective To investigate the clinical features and prognosis of patients with first-episode liver metastasis of different molecular subtypes of breast cancer and risk factors for liver metastasis of breast cancer.Methods A retrospective analysis was performed for 122 breast cancer patients with first-episode liver metastasis from January 2009 to January 2014.According to the cell surface receptors of breast cancer,these patients were divided into the four molecular subtypes of Luminal A,Luminal B,human epidermal growth factor receptor 2 (HER2) overexpression,and triple-negative breast cancer (TNBC).The association of patients' age at initial diagnosis,body mass index (BMI),menstruation status,clinical TNM (cTNM) stage,levels of lactate dehydrogenase (LDH) and alkaline phosphatase (ALP) at recurrence,liver metastasis,and treatment condition with the patients' prognosis were analyzed.The chi-square test and Fisher's exact test were used for categorical data,the Kaplan-Meier method was used for survival analysis,the log-rank test was used for univariate analysis of influencing factors,and the Cox regression model was used for multivariate analysis.Results Among the 122 patients,12 had Luminal A subtype,61 had Luminal B subtype,30 had HER2 overexpression subtype,and 19 had TNBC subtype.In the patients with Luminal A,Luminal B,HER2 overexpression,and TNBC subtypes,the median disease-free survival (DFS) was 32,23,16,and 10 months,respectively (P =0.001),the median overall survival (OS) was 54,35,26,and 13 months,respectively (P =0.003),and the median OS after liver metastasis was 30,16,10,and 9 months,respectively (P =0.019).In HER2-positive patients,the application of trastuzumab in the past significantly prolonged the patients' DFS by 11 months and OS by 18 months (P < 0.05).The results of the multivariate analysis showed that cTNM stage,molecular subtype,and targeted therapy were independent influencing factors for DFS of breast cancer patients with liver metastasis

  12. Therapeutic response to benzodiazepine in panic disorder subtypes

    Directory of Open Access Journals (Sweden)

    Alexandre Martins Valença

    Full Text Available CONTEXT: This study makes a comparison between two subtypes of panic disorder regarding the clinical efficacy of clonazepam, a benzodiazepine. OBJECTIVES: To evaluate the clinical efficacy of clonazepam in a fixed dosage (2 mg/day, compared to placebo, in the treatment of panic disorder patients and to verify whether there are any differences in the responses to clonazepam between panic disorder patients with the respiratory and non-respiratory subtypes. TYPE OF STUDY: Randomized study with clonazepam and placebo. SETTING: Outpatient Anxiety and Depression Unit of the Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil. PARTICIPANTS: 34 patients with a diagnosis of panic disorder with agoraphobia, between 18 and 55 years old. PROCEDURES: Administration of clonazepam or placebo for 6 weeks, in panic disorder patients, after they were classified within two subtypes of panic disorder: respiratory and non-respiratory. MAIN MEASUREMENTS: Changes in the number of panic attacks in comparison with the period before the beginning of the study; Hamilton Anxiety Scale; Global Clinical Impression Scale; and Patient's Global Impression scale. RESULTS: In the group that received clonazepam, by the end of the 6th week there was a statistically significant clinical improvement, shown by the remission of panic attacks (p < 0.001 and decrease in anxiety (p = 0.024. In the group that received clonazepam there was no significant difference between the respiratory and non-respiratory subtypes of panic disorder, regarding the therapeutic response to clonazepam. CONCLUSION: Clonazepam was equally effective in the treatment of the respiratory and non-respiratory subtypes of panic disorder, suggesting there is no difference in the therapeutic response between the two subtypes.

  13. Clinical and pathological differences in common subtypes of Charcot-Marie-Tooth disease%常见腓骨肌萎缩症亚型的临床和神经病理改变差异分析

    Institute of Scientific and Technical Information of China (English)

    刘菁菁; 吕鹤; 王朝霞; 刘靖; 左越焕; 贺茂林; 袁云

    2016-01-01

    目的 探讨腓骨肌萎缩症(Charcot-Marie-Tooth disease,CMT)常见亚型的临床表现和周围神经病理改变.方法 收集2005-2015年就诊于我院神经内科门诊并经基因检查证实的81例CMT患者,其中CMT1A型31例(38.3%),CMTX1型19例(23.5%),CMT2A2型16例(19.8%),其他9种少见CMT亚型患者合计15例(1.2%~4.9%).比较其中48例3种常见类型患者在平均发病年龄、病程、下肢远端肌力、高弓足出现率之间的差异,同时比较其腓肠神经病理改变的差异.结果 CMT1A型患者的发病年龄为(12.00 ±6.77)岁,CMTX1型(11.81±4.65)岁,CMT2A2型(5.00±2.68)岁(Brown-Forsythe检验,P=0.001).CMT1A型病程为(12.00±6.75)年,CMTX1型为(8.50±4.75)年,CMT2A2型为(5.00±2.73)年(Brown-Forsythe检验,P=0.001).下肢足背伸肌力在CMT1A为Ⅳ(0,Ⅴ)级,CMTX1为Ⅲ+(0,Ⅳ)级,CMT2A2为0(0,Ⅳ)级(H=11.359,P=0.020).高弓足出现在15/23的CMT1A型、10/16的CMTX1型和1/9的CMT2A2型患者(Fisher检验,P=0.017).3例出现脑部症状患者均为CMTX1型.3例伴随有视力下降的患者均为CMT2A2型.腓肠神经有髓神经纤维的洋葱球样结构出现在23/23的CMT1A、5/16的CMTX1和2/9的CMT2A2患者(Fisher检验,P=0.000);再生簇出现在16/23的CMT1A、16/16的CMTX1和9/9的CMT2A2患者(x2=7.666,P=0.016).上述指标在3组间差异均具有统计学意义.结论 CMT1A型、CMTX1型和CMT2A2型是本组患者最常见的CMT亚型,关注发病年龄、病程、肌力下降程度、高弓足出现率、脑部以及视神经损害的出现有助于三者的临床区分,注意有髓神经纤维洋葱球样结构和再生簇出现程度也有助于其病理分型.%Objective To analyze the differences of the clinical and neuropathological features among the common Charcot-Marie-Tooth disease (CMT) subtypes.Methods There were 81 CMT patients confirmed by genetic testing from 2005 to 2015 in Department of Neurology,Peking University First Hospital,including 31 cases of CMT1A (38.3%),19

  14. Comparison and interpretation of the dermatological health-related quality of life and SKINDEX-29 in patients with different subtypes of rosacea

    Directory of Open Access Journals (Sweden)

    Davydova A.M.

    2015-09-01

    Full Text Available Aim: comparison and interpretation of dermatological health-related quality of life (HRQoL and SKINDEX-29 in patients with different subtypes of rosacea. Materials and methods. Questionnaires HRQoL and SKINDEX-29 (which is very slightly described and categorized in Russian literature were used to question 48 patients with rosacea of 3 subtypes (the 1st, the 2nd and the 3rd. The data resulting from the study were processed statistically and tabulated. Results. Sensitivity and interchangeability SKINDEKS-29 and HRQoL were confirmed for patients with different subtypes of rosacea. A more detailed description and interpretation of SKINDEX-29 will increase the understanding of the scores obtained in patients with any dermatological pathology. The use of two questionnaires, investigating the quality of life, increases the control of psychosocial examination and the most narrowly figures details. Conclusions. Conversion of abstract SKINDEX-29 points and its clear categorization into clinically significant quantities will help to form, manage and to unite, if necessary, groups of patients, depending on the parameters of emotional, physical symptoms and psychological functioning for partnerships in the "doctor— patient" system.

  15. Quality of life and mild cognitive impairment in early Parkinson's disease: does subtype matter?

    Science.gov (United States)

    Lawson, Rachael A; Yarnall, Alison J; Duncan, Gordon W; Khoo, Tien K; Breen, David P; Barker, Roger A; Collerton, Daniel; Taylor, John-Paul; Burn, David J

    2014-01-01

    We evaluated the association between mild cognitive impairment (MCI) subtypes and quality of life (QoL) in 219 newly diagnosed Parkinson's disease (PD) patients without dementia. Participants completed neuropsychological tests of attention, executive function, visuospatial function, memory, and language, and reported QoL using the Parkinson's Disease Questionnaire. Impairments were most common in executive function, memory and attention. MCI subtypes were classified according to Movement Disorder Society Task Force criteria. More severe cognitive impairment was associated with poorer quality of life (p = 0.01), but subtype of impairment was not (p > 0.10), suggesting that the nature of cognitive impairment is less significant than its severity.

  16. Multiplex PCR followed by restriction length polymorphism analysis for the subtyping of bovine herpesvirus 5 isolates

    OpenAIRE

    Maidana; Morano, C.D.; Cianfrinid; de Campos, F.; Roehe, P.M.; Siedler, B.; G. De Stefano; Mauroy, Axel; Thiry, Etienne; Romera, S. A.

    2013-01-01

    Abstract Background: Several types and subtypes of bovine herpesviruses 1 and 5 (BoHV-1 and BoHV-5) have been associated to different clinical conditions of cattle, making type/subtype differentiation essential to understand the pathogenesis and epidemiology of BoHV infections. BoHV-5 subtyping is currently carried out by BstEII restriction enzyme analysis (REA) of the complete virus genome. This method allowed the description of three subtypes, one of which is the most widespread while ...

  17. Bulimia nervosa-nonpurging subtype: closer to the bulimia nervosa-purging subtype or to binge eating disorder?

    Science.gov (United States)

    Jordan, Jennifer; McIntosh, Virginia V W; Carter, Janet D; Rowe, Sarah; Taylor, Kathryn; Frampton, Christopher M A; McKenzie, Janice M; Latner, Janet; Joyce, Peter R

    2014-04-01

    DSM-5 has dropped subtyping of bulimia nervosa (BN), opting to continue inclusion of the somewhat contentious diagnosis of BN-nonpurging subtype (BN-NP) within a broad BN category. Some contend however that BN-NP is more like binge eating disorder (BED) than BN-P. This study examines clinical characteristics, eating disorder symptomatology, and Axis I comorbidity in BN-NP, BN-P, and BED groups to establish whether BN-NP more closely resembles BN-P or BED. Women with BN-P (n = 29), BN-NP (n = 29), and BED (n = 54) were assessed at baseline in an outpatient psychotherapy trial for those with binge eating. Measures included the Structured Clinical Interviews for DSM-IV, Eating Disorder Examination, and Eating Disorder Inventory-2. The BN-NP subtype had BMIs between those with BN-P and BED. Both BN subtypes had higher Restraint and Drive for Thinness scores than BED. Body Dissatisfaction was highest in BN-NP and predicted BN-NP compared to BN-P. Higher Restraint and lower BMI predicted BN-NP relative to BED. BN-NP resembled BED with higher lifetime BMIs; and weight-loss clinic than eating disorder clinic attendances relative to the BN-P subtype. Psychiatric comorbidity was comparable except for higher lifetime cannabis use disorder in the BN-NP than BN-P subtype These results suggest that BN-NP sits between BN-P and BED however the high distress driving inappropriate compensatory behaviors in BN-P requires specialist eating disorder treatment. These results support retaining the BN-NP group within the BN category. Further research is needed to determine whether there are meaningful differences in outcome over follow-up. Copyright © 2013 Wiley Periodicals, Inc.

  18. Dyscalculia and Attention Deficit Subtypes

    OpenAIRE

    1999-01-01

    The association of specific academic deficits with attention deficit disorder (ADD) subtypes was determined in 20 students (ages 8-12) with ADD with hyperactivity (ADD/H) compared to 20 with ADD without hyperactivity (ADD/noH), at the Department of Educational Psychology, University of Texas at Austin, TX.

  19. Electrophysiological Correlates of Dyslexic Subtypes.

    Science.gov (United States)

    Flynn, Jane M.; And Others

    1992-01-01

    The construct validity of Boder's typology of dyslexia was investigated using quantified electroencephalography with 39 children (ages 7-11) during a reading task and at rest. Results supported beta frequency differences in anticipated regions by dyslexia subtype during the reading task. However, the direction of difference hypothesis was not…

  20. Subtypes of functional dyspepsia

    Institute of Scientific and Technical Information of China (English)

    Georgina Baker; Robert J Fraser; Graeme Young

    2006-01-01

    Functional dyspepsia is a common clinical condition characterised by chronic or recurrent upper abdominal pain or discomfort commonly associated with a variety of associated gastrointestinal symptoms and a normal endoscopy. To standardise research-based approaches,an initial categorisation of into sub groups was agreed to, based on clusters of symptoms. However the early expectation that these subgroups would be associated with distinct pathophysiologies amenable to specific therapy has not been realised. A classification based on the most troublesome symptom has been suggested but the utility of this is also unclear. More recent data suggest that some of the pathophysiologic dysfunctions may be associated with specific symptoms and so provide a better tool for grouping patients. But this approach remains incomplete as current insights into the pathogenesis are still too limited for this to be satisfactory. In conclusion, no classification provides for an adequate treatment-based approach to the syndrome of functional dyspepsia. As a consequence treatment remains largely empiric.

  1. Depression and anxiety related subtypes in Parkinson's disease.

    Science.gov (United States)

    Brown, Richard G; Landau, Sabine; Hindle, John V; Playfer, Jeremy; Samuel, Michael; Wilson, Kenneth C; Hurt, Catherine S; Anderson, Rachel J; Carnell, Joanna; Dickinson, Lucy; Gibson, Grant; van Schaick, Rachel; Sellwood, Katie; Thomas, Bonnita A; Burn, David J

    2011-07-01

    Depression and anxiety are common in Parkinson's disease (PD) and although clinically important remain poorly understood and managed. To date, research has tended to treat depression and anxiety as distinct phenomena. There is growing evidence for heterogeneity in PD in the motor and cognitive domains, with implications for pathophysiology and outcome. Similar heterogeneity may exist in the domain of depression and anxiety. To identify the main anxiety and depression related subtype(s) in PD and their associated demographic and clinical features. A sample of 513 patients with PD received a detailed assessment of depression and anxiety related symptomatology. Latent Class Analysis (LCA) was used to identify putative depression and anxiety related subtypes. Results LCA identified four classes, two interpretable as 'anxiety related': one anxiety alone (22.0%) and the other anxiety coexisting with prominent depressive symptoms (8.6%). A third subtype (9%) showed a prominent depressive profile only without significant anxiety. The final class (60.4%) showed a low probability of prominent affective symptoms. The validity of the four classes was supported by distinct patterns of association with important demographic and clinical variables. Depression in PD may manifest in two clinical phenotypes, one 'anxious-depressed' and the other 'depressed'. However, a further large proportion of patients can have relatively isolated anxiety. Further study of these putative phenotypes may identify important differences in pathophysiology and other aetiologically important factors and focus research on developing more targeted and effective treatment.

  2. Adherence to CLSI Recommendations for Testing of Staphylococcus aureus Isolates in Louisiana Hospitals: Report of a Clinical Failure and Results of a Questionnaire Study▿

    Science.gov (United States)

    Patra, Kamakshya P.; Vanchiere, John A.; Bocchini, Joseph A.

    2011-01-01

    We report a case of failure of clindamycin therapy due to inducible clindamycin resistance. We surveyed and found that only 52% of reporting hospitals in the state of Louisiana were performing the D test for inducible clindamycin resistance according to guidelines recommended by the Clinical and Laboratory Standards Institute (formerly the National Committee for Clinical Laboratory Standards). PMID:21632893

  3. Clinical impact of de-regulated Notch-1 and Notch-3 in the development and progression of HPV-associated different histological subtypes of precancerous and cancerous lesions of human uterine cervix.

    Directory of Open Access Journals (Sweden)

    Richa Tripathi

    Full Text Available BACKGROUND: Cervical cancer is the leading cause of cancer related deaths among women in India. Limited reports are available for Notch-1 and Notch-3 protein in cervical carcinoma, which play crucial role in cell proliferation, differentiation, and apoptosis. METHODS: This study was designed to evaluate the role of Notch-1 and Notch-3 with context to HPV infection in cervical carcinoma. A total of 168 tissue biopsy samples comprising of tumor specimens (n = 98, precancer (n = 30 and non-neoplastic cervical tissues (n = 40 were screened for HPV infection by PCR and expression of Notch-1 and Notch-3 protein by Immunohistochemistry and Immunoblotting. RESULTS: 80% (24/30 were found to be positive for HPV in precancer and 86.7% (85/98 in cancer patients. Notch-1 expression of precancer and cancer cases was found to be significantly down-regulated with severity of disease in nuclear (3.43±0.29; 2.04±0.19, p = 0.0001, p = 0.0001 and cytoplasm (3.07±0.29; 2.29±0.17, p = 0.0001, p = 0.0001 obtained from different stages as compared to normal cervix tissue (5.40±0.19, 4.97±0.15; p<0.001; p<0.001. However, Notch-3 expression of above cases was significantly up-regulated with severity of disease and showed intense nuclear (4.17±0.39; 4.74±0.18, p = 0.0001, p = 0.0001 and cytoplasm (3.67±0.36; 4.48±0.18, p = 0.0001, p = 0.0001 of different stages as compared to normal cervix tissue (0.95±0.20, 0.70±0.20; p<0.001; p<0.001 respectively. CONCLUSIONS: These findings suggest that Notch-1 and Notch-3 may play an important role with synergistic effect of HPV in regulating development and proliferation of cervical cancer through the deregulation of Notch signalling. This study also shows the clinical utility of both proteins which may be used as predictable biomarkers in diagnosing different histological sub-types of HPV associated cervical cancer. Nevertheless, abnormal activation of this pathway may provide

  4. Transcriptional Network Architecture of Breast Cancer Molecular Subtypes

    Directory of Open Access Journals (Sweden)

    Guillermo de Anda-Jáuregui

    2016-11-01

    Full Text Available Breast cancer heterogeneity is evident at the clinical, histological and molecular level. High throughput technologies allowed the identification of intrinsic subtypes that capture transcriptional differences among tumors. A remaining question is whether said differences are associated to a particular transcriptional program which involves different connections between the same molecules. In other words, whether particular transcriptional network architectures can be linked to specific phenotypes.In this work we infer, construct and analyze transcriptional networks from whole-genome gene expression microarrays, by using an information theory approach. We use 493 samples of primary breast cancer tissue classified in four molecular subtypes: Luminal A, Luminal B, Basal and HER2-enriched. For comparison, a network for non-tumoral mammary tissue (61 samples is also inferred and analyzed.Transcriptional networks present particular architectures in each breast cancer subtype as well as in the non-tumor breast tissue. We find substantial differences between the non-tumor network and those networks inferred from cancer samples, in both structure and gene composition. More importantly, we find specific network architectural features associated to each breast cancer subtype. Based on breast cancer networks' centrality, we identify genes previously associated to the disease, either, generally (i.e. CNR2 or to a particular subtype (such as LCK. Similarly, we identify LUZP4, a gene barely explored in breast cancer, playing a role in transcriptional networks with subtype-specific relevance.With this approach we observe architectural differences between cancer and non-cancer at network level, as well as differences between cancer subtype networks which might be associated with breast cancer heterogeneity. The centrality measures of these networks allow us to identify genes with potential biomedical implications to breast cancer.

  5. Transcriptional Network Architecture of Breast Cancer Molecular Subtypes.

    Science.gov (United States)

    de Anda-Jáuregui, Guillermo; Velázquez-Caldelas, Tadeo E; Espinal-Enríquez, Jesús; Hernández-Lemus, Enrique

    2016-01-01

    Breast cancer heterogeneity is evident at the clinical, histological and molecular level. High throughput technologies allowed the identification of intrinsic subtypes that capture transcriptional differences among tumors. A remaining question is whether said differences are associated to a particular transcriptional program which involves different connections between the same molecules. In other words, whether particular transcriptional network architectures can be linked to specific phenotypes. In this work we infer, construct and analyze transcriptional networks from whole-genome gene expression microarrays, by using an information theory approach. We use 493 samples of primary breast cancer tissue classified in four molecular subtypes: Luminal A, Luminal B, Basal and HER2-enriched. For comparison, a network for non-tumoral mammary tissue (61 samples) is also inferred and analyzed. Transcriptional networks present particular architectures in each breast cancer subtype as well as in the non-tumor breast tissue. We find substantial differences between the non-tumor network and those networks inferred from cancer samples, in both structure and gene composition. More importantly, we find specific network architectural features associated to each breast cancer subtype. Based on breast cancer networks' centrality, we identify genes previously associated to the disease, either, generally (i.e., CNR2) or to a particular subtype (such as LCK). Similarly, we identify LUZP4, a gene barely explored in breast cancer, playing a role in transcriptional networks with subtype-specific relevance. With this approach we observe architectural differences between cancer and non-cancer at network level, as well as differences between cancer subtype networks which might be associated with breast cancer heterogeneity. The centrality measures of these networks allow us to identify genes with potential biomedical implications to breast cancer.

  6. Transcriptional Network Architecture of Breast Cancer Molecular Subtypes

    Science.gov (United States)

    de Anda-Jáuregui, Guillermo; Velázquez-Caldelas, Tadeo E.; Espinal-Enríquez, Jesús; Hernández-Lemus, Enrique

    2016-01-01

    Breast cancer heterogeneity is evident at the clinical, histological and molecular level. High throughput technologies allowed the identification of intrinsic subtypes that capture transcriptional differences among tumors. A remaining question is whether said differences are associated to a particular transcriptional program which involves different connections between the same molecules. In other words, whether particular transcriptional network architectures can be linked to specific phenotypes. In this work we infer, construct and analyze transcriptional networks from whole-genome gene expression microarrays, by using an information theory approach. We use 493 samples of primary breast cancer tissue classified in four molecular subtypes: Luminal A, Luminal B, Basal and HER2-enriched. For comparison, a network for non-tumoral mammary tissue (61 samples) is also inferred and analyzed. Transcriptional networks present particular architectures in each breast cancer subtype as well as in the non-tumor breast tissue. We find substantial differences between the non-tumor network and those networks inferred from cancer samples, in both structure and gene composition. More importantly, we find specific network architectural features associated to each breast cancer subtype. Based on breast cancer networks' centrality, we identify genes previously associated to the disease, either, generally (i.e., CNR2) or to a particular subtype (such as LCK). Similarly, we identify LUZP4, a gene barely explored in breast cancer, playing a role in transcriptional networks with subtype-specific relevance. With this approach we observe architectural differences between cancer and non-cancer at network level, as well as differences between cancer subtype networks which might be associated with breast cancer heterogeneity. The centrality measures of these networks allow us to identify genes with potential biomedical implications to breast cancer. PMID:27920729

  7. What is the impact of a national postgraduate medical specialist education reform on the daily clinical training 3.5 years after implementation? A questionnaire survey

    DEFF Research Database (Denmark)

    Mortensen, Lene; Malling, Bente; Ringsted, Charlotte Vibeke

    2010-01-01

    Many countries have recently reformed their postgraduate medical education (PGME). New pedagogic initiatives and blueprints have been introduced to improve quality and effectiveness of the education. Yet it is unknown whether these changes improved the daily clinical training. The purpose...

  8. Validación de un cuestionario para evaluar la seguridad del paciente en los laboratorios clínicos Validation of a questionnaire to evaluate patient safety in clinical laboratories

    Directory of Open Access Journals (Sweden)

    Ángeles Giménez Marín

    2012-12-01

    Full Text Available Objetivos: Es objeto de este trabajo elaborar, pilotar y validar un cuestionario para evaluar la seguridad del paciente en el ámbito específico de los laboratorios clínicos. Métodos: Se elaboró un cuestionario específico sobre seguridad del paciente en el laboratorio, con 62 ítems agrupados en 6 áreas, partiendo de los diferentes factores humanos y del entorno de los laboratorios, que contribuyen a que se generen errores. Se realizó un pilotaje de 30 cuestionarios, análisis de validez y fiabilidad mediante análisis factorial de componentes principales y alfa de Cronbach con envío de 240 cuestionarios a 21 hospitales, y test-retest con 41 cuestionarios con la versión definitiva. Resultados: La muestra la formaron 225 cuestionarios (tasa de respuesta del 80%. De los 62 ítems inicialmente valorados, se descartaron 17 por no cumplir los criterios previos a la realización del análisis factorial de componentes principales. Para los 45 ítems restantes se identificaron 12 componentes, con una varianza acumulada del 69,5%. En 7 de los 10 componentes con dos o más ítems, el alfa de Cronbach fue superior a 0,7. Los ítems valorados del cuestionario para el test-retest resultaron estables. Conclusiones: Se presenta el primer cuestionario con garantías de validez y fiabilidad para evaluar la seguridad del paciente en el ámbito específico de los laboratorios clínicos. El cuestionario resulta una herramienta de utilidad para realizar tanto un posterior macroestudio de los laboratorios clínicos hospitalarios en España como, a nivel particular, para monitorizar y fomentar el compromiso y la responsabilidad con la seguridad del paciente en un entorno de mejora continua.Objectives: The aim of this study was to prepare, pilot and validate a questionnaire to evaluate patient safety in the specific context of clinical laboratories. Methods:: A specific questionnaire on patient safety in the laboratory, with 62 items grouped into six areas

  9. Diagnosis and subtypes of adolescent antisocial personality disorder.

    Science.gov (United States)

    Jones, Meredith; Westen, Drew

    2010-04-01

    The present study examined the application of the Antisocial Personality Disorder (APD) diagnosis to adolescents and investigated the possibility of subtypes of APD adolescents. As part of a broader study of adolescent personality in clinically-referred patients, experienced clinicians provided personality data on a randomly selected patient in their care using the SWAP-II-A personality pathology instrument. Three hundred thirteen adolescents met adult DSM-IV diagnostic criteria for APD. To characterize adolescents with the disorder, we aggregated the data to identify the items most descriptive and distinctive of APD adolescents relative to other teenagers in the sample (N = 950). Q-factor analysis identified five personality subtypes: psychopathic-like, socially withdrawn, impulsive-histrionic, emotionally dysregulated, and attentionally dysregulated. The five subtypes differed in predictable ways on a set of external criteria related to global adaptive functioning, childhood family environment, and family history of psychiatric illness. Both the APD diagnosis and the empirically derived APD subtypes provided incremental validity over and above the DSM-IV disruptive behavior disorders in predicting global adaptive functioning, number of arrests, early-onset severe externalizing pathology, and quality of peer relationships. Although preliminary, these results provide support for the use of both APD and personality-based subtyping systems in adolescents.

  10. Differentiating anxious and depressive self-statements in youth: factor structure of the Negative Affect Self-Statement Questionnaire among youth referred to an anxiety disorders clinic.

    Science.gov (United States)

    Lerner, J; Safren, S A; Henin, A; Warman, M; Heimberg, R G; Kendall, P C

    1999-03-01

    Conducted a factor analysis on the items from the Negative Affect Self-Statement Questionnaire (NASSQ; Ronan, Kendall, & Rowe, 1994). This analysis yielded 4 factors (Depressive Self-Statements, Anxiety/Somatic Self-Statements, Negative Affect Self-Statements, and Positive Affect Self-Statements) broadly consistent with both the content-specificity hypothesis (Beck & Clark, 1988) and L. A. Clark and Watson's (1991b) tripartite model of anxiety and depression. The association between children's self-talk and measures of trait anxiety and depression was also examined. Self-statements with content theoretically specific to depression were the best predictors of self-reported depressive symptoms, but the results were less clear for trait anxiety. Overall, these results provide evidence for the discriminability of anxious and depressive self-talk in youth and for the utility of the NASSQ as a cognitive assessment instrument.

  11. Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire (JOACMEQ): part 4. Establishment of equations for severity scores. Subcommittee on low back pain and cervical myelopathy, evaluation of the clinical outcome committee of the Japanese Orthopaedic Association.

    Science.gov (United States)

    Fukui, Mitsuru; Chiba, Kazuhiro; Kawakami, Mamoru; Kikuchi, Shinichi; Konno, Shinichi; Miyamoto, Masabumi; Seichi, Atsushi; Shimamura, Tadashi; Shirado, Osamu; Taguchi, Toshihiko; Takahashi, Kazuhisa; Takeshita, Katsushi; Tani, Toshikazu; Toyama, Yoshiaki; Yonenobu, Kazuo; Wada, Eiji; Tanaka, Takashi; Hirota, Yoshio

    2008-01-01

    To establish a patient-oriented outcome measure for cervical myelopathy, a subcommittee of the Japanese Orthopaedic Association (JOA) developed a new scoring system to evaluate the overall clinical status of patients, which could be completed by patients themselves. The subcommittee completed three large-scale studies to select and modify questions derived from various preexisting outcome measures including Short Form-36, and then finalized and validated the questionnaire, which comprised 24 questions. The finalized questionnaire was administered to 369 patients with cervical myelopathy due to disc herniation, spondylosis, or ossification of posterior longitudinal ligament by randomly selected board-certified spine surgeons. Patients with different severities of myelopathy were included to insure accuracy and responsiveness of this questionnaire against patients' different neurological status. Data of 236 patients were employed and were subjected to rigorous statistical analyses. There was no question that was difficult to answer and distribution of answers for each question was not concentrated to one choice, indicating the appropriateness of all 24 questions. Results of factor analysis suggested that the 24 questions could be divided into five different factors or functional domains. The factors were defined as follows: factor 1, lower extremity function; factor 2, quality of life; factor 3, cervical spine function; factor 4, bladder function; and factor 5, upper extremity function. Finally, equations that would yield scores for the five factors were assembled. The score to be used to represent the degree of patients' disability or status in each domain can be calculated by multiplying prefixed numbers of selected answers to questions by preassigned coefficients. Coefficients were defined to make the minimum score 0 and the maximum score 100. We have successfully established a questionnaire that is able to demonstrate the status of patients suffering cervical

  12. Quantitative data for care of patients with systemic lupus erythematosus in usual clinical settings: a patient Multidimensional Health Assessment Questionnaire and physician estimate of noninflammatory symptoms.

    Science.gov (United States)

    Askanase, Anca Dinu; Castrejón, Isabel; Pincus, Theodore

    2011-07-01

    To analyze quantitative data in patients with systemic lupus erythematosus (SLE), seen in usual care, from a patient Multidimensional Health Assessment Questionnaire (MDHAQ) with routine assessment of patient index data (RAPID3) scores and from a physician global estimate of noninflammatory symptoms; and to compare results to self-report Systemic Lupus Activity Questionnaire (SLAQ) scores and 4 SLE indices: SLE Disease Activity Index-2K (SLEDAI-2K), British Isles Lupus Assessment Group (BILAG), Systemic Lupus Activity Measure (SLAM), and European Consensus Lupus Activity Measurement (ECLAM). Fifty consecutive patients with SLE were studied in usual care of one rheumatologist. All patients completed an MDHAQ/RAPID3 in this setting. Each patient also completed a SLAQ. The rheumatologist scored SLEDAI-2K, BILAG, SLAM, ECLAM, and 2 physician global estimates, one for overall status and one for noninflammatory symptoms. Patients were classified into 2 groups: "few" or "many" noninflammatory symptoms. Scores and indices were compared using correlations, cross-tabulations and t tests. The patients included 45 women and 5 men. MDHAQ/RAPID3 and SLAQ scores were significantly correlated. RAPID3 scores were significantly higher in patients with SLE index scores above median levels, and in 34 patients scored by the rheumatologist as having "few" noninflammatory symptoms. MDHAQ/RAPID3 and SLAQ were significantly higher in 16 patients scored as having many noninflammatory symptoms. MDHAQ/RAPID3 and SLAQ subscale scores appear to reflect disease activity in patients with SLE, but not in patients with many noninflammatory symptoms. A physician scale for noninflammatory symptoms is useful to interpret MDHAQ/RAPID3, SLAQ, and SLE index scores.

  13. Targeting the subtypes of breast cancer: rethinking investigational drugs.

    Science.gov (United States)

    Curigliano, Giuseppe; Locatelli, Marzia; Fumagalli, Luca; Brollo, Janaina; Munzone, Elisabetta; Nolé, Franco; Criscitiello, Carmen; Goldhirsch, Aron

    2012-02-01

    The choice of adjuvant treatments for women with breast cancer is based on several features that take into account the heterogeneity of the disease. Questions raised during the decision process include the following: i) What leads to the use of endocrine therapy? ii) What leads to the use of anti-HER2 therapy? iii) What justifies the use of chemotherapy? Choices of adjuvant treatment are based on parameters defined by molecular characterization of breast cancer subtypes or by approximations to this classification using traditional clinical-pathological features. Clinicians should consider cases within the various distinct subpopulation in order to properly select the most 'personalized' adjuvant therapeutic approach. Sensitivity to chemotherapy and/or targeted agents in subtypes of breast cancers are predictable based on gene pathway alterations and associated gene products. This review covers several clinical data on several investigational agents for early-stage breast cancer molecular subtypes. We selected from literature data prospective Phase I, II and III clinical trials of chemotherapy (weekly or daily schedules), including indicators of activity and toxicity and data on survival/mortality. The future of many investigational therapeutics in breast cancer is linked to our ability to identify the most druggable target in each subtype.

  14. Optimism, pessimism, and neuropsychological performance across semiology-based subtypes of psychogenic nonepileptic seizures.

    Science.gov (United States)

    Griffith, Nathan M; Smith, Kristen M; Schefft, Bruce K; Szaflarski, Jerzy P; Privitera, Michael D

    2008-10-01

    Past research has suggested that pessimistic attributional style may be a risk factor for psychopathology among patients with seizure disorders. In addition, classifying psychogenic nonepileptic seizures (PNES) into subtypes has been found to be clinically relevant. However, very few studies have addressed differences in optimism, pessimism, or neuropsychological performance among PNES subtypes. We previously classified adults with PNES into semiology-based subtypes (catatonic, minor motor, major motor). In the study described here, we compared subtypes on optimism, pessimism, depressive symptoms, and neuropsychological performance. We found that patients with PNES with low optimism had significantly greater depressive symptoms than patients with high optimism, F(2, 39)=36.49, Psemiology-based subtypes and study of normal personality traits among patients with PNES may have clinical significance.

  15. Pain Experience in Dementia Subtypes: A Systematic Review.

    Science.gov (United States)

    Binnekade, Tarik T; Van Kooten, Janime; Lobbezoo, Frank; Rhebergen, Didi; Van der Wouden, J C; Smalbrugge, Martin; Scherder, Erik J A

    2017-01-01

    Recently, the number of studies focusing on pain in dementia has increased considerably. Still, little attention has been paid to the influence of the neuropathology of different dementia subtypes on pain experience. In 2003, a review identified several studies that indicated a relation between dementia subtype and pain experience. Now, ten years later, an update is warranted. We conducted a systematic review to identify studies that assessed pain experience and dementia subtypes by searching PubMed, Embase, PsycINFO, CINAHL, and Cochrane Library. Inclusion criteria were: (1) major dementia subtype diagnosis i.e. Alzheimer's dementia (AD), vascular dementia (VaD), frontotemporal dementia (FTD), dementia with Lewy Bodies (DLB); (2) age ≥60 years; and (3) pain experience. We identified twelve studies that addressed AD, three studies VaD, one study FTD, and no studies DLB. In AD, studies on clinical pain indicate a reduced pain experience compared to controls, whereas experimental studies show inconsistent findings. In VaD, clinical studies found that primary caregivers rated pain equal to cognitively intact controls, although more painful locations were reported. During self-report, elderly with VaD reported higher pain levels than cognitively intact controls. In FTD, a significantly lower pain sensitivity to experimental pain was found. Considering the limited number of studies, these findings should be considered with caution. Existing literature provides some evidence that dementia subtype affects pain experience. Further research is needed to clarify the relation between dementia subtype and pain experience as it could serve as basis for improving the assessment and management of pain in people with dementia. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  16. Utah Drug Use Questionnaire.

    Science.gov (United States)

    Governor's Citizen Advisory Committee on Drugs, Salt Lake City, UT.

    This questionnaire assesses drug use practices in junior and senior high school students. The 21 multiple choice items pertain to drug use practices, use history, available of drugs, main reason for drug use, and demographic data. The questionnaire is untimed, group administered, and may be given by the classroom teacher in about 10 minutes. Item…

  17. Study on executive function in clinical subtypes of attention deficit hyperactivity disorder%注意缺陷多动障碍临床亚型患儿执行功能的研究

    Institute of Scientific and Technical Information of China (English)

    姚静; 金敏; 刘军; 周为; 刘从敏

    2014-01-01

    目的:探讨注意缺陷多动障碍( ADHD)各临床亚型患者的执行功能。方法对19名ADHD注意缺陷型患儿、13名ADHD多动冲动型患儿、33名ADHD混合型患儿及30名正常儿童进行Stroop色词命名测验(包括颜色干扰测验和字义干扰测验)、威斯康辛卡片分类测验( WCST)、汉诺塔测验、数字广度、言语流畅性测验的检测。结果 ADHD患儿Stroop颜色干扰测验与字义干扰测验的正确数、数字广度中倒背分、WCST的正确分类数、汉诺塔计划时间明显少于正常组[(104.8±4.0)个、(105.9±4.2)个、(104.8±3.7)个、(104.8±4.0)个, P<0.05;(84.0±9.2)个、(84.8±7.9)个、(78.2±7.8)个、(92.2±7.1)个, P<0.01;(4.0±1.8)分、(3.7±1.2)分、(3.8±1.5)分、(5.1±1.6)分, P<0.01;(3.0±1.0)个、(3.3±1.0)个、(2.7±1.3)个、(3.8±1.3)个, P<0.01;(4.1±1.6)个、(4.2±1.9)个、(4.3±2.1)个、(5.4±1.7)个, P<0.05],而WCST持续错误数、非持续错误数高于正常组[(6.6±3.2)个、(6.7±2.4)个、(8.0±2.9)个、(5.3±2.4)个, P<0.01;(10.2±2.8)个、(11.1±3.8)个、(12.3±4.0)个、(9.4±3.2)个, P<0.05]。 ADHD混合型患儿组在Stroop字义干扰测验中正确数低于注意缺陷型和多动冲动型(P<0.01)。结论 ADHD患儿存在执行功能障碍,表现在反应抑制、计划性、工作记忆、认知灵活性方面受损,其中反应抑制缺陷可能是ADHD亚型区分的指标之一。%Objective To explore the executive function in clinical subtypes of attention deficit hyperac⁃tivity disorder( ADHD) . Methods 19 children with ADHD/ inattentive type( ADHD⁃I) ,13children with ADHD/hyperactive⁃impulsive( ADHD⁃HI) 33 children with ADHD

  18. The Existential Concerns Questionnaire (ECQ)-Development and Initial Validation of a New Existential Anxiety Scale in a Nonclinical and Clinical Sample

    NARCIS (Netherlands)

    van Bruggen, Vincent; ten Klooster, Peter; Westerhof, Gerben; Vos, Joël; de Kleine, Elian; Bohlmeijer, Ernst; Glas, Gerrit

    2017-01-01

    Objective: Existential anxiety (EA) is a construct that refers to fears that are provoked by core threats of human existence, such as death, meaninglessness, and fundamental loneliness. The objective of this study was to develop an EA measure that can be used in research and clinical practice. Metho

  19. The Parent Psychological Flexibility Questionnaire (PPFQ: Item Reduction and Validation in a Clinical Sample of Swedish Parents of Children with Chronic Pain

    Directory of Open Access Journals (Sweden)

    Camilla Wiwe Lipsker

    2016-11-01

    Full Text Available In pediatric chronic pain, research indicates a positive relation between parental psychological flexibility (i.e., the parent’s willingness to experience distress related to the child’s pain in the service of valued behavior and level of functioning in the child. This points to the utility of targeting parental psychological flexibility in pediatric chronic pain. The Parent Psychological Flexibility Questionnaire (PPFQ is currently the only instrument developed for this purpose, and two previous studies have indicated its reliability and validity. The current study sought to validate the Swedish version of the 17-item PPFQ (PPFQ-17 in a sample of parents (n = 263 of children with chronic pain. Factor structure and internal reliability were evaluated by means of principal component analysis (PCA and Cronbach’s alpha. Concurrent criterion validity was examined by hierarchical multiple regression analyses with parental anxiety and depression as outcomes. The PCA supported a three-factor solution with 10 items explaining 69.5% of the total variance. Cronbach’s alpha (0.86 indicated good internal consistency. The 10-item PPFQ (PPFQ-10 further explained a significant amount of variance in anxiety (29%, and depression (35.6%, confirming concurrent validity. In conclusion, results support the reliability and validity of the PPFQ-10, and suggest its usefulness in assessing psychological flexibility in parents of children with chronic pain.

  20. [Response of Pharmaceutical Companies to the Crisis of Post-Marketing Clinical Trials of Anti-Cancer Agents -- Results of Questionnaires to Pharmaceutical Companies].

    Science.gov (United States)

    Nakajima, Toshifusa

    2016-04-01

    Investigator-oriented post-marketing clinical trials of anti-cancer agents are faced to financial crisis due to drastic decrease in research-funds from pharmaceutical companies caused by a scandal in 2013. In order to assess the balance of research funds between 2012 and 2014, we made queries to 26 companies manufacturing anti-cancer agents, and only 10 of 26 responded to our queries. Decrease in the fund was observed in 5 of 10, no change in 1, increase in 3 and no answer in 1. Companies showed passive attitude to carry out doctor-oriented clinical trials of off-patent drugs or unapproved drugs according to advanced medical care B program, though some companies answered to proceed approved routines of these drugs if clinical trials showed good results. Most companies declined to make comments on the activity of Japan Agency for Medical Research and Development (AMED), but some insisted to produce good corroboration between AMED and pharmaceutical companies in order to improve the quality of trials. Further corroboration must be necessary for this purpose among researchers, governmental administrative organs, pharmaceutical companies, patients' groups, and mass-media.

  1. 基于RDC/TMD数字化问卷的初步临床应用%Clinical application of a digital questionnaire based on RDC/TMD

    Institute of Scientific and Technical Information of China (English)

    胡萍萍; 李希吉; 王红梅; 张玉玮

    2011-01-01

    Objective: To design and develop a digital questionnaire based on the research diagnostic criteria for temporomandibular disorders (RDC/TMD) axis II.Methods: In Microsoft office access 2007 database for the background, Borland Delphi 7.0 for the development tools to establish the TMD digital form, the depression symptom scale (DSS), the pain intensity (PI) and the limitation related to mandibular functioning(LRMF) were evaluated.Results: Most patients (97.2%) had low disability, with 10 patientshaving low PI and 25 patients having moderately PI.The study demonstrated statistically significant differences in the DSS and the PI in Grade Ⅰ and Grade Ⅱ.The DSS was related to the PI.In addition, the PI was related to the LRMF.Conclusion: The patients who are severely depressed have higher PI than normal patients.Patients that are moderately or severely depressed have significantly higher scores for the LRMF than normal patients.The TMD digital questionnaire is working well and acting as an assistant diagnosis in TMD.%目的:设计和开发一种基于颞下颌关节紊乱研究诊断标准(RDC/TMD)的数字化问卷.方法:以Microsoft Office Access 2007为后台数据库,以Borland Delphi 7.0为前台开发工具,用ADO接口使两者交互连接,以RDC/TMD轴Ⅱ为标准建立TMD数字化问卷,评价36名TMD患者精神抑郁水平(DSS)、疼痛强度(PI)和颌骨功能受限(LRMF)情况.结果:大多数患者(97.2%)属于轻度功能丧失,其中10位患者有轻度疼痛(Ⅰ级);25位患者有重度疼痛(Ⅱ级).Ⅰ级组患者PI与DSS呈显著性相关(r=0.531,P<0.05),PI与LRMF呈低度线性相关(r=0.387,P<0.05);Ⅱ级组患者PI与DSS呈显著性相关(r=0.606,P<0.05),PI与LRMF呈低度线性相关(r=0.318,P<0.05),DSS与LRMF呈低度线性相关(r=0.324,P<0.05).结论:DSS值较高患者的PI值比DSS值较低的患者高.DSS值较高患者的LRMF分数高于DSS值较低的患者,且明显的被疼痛症状所困扰.该数字化问卷运行良

  2. Parental authority questionnaire.

    Science.gov (United States)

    Buri, J R

    1991-08-01

    A questionnaire was developed for the purpose of measuring Baumrind's (1971) permissive, authoritarian, and authoritative parental authority prototypes. It consists of 30 items per parent and yields permissive, authoritarian, and authoritative scores for both the mother and the father; each of these scores is derived from the phenomenological appraisals of the parents' authority by their son or daughter. The results of several studies have supported the Parental Authority Questionnaire as a psychometrically sound and valid measure of Baumrind's parental authority prototypes, and they have suggested that this questionnaire has considerable potential as a valuable tool in the investigation of correlates of parental permissiveness, authoritarianism, and authoritativeness.

  3. Defining breast cancer intrinsic subtypes by quantitative receptor expression.

    Science.gov (United States)

    Cheang, Maggie C U; Martin, Miguel; Nielsen, Torsten O; Prat, Aleix; Voduc, David; Rodriguez-Lescure, Alvaro; Ruiz, Amparo; Chia, Stephen; Shepherd, Lois; Ruiz-Borrego, Manuel; Calvo, Lourdes; Alba, Emilio; Carrasco, Eva; Caballero, Rosalia; Tu, Dongsheng; Pritchard, Kathleen I; Levine, Mark N; Bramwell, Vivien H; Parker, Joel; Bernard, Philip S; Ellis, Matthew J; Perou, Charles M; Di Leo, Angelo; Carey, Lisa A

    2015-05-01

    To determine intrinsic breast cancer subtypes represented within categories defined by quantitative hormone receptor (HR) and HER2 expression. We merged 1,557 cases from three randomized phase III trials into a single data set. These breast tumors were centrally reviewed in each trial for quantitative ER, PR, and HER2 expression by immunohistochemistry (IHC) stain and by reverse transcription-quantitative polymerase chain reaction (RT-qPCR), with intrinsic subtyping by research-based PAM50 RT-qPCR assay. Among 283 HER2-negative tumors with definition of triple-negative breast cancer significantly diminished enrichment for basal-like cancer (p 10%) expression, only 69 (54%) were HER2-enriched and 55 (43%) were luminal (39 luminal B, 16 luminal A). Quantitative HR expression by RT-qPCR gave similar results. Regardless of methodology, basal-like cases seldom expressed ER/ESR1 or PR/PGR and were associated with the lowest expression level of HER2/ERBB2 relative to other subtypes. Significant discordance remains between clinical assay-defined subsets and intrinsic subtype. For identifying basal-like breast cancer, the optimal HR IHC cut point was <1%, matching the American Society of Clinical Oncology and College of American Pathologists guidelines. Tumors with borderline HR staining are molecularly diverse and may require additional assays to clarify underlying biology. ©AlphaMed Press.

  4. 护理本科生临床专业实践行为评价问卷的编制%Development of clinical professional performance questionnaire for undergraduate nursing students

    Institute of Scientific and Technical Information of China (English)

    李晓宁; 孙宏玉

    2012-01-01

    目的 编制适合评价护理本科生临床专业实践行为的问卷.方法 在文献复习的基础上设计问卷,经专家反复修订后,对345名护理本科生进行调查,采用鉴别度检验、同质性检验和探索性因子分析筛选问卷条目,确定正式问卷.然后对正式问卷的各项指标进行评价.结果 正式问卷包括5个维度28个条目,分别为应用护理程序(5个条目)、护理操作及在操作中遵循伦理原则(6个条目)、健康教育(4个条目)、沟通交流(5个条目)、评判性思维(8个条目).该问卷信度Cronbach's α为0.937,各维度Cronbach's α在0.822~0.881;初始问卷的内容效度均值0.94;正式问卷的因子结构理想,以特征值>1为标准,用主成分分析法共提取5个公因子,累计贡献率为61.976%.结论 正式问卷具有良好的信效度,可以用来评价护理本科生的临床专业实践行为.%Objective To develop an instrument to measure the clinical professional performance of undergraduate nursing students. Methods The initial questionnaire was formed on the basis of literature review. Then it was revised by expert counseling and was used to evaluate 345 undergraduate nursing students. Discrimination test,homogeneity test,and exploratory factor analysis were conducted to select items. The reliability and validity of the final questionnaire was tested. Results The final questionnaire consisted of 28 items in 5 dimensions,including application of nursing process(5 items) .clinical practice and adherence to ethical principles(6 items),health education(4 items) .communication(5 items)and critical thinking(8 items). Cronbach's a of the questionnaire was 0.937,and Cronbach's a of each subscale ranged from 0.822 to 0.881. The content validity index of the initial questionnaire was 0.94. The factor structure of the final questionnaire was ideal and five factors were extracted by principal component analysis,which could explain 61.976% of the total variance

  5. HIV subtype, epidemiological and mutational correlations in patients from Paraná, Brazil

    Directory of Open Access Journals (Sweden)

    Monica Maria Gomes da Silva

    Full Text Available OBJECTIVE: Analyze patients with HIV infection from Curitiba, Paraná, their epidemiological characteristics and HIV RAM. METHODS: Patients regularly followed in an ID Clinic had their medical data evaluated and cases of virological failure were analyzed with genotypic report. RESULTS: Patients with complete medical charts were selected (n = 191. Demographic and clinical characteristics were compared. One hundred thirty two patients presented with subtype B infection (69.1%, 41 subtype C (21.5%, 10 subtype F (5.2%, 7 BF (3.7% and 1 CF (0.5%. Patients with subtype B infection had been diagnosed earlier than patients with subtype non-B. Also, subtype B infection was more frequent in men who have sex with men, while non-B subtypes occurred more frequently in heterosexuals and women. Patients with previous history of three classes of ARVs (n = 161 intake were selected to evaluate resistance. For RT inhibitors, 41L and 210W were more frequently observed in subtype B than in non-B strains. No differences between subtypes and mutations were observed to NNTRIs. Mutations at 10, 32 and 63 position of protease were more observed in subtype B viruses than non-B, while positions 20 and 36 of showed more amino acid substitutions in subtype non-B viruses. Patients with history of NFV intake were evaluated to resistance pathway. The 90M pathway was more frequent in subtypes B and non-B. Mutations previously reported as common in non-B viruses, such as 65R and 106M, were uncommon in our study. Mutations 63P and 36I, previously reported as common in HIV-1 subtypes B and C from Brazil, respectively, were common. CONCLUSION: There is a significant frequency of HIV-1 non-B infections in Paraná state, with isolates classified as subtypes C, F, BF and BC. Patients with subtype C infection were more frequently female, heterosexual and had a longer average time of HIV diagnosis

  6. Polish Adaptation of Wrist Evaluation Questionnaires.

    Science.gov (United States)

    Czarnecki, Piotr; Wawrzyniak-Bielęda, Anna; Romanowski, Leszek

    2015-01-01

    Questionnaires evaluating hand and wrist function are a very useful tool allowing for objective and systematic recording of symptoms reported by the patients. Most questionnaires generally accepted in clinical practice are available in English and need to be appropriately adapted in translation and undergo subsequent validation before they can be used in another culture and language. The process of translation of the questionnaires was based on the generally accepted guidelines of the International Quality of Life Assessment Project (IQOLA). First, the questionnaires were translated from English into Polish by two independent translators. Then, a joint version of the translation was prepared collectively and translated back into English. Each stage was followed by a written report. The translated questionnaires were then evaluated by a group of patients. We selected 31 patients with wrist problems and asked them to complete the PRWE, Mayo, Michigan and DASH questionnaires twice at intervals of 3-10 days. The results were submitted for statistical analysis. We found a statistically significant (pquestionnaires. A comparison of the PRWE and Mayo questionnaires with the DASH questionnaire also showed a statistically significant correlation (pquestionnaires was successful and that the questionnaires may be used in clinical practice.

  7. Subtypes of Preterm Birth and the Risk of Postneonatal Death

    Science.gov (United States)

    Kamath-Rayne, Beena D.; DeFranco, Emily A.; Chung, Ethan; Chen, Aimin

    2013-01-01

    Objective To examine the differences in postneonatal death risk among 3 clinical subtypes of preterm birth: preterm premature rupture of membranes (PROM), indicated preterm birth, and spontaneous preterm labor. Study design We analyzed the 2001–2005 US linked birth/infant death (birth cohort) datasets. The preterm birth subtypes were classified using information on the birth certificate: reported PROM, induction of labor, cesarean section, and complications of pregnancy and labor. Cox proportional hazard models were used to estimate covariate-adjusted hazard ratios and 95% CIs for postneonatal death (from days 28 to 365). Estimation was given for preterm birth subtypes in a week-by-week analysis. Causes of death were analyzed by preterm birth subtype and then separately at 24–27, 28–31, and 32–36 weeks of gestation. Results For the total of 1 895 350 singleton preterm births who survived the neonatal period, the postneonatal mortality rate was 1.11% for preterm PROM, 0.78% for indicated preterm birth, and 0.53% for spontaneous preterm labor. Preterm PROM was associated with significantly higher risk of postneonatal death compared with spontaneous preterm labor in infants born at 27 weeks gestation or later. Similarly, indicated preterm birth was associated with a significantly higher risk of postneonatal death than spontaneous preterm labor in infants born at 25 weeks gestation or later. Preterm PROM and indicated preterm birth were associated with greater risk of death in the postneonatal period compared with spontaneous preterm labor, irrespective of the cause of death. Conclusion Subtypes of preterm birth carry different risks of postneonatal mortality. Prevention of preterm-related postneonatal death may require more research into the root causes of preterm birth subtypes. PMID:22878113

  8. 基于临床视角的居民健康素养问卷的开发%Development of residents health literacy questionnaire:a new scale based on clinical perspective

    Institute of Scientific and Technical Information of China (English)

    杨文燕; 甄天民; 韩志琰; 谷景亮; 赵芳

    2016-01-01

    Objective To develop a health literacy questionnaire from clinical perspective.Methods Based on the definition on health literacy of the World Health Organization,this study defined the dimensions of health literacy from the clinical perspective according to the literature analysis results,and developed the health literacy questionnaire.The pre-survey was conducted,and the reliability and validity of the initial constructed questionnaire were tested.According to the re-sults of the pre-survey and questionnaire analysis,the feasibility of the questionnaire was preliminarily evaluated,and then the questionnaire was modified according to the results.Then the second pre-survey was carried out and the reliability and va-lidity of the questionnaire was analyzed,until the health literacy assessment questionnaire with good reliability and validity was formed.Results This study defined the health literacy as four dimensions:health knowledge,reading and comprehen-sion ability,numeracy and communication.A health literacy questionnaire was developed based on the four dimensions.After two times of the pre-survey and the reliability and validity test,the health literacy questionnaire was eventually formed with a good reliability and validity.The questionnaire contained 14 questions including:6 health knowledge questions;4 reading and comprehension questions;3 numeracy section;1 communication section.Each question offered three options,or four answer choices.The overall answer time was more or less 14 minutes.Conclusion This study defined health literacy as four dimensions from the clinical point of view,namely health knowledge,reading and comprehension,calculation and commu-nication,and constructed health literacy questionnaire with good reliability and validity.%目的:开发基于临床视角的健康素养测评问卷。方法从临床的角度出发,采用文献分析方法,界定健康素养的维度,构建健康素养测评问卷,对问卷进行预调查和信

  9. A practical guide to surveys and questionnaires.

    Science.gov (United States)

    Slattery, Eric L; Voelker, Courtney C J; Nussenbaum, Brian; Rich, Jason T; Paniello, Randal C; Neely, J Gail

    2011-06-01

    Surveys with questionnaires play a vital role in decision and policy making in society. Within medicine, including otolaryngology, surveys with questionnaires may be the only method for gathering data on rare or unusual events. In addition, questionnaires can be developed and validated to be used as outcome measures in clinical trials and other clinical research architecture. Consequently, it is fundamentally important that such tools be properly developed and validated. Just asking questions that have not gone through rigorous design and development may be misleading and unfair at best; at worst, they can result in under- or overtreatment and unnecessary expense. Furthermore, it is important that consumers of the data produced by these instruments understand the principles of questionnaire design to interpret results in an optimal and meaningful way. This article presents a practical guide for understanding the methodologies of survey and questionnaire design, including the concepts of validity and reliability, how surveys are administered and implemented, and, finally, biases and pitfalls of surveys.

  10. Use of the lung cancer-specific Quality of Life Questionnaire EORTC QLQ-LC13 in clinical trials: A systematic review of the literature 20 years after its development.

    Science.gov (United States)

    Koller, Michael; Warncke, Sophie; Hjermstad, Marianne J; Arraras, Juan; Pompili, Cecilia; Harle, Amelie; Johnson, Colin D; Chie, Wei-Chu; Schulz, Christian; Zeman, Florian; van Meerbeeck, Jan P; Kuliś, Dagmara; Bottomley, Andrew

    2015-12-15

    The European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-Lung Cancer 13 (QLQ-LC13) covers 13 typical symptoms of lung cancer patients and was the first module developed in conjunction with the EORTC core quality-of-life (QL) questionnaire. This review investigates how the module has been used and reported in cancer clinical trials in the 20 years since its publication. Thirty-six databases were searched with a prespecified algorithm. This search plus an additional hand search generated 770 hits, 240 of which were clinical studies. Two raters extracted data using a coding scheme. Analyses focused on the randomized controlled trials (RCTs). Of the 240 clinical studies that were identified using the LC13, 109 (45%) were RCTs. More than half of the RCTs were phase 3 trials (n = 58). Twenty RCTs considered QL as the primary endpoint, and 68 considered it as a secondary endpoint. QL results were addressed in the results section of the article (n = 89) or in the abstract (n = 92); and, in half of the articles, QL results were presented in the form of tables (n = 53) or figures (n = 43). Furthermore, QL results had an impact on the evaluation of the therapy that could be clearly demonstrated in the 47 RCTs that yielded QL differences between treatment and control groups. The EORTC QLQ-LC13 fulfilled its mission to be used as a standard instrument in lung cancer clinical trials. An update of the LC13 is underway to keep up with new therapeutic trends and to ensure optimized and relevant QL assessment in future trials. © 2015 American Cancer Society.

  11. Relations between pure dietary and dietary-negative affect subtypes and impulsivity and reinforcement sensitivity in binge eating individuals.

    Science.gov (United States)

    Carrard, Isabelle; Crépin, Christelle; Ceschi, Grazia; Golay, Alain; Van der Linden, Martial

    2012-01-01

    To investigate potential predictors of the severity of binge eating disorder (BED), two subtypes of patients with the disorder, a pure dietary subtype and a dietary-negative affect subtype, were identified. This study investigated the relationships between the two subtypes and impulsivity and reinforcement sensitivity. Ninety-two women meeting threshold and subthreshold criteria for BED diagnosis filled out questionnaires to determine eating disorder severity, impulsivity and reinforcement sensitivity before and after participating in an online guided self-help program for BED. Cluster analyses revealed a pure dietary subtype (N=66, 71.7%) and a dietary-negative affect subtype (N=26, 28.3%). Compared to the pure dietary subtype, the dietary-negative affect subtype reported a higher frequency of objective binge episodes, more severe eating disorders, higher urgency scores (defined as a tendency to act rashly in the context of negative affect), a greater sensitivity to punishment, and a higher dropout rate during treatment. These findings suggest that BED patients in the dietary-negative affect subtype exhibit heightened anxiety and are highly impulsive, especially in contexts of negative affect. For these individuals, psychological interventions for BED should focus on inhibiting automatic responses to negative emotions.

  12. GENETIC SUBTYPES OF BLASTOCYSTIS ISOLATED FROM THAI HOSPITALIZED PATIENTS IN NORTHEASTERN THAILAND.

    Science.gov (United States)

    Sanpool, Oranuch; Laoraksawong, Pokkamol; Janwan, Penchom; Intapan, Pewpan M; Sawanyawisuth, Kittisak; Thanchomnang, Tongjit; Changtrakul, Yossombat; Maleewong, Wanchai

    2015-03-01

    Blastocystis sp is probably the most common intestinal protozoan of humans. This taxon is known to include more than 17 subtypes, some of which likely cause human disease. We investigated the distribution of Blastocystis subtypes in Thai patients admitted for a variety of conditions at a hospital in northeastern Thailand. Fresh fecal samples, positive for Blastocystis by microscopy, were individually cultured in Jones' medium (n = 20) and each sample was used for amplification and sequencing a fragment of 18S rDNA. BLAST search and phylogenetic analysis demonstrated that Blastocystis subtypes ST1 (20%), ST3 (60%), ST6 (10%) and ST7 (10%) were present. No clear link between gastro-intestinal symptoms and any particular subtype of Blastocystis was apparent. Thus, there is a need to extend the work to evaluate clinical signs and subtypes in a larger cohort of patients.

  13. A DNA methylation-based definition of biologically distinct breast cancer subtypes.

    Science.gov (United States)

    Stefansson, Olafur A; Moran, Sebastian; Gomez, Antonio; Sayols, Sergi; Arribas-Jorba, Carlos; Sandoval, Juan; Hilmarsdottir, Holmfridur; Olafsdottir, Elinborg; Tryggvadottir, Laufey; Jonasson, Jon G; Eyfjord, Jorunn; Esteller, Manel

    2015-03-01

    In cancer, epigenetic states are deregulated and thought to be of significance in cancer development and progression. We explored DNA methylation-based signatures in association with breast cancer subtypes to assess their impact on clinical presentation and patient prognosis. DNA methylation was analyzed using Infinium 450K arrays in 40 tumors and 17 normal breast samples, together with DNA copy number changes and subtype-specific markers by tissue microarrays. The identified methylation signatures were validated against a cohort of 212 tumors annotated for breast cancer subtypes by the PAM50 method (The Cancer Genome Atlas). Selected markers were pyrosequenced in an independent validation cohort of 310 tumors and analyzed with respect to survival, clinical stage and grade. The results demonstrate that DNA methylation patterns linked to the luminal-B subtype are characterized by CpG island promoter methylation events. In contrast, a large fraction of basal-like tumors are characterized by hypomethylation events occurring within the gene body. Based on these hallmark signatures, we defined two DNA methylation-based subtypes, Epi-LumB and Epi-Basal, and show that they are associated with unfavorable clinical parameters and reduced survival. Our data show that distinct mechanisms leading to changes in CpG methylation states are operative in different breast cancer subtypes. Importantly, we show that a few selected proxy markers can be used to detect the distinct DNA methylation-based subtypes thereby providing valuable information on disease prognosis.

  14. Principle component analyses of questionnaires measuring individual differences in synaesthetic phenomenology.

    Science.gov (United States)

    Anderson, Hazel P; Ward, Jamie

    2015-05-01

    Questionnaires have been developed for categorising grapheme-colour synaesthetes into two sub-types based on phenomenology: associators and projectors. The general approach has been to assume a priori the existence of two sub-types on a single dimension (with endpoints as projector and associator) rather than explore, in a data-driven fashion, other possible models. We collected responses from 175 grapheme-colour synaesthetes on two questionnaires, the Illustrated Synaesthetic Experience Questionnaire (Skelton, Ludwig, & Mohr, 2009) and Rouw and Scholte's (2007) Projector-Associator Questionnaire. After Principle Component Analysis both questionnaires were comprised of two factors which coincide with the projector/associator distinction. This suggests that projectors and associators are not opposites of each other, but separate dimensions of experience (e.g. some synaesthetes claim to be both, others claim to be neither). The revised questionnaires provide a useful tool for researchers and insights into the phenomenology of synaesthesia.

  15. 癌症临床医患交流满意度问卷的编制与测评%Development and evaluation of the doctor & nurse-patient communication satisfaction questionnaire for cancer clinical practice

    Institute of Scientific and Technical Information of China (English)

    刘建新; 黄雪薇; 王秀利; 张瑛; 吕保祥

    2008-01-01

    Objective To develop and evaluate the doctor & nurses-patient communication satisfaction questionnaire for cancer clinical practice(DNPCSQC),including for assessing doctors and nurses.Methods A self-report questionnaire was developed with structured methods.A total of 557 cancer patients were asked to complete the questionnaire and evaluate the importance of each item.And 183 relatives and 96 doctors and nurses were also asked to evaluate the importance of each item.The questionnaire was refined and its reliability and validity were evaluated.Results 1.DNPCSQC Was finally refined as a questionnaire with 14-item,3 dimensions including communicating information,style and the performance of doctors and nurses,and an item for general satisfaction.2.The questionnaire had good content validity and it Can well reflect the satisfaction for doctor & nurse-patient communication by cancer patients.Its construct was consistent with the concept designed.The criterion validity with general satisfaction of doctors' and nurses' questionnaire was 0.83 and 0.80 respectively.3.The test-retest coefficients for the 3 dimensions and the total score:doctors' questionnaire was 0.82,0.78,0.88 and 0.86 respectively,nurses' questionnaire was 0.83,0.76,0.80 and 0.83 respectively;Cronbach α:doctors' questionnaire was 0.89,0.76,0.78 and 0.86 respectively,nurses' questionnaire Was 0.83,0.77,0.80 and 0.83 respectively.The split-half reliability for the questionnaire wag 0.90.Conclusion DNPCSQC has high validity and reliability.It is applicable in clinical practice in China.%目的 研制和测评癌症临床医患交流满意度问卷(DNPCSQC),包括评价医生和护士的问卷.方法 以严谨的程序编制问卷,随机抽取557例癌症患者进行测定,对请患者、183位亲属和96位医护人员做重要性评分,并对问卷进行筛选和信度、效度进行分析.结果 1.最后问卷共有14个条目,包括医患交流信息、形式与医生、护士的表现满意度三个维

  16. Assessing self-determined motivation for addiction treatment: validity of the Treatment Entry Questionnaire.

    Science.gov (United States)

    Urbanoski, Karen A; Wild, T Cameron

    2012-07-01

    Although legal, formal, and informal social controls are frequently used to pressure individuals to enter treatment, motivational consequences of using these tactics have been neglected. Self-determination theory (SDT) provides a useful perspective for understanding client experiences of social controls and highlights the importance of self-determined motivation for long-term behavior change. This study assessed the construct validity of the Treatment Entry Questionnaire (TEQ), a brief scale derived from SDT to measure identified, introjected, and external treatment motivation. Two independent samples of clients entering Canadian residential and outpatient treatment completed TEQ items (ns = 529 and 623). Exploratory and confirmatory factor analyses supported a 9-item version of the scale, with 3 factors aligning with SDT motivational subtypes. Subscales showed high internal consistency and correlated as expected with social controls and perceived coercion at treatment entry. The TEQ-9 is a valid option for assessing self-determined motivation in clinical practice and evaluating coerced addiction treatment.

  17. [Visual detection of H1 subtype and identification of N1, N2 subtype of avian influenza virus by reverse transcription loop-mediated isothermal amplification assay].

    Science.gov (United States)

    Peng, Yi; Xie, Zhi-Xun; Guo, Jie; Zhou, Chen-Yu; Liu, Jia-Bo; Pang, Yao-Shan; Deng, Xian-Wen; Xie, Zhi-Qin; Xie, Li-Ji; Fan, Qing; Luo, Si-Si

    2013-03-01

    In order to visually detect H1, N1 and N2 subtype of avian influenza virus (AIV), three reverse transcription loop-mediated isothermal amplification (RT-LAMP) assays were developed. According to the sequences of AIV gene available in GenBank, three degenerate primer sets specific to HA gene of H1 subtype AIV, NA gene of N1 and N2 subtype AIV were designed, and the reaction conditions were optimized. The results showed that all the assays had no cross-reaction with other subtype AIV and other avian respiratory pathogens, and the detection limit was higher than that of conventional RT-PCR. These assays were performed in water bath within 50 minutes. Without opening tube, the amplification result could be directly determined by inspecting the color change of reaction system as long as these assays were fin-ished. Fourteen specimens of H1N1 subtype and eight specimens of H1N2 subtype of AIV were identified from the 120 clinical samples by RT-LAMP assays developed, which was consistent with that of virus isolation. These results suggested that the three newly developed RT-LAMEP assays were simple, specific and sensitive and had potential for visual detection of H1, N1 and N2 subtype of AIV in field.

  18. Genetic contributions to subtypes of aggression

    OpenAIRE

    2005-01-01

    Boys and girls may display different styles of aggression. The aim of this study was to identify subtypes of aggression within the Child Behavior Checklist (CBCL) aggression scale, and determine their characteristics for both sexes. Maternal CBCL ratings of 7449 7-year-old twin pairs were analyzed using principal components analyses to identify subtypes of aggression, and structural equation modeling to carry out genetic analyses. Two aggression subtypes were identified: relational and direct...

  19. Respiratory panic disorder subtype and sensitivity to the carbon dioxide challenge test

    Directory of Open Access Journals (Sweden)

    Valença A.M.

    2002-01-01

    Full Text Available The aim of the present study was to verify the sensitivity to the carbon dioxide (CO2 challenge test of panic disorder (PD patients with respiratory and nonrespiratory subtypes of the disorder. Our hypothesis is that the respiratory subtype is more sensitive to 35% CO2. Twenty-seven PD subjects with or without agoraphobia were classified into respiratory and nonrespiratory subtypes on the basis of the presence of respiratory symptoms during their panic attacks. The tests were carried out in a double-blind manner using two mixtures: 1 35% CO2 and 65% O2, and 2 100% atmospheric compressed air, 20 min apart. The tests were repeated after 2 weeks during which the participants in the study did not receive any psychotropic drugs. At least 15 of 16 (93.7% respiratory PD subtype patients and 5 of 11 (43.4% nonrespiratory PD patients had a panic attack during one of two CO2 challenges (P = 0.009, Fisher exact test. Respiratory PD subtype patients were more sensitive to the CO2 challenge test. There was agreement between the severity of PD measured by the Clinical Global Impression (CGI Scale and the subtype of PD. Higher CGI scores in the respiratory PD subtype could reflect a greater sensitivity to the CO2 challenge due to a greater severity of PD. Carbon dioxide challenges in PD may define PD subtypes and their underlying mechanisms.

  20. Molecular subtypes and clinicopathological features of breastcancer

    Directory of Open Access Journals (Sweden)

    Irianiwati Irianiwati

    2013-04-01

    Full Text Available Breast cancer is a heterogeneous disease with regard to morphological spectrum, clinical presentation and response to therapy. Based on immunohistochemistry detection of estrogen receptor, progesterone receptor, Her-2 status, proliferation rate and clusters of basal gene expression, breast cancers can be classified into luminal A, luminal B, basal-like/triple negative, and Her-2 positive. It was suggested that there was a close relationship between molecular subtypes and clinicopathological features of breast cancer, as they are very important to predict prognosis and therapeutic implications. Keywords: molecular subtypes - breast cancer- clinicopathological features -heterogeneity –theraputicimplications   Normal 0 false false false EN-US X-NONE X-NONE /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;}

  1. Discovery and validation of breast cancer subtypes

    Directory of Open Access Journals (Sweden)

    Bukholm Ida RK

    2006-09-01

    Full Text Available Abstract Background Previous studies demonstrated breast cancer tumor tissue samples could be classified into different subtypes based upon DNA microarray profiles. The most recent study presented evidence for the existence of five different subtypes: normal breast-like, basal, luminal A, luminal B, and ERBB2+. Results Based upon the analysis of 599 microarrays (five separate cDNA microarray datasets using a novel approach, we present evidence in support of the most consistently identifiable subtypes of breast cancer tumor tissue microarrays being: ESR1+/ERBB2-, ESR1-/ERBB2-, and ERBB2+ (collectively called the ESR1/ERBB2 subtypes. We validate all three subtypes statistically and show the subtype to which a sample belongs is a significant predictor of overall survival and distant-metastasis free probability. Conclusion As a consequence of the statistical validation procedure we have a set of centroids which can be applied to any microarray (indexed by UniGene Cluster ID to classify it to one of the ESR1/ERBB2 subtypes. Moreover, the method used to define the ESR1/ERBB2 subtypes is not specific to the disease. The method can be used to identify subtypes in any disease for which there are at least two independent microarray datasets of disease samples.

  2. Different response to neoadjuvant chemotherapy for different molecular subtypes in patients with locally advanced breast cancer

    Institute of Scientific and Technical Information of China (English)

    Huafeng Kang; Zhijun Dai; Xiaobin Ma; Xing Bao; Shuai Lin; Hongbing Ma; Xiaoxu Liu; Xijing Wang

    2013-01-01

    Objective: The aim of this study was to evaluate the impact of different molecular subtypes defined by immunohistochemistry (IHC) staining on the response rate for patients with locally advanced breast cancer received neoadjuvant chemotherapy. Methods: One hundred and seven breast cancer patients admitted from 2007 to 2011 who received 4 cycles of docetaxel/epirubicin-combined (TE) neoadjuvant chemotherapy were retrospectively reviewed, the patients were classified into 4 subtypes: luminal A, luminal B, HER-2 and triple negative breast cancer (TNBC) according to different combination patterns of estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor-2 (HER-2) expression defined by IHC method. The correlation between response rate and the molecular subtypes were analyzed. Results: The pathological complete response (PCR), clinical complete response (CCR), clinical partial response (CPR), and clinical stable disease (CSD) rate of whole group was 15.89% (17/107), 22.43% (24/107), 63.55% (68/107), 14.02% (15/107), respectively, and the overall response rate (ORR) was 85.98% (92/107). The PCR rate and ORR of luminal A, luminal B, HER-2 and TNBC subtypes was 4.76% and 73.81%; 16.67% and 83.33%;17.65% and 100.00%; 30.00% and 96.67%, respectively. The PCR and ORR rate of HER-2/TNBC subtypes was higher than that of luminal A/B subtypes (P = 0.019, P = 0.002, respectively). Conclusion: Different molecular subtypes display different response rate for patients with locally advanced breast cancer received neoadjuvant TE chemotherapy, HER-2/TNBC subtypes have a higher PCR and ORR rate than that of luminal A/B subtypes.

  3. 护理学硕士研究生临床职业期望问卷的研制%Development of clinical occupational expectation questionnaire for nursing postgraduate student

    Institute of Scientific and Technical Information of China (English)

    王琤

    2015-01-01

    目的:研制护理硕士研究生职业期望的测量工具,初步了解护理研究生职业期望的现状。方法通过文献研究、深入访谈22名全日制护理研究生,编制符合临床职业期望的测量工具,并使用研制的量表对210名护理研究生进行职业期望现状调查,进行主成分分析及信、效度的检验形成最终职业期望调查问卷。结果最终形成的护理学硕士研究生职业期望问卷包括3个方面、5个维度、24个条目。3方面为自我发展需要、亲和力需要和权力需要;5个维度分别为技术、科研、管理、人际和名望维度。问卷KOM值为0.851,Cronbach′s α系数为0.897,总问卷的折半信度为0.754。结论教育者应引导护理研究生向专科护士发展,提高其临床实践能力,满足自身科研发展需要。从研究生个人期望提高自身的人际交往能力等方面调整自身的职业期望水平,提高工作满意度,以在临床工作中更好、更稳定地发展。%Objective To develop the professional measurement tools for nursing postgraduate expectations and probe to the current status of nursing postgraduate expectation. Methods By literature review and depth interview of 22 full time nursing postgraduates, we made a suitable measure tool for clinical occupational expectation and self-designed clinical occupational for investigation of 210 postgraduates occupational expectation. The result of questionnaire had been analyzed and checked its reliability and validity, and the final occupational expectation questionnaire formed. Results The final nursing postgraduate occupational expectation questionnaire included 3 aspects, 5 dimensions and 24 clauses, that 3 aspects contained self-development, affinity, and requirement of power, and 5 dimensions included technique, scientific research, management, interpersonal relationship and reputation. The KOM value of questionnaire was 0. 851, coefficient of Cronbach′s α was 0. 897

  4. Physical Activity Questionnaire

    Directory of Open Access Journals (Sweden)

    Kostencka Alicja

    2016-11-01

    Full Text Available Study aim: The aim of the study was to determine the weekly energy expenditure measuring MET/min/week based on data collected through the Canada Fitness Survey (CFS, according to the classification used in the International Physical Activity Questionnaire (IPAQ, and to verify the adopted method to assess the level of physical activity in students of physical education.

  5. Questionnaire typography and production.

    Science.gov (United States)

    Gray, M

    1975-06-01

    This article describes the typographic principles and practice which provide the basis of good design and print, the relevant printing processes which can be used, and the graphic designer's function in questionnaire production. As they impose constraints on design decisions to be discussed later in the text, the various methods of printing and production are discussed first.

  6. Identification of an atypical etiological head and neck squamous carcinoma subtype featuring the CpG island methylator phenotype

    Directory of Open Access Journals (Sweden)

    K. Brennan

    2017-03-01

    Further distinguishing features of this ‘CIMP-Atypical’ subtype include an antiviral gene expression profile associated with pro-inflammatory M1 macrophages and CD8+ T cell infiltration, CASP8 mutations, and a well-differentiated state corresponding to normal SOX2 copy number and SOX2OT hypermethylation. We developed a gene expression classifier for the CIMP-Atypical subtype that could classify atypical disease features in two independent patient cohorts, demonstrating the reproducibility of this subtype. Taken together, these findings provide unprecedented evidence that atypical HNSCC is molecularly distinct, and postulates the CIMP-Atypical subtype as a distinct clinical entity that may be caused by chronic inflammation.

  7. Clinical normative data for eating disorder examination questionnaire and eating disorder inventory for DSM-5 feeding and eating disorder classifications: a retrospective study of patients formerly diagnosed via DSM-IV.

    Science.gov (United States)

    Brewin, Nicola; Baggott, Jonathan; Dugard, Pat; Arcelus, Jon

    2014-07-01

    Normative data for measures of eating disorder (ED) psychopathology provide a fundamental description of a presentation and a means to establish clinically significant change following an intervention. Clinical norms for the ED population are lacking and out of date following the publication of Diagnostic and Statistical Manual of Mental Health Disorders (DSM) 5. This study aimed to show that scores from the Eating Disorder Examination Questionnaire (EDE-q) and the Eating Disorder Inventory (EDI) differ across ED diagnosis groups and provide norm data for DSM-5 ED diagnoses. Patients (n = 932) presenting to an out-patient service over 5 years were retrospectively re-diagnosed based on DSM-5 criteria. Statistical analysis showed a significant difference on most subscale scores of the EDE-q and the EDI across diagnosis. Means, standard deviations and percentile ranks are presented by diagnosis. The norms detailed contribute to improving the accuracy with which scores are interpreted when using DSM-5 and aid with the assessment of clinically significant change following treatment.

  8. Chemotherapy-induced neuropathy in multiple myeloma: influence on quality of life and development of a questionnaire to compose common toxicity criteria grading for use in daily clinical practice.

    Science.gov (United States)

    Beijers, A J M; Vreugdenhil, G; Oerlemans, S; Eurelings, M; Minnema, M C; Eeltink, C M; van de Poll-Franse, L V; Mols, F

    2016-06-01

    Chemotherapy-induced peripheral neuropathy (CIPN) may negatively influence multiple myeloma (MM) patients' health-related quality of life (HRQOL). Dose modification is the only way to minimize CIPN. To measure CIPN in daily practice, the Indication for Common Toxicity Criteria (CTC) Grading of Peripheral Neuropathy Questionnaire (ICPNQ) was developed which can be completed within five minutes by the patient. The aims of this study were to (1) perform a psychometric evaluation of the ICPNQ and (2) examine the prevalence of CIPN and its influence on HRQOL in population-based MM patients. One hundred fifty-six MM patients, diagnosed between 2000 and 2014, completed the ICPNQ, European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Chemotherapy-Induced Peripheral Neuropathy 20 (EORTC QLQ-CIPN20), and EORTC QLQ-C30 (65 % response). The psychometric analyses showed a Cronbach's alpha of 0.84, 0.74, and 0.61 for, respectively, the sensory, motoric, and autonomic subscales of the ICPNQ. Test-retest reliability and construct validity were good for all subscales. Overall, 65 % of patients reported grade 2-3 neuropathy according to the ICPNQ. Patients with the highest CTC grades (grade 2 with neuropathic pain and grade 3 (38 %)) according to the ICPNQ reported significantly worse scores on all EORTC QLQ-CIPN20 subscales compared to patients with lower CTC grades (p ≤ 0.002). In addition, they reported statistically significant and clinically relevant worse HRQOL scores on almost all EORTC QLQ-C30 subscales. CIPN is a common side effect in MM patients, which has a negative impact on HRQOL. The ICPNQ is a valid instrument to distinguish the highest CIPN CTC grades from the lower CTC grades necessary to decide on dose modifications of chemotherapy in daily clinical practice.

  9. Breast cancer molecular subtypes: from TNBC to QNBC

    Science.gov (United States)

    Hon, Jane Date C; Singh, Baljit; Sahin, Aysegul; Du, Gang; Wang, Jinhua; Wang, Vincent Y; Deng, Fang-Ming; Zhang, David Y; Monaco, Marie E; Lee, Peng

    2016-01-01

    Treatment protocols for breast cancer depend predominantly on receptor status with respect to estrogen (estrogen receptor alpha), progesterone (progesterone receptor) and human epidermal growth factor [human epidermal growth factor receptor 2 (HER2)]. The presence of one or more of these receptors suggests that a treatment targeting these pathways might be effective, while the absence of, or in the case of HER2, lack of overexpression of, all of these receptors, termed triple negative breast cancer (TNBC), indicates a need for the more toxic chemotherapy. In an effort to develop targeted therapies for TNBC, it will be necessary to differentiate among specific TNBC subtypes. The subset of TNBC that expresses androgen receptor (AR) has been determined to express genes consistent with a luminal subtype and therefore may be amenable to therapies targeting either AR, itself, or other pathways typical of a luminal subtype. Recent investigations of the AR signal pathway within breast cancer lead to AR as a significant target for breast cancer therapy with several clinical trials currently in progress. The subclass of TNBC that lacks AR, which we have termed quadruple negative breast cancer (QNBC) currently lacks a defined targetable pathway. Unlike AR-positive TNBC, QNBC predominantly exhibits a basal-like molecular subtype. Several subtypes and related pathway proteins are preferentially expressed in QNBC that may serve as effective targets for treatment, such as ACSL4, SKP2 and EGFR. ACSL4 expression has been demonstrated to be inversely correlated with expression of hormone/growth factor receptors and may thus serve as a biomarker for QNBC as well as a target for therapy. In the following review we summarize some of the current efforts to develop alternatives to chemotherapy for TNBC and QNBC.

  10. Prehospital Identification of Stroke Subtypes in Chinese Rural Areas

    Institute of Scientific and Technical Information of China (English)

    Hai-Qiang Jin; Jin-Chao Wang; Yong-An Sun; Pu Lyu; Wei Cui; Yuan-Yuan Liu; Zhi-Gang Zhen

    2016-01-01

    Background:Differentiating intracerebral hemorrhage (ICH) from cerebral infarction as early as possible is vital for the timely initiation of different treatments.This study developed an applicable model for the ambulance system to differentiate stroke subtypes.Methods:From 26,163 patients initially screened over 4 years,this study comprised 1989 consecutive patients with potential first-ever acute stroke with sudden onset of the focal neurological deficit,conscious or not,and given ambulance transport for admission to two county hospitals in Yutian County of Hebei Province.All the patients underwent cranial computed tomography (CT) or magnetic resonance imaging to confirm the final diagnosis based on stroke criteria.Correlation with stroke subtype clinical features was calculated and Bayes' discriminant model was applied to discriminate stroke subtypes.Results:Among the 1989 patients,797,689,109,and 394 received diagnoses of cerebral infarction,ICH,subarachnoid hemorrhage,and other forms of nonstroke,respectively.A history of atrial fibrillation,vomiting,and diabetes mellitus were associated with cerebral infarction,while vomiting,systolic blood pressure ≥180 mmHg,and age <65 years were more typical of ICH.For noncomatose stroke patients,Bayes' discriminant model for stroke subtype yielded a combination of multiple items that provided 72.3% agreement in the test model and 79.3% in the validation model; for comatose patients,corresponding agreement rates were 75.4% and 73.5%.Conclusions:The model herein presented,with multiple parameters,can predict stroke subtypes with acceptable sensitivity and specificity before CT scanning,either in alert or comatose patients.This may facilitate prehospital management for patients with stroke.

  11. Distinct DNA methylation profiles in subtypes of orofacial cleft.

    Science.gov (United States)

    Sharp, Gemma C; Ho, Karen; Davies, Amy; Stergiakouli, Evie; Humphries, Kerry; McArdle, Wendy; Sandy, Jonathan; Davey Smith, George; Lewis, Sarah J; Relton, Caroline L

    2017-01-01

    Epigenetic data could help identify risk factors for orofacial clefts, either by revealing a causal role for epigenetic mechanisms in causing clefts or by capturing information about causal genetic or environmental factors. Given the evidence that different subtypes of orofacial cleft have distinct aetiologies, we explored whether children with different cleft subtypes showed distinct epigenetic profiles. In whole-blood samples from 150 children from the Cleft Collective cohort study, we measured DNA methylation at over 450,000 sites on the genome. We then carried out epigenome-wide association studies (EWAS) to test the association between methylation at each site and cleft subtype (cleft lip only (CLO) n = 50; cleft palate only (CPO) n = 50; cleft lip and palate (CLP) n = 50). We also compared methylation in the blood to methylation in the lip or palate tissue using genome-wide data from the same 150 children and conducted an EWAS of CLO compared to CLP in lip tissue. We found four genomic regions in blood differentially methylated in CLO compared to CLP, 17 in CPO compared to CLP and 294 in CPO compared to CLO. Several regions mapped to genes that have previously been implicated in the development of orofacial clefts (for example, TBX1, COL11A2, HOXA2, PDGFRA), and over 250 associations were novel. Methylation in blood correlated with that in lip/palate at some regions. There were 14 regions differentially methylated in the lip tissue from children with CLO and CLP, with one region (near KIAA0415) showing up in both the blood and lip EWAS. Our finding of distinct methylation profiles in different orofacial cleft (OFC) subtypes represents a promising first step in exploring the potential role of epigenetic modifications in the aetiology of OFCs and/or as clinically useful biomarkers of OFC subtypes.

  12. Borderline, avoidant, sadistic personality traits and emotion dysregulation predict different pathological skin picking subtypes in a community sample.

    Science.gov (United States)

    Pozza, Andrea; Giaquinta, Nicoletta; Dèttore, Davide

    2016-01-01

    Pathological skin picking (SP) is a strongly impairing condition characterized by repetitive picking behaviors resulting in significant tissue damage and distress. Recent research suggested the presence of different subtypes of SP. No study has investigated which personality traits could be specifically associated with different subtypes. In a community sample (N=285, 71.20% females, mean age =34.98 years, standard deviation =15.91), this cross-sectional study investigated which personality traits and emotion regulation deficits could predict specific SP subtypes. Participants completed the Milwaukee Inventory for the Dimensions of Adult Skin Picking (MIDAS), Millon Clinical Multiaxial Inventory-III personality scales (MCMI-III), and Difficulties in Emotion Regulation Scale (DERS) questionnaires. Higher scores on the MCMI-III borderline (β=0.28, t=4.88, P<0.001), MCMI-III avoidant scale (β=0.18, t=2.59, P<0.01), and DERS difficulties engaging in goal-directed behavior (β=0.19, t=3.27, P<0.01) predicted higher scores on the MIDAS automatic scale. Higher scores on the MCMI-III borderline (β=0.30, t=5.23, P<0.001) and DERS difficulties engaging in goal-directed behavior (β=0.15, t=2.52, P<0.05) and DERS limited access to emotion regulation strategies (β=0.21, t=3.26, P<0.01) predicted higher scores on the MIDAS focused scale. Higher scores on the MCMI-III sadistic (β=0.19, t=3.30, P<0.001) and DERS difficulties engaging in goal-directed behavior (β=0.15, t=2.68, P<0.01) predicted higher scores on the MIDAS mixed scale. Implications for future research and treatment are discussed.

  13. Diagnosis and subtype analysis of Blastocystis sp. in 442 patients in a hospital setting in the Netherlands.

    Science.gov (United States)

    Bart, Aldert; Wentink-Bonnema, Ellen M S; Gilis, Henk; Verhaar, Nienke; Wassenaar, Carla J A; van Vugt, Michèle; Goorhuis, Abraham; van Gool, Tom

    2013-08-23

    Blastocystis sp. are among the most commonly observed intestinal parasites in routine clinical parasitology. Blastocystis in humans consists of at least 9 genetic subtypes. Different subtypes of Blastocystis may be associated with differences in pathogenicity and symptomatology. Advanced microscopy on two samples and sequence-confirmed PCR on a third sample from the same individual were used for Blastocystis diagnosis and subtype analyses on routine clinical samples in a university hospital. With a combined gold standard of sequence-confirmed PCR and positive advanced microscopy, 107 out of 442 (24.2%) patients were diagnosed with Blastocystis. infection, which is a high frequency of detection in comparison to previous reports from industrialized countries. The sensitivity of microscopy and sequence-confirmed PCR was 99.1% (106/107) and 96.3% (103/107), respectively.Among 103 typable samples, subtype 3 was most abundant (n = 43, 42%), followed by subtypes 1 and 2 (both n = 23, 22%), subtype 4 (n = 12, 12%), and single samples with subtypes 6 (1%) and subtype 7 (1%). The prevalence of Blastocystis infection was 38% in patients from the Department of Tropical Medicine and 18% in patients from other departments. A high prevalence of Blastocystis infection was found with both advanced microscopy and sequence-confirmed PCR in our patient population. Most cases were caused by subtypes ST1, ST2, ST3 and ST4. A significantly higher prevalence was found among patients with a history of recent travel to tropical countries.

  14. Temporomandibular joint disorder complaints in tinnitus: further hints for a putative tinnitus subtype.

    Directory of Open Access Journals (Sweden)

    Veronika Vielsmeier

    Full Text Available OBJECTIVE: Tinnitus is considered to be highly heterogeneous with respect to its etiology, its comorbidities and the response to specific interventions. Subtyping is recommended, but it remains to be determined which criteria are useful, since it has not yet been clearly demonstrated whether and to which extent etiologic factors, comorbid states and interventional response are related to each other and are thus applicable for subtyping tinnitus. Analyzing the Tinnitus Research Initiative Database we differentiated patients according to presence or absence of comorbid temporomandibular joint (TMJ disorder complaints and compared the two groups with respect to etiologic factors. METHODS: 1204 Tinnitus patients from the Tinnitus Research Initiative (TRI Database with and without subjective TMJ complaints were compared with respect to demographic, tinnitus and audiological characteristics, questionnaires, and numeric ratings. Data were analysed according to a predefined statistical analysis plan. RESULTS: Tinnitus patients with TMJ complaints (22% of the whole group were significantly younger, had a lower age at tinnitus onset, and were more frequently female. They could modulate or mask their tinnitus more frequently by somatic maneuvers and by music or sound stimulation. Groups did not significantly differ for tinnitus duration, type of onset (gradual/abrupt, onset related events (whiplash etc., character (pulsatile or not, hyperacusis, hearing impairment, tinnitus distress, depression, quality of life and subjective ratings (loudness etc.. CONCLUSION: Replicating previous work in tinnitus patients with TMJ complaints, classical risk factors for tinnitus like older age and male gender are less relevant in tinnitus patients with TMJ complaints. By demonstrating group differences for modulation of tinnitus by movements and sounds our data further support the notion that tinnitus with TMJ complaints represents a subgroup of tinnitus with clinical

  15. Is Real-Time Feedback of Burn-Specific Patient-Reported Outcome Measures in Clinical Settings Practical and Useful? A Pilot Study Implementing the Young Adult Burn Outcome Questionnaire.

    Science.gov (United States)

    Ryan, Colleen M; Lee, Austin F; Kazis, Lewis E; Shapiro, Gabriel D; Schneider, Jeffrey C; Goverman, Jeremy; Fagan, Shawn P; Wang, Chao; Kim, Julia; Sheridan, Robert L; Tompkins, Ronald G

    2016-01-01

    Long-term follow-up care of survivors after burn injuries can potentially be improved by the application of patient-reported outcome measures (PROMs). PROMs can inform clinical decision-making and foster communication between the patient and provider. There are no previous reports using real-time, burn-specific PROMs in clinical practice to track and benchmark burn recovery over time. This study examines the feasibility of a computerized, burn-specific PROM, the Young Adult Burn Outcome Questionnaire (YABOQ), with real-time benchmarking feedback in a burn outpatient practice. The YABOQ was redesigned for formatting and presentation purposes using images and transcribed to a computerized format. The redesigned questionnaire was administered to young adult burn survivors (ages 19-30 years, 1-24 months from injury) via an ipad platform in the office before outpatient visits. A report including recovery curves benchmarked to a nonburned relatively healthy age-matched population and to patients with similar injuries was produced for the domains of physical function and social function limited by appearance. A copy of the domain reports as well as a complete copy of the patient's responses to all domain questions was provided for use during the clinical visit. Patients and clinicians completed satisfaction surveys at the conclusion of the visit. Free-text responses, included in the satisfaction surveys, were treated as qualitative data adding contextual information about the assessment of feasibility. Eleven patients and their providers completed the study for 12 clinical visits. All patients found the ipad survey and report "easy" or "very easy" to use. In nine instances, patients "agreed" or "strongly agreed" that it helped them communicate their situation to their doctor/nurse practitioner. Patients "agreed" or "strongly agreed" that the report helped them understand their course of recovery in 10 visits. In 11 visits, the patients "agreed" or "strongly agreed" that

  16. Correlation evaluation between questionnaire and clinical examination in dry eye%两种干眼症状问卷评分与干眼临床检查的关联性研究

    Institute of Scientific and Technical Information of China (English)

    张佳楠; 李海丽; 晏晓明

    2012-01-01

    Background There are two types of different questionnaires in dry eye diagnosis.But the associations about two questionnaires or questionnaire and clinical examination are still unclear.To effectively quantize the symptoms is helpful for a correct diagnosis of dry eye disease. Objective This survey was to evaluate the Standard Patient Evaluation of Eye Dryness (SPEED) and Ocular Surface Disease Index(OSDI) questionnaire for the diagnosis of dry eye and investigate the correlation between the clinical examinations and questionnaires. Methods A perspective cohort study was designed.Sixty-six patients were enrolled in this study.This study was approved by the Ethic Committee of Peking University First Hospital,and written informed consent was obtained from each subject before any ocular examination.SPEED-based and OSDI-based questionnaires were used to score the dry eye symptom and grouped according to severity of complains.Corneal fluorescence staining,tear film breakup time(BUT),Schirmer I test and tear film interferometry were performed in all patients.The correlations between two questionnaires scores and their association with clinical examinations were evaluated. Results The negative correlations were found between the SPEED-based score or OSDI-based score with BUT value(r=0.390,P=0.001 ;r=-0.395,P=0.001 ),but no significant correlations were seen between the SPEED-based score or OSDI-based score with Schirmer test( r=-0.081,P=0.515; r=-0.080,P=0.525)and tear film interferometry score(r=0.158,P=0.204;r=0.219,P=0.077).The BUT was significantly prolonged in mild symptom group compared with serious group(t=2.339,P=0.022),but no significant difference was seen in Schirmer Ⅰ test and tear film interferometry scores using SPEED-based questionnaire ( t =0.404,P =0.687 ; t =- 0.947,P =0.347 ) ; while the positive fluorescence staining rate between two groups was significantly different (x2 =0.164,P =0.685 ).When using OSDI-based questionnaire,significant difference in

  17. The patient health questionnaire-9: validation among patients with glaucoma.

    Directory of Open Access Journals (Sweden)

    Vijaya K Gothwal

    Full Text Available BACKGROUND: Depression and anxiety are two common normal responses to a chronic disease such as glaucoma. This study analysed the measurement properties of the depression screening instrument - Patient Health Questionnaire-9 (PHQ-9 using Rasch analysis to determine if it can be used as a measure. METHODS: In this hospital-based cross-sectional study, the PHQ-9 was administered to primary glaucoma adults attending a glaucoma clinic of a tertiary eye care centre, South India. All patients underwent a comprehensive clinical evaluation. Patient demographics and sub-type of glaucoma were abstracted from the medical record. Rasch analysis was used to investigate the following properties of the PHQ-9: behaviour of the response categories, measurement precision (assessed using person separation reliability, PSR; minimum recommended value 0.80, unidimensionality (assessed using item fit [0.7-1.3] and principal components analysis of residuals, and targeting. RESULTS: 198 patients (mean age ± standard deviation  = 59.83±12.34 years; 67% male were included. The native PHQ-9 did not fit the Rasch model. The response categories showed disordered thresholds which became ordered after category reorganization. Measurement precision was below acceptable limits (0.62 and targeting was sub-optimal (-1.27 logits. Four items misfit that were deleted iteratively following which a set of five items fit the Rasch model. However measurement precision failed to improve and targeting worsened further (-1.62 logits. CONCLUSIONS: The PHQ-9, in its present form, provides suboptimal assessment of depression in patients with glaucoma in India. Therefore, there is a need to develop a new depression instrument for our glaucoma population. A superior strategy would be to use the item bank for depression but this will also need to be validated in glaucoma patients before deciding its utility.

  18. Burnout Syndrome Among Medical Practitioners Across India: A Questionnaire-Based Survey.

    Science.gov (United States)

    Langade, Deepak; Modi, Pranav D; Sidhwa, Yazad F; Hishikar, Namita A; Gharpure, Amit S; Wankhade, Kalpana; Langade, Jayshree; Joshi, Kedar

    2016-09-08

    Excessive and prolonged work-related stress has always been a cause for burnout among healthcare professionals. This has led to emotional, mental, and physical exhaustion. This survey was conducted to assess the burnout among medical practitioners using the abbreviated Maslach Burnout Inventory (aMBI) and Burnout Clinical Subtype Questionnaire (BCSQ-12) scales. A cross-sectional survey was conducted among 482 registered medical practitioners across India. A questionnaire consisting of 25 socio-demographic and occupational questions related to aMBI and BCSQ-12 scales was used to assess the burnout. The distribution of responses for each variable was examined using frequencies and percentages among the subgroups to find out the burnout levels of various components of the scales. High burnout levels were uniformly recorded for the entire population. For the aMBI, 45.02% (n = 217) and 65.98% (n = 318) of the participants scored high on the emotional exhaustion and depersonalization scales, respectively, whereas 87.14% (n = 420) scored low on the personal accomplishment scale and 62.86% (n = 303) and 11.41% (n = 55) had medium and low scores on the satisfaction with the medical practice scale. The BCSQ-12 scale showed the mean values of 15.89, 11.56, and 10.28 on a scale of 28 for overload, lack of development, and neglect subtypes, respectively, whereas, satisfaction with the financial compensation item showed a mean value of 3.79 on a scale of seven. All these values indicate high levels of burnout. The results suggest high levels of burnout in all domains of aMBI and BCSQ-12 scales in all the occupational and socio-demographic groups of medical practitioners and warrant immediate actions to address this issue.

  19. Burnout Syndrome Among Medical Practitioners Across India: A Questionnaire-Based Survey

    Science.gov (United States)

    Langade, Deepak; Sidhwa, Yazad F; Hishikar, Namita A; Gharpure, Amit S; Wankhade, Kalpana; Langade, Jayshree; Joshi, Kedar

    2016-01-01

    Background and objectives Excessive and prolonged work-related stress has always been a cause for burnout among healthcare professionals. This has led to emotional, mental, and physical exhaustion. This survey was conducted to assess the burnout among medical practitioners using the abbreviated Maslach Burnout Inventory (aMBI) and Burnout Clinical Subtype Questionnaire (BCSQ-12) scales. Materials and methods A cross-sectional survey was conducted among 482 registered medical practitioners across India. A questionnaire consisting of 25 socio-demographic and occupational questions related to aMBI and BCSQ-12 scales was used to assess the burnout. The distribution of responses for each variable was examined using frequencies and percentages among the subgroups to find out the burnout levels of various components of the scales. Results High burnout levels were uniformly recorded for the entire population. For the aMBI, 45.02% (n = 217) and 65.98% (n = 318) of the participants scored high on the emotional exhaustion and depersonalization scales, respectively, whereas 87.14% (n = 420) scored low on the personal accomplishment scale and 62.86% (n = 303) and 11.41% (n = 55) had medium and low scores on the satisfaction with the medical practice scale. The BCSQ-12 scale showed the mean values of 15.89, 11.56, and 10.28 on a scale of 28 for overload, lack of development, and neglect subtypes, respectively, whereas, satisfaction with the financial compensation item showed a mean value of 3.79 on a scale of seven. All these values indicate high levels of burnout. Conclusion The results suggest high levels of burnout in all domains of aMBI and BCSQ-12 scales in all the occupational and socio-demographic groups of medical practitioners and warrant immediate actions to address this issue. PMID:27833826

  20. Unique Migraine Subtypes, Rare Headache Disorders, and Other Disturbances.

    Science.gov (United States)

    Goadsby, Peter J

    2015-08-01

    The medical aphorism that common things happen commonly makes unique (and less common) migraine subtypes especially appropriate to review for the general neurologist. This article also identifies some rare headache disorders and other disturbances, and offers strategies to manage them. This article discusses migraine with brainstem aura, which is troublesome clinically and has had a change in terminology in the International Classification of Headache Disorders, Third Edition, beta version (ICHD-3 beta), and hemiplegic migraine, which is also troublesome in practice. The rare headache disorder hypnic headache and the exploding head syndrome are also discussed. When hypnic headache is recognized, it is eminently treatable, while exploding head syndrome is a benign condition with no reported consequences. Unique migraine subtypes, rare headache disorders, and other disturbances present to neurologists. When recognized, they can often be managed very well, which offers significant benefits to patients and practice satisfaction to neurologists.

  1. Refining developmental coordination disorder subtyping with multivariate statistical methods

    Directory of Open Access Journals (Sweden)

    Lalanne Christophe

    2012-07-01

    Full Text Available Abstract Background With a large number of potentially relevant clinical indicators penalization and ensemble learning methods are thought to provide better predictive performance than usual linear predictors. However, little is known about how they perform in clinical studies where few cases are available. We used Random Forests and Partial Least Squares Discriminant Analysis to select the most salient impairments in Developmental Coordination Disorder (DCD and assess patients similarity. Methods We considered a wide-range testing battery for various neuropsychological and visuo-motor impairments which aimed at characterizing subtypes of DCD in a sample of 63 children. Classifiers were optimized on a training sample, and they were used subsequently to rank the 49 items according to a permuted measure of variable importance. In addition, subtyping consistency was assessed with cluster analysis on the training sample. Clustering fitness and predictive accuracy were evaluated on the validation sample. Results Both classifiers yielded a relevant subset of items impairments that altogether accounted for a sharp discrimination between three DCD subtypes: ideomotor, visual-spatial and constructional, and mixt dyspraxia. The main impairments that were found to characterize the three subtypes were: digital perception, imitations of gestures, digital praxia, lego blocks, visual spatial structuration, visual motor integration, coordination between upper and lower limbs. Classification accuracy was above 90% for all classifiers, and clustering fitness was found to be satisfactory. Conclusions Random Forests and Partial Least Squares Discriminant Analysis are useful tools to extract salient features from a large pool of correlated binary predictors, but also provide a way to assess individuals proximities in a reduced factor space. Less than 15 neuro-visual, neuro-psychomotor and neuro-psychological tests might be required to provide a sensitive and

  2. Mindfulness, Resilience, and Burnout Subtypes in Primary Care Physicians: The Possible Mediating Role of Positive and Negative Affect

    Science.gov (United States)

    Montero-Marin, Jesús; Tops, Mattie; Manzanera, Rick; Piva Demarzo, Marcelo M.; Álvarez de Mon, Melchor; García-Campayo, Javier

    2015-01-01

    Purpose: Primary care health professionals suffer from high levels of burnout. The aim of the present study was to evaluate the associations of mindfulness and resilience with the features of the burnout types (overload, lack of development, neglect) in primary care physicians, taking into account the potential mediating role of negative and positive affect. Methods: A cross-sectional design was used. Six hundred and twenty-two Spanish primary care physicians were recruited from an online survey. The Mindful Attention Awareness Scale (MAAS), Connor-Davidson Resilience Scale (CD-RISC), Positive and Negative Affect Schedule (PANAS), and Burnout Clinical Subtype Questionnaire (BCSQ-12) questionnaires were administered. Polychoric correlation matrices were calculated. The unweighted least squares (ULS) method was used for developing structural equation modeling. Results: Mindfulness and resilience presented moderately high associations (φ = 0.46). Links were found between mindfulness and overload (γ = −0.25); resilience and neglect (γ = −0.44); mindfulness and resilience, and negative affect (γ = −0.30 and γ = −0.35, respectively); resilience and positive affect (γ = 0.70); negative affect and overload (β = 0.36); positive affect and lack of development (β = −0.16). The links between the burnout types reached high and positive values between overload and lack of development (β = 0.64), and lack of development and neglect (β = 0.52). The model was a very good fit to the data (GFI = 0.96; AGFI = 0.96; RMSR = 0.06; NFI = 0.95; RFI = 0.95; PRATIO = 0.96). Conclusions: Interventions addressing both mindfulness and resilience can influence burnout subtypes, but their impact may occur in different ways, potentially mediated by positive and negative affect. Both sorts of trainings could constitute possible tools against burnout; however, while mindfulness seems a suitable intervention for preventing its initial stages, resilience may be more effective for

  3. Multi-Phenotypic subtyping of circulating tumor cells using sequential fluorescent quenching and restaining

    Science.gov (United States)

    Adams, Daniel L.; Alpaugh, R. Katherine; Tsai, Susan; Tang, Cha-Mei; Stefansson, Steingrimur

    2016-09-01

    In tissue biopsies formalin fixed paraffin embedded cancer blocks are micro-sectioned producing multiple semi-identical specimens which are analyzed and subtyped proteomically, and genomically, with numerous biomarkers. In blood based biopsies (BBBs), blood is purified for circulating tumor cells (CTCs) and clinical utility is typically limited to cell enumeration, as only 2–3 positive fluorescent markers and 1 negative marker can be used. As such, increasing the number of subtyping biomarkers on each individual CTC could dramatically enhance the clinical utility of BBBs, allowing in depth interrogation of clinically relevant CTCs. We describe a simple and inexpensive method for quenching the specific fluors of fluorescently stained CTCs followed by sequential restaining with additional biomarkers. As proof of principle a CTC panel, immunosuppression panel and stem cell panel were used to sequentially subtype individual fluorescently stained patient CTCs, suggesting a simple and universal technique to analyze multiple clinically applicable immunomarkers from BBBs.

  4. QUESTIONNAIRE 5YR 2013

    CERN Multimedia

    Association du personnel

    2013-01-01

    CERN must remain the centre of excellence that it has been for the last sixty years. Therefore, the Organization must continue to be able to attract, motivate and retain the best specialists coming from all the Member States. This is why, every five years, on the occasion of a five-yearly review, our employment conditions are compared with bodies having similar activities.In order to prepare the next five-yearly review, the topics of which will be decided by the CERN Council in June 2014, the Staff Association has drawn up a questionnaire that gives you the opportunity to tell us what you think about your current employment conditions. You can also indicate how you wish to see them evolve, and to help you we present some proposals for improvement on which you can give your opinion. Above all, do not hesitate, by using the comments’ fields available in the questionnaire, to formulate your own suggestions in all areas of your conditions of employment that are of interest to you. Your replies will hel...

  5. Functional conservation and coherence of HIV-1 subtype A Vpu alleles

    Science.gov (United States)

    Romani, Bizhan; Kavyanifard, Amirarsalan; Allahbakhshi, Elham

    2017-01-01

    Functional studies of HIV-1 proteins are normally conducted using lab adapted strains of HIV-1. The extent of those functions in clinical strains is sometimes unknown. In this study, we amplified and sequenced HIV-1 Vpu from 10 Iranian patients infected with HIV-1. Phylogenetic analysis indicated that the Vpu alleles were closely related to the CRF35_AD from Iran and subtype A Vpu. We addressed some of the well-established functions of the HIV-1 Vpu, as well as some of its recently reported functions. Ability of the clinical strains of subtype A Vpu alleles for downregulation of CD4 was similar to that of the lab adapted NL4.3 Vpu. Majority of the subtype A Vpu alleles performed stronger than NL4.3 Vpu for downregulation of SNAT1. The Vpu alleles differentially induced downregulation of HLA-C, ranging from no effect to 88% downregulation of surface HLA-C. Downregulation of tetherin and enhancement of virus release was similar for the subtype A Vpu alleles and NL4.3. Subtype A Vpu alleles were more potent when compared with NL4.3 for inhibition of NF-κB activation. Our study shows that subtype A Vpu alleles exert the classical functions of HIV-1 Vpu. PMID:28317943

  6. Clinical value of posture test in subtype differentiation of primary aldosteronism%体位试验对鉴别原发性醛固酮增多症分型的价值

    Institute of Scientific and Technical Information of China (English)

    邢玉微; 邹俊杰; 石勇铨; 刘志民

    2016-01-01

    Objective To evaluate the value of posture test in the subtype differentiation of primary aldosteronism.Methods In total,91 patients with primary aldosteronism were divided into the aldosterone-producing adenoma (n =43)and idiopathic hyperaldosteronism groups (IHA,n =48).General characteris-tics,renin activity and aldosterone changes after posture test were statistically compared between two groups.Results Age,gender constitution,systolic and diastolic pressure and plasma potassium did not significantly differ between two groups (all P >0.05).Compared with IHA group,renin activity was significantly lower whereas aldosterone changes and the ratio of aldosterone /renin activity were significantly higher after saline ad-ministration in the aldosterone-producing adenoma group (all P 30% eleva-tion.In the IHA group,aldosterone level in a standing posture was elevated compared with that in a lying pos-ture including 8 cases with 30% elevation.The percentage of patients with 0.05).Conclusions Posture test contributes to directly identif-ying the aldosterone-producing adenoma with decreasing aldosterone level in a standing posture.For those with elevated aldosterone level after a standing posture,comprehensive tests are required to differentiate the subtype of primary aldosteronism.%目的:探讨体位试验对鉴别原发性醛固酮增多症分型的价值。方法将91例原发性醛固酮增多症患者分为醛固酮瘤组(43例)及特发性醛固酮增多症(IHA)组(48例),比较2组的一般特征及体位试验后肾素活性、醛固酮的变化特点。结果2组的年龄、性别构成比、收缩压、舒张压、血钾比较差异无统计学意义(P 均>0.05),醛固酮瘤组滴注生理盐水后肾素活性低于 IHA组,而滴注生理盐水后血浆醛固酮及醛固酮与肾素活性比值均高于 IHA 组(P 均<0.05)。体位试验显示醛固酮瘤组患者立位血浆醛固酮较卧位下降的有19例,升高的有24

  7. HIV-1 subtype distribution and its demographic determinants in newly diagnosed patients in Europe suggest highly compartmentalized epidemics

    NARCIS (Netherlands)

    A.B. Abecasis (Ana ); A.M.J. Wensing (Annemarie); D. Paraskevis (Dimitrios); J. Vercauteren (Jurgen); K. Theys (Kristof); D.A.M.C. van de Vijver (David); J. Albert (Jan); B. Asjö (Birgitta); C. Balotta (Claudia); D. Beshkov (Danail); R.J. Camacho (Ricardo Jorge); B. Clotet; C. de Gascun (Cillian); A. Griskevicius (Algis); Z. Grossman (Zehava); O. Hamouda (Osamah); A. Horban (Andrzej); T. Kolupajeva (Tatjana); K. Korn; L.G. Kostrikis (Leondios); C. Kücherer (Claudia); K. Liitsola (Kirsi); M. Linka (Marek); C. Nielsen (Claus); D. Otelea (Dan); R. Paredes (Roger); M. Poljak (Mario); E. Puchhammer-Stöckl (Elisabeth); J.-C. Schmit (Jean-Claude); A. Sonnerborg (Anders); D. Stanekova (Danica); M. Stanojevic (Maja); D. Struck (Daniel); C.A. Boucher (Charles); A.M. Vandamme (Anne Mieke)

    2013-01-01

    textabstractBackground: Understanding HIV-1 subtype distribution and epidemiology can assist preventive measures and clinical decisions. Sequence variation may affect antiviral drug resistance development, disease progression, evolutionary rates and transmission routes.Results: We investigated the s

  8. Racial Differences in PAM50 Subtypes in the Carolina Breast Cancer Study.

    Science.gov (United States)

    Troester, Melissa A; Sun, Xuezheng; Allott, Emma H; Geradts, Joseph; Cohen, Stephanie M; Tse, Chiu-Kit; Kirk, Erin L; Thorne, Leigh B; Mathews, Michelle; Li, Yan; Hu, Zhiyuan; Robinson, Whitney R; Hoadley, Katherine A; Olopade, Olufunmilayo I; Reeder-Hayes, Katherine E; Earp, H Shelton; Olshan, Andrew F; Carey, Lisa A; Perou, Charles M

    2018-02-01

    African American breast cancer patients have lower frequency of hormone receptor-positive (HR+)/human epidermal growth factor receptor 2 (HER2)-negative disease and higher subtype-specific mortality. Racial differences in molecular subtype within clinically defined subgroups are not well understood. Using data and biospecimens from the population-based Carolina Breast Cancer Study (CBCS) Phase 3 (2008-2013), we classified 980 invasive breast cancers using RNA expression-based PAM50 subtype and recurrence (ROR) score that reflects proliferation and tumor size. Molecular subtypes (Luminal A, Luminal B, HER2-enriched, and Basal-like) and ROR scores (high vs low/medium) were compared by race (blacks vs whites) and age (≤50 years vs > 50 years) using chi-square tests and analysis of variance tests. Black women of all ages had a statistically significantly lower frequency of Luminal A breast cancer (25.4% and 33.6% in blacks vs 42.8% and 52.1% in whites; younger and older, respectively). All other subtype frequencies were higher in black women (case-only odds ratio [OR] = 3.11, 95% confidence interval [CI] = 2.22 to 4.37, for Basal-like; OR = 1.45, 95% CI = 1.02 to 2.06, for Luminal B; OR = 2.04, 95% CI = 1.33 to 3.13, for HER2-enriched). Among clinically HR+/HER2- cases, Luminal A subtype was less common and ROR scores were statistically significantly higher among black women. Multigene assays highlight racial disparities in tumor subtype distribution that persist even in clinically defined subgroups. Differences in tumor biology (eg, HER2-enriched status) may be targetable to reduce disparities among clinically ER+/HER2- cases.

  9. The validity and utility of subtyping bulimia nervosa.

    Science.gov (United States)

    van Hoeken, Daphne; Veling, Wim; Sinke, Sjoukje; Mitchell, James E; Hoek, Hans W

    2009-11-01

    To review the evidence for the validity and utility of subtyping bulimia nervosa (BN) into a purging (BN-P) and a nonpurging subtype (BN-NP), and of distinguishing BN-NP from binge eating disorder (BED), by comparing course, complications, and treatment. A literature search of psychiatry databases for studies published in peer-reviewed journals that used the DSM-definitions of BN and BED, and included both individuals with BN-NP and individuals with BN-P and/or BED. Twenty-three studies compared individuals with BN-NP (N = 671) to individuals with BN-P (N = 1795) and/or individuals with BED (N = 1921), two of which reported on course, 12 on comorbidity and none on treatment response-the indicators for validity and clinical utility. The differences found were mainly quantitative rather than qualitative, suggesting a gradual difference in severity from BN-P (most severe) through BN-NP to BED (least severe). None of the comparisons provided convincing evidence for the validity or utility of the BN-NP diagnosis. Three options for the position of BN-NP in DSM-V were suggested: (1) maintaining the BN-NP subtype, (2) dropping nonpurging compensatory behavior as a criterion for BN, so that individuals currently designated as having BN-NP would be designated as having BED, and (3) including BN-NP in a broad BN category.

  10. Hypertension Subtypes among Hypertensive Patients in Ibadan

    Directory of Open Access Journals (Sweden)

    Abiodun M. Adeoye

    2014-01-01

    Full Text Available Background. Certain hypertension subtypes have been shown to increase the risk for cardiovascular morbidity and mortality and may be related to specific underlying genetic determinants. Inappropriate characterization of subtypes of hypertension makes efforts at elucidating the genetic contributions to the etiology of hypertension largely vapid. We report the hypertension subtypes among patients with hypertension from South-Western Nigeria. Methods. A total of 1858 subjects comprising 76% female, hypertensive, aged 18 and above were recruited into the study from two centers in Ibadan, Nigeria. Hypertension was identified using JNCVII definition and was further grouped into four subtypes: controlled hypertension (CH, isolated systolic hypertension (ISH, isolated diastolic hypertension (IDH, and systolic-diastolic hypertension (SDH. Results. Systolic-diastolic hypertension was the most prevalent. Whereas SDH (77.6% versus 73.5% and IDH (4.9% versus 4.7% were more prevalent among females, ISH (10.1% versus 6.2% was higher among males (P=0.048. Female subjects were more obese (P<0.0001 and SDH was prevalent among the obese group. Conclusion. Gender and obesity significantly influenced the distribution of the hypertension subtypes. Characterization of hypertension by subtypes in genetic association studies could lead to identification of previously unknown genetic variants involved in the etiology of hypertension. Large-scale studies among various ethnic groups may be needed to confirm these observations.

  11. Item response theory analysis to evaluate reliability and minimal clinically important change of the Roland-Morris Disability Questionnaire in patients with severe disability due to back pain from vertebral compression fractures.

    Science.gov (United States)

    Lee, Minji K; Yost, Kathleen J; McDonald, Jennifer S; Dougherty, Ryne W; Vine, Roanna L; Kallmes, David F

    2017-06-01

    The majority of validation done on the Roland-Morris Disability Questionnaire (RMDQ) has been in patients with mild or moderate disability. There is paucity of research focusing on the psychometric quality of the RMDQ in patients with severe disability. To evaluate the psychometric quality of the RMDQ in patients with severe disability. Observational clinical study. The sample consisted of 214 patients with painful vertebral compression fractures who underwent vertebroplasty or kyphoplasty. The 23-item version of the RMDQ was completed at two time points: baseline and 30-day postintervention follow-up. With the two-parameter logistic unidimensional item response theory (IRT) analyses, we derived the range of scores that produced reliable measurement and investigated the minimal clinically important difference (MCID). Scores for 214 (100%) patients at baseline and 108 (50%) patients at follow-up did not meet the reliability criterion of 0.90 or higher, with the majority of patients having disability due to back pain that was too severe to be reliably measured by the RMDQ. Depending on methodology, MCID estimates ranged from 2 to 8 points and the proportion of patients classified as having experienced meaningful improvement ranged from 26% to 68%. A greater change in score was needed at the extreme ends of the score scale to be classified as having achieved MCID using IRT methods. Replacing items measuring moderate disability with items measuring severe disability could yield a version of the RMDQ that better targets patients with severe disability due to back pain. Improved precision in measuring disability would be valuable to clinicians who treat patients with greater functional impairments. Caution is needed when choosing criteria for interpreting meaningful change using the RMDQ. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Validation of the burns itch questionnaire

    NARCIS (Netherlands)

    Van Loey, N E; Hofland, H W; Hendrickx, H; Van de Steenoven, J; Boekelaar, A; Nieuwenhuis, M K

    2016-01-01

    Itch (pruritus) is a common multidimensional complaint after burn that can persist for months to years. A questionnaire able to investigate itch and its consequences is imperative for clinical and research purposes. The current study investigated the factor structure, internal consistency and constr

  13. Selective Mutism Questionnaire: Measurement Structure and Validity

    Science.gov (United States)

    Letamendi, Andrea M.; Chavira, Denise A.; Hitchcock, Carla A.; Roesch, Scott C.; Shipon-Blum, Elisa; Stein, Murray B.

    2008-01-01

    The psychometric properties of the Selective Mutism Questionnaire (SMQ) are evaluated using a clinical sample of children with selective mutism (SM). The study shows that SMQ is useful in determining the severity of a child's nonspeaking behaviors, the scope of these behaviors and necessary follow up assessment.

  14. KEZKAK: cuestionario bilingüe de estresores de los estudiantes de enfermería en las prácticas clínicas KEZKAK: a new bilingual questionnaire to measure nursing students' stressors in clinical practice

    Directory of Open Access Journals (Sweden)

    X. Zupiria Gorostidi

    2003-02-01

    Full Text Available Objetivo: Construir y validar un cuestionario bilingüe (castellano/euskera para medir los estresores que tienen los estudiantes de enfermería en las prácticas clínicas. Metodos: Se ha partido de las ideas recogidas fundamentalmente en reuniones realizadas con los alumnos. En un primer momento 287 estudiantes de enfermería de la Escuela de Enfermería de San Sebastián respondieron a la versión inicial de 55 ítemes y al cuestionario STAI de ansiedad. Tras la depuración por ítem-análisis, se ha obtenido la versión final de 41 ítemes. Algunos de los sujetos respondieron nuevamente la versión final a los 2 meses (n = 198 y a los 6 meses (n = 211. Resultados: El cuestionario presenta una alta consistencia interna (α de Cronbach, 0,95, una fiabilidad considerable (0,72 a los 2 meses y 0,68 a los 6 meses, y una validez concurrente aceptable (0,39 con ansiedad-rasgo. El anαlisis factorial arroja nueve factores que tienen una alta consistencia interna y explican el 64,4% de la varianza. Segϊn esos factores, los principales estresores para los estudiantes de enfermería en las prácticas clínicas se derivan de la falta de competencia (11,2%, del contacto con el sufrimiento (9,1%, de la relación con tutores y compañeros (8,9%, de la impotencia e incertidumbre (7,7%, de no controlar la relación con el enfermo (7,6%, de la implicación emocional (5,8%, de la relación con el enfermo (dañarse en la relación [5,2%] y el enfermo busca una relación íntima [4,6%] y de la sobrecarga (4,3%. Se discuten aspectos metodológicos y prácticos del cuestionario y su utilidad en la planificación pedagógica de futuras enfermeras. Conclusión: El cuestionario KEZKAK es un instrumento útil para medir los estresores de los estudiantes de enfermería en las prácticas clínicas.Objective: To develop a bilingual questionnaire (Basque-Spanish to measure nursing students' stressors in clinical practice. Methods: Ideas were gathered from nursing students

  15. Diet History Questionnaire: International Applications

    Science.gov (United States)

    ARP staff adapted the Diet History Questionnaire (DHQ) for use by Canadian populations in collaboration with the Alberta Cancer Board. This questionnaire takes into account the different food fortification polices of the U.S. and Canada.

  16. Diet History Questionnaire: Suggested Citations

    Science.gov (United States)

    Use of the Diet History Questionnaire and Diet*Calc Analysis Software for publication purposes should contain a citation which includes version information for the software, questionnaire, and nutrient database.

  17. Equal Opportunities Questionnaire

    CERN Document Server

    2007-01-01

    The initiative to promote Equal Opportunities at CERN started in 1993. The first Equal Opportunities Officer was appointed in 1996, which was followed by the creation of the Equal Opportunities Advisory Panel in 1998. Initially the concern was mainly the fair treatment of women in the work-place. Today the emphasis has evolved to ensuring that diversity is used to increase creativity and productivity in the work-place. In order to ensure that all aspects of Equal Opportunities and Diversity are covered, CERN’s Equal Opportunities team has prepared a survey to obtain your input. Your answers are confidential and will only be used for generating statistics. The questionnaire is on-line and can be accessed via: https://espace.cern.ch/EOQ. We hope that you will take a few minutes of your time to give your input and would be grateful if you could reply before 15/10/07. For further information about Equal Opportunities at CERN see: http://cern.ch/equal-opportunities The Equa...

  18. Equal Opportunities Questionnaire

    CERN Document Server

    2007-01-01

    The initiative to promote Equal Opportunities at CERN started in 1993. The first Equal Opportunities Officer was appointed in 1996 followed by the creation of the Equal Opportunities Advisory Panel in 1998. Initially the concern was mainly the fair treatment of women in the work-place. Today the emphasis has evolved to ensuring that diversity is used to increase creativity and productivity in the work-place. In order to ensure that all aspects of Equal Opportunities and Diversity are covered, CERN’s Equal Opportunities team has prepared a survey to obtain your input. Your answers are confidential and will only be used for generating statistics. The questionnaire is on-line and can be accessed via: https://espace.cern.ch/EOQ. We hope that you will take a few minutes of your time to give your input and would be grateful if you could reply before 15/10/07. For further information about Equal Opportunities at CERN see: http://cern.ch/equal-opportunities The Equal Opportuni...

  19. The Drug-Abuse Questionnaire.

    Science.gov (United States)

    Ferneau, E.; Mueller, S.

    The drug-abuse questionnaire used to survey college student attitudes on the subject is provided. It is identical to the alcoholism questionnaire except for word changes appropriate to the subject matter. The questionnaire consists of 40 statements about drug abuse and drug abusers, with 7 possible responses: (1) completely disagree; (2) mostly…

  20. Evaluation of Hologic Aptima HIV-1 Quant Dx Assay on the Panther System on HIV Subtypes.

    Science.gov (United States)

    Manak, Mark M; Hack, Holly R; Nair, Sangeetha V; Worlock, Andrew; Malia, Jennifer A; Peel, Sheila A; Jagodzinski, Linda L

    2016-10-01

    Quantitation of the HIV-1 viral load in plasma is the current standard of care for clinical monitoring of HIV-infected individuals undergoing antiretroviral therapy. This study evaluated the analytical and clinical performances of the Aptima HIV-1 Quant Dx assay (Hologic, San Diego, CA) for monitoring viral load by using 277 well-characterized subtype samples, including 171 cultured virus isolates and 106 plasma samples from 35 countries, representing all major HIV subtypes, recombinants, and circulating recombinant forms (CRFs) currently in circulation worldwide. Linearity of the Aptima assay was tested on each of 6 major HIV-1 subtypes (A, B, C, D, CRF01_AE, and CRF02_AG) and demonstrated an R(2) value of ≥0.996. The performance of the Aptima assay was also compared to those of the Roche COBAS AmpliPrep/COBAS TaqMan HIV-1 v.2 (CAP/CTM) and Abbott m2000 RealTime HIV-1 (RealTime) assays on all subtype samples. The Aptima assay values averaged 0.21 log higher than the CAP/CTM values and 0.30 log higher than the RealTime values, and the values were >0.4 log higher than CAP/CTM values for subtypes F and G and than RealTime values for subtypes C, F, and G and CRF02_AG. Two samples demonstrated results with >1-log differences from RealTime results. When the data were adjusted by the average difference, 94.9% and 87.0% of Aptima results fell within 0.5 log of the CAP/CTM and RealTime results, respectively. The linearity and accuracy of the Aptima assay in correctly quantitating all major HIV-1 subtypes, coupled with the completely automated format and high throughput of the Panther system, make this system well suited for reliable measurement of viral load in the clinical laboratory. Copyright © 2016, American Society for Microbiology. All Rights Reserved.

  1. High-Resolution Hepatitis C Virus Subtyping Using NS5B Deep Sequencing and Phylogeny, an Alternative to Current Methods

    Science.gov (United States)

    Gregori, Josep; Rodríguez-Frias, Francisco; Buti, Maria; Madejon, Antonio; Perez-del-Pulgar, Sofia; Garcia-Cehic, Damir; Casillas, Rosario; Blasi, Maria; Homs, Maria; Tabernero, David; Alvarez-Tejado, Miguel; Muñoz, Jose Manuel; Cubero, Maria; Caballero, Andrea; delCampo, Jose Antonio; Domingo, Esteban; Belmonte, Irene; Nieto, Leonardo; Lens, Sabela; Muñoz-de-Rueda, Paloma; Sanz-Cameno, Paloma; Sauleda, Silvia; Bes, Marta; Gomez, Jordi; Briones, Carlos; Perales, Celia; Sheldon, Julie; Castells, Lluis; Viladomiu, Lluis; Salmeron, Javier; Ruiz-Extremera, Angela; Quiles-Pérez, Rosa; Moreno-Otero, Ricardo; López-Rodríguez, Rosario; Allende, Helena; Romero-Gómez, Manuel; Guardia, Jaume; Esteban, Rafael; Garcia-Samaniego, Javier; Forns, Xavier

    2014-01-01

    Hepatitis C virus (HCV) is classified into seven major genotypes and 67 subtypes. Recent studies have shown that in HCV genotype 1-infected patients, response rates to regimens containing direct-acting antivirals (DAAs) are subtype dependent. Currently available genotyping methods have limited subtyping accuracy. We have evaluated the performance of a deep-sequencing-based HCV subtyping assay, developed for the 454/GS-Junior platform, in comparison with those of two commercial assays (Versant HCV genotype 2.0 and Abbott Real-time HCV Genotype II) and using direct NS5B sequencing as a gold standard (direct sequencing), in 114 clinical specimens previously tested by first-generation hybridization assay (82 genotype 1 and 32 with uninterpretable results). Phylogenetic analysis of deep-sequencing reads matched subtype 1 calling by population Sanger sequencing (69% 1b, 31% 1a) in 81 specimens and identified a mixed-subtype infection (1b/3a/1a) in one sample. Similarly, among the 32 previously indeterminate specimens, identical genotype and subtype results were obtained by direct and deep sequencing in all but four samples with dual infection. In contrast, both Versant HCV Genotype 2.0 and Abbott Real-time HCV Genotype II failed subtype 1 calling in 13 (16%) samples each and were unable to identify the HCV genotype and/or subtype in more than half of the non-genotype 1 samples. We concluded that deep sequencing is more efficient for HCV subtyping than currently available methods and allows qualitative identification of mixed infections and may be more helpful with respect to informing treatment strategies with new DAA-containing regimens across all HCV subtypes. PMID:25378574

  2. Differential involvement of RASSF2 hypermethylation in breast cancer subtypes and their prognosis

    Science.gov (United States)

    Perez-Janices, Noemi; Blanco-Luquin, Idoia; Torrea, Natalia; Liechtenstein, Therese; Escors, David; Cordoba, Alicia; Vicente-Garcia, Francisco; Jauregui, Isabel; De La Cruz, Susana; Illarramendi, José Juan; Coca, Valle; Berdasco, Maria; Kochan, Grazyna; Ibañez, Berta; Lera, José Miguel; Guerrero-Setas, David

    2015-01-01

    Breast cancer is a heterogeneous disease that can be subdivided into clinical, histopathological and molecular subtypes (luminal A-like, luminal B-like/HER2-negative, luminal B-like/HER2-positive, HER2-positive, and triple-negative). The study of new molecular factors is essential to obtain further insights into the mechanisms involved in the tumorigenesis of each tumor subtype. RASSF2 is a gene that is hypermethylated in breast cancer and whose clinical value has not been previously studied. The hypermethylation of RASSF1 and RASSF2 genes was analyzed in 198 breast tumors of different subtypes. The effect of the demethylating agent 5-aza-2′-deoxycytidine in the re-expression of these genes was examined in triple-negative (BT-549), HER2 (SK-BR-3), and luminal cells (T-47D). Different patterns of RASSF2 expression for distinct tumor subtypes were detected by immunohistochemistry. RASSF2 hypermethylation was much more frequent in luminal subtypes than in non-luminal tumors (p = 0.001). The re-expression of this gene by lentiviral transduction contributed to the differential cell proliferation and response to antineoplastic drugs observed in luminal compared with triple-negative cell lines. RASSF2 hypermethylation is associated with better prognosis in multivariate statistical analysis (P = 0.039). In conclusion, RASSF2 gene is differently methylated in luminal and non-luminal tumors and is a promising suppressor gene with clinical involvement in breast cancer. PMID:26284587

  3. Social skills and social phobia: an investigation of DSM-IV subtypes.

    Science.gov (United States)

    Beidel, Deborah C; Rao, Patricia A; Scharfstein, Lindsay; Wong, Nina; Alfano, Candice A

    2010-10-01

    Social phobia is characterized as pervasive social timidity in social settings. Although much is known about this disorder, aspects of its clinical presentation remain unexplored, in particular characteristics that distinguish the generalized and non-generalized subtypes. For example, it remains unclear whether patients with the non-generalized subtype display social skills deficits in social interactions, and if so, are these deficits clinically, as well as statistically, significant? In this study, adults with either the non-generalized (NGSP; n=60) or generalized (GSP; n=119) subtype of social phobia and adults with no psychological disorder (n=200) completed an extensive behavioral assessment of social skill and social anxiety. As expected, adults with NGSP and GSP reported equal distress and displayed similar rates of avoidance during an Impromptu Speech Task when compared to adults with no disorder. In contrast, the three groups were distinctly different when interacting with another person in various social situations. Adults with NGSP displayed social skill deficits when compared to individuals with no disorder, but they had fewer deficits than the GSP subtype. However, the identified skill deficits were clinically as well as statistically significant only for the GSP subtype. The results are discussed in terms of the contribution of skill deficits to the conceptualization and treatment of social phobia.

  4. Subtype distribution of Blastocystis isolates from synanthropic and zoo animals and identification of a new subtype

    DEFF Research Database (Denmark)

    Stensvold, C. R.; Alfellani, M. A.; Nørskov-Lauritsen, S.

    2009-01-01

    Blastocystis isolates from 56 Danish synanthropic and zoo animals, 62 primates primarily from United Kingdom (UK) collections and 16 UK primate handlers were subtyped by PCR, sequencing and phylogenetic analysis. A new subtype (ST) from primates and artiodactyls was identified and designated...

  5. Dissociative subtype of DSM-5 posttraumatic stress disorder in U.S. veterans.

    Science.gov (United States)

    Tsai, Jack; Armour, Cherie; Southwick, Steven M; Pietrzak, Robert H

    2015-01-01

    The Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) formally introduced a dissociative subtype of posttraumatic stress disorder (PTSD). This study examined the proportion of U.S. veterans with DSM-5 PTSD that report dissociative symptoms; and compared veterans with PTSD with and without the dissociative subtype and trauma-exposed controls on sociodemographics, clinical characteristics, and quality of life. Multivariable analyses were conducted on a nationally representative sample of 1484 veterans from the National Health and Resilience in Veterans Study (second baseline survey conducted September-October, 2013). Of the 12.0% and 5.2% of veterans who screened positive for lifetime and past-month DSM-5 PTSD, 19.2% and 16.1% screened positive for the dissociative subtype, respectively. Among veterans with PTSD, those with the dissociative subtype reported more severe PTSD symptoms, comorbid depressive and anxiety symptoms, alcohol use problems, and hostility than those without the dissociative subtype. Adjusting for PTSD symptom severity, those with the dissociative subtype continued to report more depression and alcohol use problems. These results underscore the importance of assessing, monitoring, and treating the considerable proportion of veterans with PTSD and dissociative symptoms. Published by Elsevier Ltd.

  6. Does subtype of developmental coordination disorder count: is there a differential effect on outcome following intervention?

    Science.gov (United States)

    Green, D; Chambers, M E; Sugden, D A

    2008-04-01

    It is well known that developmental coordination disorder (DCD) is a heterogeneous condition in which children frequently present with co-occurring conditions in addition to their motor difficulties. This study considered whether there would be a differential effect of a group treatment program on subtypes of perceptual and movement problems or associated co-occurring conditions. A subset of children (n=43) from a larger clinical sample (n=100) with DCD participated in a 214 year cross-over intervention study which followed the cognitive orientation to daily occupational performance (CO-OP) approach. Original subtypes were determined by contrasting the current sample with previously published subtyping studies in DCD [Hoare, D. (1994). Subtypes of developmental coordination disorder. Adapted Physical Activity Quarterly, 11, 158-169; Macnab, J. J., Miller, L. T., & Polatajko, H. J. (2001). The search for subtypes of DCD: Is cluster analysis the answer? Human Movement Science, 20, 49-72]. No advantage was conferred to any subtype although children with more profound and complex difficulties at initial assessment, despite progress following intervention, were most likely to have continuing difficulties at the end of the project.

  7. Using existing questionnaires in latent class analysis

    DEFF Research Database (Denmark)

    Nielsen, Anne Molgaard; Vach, Werner; Kent, Peter

    2016-01-01

    BACKGROUND: Latent class analysis (LCA) is increasingly being used in health research, but optimal approaches to handling complex clinical data are unclear. One issue is that commonly used questionnaires are multidimensional, but expressed as summary scores. Using the example of low back pain (LBP......), the aim of this study was to explore and descriptively compare the application of LCA when using questionnaire summary scores and when using single items to subgrouping of patients based on multidimensional data. MATERIALS AND METHODS: Baseline data from 928 LBP patients in an observational study were...

  8. The Rome II and Rome III criteria identify the same subtype-populations in irritable bowel syndrome: agreement depends on the method used for symptom report.

    Science.gov (United States)

    Engsbro, A L; Simrén, M; Bytzer, P

    2012-07-01

    For comparing trials using different classifications for irritable bowel syndrome (IBS) subtypes, it is important to know whether these identify the same sub-populations. Our aim was to determine the agreement between Rome II and Rome III subtypes, and to explore whether agreement depends on the symptom reporting method. Rome II IBS patients from two identical, randomized placebo-controlled trials of probiotics were included. Retrospective subtypes were based on the Rome II questionnaire. Prospective subtypes were based on diary cards for 2 weeks of run-in. Agreement was determined between: (i) retrospective Rome II and Rome III, (ii) prospective Rome II and Rome III, (iii) retrospective Rome II and prospectively Rome III, (iv) retrospective and prospective Rome II, and (v) retrospective and prospective Rome III. A total of 126 patients, 72% women, mean age 46 ± 15 years, were included. The agreement between subtypes using the same symptom reporting method was: (i) 90.3% (κ = 0.85) for retrospective subtypes, and (ii) 84% (κ = 0.76) for prospective subtypes. The agreement between subtypes using different symptom reporting methods was, (iii) 49% (κ = 0.23) for retrospective Rome II and prospective Rome III, (iv) 51% (κ = 0.26) for Rome II subtypes, and (v) 41% (κ = 0.25) for Rome III subtypes. Agreement between Rome II and Rome III subtypes is good to very good when using the same symptom reporting method. When mixing methods, agreement is only fair even within the same classification. This has implications for comparison of trials using different symptom reporting methods for subtyping. © 2012 Blackwell Publishing Ltd.

  9. Development of the Young Spine Questionnaire

    DEFF Research Database (Denmark)

    Lauridsen, Henrik Hein; Hestbæk, Lise

    Title Development of the Young Spine Questionnaire Authors & Affiliations Henrik Hein Lauridsen1, Lise Hestbæk1,2 1. Research Unit for Clinical Biomechanics, Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Clinical Locomotion Network, Campusvej 55, DK-5230...... and adolescents are absent. The purpose of this study was to develop an instrument for children aged 9-12 years which could fill this gap in the literature. Methods The Young Spine Questionnaire (YSQ) was developed in three phases – the conceptualisation, development and testing phase. We used the conceptual...... model of Wilson and Cleary (1995) and divided the YSQ into two parts: part one included spinal prevalence estimates (including pictures of spinal area) and part two questions regarding pain, activity restrictions, care seeking behaviour and influence of parental back trouble. During the developing phase...

  10. A new subtype of 3' region of cagA gene in Helicobacter pyloristrains isolated from Zhejiang Province in China

    Institute of Scientific and Technical Information of China (English)

    Ran Tao; Ping-Chu Fang; Hai-Yan Liu; Yun-Shui Jiang; Jing Chen

    2004-01-01

    AIM: To isolate the subtypes of 3' region of cagA gene in Helicobacter pylori (H pylori) strains from Zhejiang Province in China and to investigate their relations to H pylori-associated gastroduodenal diseases.METHODS: One hundred and thirty-seven H pylori clinical strains were isolated from the gastric mucosa specimens of 74 patients with chronic gastritis, 61 with peptic ulceration,and 2 with gastric cancer. Bacterial genomic DNA was extracted and 3' region of cagA gene was amplified by polymerase chain reaction (PCR). Subtypes of 3' region of cagA gene were determined by the size of PCR amplified segments. The sequences of the subtypes were analyzed by PCR-based sequencing.RESULTS: Of the 137 Hpylori isolates from Zhejiang Province,132 (96.4%) yielded PCR products that could be classified into three groups of subtypes, named as subtypes Ⅰ, Ⅱ,and Ⅲ according to their sizes. The sizes of subtypes Ⅰ, Ⅱ,and Ⅲ were 648-650 bp, 705-707 bp, and 815 bp, respectively.Among the 132 cagA-positive H pyloristrains, 123 (93.2%)belonged to the group of subtype Ⅰ, 6 (4.5%) presented subtype Ⅱ, 1 (0.8%) was subtype Ⅲ, and 2 (1.5%) presented subtypes Ⅰ and Ⅲ both. The primary structure of subtype Ⅰwas composed of 3 repeats of R1, 1 repeat of R2 and 1repeat of R3. Subtype Ⅱ possessing 4 repeats of R1, 2repeats of R2 and 1 repeat of R3 was a newly found type of 3' region of cagA gene which had not been reported before. The primary structure of subtype Ⅲ consisted of 4repeats of R1, 1 repeat of R2 and 2 repeats of R3. Comparison of the sequences of subtype Ⅰ strains with the corresponding sequences deposited in GenBank, showed a similarity of95.0% (94.0-96.1%) for nucleotide sequences and 95.9%(94.9-97.4%) for deduced amino acid sequences.Comparison of the sequences of subtype Ⅲ strains with the corresponding sequences deposited in GenBank,showed a similarity of 93.9% (90.8-96.9%) for nucleotide sequences and 93.2% (90.2-96.2%) for deduced amino acid

  11. Frontotemporal dementia and its subtypes

    DEFF Research Database (Denmark)

    Ferrari, Raffaele; Hernandez, Dena G; Nalls, Michael A

    2014-01-01

    BACKGROUND: Frontotemporal dementia (FTD) is a complex disorder characterised by a broad range of clinical manifestations, differential pathological signatures, and genetic variability. Mutations in three genes-MAPT, GRN, and C9orf72-have been associated with FTD. We sought to identify novel gene...

  12. Early maladaptive schemas of personality disorder subtypes.

    Science.gov (United States)

    Petrocelli, J V; Glaser, B A; Calhoun, G B; Campbell, L F

    2001-12-01

    This investigation attempted to examine the cognitive schemas of five distinct clusters that emerged from a cluster analysis of the personality disorder scales of the Millon Clinical Multiaxial Inventory-II (Millon, 1987). Specifically, the degree to which early maladaptive schemas, as measured by the Cognitive Schema Questionnaire-Short Form (Young, 1994), could correctly identify empirically derived patterns of personality disorders was examined. Between-cluster differences centered on five personality components and five schemas. Discriminant analyses revealed two significant functions composed of cognitive schemas, which correctly identified 61.2% of the entire sample in terms of cluster group membership. The total proportion of variance in the two significant functions associated with cluster group differences was 76.8%. Findings are discussed in relation to the domain theory of personality disorders posited by Millon and Davis (1996).

  13. Subtypes of Pathological Gambling with Concurrent Illegal Behaviors.

    Science.gov (United States)

    Granero, Roser; Fernández-Aranda, Fernando; Aymamí, Neus; Gómez-Peña, Mónica; Fagundo, Ana Beatriz; Sauchelli, Sarah; Del Pino-Gutiérrez, Amparo; Moragas, Laura; Savvidou, Lamprini G; Islam, Mohammed A; Tàrrega, Salomé; Menchón, José M; Jiménez-Murcia, Susana

    2015-12-01

    The aims of this study are: to explore empirical clusters in a sample of individuals with a gambling disorder (GD) according to the presence of illegal behaviors, to describe the subgroups at a clinical level and to examine whether a temporal change has taken place across the last 9 years. The sample consisted of 378 patients with a GD who consecutively received outpatient treatment, and who reported the presence of the DSM-IV criteria "presence of illegal behavior". Two-step clustering procedure revealed the existence of four empirical groups, which differed in both sociodemographic and clinical profiles. The patients, who have committed illegal acts due to their gambling behavior, are a heterogeneous group in which it is possible to identify different subtypes, based on sociodemographic, psychopathological, clinical and personality characteristics.

  14. Questionnaire de Schwartz

    Directory of Open Access Journals (Sweden)

    Alejandro Castro Solano

    2006-01-01

    Full Text Available El estudio de los valores puede ser abordado desde múltiples perspectivas (filosófica, psicológica, sociológica, etc.. En Psicología, el análisis de las orientaciones valóricas de los individuos ha cobrado especial importancia a partir de las conceptualizaciones de Schwartz (1992, 2001 quien verificó una estructura de diez valores (Poder, Logro, Hedonismo, Estimulación, Autodirección, Universalismo, Benevolencia, Tradición, Conformidad y Seguridad, los cuales se organizan en cuatro bipolaridades (Autotrascendencia, Autopromoción, Conservación y Apertura al cambio en más de 60 países, dando soporte empírico a la clasificación de los valores humanos. Este estudio tiene como objetivos: (a adaptar y validar el Portrait Values Questionnaire (PVQ de Schwartz (1992, 2001 y (b verificar si existen diferencias individuales según dos contextos objeto de estudio (civil y militar y según sexo y edad. Se recogieron datos de una población argentina (N = 692 en tres contextos diferentes: (a población civil (n = 471, (b oficiales militares (n = 97 y (c cadetes (n = 124. El estudio permitió verificar parcialmente la estructura de los valores propuestos por el autor. La fiabilidad del PVQ resulta muy adecuada en los tres contextos estudiados. Asimismo se pudo verificar que los civiles están más orientados hacia el logro de objetivos personales (Autopromoción y la independencia para decir y hacer lo que uno quiere (Apertura al cambio, mientras que los militares están más orientados hacia los valores relacionados con el mantenimiento del orden social, la seguridad, la conservación de las tradiciones (Tradición y Conformidad. Por otra parte, los resultados mostraron que no existen diferencias en las orientaciones valóricas según sexo y edad.

  15. Precise subtyping for synchronous multiparty sessions

    Directory of Open Access Journals (Sweden)

    Mariangiola Dezani-Ciancaglini

    2016-02-01

    Full Text Available The notion of subtyping has gained an important role both in theoretical and applicative domains: in lambda and concurrent calculi as well as in programming languages. The soundness and the completeness, together referred to as the preciseness of subtyping, can be considered from two different points of view: operational and denotational. The former preciseness has been recently developed with respect to type safety, i.e. the safe replacement of a term of a smaller type when a term of a bigger type is expected. The latter preciseness is based on the denotation of a type which is a mathematical object that describes the meaning of the type in accordance with the denotations of other expressions from the language. The result of this paper is the operational and denotational preciseness of the subtyping for a synchronous multiparty session calculus. The novelty of this paper is the introduction of characteristic global types to prove the operational completeness.

  16. GABAA receptor subtype involvement in addictive behaviour.

    Science.gov (United States)

    Stephens, D N; King, S L; Lambert, J J; Belelli, D; Duka, T

    2017-01-01

    GABAA receptors form the major class of inhibitory neurotransmitter receptors in the mammalian brain. This review sets out to summarize the evidence that variations in genes encoding GABAA receptor isoforms are associated with aspects of addictive behaviour in humans, while animal models of addictive behaviour also implicate certain subtypes of GABAA receptor. In addition to outlining the evidence for the involvement of specific subtypes in addiction, we summarize the particular contributions of these isoforms in control over the functioning of brain circuits, especially the mesolimbic system, and make a first attempt to bring together evidence from several fields to understanding potential involvement of GABAA receptor subtypes in addictive behaviour. While the weight of the published literature is on alcohol dependency, the underlying principles outlined are relevant across a number of different aspects of addictive behaviour. © 2016 John Wiley & Sons Ltd and International Behavioural and Neural Genetics Society.

  17. Depression, anxiety and anger in subtypes of irritable bowel syndrome patients.

    Science.gov (United States)

    Muscatello, Maria Rosaria A; Bruno, Antonio; Pandolfo, Gianluca; Micò, Umberto; Stilo, Simona; Scaffidi, Mariagrazia; Consolo, Pierluigi; Tortora, Andrea; Pallio, Socrate; Giacobbe, Giuseppa; Familiari, Luigi; Zoccali, Rocco

    2010-03-01

    The present study aimed to elucidate the differences in depression, anxiety, anger, and quality of life in a sample of non-psychiatric IBS patients, starting from the hypothesis that IBS subtypes may have different symptomatic expressions of negative emotions with different outcomes on quality of life measures. Forty-two constipation-predominant IBS (C-IBS) subjects and 44 diarrhea-predominant IBS (D-IBS) subjects, after an examination by a gastroenterologist and a total colonoscopy, underwent a clinical interview and psychometric examination for the assessment of depression, anxiety, anger and quality of life. IBS subtypes showed different symptomatic profiles in depression, anxiety and anger, with C-IBS patients more psychologically distressed than D-IBS subjects. Affective and emotional symptoms should be considered as specific and integral to the syndrome, and recognizing the differences between IBS subtypes may have relevant implications for treatment options and clinical outcome.

  18. Clinical patterns in Parkinson's disease

    NARCIS (Netherlands)

    Rooden, Stephanie Maria van

    2012-01-01

    The clinical heterogeneity of Parkinson’s disease (PD) patients may reflect the existence of subtypes of the disease. PD subtypes have often been defined by a classification according to researcher-specified criteria, such as age-at-onset or predominant clinical motor features. The general objective

  19. Relationship between subtypes and symptoms of ADHD, insomnia, and nightmares in connection with quality of life in children

    Directory of Open Access Journals (Sweden)

    Grünwald J

    2017-09-01

    Full Text Available Julia Grünwald,1 Angelika Anita Schlarb2 1Department of Psychology, Faculty of Science, University of Tübingen, Tübingen, 2Department of Clinical Psychology and Psychotherapy, Faculty of Psychology and Sports Science, University of Bielefeld, Bielefeld, Germany Objectives: This study examined the links between sleep disorders and subtypes of attention deficit-hyperactivity disorder (ADHD-inattention, ADHD-combined, ADHD-hyperactive/impulsive in childhood. We set up a hypothetical model linking different symptoms of both disorders to construct the underlying and shared pathways. By examining a sample of children with ADHD we firstly tested parts of the model.Methods: A total of 72 children with symptoms of ADHD (aged 6–13 years; 79.2% boys were diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, fifth edition and the International Classification of Sleep Disorders, third edition in regards to ADHD and sleep disorders via standardized parent-rated questionnaires. Additionally, quality of life (QoL was assessed. Overall, 46 children fulfilled the criteria of ADHD and were medication-naive.Results: On average, the whole sample had clinically elevated total scores of the Children’s Sleep Habits Questionnaire in the validated German version (CSHQ-DE, indicating an increased prevalence of sleep disorders in children with ADHD. In accordance to our hypothetical model, children with primarily hyperactive–impulsive ADHD showed the highest CSHQ-DE scores. Moreover, we found a high impact for insomnia in this subgroup and a high comorbid load for the mutual occurrence of insomnia and nightmares. Furthermore, QoL was reduced in our whole sample, and again intensified in children with comorbid insomnia and nightmares.Conclusion: We verified an elevated occurrence of sleep disorders in children with ADHD and were able to link them to specific subtypes of ADHD. These results were in line with our hypothetical model

  20. Integrated Classification of Prostate Cancer Reveals a Novel Luminal Subtype with Poor Outcome.

    Science.gov (United States)

    You, Sungyong; Knudsen, Beatrice S; Erho, Nicholas; Alshalalfa, Mohammed; Takhar, Mandeep; Al-Deen Ashab, Hussam; Davicioni, Elai; Karnes, R Jeffrey; Klein, Eric A; Den, Robert B; Ross, Ashley E; Schaeffer, Edward M; Garraway, Isla P; Kim, Jayoung; Freeman, Michael R

    2016-09-01

    Prostate cancer is a biologically heterogeneous disease with variable molecular alterations underlying cancer initiation and progression. Despite recent advances in understanding prostate cancer heterogeneity, better methods for classification of prostate cancer are still needed to improve prognostic accuracy and therapeutic outcomes. In this study, we computationally assembled a large virtual cohort (n = 1,321) of human prostate cancer transcriptome profiles from 38 distinct cohorts and, using pathway activation signatures of known relevance to prostate cancer, developed a novel classification system consisting of three distinct subtypes (named PCS1-3). We validated this subtyping scheme in 10 independent patient cohorts and 19 laboratory models of prostate cancer, including cell lines and genetically engineered mouse models. Analysis of subtype-specific gene expression patterns in independent datasets derived from luminal and basal cell models provides evidence that PCS1 and PCS2 tumors reflect luminal subtypes, while PCS3 represents a basal subtype. We show that PCS1 tumors progress more rapidly to metastatic disease in comparison with PCS2 or PCS3, including PSC1 tumors of low Gleason grade. To apply this finding clinically, we developed a 37-gene panel that accurately assigns individual tumors to one of the three PCS subtypes. This panel was also applied to circulating tumor cells (CTC) and provided evidence that PCS1 CTCs may reflect enzalutamide resistance. In summary, PCS subtyping may improve accuracy in predicting the likelihood of clinical progression and permit treatment stratification at early and late disease stages. Cancer Res; 76(17); 4948-58. ©2016 AACR.

  1. Stem cell-like gene expression in ovarian cancer predicts type II subtype and prognosis.

    Directory of Open Access Journals (Sweden)

    Matthew Schwede

    Full Text Available Although ovarian cancer is often initially chemotherapy-sensitive, the vast majority of tumors eventually relapse and patients die of increasingly aggressive disease. Cancer stem cells are believed to have properties that allow them to survive therapy and may drive recurrent tumor growth. Cancer stem cells or cancer-initiating cells are a rare cell population and difficult to isolate experimentally. Genes that are expressed by stem cells may characterize a subset of less differentiated tumors and aid in prognostic classification of ovarian cancer. The purpose of this study was the genomic identification and characterization of a subtype of ovarian cancer that has stem cell-like gene expression. Using human and mouse gene signatures of embryonic, adult, or cancer stem cells, we performed an unsupervised bipartition class discovery on expression profiles from 145 serous ovarian tumors to identify a stem-like and more differentiated subgroup. Subtypes were reproducible and were further characterized in four independent, heterogeneous ovarian cancer datasets. We identified a stem-like subtype characterized by a 51-gene signature, which is significantly enriched in tumors with properties of Type II ovarian cancer; high grade, serous tumors, and poor survival. Conversely, the differentiated tumors share properties with Type I, including lower grade and mixed histological subtypes. The stem cell-like signature was prognostic within high-stage serous ovarian cancer, classifying a small subset of high-stage tumors with better prognosis, in the differentiated subtype. In multivariate models that adjusted for common clinical factors (including grade, stage, age, the subtype classification was still a significant predictor of relapse. The prognostic stem-like gene signature yields new insights into prognostic differences in ovarian cancer, provides a genomic context for defining Type I/II subtypes, and potential gene targets which following further

  2. Salmonella source attribution based on microbial subtyping

    DEFF Research Database (Denmark)

    Barco, Lisa; Barrucci, Federica; Olsen, John Elmerdahl

    2013-01-01

    Source attribution of cases of food-borne disease represents a valuable tool for identifying and prioritizing effective food-safety interventions. Microbial subtyping is one of the most common methods to infer potential sources of human food-borne infections. So far, Salmonella microbial subtyping...... source attribution models have been implemented by using serotyping and phage-typing data. Molecular-based methods may prove to be similarly valuable in the future, as already demonstrated for other food-borne pathogens like Campylobacter. This review assesses the state of the art concerning Salmonella...... in the context of their potential applicability for Salmonella source attribution studies....

  3. Japanese Orthopaedic Association Back Pain Evaluation Questionnaire. Part 3. Validity study and establishment of the measurement scale : Subcommittee on Low Back Pain and Cervical Myelopathy Evaluation of the Clinical Outcome Committee of the Japanese Orthopaedic Association, Japan.

    Science.gov (United States)

    Fukui, Mitsuru; Chiba, Kazuhiro; Kawakami, Mamoru; Kikuchi, Shin-ichi; Konno, Shin-ichi; Miyamoto, Masabumi; Seichi, Atsushi; Shimamura, Tadashi; Shirado, Osamu; Taguchi, Toshihiko; Takahashi, Kazuhisa; Takeshita, Katsushi; Tani, Toshikazu; Toyama, Yoshiaki; Wada, Eiji; Yonenobu, Kazuo; Tanaka, Takashi; Hirota, Yoshio

    2008-05-01

    The Japanese Orthopaedic Association decided to revise the JOA score for low back pain and to develop a new outcome measure. In February 2002, the first survey was performed with a preliminary questionnaire consisting of 60 evaluation items. Based on findings of that survey, 25 items were selected for a draft of the JOA Back Pain Evaluation Questionnaire (JOABPEQ). The second survey was performed to confirm the reliability of the draft questionnaire. This article further evaluates the validity of this questionnaire and establishes a measurement scale. The subjects of this study consisted of 355 patients with low back disorders of any type (201 men, 154 women; mean age 50.7 years). Each patient was asked to fill in a self-administered questionnaire. Superficial validity was checked in terms of the completion rate for filling out the entire questionnaire. Factor analysis was then performed to evaluate the validity of the questionnaire and establish a measurement scale. As a result of the factor analysis, 25 items were categorized into five factors. The factors were named based on the commonality of the items: social function, mental health, lumbar function, walking ability, and low back pain. To establish a measurement scale for each factor, we determined the coefficient for each item so the difference between the maximum factor scores and minimum factor scores was approximately 100. We adjusted the formula so the maximum for each factor score was 100 and the minimum was 0. We confirmed the validity of the JOA Back Pain Evaluation Questionnaire and established a measurement scale.

  4. Review of renal cell carcinoma and its common subtypes in radiology

    Institute of Scientific and Technical Information of China (English)

    Gavin Low; Guan Huang; Winnie Fu; Zaahir Moloo; Safwat Girgis

    2016-01-01

    Representing 2%-3% of adult cancers, renal cell carcinoma(RCC) accounts for 90% of renal malignancies and is the most lethal neoplasm of the urologic system. Over the last 65 years, the incidence of RCC has increased at a rate of 2% per year. The increased incidence is at least partly due to improved tumor detection secondary to greater availability of high-resolution cross-sectional imaging modalities over the last few decades. Most RCCs are asymptomatic at discovery and are detected as unexpected findings on imaging performed for unrelated clinical indications. The 2004 World Health Organization Classification of adult renal tumors stratifies RCC into several distinct histologic subtypes of which clear cell, papillary and chromophobe tumors account for 70%, 10%-15%, and 5%, respectively. Knowledge of the RCC subtype is important because the various subtypes are associated with different biologic behavior, prognosis and treatment options. Furthermore, the common RCC subtypes can often be discriminated non-invasively based on gross morphologic imaging appearances, signal intensity on T2-weighted magnetic resonance images, and the degree of tumor enhancement on dynamic contrast-enhanced computed tomography or magnetic resonance imaging examinations. In this article, we review the incidence and survival data, risk factors, clinical and biochemical findings, imaging findings, staging, differential diagnosis, management options and posttreatment follow-up of RCC, with attention focused on the common subtypes.

  5. Questionnaire Designing for a Survey

    Directory of Open Access Journals (Sweden)

    S Roopa

    2012-01-01

    Full Text Available Questionnaires are frequently used in quantitative marketing research and social research. A questionnaire is a series of questions asked to individuals to obtain statistically useful information about a given topic. When properly constructed and responsibly administered, questionnaires become a vital instrument by which statements can be made about specific groups or people or entire populations. They are a valuable method of collecting a wide range of information from a large number of individuals, often referred to as respondents. Adequate questionnaire construction is critical to the success of a survey. Appropriate questions, correct ordering of questions, correct scaling, or good questionnaire format can make the survey worthwhile, as it may accurately reflect the views and opinions of the participants. A useful method for checking a questionnaire and making sure it is accurately capturing the intended information is to pretest among a smaller subset of target respondents.

  6. Identification of Subtype Specific miRNA-mRNA Functional Regulatory Modules in Matched miRNA-mRNA Expression Data: Multiple Myeloma as a Case

    Directory of Open Access Journals (Sweden)

    Yunpeng Zhang

    2015-01-01

    Full Text Available Identification of miRNA-mRNA modules is an important step to elucidate their combinatorial effect on the pathogenesis and mechanisms underlying complex diseases. Current identification methods primarily are based upon miRNA-target information and matched miRNA and mRNA expression profiles. However, for heterogeneous diseases, the miRNA-mRNA regulatory mechanisms may differ between subtypes, leading to differences in clinical behavior. In order to explore the pathogenesis of each subtype, it is important to identify subtype specific miRNA-mRNA modules. In this study, we integrated the Ping-Pong algorithm and multiobjective genetic algorithm to identify subtype specific miRNA-mRNA functional regulatory modules (MFRMs through integrative analysis of three biological data sets: GO biological processes, miRNA target information, and matched miRNA and mRNA expression data. We applied our method on a heterogeneous disease, multiple myeloma (MM, to identify MM subtype specific MFRMs. The constructed miRNA-mRNA regulatory networks provide modular outlook at subtype specific miRNA-mRNA interactions. Furthermore, clustering analysis demonstrated that heterogeneous MFRMs were able to separate corresponding MM subtypes. These subtype specific MFRMs may aid in the further elucidation of the pathogenesis of each subtype and may serve to guide MM subtype diagnosis and treatment.

  7. Der Fragebogen "SFDP26-German": Ein verlässliches Instrument zur Evaluation des klinischen Unterrichts? [The Questionnaire "SFDP26-German": a reliable tool for evaluation of clinical teaching?

    Directory of Open Access Journals (Sweden)

    Iblher, Peter

    2011-05-01

    Full Text Available [english] Aims: Evaluation of the effectiveness of clinical teaching is an important contribution for the quality control of medical teaching. This should be evaluated using a reliable instrument in order to be able to both gauge the status quo and the effects of instruction. In the Stanford Faculty Development Program (SFDP, seven categories have proven to be appropriate: Since 1998, the SFDP26 questionnaire has established itself as an evaluation tool in English speaking countries. To date there is no equivalent German-language questionnaire available which evaluates the overall effectiveness of teaching.Question: Methods: 19 anaesthetists (7 female, 12 male from the University of Lübeck were evaluated at the end of a teaching seminar on emergency medical care using SFDP-German. The sample consisted of 173 medical students (119 female (68.8% and 54 male (31.2%, mostly from the fifth semester (6.6% and sixth semester (80.3%. The mean age of the students was 23±3 years. Results: The discriminatory power of all items ranged between good and excellent (r=0.48-0.75. All subscales displayed good internal consistency (α=0.69-0.92 and significant positive inter-scale correlations (r=0.40-0.70. The subscales and “overall effectiveness of teaching” showed significant correlation, with the highest correlation for the subscale “communication of goals (p< 0.001; r = 0.61.Conclusion: The analysis of SFDP26-German confirms high internal consistency. Future research should investigate the effectiveness of the individual categories on the overall effectiveness of teaching and validate according to external criteria. [german] Zielsetzung: Die Evaluation klinischer Lehrkompetenz ist ein wichtiger Beitrag zur Qualitätssicherung medizinischer Lehrveranstaltungen. Die Evaluation sollte mit einem verlässlichen Instrument durchgeführt werden, um Status quo sowie Effekte von medizindidaktischen Schulungsmaßnahmen beurteilen zu können. Im

  8. Paper to Electronic Questionnaires: Effects on Structured Questionnaire Forms

    Science.gov (United States)

    Trujillo, Anna C.

    2009-01-01

    With the use of computers, paper questionnaires are being replaced by electronic questionnaires. The formats of traditional paper questionnaires have been found to effect a subject's rating. Consequently, the transition from paper to electronic format can subtly change results. The research presented begins to determine how electronic questionnaire formats change subjective ratings. For formats where subjects used a flow chart to arrive at their rating, starting at the worst and middle ratings of the flow charts were the most accurate but subjects took slightly more time to arrive at their answers. Except for the electronic paper format, starting at the worst rating was the most preferred. The paper and electronic paper versions had the worst accuracy. Therefore, for flowchart type of questionnaires, flowcharts should start at the worst rating and work their way up to better ratings.

  9. Neutralization of several adult and paediatric HIV-1 subtype C isolates using a shortened synthetic derivative of gp120 binding aptamer called UCLA1.

    CSIR Research Space (South Africa)

    Mufhandu, Hazel T

    2009-07-01

    Full Text Available This paper present a chemically synthesised derivative of the B40 parental aptamer, called UCLA1 (Cohen et al., 2008), was used for neutralization of endemic subtype C clinical isolates of HIV-1 from adult and paediatric patients and subtype B lab...

  10. Development of the Young Spine Questionnaire

    DEFF Research Database (Denmark)

    Lauridsen, Henrik Hein; Hestbæk, Lise

    model of Wilson and Cleary (1995) and divided the YSQ into two parts: part one included spinal prevalence estimates (including pictures of spinal area) and part two questions regarding pain, activity restrictions, care seeking behaviour and influence of parental back trouble. During the developing phase......Title Development of the Young Spine Questionnaire Authors & Affiliations Henrik Hein Lauridsen1, Lise Hestbæk1,2 1. Research Unit for Clinical Biomechanics, Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Clinical Locomotion Network, Campusvej 55, DK-5230...... Odense M, Denmark 2. Nordic Institute of Chiropractic and Clinical Biomechanics, Clinical Locomotion Network, Forskerparken 10A, 5230 Odense M, Denmark Background Back pain in children is common and early onset of back pain has been shown to increase the risk of back pain significantly in adulthood...

  11. Proteomic maps of breast cancer subtypes

    DEFF Research Database (Denmark)

    Tyanova, Stefka; Albrechtsen, Reidar; Kronqvist, Pauliina

    2016-01-01

    oestrogen receptor positive (luminal), Her2 positive and triple negative breast tumours and reached a quantitative depth of >10,000 proteins. These proteomic profiles identified functional differences between breast cancer subtypes, related to energy metabolism, cell growth, mRNA translation and cell...

  12. Subtyping Male Perpetrators of Intimate Partner Violence

    Science.gov (United States)

    Fowler, Katherine A.; Westen, Drew

    2011-01-01

    Domestic violence is a serious problem with far-reaching consequences. This study applies a new methodology to derive subtypes of male perpetrators of intimate partner violence. As part of a larger National Institute of Mental Health (NIMH)-funded study, a national sample of randomly selected psychologists and psychiatrists describe 188 adult male…

  13. A Taxometric Investigation of Developmental Dyslexia Subtypes

    Science.gov (United States)

    O'Brien, Beth A.; Wolf, Maryanne; Lovett, Maureen W.

    2012-01-01

    Long-standing issues with the conceptualization, identification and subtyping of developmental dyslexia persist. This study takes an alternative approach to examine the heterogeneity of developmental dyslexia using taxometric classification techniques. These methods were used with a large sample of 671 children ages 6-8 who were diagnosed with…

  14. A Taxometric Investigation of Developmental Dyslexia Subtypes

    Science.gov (United States)

    O'Brien, Beth A.; Wolf, Maryanne; Lovett, Maureen W.

    2012-01-01

    Long-standing issues with the conceptualization, identification and subtyping of developmental dyslexia persist. This study takes an alternative approach to examine the heterogeneity of developmental dyslexia using taxometric classification techniques. These methods were used with a large sample of 671 children ages 6-8 who were diagnosed with…

  15. Temporal lobe epilepsy subtypes, differential patterns of cerebral perfusion on ictal SPECT

    NARCIS (Netherlands)

    Ho, SS; Berkovic, SF; McKay, WJ; Kalnins, RM; Bladin, PF

    1996-01-01

    Purpose: We studied cerebral perfusion patterns in the various subtypes of TLE, as determined by pathology and good outcome after temporal lobectomy (as confirmation of temporal origin). Methods: We studied clinical features and ictal technetium 99m hexamethyl-propyleneamineoxime (Tc-99m-HMPAO) sing

  16. The impact of specific language impairment on working memory in children with ADHD combine