WorldWideScience

Sample records for program clinical correlates

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

    Science.gov (United States)

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

    2009-01-01

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

  2. Clinical Investigation Program.

    Science.gov (United States)

    1979-10-01

    fish responsible for clinical scombroid poisoning. This will be attempted by correlating known patients, fish, specimens, and suspected outbreaks ...by parents, special program, and TAHC staff to evaluate the level of psychotic behavior. After one month, the procedure will be reversed, in that

  3. Programming services with correlation sets

    DEFF Research Database (Denmark)

    Montesi, Fabrizio; Carbone, Marco

    2011-01-01

    Correlation sets define a powerful mechanism for routing incoming communications to the correct running session within a server, by inspecting the content of the received messages. We present a language for programming services based on correlation sets taking into account key aspects of service-...... properties of programs with respect to correlation sets. We provide an implementation as an extension of the JOLIE language and apply it to a nontrivial real-world example of a fully-functional distributed user authentication system....

  4. Psychosocial and treatment correlates of opiate free success in a clinical review of a naltrexone implant program

    Directory of Open Access Journals (Sweden)

    Reece AS

    2007-11-01

    Full Text Available Abstract Background There is on-going controversy in relation to the efficacy of naltrexone used for the treatment of heroin addiction, and the important covariates of that success. We were also interested to review our experience with two depot forms of implantable naltrexone. Methods A retrospective review of patients' charts was undertaken, patients were recalled by telephone and by letter, and urine drug screen samples were collected. Opiate free success (OFS was the parameter of interest. Three groups were defined. The first two were treated in the previous 12 months and comprised "implant" and "tablet" patients. A third group was "historical" comprising those treated orally in the preceding 12 months. Results There were 102, 113 and 161 patients in each group respectively. Groups were matched for age, sex, and dose of heroin used, but not financial status or social support. The overall follow-up rate was 82%. The Kaplan Meier 12 month OFS were 82%, 58% and 52% respectively. 12 post-treatment variables were independently associated with treatment retention. In a Cox proportional hazard multivariate model social support, the number of detoxification episodes, post-treatment employment, the use of multiple implant episodes and spiritual belief were significantly related to OFS. Conclusion Consistent with the voluminous international literature clinically useful retention rates can be achieved with naltrexone, which may be improved by implants and particularly serial implants, repeat detoxification, meticulous clinical follow-up, and social support. As depot formulations of naltrexone become increasingly available such results can guide their clinical deployment, improve treatment outcomes, and enlarge the policy options for an exciting non-addictive pharmacotherapy for opiate addiction.

  5. Clinical Investigation Program.

    Science.gov (United States)

    1987-09-30

    1 V TILE COPY q Laboratory N Report No. 23 CLINICAL INVESTIGATION PROGRAM ANNUAL PROGRESS REPORT DTIC 30 September 1987 TLE CTE JAN 2 8 IM Approved...1987. Kucera RF, Blue PW, Thomas HM, Bowden WD: Anomalous Origin of the Right Coronary Artery from the Left Sinus of Valsalva - A Case Report. Cath...University of New York at Buffalo . Civilian Hospital Savitz DA, Hamman RF, Grace C, and Stroo K: Respondents’ At- titudes Regarding Participation in

  6. Alteration in regulatory T cells and programmed cell death 1-expressing regulatory T cells in active generalized vitiligo and their clinical correlation.

    Science.gov (United States)

    Tembhre, M K; Parihar, A S; Sharma, V K; Sharma, A; Chattopadhyay, P; Gupta, S

    2015-04-01

    Vitiligo is an autoimmune depigmentation disease, and defects in regulatory T cells (Tregs) have been proposed in the pathogenesis of generalized vitiligo (GV). However, the role of programmed cell death (PD)1(+) Tregs has not been studied. To investigate the status of Tregs, PD1(+) Tregs and associated parameters in active GV (aGV) during the first episode of disease attack and to establish the clinical correlation. The percentages of circulating Tregs, PD1(+) Tregs and CD3(+) CD4(+) PD1(+) T cells were evaluated in 50 patients with aGV and 51 controls. Expression levels of FOXP3, TGFB1, CTLA4 and genes for chemokine receptors (CCR4, CCR7) and their ligands (CCL21, CCL22) were quantified in peripheral blood and in lesional, perilesional, nonlesional and normal skin sections. The corresponding proteins were immunolocalized in tissue of aGV. The percentage of Tregs was decreased (P = 0·001) and that of PD1(+) Tregs increased (P = 0·001) in peripheral blood of patients with aGV compared with controls. The abundance of TGFB1 and CCL21 mRNA was significantly decreased in the peripheral blood of patients with aGV. Significant differences in forkhead box P3, transforming growth factor-β and CCL21 protein expression were found in skin sections. Deficiency in Treg frequency and decreased expression of Treg-associated parameters (TGFB and CCL21) suggested a possible defect in Tregs that may alter their suppression function and skin homing in aGV. The increased PD1(+) Tregs suggests that the PD1/PD ligand pathway may be involved in aGV and may have a role in Treg exhaustion. Further study is required to delineate the effect of PD1 in regulating Treg function in aGV. © 2014 British Association of Dermatologists.

  7. Clinical correlation of antimitochondrial antibodies.

    Science.gov (United States)

    Zuber, M A; Recktenwald, C

    2003-02-21

    Antimitochondrial antibodies (AMA) are a hallmark of primary biliary cirrhosis (PBC). They are believed to be absolutely disease specific. It does occur that patients with positive AMA are diagnosed with PBC in the absence of liver specific signs and symptoms. The aim of the present study was to examine the disease spectrum of unselected AMA positive patients of an university hospital. All of the AMA tests performed in the immunological laboratory of the hospital between 1992 and 1998 were examined for positivity. 100 patients with a positive result were analyzed retrospectively for diagnosis, clinical and laboratory features. 61 patients suffered from liver diseases and 39 from non-liver diseases. The patients with liver diseases were 36 patients with PBC, 2 patients with PBC/PSC-overlap syndrome, 4 patients with autoimmune hepatitis and 19 patients with different liver diseases of other than autoimmune origin. The 39 patients with non-liver diseases included 9 patients with systemic autoimmune diseases, 3 patients with organ-specific autoimmune diseases, 8 patients with carcinoma and 19 patients with different diseases. 97 patients had an ELISA test for antibodies to the mitochondrial antigen M2 performed in addition to the immunofluorescence test for AMA. 73 patients had positive values for anti-M2 antibodies and 24 patients had negative results. Anti-M2 antibody values were divided in negative, low (5-100 U/ml), medium (101-1000 U/ml), high (1001-10000 U/ml) and very high (>10000 U/ml). Very high and high anti-M2 values were present mainly in patients with PBC and some patients with other liver diseases, medium high and low values in patients with different disease groups. In this unselected patient population only one third of AMA positive patients had an established diagnosis of PBC, about 10% a diagnosis of a systemic autoimmune disease and 3 % had other organ-specific autoimmune diseases. It can be concluded that, although high titers of antibodies against

  8. Clinic Health Awareness Program Subsystem -

    Data.gov (United States)

    Department of Transportation — Clinic Health Awareness Program Subystem (CHAPS) is a comprehensive system for recording, reporting, and analyzing a patient’s medical information and managing an...

  9. Benchmarking clinical engineering program.

    Science.gov (United States)

    David, Yadin

    2004-01-01

    Professional labor shortage in healthcare delivery system and specifically the management of staffing effectiveness in clinical engineering field are recent developments where shortage of comparative information exist and almost no information on its impact on performance outcomes. We attempted over the past few years to define and measure optimal application of manpower to medical technology management in the hospital setting.

  10. Clinical neuropsychiatric correlates and EEG findings among ...

    African Journals Online (AJOL)

    This present study focuses on psychomotor developmental delays or disorders; which are divided into specific disorders in which only a single function is involved (such as language or motor) and global developmental disorder in which a wide range. Clinical neuropsychiatric correlates and EEG findings among children.

  11. Clinical Investigation Program Report

    Science.gov (United States)

    1992-10-01

    BENNING, GA 1980 Intraocular Lens Study. (T) 183 78-14 USA MEDDAC, FT CAMPBELL, KY 1981 Intraocular Lens Study. (0) 184 78-14 1990 Pediatric ...Tympanic Thermometry to Rectal Thermometry 191 91-83 in an Ambulatory Pediatric Clinic. (C) USA MEDDAC. FT RUCKER. AL 1990 Comparison of Cefpodoxime...oral macrolide therapy. Technical Approach: Randomized, investigator blind, multicenter trial. Subjects enrolled to date: 0 Progress: Prepared for

  12. Interpretation of correlations in clinical research.

    Science.gov (United States)

    Hung, Man; Bounsanga, Jerry; Voss, Maren Wright

    2017-11-01

    Critically analyzing research is a key skill in evidence-based practice and requires knowledge of research methods, results interpretation, and applications, all of which rely on a foundation based in statistics. Evidence-based practice makes high demands on trained medical professionals to interpret an ever-expanding array of research evidence. As clinical training emphasizes medical care rather than statistics, it is useful to review the basics of statistical methods and what they mean for interpreting clinical studies. We reviewed the basic concepts of correlational associations, violations of normality, unobserved variable bias, sample size, and alpha inflation. The foundations of causal inference were discussed and sound statistical analyses were examined. We discuss four ways in which correlational analysis is misused, including causal inference overreach, over-reliance on significance, alpha inflation, and sample size bias. Recent published studies in the medical field provide evidence of causal assertion overreach drawn from correlational findings. The findings present a primer on the assumptions and nature of correlational methods of analysis and urge clinicians to exercise appropriate caution as they critically analyze the evidence before them and evaluate evidence that supports practice. Critically analyzing new evidence requires statistical knowledge in addition to clinical knowledge. Studies can overstate relationships, expressing causal assertions when only correlational evidence is available. Failure to account for the effect of sample size in the analyses tends to overstate the importance of predictive variables. It is important not to overemphasize the statistical significance without consideration of effect size and whether differences could be considered clinically meaningful.

  13. [Herpetic keratitis: clinical-virological correlation].

    Science.gov (United States)

    Martínez, M J; Vogel, M; Stoppel, J; Charlin, R; Squella, O; Srur, M; Traipe, L; Verdaguer, J; Suárez, M

    1997-06-01

    Herpetic keratitis is the main infectious cause of corneal opacity. The existence of effective antiviral agents underscores the need of an early diagnosis. To correlate clinical features of herpetic keratitis with virological studies. Forty one patients with a clinical diagnosis of herpetic keratitis were studied. Viral isolation, polymerase chain reaction (PCR) and typification were done in a sample taken by swabbing the ocular lesion. Twenty six patients (31% female) had epithelial keratitis, that was mild or moderate in 88% of cases and acute in 77% of them. In 20 patients (77%), viral isolation and PCR were positive (HSV-2 in one case). Fifteen patients (67% female) had stromal keratitis, 93% of cases were moderate or severe and 53% were acute. Viral isolation was negative in all cases and in 20% PCR was positive. Viral isolation and PCR were equally sensitive in epithelial keratitis, but in stromal keratitis only PCR could detect the virus. Moderate acute dendrite was the predominant clinical manifestation. The higher proportion of women with stromal keratitis supports its possibly autoimmune etiology. HSV-2 is seldomly isolated and possibly associated to vertical transmission.

  14. Clinical correlates of the restless legs syndrome

    Directory of Open Access Journals (Sweden)

    Luis Fabiano Marin

    2012-07-01

    Full Text Available OBJECTIVE: To determine the clinical correlates of the restless legs syndrome (RLS in a Brazilian sleep disorders center. METHODS: We retrospectively studied 118 patients with RLS from January, 2004, to December, 2010. The analyzed variables were: age at disease onset, gender, race, years of school instruction, primary and secondary RLS, and treatment options. RESULTS: Among the studied patients, 83.9% were women with a female/male sex ratio of 5:1. Mean age of the patients at symptom onset ± standard deviation was 41.7±17.9 years-old. The primary RLS was found in 85% of patients. The other 15% remainders consisted of secondary forms, and they were associated with neuropathy, iron deficiency anemia, end-stage renal disease, or Parkinson's disease. Drug therapy for RLS was introduced in 67% of patients. CONCLUSIONS: Most patients presented primary RLS with an early disease onset. Further epidemiological studies are welcomed to provide better information on secondary RLS in Brazil.

  15. Antineutrophil cytoplasm antibody: positivity and clinical correlation.

    Science.gov (United States)

    Martínez Téllez, Goitybell; Torres Rives, Bárbara; Rangel Velázquez, Suchiquil; Sánchez Rodríguez, Vicky; Ramos Ríos, María Antonia; Fuentes Smith, Lisset Evelyn

    2015-01-01

    To determine positivity and clinical correlation of anti-neutrophil cytoplasmic antibodies (ANCA), taking into account the interference of antinuclear antibodies (ANA). A prospective study was conducted in the Laboratory of Immunology of the National Cuban Center of Medical Genetic during one year. Two hounded sixty-seven patients with indication for ANCA determination were included. ANCA and ANA determinations with different cut off points and assays were determined by indirect immunofluorescense. Anti proteinase 3 and antimyeloperoxidase antibodies were determined by ELISA. Most positivity for ANCA was seen in patients with ANCA associated, primary small-vessel vasculitides, rheumatoid arthritis and systemic lupus erythematosus. Presence of ANCA without positivity for proteinase 3 and myeloperoxidase was higher in patients with ANA and little relation was observed between the perinuclear pattern confirmed in formalin and specificity by myeloperoxidase. Highest sensibility and specificity values for vasculitides diagnostic were achieved by ANCA determination using indirect immunofluorescense with a cut off 1/80 and confirming antigenic specificities with ELISA. ANCA can be present in a great number of chronic inflammatory or autoimmune disorders in the population studied. This determination using indirect immunofluorescence and following by ELISA had a great value for vasculitis diagnosis. Anti mieloperoxidasa assay has a higher utility than the formalin assay when ANA is present. Copyright © 2013 Elsevier España, S.L.U. All rights reserved.

  16. Biennial survey of clinical nutrition training programs.

    Science.gov (United States)

    Morgan, S L; Merritt, R J; Jackson, J R; Brooks, C M; Rombeau, J

    1990-07-01

    Three posttraining program surveys have been done by The American Society for Clinical Nutrition Committee on Subspecialty Training to evaluate the status of training programs in clinical nutrition. This survey updates demographic data about programs and determines which classes are offered or required as a part of basic nutrition-science requirements for nutrition training programs. In addition, the importance of board certification and accreditation of training programs is examined.

  17. Clinical Oncology Assistantship Program for Medical Students.

    Science.gov (United States)

    Neilan, Barbara A.; And Others

    1985-01-01

    The Clinical Oncology Assistantship Program at the University of Arkansas for Medical Sciences is described, along with student reactions to the program. The summer elective program involves cancer lectures (one week) and clinical exposure (nine weeks) in medical, surgical, and pediatric oncology services, as well as self-directed learning…

  18. Seronegative chronic polyarthritis: clinical and serological correlates.

    OpenAIRE

    Rasker, J L; Davis, P; Bacon, P A

    1980-01-01

    Twenty-seven patients with chronic, active, seronegative polyarthritis were assessed clinically and serologically by accepted criteria for evidence of connective tissue diseases. The patients were divided into 2 groups, 13 positive for fluorescent antinuclear antibody (FANA) and 14 that were negative. All but 1 patient fulfilled the clinical criteria for the diagnosis of definite rheumatoid arthritis. Four patients (2 in each group) fulfilled the preliminary criteria for the classification of...

  19. Correlation between clinical and histologic pulp diagnoses.

    Science.gov (United States)

    Ricucci, Domenico; Loghin, Simona; Siqueira, José F

    2014-12-01

    Clinicians routinely face conditions in which they have to decide whether the dental pulp can be saved or not. This study evaluated how reliable the clinical diagnosis of normal pulp/reversible pulpitis (savable pulp) or irreversible pulpitis (nonsavable pulp) is when compared with the histologic diagnosis. The study material consisted of 95 teeth collected consecutively in a general practice over a 5-year period and extracted for reasons not related to this study. Based on clinical criteria, teeth were categorized as having normal pulps, reversible pulpitis, or irreversible pulpitis. The former 2 were grouped together because they represent similar conditions in terms of prognosis. Teeth were processed for histologic and histobacteriologic analyses, and pulps were categorized as healthy, reversibly inflamed, or irreversibly inflamed according to defined criteria. The number of matching clinical/histologic diagnosis was recorded. The clinical diagnosis of normal pulp/reversible pulpitis matched the histologic diagnosis in 57 of 59 (96.6%) teeth. Correspondence of the clinical and histologic diagnosis of irreversible pulpitis occurred in 27 of 32 (84.4%) cases. Infection advancing to the pulp tissue was a common finding in teeth with irreversible pulpitis but was never observed in normal/reversibly inflamed pulps. Findings using defined criteria for clinical and histologic classification of pulp conditions revealed a good agreement, especially for cases with no disease or reversible disease. This means that the classification of pulp conditions as normal pulps, reversible pulpitis, and irreversible pulpitis has high chances of guiding the correct therapy in the large majority of cases. However, there is still a need for refined and improved means for reliable pulp diagnosis. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  20. Abnormal bone scan : Importance of clinical correlation

    Directory of Open Access Journals (Sweden)

    Dharm Raj Singh

    2002-01-01

    Full Text Available A case of renal cell carcinoma which was diagnosed to have metastatic disease on the basis of two hot spots in ribs on bone scan, is presented. After careful and thor-ough history, it turned out to be fracture ribs which oc-curred due to bad positioning during radical nephrectoiny. This case highlights the importance of clinical judgement especially in the modern era of sophisticated investiga-tions.

  1. Hemoglobin Variants: Biochemical Properties and Clinical Correlates

    Science.gov (United States)

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

    2013-01-01

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

  2. Clinical correlation between hypercalciuria and nocturnal enuresis

    Directory of Open Access Journals (Sweden)

    Ehsan Valavi

    2011-01-01

    Full Text Available Hypercalciuria may present with dysuria, urinary incontinence and nocturnal enuresis (NE. To determine the frequency of hypercalciuria in NE patients and normally continent children, we studied 122 consecutive pre- school children with NE referred to our nephrology clinic during two years, from September 2007 to August 2009. We measured the 24- hour urinary calcium. Furthermore, we compared the response to nasal desmopressin in hypercalciuric and normocalciuric patients. Hypercalciuria was found in 26 (21.3 % of the NE patients as compared with five (4.5% of 110 continent children [(P 0.05. The response to desmopressin above 90% occurred within one month of therapy without a significant change in the levels of hypercalciuria. We conclude that these results suggest that hypercalciuria has a significant association with NE and does not interfere with the desmopressin therapy.

  3. Clinical Correlations as a Tool in Basic Science Medical Education

    Directory of Open Access Journals (Sweden)

    Brenda J. Klement

    2016-01-01

    Full Text Available Clinical correlations are tools to assist students in associating basic science concepts with a medical application or disease. There are many forms of clinical correlations and many ways to use them in the classroom. Five types of clinical correlations that may be embedded within basic science courses have been identified and described. (1 Correlated examples consist of superficial clinical information or stories accompanying basic science concepts to make the information more interesting and relevant. (2 Interactive learning and demonstrations provide hands-on experiences or the demonstration of a clinical topic. (3 Specialized workshops have an application-based focus, are more specialized than typical laboratory sessions, and range in complexity from basic to advanced. (4 Small-group activities require groups of students, guided by faculty, to solve simple problems that relate basic science information to clinical topics. (5 Course-centered problem solving is a more advanced correlation activity than the others and focuses on recognition and treatment of clinical problems to promote clinical reasoning skills. Diverse teaching activities are used in basic science medical education, and those that include clinical relevance promote interest, communication, and collaboration, enhance knowledge retention, and help develop clinical reasoning skills.

  4. Clinical Correlations as a Tool in Basic Science Medical Education.

    Science.gov (United States)

    Klement, Brenda J; Paulsen, Douglas F; Wineski, Lawrence E

    2016-01-01

    Clinical correlations are tools to assist students in associating basic science concepts with a medical application or disease. There are many forms of clinical correlations and many ways to use them in the classroom. Five types of clinical correlations that may be embedded within basic science courses have been identified and described. (1) Correlated examples consist of superficial clinical information or stories accompanying basic science concepts to make the information more interesting and relevant. (2) Interactive learning and demonstrations provide hands-on experiences or the demonstration of a clinical topic. (3) Specialized workshops have an application-based focus, are more specialized than typical laboratory sessions, and range in complexity from basic to advanced. (4) Small-group activities require groups of students, guided by faculty, to solve simple problems that relate basic science information to clinical topics. (5) Course-centered problem solving is a more advanced correlation activity than the others and focuses on recognition and treatment of clinical problems to promote clinical reasoning skills. Diverse teaching activities are used in basic science medical education, and those that include clinical relevance promote interest, communication, and collaboration, enhance knowledge retention, and help develop clinical reasoning skills.

  5. Prevalence and Clinical Correlates of Ventricular Arrhythmias on 24 ...

    African Journals Online (AJOL)

    This study examined the prevalence and clinical correlates of ventricular arrhythmias in individuals without apparent heart disease. Method 24-Hour ambulatory electrocardiogram was recorded in 60 apparently healthy subjects with normal echocardiography findings. Premature ventricular complex was analyzed and

  6. Clinical correlates of laboratory abnormalities in patients with severe ...

    African Journals Online (AJOL)

    Preeclampsia is adiseaseunique tohumanpregnancy.Severeproteinuria, thrombocytopenia and elevated creatinine levels arewell documented complications of the disease. We aimed to detect the frequency of these abnormalities in severe preeclamptics in Benin City, and to determine their clinical correlates.

  7. Developing a mentoring program in clinical nutrition.

    Science.gov (United States)

    Martindale, Robert G; McClave, Stephen; Heyland, Daren; August, David

    2010-01-01

    Mentoring programs in nutrition are essential to the survival of clinical nutrition as we know it today. The best method known to maintain an influx of talent to a discipline is by developing an active mentoring program. This paper describes 1 concept for development of a viable mentor program. Mentoring should be flexible and based on mentees' training background. Realistic goals should be set, with written and verbal feedback, to sustain a successful program. Programs should incorporate the Socratic Method whenever possible. Factors that leave doubt about the survival of nutrition as a viable area of focus for physicians include the inability to generate adequate funds to support oneself and limited numbers of mentors available with dedicated time to be a mentor. A healthy, sustainable mentoring program in clinical nutrition will ensure survival of physician-based nutrition programs.

  8. Workplace Correlates and Scholarly Performance of Clinical Pharmacy Faculty.

    Science.gov (United States)

    Jungnickel, Paul W.; Creswell, John W.

    1994-01-01

    This study sought to develop a correlate model of 3-year scholarly performance of 296 clinical pharmacy faculty. Participants were surveyed concerning refereed research, grants/books research, and nonresearch scholarship. Eight correlates, including two related to the departmental workplace, emerged as significant factors in scholarly performance.…

  9. Graduate Program Organization in Clinical Veterinary Medicine.

    Science.gov (United States)

    Horne, R. D.

    1979-01-01

    Graduate training in clinical veterinary medicine is discussed. The options available to the student and problems that must be dealt with are presented, along with the requirements to accomplish a finely structured program that satisfies the needs of both the trainee and clinical veterinary medicine. (Author/MLW)

  10. A modular radiative transfer program for gas filter correlation radiometry

    Science.gov (United States)

    Casas, J. C.; Campbell, S. A.

    1977-01-01

    The fundamentals of a computer program, simulated monochromatic atmospheric radiative transfer (SMART), which calculates atmospheric path transmission, solar radiation, and thermal radiation in the 4.6 micrometer spectral region, are described. A brief outline of atmospheric absorption properties and line by line transmission calculations is explained in conjunction with an outline of the SMART computational procedures. Program flexibility is demonstrated by simulating the response of a gas filter correlation radiometer as one example of an atmospheric infrared sensor. Program limitations, input data requirements, program listing, and comparison of SMART transmission calculations are presented.

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

    Science.gov (United States)

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

    2011-01-01

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

  12. Clinical Correlates of Depression among Diabetics in Jos, Nigeria ...

    African Journals Online (AJOL)

    Background: Studies have consistently shown that depression among diabetics is associated with poor glyceamic control and an increase risk for the complications of diabetes. However, few studies have look at the clinical correlates of depression among diabetics in this environment. The aim of this study was to identify ...

  13. Clinical training: a simulation program for phlebotomy

    Directory of Open Access Journals (Sweden)

    Araki Toshitaka

    2008-01-01

    Full Text Available Abstract Background Basic clinical skills training in the Japanese medical education system has traditionally incorporated on-the-job training with patients. Recently, the complementary use of simulation techniques as part of this training has gained popularity. It is not known, however, whether the participants view this new type of education program favorably; nor is the impact of this program known. In this study we developed a new simulation-based training program in phlebotomy for new medical residents and assessed their satisfaction with the program Methods The education program comprised two main components: simulator exercise sessions and the actual drawing of blood from other trainees. At the end of the session, we surveyed participant sentiment regarding the program. Results There were 43 participants in total. In general, they were highly satisfied with the education program, with all survey questions receiving scores of 3 or more on a scale of 1–5 (mean range: 4.3 – 4.8, with 5 indicating the highest level of satisfaction. Additionally, their participation as a 'patient' for their co-trainees was undertaken willingly and was deemed to be a valuable experience. Conclusion We developed and tested an education program using a simulator for blood collection. We demonstrated a high satisfaction level among the participants for this unique educational program and expect that it will improve medical training, patient safety, and quality of care. The development and dissemination of similar educational programs involving simulation for other basic clinical skills will be undertaken in the future.

  14. Early Repolarization Syndrome; Mechanistic Theories and Clinical Correlates.

    Science.gov (United States)

    Mercer, Ben N; Begg, Gordon A; Page, Stephen P; Bennett, Christopher P; Tayebjee, Muzahir H; Mahida, Saagar

    2016-01-01

    The early repolarization (ER) pattern on the 12-lead electrocardiogram is characterized by J point elevation in the inferior and/or lateral leads. The ER pattern is associated with an increased risk of ventricular arrhythmias and sudden cardiac death (SCD). Based on studies in animal models and genetic studies, it has been proposed that J point elevation in ER is a manifestation of augmented dispersion of repolarization which creates a substrate for ventricular arrhythmia. A competing theory regarding early repolarization syndrome (ERS) proposes that the syndrome arises as a consequence of abnormal depolarization. In recent years, multiple clinical studies have described the characteristics of ER patients with VF in more detail. The majority of these studies have provided evidence to support basic science observations. However, not all clinical observations correlate with basic science findings. This review will provide an overview of basic science and genetic research in ER and correlate basic science evidence with the clinical phenotype.

  15. Quantitative Susceptibility Mapping in Cerebral Cavernous Malformations: Clinical Correlations.

    Science.gov (United States)

    Tan, H; Zhang, L; Mikati, A G; Girard, R; Khanna, O; Fam, M D; Liu, T; Wang, Y; Edelman, R R; Christoforidis, G; Awad, I A

    2016-07-01

    Quantitative susceptibility mapping has been shown to assess iron content in cerebral cavernous malformations. In this study, our aim was to correlate lesional iron deposition assessed by quantitative susceptibility mapping with clinical and disease features in patients with cerebral cavernous malformations. Patients underwent routine clinical scans in addition to quantitative susceptibility mapping on 3T systems. Data from 105 patients met the inclusion criteria. Cerebral cavernous malformation lesions identified on susceptibility maps were cross-verified by T2-weighted images and differentiated on the basis of prior overt hemorrhage. Mean susceptibility per cerebral cavernous malformation lesion (χ̄lesion) was measured to correlate with lesion volume, age at scanning, and hemorrhagic history. Temporal rates of change in χ̄lesion were evaluated in 33 patients. Average χ̄lesion per patient was positively correlated with patient age at scanning (P cavernous malformation lesions with prior overt hemorrhages exhibited higher χ̄lesion than those without (P cavernous malformation lesions, higher mean quantitative susceptibility mapping signal in hemorrhagic lesions, and minimum longitudinal quantitative susceptibility mapping signal change in clinically stable lesions. Quantitative susceptibility mapping has the potential to be a novel imaging biomarker supplementing conventional imaging in cerebral cavernous malformations. The clinical significance of such measures merits further study. © 2016 by American Journal of Neuroradiology.

  16. Professional socialization of students in clinical nurse specialist programs.

    Science.gov (United States)

    Ares, Terri L

    2014-11-01

    Graduate nursing programs facilitate the transition of RNs to advanced roles through a complex process of professional socialization. The purpose of this study was to explore the professional socialization of clinical nurse specialist (CNS) students. Two hundred twenty-five students, representing 73 CNS programs, responded to an online survey. Both preprogram variables and educational experiences contributed to an adequate level of CNS socialization. Students' self-concept was strong, and they felt prepared to practice in the role, which was highly correlated with their perceptions of how well the program prepared them academically and experientially. Having a CNS mentor was positively associated with readiness to practice. Outcomes did not vary with cohort status, and online instruction did not impede socialization. These findings provide implications for CNS program advisement and design. Copyright 2014, SLACK Incorporated.

  17. Correlation of clinical disease severity to radiographic thumb osteoarthritis index.

    Science.gov (United States)

    Ladd, Amy L; Messana, Joseph M; Berger, Aaron J; Weiss, Arnold-Peter C

    2015-03-01

    To determine if a slight modification of the 1987 Eaton-Glickel staging and interpreting 4 standardized radiographs for trapeziometacarpal (TMC) osteoarthritis (OA) improved analysis, to determine if a quantifiable index measurement from a single Robert (pronated anteroposterior) view enhanced reproducibility, and to examine whether improved radiographic staging correlated to clinically relevant disease and thus support validity. We analyzed 4 thumb radiographs (posteroanterior, lateral, Robert, and stress views) in 60 consecutive subjects representing an adult population spectrum of asymptomatic to advanced disease. Two experienced hand surgeons (A.L.L. and A.P.C.W.), 1 chief resident (A.J.B.), and 1 medical student (J.M.M.) performed the analysis on each subject's radiographs. We analyzed all 4 radiographs for Eaton and modified Eaton staging and then later analyzed only the Robert view for the thumb osteoarthritis (ThOA) index measurement. The radiographs were randomized and reread a week later for each classification at separate times. Surgically excised trapeziums from 20/60 subjects were inspected for first metacarpal surface disease and correlated to the 3 classifications. All 3 staging classifications demonstrated high reproducibility, with the intraclass correlation coefficient averaging 0.73 for the Eaton, 0.83 for the modified Eaton, and 0.95 for the ThOA index. Articular wear and metacarpal surface eburnation correlated highest to the ThOA index, with advanced disease 1.55 or greater correlating to Eaton III/IV and modified Eaton stage 3/4 in a linear relationship. The ThOA index based on a Robert view provided a measurable alternative to Eaton staging and correlated to severity of surgically relevant thumb TMC OA. A simple reproducible radiographic measurement may enhance TMC OA classification and provide a reliable means to predict clinical disease. Diagnostic II. Copyright © 2015 American Society for Surgery of the Hand. Published by Elsevier Inc

  18. [Multicystic encephalomalacia: MR imaging findings and clinical correlation].

    Science.gov (United States)

    Coşkun, Abdulhakim; Mavili, Ertuğrul; Kumandaş, Sefer; Karahan, Okkeş Ibrahim; Imamoğlu, Hakan; Gümüş, Hakan

    2004-03-01

    To review the MR imaging findings of multicystic encephalomalacia and to investigate the correlation between MR imaging and clinical findings. Twenty-one patients who presented with convulsion, mental-motor retardation and microcephaly and had evidence of multicystic encephalomalacia on MR images were included in this study. MR imaging patterns and clinical findings were reviewed. Consequently, we correlated MR imaging findings and clinical outcome. All patients had cortical thinning, white matter destruction, atrophy and gliosis. Tetraplegia was seen in 17 out of 19 patients with mixed type cerebral palsy in two patients with diffuse or symmetric involvement on MR imaging. Both of the patients with mixed type cerebral palsy had basal ganglia involvement on MR imaging. Hemiplegia was seen in two patients with asymmetric involvement on MR imaging. Microcephaly was seen in 17 patients with diffuse or symmetrical, and in one patient with asymmetrical, involvement. Microcephaly and tetraplegia was seen in all patients with cerebellar and basal ganglion involvement. Microcephaly and spastic tetraplegia were developed mostly in patients with diffuse involvement, whereas hemiplegia was seen in patients with asymmetric involvement. The clinical outcome was worse in patients with cerebellar and brainstem involvement. Therefore, we supposed that the symmetry of lesions and cerebellar or brainstem involvement might be used as a prognostic indicator.

  19. Cortical echogenicity in the hemolytic uremic syndrome: clinical correlation.

    Science.gov (United States)

    Choyke, P L; Grant, E G; Hoffer, F A; Tina, L; Korec, S

    1988-08-01

    The initial renal sonograms of 15 patients, aged 8 months to 5 years, with hemolytic uremic syndrome (HUS) were reviewed. Ultrasound studies were graded according to cortical echogenicity relative to the liver, they were compared to the severity of the clinical syndrome at admission and to the ultimate outcome of the disease. The degree of cortical echogenicity correlated with the clinical outcome of HUS in 12 of the patients, whereas clinical assessment alone predicted outcome in 13 patients. Sonography overestimated severity in three patients with mild disease correctly assessed clinically, whereas clinical assessment overestimated severity in two patients with moderate disease in whom the sonographic assessment proved correct. The sonographic changes are most likely multifactorial. They appear to reflect a combination of platelet-thrombus deposition in the renal cortex, as well as the general fluid status of the patient. Ultrasound is useful in ruling out other causes of acute renal failure such as obstruction or congenital diseases. It cannot replace laboratory tests and clinical judgement, but nevertheless provides another index of severity in patients with HUS.

  20. Personality in Parkinson's disease: Clinical, behavioural and cognitive correlates.

    Science.gov (United States)

    Santangelo, Gabriella; Piscopo, Fausta; Barone, Paolo; Vitale, Carmine

    2017-03-15

    Affective disorders and personality changes have long been considered pre-motor aspects of Parkinson's disease (PD). Many authors have used the term "premorbid personality" to define distinctive features of PD patients' personality characterized by reduced exploration of new environmental stimuli or potential reward sources ("novelty seeking") and avoidance behaviour ("harm avoidance") present before motor features. The functional correlates underlying the personality changes described in PD, implicate dysfunction of meso-cortico-limbic and striatal circuits. As disease progresses, the imbalance of neurotransmitter systems secondary to degenerative processes, along with dopamine replacement therapy, can produce a reversal of behaviours and an increase in reward seeking, laying the foundations for the emergence of the impulse control disorders. Personality disorders can be interpreted, therefore, as the result of individual susceptibility arising from intrinsic degenerative processes and individual personality features, in combination with extrinsic factors such as lifestyle, PD motor dysfunction and drug treatment. For a better understanding of personality disorders observed in PD and their relationship with the prodromal stage of the disease, prospective clinical studies are needed that correlate different personality profiles with other disease progression markers. Here, we review previous studies investigating the clinical, cognitive and behavioural correlates of personality traits in PD patients. Copyright © 2017 Elsevier B.V. All rights reserved.

  1. Progressive demyelinating neuropathy correlates with clinical severity in Cockayne syndrome.

    Science.gov (United States)

    Gitiaux, Cyril; Blin-Rochemaure, Nathalie; Hully, Marie; Echaniz-Laguna, Andoni; Calmels, Nadège; Bahi-Buisson, Nadia; Desguerre, Isabelle; Dabaj, Ivana; Wehbi, Samer; Quijano-Roy, Susana; Laugel, Vincent

    2015-07-01

    Cockayne syndrome (CS) is characterized by postnatal growth failure and progressive multi-organ dysfunctions. CSA and CSB gene mutations account for the majority of cases and three degrees of severity are delineated. A peripheral neuropathy is known to be associated with CS but the type, severity and correlation of the nerve involvement with CS subtypes remain unknown in genetically identified patients. Clinical and nerve conduction studies (NCS) in 25 CS patients with CSA (n=13) CSB (n=12) mutations. NCS show a widespread decrease in motor and sensory conduction velocities (CV) in all severe and classical form of CS. In one patient, CV were normal at age 8months but severe slowing was detected at 2years. Conduction block and/or temporal dispersion were observed in 68% of patients. CS is associated with a progressive sensory and motor neuropathy. Signs of segmental demyelination, including conduction blocks, may not be obvious before the age of 2years. CV slowing is correlated with the CS clinical severity. NCS should be performed in patients with suspected CS as an additional tool to guide the diagnosis before molecular studies. Further studies focused on NCS course are required in order to assess its relevance as a biomarker in research therapy projects. Copyright © 2014 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

  2. Non tumoral intracranial expansive processes: clinical-tomographic correlation

    Directory of Open Access Journals (Sweden)

    Patricia Campos

    1991-09-01

    Full Text Available Presentation of clinical-tomographic correlation in 111 cases of non tumoral intracranial expansive processes seen between 1984-1988 in the Hospital Cayetano Heredia (Lima, Peru. Emphasis is given fundamentally to: (1 the importance of stablishing the or-ganicity of partial and late epilepsy; (2 the high incidence rate of inflammatory infectious processes with CNS compromise in underdeveloping countries; (3 the necessity of making public the importance of two parisitic diseases in the differential diagnosis of non tumoral intracranial expansive processes: free living amebiasis, and toxoplasmosis (especially in association with AIDS.

  3. [Anatomical and clinical correlations in the cerebellar eredodegeneration].

    Science.gov (United States)

    Pea, Umberto; de Luca, Francesco; Nicola, Massimiliano; Galli, Luigi

    2003-06-01

    Spinocerebellar hereditary degeneration makes up a heterogeneous group of diseases headed by Strumpell-Lorrain syndrome and Friedreich's disease. They are a heterogeneous group characterized by spasticity and paraplegia and related to demyelinization of the pyramidal tract and of the posterior cordons. During a 4-year period, we studied 14 patients (42-61 years old) suffering cerebellar eredodegeneration (hereditary ataxia). The aim of our work was to correlate anatomopathological findings with clinical signs. The important role played by the cerebellum in vesicosphincterial coordination was shown; in particular severe alteration of the ponto-cerebellar bundles could be cause of the abnormal behaviour of the detrusor.

  4. Pretreatment Mitochondrial Priming Correlates with Clinical Response to Cytotoxic Chemotherapy

    Science.gov (United States)

    Chonghaile, Triona Ni; Sarosiek, Kristopher A.; Vo, Thanh-Trang; Ryan, Jeremy A.; Tammareddi, Anupama; Moore, Victoria Del Gaizo; Deng, Jing; Anderson, Ken; Richardson, Paul; Tai, Yu-Tzu; Mitsiades, Constantine S.; Matulonis, Ursula A.; Drapkin, Ronny; Stone, Richard; DeAngelo, Daniel J.; McConkey, David J.; Sallan, Stephen E.; Silverman, Lewis; Hirsch, Michelle S.; Carrasco, Daniel Ruben; Letai, Anthony

    2011-01-01

    Cytotoxic chemotherapy targets elements common to all nucleated human cells, such as DNA and microtubules, yet it selectively kills tumor cells. Here we show that clinical response to these drugs correlates with, and may be partially governed by, the pre-treatment proximity of tumor cell mitochondria to the apoptotic threshold, a property called mitochondrial priming. We used BH3 profiling to measure priming in tumor cells from patients with multiple myeloma, acute myelogenous and lymphoblastic leukemia, and ovarian cancer. This assay measures mitochondrial response to peptides derived from pro-apoptotic BH3 domains of proteins critical for death signaling to mitochondria. Patients with highly primed cancers exhibited superior clinical response to chemotherapy. In contrast, chemoresistant cancers and normal tissues were poorly primed. Manipulation of mitochondrial priming might enhance the efficacy of cytotoxic agents. PMID:22033517

  5. Characteristics of liver cancer stem cells and clinical correlations.

    Science.gov (United States)

    Cheng, Zhuo; Li, Xiaofeng; Ding, Jin

    2016-09-01

    Liver cancer is an aggressive malignant disease with a poor prognosis. Patients with liver cancer are usually diagnosed at an advanced stage and thus miss the opportunity for surgical resection. Chemotherapy and radiofrequency ablation, which target tumor bulk, have exhibited limited therapeutic efficacy to date. Liver cancer stem cells (CSCs) are a small subset of undifferentiated cells existed in liver cancer, which are considered to be responsible for liver cancer initiation, metastasis, relapse and chemoresistance. Elucidating liver CSC characteristics and disclosing their regulatory mechanism might not only deepen our understanding of the pathogenesis of liver cancer but also facilitate the development of diagnostic, prognostic and therapeutic approaches to improve the clinical management of liver cancer. In this review, we will summarize the recent advances in liver CSC research in terms of the origin, identification, regulation and clinical correlation. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    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.

  7. Vaginismus and its correlates in an Iranian clinical sample.

    Science.gov (United States)

    Farnam, F; Janghorbani, M; Merghati-Khoei, E; Raisi, F

    2014-01-01

    Although vaginismus is a relatively common female sexual dysfunction in Iran, there are scant studies reporting on its clinical and social features. The aim of the present study was to compare the social and clinical characteristics of women with vaginismus with those of healthy women. The study comprises 22 patients with vaginismus and 22 healthy controls who presented to the health clinics of Tehran University of Medical Sciences, Iran. We used three assessment tools: interview, a (34-item) questionnaire for demographic and clinical characteristics of vaginismus and a 13-item questionnaire of Female Sexual Distress Scale-Revised (FSDS-R) for sexual distress. The majority (73%) of women with vaginismus had primary vaginismus (unconsummated marriage). These women demonstrated significant higher phobia than healthy women, including fear of genital pain and penetration, fear of bleeding during intercourse, height phobia, aversion to looking or touching the genitalia, fear of vaginal disproportion and also disgust of semen. Compared with the healthy women, these women displayed a significantly higher sexual distress score, defecation or urination problems, general anxiety, higher education levels and lower self-esteem. Our findings suggest that there is a strong correlation between vaginismus, phobia and anxiety.

  8. Correlation between demographic and clinical variables and fibromyalgia severity.

    Science.gov (United States)

    Martinez, José Eduardo; Casagrande, Pâmela de Melo; Ferreira, Paula Pratti Rodrigues; Rossatto, Bruno Luigi Giaccio

    2013-01-01

    Fibromyalgia (FM) is a rheumatic condition characterized by a picture of generalized chronic pain, hyperalgesia and allodynia. Symptoms such as fatigue, sleep disorders, morning stiffness, headache and paresthesia can also be present. It is also associated with other comorbidities, such as depression, anxiety, irritable bowel syndrome, myofascial pain syndrome and nonspecific urethral syndrome. Few studies have addressed the evolution of FM, especially regarding medium and long-term evolution, such as why some patients do better than others, despite the fact of being submitted to the same treatment. To determine whether there is a correlation between demographic and clinical variables and FM severity. Sixty women who met the classification criteria for FM of the American College of Rheumatology of 1990 were divided into three groups, according to the severity established by the Fibromyalgia Impact Questionnaire (FIQ): severe (70-100), moderate (50 to 70) and mild (0 to 50). Nine demographic and clinical variables were assessed, with a significant difference (P <0.05) being observed only in the groups showing higher FIQ scores with the presence of depression and workers' compensation interests. The impact of FM measured by the FIQ is directly correlated with the severity of depression and the presence of workers' compensation interests.

  9. Clinical color vision testing and correlation with visual function.

    Science.gov (United States)

    Zhao, Jiawei; Davé, Sarita B; Wang, Jiangxia; Subramanian, Prem S

    2015-09-01

    To determine if Hardy-Rand-Rittler (H-R-R) and Ishihara testing are accurate estimates of color vision in subjects with acquired visual dysfunction. Assessment of diagnostic tools. Twenty-two subjects with optic neuropathy (aged 18-65) and 18 control subjects were recruited prospectively from an outpatient clinic. Individuals with visual acuity (VA) color blindness were excluded. All subjects underwent a comprehensive eye examination including VA, color vision, and contrast sensitivity testing. Color vision was assessed using H-R-R and Ishihara plates and Farnsworth D-15 (D-15) discs. D-15 is the accepted standard for detecting and classifying color vision deficits. Contrast sensitivity was measured using Pelli-Robson contrast sensitivity charts. No relationship was found between H-R-R and D-15 scores (P = .477). H-R-R score and contrast sensitivity were positively correlated (P = .003). On multivariate analysis, contrast sensitivity (β = 8.61, P color identification in patients with optic neuropathy. Both H-R-R and Ishihara testing are correlated with contrast sensitivity, and these tests may be useful clinical surrogates for contrast sensitivity testing. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. Oxidative stress and aging: correlation with clinical parameters.

    Science.gov (United States)

    da Cruz, Ana Carla; Petronilho, Fabricia; Heluany, Claudia Cipriano Vidal; Vuolo, Francieli; Miguel, Samantha Pereira; Quevedo, João; Romano-Silva, Marco Aurélio; Dal-Pizzol, Felipe

    2014-02-01

    The free radical theory of aging has been receiving a lot of attention in the past years. The aim of this study was to examine the correlation between oxidative damage, antioxidant enzyme activities and plasma antioxidant potential with clinical parameters in elderly people. Elderly subjects over 80 years old were included in the study. Clinical data were collected based on the Cumulative Illness Rating Scale (n = 132). In addition, blood samples were collected to determine biochemical and oxidative stress. The results showed that the mean age of the participants was 85.1 ± 4.0 years old. Diabetic patients presented higher plasma protein carbonyl levels when compared with non-diabetic, and plasma levels of thiobarbituric acid-reactive substances were correlated to serum triglyceride and LDL fraction. In contrast, a lower plasma total antioxidant capacity presented a relation with the presence of diabetes and arterial hypertension. In addition, healthy elderly subjects presented a higher plasma total antioxidant capacity. Thus, it seemed that plasma antioxidant potential is a better predictor of successful aging in the elderly than oxidative damage parameters or plasma antioxidant enzyme activities.

  11. Gray Matter Changes in Demyelinating Disease: Correlations with Clinical Scores.

    Science.gov (United States)

    Onu, Mihaela; Aroceanu, Adina; Ferastraoaru, Victor; Bajenaru, Ovidiu

    2015-09-01

    Recent MR studies have shown that, in multiple sclerosis, selective regional, but not global gray matter atrophy occurs in multiple sclerosis. Our aim was to identify specific areas of gray matter volume changes and explore the relationship between atrophy and clinical motor outcomes. Nine patients with relapsing remitting MS and 9 matched healthy controls were recruited. The Multiple Sclerosis Functional Composite was administered. For MR acquisitions, a GE- Genesis- Signa, 1.5T MR system, was used. A voxel-based morphometry (VBM), subcortical structures segmentation (FIRST) and volumetric (SIENAx) FSL tools were used in the study. Group comparison showed atrophy for several gray matter regions. The most important volume reductions were found for subcortical deep gray matter areas. Correlations with clinical scores were checked and specific gray matter areas showed significant volume reductions associated with motor scores (9-hole peg time and 25-feet walk time) and EDSS (Expanded Disability Status Scale). We performed a voxelwise analysis of gray matter changes in MS and found a more prominent atrophy for the subcortical structures than for cortical gray matter. Using an additional analysis (FIRST and SIENAx segmentation/volumetry) we were able to confirm the VBM results and to quantify the degree of atrophy in specific structures. Specific gray matter regions which volume reductions correlate with 25-feet walk, 9-hole peg times and EDSS suggest that 25-feet walk time is the best predictor of disease progression in terms of gray matter reduction.

  12. Correlation between the limit values of laboratory and clinical mycotoxicosis

    Directory of Open Access Journals (Sweden)

    Stojanov Igor M.

    2013-01-01

    Full Text Available Analysis of feed for the presence of fungi and mycotoxins is a request necessary to meet in order to ensure a healthy and economical production in livestock. These tests are related to legal regulation which prescribes the maximum legislated content (MLC, both for the presence of mycotoxins and the total number of fungi in certain feeds. Health problems that can occur during the production of animals are sometimes caused by the presence of mycotoxins in the feed. Laboratory testing is a good practice to confirm a suspicion, and allows timely treatment of contaminated feed. Potential problems arise under circumstances when there is a clinical outcome of mycotoxicosis and animal and laboratory findings suggest that the obtained values are below the level that is within the MLC. For these reasons, the subject of our research was to investigate the occurrence of mycotoxins and mold in feed, as well as the clinical presentation for animals that were fed with the feed with allowed values of these agents according to the recommended levels. The aim of this paper was to highlight the problems associated with clinical correlation of sick animals and laboratory findings, and suggest their overcoming. In the period of one year, a total of 176 samples of feed (complete mixture for broilers, corn and soy products were examined for the presence of fungi, 106 samples were examined for the presence of mycotoxins and 26 flocks of broilers and turkeys were clinically observed. Standard methods were used for isolation of molds and the ELISA test was used for the detection of mycotoxins. Clinical and pathomorphological observation of the flocks was done to determine the natural indicators of production. Studies indicated a problem because clinical and pathomorphological findings in some cases were not correlated with laboratory findings of molds and mycotoxins in the feed, and in some cases it did not necessarily mean that the animals were healthy. Synergism and

  13. Transfusional hemosiderosis; correlation of MR findings with clinical findings

    Energy Technology Data Exchange (ETDEWEB)

    Park, Mi Ok; Kim, Ju Heon; Jeon, Woo Jin; Lee, Sung Moon; Kim, Hong; Suh, Soo Jhi [School of Medicine, Keimyung University, Taegu (Korea, Republic of)

    1994-08-15

    Parenchymal iron deposition occurs in hemochromatosis, while iron is deposited in reticuloendothelial cells after blood transfusions(Hemosiderosis). We studied correlation between MR finding and clinical findings(serum ferritin, TSI, LFT, disease duration) of hemosiderosis. 12 patients with chronic renal failure and one patient with aplastic anemia, who have received multiple transfusion, were performed MRI with a 2.0 Tesla unit. In all of 13 patients(17 cases), the liver revealed low signal intensity equal to background noise. In 4 of 17 cases whose serum ferritin level was below 1000 ng/ml, pancreas, gastric wall, adrenal gland were involved in 1 case. In 4 cases with serum ferritin level between 1000 and 1500, pancreas was involved in 2 cases, and other organ was involved in 1 case. In 9 cases with serum ferritin level above 1500ng/ml, pancreas was involved in 9 cases, and other origin 4 cases. The MR findings are well correlated with serum ferritin level whereas the TSI, LFT, disease duration are not correlated with involved organ on MR.

  14. Clinical correlations of steroid receptors and male breast cancer.

    Science.gov (United States)

    Everson, R B; Lippman, M E; Thompson, E B; McGuire, W L; Wittliff, J L; De Sombre, E R; Jensen, E V; Singhakowinta, A; Brooks, S C; Neifeld, J P

    1980-04-01

    Estrogen receptors (ER) were present in tumor specimens from 29 of 34 cases of male breast cancer. There was a significant negative correlation of ER concentration with age. The quantity of ER tended to correlate directly with progesterone receptor levels, disease-free interval, and response duration among responders, but not to a statistically significant extent. In 13 patients for whom response data were available, no significant correlation was observed between ER levels and either frequency or duration of orchiectomy response. Among the six patients with tumor ER levels of less than 30 fmol per mg of protein, however, only two brief responses to orchiectomy occurred that were of little clinical benefit, while three of seven patients with higher ER responded more favorably. Thus, although this suggests that a relationship between low ER and unfavorable orchiectomy response may emerge as more patients are studied, currently available data do not justify basing therapeutic intervention on ER status of a biopsy in a manner analogous to that used for female breast cancer. Nine of 14 male breast cancer patients had positive progesterone receptor assays and several had androgen or glucocorticoid receptors. Tissue from only three of ten men with gynecomastia had measurable ER, and these were limited to the 4S component on sucrose gradients.

  15. Diffusion abnormality maps in demyelinating disease: correlations with clinical scores.

    Science.gov (United States)

    Onu, Mihaela; Roceanu, Adina; Sboto-Frankenstein, Uta; Bendic, Robert; Tarta, Eugen; Preoteasa, Florentin; Bajenaru, Ovidiu

    2012-03-01

    Magnetic resonance imaging (MRI) has been explored as a noninvasive tool to assess pathology in multiple sclerosis (MS) patients. However, the correlation between classical MRI measures and physical disability is modest in MS. The diffusion tensor imaging (DTI) MRI technique holds particular promise in this regard. The present study shows brain regions where FA and individual diffusivities abnormalities are present and check their correlations with physical disability clinical scores. Eight patients and 12 matched healthy controls were recruited. The Multiple Sclerosis Functional Composite was administered. For MR-DTI acquisitions, a Genesis Signa 1.5 T MR system, an EP/SE scanning sequence, 25 gradient directions were used. Tract Based Spatial Statistics (TBSS) group comparisons showed reduced FA and increased individual diffusivities in several brain regions in patients. Significant correlations were found between FA and: EDSS, 9-HPT(NON)DOM and 25 FW score; between λ2 and: P100 (r&l), 9-HPT(NON)DOM and 25 FW; between λ3 and: 9-HPT(NON)DOM and 25 FW score. Fractional anisotropy and individual radial diffusivities proved to be important markers of motor disabilities in MS patients when the disease duration mean and the disability scores values range are relatively high. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  16. Glutaric aciduria type 1: neuroimaging features with clinical correlation

    Energy Technology Data Exchange (ETDEWEB)

    Mohammad, Shaimaa Abdelsattar; Ahmed, Khaled A. [Ain-Shams University, Department of Radiodiagnosis, Faculty of Medicine, Cairo (Egypt); Abdelkhalek, Heba Salah; Zaki, Osama K. [Ain-Shams University, Medical Genetics Unit, Pediatric Department, Faculty of Medicine, Cairo (Egypt)

    2015-10-15

    Glutaric aciduria type 1 is a rare neurometabolic disease with high morbidity. To describe the MR imaging abnormalities in glutaric aciduria type 1 and to identify any association between the clinical and imaging features. MRI scans of 29 children (mean age: 16.9 months) with confirmed diagnosis of glutaric aciduria type 1 were retrospectively reviewed. Gray matter and white matter scores were calculated based on a previously published pattern-recognition approach of assessing leukoencephalopathies. Hippocampal formation and opercular topography were assessed in relation to the known embryological basis. MRI scores were correlated with morbidity score. The most consistent MRI abnormality was widened operculum with dilatation of the subarachnoid spaces surrounding underdeveloped frontotemporal lobes. Incomplete hippocampal inversion was also seen. The globus pallidus was the most frequently involved gray matter structure (86%). In addition to the central tegmental tract, white matter abnormalities preferentially involved the central and periventricular regions. The morbidity score correlated with the gray matter abnormality score (P = 0.004). Patients with dystonia had higher gray matter and morbidity scores. Morbidity is significantly correlated with abnormality of gray matter, rather than white matter, whether secondary to acute encephalopathic crisis or insidious onset disease. (orig.)

  17. MR findings of cerebral palsy and clinical correlation

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Sun Ho; Kim, In One; Kim, Woo Sun; Yeon, Kyung Mo [Seoul National Univ. College of Medicine, Seoul (Korea, Republic of)

    1997-04-01

    To demonstrate MR findings of cerebral palsy (CP), correlation with clinical findings, and differences between the full-term and pre-term group. Brain MRI of 94 patients with cerebral palsy (CP) were reviewed. The frequency of each MR finding, statistical correlation with clinical findings including type, severity and extent of CP, and differences between the full-term and pre-term group were analyzed. Abnormal MR findings were found in 83 patients(88%), and were as follows : diffuse brain atrophy(30%); periventricular leukomalacia(PVL)(28%); infarction(11%), basal ganglia abnormality(11%); delayed myelination(10%); nonspecific tissue loss or encephalomalacia(9%); and cortical dysplasia(7%). Hemiplegia was the most common condition among patients with infarction, and was found in 80% of this group; diplegia was found in 50% of cases with diffuse brain atrophy, while paraplegia was found in 36% of those with normal MR findings (p < .05). Mild symptoms were dominant in patients with normal MR findings(82%) and in those with infarctions(90%)(p < .05). PVL was the dominant finding in the pre-term group (65%) whereas findings in the full-term group varied; in this group, 38% of MR findings suggested prenatal insults. Possible causative factors were found in 66% of the full-term and 80% of the pre-term group. Perinatal factors were dominant in the pre-term group(81%), whereas prenatal and postnatal factors showed relatively higher frequencies in the full-term group(30% and 24%, respectively). Diffuse brain atrophy and PVL were the most common MR findings. The extent of CP the pre-term correlated well with MR findings. PVL and perinatal factors were dominant in the pre-term group, whereas variable MR findings and relatively higher frequencies of pre- and postnatal factors were found in the full-term group.

  18. Bronchopulmonary dysplasia: correlation of radiographic and clinical findings

    Energy Technology Data Exchange (ETDEWEB)

    Breysem, L. [Department of Radiology, University Hospitals, K. U. Leuven, Herestraat 49, B-3000 Leuven (Belgium); Smet, M.H. [Department of Radiology, University Hospitals, K. U. Leuven, Herestraat 49, B-3000 Leuven (Belgium); Lierde, S. van [Department of Pediatrics, University Hospitals of Leuven, Leuven (Belgium); Devlieger, H. [Department of Pediatrics, University Hospitals of Leuven, Leuven (Belgium); Boeck, K. de [Department of Pediatrics, University Hospitals of Leuven, Leuven (Belgium); Marchal, G. [Department of Radiology, University Hospitals, K. U. Leuven, Herestraat 49, B-3000 Leuven (Belgium)

    1997-08-01

    Background and purpose. Abnormalities of the chest wall have been described in bronchopulmonary dysplasia (BPD). Clinical, radiographic and pulmonary function variables were evaluated in 1-year-old children ventilated because of neonatal lung disease in order to quantify these thoracic changes and to evaluate the lung disease. Methods. The pulmonary status of 51 infants with neonatal lung disease requiring artificial ventilation was reevaluated clinically and radiographically at the age of 1 year. Twenty-two of these infants had developed BPD. Thoracic depth and width were measured clinically and on chest X-ray. The Toce score evaluated the presence of cardiomegaly, hyperinflation, emphysema and interstitial lung disease. Lung function was measured after sedation using previously reported methods. In BPD patients, Toce score and lung function were determined and compared at 1 month and at 1 year of age. Results. In BPD patients, chest depth was significantly smaller when measured clinically as well as on chest radiograph (P < 0.05; Mann-Whitney U-test). There was a statistically significant correlation between chest depth measured clinically and on chest X-ray. Toce score was significantly higher in BPD patients (P < 0.05). In BPD patients intersitial abnormalities and decreased lung compliance were more frequent at the age of 1 month than at the age of 1 year. At the age of 1 year, hyperinflation was more frequent and at that time increased airway resistance was still noted. Thus the type of X-ray abnormality reflects the type of lung function disturbance. Conclusion. The flatness of the chest is most likely a consequence of the long-standing lung function abnormalities. (orig.). With 3 figs., 6 tabs.

  19. Clinical measurement of von Willebrand factor by fluorescence correlation spectroscopy.

    Science.gov (United States)

    Torres, Richard; Genzen, Jonathan R; Levene, Michael J

    2012-06-01

    Identification of von Willebrand factor (vWF) abnormalities in a variety of conditions is hampered by the limitations of currently available diagnostic tests. Although direct multimer visualization by immunoelectrophoresis is a commonly used method, it is impractical as a routine clinical test. In this study, we used a biophysical analysis tool, fluorescence correlation spectroscopy (FCS), to measure vWF distributions. The goals were to develop a method that is quicker and simpler than vWF gel electrophoresis and to evaluate the potential of FCS as a clinical diagnostic technique. We analyzed plasma from 12 patients with type 1 von Willebrand disease (vWD), 14 patients with type 2 vWD, and 10 healthy controls using a fluctuation-based immunoassay approach. FCS enabled identification and proper classification of type 1 and type 2 vWD, producing quantitative results that correspond to qualitative gel multimer patterns. FCS required minimal sample preparation and only a 5-min analysis time. This study represents the first implementation of FCS for clinical diagnostics directly on human plasma. The technique shows potential for further vWF studies and as a generally applicable laboratory test method.

  20. Radiographic findings of gastrointestinal anisakiasis: clinical and pathologic correlation

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Tae Woong; Kang, Heoung Keun; Jeong, Yong Yeon [Medical School, Chonnam University, Kwangju (Korea, Republic of); And Others

    2000-08-01

    To evaluate the radiographic findings of gastrointestinal anisakiasis with clinical and pathologic correlation. In ten patients, findings were retrospectively analysed. There were two cases of the gastric variety of gastrointestinal anisakiasis and eight of the intestinal, and they were diagnosed during gastroscopy, by resection during surgery, and on the basis of typical clinical findings. All ten patients underwent both plain radiography and CT scanning of the abdomen. US was performed in five patients and an upper gastrointestinal series in one. Clinical data were evaluated with regard to a history of raw fish ingestion, time from ingestion of raw fish to onset of symptoms, location of abdominal pain, and laboratory data. Radiologic findings were analysed in terms of wall thickening and appearance, mesenteric infiltration, bowel dilatation proximal to lesion, and ascites. All patients had a history of recent ingestion of raw fish and complained of severe abdominal pain that occurred approximately 7-48 hours later. Pain occurred in the lower abdomen in five patients, the epigastrium in four, and the right lower abdomen in two. Laboratory test disclosed the leukocytosis in eight patients and eosinophilia in three. In all cases of intestinal anisakiasis, ileus was demonstrated on plain radiographs of the abdomen, while the upper gastrointestinal series showed mucosal thickening and multiple filling defects. US findings were bowel thickening and dilation, and on CT images, wall thickening revealed a target sign. Mesenteric infiltration and ascites were seen in seven patients. In four who underwent surgery, a cross-section through the lesion revealed submucosal eosinophilic granuloma with anisakis larva. Although the CT findings are non-specific, taken in conjunction with characteristic clinical findings, they may be helpful in the diagnosis of gastrointestinal anisakiasis. (author)

  1. Clinical correlates of resilience factors in geriatric depression.

    Science.gov (United States)

    Laird, Kelsey T; Lavretsky, Helen; Paholpak, Pattharee; Vlasova, Roza M; Roman, Michael; St Cyr, Natalie; Siddarth, Prabha

    2018-01-16

    Traditional perspectives conceptualize resilience as a trait and depression as resulting from resilience deficiency. However, research indicates that resilience varies substantially even among adults who are clinically depressed, as well as across the lifespan of an individual. Few studies have investigated resilience in depression, and even fewer have examined resilience in depressed older adults. Three hundred thirty-seven adults ≥60 years with major depressive disorder completed the Connor-Davidson Resilience Scale (CD-RISC) and measures of mental health, quality of life (QOL), and medical comorbidity. Exploratory factor analysis was used to explore the factor structure of the CD-RISC. Correlations and general linear models were used to examine associations between resilience and other variables. The rotated component matrix indicated a four-factor model. Sorting of items by highest factor loading revealed constructs associated with (1) grit, (2) active coping self-efficacy, (3) accommodative coping self-efficacy, and (4) spirituality. Resilience was significantly correlated with increased age, lower cognitive functioning, greater cerebrovascular risk, and greater medical comorbidity. Resilience was negatively associated with mental health symptoms (depression, apathy, and anxiety) and positively associated with QOL. The final optimal model identified less depression, less apathy, greater medical comorbidity, higher QOL, and minority (non-White) race as factors that significantly explained variability in resilience. Resilience was significantly associated with a range of mental health constructs in a sample of older adults with depression. Future clinical trials and dismantling studies may help determine whether interventions targeting grit, active coping, accommodative coping, and spirituality can increase resilience and help prevent and treat depression in older adults.

  2. Correlation between bullying and clinical depression in adolescent patients

    Directory of Open Access Journals (Sweden)

    Kaltiala-Heino R

    2011-03-01

    Full Text Available Riittakerttu Kaltiala-Heino1, Sari Fröjd21University of Tampere Medical School, Tampere, Finland; 2Tampere School of Public Health, University of Tampere, FinlandAbstract: A literature review of the associations between involvement in bullying and depression is presented. Many studies have demonstrated a concurrent association between involvement in bullying and depression in adolescent population samples. Not only victims but also bullies display increased risk of depression, although not all studies have confirmed this for the bullies. Retrospective studies among adults support the notion that victimization is followed by depression. Prospective follow-up studies have suggested both that victimization from bullying may be a risk factor for depression and that depression may predispose adolescents to bullying. Research among clinically referred adolescents is scarce but suggests that correlations between victimization from bullying and depression are likely to be similar in clinical and population samples. Adolescents who bully present with elevated numbers of psychiatric symptoms and psychiatric and social welfare treatment contacts.Keywords: depression, bullying, adolescence 

  3. Gray Matter Pathology in MS: Neuroimaging and Clinical Correlations

    Science.gov (United States)

    Honce, Justin Morris

    2013-01-01

    It is abundantly clear that there is extensive gray matter pathology occurring in multiple sclerosis. While attention to gray matter pathology was initially limited to studies of autopsy specimens and biopsies, the development of new MRI techniques has allowed assessment of gray matter pathology in vivo. Current MRI techniques allow the direct visualization of gray matter demyelinating lesions, the quantification of diffuse damage to normal appearing gray matter, and the direct measurement of gray matter atrophy. Gray matter demyelination (both focal and diffuse) and gray matter atrophy are found in the very earliest stages of multiple sclerosis and are progressive over time. Accumulation of gray matter damage has substantial impact on the lives of multiple sclerosis patients; a growing body of the literature demonstrates correlations between gray matter pathology and various measures of both clinical disability and cognitive impairment. The effect of disease modifying therapies on the rate accumulation of gray matter pathology in MS has been investigated. This review focuses on the neuroimaging of gray matter pathology in MS, the effect of the accumulation of gray matter pathology on clinical and cognitive disability, and the effect of disease-modifying agents on various measures of gray matter damage. PMID:23878736

  4. Black holes in multiple sclerosis: definition, evolution, and clinical correlations.

    Science.gov (United States)

    Sahraian, M A; Radue, E-W; Haller, S; Kappos, L

    2010-07-01

    Magnetic resonance imaging (MRI) is a sensitive paraclinical test for diagnosis and assessment of disease progression in multiple sclerosis (MS) and is often used to evaluate therapeutic efficacy. The formation of new T2-hyperintense MRI lesions is commonly used to measure disease activity, but lacks specificity because edema, inflammation, gliosis, and axonal loss all contribute to T2 lesion formation. As the role of neurodegeneration in the pathophysiology of MS has become more prominent, the formation and evolution of chronic or persistent Tl-hypointense lesions (black holes) have been used as markers of axonal loss and neuronal destruction to measure disease activity. Despite the use of various detection methods, including advanced imaging techniques such as magnetization transfer imaging and magnetic resonance spectroscopy, correlation of persistent black holes with clinical outcomes in patients with MS remains uncertain. Furthermore, although axonal loss and neuronal tissue destruction are known to contribute to irreversible disability in patients with MS, there are limited data on the effect of therapy on longitudinal change in Tl-hypointense lesion volume. Measurement of black holes in clinical studies may elucidate the underlying pathophysiology of MS and may be an additional method of evaluating therapeutic efficacy.

  5. Clinical correlates of memory complaints during AED treatment.

    Science.gov (United States)

    Mula, M; von Oertzen, T J; Cock, H R; Lozsadi, D A; Agrawal, N

    2016-11-01

    To investigate clinical correlates of memory complaints (MC) during anti-epileptic drug (AEDs) treatment in adults with epilepsy with special attention to the role of depression, using user-friendly standardized clinical instruments which can be adopted in any outpatient setting. Data from a consecutive sample of adult outpatients with epilepsy assessed with the Neurological Disorder Depression Inventory for Epilepsy (NDDIE), the Adverse Event Profile (AEP) and the Emotional Thermometer (ET) were analysed. From a total sample of 443 patients, 28.4% reported MC as 'always' a problem. These patients were less likely to be seizure free (18.3% vs 34.3%; P a high number of previous AED trials (4 vs 3; P AED type or combination. Depression was the major determinant with a 2-fold increased risk (95%CI 1.15-3.86; P = 0.016). When depression was already known and under treatment, patients with MC were less likely to be in remission from depression despite antidepressant treatment (11.9% vs 1.6% P A/S. Published by John Wiley & Sons Ltd.

  6. Spinal dural arteriovenous fistula: correlation between radiological and clinical findings.

    Science.gov (United States)

    Yen, Peggy P W; Ritchie, Krista C; Shankar, Jai Jai Shiva

    2014-11-01

    The pathophysiology of spinal dural arteriovenous fistulas (SDAVFs) results in perimedullary venous congestion and in turn central cord congestion. Clinically, this presents with progressive neurological dysfunctions that, if diagnosed in a timely fashion, can be at least halted and in part reversed. In SDAVFs, imaging features on MRI and digital subtraction angiography (DSA) have not been studied in conjunction with clinical findings. The primary purpose of the present study was to test if severity of clinical presentation varies in relation to imaging. This retrospective cohort study identified 12 patients treated for SDAVF at the authors' institution. The extent of venous congestion and cord edema was quantified by the number of vertebral levels shown to be affected on DSA and MRI. A modified Aminoff-Logue Scale (ALS) score was assigned at the time of diagnosis and again after definitive therapy. The patients were divided into one of two groups: those with venous congestion functional disability (DSA: p ≤ 0.001, Cohen's d = 0.509; and MRI: p ≤ 0.001, d = 0.632). Patients with a greater extent of cord edema also reported worse functional disability (p ≤ 0.001, d = 2.31). There was a strong linear correlation between the post- and pretreatment ALS scores (R(2) = 0.86) for those with successful interventions (n = 9). In patients with an SDAVF, the severity of the neurological dysfunction may be predicted by the extent of DSA- and MRI-documented venous congestion and cord edema. There was a strong positive relationship between initial and posttreatment neurological dysfunction.

  7. Incorporating Topic Assignment Constraint and Topic Correlation Limitation into Clinical Goal Discovering for Clinical Pathway Mining

    Directory of Open Access Journals (Sweden)

    Xiao Xu

    2017-01-01

    Full Text Available Clinical pathways are widely used around the world for providing quality medical treatment and controlling healthcare cost. However, the expert-designed clinical pathways can hardly deal with the variances among hospitals and patients. It calls for more dynamic and adaptive process, which is derived from various clinical data. Topic-based clinical pathway mining is an effective approach to discover a concise process model. Through this approach, the latent topics found by latent Dirichlet allocation (LDA represent the clinical goals. And process mining methods are used to extract the temporal relations between these topics. However, the topic quality is usually not desirable due to the low performance of the LDA in clinical data. In this paper, we incorporate topic assignment constraint and topic correlation limitation into the LDA to enhance the ability of discovering high-quality topics. Two real-world datasets are used to evaluate the proposed method. The results show that the topics discovered by our method are with higher coherence, informativeness, and coverage than the original LDA. These quality topics are suitable to represent the clinical goals. Also, we illustrate that our method is effective in generating a comprehensive topic-based clinical pathway model.

  8. First-episode schizophrenia: characterization and clinical correlates

    Directory of Open Access Journals (Sweden)

    Robert M. Bilder

    2007-11-01

    Full Text Available Neuropsychological impairments are well documented in schizophrenia and are important targets of treatment. Information about the severity and pattern of deficits after treatment for the first psychotic episode and about relationships between these deficits and syndromal characteristics remains limited. Comprehensive neuropsychological assessments including 41 individual tests were given to 94 patients with first-episode schizophrenia after initial stabilization of psychosis and to a comparison group of 36 healthy volunteers. Profiles of neuropsychological deficits and the relationship of deficits to sex and handedness were examined. Correlations of neuropsychological deficit with a broad range of historical and clinical characteristics, including outcome, were explored. Patients had a large generalized neuropsychological deficit. Patients also had, superimposed on the generalized deficit, subtle relative deficits in memory and executive functions. Learning/memory dysfunction best distinguished patients from healthy individuals; after accounting for this difference, only motor deficits further distinguished the groups. Patients with higher neuropsychological ability had only memory deficits, and patients with lower ability had both memory and executive deficits. Dextral patients had less severe generalized deficit. Severity of residual symptoms was associated with greater generalized deficit. Executive and attentional deficits were most linked to global functional impairment and poor outcome. The results document a large generalized deficit, and more subtle differential deficits, in clinically stabilized first-episode patients. Learning/memory deficits were observed even in patients with less severe generalized deficit, but the pattern was unlike the amnestic syndrome and probably reflects different mechanisms. Executive and attentional deficits marked the more severe ly disabled patients, and may portend relatively poor outcome. Failure to

  9. PREVALENCE OF TOXOPLASMOSIS IN PREGNANT WOMEN AND ITS CLINICAL CORRELATION

    Directory of Open Access Journals (Sweden)

    Bhaskar Das

    2016-08-01

    Full Text Available CONTEXT Toxoplasmosis is one of the cause of abortion in pregnant women. Transplacental passage of the parasite from infected mother to the child may present with blindness, neurological impairment and mental retardation in congenital toxoplasmosis. Serological screening of pregnant women for Toxoplasmosis is very important to rule out causes of abortion and congenital malformation. AIM To analyse the prevalence of Toxoplasmosis by evaluating Toxoplasma IgG and IgM antibodies and correlating with age and trimester of pregnancy and other predisposing factors like h/o animal contact and socioeconomic status of the pregnant women attending antenatal clinic. SETTINGS & DESIGN Prospective study. MATERIAL & METHODS Serum samples were collected from 217 pregnant women without any h/o abortion, attending antenatal clinic along with epidemiological data. ELISA test for IgG and IgM Toxoplasma antibodies done with serum samples. The study carried out over a period of two years from October 2011 to September 2013. STATISTICAL ANALYSIS The Chi-square test was used to evaluate the association between age, trimester of pregnancy, animal contact history and socioeconomic status. RESULTS Toxoplasma IgG prevalence was 27.7% and that of IgM was 14.8%. The distribution showed increase of IgG and IgM positivity with increases in age and trimester of pregnancy. Both IgG and IgM positivity is associated with high socioeconomic group and with h/o contact with dog. CONCLUSION Toxoplasmosis prevalence is quite high and associated with predisposing factors. Early detection in pregnant women can reduce the severity of the disease.

  10. Focal choroidal excavation-morphological features and clinical correlation.

    Science.gov (United States)

    Chung, C Y; Li, S H; Li, K K W

    2017-09-01

    PurposeTo describe and correlate the morphological and clinical features of focal choroidal excavation (FCE).MethodsThis is a consecutive case series from the review of the 4436 optical coherence tomography scans performed by Kowloon East Cluster Ophthalmic Service from 1 August 2014-31 January 2016. Statistical analysis was performed on SPSS 18.0 (SPSS, Chicago, IL, USA). A significance level of P<0.05 was taken.ResultsAll 16 patients with FCE had unilateral involvement. The mean age of diagnosis was 52.56±14.00. The mean greatest linear dimension (GLD) of FCE was 636.25±265.11 μm. The mean choroidal thickness was 183.63±52.39 μm. Fourteen FCEs (87.5%) were conforming and two were non-conforming (12.5%). In the eyes with FCE, concurrent macular pathology was present in four cases (25.0%). Tractional pathologies of macular pucker and macular scar corresponded to the two non-conforming FCEs in the series. Polypoidal choroidal vasculopathy (PCV) and lacquer crack had a close topographic relationship with the FCE. The mean GLD was significantly larger in eyes with concurrent macular pathology than those without (878.00 vs 555.67 μm, P=0.029). In the fellow eyes, concurrent macular pathology was present in 5 cases (31.3%): PCV in 3 cases and chronic central serous chorioretinopathy in 2 cases.ConclusionAs a significant proportion of FCE is associated with concurrent macular pathology in the involved or fellow eye, angiography for both eyes is recommended even for asymptomatic cases. The GLD of FCE may have clinical value in risk stratification.

  11. Nontraumatic frontal lobe hemorrhages: Clinical-computed tomographic correlations

    Energy Technology Data Exchange (ETDEWEB)

    Weisberg, L.A.; Stazio, A.

    1988-12-01

    Correlation of lesion location and appearance with clinical sequelae in 25 patients with CT-proven frontal lobe hematomas reveals 10 of 25 hematomas were located above the frontal horns of the lateral ventricles. Nine of the 10 patients were normotensive. All presented with contralateral motor and sensory deficits. Four of 25 hematomas were situated inferior to the frontal horns. All these patients were hypertensive, rapidly became comatose and exhibited hemiplegia, hemianestesia and gaze preference contralateral to the hemiplegia. Five patients had frontal hematomas which extended inward from the interhemispheric fissure or caval-septal region. All were normotensive. All had anterior cerebral-anterior communicating artery aneurysms on angiography. Four patients had hematomas involving both the frontal and temporal region. All were normotensive with no known cause for hemorrhage. Two patients had bifrontal hematomas; one had butterfly appearance extending across the interhemispheric fissure and the other was midline but had no interhemispheric blood. Both were normotensive. One had an anterior cerebral-anterior communicating artery aneurysm.

  12. Ischiofemoral Impingement in Children: Imaging With Clinical Correlation.

    Science.gov (United States)

    Stenhouse, Gregor; Kaiser, Scott; Kelley, Simon P; Stimec, Jennifer

    2016-02-01

    The purpose of this study is to correlate the MRI finding of quadratus femoris edema in children with established measures of ischiofemoral impingement in adults and to determine their clinical significance. A case-control retrospective review was performed of MR images of 12 hips of nine children (mean age, 10 years) that showed abnormal signal intensity in the quadratus femoris muscle. The findings were compared with those for 13 hips in 13 control subjects (mean age, 9.8 years). Two musculoskeletal radiologists independently measured the ischiofemoral space, quadratus femoris space, inclination angle, and hamstring tendon area. Quadratus femoris muscle edema, tears, or fatty replacement were assessed visually. Statistical analysis determined inter- and intraobserver variability and statistical differences between the two subject groups. Subjects with abnormal signal in the quadratus femoris muscle had a statistically significantly narrower ischiofemoral space (mean, 11.5 vs 20.7 mm; p Coxa valga may contribute to narrowing of these parameters and predispose to ischiofemoral impingement. The MRI features of ischiofemoral impingement, however, are nonspecific and may be seen in patients with pain localized to that hip or in patients with symptoms unrelated to the abnormality.

  13. Age at Onset and Clinical Correlates in Body Dysmorphic Disorder

    Science.gov (United States)

    Bjornsson, Andri S.; Didie, Elizabeth R.; Grant, Jon E.; Menard, William; Stalker, Emily; Phillips, Katharine A.

    2013-01-01

    OBJECTIVE Age at onset is an important clinical feature of all disorders. However, no prior studies have focused on this important construct in body dysmorphic disorder (BDD). In addition, across a number of psychiatric disorders, early age at disorder onset is associated with greater illness severity and greater comorbidity with other disorders. However, clinical correlates of age at onset have not been previously studied in BDD. METHODS Age at onset and other variables of interest were assessed in two samples of adults with DSM-IV BDD; sample 1 consisted of 184 adult participants in a study of the course of BDD, and sample 2 consisted of 244 adults seeking consultation or treatment for BDD. Reliable and valid measures were used. Subjects with early-onset BDD (age 17 or younger) were compared to those with late-onset BDD. RESULTS BDD had a mean age at onset of 16.7 (SD=7.3) in sample 1 and 16.7 (SD=7.2) in sample 2. 66.3% of subjects in sample 1 and 67.2% in sample 2 had BDD onset before age 18. A higher proportion of females had early-onset BDD in sample 1 but not in sample 2. On one of three measures in sample 1, those with early-onset BDD currently had more severe BDD symptoms. Individuals with early-onset BDD were more likely to have attempted suicide in both samples and to have attempted suicide due to BDD in sample 2. Early age at BDD onset was associated with a history of physical violence due to BDD and psychiatric hospitalization in sample 2. Those with early-onset BDD were more likely to report a gradual onset of BDD than those with late-onset in both samples. Participants with early-onset BDD had a greater number of lifetime comorbid disorders on both Axis I and Axis II in sample 1 but not in sample 2. More specifically, those with early-onset BDD were more likely to have a lifetime eating disorder (anorexia nervosa or bulimia nervosa) in both samples, a lifetime substance use disorder (both alcohol and non-alcohol) and borderline personality disorder

  14. Age at onset and clinical correlates in body dysmorphic disorder.

    Science.gov (United States)

    Bjornsson, Andri S; Didie, Elizabeth R; Grant, Jon E; Menard, William; Stalker, Emily; Phillips, Katharine A

    2013-10-01

    Age at onset is an important clinical feature of all disorders. However, no prior studies have focused on this important construct in body dysmorphic disorder (BDD). In addition, across a number of psychiatric disorders, early age at disorder onset is associated with greater illness severity and greater comorbidity with other disorders. However, clinical correlates of age at onset have not been previously studied in BDD. Age at onset and other variables of interest were assessed in two samples of adults with DSM-IV BDD; sample 1 consisted of 184 adult participants in a study of the course of BDD, and sample 2 consisted of 244 adults seeking consultation or treatment for BDD. Reliable and valid measures were used. Subjects with early-onset BDD (age 17 or younger) were compared to those with late-onset BDD. BDD had a mean age at onset of 16.7 (SD=7.3) in sample 1 and 16.7 (SD=7.2) in sample 2. 66.3% of subjects in sample 1 and 67.2% in sample 2 had BDD onset before age 18. A higher proportion of females had early-onset BDD in sample 1 but not in sample 2. On one of three measures in sample 1, those with early-onset BDD currently had more severe BDD symptoms. Individuals with early-onset BDD were more likely to have attempted suicide in both samples and to have attempted suicide due to BDD in sample 2. Early age at BDD onset was associated with a history of physical violence due to BDD and psychiatric hospitalization in sample 2. Those with early-onset BDD were more likely to report a gradual onset of BDD than those with late-onset in both samples. Participants with early-onset BDD had a greater number of lifetime comorbid disorders on both Axis I and Axis II in sample 1 but not in sample 2. More specifically, those with early-onset BDD were more likely to have a lifetime eating disorder (anorexia nervosa or bulimia nervosa) in both samples, a lifetime substance use disorder (both alcohol and non-alcohol) and borderline personality disorder in sample 1, and a lifetime

  15. Biennial survey of physician clinical nutrition training programs.

    Science.gov (United States)

    Merritt, R J; Heymsfield, S B; Howard, L; Rombeau, J

    1988-05-01

    This is the third survey of physician clinical nutrition training programs. Current training programs were identified, descriptive information obtained, and training program content was compared with that recommended at the 1984 Conference on Clinical Nutrition Training. In general, goals as to the quantity of research, clinical, and teaching training are being met. Virtually all programs provide training in nutritional support activities. Most training programs are not as broad in scope of exposure to the less clinical aspects of nutrition nor to all the illness and age groups recommended by the 1984 conference. Consideration of broadening the scope of physician training programs or redefinition of training guidelines is warranted. A program-certifying agency may be helpful in identifying programs achieving certain minimal standards.

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

    Directory of Open Access Journals (Sweden)

    Rivka Colen

    2014-10-01

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

  17. Relationship Between the Number of Clinical Sites in Radiography Programs and Job Placement Rates of Graduates.

    Science.gov (United States)

    Harrell, Angela; Matthews, Eric

    2016-07-01

    To determine whether a relationship exists between the number of clinical sites available in radiography programs accredited by the Joint Review Committee on Education in Radiologic Technology and the job placement rates of graduates. We performed a secondary analysis of data on job placement rates and the number of clinical sites available in 438 degree-granting radiography programs from January 2015 to March 2015. A weak, negative, nonsignificant correlation existed between the number of clinical sites and the job placement rate (Spearman's rho = -.113, n = 438, P = .018). The coefficient of determination was 1.28%.Discussion Research evaluating factors contributing to graduate employability is limited but indicates no need for radiography program administrators to adjust clinical site numbers solely on the basis of improving graduate employability. The number of clinical sites available in a radiography program is not related to the job placement rate of its graduates. ©2016 American Society of Radiologic Technologists.

  18. A Leadership Education and Development Program for Clinical Nurses.

    Science.gov (United States)

    Fitzpatrick, Joyce J; Modic, Mary Beth; Van Dyk, Jennifer; Hancock, K Kelly

    2016-11-01

    The Leadership Education and Development (LEAD) Program was designed to transform care at the bedside by empowering clinical nurses as leaders. The heart of LEAD was enhancing communication skills of clinical nurses with clinical colleagues and, most importantly, patients and families. Key concepts of leadership/management were included: personal awareness, personal leadership skills/abilities, leading change, leading others individually and in teams, enhancing the patient/provider experience, and the leadership role in outcomes management. A quantitative, longitudinal, survey design was used with 2 cohorts. The program consisted of six 4-hour sessions for 3 to 6 months. Leadership practices were measured before program implementation, at the end of the program, and 3 months after program completion. There were significant increases in leadership practices sustained 3 months after program completion. A range of other outcome measures was included. There is a need for additional leadership development programs for clinical nurses.

  19. 21 CFR 320.28 - Correlation of bioavailability with an acute pharmacological effect or clinical evidence.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 5 2010-04-01 2010-04-01 false Correlation of bioavailability with an acute pharmacological effect or clinical evidence. 320.28 Section 320.28 Food and Drugs FOOD AND DRUG ADMINISTRATION... Correlation of bioavailability with an acute pharmacological effect or clinical evidence. Correlation of in...

  20. Apathy among institutionalized stroke patients: prevalence and clinical correlates.

    Science.gov (United States)

    van Almenkerk, Suzanne; Smalbrugge, Martin; Depla, Marja F I A; Eefsting, Jan A; Hertogh, Cees M P M

    2015-02-01

    Apathy is a frequent neuropsychiatric consequence of stroke. In the under-researched population of institutionalized stroke patients, we aimed to explore the prevalence of apathy, its clinical correlates, and the relation to the amount of stimulating activities in the nursing home (NH). A cross-sectional, observational study. Dutch NHs. 274 chronic stroke patients. Data were collected through observation lists that were filled out in structured interviews with qualified nurse assistants who knew the residents well. The lists comprised the NH-version of the Apathy Evaluation Scale (AES10), the Barthel Index, the Neuropsychiatric Inventory Questionnaire, and sections of the Resident Assessment Instrument for Long-Term Care Facilities. Attending physicians and therapists provided additional information. Apathy (AES10 score ≥30) was present in 28% of residents. Multilevel regression analyses revealed that this apathy was independently related to (moderate, severe) cognitive impairment (odds ratio [OR] 11.30 [95% confidence interval (CI): 4.96-25.74], OR 5.54 [95% CI: 2.48-12.40]), very severe ADL-dependency (OR 12.10 [95% CI: 1.35-108.66]), and being >12 hours per day in bed (OR 2.10 [95% CI: 1.07-4.13]). It was not related to depressive mood symptoms (OR 1.75 [95% CI: 0.91-3.37]). Only in residents aged less than 80 years were a higher amount of activities independently related to a lower AES10 score (-0.70 [95% CI: -1.18 to -0.20] points per four extra activities in a 4-week period). Apathy is prevalent in largely one-quarter of institutionalized stroke patients, and that is most strongly related to cognitive impairment in this explorative study. We discuss the need for research on the relation with distinct dimensions of depression and fatigue as partly overlapping constructs, and on (individualized) stimulating activities as a possible intervention method. Copyright © 2015 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights

  1. Clinical Pharmacists as Educators in Family Medicine Residency Programs: A CERA Study of Program Directors.

    Science.gov (United States)

    Jarrett, Jennie B; Lounsbery, Jody L; D'Amico, Frank; Dickerson, Lori M; Franko, John; Nagle, John; Seehusen, Dean A; Wilson, Stephen A

    2016-03-01

    The clinical pharmacist's role within family medicine residency programs (FMRPs) is well established. However, there is limited information regarding perceptions of program directors (PDs) about clinical pharmacy educators. The study objectives were (1) to estimate the prevalence of clinical pharmacists within FMRPs and (2) to determine barriers and motivations for incorporation of clinical pharmacists as educators. The Council of Academic Family Medicine Educational Research Alliance (CERA) distributed an electronic survey to PDs. Questions addressed formalized pharmacotherapy education, clinical pharmacists in educator roles, and barriers and benefits of clinical pharmacists in FMRPs. The overall response rate was 50% (224/451). Seventy-six percent (170/224) of the responding PDs reported that clinical pharmacists provide pharmacotherapy education in their FMRPs, and 57% (97/170) consider clinical pharmacists as faculty members. In programs with clinical pharmacists, 72% (83/116) of PDs reported having a systematic approach for teaching pharmacotherapy versus 22% (21/95) in programs without. In programs without clinical pharmacists, the top barrier to incorporation was limited ability to bill for clinical services 48% (43/89) versus 29% (32/112) in programs with clinical pharmacists. In both programs with and without clinical pharmacists, the top benefit of having clinical pharmacists was providing a collaborative approach to pharmacotherapy education for residents (35% and 36%, respectively). Less than half of FMRPs incorporate clinical pharmacists as faculty members. Despite providing collaborative approaches to pharmacotherapy education, their limited ability to bill for services is a major barrier.

  2. Clinical signs and anatomical correlation of patellar tendinitis

    OpenAIRE

    Rath Ehud; Schwarzkopf Ran; Richmond John

    2010-01-01

    Background: Patellar tendinitis is one of the several differential diagnosis of anterior knee pain. The clinical diagnosis of patellar tendinitis is based on tenderness to palpation at the inferior pole of the patella. The tenderness has been noted to be maximal when the knee is extended and the quadriceps relaxed, but a definite clinical sign for diagnosis is lacking. The accuracy of two clinical signs was assesed by a two-stage study which included physical examination, MRI and a cadaveric ...

  3. Infectious Disease Clinical Research Program (IDCRP)

    Data.gov (United States)

    Federal Laboratory Consortium — Our mission is to conduct infectious disease clinical research of importance to the military through a unique, adaptive, and collaborative network, to inform health...

  4. Tobacco Cessation Training in Clinical Psychology and Clinical Social Work Programs

    Science.gov (United States)

    Kleinfelder, JoAnn

    2009-01-01

    The purpose of this study was to explore the tobacco and smoking cessation training and curriculum in graduate clinical psychology and graduate clinical social work programs. The current status of the clinical graduate programs' tobacco education curricula was evaluated by using the Transtheoretical Model's Stages of Change. Perceived barriers to…

  5. Important clinical and laboratory correlates of glomerular filtration ...

    African Journals Online (AJOL)

    Background: Renal impairment is routinely assessed using the estimated glomerular filtration rate (eGFR) and it may be helpful to obtain certain clinical or laboratory markers, which show relationship with glomerular filtration rate (GFR) in sickle cell disease (SCD). Aim: To assess the relationship between important clinical ...

  6. Correlation of cardiac troponin T level, clinical parameters and ...

    African Journals Online (AJOL)

    Introduction: Resource limitation in developing countries may preclude access to cardiac troponin-T assay thereby necessitating reliance on clinical judgment for identification of hypoxic myocardial cellular injury. Objectives: To relate selected clinical signs with elevated serum cardiac troponin-T in asphyxiated term ...

  7. Psychological Assessment Training in Clinical Psychology Doctoral Programs.

    Science.gov (United States)

    Mihura, Joni L; Roy, Manali; Graceffo, Robert A

    2017-01-01

    We surveyed American Psychological Association-accredited clinical psychology doctoral programs' (n = 83) training in psychological assessment-specifically, their coverage of various assessment topics and tests in courses and practica, and whether the training was optional or required. We report results overall and separately per training model (clinical science, scientist-practitioner, and practitioner-focused). Overall, our results suggest that psychological assessment training is as active, or even more active, than in previous years. Areas of increased emphasis include clinical interviewing and psychometrics; multimethod, outcomes, health, and collaborative or therapeutic assessment; and different types of cognitive and self-report personality tests. All or almost all practice-focused programs offered training with the Thematic Apperception Test and Rorschach compared to about half of the scientist-practitioner programs and a third of the clinical science programs. Although almost all programs reported teaching multimethod assessment, what constitutes different methods of assessing psychopathology should be clarified in future studies because many programs appear to rely on one method-self-report (especially clinical science programs). Although doctoral programs covered many assessment topics and tests in didactic courses, there appears to be a shortage of program-run opportunities for students to obtain applied assessment training. Finally, we encourage doctoral programs to be familiar with (a) internships' assessment expectations and opportunities, (b) the professional guidelines for assessment training, and (c) the American Psychological Association's requirements for preinternship assessment competencies.

  8. Chronic widespread pain : clinical comorbidities and psychological correlates

    NARCIS (Netherlands)

    Burri, Andrea; Ogata, Soshiro; Vehof, Jelle; Williams, Frances

    Recent studies have provided consistent evidence for a genetic influence on chronic widespread pain (CWP). The aim of this study was to investigate (1) the etiological structure underlying CWP by examining the covariation between CWP and psychological comorbidities and psychoaffective correlates and

  9. Bimodal Programming: A Survey of Current Clinical Practice.

    Science.gov (United States)

    Siburt, Hannah W; Holmes, Alice E

    2015-06-01

    The purpose of this study was to determine the current clinical practice in approaches to bimodal programming in the United States. To be specific, if clinicians are recommending bimodal stimulation, who programs the hearing aid in the bimodal condition, and what method is used for programming the hearing aid? An 11-question online survey was created and sent via email to a comprehensive list of cochlear implant programming centers in the United States. The survey was sent to 360 recipients. Respondents in this study represented a diverse group of clinical settings (response rate: 26%). Results indicate little agreement about who programs the hearing aids, when they are programmed, and how they are programmed in the bimodal condition. Analysis of small versus large implant centers indicated small centers are less likely to add a device to the contralateral ear. Although a growing number of cochlear implant recipients choose to wear a hearing aid on the contralateral ear, there is inconsistency in the current clinical approach to bimodal programming. These survey results provide evidence of large variability in the current bimodal programming practices and indicate a need for more structured clinical recommendations and programming approaches.

  10. Clinical correlates of leukoaraiosis: A study of 175 patients

    Directory of Open Access Journals (Sweden)

    Rustom S Wadia

    2016-01-01

    Full Text Available Background: In India, the correlates of leukoaraiosis (LA have not been widely reported. This study was designed to investigate the factors which correlate with LA. Materials and Methods: We included patients with LA who consented for the study and graded their severity on the basis of Fazekas scale. We excluded patients with LA who did not consent/cooperate for the study as also patients with other white matter changes which mimic LA. Results: LA is a common and under-rated cause of disability. Presentations include cognitive decline, gait disturbance, dysarthria, bladder/bowel sphincter disturbances, and increased risk of stroke. The comorbidities include hyperhomocysteinemia, hypertension, dyslipidemia, tobacco use, ischemic heart disease, previous stroke, atrial fibrillation, chronic renal failure, and bariatric surgery.

  11. Panic symptoms in schizophrenia: comorbidity and clinical correlates.

    Science.gov (United States)

    Ulas, Halis; Alptekin, Koksal; Akdede, Berna Binnur; Tumuklu, Mevhibe; Akvardar, Yildiz; Kitis, Arzu; Polat, Selma

    2007-12-01

    The aim of the present study was to investigate the prevalence of panic attack (PA) and panic disorder (PD) in patients with schizophrenia and detect the clinical features. Forty-nine patients with schizophrenia were included in the study. Positive and Negative Syndrome Scale (PANSS), Hamilton Depression Rating Scale (HDRS), Clinical Global Impression (CGI), Extrapyramidal Symptom Rating Scale (ESRS) and Bandelow Panic and Agoraphobia Rating Scale were administered. Fifteen patients were found to have PA and seven patients had PD. Patients with panic symptoms had higher scores of PANSS, HDRS, CGI and ESRS. Comorbid panic symptoms in schizophrenia may be related to positive symptoms, extrapyramidal side-effects and depression.

  12. Chronic widespread pain: clinical comorbidities and psychological correlates.

    Science.gov (United States)

    Burri, Andrea; Ogata, Soshiro; Vehof, Jelle; Williams, Frances

    2015-08-01

    Recent studies have provided consistent evidence for a genetic influence on chronic widespread pain (CWP). The aim of this study was to investigate (1) the etiological structure underlying CWP by examining the covariation between CWP and psychological comorbidities and psychoaffective correlates and (2) the decomposition of the covariation into genetic and environmental components. A total of 3266 female twins (mean age 56.6 years) were subject to multivariate analyses. Using validated questionnaires to classify twins as having CWP, the prevalence of CWP was 20.8%. In the multivariate analysis, the most suitable model was the common pathway model. This model revealed 2 underlying latent variables, one common to anxiety, emotional intelligence, and emotional instability (f1) and the other common to depression and CWP (f2), the latter being highly heritable (86%). Both latent variables (f1 and f2) shared an additive genetic and a nonshared environmental factor. In addition, a second additive genetic factor loading only on f2 was found. This study reveals the structure of genetic and environmental influences of CWP and its psychoaffective correlates. The results show that the clustering of CWP and depression is due to a common, highly heritable, underlying latent trait. In addition, we found evidence that CWP, anxiety, emotional instability, and emotional intelligence are influenced by different underlying latent traits sharing the same genetic and nonshared environmental factors. This is the first study to reveal the structure and relative importance of genetic and environmental influences on complex etiological mechanisms of CWP and its correlates.

  13. Mucopolysaccharidosis Type IIIA: Clinical Spectrum and Genotype-Phenotype Correlations

    NARCIS (Netherlands)

    Valstar, Marlies J.; Neijs, Sanne; Bruggenwirth, Hennie T.; Olmer, Renske; Ruijter, George J. G.; Wevers, Ron A.; van Diggelen, Otto P.; Poorthuis, Ben J.; Halley, Dicky J.; Wijburg, Frits A.

    2010-01-01

    Objective: Mucopolysaccharidosis (MPS) IIIA (Sanfilippo syndrome type A) is a lysosomal storage disorder caused by deficiency of the enzyme sulfamidase. Information on the natural course of MPS IIIA is scarce, but is much needed in view of emerging therapies. Methods: Clinical history and molecular

  14. Correlation of laboratory result and clinical diagnosis of ...

    African Journals Online (AJOL)

    Malaria remains a major cause of morbidity and mortality especially among children. While early diagnosis and prompt treatment are crucial to its control, anecdotal evidence has shown that there is increasing overdiagnosis of the illness. This study therefore aims to compare the outcome of laboratory and clinical diagnosis ...

  15. MRI white Matter Lesions in a Stroke Clinic Population: Correlation ...

    African Journals Online (AJOL)

    Cerebral white matter lesions (WML) on MRI have been related not only to age but also to cerebrovascular disorders. This study aimed to determine the prevalence of WML in a population of patients attending a stroke clinic and relate it to the presence of carotid atherosclerosis as determined by increased carotid ...

  16. Correlation of clinical and echo-cardiographic scores with blood ...

    African Journals Online (AJOL)

    Subjects: All patients one month to 18 years of age with the clinical diagnosis of CHF were included. Results: Sixty seven patients were enrolled, 39 (58%) had congenital heart disease (CHD), 27 (32%) had rheumatic heart disease (RHD), and seven (10%) had dilated cardiomyopathy (DCM).Twenty four younger children ...

  17. Risk Factors and Clinical Correlates of Hepatitits B Seroprevalence ...

    African Journals Online (AJOL)

    Circumcision, scarification, ear piercing, history of blood transfusion, receipt of unsafe injections, present/ past history of jaundice and malnutrition were not significantly associated with being seropositive (p>0.05). Conclusion: This study did not identify any pathognomonic clinical feature of hepatitis b seroprevalence.

  18. Correlation of clinical data, anatomical site and disease stage in ...

    African Journals Online (AJOL)

    Objective: To evaluate the colorectal cancer clinical data with respect to the anatomical location and stage of disease. Design: Retrospective observational study. Setting: Kenyatta National Hospital (KNH), Nairobi, Kenya. Subjects: Two hundred and fifty three tumours were categorised as right colonic (RCC), left colonic ...

  19. Clinical signs and anatomical correlation of patellar tendinitis

    Directory of Open Access Journals (Sweden)

    Rath Ehud

    2010-01-01

    Full Text Available Background: Patellar tendinitis is one of the several differential diagnosis of anterior knee pain. The clinical diagnosis of patellar tendinitis is based on tenderness to palpation at the inferior pole of the patella. The tenderness has been noted to be maximal when the knee is extended and the quadriceps relaxed, but a definite clinical sign for diagnosis is lacking. The accuracy of two clinical signs was assesed by a two-stage study which included physical examination, MRI and a cadaveric study. Materials and Methods: Two clinical signs, the "passive flexion-extension sign" and the "standing active quadriceps sign" were assessed in 10 consecutive patients with presumed patellar tendinitis. Five patients had an MRI, showed focal abnormality in the tendon. The location of the MRI finding corresponded, to the region of maximal tenderness. A cadaveric dissection was undertaken to describe the anatomy of the patella and the patellar tendon during these tests. Results: Both tests showed a significant decrease in tenderness at the area of inflammation when the patellar tendon was under tension. The cadaveric dissection showed that when the knee is flexed to 90΀ or when the quadriceps is tensioned the deep fibers of the tendon do not deform to anteriorly applied pressure. Conclusion: We suggest using these studies routinely in the evaluation of patients with anterior knee pain.

  20. Clinical correlates of suicidality among individuals with HIV infection ...

    African Journals Online (AJOL)

    This paper describes clinical risk factors for suicidality among individuals with HIV infection and AIDS disease in Mbarara, Uganda. In this study, suicidality includes both suicidal ideation and suicidal attempts. A cross-sectional survey was conducted with 543 HIV-positive individuals aged 15 years and above, recruited from ...

  1. Correlation of radiological investigations with clinical findings in ...

    African Journals Online (AJOL)

    Background: The aim of the following study is to find out the accuracy of clinical examination and radiological investigations in determining the organ of origin and diagnosis in cases of abdominal mass. Patients and Methods: This prospective study included patients presenting with a palpable abdominal mass. Complete ...

  2. Clinical and functional correlates of foot pain in diabetic patients.

    NARCIS (Netherlands)

    Rijken, P.M.; Dekker, J.; Rauwerda, J.A.; Dekker, E.; Lankhorst, G.J.; Bakker, K.; Dooren, J.

    1998-01-01

    Purpose: patients with diabetes mellitus frequently suffer from foot pain. This pain seems to be a neglected area in studies on the diabetic foot. The purpose of this study was to identify clinical variables associated with foot pain in diabetic patients. In addition, the relationships between foot

  3. Molecular and Clinical Based Cardiovascular Care Program

    Science.gov (United States)

    2010-11-01

    DNA isolated from serum and plasma on high density single nucleotide polymorphism arrays. J Mol Diagn 2008; 10:249-257. Field LA , Jordan RM, Hadix...apolipoproteins in an Ornish lifestyle modification program. American Heart Journal 2006; 151:484-491. Ru QC, Katenhusen RA, Zhu LA , Silberman J, Yang... metformin . N Engl J Med. 2002;346:393–403. 30. Yusuf S, Hawken S, Ounpuu S, et al. Effect of potentially mod- ifiable risk factors associated with

  4. Mental health and clinical correlates in lesbian, gay, bisexual, and queer young adults

    DEFF Research Database (Denmark)

    Grant, Jon E; Odlaug, Brian Lawrence; Derbyshire, Katherine

    2014-01-01

    This study examined the prevalence of mental health disorders and their clinical correlates in a university sample of lesbian, gay, bisexual, and queer (LGBQ) students.......This study examined the prevalence of mental health disorders and their clinical correlates in a university sample of lesbian, gay, bisexual, and queer (LGBQ) students....

  5. Trauma experience among homeless female veterans: correlates and impact on housing, clinical, and psychosocial outcomes.

    Science.gov (United States)

    Tsai, Jack; Rosenheck, Robert A; Decker, Suzanne E; Desai, Rani A; Harpaz-Rotem, Ilan

    2012-12-01

    This study examined lifetime exposure to traumatic events as reported by 581 homeless female veterans enrolled in a Homeless Women Veterans Program across 11 sites to characterize the types of trauma they experienced; their correlation with baseline characteristics; and their association with housing, clinical outcomes, and psychosocial functioning over a 1-year treatment period. Almost all participants endorsed multiple types and episodes of traumatic events. Among the most common were having someone close experience a serious or life-threatening illness (82%) and rape (67%). Exploratory factor analysis revealed 6 potential trauma categories: being robbed, experiencing accident or disasters, illness or death of others, combat, sexual assault, and physical assault. At baseline, trauma from sexual assault was associated with more days homeless (β = .18, p homeless women veterans can achieve through homeless services. Published © 2012. This article is a US Government work and is in the public domain in the USA.

  6. Villitis of unknown aetiology: correlation of recurrence with clinical outcome.

    LENUS (Irish Health Repository)

    Feeley, L

    2010-01-01

    Villitis of unknown aetiology (VUA) is associated with adverse pregnancy outcome. Consequently, an ability to predict recurrence could be clinically relevant. We examined placentas where villitis was diagnosed in a previous pregnancy to establish the risk of recurrence and outcome. A total of 304 cases of VUA were diagnosed in our laboratory over a 4-year period. Subsequently, 19 of this cohort had a second placenta examined histologically. Recurrence and clinical outcome were recorded. Villitis recurred in 7 of 19 cases (37%). There was a high level of adverse pregnancy outcome in this cohort overall, characterised by small for gestational age infants and stillbirth, particularly in cases with high-grade villitis. We identified recurrent villitis more frequently than previously reported. Our findings confirm an association between high-grade villitis and poor outcome. Adequately powered prospective studies are required to determine if enhanced surveillance of subsequent pregnancies is indicated following a diagnosis of villitis.

  7. Clinical Correlates of Planned and Unplanned Suicide Attempts.

    Science.gov (United States)

    Chaudhury, Sadia R; Singh, Tanya; Burke, Ainsley; Stanley, Barbara; Mann, J John; Grunebaum, Michael; Sublette, M Elizabeth; Oquendo, Maria A

    2016-11-01

    Suicide attempters differ in the degree of planning for their suicide attempts. The purpose of this study was to identify differences between individuals who make planned (≥3 hours of planning) and unplanned (suicide attempts. Depressed suicide attempters (n = 110) were compared based on degree of planning of their most recent suicide attempt on demographic and clinical variables. Participants who made planned suicide attempts were more likely to have family history of completed suicide, more severe and frequent suicidal ideation, greater trait impulsivity, and greater suicidal intent and more severe medical consequences for both their most recent and most serious suicide attempts. These results suggest clear clinical differences based on the degree of suicide attempt planning. Severe suicidal ideation, high suicide intent, family history of suicide completion, and high levels of motor impulsivity contribute to a phenotype that is at greater risk of planned, highly lethal suicide attempts.

  8. Reasoning about Frailty in Neurology: Neurobiological Correlates and Clinical Perspectives.

    Science.gov (United States)

    Canevelli, M; Troili, F; Bruno, G

    2014-01-01

    To date, the frailty syndrome has surprisingly attracted limited attention in the field of neurology and neuroscience. Nevertheless, several concepts closely related to frailty, such as vulnerability, susceptibility, and homeostatic reserves, have been increasingly investigated and documented at level of neuronal cells, brain networks, and functions. Similarly, several aspects commonly assessed in the neurological practice, including cognitive functioning and emotional/affective status, clearly appear to be major determinants of the individual's vulnerability and resiliency to stressors. Therefore, they should be carefully considered in the clinical approach to frail subjects. Moreover, dysfunctions of these domains, if timely detected, may be suitable to be targeted by interventions providing beneficial effects to the overall health status of the individual. In the present article, we discuss the neurobiological processes potentially contributing to frailty. Moreover, we reason about the clinical manifestations allowing the prompt and easy recognition of frail persons in the neurological practice.

  9. Clinical Correlates of Planned and Unplanned Suicide Attempts

    Science.gov (United States)

    Chaudhury, Sadia R.; Singh, Tanya; Burke, Ainsley; Stanley, Barbara; Mann, J. John; Grunebaum, Michael; Sublette, M. Elizabeth; Oquendo, Maria A.

    2016-01-01

    Suicide attempters differ in the degree of planning for their suicide attempts. The purpose of this study is to identify differences between individuals who make planned (≥3 hours of planning) and unplanned (attempts. Depressed suicide attempters (n=110) were compared based on degree of planning of their most recent suicide attempt on demographic and clinical variables. Participants who made planned suicide attempts were more likely to have: family history of completed suicide; more severe and frequent suicidal ideation; greater trait impulsivity; and greater suicidal intent and more severe medical consequences for both their most recent and most serious suicide attempts. These results suggest clear clinical differences based on the degree of suicide attempt planning. Severe suicidal ideation, high suicide intent, family history of suicide completion, and high levels of motor impulsivity contribute to a phenotype that is at greater risk for planned, highly lethal suicide attempts. PMID:27105457

  10. Regional orientation program for the department of clinical neurosciences.

    Science.gov (United States)

    Wong, Frankie W H

    2006-01-01

    A regional orientation program increases the efficient and effective use of resources such as classroom, equipment, and educator time. It provides consistent information to all new nurses and maintains standards of nursing practice throughout the Department of Clinical Neurosciences.

  11. Risk factors and clinical correlates in eating disorders

    OpenAIRE

    Gunnard, Katarina

    2012-01-01

    The central scientific objective of the current dissertation was to take a multidisciplinary approach to make use of the full potential information, both scientific and clinical to aid prevention and treatment of EDs. In our studies we assessed a.) social and individual risk factors in EDs (Study 1), b.) empirical ED subtypes based on drive for thinness (DT) and depression (Study 2) and c.) the classification based on these four different empirical ED subtypes without cluster analysis and bas...

  12. Social cognition in schizophrenia: factor structure, clinical and functional correlates.

    Science.gov (United States)

    Buck, Benjamin E; Healey, Kristin M; Gagen, Emily C; Roberts, David L; Penn, David L

    2016-08-01

    Social cognition is consistently impaired in people with schizophrenia, separable from general neurocognition, predictive of real-world functioning and amenable to psychosocial treatment. Few studies have empirically examined its underlying factor structure. This study (1) examines the factor structure of social cognition in both a sample of individuals with schizophrenia-spectrum disorders and non-clinical controls and (2) explores relationships of factors to neurocognition, symptoms and functioning. A factor analysis was conducted on social cognition measures in a sample of 65 individuals with schizophrenia or schizoaffective disorder, and 50 control participants. The resulting factors were examined for their relationships to symptoms and functioning. Results suggested a two-factor structure in the schizophrenia sample (social cognition skill and hostile attributional style) and a three-factor structure in the non-clinical sample (hostile attributional style, higher-level inferential processing and lower-level cue detection). In the schizophrenia sample, the social cognition skill factor was significantly related to negative symptoms and social functioning, whereas hostile attributional style predicted positive and general psychopathology symptoms. The factor structure of social cognition in schizophrenia separates hostile attributional style and social cognition skill, and each show differential relationships to relevant clinical variables in schizophrenia.

  13. Lacunar infarcts in childhood. Clinical and computed tomographic correlations

    Energy Technology Data Exchange (ETDEWEB)

    Nakano, Chizuko; Eda, Isematsu; Takashima, Sachio; Takeshita, Kenzo (Tottori Univ., Yonago (Japan). School of Medicine); Kanetoh, Yasuko

    1984-09-01

    Nine cases, ranging in age from 6 months to 9 years, were diagnosed as lacunar infarcts on computed tomography (CT). Hemiplegia developed rapidly or gradually in 8 cases. Three of 8 cases had transient ischemic attacks of hemiplegia. Other neurological deficits were dysarthria, aphasia, confusion and coarse tremor. One case was asymptomatic. Each of 8 cases had single lacuna and one case two lacunae on CT. These lacunae were localized in the internal capsule, the putamen or the caudate nucleus. Lacunae involving the internal capsule were associated with contralateral hemiplegia, whereas asymptomatic lacunae did not involve it. Severity of hemiplegia in the acute stage did not correlate with localization or size of lacunae. Moderate neurological sequelae were noticed in 3 cases, mild sequelae in two and none in three. The sequelae were related to the lacunae which involved the lateral lenticulostriate branch zone of the middle cerebral artery or larger areas. Prognosis did not correlate with the mode of onset or the severity of neurological signs in the acute stage. There were 2 cases with the occlusion of the left internal carotid artery or congenital heart disease, but the etiology of lacunae was unknown in the other cases.

  14. [EEQ in clinical embryology: a starting program].

    Science.gov (United States)

    Boyer, Pierre; Brugnon, Florence; Levy, Rachel; Pfeffer, Jérôme; Siest, Jean-Pascal

    2014-01-01

    Every laboratory including those working in assisted reproductive technologies have to be accredited EN ISO 15189 before 2020. This standardisation includes an external quality evaluation (EQE). In order to work out an EQE tool, we used images extracted from our own database developed during daily practice. We achieved an easily online tool called: "EEQ en embryologie clinique", developed on Biologie prospective web site with ART French biologists Association (Blefco) expertise in evaluation of early human embryonic stages. In 2013, 38 ART laboratories participate to the first program with more than 90% of appropriates results. The present article aims at describing this tool and discussing its limits.

  15. LASER CORRELATION SPECTROSCOPY (LCS AND ITS CLINICAL PERSPECTIVES IN OPHTHALMOLOGY

    Directory of Open Access Journals (Sweden)

    Karganov Mikhail

    2015-12-01

    Full Text Available The method of laser correlation spectroscopy (LCS is based on the analysis of the spectrum of quasielastic light scatter during coherent monochromatic laser irradiation of micro-particles in biological fluids (blood serum, urine, oropharyngeal washout fluid, tear fluid etc.. Spectrum provides information on dynamic processes in the analyzed system: translation motion of scattering particles and their orientation and conformation dynamics. Special procedures of cluster analysis make it possible to find out to which linkage group a particular spectrum belongs. LCS allows evaluation of sub-fractional composition of biological fluids in a wide range of molecular sizes (from 1 to 10,000 nm, which determines principal novelty of this approach in ophthalmology.

  16. Clinical correlations of brain lesion distribution in multiple sclerosis

    DEFF Research Database (Denmark)

    Vellinga, M M; Geurts, J J G; Rostrup, E

    2009-01-01

    PURPOSE: To explore relations between spatial distribution of multiple sclerosis (MS) lesions, and disability. In MS, the presence of asymptomatic brain lesions challenges the prediction of disability based on conventional brain MRI. Hypothesizing that symptomatology may partly be determined...... by lesion location, this retrospective study explored relations between lesion location and disability using voxelwise analyses in standard space. MATERIALS AND METHODS: Using nonparametric permutation-based statistics, voxelwise lesion probability on T2 lesion masks was related to expanded disability...... significantly (P disability and disease duration, and was higher in progressive than in relapsing disease. When controlled for lesion load (LL), no significant clusters survived. Presence and number of spinal cord lesions did not correlate with lesion probability in any location, and did...

  17. Clinical tomographic correlations of 220 patients with neurocisticercosis, Bahia, Brazil.

    Science.gov (United States)

    Andrade-Filho, Antônio de Souza; Figuerôa, Luiz Frederico da Silva; Andrade-Souza, Victor Mascarenhas

    2007-02-01

    Neurocysticercosis (NCC) is a common parasitic disease in our region, presenting diversity of neurological symptoms and signs. The present study has as primary objective an evaluation of the NCC's clinical and epidemiological profile within Bahia State, by means of a prospective study of 220 patients diagnosed from March 1988 to March 1999, with a follow-up of six months. Exams, such as Computed Cranial Tomography Scan (CT), Cerebral Spine Fluid (CSF) and Electroencephalogram (EEG), were accomplished in three distinct moments of these patients' evolution: at starting or diagnostic point (zero time), at after-intervention period (one month after treatment), and at control period (six months after treatment).

  18. Clinical tomographic correlations of 220 patients with neurocisticercosis, Bahia, Brazil

    Directory of Open Access Journals (Sweden)

    Antônio de Souza Andrade-Filho

    Full Text Available Neurocysticercosis (NCC is a common parasitic disease in our region, presenting diversity of neurological symptoms and signs. The present study has as primary objective an evaluation of the NCC's clinical and epidemiological profile within Bahia State, by means of a prospective study of 220 patients diagnosed from March 1988 to March 1999, with a follow-up of six months. Exams, such as Computed Cranial Tomography Scan (CT, Cerebral Spine Fluid (CSF and Electroencephalogram (EEG, were accomplished in three distinct moments of these patients' evolution: at starting or diagnostic point (zero time, at after-intervention period (one month after treatment, and at control period (six months after treatment.

  19. A STUDY OF OVARIAN TUMOURS : CLINICAL AND PATHOLOGICAL CORRELATION

    Directory of Open Access Journals (Sweden)

    Uma Devi

    2015-10-01

    Full Text Available OBJECTIVE: To study incidence age distribution of benign and malignant ovarian tu mours in general population. METHODS AND MATERIAL : To study 120 patients with ovarian tumours in Govt . general hospital during June 2003 and June 2005. RESULTS: Clinical and pathological evaluation of all ovarian tumours was done and incidence, age distrib ution of various benign and malignant ovarian neoplasms were tabulated and compared with other studies. CONCLUSIONS: Most common ovarian tumours are benign tumours and serous cystadenoma is the commonest benign tumour and S erous cystadeno carcinoma is the most common malignant tumour.

  20. Muscle MRI in pediatrics: clinical, pathological and genetic correlation

    Energy Technology Data Exchange (ETDEWEB)

    Cejas, Claudia P.; Serra, Maria M.; Galvez, David F.G. [Foundation for Neurological Research Dr. Raul Carrea (FLENI), Radiology Department, Buenos Aires (Argentina); Cavassa, Eliana A.; Vazquez, Gabriel A.; Massaro, Mario E.L.; Schteinschneider, Angeles V. [Foundation for Neurological Research Dr. Raul Carrea (FLENI), Department of Neuropediatrics, Buenos Aires (Argentina); Taratuto, Ana L. [Foundation for Neurological Research Dr. Raul Carrea (FLENI), Neuropathology Consultant, Buenos Aires (Argentina)

    2017-05-15

    Pediatric myopathies comprise a very heterogeneous group of disorders that may develop at different ages and affect different muscle groups. Its diagnosis is sometimes difficult and must be confirmed by muscle biopsy and/or genetic analysis. In recent years, muscle involvement patterns observed on MRI have become a valuable tool, aiding clinical diagnosis and enriching pathological and genetic assessments. We selected eight myopathy cases from our institutional database in which the pattern of muscle involvement observed on MRI was almost pathognomonic and could therefore contribute to establishing diagnosis. Muscle biopsy, genetic diagnosis or both confirmed all cases. (orig.)

  1. Anhedonia as a clinical correlate of suicidal thoughts in clinical ketamine trials.

    Science.gov (United States)

    Ballard, Elizabeth D; Wills, Kathleen; Lally, Níall; Richards, Erica M; Luckenbaugh, David A; Walls, Tessa; Ameli, Rezvan; Niciu, Mark J; Brutsche, Nancy E; Park, Lawrence; Zarate, Carlos A

    2017-08-15

    Identifying clinical correlates associated with reduced suicidal ideation may highlight new avenues for the treatment of suicidal thoughts. Anhedonia occurs across psychiatric diagnoses and has been associated with specific neural circuits in response to rapid-acting treatments, such as ketamine. This analysis sought to evaluate whether reductions in suicidal ideation after ketamine administration were related to reduced levels of anhedonia, independent of depressive symptoms. This post-hoc analysis included treatment-resistant patients with either major depressive disorder (MDD) or bipolar disorder (BD) from several clinical trials of ketamine. Anhedonia was assessed using a subscale of the Beck Depression Inventory (BDI) and the Snaith-Hamilton Pleasure Scale (SHAPS). The outcome of interest was suicidal ideation, as measured by a subscale of the Scale for Suicide Ideation (SSI5), one day post-ketamine administration. Anhedonia, as measured by the SHAPS, was associated with suicidal thoughts independent of depressive symptoms both before and after ketamine administration. One day post-ketamine administration, improvements on the SHAPS accounted for an additional 13% of the variance in suicidal thought reduction, beyond the influence of depressive symptoms. The BDI anhedonia subscale was not significantly associated with suicidal thoughts after adjusting for depressive symptoms. Data were limited to patients experiencing a major depressive episode and may not be generalizable to patients experiencing an active suicidal crisis. Suicidal thoughts may be related to symptoms of anhedonia independent of other depressive symptoms. These results have implications for the potential mechanisms of action of ketamine on suicidal thoughts. Published by Elsevier B.V.

  2. Clinical-histopathological correlation in a case of Coats' disease

    Directory of Open Access Journals (Sweden)

    Zajdenweber Moyses E

    2006-08-01

    Full Text Available Abstract Background Coats' disease is a non-hereditary ocular disease, with no systemic manifestation, first described by Coats in 1908. It occurs more commonly in children and has a clear male predominance. Most patients present clinically with unilateral decreased vision, strabismus or leukocoria. The most important differential diagnosis is unilateral retinoblastoma, which occurs in the same age group and has some overlapping clinical manifestations. Case presentation A 4 year-old girl presented with a blind and painful right eye. Ocular examination revealed neovascular glaucoma, cataract and posterior synechiae. Although viewing of the fundus was impossible, computed tomography disclosed total exsudative retinal detachment in the affected eye. The eye was enucleated and subsequent histopathological evaluation confirmed the diagnosis of Coats' disease. Conclusion General pathologists usually do not have the opportunity to receive and study specimens from patients with Coats' disease. Coats' disease is one of the most important differential diagnoses of retinoblastoma. Therefore, It is crucial for the pathologist to be familiar with the histopathological features of the former, and distinguish it from the latter.

  3. Headache in the paediatrics patients, clinical-EEG Correlation.

    Directory of Open Access Journals (Sweden)

    Marcelino Lizano Rabelo

    2011-12-01

    Full Text Available A descriptive study was made, with the objective to describe to a clinical group of variables epidemiologists and of laboratory of 108 patients to whom it was made to them and EEG and whose fundamental symptom was the headache; in the period January to December of 2009. The data was taken from the registry of patients of the neurophysiology department of Paediatric Hospital. The variables of the study were: age, sex, type of headache, results of the EEG, and characteristics of pathological EEG activity. The results were expressed in graphical and analyzed tables and of percentage form. The patients of 14 to 16 years predominated (40,7%, female patient (53,7%, clinically the observed recurrent acute migraine in 60 cases was the one that prevailed, as well as normality in the EEG (81,5%, the pathological cases we observed focal paroxysms in 15 patients (75% and focal alterations in 80% of the pathological EEG. Conclusions: In our environment the migraine in the paediatric patient is a frequent pathology that motivates the accomplishment of diverse studies among them the EEG, being this normal one in most of the cases and the non-specific alterations, the recurrent acute migraine and female patients prevailed.

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

    Science.gov (United States)

    Haneef, Zulfi; Chiang, Sharon

    2014-11-01

    Temporal lobe epilepsy (TLE) is considered a brain network disorder, additionally representing the most common form of pharmaco-resistant epilepsy in adults. There is increasing evidence that seizures in TLE arise from abnormal epileptogenic networks, which extend beyond the clinico-radiologically determined epileptogenic zone and may contribute to the failure rate of 30-50% following epilepsy surgery. Graph theory allows for a network-based representation of TLE brain networks using several neuroimaging and electrophysiologic modalities, and has potential to provide clinicians with clinically useful biomarkers for diagnostic and prognostic purposes. We performed a review of the current state of graph theory findings in TLE as they pertain to localization of the epileptogenic zone, prediction of pre- and post-surgical seizure frequency and cognitive performance, and monitoring cognitive decline in TLE. Although different neuroimaging and electrophysiologic modalities have yielded occasionally conflicting results, several potential biomarkers have been characterized for identifying the epileptogenic zone, pre-/post-surgical seizure prediction, and assessing cognitive performance. For localization, graph theory measures of centrality have shown the most potential, including betweenness centrality, outdegree, and graph index complexity, whereas for prediction of seizure frequency, measures of synchronizability have shown the most potential. The utility of clustering coefficient and characteristic path length for assessing cognitive performance in TLE is also discussed. Future studies integrating data from multiple modalities and testing predictive models are needed to clarify findings and develop graph theory for its clinical utility. Copyright © 2014 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  5. Histomorphological Features of Intestinal Atresia and its Clinical Correlation.

    Science.gov (United States)

    Subbarayan, Devi; Singh, Meeta; Khurana, Nita; Sathish, Agarwal

    2015-11-01

    Intestinal atresia accounts for approximately one third of all cases of neonatal intestinal obstruction. There is controversy regarding pathogenesis of congenital atresia and stenosis of small bowel. Studies regarding clinical manifestations and specific histopathological features of neonatal intestinal atresia are scarce in Indian literature. To understand the histomorphological features and thus suggest pathophysiology of cases with Intestinal Atresia. Out of 147 cases, of intestinal obstruction in newborn studied over a period of 5 years, 39 cases of intestinal atresia were found. Their histomorphological details with clinical manifestations were studied. Type II was the commonest type of atresia. Associated anomalies noted were gastroschisis, volvulus, anal stenosis, microcolon, annular pancreas, meconium cyst and duplication cyst. Histological changes observed were ulceration, flattening, abnormal villous configuration, luminal obliteration, narrowing, haemangiomatous proliferation of blood vessels, fibrosis, haemorrhage, calcification, and mesenchymal condensation around the blood vessels. Gangrene and perforation has also noted in some cases. An intrauterine intestinal ischemia due to vascular pathology followed by resorption of the bowel is the possible explanation for the development of intestinal atresia.

  6. Clinical correlation of mesenteric vascular disease in older patients.

    Science.gov (United States)

    Cardin, Fabrizio; Fratta, Stefania; Perissinotto, Egle; Casarrubea, Giuseppe; Inelmen, Emine Meral; Terranova, Claudio; Sergi, Giuseppe; Militello, Carmelo

    2012-06-01

    Mesenteric vascular obstruction is difficult to characterize, since it may produce differing acute or chronic clinical pictures and various organic symptoms, such as ischemic colitis and abdominal angina. The diagnosis of chronic mesenteric ischemia (CMI) is thus still mainly based on historic diagnostic criteria drawn up before non-invasive radiological imaging of the mesenteric vessels became widespread, and before the current demographic developments leading to a rise in the number of older patients with multiple pathologies. With this premise, we studied the clinical condition of 85 patients aged over 65 years of age, submitted to angio-CT scan for reasons other than neoplastic and general pathologies which may cause alterations in mesenteric blood flow, and without the typical symptoms of acute intestinal ischemia. Of these, 34 patients presented occlusion of at least one mesenteric vessel and 13 were affected by multivessel injury. Compared with controls, patients with mesenteric artery disease had lower BMI (24.9+/-3.3 vs 26.8+/-4.5) and longer hospital stays (14 vs 6 days), and were more frequently affected by vasculopathies in other districts (97.1% vs 80.4%), but the only bowel symptom present was diarrhea (21.2% vs 5.9%). These patients also took more benzodiazepines and acetylsalicylic acid. The results of stepwise logistic analysis of length of hospital stay, vasculopathies, diarrhea, and use of benzodiazepines yielded a predictive model with an AUC (area under the curve) of 0.81. Our data show that some features characterizing CMI in the geriatric population differ from those of the general population.

  7. Correlates of depressive symptoms in individuals attending outpatient stroke clinics.

    Science.gov (United States)

    Vermeer, Julianne; Rice, Danielle; McIntyre, Amanda; Viana, Ricardo; Macaluso, Steven; Teasell, Robert

    2017-01-01

    Background and purpose Depressive symptoms are common post-stroke. We examined stroke deficits and lifestyle factors that are independent predictors for depressive symptomology. Methods A retrospective chart review was performed for patients' post-stroke who attended outpatient clinics at a hospital in Southwestern Ontario between 1 January 2014 and 30 September 2014. Demographic variables, stroke deficits, secondary stroke risk factors and disability study measures [Patient Health Questionnaire-9 (PHQ-9) and Montreal Cognitive Assessment (MoCA)] were analyzed. Results Of the 221 outpatients who attended the stroke clinics (53% male; mean age = 65.2 ± 14.9 years; mean time post-stroke 14.6 ± 20.1 months), 202 patients were used in the final analysis. About 36% of patients (mean = 5.17 ± 5.96) reported mild to severe depressive symptoms (PHQ-9 ≥ 5). Cognitive impairment (CI), smoking, pain and therapy enrollment (p symptoms. Patients reporting CI were 4 times more likely to score highly on the PHQ-9 than those who did not report CI (OR = 4.72). While controlling for age, MoCA scores negatively related to depressive symptoms with higher PHQ-9 scores associated with lower MoCA scores (r= -0.39, p symptoms are common in the chronic phase post-stroke and were partially related to cognition, pain, therapy enrollment and lifestyle factors. Implications for Rehabilitation Stroke patients who report cognitive deficits, pain, tobacco use or being enrolled in therapy may experience increased depressive symptoms. A holistic perspective of disease and lifestyle factors should be considered while assessing risk of depressive symptoms in stroke patients. Patients at risk for depressive symptoms should be monitored at subsequent outpatient visits.

  8. Anhedonia and substance dependence: clinical correlates and treatment options

    Directory of Open Access Journals (Sweden)

    Daniele Stavros eHatzigiakoumis

    2011-03-01

    Full Text Available Anhedonia is a condition in which the capacity of experiencing pleasure is totally or partially lost, and it refers to both a state symptom in various psychiatric disorders and a personality trait. It has a putative neural substrate, consisting in the dopaminergic mesolimbic and mesocortical reward circuit. Anhedonia frequently occurs in mood disorders, as a negative symptom in schizophrenia, and in substance use disorders. In particular, we focus our attention on the relationships occurring between anhedonia and substance use disorders, as highlighted by many studies. Several authors suggested that anhedonia is an important factor involved in relapse as well as in the transition from recreational use to excessive drug intake. In particular, anhedonia has been found to be a frequent feature in alcoholics and addicted patients during acute and chronic withdrawal as well as in cocaine, stimulant and cannabis abusers. Furthermore, in subjects with a substance dependence disorder, there is a significant correlation between anhedonia, craving, intensity of withdrawal symptoms and psychosocial and personality characteristics. Therefore treating anhedonia in detoxified alcohol dependent subjects could be critical in terms of relapse prevention strategies, given its strong relationship with craving. On this purpose many different strategies have been proposed.

  9. Community based clinical program: the Medunsa physiotherapy students` experience

    Directory of Open Access Journals (Sweden)

    N. P. Taukobong

    2004-02-01

    Full Text Available Backgound: The aim of community based clinical training is tproduce graduates who are responsive to the health needs of their communit It is envisaged that upon completion of training graduates would go back an serve their respective communities following exposure to community need Program evaluation should therefore allow students to express the inadequacie and strengths of the program.Aim: To evaluate the community-based clinical program through student's experiences.Methodology: A qualitative research design was used. End of block students reports for both third (8 and fourth (15 year physiotherapy students (n = 23 were used to collect the data. Responses in the reports were grouped into the following categories for purpose of data analysis: feeling about the block, suggestion/s and supervision.Results: The students described the community based clinical program as an unique learning experience which equipped them with the understanding of life within communities. Sixty five percent (65% expressed satisfaction with the supervision given. The main complaints were amounts of paper work involved and clinical workload.Conclusion: The student's experiences indicated that the community-based clinical program within the MEDUNSA physiotherapy department realizes the goal of community-based clinical training as determined by WHO, except for inclusion of some multi-professional approaches and adaptation of the supervision provided.

  10. Posttraumatic Retronychia of the Foot with Clinical and Ultrasound Correlation.

    Science.gov (United States)

    Pizarro, Mariana; Pieressa, Nicolás; Wortsman, Ximena

    2017-05-01

    Retronychia, the posterior embedding of the nail bed into the proximal nail fold, can be a complex clinical dermatologic diagnosis that may mimic other inflammatory ungual diseases or tumors of the nail. It has been related to a history of severe systemic conditions that secondarily affect the nail matrix and is commonly associated with onychomadesis. We present a case of retronychia of the foot with a purely traumatic origin, nonconcomitant with onychomadesis, that was diagnosed by color Doppler ultrasound in a long-time practitioner of martial arts who was otherwise healthy. Color Doppler ultrasound is an excellent imaging technique for supporting the diagnosis of retronychia. It provides information on the exact location and morphology of the nail plate as well as the presence of inflammatory signs in the ungual and proximal periungual regions. Additionally, this imaging technique can support the differential diagnosis with other nail conditions. Since there are many sports or activities that can potentially injure the toenails, retronychia may be an underestimated entity and the present case can raise the awareness of this condition and show the usefulness of color Doppler ultrasound.

  11. Value of Multiple Sleep Latency Test Periods and Clinical Correlation

    Directory of Open Access Journals (Sweden)

    Ibrahim Oztura

    2013-08-01

    Full Text Available Aim:Patients with complaints excessive daytime sleepiness were evaluated with Multiple Sleep Latency Test (MSLT electrophysiological findings and researched narcolepsy symptoms like nightmare, hallucinations, cataplexy in this study. Material and Method: To study 26 patients were admitted retrospectively with complaints of excessive daytime sleepiness at Dokuz Eylul University Faculty of Medicine Sleep Clinic in the dates December 2009- December 2010. Cases of narcolepsy symptoms (hallucinations-nightmare-cataplexy and MSLT were evaluated together. The onset of REM sleep (SOREM was counted, than SOREM (+ and SOREM (- patients’ sleep latency and narcolepsy symptoms were compared. All data were analyzed with SPSS 20.0. Results: The mean sleep latency assessed sleep latencies, gradually widening towards the end of the first sleep period, and it has been observed to be statistically significant(p:0.007. Conclusion: The mean sleep latency assessed sleep latencies, gradually widening towards the end of the first sleep period, and it has been observed to be statistically significant(p:0.007 and we thinked that it can be decreased of need to sleep during nap periods. [Cukurova Med J 2013; 38(4.000: 712-718

  12. [Clinical research of correlation between osteonecrosis and steroid].

    Science.gov (United States)

    Li, Zi-rong; Sun, Wei; Qu, Hui; Zhou, Yi-xiong; Dou, Bao-xin; Shi, Zhen-cai; Zhang, Nian-fei; Cheng, Xiao-guang; Wang, Da-li; Guo, Wan-shou

    2005-08-15

    To explore the correlation between the dosage of corticosteroid, time of onset and incidence of osteonecrosis (ON) in patients with SARS. From July 2003 to January 2004, general survey carried out for ON in 551 patients with SARS. Five hundred and fifty-one patients except 12 were administrated by corticosteroid from 80 mg to 30 000 mg. The age of patients was (33 +/- 9) years old ranging from 19 to 59 years old. One hundred and thirty-one were male, and four hundred and twenty were female. MRI and X-ray film were taken in all patients including both hips, knees, shoulders, ankles and wrists. CT scan was taken in partial patients. Common classification system were used for staging of hip (ARCO), knee (Lotka) and shoulder (Cruess). Independent test, rank-sum test and multiple factor logistic regression analysis were used for statistical analysis. No osteonecrosis was detected in 12 patients without corticosteroid. Osteonecrosis was detected in 176 patients (32.7 percent) among 539 patients. There were ON of femoral head in 130 cases (210 hips), ON of knee in 98 cases (130 knees), ON of humeral head in 21 cases (36 shoulders), ON of talus and calcaneus in 16 cases (26 ankles), ON of scaphoid and lunate in 11 cases (17 wrists), ON of patella in 3 cases (4 patella), ON of ilium in 1 case and bone infarction (femur, tibia) in 18 cases. One hundred and nineteen cases (195 hips) with ONFH were in stage I (IA 45 hips, IB 77 hips, IC 73 hips). Eleven cases (15 hips) were in stage II. All osteonecrosis of the knee and humoral head was stage I. Thirty-four patients with ON had one joint affected, 45 patients had 2 joints, 93 patients had more than 3 joints. The dosage of corticosteroid was (5842 +/- 4988) mg in ON group and (2719 +/- 2571) mg in non-ON group (P corticosteroid occurred osteonecrosis. ON is frequently multiple focuses. The actual time of onset of ON is early of steroid used. MRI is golden standard for early diagnosis of ON. The patients who were treated with a

  13. Clinical Correlates of Carbon Dioxide Hypersensitivity in Children.

    Science.gov (United States)

    Rappaport, Lance M; Sheerin, Christina; Carney, Dever M; Towbin, Kenneth E; Leibenluft, Ellen; Pine, Daniel S; Brotman, Melissa A; Roberson-Nay, Roxann; Hettema, John M

    2017-12-01

    Hypersensitivity to carbon dioxide (CO 2 )-enriched air may be a promising risk marker for anxiety disorders. Among adult and adolescent samples, heterogeneity in distress response to the CO 2 challenge task indexes 3 underlying classes of individuals, which distinguish between sustained and acute threat response as markers for internalizing disorders, broadly, and anxiety disorders, specifically. The present study examines latent classes in children's response to the CO 2 challenge task to clarify the association of CO 2 hypersensitivity with anxiety and internalizing symptomatology in childhood. Healthy children from a community twin sample (N = 538; age 9-13 years) rated anxious distress every 2 minutes while breathing air enriched to 7.5% CO 2 for 8 minutes. Latent growth mixture modeling evaluated potential classes of individuals with characteristic trajectories of distress during the task to clarify the association with internalizing disorder symptoms and related traits (e.g., anxiety sensitivity, irritability). Although all participants reported increased distress during the task, interindividual heterogeneity in distress indexed 3 underlying classes: a consistently low class ("low"), a consistently high class ("high"), and participants who demonstrated markedly increased acute distress ("acute"). Compared to the low class, the high class reported greater internalizing psychopathology, whereas membership in the acute class was associated with experiencing a panic-like event during the task. As in older individuals, 3 distinct trajectories emerged to capture interindividual heterogeneity in children's distress during the CO 2 challenge task. These classes were distinguished by clinical validators that reinforce the association of CO 2 hypersensitivity and internalizing disorder phenotypes in children. Copyright © 2017 American Academy of Child and Adolescent Psychiatry. All rights reserved.

  14. Clinical and Pathological Correlation in Pediatric Invasive Pulmonary Aspergillosis

    Directory of Open Access Journals (Sweden)

    Nattachai Anantasit

    2018-02-01

    Full Text Available IntroductionInvasive’ pulmonary aspergillosis (IPA has been one of the major causes of mortality in immunocompromised patients. The gold standard method for a diagnosis of IPA is histopathological examination of the lung tissue; however, post-procedural bleeding limits the feasibility of lung biopsy. The European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and The National Institute of Allergy and Infectious Disease Mycoses Study Group (EORTC/MSG defined IPA. The objective of this study was to validate the EORTC/MSG 2008 definition of IPA, compared with histopathology in the pediatric population.MethodsHistopathological examinations of lung tissues of children aged 1 month–18 years with respiratory tract infection at the time of obtaining biopsy were retrieved. Retrospective chart reviews for clinical characteristics were performed. IPA diagnosis was classified according to the EORTC/MSG 2008 definition.ResultsDuring the 10-year period, there were 256 lung tissues, of which 58 specimens were suspected to have pulmonary infection. Fourteen patients (24% were noted to have IPA. Seven patients (50% with proven IPA were classified as probable, while the remaining 50% were classified as possible, and none were classified as no IPA, by using EORTC/MSG 2008 definition. Other 44 specimens demonstrated 14 (32%, 14 (32%, and 16 (36% were classified as probable, possible, and no IPA, respectively. When comparing probable or possible IPA with no IPA, we found that the EORTC/MSG 2008 definition had 100% sensitivity, 36% specificity, 33% positive predictive value, and 100% negative predictive value in diagnosis of IPA.ConclusionOur study illustrated that the EORTC/MSG 2008 definition provided an excellent sensitivity but low specificity for diagnosing IPA.

  15. Clinical correlates of acute bipolar depressive episode with psychosis.

    Science.gov (United States)

    Caldieraro, Marco Antonio; Sylvia, Louisa G; Dufour, Steven; Walsh, Samantha; Janos, Jessica; Rabideau, Dustin J; Kamali, Masoud; McInnis, Melvin G; Bobo, William V; Friedman, Edward S; Gao, Keming; Tohen, Mauricio; Reilly-Harrington, Noreen A; Ketter, Terence A; Calabrese, Joseph R; McElroy, Susan L; Thase, Michael E; Shelton, Richard C; Bowden, Charles L; Kocsis, James H; Deckersbach, Thilo; Nierenberg, Andrew A

    2017-08-01

    Psychotic bipolar depressive episodes remain remarkably understudied despite being common and having a significant impact on bipolar disorder. The aim of this study is to identify the characteristics of depressed bipolar patients with current psychosis compared to those without psychosis. We used baseline data of a comparative effectiveness study of lithium and quetiapine for bipolar disorder (the Bipolar CHOICE study) to compare demographic, clinical, and functioning variables between those with and without psychotic symptoms. Of the 482 participants, 303 (62.9%) were eligible for the present study by meeting DSM-IV criteria for an acute bipolar depressive episode. Univariate analyses were conducted first, and then included in a model controlling for symptom severity. The sample was composed mostly of women (60.7%) and the mean age was 39.5±12.1 years. Psychosis was present in 10.6% (n=32) of the depressed patients. Psychotic patients had less education, lower income, and were more frequently single and unemployed. Psychosis was also associated with a more severe depressive episode, higher suicidality, more comorbid conditions and worse functioning. Most group differences disappeared when controlling for depression severity. Only outpatients were included and the presence of psychosis in previous episodes was not assessed. Psychosis during bipolar depressive episodes is present even in an outpatient sample. Psychotic, depressed patients have worse illness outcomes, but future research is necessary to confirm if these outcomes are only associated with the severity of the disorder or if some of them are independent of it. Copyright © 2017 Elsevier B.V. All rights reserved.

  16. A national clinical quality program for Veterans Affairs catheterization laboratories (from the Veterans Affairs clinical assessment, reporting, and tracking program).

    Science.gov (United States)

    Maddox, Thomas M; Plomondon, Mary E; Petrich, Megan; Tsai, Thomas T; Gethoffer, Hans; Noonan, Gregory; Gillespie, Brian; Box, Tamara; Fihn, Stephen D; Jesse, Robert L; Rumsfeld, John S

    2014-12-01

    A "learning health care system", as outlined in a recent Institute of Medicine report, harnesses real-time clinical data to continuously measure and improve clinical care. However, most current efforts to understand and improve the quality of care rely on retrospective chart abstractions complied long after the provision of clinical care. To align more closely with the goals of a learning health care system, we present the novel design and initial results of the Veterans Affairs (VA) Clinical Assessment, Reporting, and Tracking (CART) program-a national clinical quality program for VA cardiac catheterization laboratories that harnesses real-time clinical data to support clinical care and quality-monitoring efforts. Integrated within the VA electronic health record, the CART program uses a specialized software platform to collect real-time patient and procedural data for all VA patients undergoing coronary procedures in VA catheterization laboratories. The program began in 2005 and currently contains data on 434,967 catheterization laboratory procedures, including 272,097 coronary angiograms and 86,481 percutaneous coronary interventions, performed by 801 clinicians on 246,967 patients. We present the initial data from the CART program and describe 3 quality-monitoring programs that use its unique characteristics-procedural and complications feedback to individual labs, coronary device surveillance, and major adverse event peer review. The VA CART program is a novel approach to electronic health record design that supports clinical care, quality, and safety in VA catheterization laboratories. Its approach holds promise in achieving the goals of a learning health care system. Published by Elsevier Inc.

  17. Prenatal prediction of pulmonary hypoplasia: clinical, biometric, and Doppler velocity correlates

    NARCIS (Netherlands)

    J.A.M. Laudij (Jacqueline); D. Tibboel (Dick); S.G.F. Robben (Simon); R.R. de Krijger (Ronald); M.A.J. de Ridder (Maria); J.W. Wladimiroff (Juriy)

    2002-01-01

    textabstractOBJECTIVES: To determine the value of pulmonary artery Doppler velocimetry relative to fetal biometric indices and clinical correlates in the prenatal prediction of lethal lung hypoplasia (LH) in prolonged (>1 week) oligohydramnios. METHODS: Forty-two singleton

  18. Demographic, clinical, psychosocial, and environmental correlates of objectively assessed physical activity among breast cancer survivors

    NARCIS (Netherlands)

    Kampshoff, C.S.; Stacey, F.; Short, C.E.; van Mechelen, W.; Chinapaw, M.J.M.; Brug, J.; Plotnikoff, R.; James, E.L.; Buffart, L.M.

    Purpose The aim of this study was to identify demographic, clinical, psychosocial, and environmental correlates of objectively assessed physical activity among breast cancer survivors. Methods Baseline data were utilized from 574 female breast cancer survivors who participated in three different

  19. CORRELATION BETWEEN OBESITY, SAGITTAL BALANCE AND CLINICAL OUTCOME IN SPINAL FUSION

    Directory of Open Access Journals (Sweden)

    Marcel Machado da Motta

    2015-09-01

    Full Text Available Objective:To correlate obesity with radiographic parameters of spinal and spinopelvic balance in patients undergoing spinal arthrodesis, and to correlate obesity with clinical outcome of these patients.Methods:Observational retrospective study including patients who underwent spinal arthrodesis, with minimum follow-up period of three months. We measured waist circumference, as well as height and weight to calculate body mass index (BMI and obtained radiographs of the total column. The clinical parameters studied were pain by visual analog scale (VAS and the Oswestry questionnaire (ODI. Obesity correlated with radiographic parameters of the sagittal and spinopelvic balance and postoperative clinical parameters.Results:32 patients were analyzed. The higher the BMI, the greater the value of VAS found, but without statistical significance (p=0.83. There was also no correlation between BMI and the ODI questionnaire. Analyzing the abdominal circumference, there was no correlation between the VAS and ODI. There was no correlation between BMI or waist circumference and the radiographic parameters of global spinopelvic sagittal alignment. Regarding the postoperative results, there was no correlation between the mean BMI and waist circumference and the postoperative results for ODI and VAS (p=0.75 and p=0.7, respectively.Conclusions:The clinical outcomes of patients who undergone spinal fusion were not affected by the BMI and waist circumference. Also, there was no correlation between radiographic parameters of spinal and spinopelvic sagittal balance with obesity in patients previously treated with arthrodesis of the spine.

  20. Healthcare reform from the inside: A neurosurgical clinical quality program

    OpenAIRE

    Afsar-Manesh, Nasim; Martin, Neil A.

    2012-01-01

    During the past decade, the U.S. health care system has faced increasing challenges in delivering high quality of care, ensuring patient safety, providing access to care, and maintaining manageable costs. While reform progresses at a national level, health care providers have a responsibility and obligation to advance quality and safety. In 2009, the authors implemented a department-wide Clinical Quality Program. This Program comprised of an inter-disciplinary group of providers and staff wor...

  1. Descriptive Assessment of Exercise Program on Fitness and Correlates of Participation

    Science.gov (United States)

    Lanier, Angela Baldwin; Jackson, Erica Marie; Azar-Dickens, John; Anderson, Brock; Briggs, Meredith

    2012-01-01

    Objective: To assess health-related fitness, physical activity correlates, and completion of a half-marathon using a 3-day training program in a college community. Methods: 26 volunteers participated in a 20-week, half-marathon training program. Results: All participants completed the half-marathon. Positive changes in health-related fitness and…

  2. Leadership Styles at Middle- and Early-College Programs: A Quantitative Descriptive Correlational Study

    Science.gov (United States)

    Berksteiner, Earl J.

    2013-01-01

    The purpose of this quantitative descriptive correlational study was to determine if associations existed between middle- and early-college (MEC) principals' leadership styles, teacher motivation, and teacher satisfaction. MEC programs were programs designed to assist high school students who were not served well in a traditional setting (Middle…

  3. CT scan in severe diffuse head injury: physiological and clinical correlations.

    OpenAIRE

    Teasdale, E.; Cardoso, E.; Galbraith, S; Teasdale, G

    1984-01-01

    CT scan findings, clinical features and intracranial pressure were studied in patients with severe diffuse head injury. Compression of the 3rd ventricle and basal cisterns closely correlated with an intracranial pressure greater than 20 mmHg, with clinical signs of midbrain dysfunctions and worse prognosis. These CT scan findings can indicate whether intracranial pressure monitoring is appropriate.

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

    Science.gov (United States)

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

    2010-01-01

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

  5. Redesigning a clinical mentoring program for improved outcomes in the clinical training of clerks

    Science.gov (United States)

    Lin, Chia-Der; Lin, Blossom Yen-Ju; Lin, Cheng-Chieh; Lee, Cheng-Chun

    2015-01-01

    Introduction Mentorship has been noted as critical to medical students adapting to clinical training in the medical workplace. A lack of infrastructure in a mentoring program might deter relationship building between mentors and mentees. This study assessed the effect of a redesigned clinical mentoring program from the perspective of clerks. The objective was to assess the benefits of the redesigned program and identify potential improvements. Methods A redesigned clinical mentoring program was launched in a medical center according to previous theoretical and practical studies on clinical training workplaces, including the elements of mentor qualifications, positive and active enhancers for mentor–mentee relationship building, the timing of mentoring performance evaluation, and financial and professional incentives. A four-wave web survey was conducted, comprising one evaluation of the former mentoring program and three evaluations of the redesigned clinical mentoring program. Sixty-four fifth-year medical students in clerkships who responded to the first wave and to at least two of the three following waves were included in the study. A structured and validated questionnaire encompassing 15 items on mentor performance and the personal characteristics of the clerks was used. Mixed linear models were developed for repeated measurements and to adjust for personal characteristics. Results The results revealed that the redesigned mentoring program improved the mentors’ performance over time for most evaluated items regarding professional development and personal support provided to the mentees. Conclusions Our findings serve as an improved framework for the role of the institution and demonstrate how institutional policies, programs, and structures can shape a clinical mentoring program. We recommend the adoption of mentorship schemes for other cohorts of medical students and for different learning and training stages involved in becoming a physician. PMID

  6. Differential prevalence and demographic and clinical correlates of second-generation antipsychotic use in bipolar I versus bipolar II disorder.

    Science.gov (United States)

    Park, Dong Yeon; Goffin, Kathryn C; Shah, Saloni; Yuen, Laura D; Holtzman, Jessica N; Hooshmand, Farnaz; Miller, Shefali; Wang, Po W; Ketter, Terence A

    2016-05-01

    To assess second-generation antipsychotic (SGA) use, demographics, and clinical correlates in patients with bipolar I disorder (BDI) versus bipolar II disorder (BDII). Stanford Bipolar Disorder (BD) Clinic outpatients enrolled during 2000-2011 were assessed with the Systematic Treatment Enhancement Program for BD (STEP-BD) Affective Disorders Evaluation. Current SGA use, demographics, and clinical correlates were assessed for BDI versus BDII. Among 503 BD outpatients, in BDI versus BDII, SGA use was more than twice as common (44.0% versus 21.2%), and doses were approximately twice as high. BDI patients taking (N = 107) versus not taking (N = 136) SGAs less often had current full time employment and college degree; and more often had lifetime psychiatric hospitalization, current depression, and current complex pharmacotherapy, and had a higher mean current Clinical Global Impression for Bipolar Version Overall Severity score, and these persisted significantly after covarying for employment and education. Prior psychiatric hospitalization was the most robust correlate of SGA use in BDI patients. In contrast, these demographic and clinical correlates of SGA use were not statistically significant among patients with BDII, although BDII (but not BDI) patients taking (N = 55) versus not taking (N = 205) SGAs were more likely to have current mood stabilizer use (67.3% versus 51.7%). American tertiary bipolar disorder clinic referral sample, cross-sectional design. Current SGA use was robustly associated with prior psychiatric hospitalization in BDI and to a more limited extent with current mood stabilizer use in BDII. SGA use associations with other unfavorable illness characteristics in BDI were less robust. Copyright © 2016 Elsevier Ltd. All rights reserved.

  7. Correlative Studies in Clinical Trials: A Position Statement From the International Thyroid Oncology Group.

    Science.gov (United States)

    Bible, Keith C; Cote, Gilbert J; Demeure, Michael J; Elisei, Rossella; Jhiang, Sissy; Ringel, Matthew D

    2015-12-01

    Patients with progressive thyroid cancer in distant metastatic sites represent a population with a need for new therapeutic options. Aspiring to improve the treatment of such patients, the objective of this position statement from the International Thyroid Oncology Group (ITOG) is to clarify the importance of incorporating high-quality correlative studies into clinical trials. ITOG was formed to develop and support high-quality multicenter and multidisciplinary clinical trials for patients with aggressive forms of thyroid cancer. The Correlative Sciences Committee of the ITOG focuses on the quality and types of correlative studies included in ITOG-associated clinical trials. This document represents expert consensus from ITOG regarding this issue based on extensive collective experience in clinical and translational trials informed by basic science. The Correlative Studies Committee identified an international writing group representative of diverse specialties, including basic sciences. Drafts were reviewed by all members of the writing group, the larger committee, and the ITOG board. After consideration of all comments by the writing group and modification of the document, the final document was then approved by the authors and the ITOG board. High-quality correlative studies, which include variety in the types of correlates, should be intrinsic to the design of thyroid cancer clinical trials to offer the best opportunity for each study to advance treatment for patients with advanced and progressive thyroid cancer.

  8. Developing a Peer Mentorship Program to Increase Competence in Clinical Supervision in Clinical Psychology Doctoral Training Programs.

    Science.gov (United States)

    Foxwell, Aleksandra A; Kennard, Beth D; Rodgers, Cynthia; Wolfe, Kristin L; Cassedy, Hannah F; Thomas, Anna

    2017-12-01

    Supervision has recently been recognized as a core competency for clinical psychologists. This recognition of supervision as a distinct competency has evolved in the context of an overall focus on competency-based education and training in health service psychology, and has recently gained momentum. Few clinical psychology doctoral programs offer formal training experiences in providing supervision. A pilot peer mentorship program (PMP) where graduate students were trained in the knowledge and practice of supervision was developed. The focus of the PMP was to develop basic supervision skills in advanced clinical psychology graduate students, as well as to train junior doctoral students in fundamental clinical and practical skills. Advanced doctoral students were matched to junior doctoral students to gain experience in and increase knowledge base in best practices of supervision skills. The 9-month program consisted of monthly mentorship meetings and three training sessions. The results suggested that mentors reported a 30% or more shift from the category of not competent to needs improvement or competent, in the following supervision competencies: theories of supervision, improved skill in supervision modalities, acquired knowledge in supervision, and supervision experience. Furthermore, 50% of the mentors reported that they were not competent in supervision experience at baseline and only 10% reported that they were not competent at the end of the program. Satisfaction data suggested that satisfaction with the program was high, with 75% of participants indicating increased knowledge base in supervision, and 90% indicating that it was a positive addition to their training program. This program was feasible and acceptable and appears to have had a positive impact on the graduate students who participated. Students reported both high satisfaction with the program as well as an increase in knowledge base and experience in supervision skills.

  9. Multistage Stochastic Programming Models for Pharmaceutical Clinical Trial Planning

    Directory of Open Access Journals (Sweden)

    Zuo Zeng

    2017-11-01

    Full Text Available Clinical trial planning of candidate drugs is an important task for pharmaceutical companies. In this paper, we propose two new multistage stochastic programming formulations (CM1 and CM2 to determine the optimal clinical trial plan under uncertainty. Decisions of a clinical trial plan include which clinical trials to start and their start times. Its objective is to maximize expected net present value of the entire clinical trial plan. Outcome of a clinical trial is uncertain, i.e., whether a potential drug successfully completes a clinical trial is not known until the clinical trial is completed. This uncertainty is modeled using an endogenous uncertain parameter in CM1 and CM2. The main difference between CM1 and CM2 is an additional binary variable, which tracks both start and end time points of clinical trials in CM2. We compare the sizes and solution times of CM1 and CM2 with each other and with a previously developed formulation (CM3 using different instances of clinical trial planning problem. The results reveal that the solution times of CM1 and CM2 are similar to each other and are up to two orders of magnitude shorter compared to CM3 for all instances considered. In general, the root relaxation problems of CM1 and CM2 took shorter to solve, CM1 and CM2 yielded tight initial gaps, and the solver required fewer branches for convergence to the optimum for CM1 and CM2.

  10. Cortical microinfarcts on 3T MRI : Clinical correlates in memory-clinic patients

    NARCIS (Netherlands)

    Van Veluw, Susanne J.; Hilal, Saima; Kuijf, Hugo J.; Ikram, Mohammad Kamran; Xin, Xu; Yeow, Tan Boon; Venketasubramanian, Narayanaswamy; Biessels, Geert Jan; Chen, Christopher

    2015-01-01

    Introduction This is the first study to assess cerebral microinfarcts (CMIs) on 3 tesla (3T) magnetic resonance imaging (MRI) in a memory clinic population. Methods We included 238 consecutive patients (aged 72.5 ± 9.1 years) from a memory clinic in Singapore. All patients underwent extensive

  11. Model Programs, Compensatory Education. Diagnostic Reading Clinic, Cleveland, Ohio.

    Science.gov (United States)

    American Institutes for Research in the Behavioral Sciences, Palo Alto, CA.

    Designed to treat reading problems which are beyond the scope of regular classroom reading instruction, the clinic program provides for short, moderate, and long term remediation. Diagnosis of pupils referred by the schools is conducted by a team consisting of a reading clinician, psychologist, nurse and speech and hearing specialist. Based on the…

  12. Optical projects in the Clinic program at Harvey Mudd College

    Science.gov (United States)

    Yang, Q.

    2017-08-01

    Clinic program is the senior capstone program at Harvey Mudd College (HMC). Multidisciplinary and industry-sponsored projects allow a team of students to solve a real-world problem over one academic year. Over its 50 plus years, Clinic program has completed numerous optics related projects. This report gives an overview of the Clinic program, reviews recent optical projects and discusses how this program supports the learning of the HMC engineering students. A few sample optical projects with more details are presented to provide an insight of what challenges that undergraduates can overcome. Students achieve learning within the optics discipline and the related engineering disciplines. The experiences in these optical projects indicate the great potential to bringing optical hands-on projects into the undergraduate level. Because of the general engineering curriculum at HMC, these projects often work the best with a multidisciplinary nature even if the core of the project is optically focused. Students gain leadership training, oral and written communication skills and experiences in team work. Close relationship with the sponsor liaisons allows for the students to gain skills in professional conduct, management of tight schedule and a specified budget, and it well prepares the students to their engineering practice. Optical projects have their own sets of specific challenges, so it needs to be chosen properly to match the undergraduate skill sets such as those of HMC engineering students.

  13. Effectiveness of a Clinically Relevant Educational Program for Improving Medical Communication and Clinical Skills of International Medical Graduates

    Directory of Open Access Journals (Sweden)

    David Watt

    2010-07-01

    Conclusions:  IMGs who participated in a clinically relevant educational program improved their English language proficiency, clinical skills and professionalism for medical practice in a host country.

  14. Residency Programs and Clinical Leadership Skills Among New Saudi Graduate Nurses.

    Science.gov (United States)

    Al-Dossary, Reem Nassar; Kitsantas, Panagiota; Maddox, P J

    2016-01-01

    Nurse residency programs have been adopted by health care organizations to assist new graduate nurses with daily challenges such as intense working environments, increasing patient acuity, and complex technologies. Overall, nurse residency programs are proven beneficial in helping nurses transition from the student role to independent practitioners and bedside leaders. The purpose of this study was to assess the impact of residency programs on leadership skills of new Saudi graduate nurses who completed a residency program compared to new Saudi graduate nurses who did not participate in residency programs. The study design was cross-sectional involving a convenience sample (n = 98) of new graduate nurses from three hospitals in Saudi Arabia. The Clinical Leadership Survey was used to measure the new graduate nurses' clinical leadership skills based on whether they completed a residency program or not. Descriptive statistics, correlation, and multiple linear regression analyses were conducted to examine leadership skills in this sample of new Saudi graduate nurses. A significant difference was found between residents and nonresidents in their leadership skills (t = 10.48, P = .000). Specifically, residents were significantly more likely to show higher levels of leadership skills compared to their counterparts. Attending a residency program was associated with a significant increase in clinical leadership skills. The findings of this study indicate that there is a need to implement more residency programs in hospitals of Saudi Arabia. It is imperative that nurse managers and policy makers in Saudi Arabia consider these findings to improve nurses' leadership skills, which will in turn improve patient care. Further research should examine how residency programs influence new graduate nurses' transition from student to practitioner with regard to clinical leadership skills in Saudi Arabia. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. The effects of a deliberate practice program on nursing students' perception of clinical competence.

    Science.gov (United States)

    Liou, Shwu-Ru; Chang, Chia-Hao; Tsai, Hsiu-Min; Cheng, Ching-Yu

    2013-04-01

    New nursing graduates' readiness for practice often does not meet the requirements needed in the real situation of clinical sites. Therefore, nurse education has placed more emphasis on developing students' technical skills to cultivate proficiencies needed for clinical sites. To develop a program including deliberate skill practices and technical skill testing, each conducted before students' clinical practicum, and to examine the program's effects on nursing students' clinical competence. The study was a repeated measure correlational design. One nursing university. Two-hundred-fifty-six and 266 nursing students in a RN-to-BSN night school program in Taiwan completed pretest and posttest surveys, respectively in 2009 and 2010. Their mean age was 22.61 years and had worked 12.75 months as a nurse. Students were asked to participate in the deliberate nursing practice program, which includes skill practice and tests, before their last clinical practicum. The Clinical Competence Questionnaire was used to measure the outcome of deliberate practice. Findings indicated that participants who had nursing work experience, a higher grade point average, practiced their skills by watching videos, and higher pretest competence scores exhibited significantly higher posttest competence scores. Participants who worked in the operating room/outpatient department, scored higher on self-confidence in clinical performance, and had a higher level of future job stress exhibited significantly lower posttest competence scores. Although work experience increased clinical competence, working in the operating room/outpatient department where many nursing skills were not performed did not have the effects. In contrast, skill reviews and better performance before practice promoted competence. Attaining motor skill competency is a slow process requiring practices. Thus, providing deliberate skill-practice program is suggested to help students increase their competence. Copyright © 2012

  16. Indigenous health: designing a clinical orientation program valued by learners.

    Science.gov (United States)

    Huria, Tania; Palmer, Suetonia; Beckert, Lutz; Lacey, Cameron; Pitama, Suzanne

    2017-10-05

    Indigenous health programs are seen as a curriculum response to addressing health disparities and social accountability. Several interrelated teaching approaches to cultural competency curricula have been recommended, however evidence of the impact of these on learner outcomes including engagement and self-reported competencies is limited. We aimed to explore undergraduate medical student perspectives of an indigenous health orientation program to inform curriculum strategies that promote learning and development of clinical skills. We analyzed quantitative and qualitative student evaluations (n = 602) of a three-day immersed indigenous health orientation program between 2006 and 2014 based on Likert-scale responses and open-text comments. We conducted a thematic analysis of narrative student experiences (n = 426). Overall, 509 of 551 respondents (92%) rated the indigenous health orientation program as extremely or highly valuable and most (87%) reported that the course strongly increased their interest in indigenous health. The features of the clinical course that enhanced value for learners included situated learning (learning environment; learning context); teaching qualities (enthusiasm and passion for Māori health; role-modelling); curriculum content (re-presenting Māori history; exploring Māori beliefs, values and practices; using a Māori health framework in clinical practice); teaching methodologies (multiple teaching methods; simulated patient interview); and building relationships with peers (getting to know the student cohort; developing professional working relationships). Undergraduate medical students valued an indigenous health program delivered in an authentic indigenous environment and that explicitly reframed historical notions of indigenous health to contextualize learning. Content relevant to clinical practice, faculty knowledge, and strengthened peer interactions combined to build learner confidence and self-reported indigenous health

  17. Collaborative Clinical Placements: Interactions Among Students From Different Programs.

    Science.gov (United States)

    Lait, Jana

    2015-08-01

    Shortages of clinical placements for health care students in Canada have led education and health care organizations to explore innovative ways to increase placement capacity. One way to increase capacity is to bring together students from various programs for their placements, which also allows students to learn about each other's roles and how to work collaboratively. This article describes shared placements for students from bachelor of nursing, practical nurse, and health care aide programs. Qualitative interviews were used. Students benefited from this approach by learning about the roles of other providers and how to coordinate care with others. The challenges of the approach were competition among students for opportunities to practice clinical procedures and concerns about how to communicate with other students when sharing the care of patients. The objectives of increasing student placement capacity and expanding collaboration opportunities were partially achieved through this approach to clinical education. Copyright 2015, SLACK Incorporated.

  18. Correlations between PANCE performance, physician assistant program grade point average, and selection criteria.

    Science.gov (United States)

    Brown, Gina; Imel, Brittany; Nelson, Alyssa; Hale, LaDonna S; Jansen, Nick

    2013-01-01

    The purpose of this study was to examine correlations between first-time Physician Assistant National Certifying Exam (PANCE) scores and pass/fail status, physician assistant (PA) program didactic grade point average (GPA), and specific selection criteria. This retrospective study evaluated graduating classes from 2007, 2008, and 2009 at a single program (N = 119). There was no correlation between PANCE performance and undergraduate grade point average (GPA), science prerequisite GPA, or health care experience. There was a moderate correlation between PANCE pass/fail and where students took science prerequisites (r = 0.27, P = .003) but not with the PANCE score. PANCE scores were correlated with overall PA program GPA (r = 0.67), PA pharmacology grade (r = 0.68), and PA anatomy grade (r = 0.41) but not with PANCE pass/fail. Correlations between selection criteria and PANCE performance were limited, but further research regarding the influence of prerequisite institution type may be warranted and may improve admission decisions. PANCE scores and PA program GPA correlations may guide academic advising and remediation decisions for current students.

  19. Clinical, Endoscopical and Histological Correlation and Measures of Association in Ulcerative Colitis.

    Science.gov (United States)

    Fluxá, Daniela; Simian, Daniela; Flores, Lilian; Ibáñez, Patricio; Lubascher, Jaime; Figueroa, Carolina; Quera, Rodrigo; Kronberg, Udo; Pizarro, Gonzalo; Castro, Magdalena; Piottante, Antonio; Vial, María Teresa

    2017-09-26

    To determine the correlation between clinical, fecal, endoscopic and histologic activity in patients with ulcerative colitis. A correlational analytic cross-sectional study was performed in patients with ulcerative colitis who underwent colonoscopy between February and December 2016. Clinical, endoscopic, fecal and histologic activities were determined using the Partial Mayo Subscore, Endoscopic Subscore and Mayo Modified Endoscopic Subscore, Fecal Calprotectin and Geboes Score and the presence of basal plasmacytosis, respectively. Scores were analyzed with Spearman's rank correlation coefficient test. To determine the association between scores and some clinical variables and active ulcerative colitis, univariate and multivariate logistic regression were used. 105 endoscopic procedures (91 patients), were included. In 65% of the procedures, the mucosa was inflamed; however, 15% did not show histological inflammation. Endoscopic remission was observed in the other 35% of procedures; however, 22% exhibited histologic inflammation in their biopsies. Mayo Endoscopic Subscore and Mayo Modified Endoscopic Score were well correlated but were only moderately correlated with clinical and histologic scores. Further, there was a moderate correlation between Mayo Endoscopic Score and Geboes Score. Conversely, histologic scores were poorly correlated with Partial Mayo Score. Using multivariate analysis, Geboes Score and basal plasmacytosis were predictive of active disease (OR 3.05; 95% CI: 1.54-7.95 and OR 3.24; 95% CI: 1.12-9.34, respectively), whereas biological therapy usage was found to be protective factor for ulcerative colitis (OR 0.02; 95% CI: 0.00-0.64). Clinical, endoscopic and histologic activities were moderately correlated, while Geboes Score and basal plasmacytosis were predictive of endoscopically active disease. This article is protected by copyright. All rights reserved.

  20. Adductor-related groin pain in athletes: correlation of MR imaging with clinical findings

    Energy Technology Data Exchange (ETDEWEB)

    Robinson, P. [Department of Radiology, Leeds Teaching Hospitals, Leeds (United Kingdom); MRI Department, Clarendon Wing, Leeds General Infirmary, Great George Street, LS1 3EX, Leeds (United Kingdom); Barron, D.A.; Grainger, A.J.; O' Connor, P.J. [Department of Radiology, Leeds Teaching Hospitals, Leeds (United Kingdom); Parsons, W. [Research and Development Department, Leeds Teaching Hospitals, Leeds (United Kingdom); Schilders, E.M.G. [Department of Orthopaedic Surgery, Bradford Royal Infirmary, Bradford (United Kingdom)

    2004-08-01

    To evaluate gadolinium-enhanced MR imaging in athletes with chronic groin pain and correlate with the clinical features. MR examinations performed in 52 athletes (51 male, 1 female; median age 26 years) with chronic groin pain and 6 asymptomatic control athletes (6 male; median age 29 years) were independently reviewed by two radiologists masked to the clinical details. Symptom duration (median 6 months) and clinical side of severity were recorded. Anatomical areas in the pelvis were scored for abnormality (as normal, mildly abnormal or abnormal) and an overall assessment for side distribution of abnormality was recorded, initially without post-gadolinium sequences and then, 3 weeks later (median 29 days), the post-gadolinium sequences only. Correlation between radiological and clinical abnormality was calculated by Spearman's correlation. Abnormal anterior pubis and enthesis enhancement significantly correlated with clinical side for both radiologists (both P=0.008). Abnormal anterior pubis and adductor longus enthesis oedema was significant for one radiologist (P=0.009). All other features showed no significant correlation (P>0.05). In the control cases there was no soft tissue abnormality but symphyseal irregularity was present (n=2). For both radiologists assessment of imaging side severity significantly correlated with clinical side for post-gadolinium (P=0.048 and P=0.023) but not non-gadolinium sequences (P>0.05). The extent and side of anterior pubis and adductor longus enthesis abnormality on MR imaging significantly and reproducibly correlates with the athletes' current symptoms in chronic adductor-related groin pain. (orig.)

  1. Correlations of magnetic resonance imaging findings with clinical symptom severity and prognosis of frozen shoulder.

    Science.gov (United States)

    Yoon, Jong Pil; Chung, Seok Won; Lee, Byung Joo; Kim, Hyung Sup; Yi, Jae Hyuck; Lee, Hyun-Joo; Jeong, Won-Ju; Moon, Sung Gyu; Oh, Kyung-Soo; Yoon, Seok Tae

    2015-11-26

    To evaluate the correlation between indirect magnetic resonance (MR) arthrographic imaging findings and the clinical symptoms and prognosis of patients with frozen shoulder. Indirect MR arthrography was performed for 52 patients with primary frozen shoulder (mean age 55.1 ± 9.0 years) and 52 individuals without frozen shoulder (mean age 53.1 ± 10.7 years); capsular thickening and enhancement of the axillary recess as well as soft tissue thickening of the rotator interval were evaluated. Clinical symptom severity was assessed using the Visual Analogue Scale for Pain (VAS Pain), simple shoulder test (SST), Constant score, American Shoulder and Elbow Surgeons (ASES) score, and range of motion (ROM). At 6-month follow-up, we evaluated whether MR arthrography findings correlated with the clinical symptoms and prognosis. Capsular thickening and enhancement of the axillary recess as well as soft tissue thickening of the rotator interval were significantly greater in the patient group than in the controls (p symptoms or ROM (n.s.); however, capsular enhancement correlated with clinical symptom severity according to VAS Pain (p = 0.005), SST (p = 0.046), and ASES scores (p = 0.009). Soft tissue thickening of the rotator interval did not correlate with clinical symptom severity, but was associated with external rotation limitation (p = 0.002). However, none of the parameters correlated with clinical symptoms at 6-month follow-up. Indirect MR arthrography provided ancillary findings, especially with capsular enhancement, for evaluating clinical symptom severity of frozen shoulder, but did not reflect the prognosis. MR findings in frozen shoulder should not replace clinical judgments regarding further prognosis and treatment decisions. IV.

  2. Attrition in a clinical laboratory technician associate degree program.

    Science.gov (United States)

    Blume, W M; Krefetz, R G

    1997-01-01

    To determine the reasons for attrition in a clinical laboratory technician-associate degree program, a retrospective study was done on classes entering from 1987 to 1992. Suggestions are made to increase retention. The medical laboratory department at the Community College of Philadelphia in Pennsylvania. There were 43,987 students enrolled for the 1993 to 1994 academic year; 17,846 full time equivalents at the college. Clinical laboratory technician students averaged 26.2 years and were 26% male and 74% female, which closely paralleled the college. The ethnic make-up of the clinical laboratory technician classes was 54% White, 32% African American, 11% Asian, and 3% Latin American, compared to 48% African American, 36% White, 10% Asian, and 6% Latin American students in the college. A retrospective study was performed to evaluate attrition rates for the classes entering the clinical laboratory technician program at the Community College of Philadelphia from 1987 to 1992. Reasons for this attrition were tabulated and evaluated. One hundred twenty-nine students entered the program and 75 graduated, producing an attrition rate of 42%. There were 6 categories of reasons given for not completing the program: academic difficulties, dislike of the laboratory science field, family problems, financial problems, substance abuse, and other problems not specified. Because 80% of the attrition was due to poor academic performance and a dislike of the field, several changes are being made in the Community College of Philadelphia's retention program. An enhanced orientation will be given to all students, and students will be required to visit a hospital laboratory. Early faculty intervention and peer counseling for students with poor academic performance will be instituted.

  3. The UCLA Health Resident Informaticist Program - A Novel Clinical Informatics Training Program.

    Science.gov (United States)

    Singer, Jennifer S; Cheng, Eric M; Baldwin, Kevin; Pfeffer, Michael A

    2017-07-01

    Few opportunities exist for physician trainees to gain exposure to, and training in, the field of clinical informatics, an Accreditation Council for Graduate Medical Education-accredited, recently board-certified specialty. Currently, 21 approved programs exist nationwide for the formal training of fellows interested in pursuing careers in this discipline. Residents and fellows training in medical and surgical fields, however, have few avenues available to gain experience in clinical informatics. An early introduction to clinical informatics brings an opportunity to generate interest for future career trajectories. At University of California Los Angeles (UCLA) Health, we have developed a novel, successful, and sustainable program, the Resident Informaticist Program, with the goals of exposing physician trainees to the field of clinical informatics and its academic nature and providing opportunities to expand the clinical informatics workforce. Herein, we provide an overview of the development, implementation, and current state of the UCLA Health Resident Informaticist Program, with a blueprint for development of similar programs. © The Author 2017. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  4. Bayesian sample size determination for a clinical trial with correlated continuous and binary outcomes.

    Science.gov (United States)

    Stamey, James D; Natanegara, Fanni; Seaman, John W

    2013-01-01

    In clinical trials, multiple outcomes are often collected in order to simultaneously assess effectiveness and safety. We develop a Bayesian procedure for determining the required sample size in a regression model where a continuous efficacy variable and a binary safety variable are observed. The sample size determination procedure is simulation based. The model accounts for correlation between the two variables. Through examples we demonstrate that savings in total sample size are possible when the correlation between these two variables is sufficiently high.

  5. Imaging diagnosis in relapsing polychondritis and correlation with clinical and serological data

    Energy Technology Data Exchange (ETDEWEB)

    Thaiss, W.M.; Nikolaou, K.; Horger, M. [Eberhard Karls University, Department of Radiology, Diagnostic and Interventional Radiology, Tuebingen (Germany); Spengler, W.; Xenitidis, T.; Henes, J. [Eberhard Karls University, Department of Internal Medicine II, Tuebingen (Germany); Spira, D. [Eberhard Karls University, Department of Radiology, Diagnostic and Interventional Radiology, Tuebingen (Germany); University Medical Center Heidelberg, Diagnostic and Interventional Radiology, Heidelberg (Germany)

    2016-03-15

    We hypothesize that imaging findings from CT and MRI correlate better with clinical markers for assessment of disease activity in patients with the rare relapsing polychondritis (RPC) than with serological inflammatory markers. Retrospective database search at our institution identified 28 patients (13 females; age 49.0 years ± 15.0 SD) with RP between September 2004 and March 2014. Institutional review board approval was obtained for this retrospective data analysis. All patients had clinically proven RPC with at least two episodes of active disease. Of those, 18 patients were examined with CT- and MRI and presented all morphologic features of RPC like bronchial/laryngeal/auricular cartilage thickness, contrast enhancement, increased T2-signal intensity. Imaging data was subsequently correlated with corresponding clinical symptoms like fever, dyspnea, stridor, uveitis, pain, hearing impairment as well as with acute-phase-inflammatory parameters like C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). The clinical parameters were in good agreement with imaging findings and clinical symptoms such as tracheal wall thickening and dyspnea (r =0.65 p = 0.05), joint synovitis on MRI and a higher McAdam score (r = 0.84 p < 0.001). No correlations were found between inflammatory laboratory markers, imaging findings and clinical features. Imaging diagnosis in RPC using CT and/or MRI delivers information about the degree of disease activity that correlates better with clinical features than unspecific inflammatory laboratory markers. Additionally, clinically unapparent cartilage involvement can be assessed adding value to the clinical diagnosis and therapy planning in this rare disease. (orig.)

  6. Latent profile analysis in frontotemporal lobar degeneration and related disorders: clinical presentation and SPECT functional correlates

    Directory of Open Access Journals (Sweden)

    Di Luca Monica

    2007-05-01

    Full Text Available Abstract Background Frontotemporal Lobar Degeneration (FTLD thus recently renamed, refers to a spectrum of heterogeneous conditions. This same heterogeneity of presentation represents the major methodological limit for the correct evaluation of clinical designation and brain functional correlates. At present, no study has investigated clinical clusters due to specific cognitive and behavioural disturbances beyond current clinical criteria. The aim of this study was to identify clinical FTLD presentation, based on cognitive and behavioural profile, and to define their SPECT functional correlations. Methods Ninety-seven FTLD patients entered the study. A clinical evaluation and standardised assessment were preformed, as well as a brain SPECT perfusion imaging study. Latent Profile Analysis on clinical, neuropsychological, and behavioural data was performed. Voxel-basis analysis of SPECT data was computed. Results Three specific clusters were identified and named "pseudomanic behaviour" (LC1, "cognitive" (LC2, and "pseudodepressed behaviour" (LC3 endophenotypes. These endophenotypes showed a comparable hypoperfusion in left temporal lobe, but a specific pattern involving: medial and orbitobasal frontal cortex in LC1, subcortical brain region in LC2, and right dorsolateral frontal cortex and insula in LC3. Conclusion These findings provide evidence that specific functional-cluster symptom relationship can be delineated in FTLD patients by a standardised assessment. The understanding of the different functional correlates of clinical presentations will hopefully lead to the possibility of individuating diagnostic and treatment algorithms.

  7. Correlation Between Screening Mammography Interpretive Performance on a Test Set and Performance in Clinical Practice.

    Science.gov (United States)

    Miglioretti, Diana L; Ichikawa, Laura; Smith, Robert A; Buist, Diana S M; Carney, Patricia A; Geller, Berta; Monsees, Barbara; Onega, Tracy; Rosenberg, Robert; Sickles, Edward A; Yankaskas, Bonnie C; Kerlikowske, Karla

    2017-10-01

    Evidence is inconsistent about whether radiologists' interpretive performance on a screening mammography test set reflects their performance in clinical practice. This study aimed to estimate the correlation between test set and clinical performance and determine if the correlation is influenced by cancer prevalence or lesion difficulty in the test set. This institutional review board-approved study randomized 83 radiologists from six Breast Cancer Surveillance Consortium registries to assess one of four test sets of 109 screening mammograms each; 48 radiologists completed a fifth test set of 110 mammograms 2 years later. Test sets differed in number of cancer cases and difficulty of lesion detection. Test set sensitivity and specificity were estimated using woman-level and breast-level recall with cancer status and expert opinion as gold standards. Clinical performance was estimated using women-level recall with cancer status as the gold standard. Spearman rank correlations between test set and clinical performance with 95% confidence intervals (CI) were estimated. For test sets with fewer cancers (N = 15) that were more difficult to detect, correlations were weak to moderate for sensitivity (woman level = 0.46, 95% CI = 0.16, 0.69; breast level = 0.35, 95% CI = 0.03, 0.61) and weak for specificity (0.24, 95% CI = 0.01, 0.45) relative to expert recall. Correlations for test sets with more cancers (N = 30) were close to 0 and not statistically significant. Correlations between screening performance on a test set and performance in clinical practice are not strong. Test set performance more accurately reflects performance in clinical practice if cancer prevalence is low and lesions are challenging to detect. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

  8. Estimation of positive semidefinite correlation matrices by using convex quadratic semidefinite programming.

    Science.gov (United States)

    Fushiki, Tadayoshi

    2009-07-01

    The correlation matrix is a fundamental statistic that is used in many fields. For example, GroupLens, a collaborative filtering system, uses the correlation between users for predictive purposes. Since the correlation is a natural similarity measure between users, the correlation matrix may be used in the Gram matrix in kernel methods. However, the estimated correlation matrix sometimes has a serious defect: although the correlation matrix is originally positive semidefinite, the estimated one may not be positive semidefinite when not all ratings are observed. To obtain a positive semidefinite correlation matrix, the nearest correlation matrix problem has recently been studied in the fields of numerical analysis and optimization. However, statistical properties are not explicitly used in such studies. To obtain a positive semidefinite correlation matrix, we assume the approximate model. By using the model, an estimate is obtained as the optimal point of an optimization problem formulated with information on the variances of the estimated correlation coefficients. The problem is solved by a convex quadratic semidefinite program. A penalized likelihood approach is also examined. The MovieLens data set is used to test our approach.

  9. TETRA-COM: a comprehensive SPSS program for estimating the tetrachoric correlation.

    Science.gov (United States)

    Lorenzo-Seva, Urbano; Ferrando, Pere J

    2012-12-01

    We provide an SPSS program that implements descriptive and inferential procedures for estimating tetrachoric correlations. These procedures have two main purposes: (1) bivariate estimation in contingency tables and (2) constructing a correlation matrix to be used as input for factor analysis (in particular, the SPSS FACTOR procedure). In both cases, the program computes accurate point estimates, as well as standard errors and confidence intervals that are correct for any population value. For purpose (1), the program computes the contingency table together with five other measures of association. For purpose (2), the program checks the positive definiteness of the matrix, and if it is found not to be Gramian, performs a nonlinear smoothing procedure at the user's request. The SPSS syntax, a short manual, and data files related to this article are available as supplemental materials from brm.psychonomic-journals.org/content/supplemental.

  10. Correlation between spinal cord MRI and clinical features in patients with demyelinating disease

    Energy Technology Data Exchange (ETDEWEB)

    Papadopoulos, A. [Areteion Hospital, Athens (Greece). CT and MRI Unit, X-ray Dept.; Gatzonis, S. [Univ. of Athens Medical School, Eginition Hospital (Greece). Neurology Dept.; Gouliamos, A. [Areteion Hospital, Athens (Greece). CT and MRI Unit, X-ray Dept.; Trakadas, S. [Areteion Hospital, Athens (Greece). CT and MRI Unit, X-ray Dept.; Kalovidouris, A. [Areteion Hospital, Athens (Greece). CT and MRI Unit, X-ray Dept.; Sgouropoulos, P. [Univ. of Athens Medical School, Eginition Hospital (Greece). Neurology Dept.; Vlachos, L. [Areteion Hospital, Athens (Greece). CT and MRI Unit, X-ray Dept.; Papavasiliou, C. [Areteion Hospital, Athens (Greece). CT and MRI Unit, X-ray Dept.

    1994-02-01

    Localisation of spinal cord lesions by MRI was correlated with neurological symptoms and signs in 16 patients with clinical and laboratory evidence of multiple sclerosis. There was good correspondence between spinal cord lesions and motor tract signs. On the other hand, superficial or deep sensory disturbances correlated with spinal cord lesions in only about a quarter of the patients. MRI of the spinal cord appeared to explain the myelopathy in 11 patients, while in 3 there was strong clinical evidence of more extensive demyelinating lesions. In 7 of the 16 patients MRI of the brain was normal. (orig.)

  11. Promising practices for school-located vaccination clinics-- part II: clinic operations and program sustainability.

    Science.gov (United States)

    Lott, John; Johnson, Jennifer

    2012-03-01

    A school-located mass vaccination program can enable rapid vaccination of a large number of students while minimizing disruption of their school activities. During 3 consecutive influenza seasons beginning in 2005, the Knox County Health Department conducted school-located mass vaccination clinics using live attenuated influenza vaccine. Overall, the proportion of elementary schoolchildren vaccinated with live attenuated influenza vaccine exceeded 40% each year. We describe key lessons learned in clinic operations, including obtaining informed consent, defining the organizational structure and roles, preparing the school, staffing, training, supplies, vaccine management, team communication, and data management. We conclude by discussing program costs and sustainability.

  12. Correlation of severity of sarcoidosis shown by chest CT with clinical and pulmonary functional findings

    Energy Technology Data Exchange (ETDEWEB)

    Toyoshima, Masami; Kaminou, Toshio; Yamada, Hisashi; Sekine, Hiroshi; Furukawa, Takashi; Matsui, Yasuo; Oritsu, Minoru (Japan Red Cross Medical Center, Tokyo (Japan)); Minaguchi, Kazuo; Onoyama, Yasuto

    1991-01-01

    For 39 patients with sarcoidosis, we evaluated the correlation of chest CT findings (granular shadows, nodular shadows, irregular enlargement of pulmonary vascular shadows, infiltrative shadows, reticular shadows, linear shadows, incresed density of lung field areas, and lymphadenopathy) with results of clinical and pulmonary function tests (PFTs). CT detected and delineated lung field involvement and lymphadenopathy better than Ga scanning. The severity of parenchymal changes on the CT scan was correlated with PFTs results for VC% and DLco%. The severity of lymphadenopathy on the CT scan was correlated with the serum levels of angiotensin converting enzyme and OKT4/OKT8 in bronchoalveolar lavage fluid. (author).

  13. Clinical and Morphological Changes Following 2 Rehabilitation Programs for Acute Hamstring Strain Injuries: A Randomized Clinical Trial

    Science.gov (United States)

    SILDER, AMY; SHERRY, MARC A.; SANFILIPPO, JENNIFER; TUITE, MICHAEL J.; HETZEL, SCOTT J.; HEIDERSCHEIT, BRYAN C.

    2013-01-01

    STUDY DESIGN Randomized, double-blind, parallel-group clinical trial. OBJECTIVES To assess differences between a progressive agility and trunk stabilization rehabilitation program and a progressive running and eccentric strengthening rehabilitation program in recovery characteristics following an acute hamstring injury, as measured via physical examination and magnetic resonance imaging (MRI). BACKGROUND Determining the type of rehabilitation program that most effectively promotes muscle and functional recovery is essential to minimize reinjury risk and to optimize athlete performance. METHODS Individuals who sustained a recent hamstring strain injury were randomly assigned to 1 of 2 rehabilitation programs: (1) progressive agility and trunk stabilization or (2) progressive running and eccentric strengthening. MRI and physical examinations were conducted before and after completion of rehabilitation. RESULTS Thirty-one subjects were enrolled, 29 began rehabilitation, and 25 completed rehabilitation. There were few differences in clinical or morphological outcome measures between rehabilitation groups across time, and reinjury rates were low for both rehabilitation groups after return to sport (4 of 29 subjects had reinjuries). Greater craniocaudal length of injury, as measured on MRI before the start of rehabilitation, was positively correlated with longer return-to-sport time. At the time of return to sport, although all subjects showed a near-complete resolution of pain and return of muscle strength, no subject showed complete resolution of injury as assessed on MRI. CONCLUSION The 2 rehabilitation programs employed in this study yielded similar results with respect to hamstring muscle recovery and function at the time of return to sport. Evidence of continuing muscular healing is present after completion of rehabilitation, despite the appearance of normal physical strength and function on clinical examination. LEVEL OF EVIDENCE Therapy, level 1b–. J Orthop

  14. Clinical and morphological changes following 2 rehabilitation programs for acute hamstring strain injuries: a randomized clinical trial.

    Science.gov (United States)

    Silder, Amy; Sherry, Marc A; Sanfilippo, Jennifer; Tuite, Michael J; Hetzel, Scott J; Heiderscheit, Bryan C

    2013-05-01

    Randomized, double-blind, parallel-group clinical trial. To assess differences between a progressive agility and trunk stabilization rehabilitation program and a progressive running and eccentric strengthening rehabilitation program in recovery characteristics following an acute hamstring injury, as measured via physical examination and magnetic resonance imaging (MRI). Determining the type of rehabilitation program that most effectively promotes muscle and functional recovery is essential to minimize reinjury risk and to optimize athlete performance. Individuals who sustained a recent hamstring strain injury were randomly assigned to 1 of 2 rehabilitation programs: (1) progressive agility and trunk stabilization or (2) progressive running and eccentric strengthening. MRI and physical examinations were conducted before and after completion of rehabilitation. Thirty-one subjects were enrolled, 29 began rehabilitation, and 25 completed rehabilitation. There were few differences in clinical or morphological outcome measures between rehabilitation groups across time, and reinjury rates were low for both rehabilitation groups after return to sport (4 of 29 subjects had reinjuries). Greater craniocaudal length of injury, as measured on MRI before the start of rehabilitation, was positively correlated with longer return-to-sport time. At the time of return to sport, although all subjects showed a near-complete resolution of pain and return of muscle strength, no subject showed complete resolution of injury as assessed on MRI. The 2 rehabilitation programs employed in this study yielded similar results with respect to hamstring muscle recovery and function at the time of return to sport. Evidence of continuing muscular healing is present after completion of rehabilitation, despite the appearance of normal physical strength and function on clinical examination. Therapy, level 1b-.

  15. Comparison of recent graduates of clinical versus counseling psychology programs.

    Science.gov (United States)

    Brems, C; Johnson, M E

    1997-01-01

    Recent graduates from clinical (N = 65) and counseling (N = 64) psychology programs were surveyed to assess similarities and differences of aspects of their programs and job-related activity. Results revealed only minor differences. Counseling psychologists were more likely to provide group therapy, career counseling and assessment, public lectures and workshops, to have more knowledge of the Strong Interest Inventory, to be more likely to work in university counseling centers, and to endorse humanistic theoretical orientations. Clinical psychologists were more likely to work in medical school settings, to ascribe human behavior to internal states rather than to social causes, and to have greater knowledge of the Rorschach. However, the similarities between the two specialities relative to work setting, theoretical orientation, service, research, and teaching activities, far outweighed these minor differences. Implications of these findings are placed in the context of previous research that has suggested the possible merger of the two specialities.

  16. Correlation of clinical, cytological and histological findings in oral squamous cell carcinomas

    OpenAIRE

    SOUSA, MICHELE CARDOSO; ALVES, MONICA GHISLAINE OLIVEIRA; SOUZA, LUCIANO ALBINO; BRANDÃO, ADRIANA AIGOTTI HABERBECK; ALMEIDA, JANETE DIAS; CABRAL, LUIZ ANTONIO GUIMARÃES

    2014-01-01

    The present study aimed to investigate the efficiency of exfoliative cytology by correlating the clinical lesions of oral squamous cell carcinoma (OSCC) with exfoliative cytology and histopathological findings. Cases of OSCC diagnosed between 1984 and 2010 were analyzed. The inclusion criteria for the present study were the availability of detailed clinical findings and a diagnosis of the disease through exfoliative cytology and histopathology. The cases were assessed and assigned scores, whi...

  17. Correlations between Clinical Judgement and Learning Style Preferences of Nursing Students in the Simulation Room

    OpenAIRE

    Hallin, Karin; H?ggstr?m, Marie; B?ckstr?m, Britt; Kristiansen, Lisbeth Porskrog

    2015-01-01

    Background: Health care educators account for variables affecting patient safety and are responsible for developing the highly complex process of education planning. Clinical judgement is a multidimensional process, which may be affected by learning styles. The aim was to explore three specific hypotheses to test correlations between nursing students? team achievements in clinical judgement and emotional, sociological and physiological learning style preferences. Methods: A descriptive cross-...

  18. Advancing patient care through innovative practice: the Clinical Partners Program.

    Science.gov (United States)

    Mehta, Bella H; Rodis, Jennifer L; Nahata, Milap C; Bennett, Marialice S

    2005-12-01

    The development, implementation, and outcomes assessment of an innovative pharmacist-managed ambulatory care and community pharmacy practice clinic are described. The Clinical Partners Program at The Ohio State University (OSU) provides an active learning environment for students and residents, offers a patient-focused practice model based on pharmaceutical care principles, and serves as an arena for applied research in pharmacy practice. The program offers multiple services, including anticoagulation management, diabetes self-management, cholesterol management, hepatitis C education, herbal product and dietary supplement consultations, medication management, smoking cessation, and wellness. The practice is currently staffed by two faculty members from the college of pharmacy, with a 0.8 full-time-equivalent (FTE) pharmacist and a 0.65 FTE community pharmacy resident. It has served as a training site for 17 pharmacy residents, 28 bachelor of science (B.S.) in pharmacy students, 30 post-B.S. doctor of pharmacy (Pharm.D.) students, and 132 entry-level Pharm.D. students at various levels of training. The most successful methods of reimbursement for programs have been contracted services with OSU Managed Health Care Systems, Inc., which serves OSU faculty and staff and fee-for-service billing, charged directly to non-OSU patients. Numerous studies have shown that Clinical Partners has consistently demonstrated improved therapeutic outcomes over those achieved in traditional practice. Faculty are exploring outreach services, including the development of advanced practice community sites for the college, establishing patient care services within physician offices, and providing disease management services for self-insured employers. The Clinical Partners Program has improved patient care and provided education and training opportunities for pharmacy students and residents.

  19. An oracle: antituberculosis pharmacokinetics-pharmacodynamics, clinical correlation, and clinical trial simulations to predict the future.

    Science.gov (United States)

    Pasipanodya, Jotam; Gumbo, Tawanda

    2011-01-01

    Antimicrobial pharmacokinetic-pharmacodynamic (PK/PD) science and clinical trial simulations have not been adequately applied to the design of doses and dose schedules of antituberculosis regimens because many researchers are skeptical about their clinical applicability. We compared findings of preclinical PK/PD studies of current first-line antituberculosis drugs to findings from several clinical publications that included microbiologic outcome and pharmacokinetic data or had a dose-scheduling design. Without exception, the antimicrobial PK/PD parameters linked to optimal effect were similar in preclinical models and in tuberculosis patients. Thus, exposure-effect relationships derived in the preclinical models can be used in the design of optimal antituberculosis doses, by incorporating population pharmacokinetics of the drugs and MIC distributions in Monte Carlo simulations. When this has been performed, doses and dose schedules of rifampin, isoniazid, pyrazinamide, and moxifloxacin with the potential to shorten antituberculosis therapy have been identified. In addition, different susceptibility breakpoints than those in current use have been identified. These steps outline a more rational approach than that of current methods for designing regimens and predicting outcome so that both new and older antituberculosis agents can shorten therapy duration.

  20. Rasch analysis of three dry eye questionnaires and correlates with objective clinical tests.

    Science.gov (United States)

    McAlinden, Colm; Gao, Rongrong; Wang, Qinmei; Zhu, Senmiao; Yang, Jing; Yu, Ayong; Bron, Anthony J; Huang, Jinhai

    2017-04-01

    To assess the psychometric properties of Chinese versions of the Ocular Comfort Index (OCI), Ocular Surface Disease Index (OSDI) and McMonnies questionnaires. Further, to assess the correlation between questionnaire scores and objective dry eye disease (DED) clinical tests. Translated versions of the OCI, OSDI and McMonnies questionnaires were completed in a random order by 238 participants with DED. Objective clinical tests included visual acuity (VA), fluorescein tear film break-up time (TBUT), corneal fluorescein staining, Schirmer I testing and meibomian gland grading. Rasch analysis was used to assess questionnaire psychometrics and spearman rank for correlations. For the OCI, the person separation was 2.31, item infit and outfit statistics ranged from 0.74-1.14 and 0.75-1.32, respectively, and targeting 1.54 logits. For the OSDI, person separation was 0.94. None of the three subscales provided valid measurements based on Rasch analysis. For the McMonnies questionnaire, person separation was 1.17, item infit and outfit statistics ranged from 0.7 to 1.21 and 0.51-3.49, respectively. There were weak correlations between questionnaire scores and clinical tests. There were weak correlations between OSDI scores and VA, fluorescein TBUT, Schirmer I testing and corneal fluorescein staining. There were weak correlations between McMonnies scores and VA, fluorescein TBUT, Schirmer I testing, and corneal fluorescein staining and meibomian gland grading. The OCI questionnaire was the only questionnaire that provided valid measurement on the basis of Rasch analysis, although slight multidimensionality was found. There were weak correlations between OCI scores and fluorescein TBUT, Schirmer I testing, and corneal fluorescein staining. Due to this paradoxical disconnect between symptoms and signs and the repeatability of tests, the use of both subjective and objective markers in the clinical management of patients or as endpoints in clinical trials would appear prudent

  1. Routine Clinical-Pathologic Correlation of Pigmented Skin Tumors Can Influence Patient Management.

    Science.gov (United States)

    Longo, Caterina; Piana, Simonetta; Lallas, Aimilios; Moscarella, Elvira; Lombardi, Mara; Raucci, Margherita; Pellacani, Giovanni; Argenziano, Giuseppe

    2015-01-01

    Several studies have demonstrated the benefit of integrating clinical with pathologic information, to obtain a confident diagnosis for melanocytic tumors. However, all those studies were conducted retrospectively and no data are currently available about the role of a clinical-pathologic correlation approach on a daily basis in clinical practice. In our study, we evaluated the impact of a routine clinical-pathologic correlation approach for difficult skin tumors seen over 3 years in a tertiary referral center. Interestingly, a re-appraisal was requested for 158 out of 2015 (7.7%) excised lesions because clinical-pathologic correlation was missing. Of note, in 0.6% of them (13 out of 2045) the first histologic diagnosis was revised in the light of clinical information that assisted the Pathologist to re-evaluate the histopathologic findings that might be bland or inconspicuous per se. In conclusion, our study demonstrated that an integrated approach involving clinicians and pathologists allows improving management of selected patients by shifting from a simply disease-focused management (melanoma versus nevus) to a patient-centered approach.

  2. Routine Clinical-Pathologic Correlation of Pigmented Skin Tumors Can Influence Patient Management.

    Directory of Open Access Journals (Sweden)

    Caterina Longo

    Full Text Available Several studies have demonstrated the benefit of integrating clinical with pathologic information, to obtain a confident diagnosis for melanocytic tumors. However, all those studies were conducted retrospectively and no data are currently available about the role of a clinical-pathologic correlation approach on a daily basis in clinical practice.In our study, we evaluated the impact of a routine clinical-pathologic correlation approach for difficult skin tumors seen over 3 years in a tertiary referral center.Interestingly, a re-appraisal was requested for 158 out of 2015 (7.7% excised lesions because clinical-pathologic correlation was missing. Of note, in 0.6% of them (13 out of 2045 the first histologic diagnosis was revised in the light of clinical information that assisted the Pathologist to re-evaluate the histopathologic findings that might be bland or inconspicuous per se.In conclusion, our study demonstrated that an integrated approach involving clinicians and pathologists allows improving management of selected patients by shifting from a simply disease-focused management (melanoma versus nevus to a patient-centered approach.

  3. CT assessment of the correlation between clinical examination and bone involvement in oral malignant tumors

    Energy Technology Data Exchange (ETDEWEB)

    Albuquerque, Marco Antonio Portela; Oliveira, Ilka Regina Souza; Cavalcanti, Marcelo Gusmao Paraiso [Universidade de Sao Paulo (USP), SP (Brazil). Faculdade de Odontologia. Dept. de Radiologia], e-mail: mgpcaval@usp.br; Kuruoshi, Marcia Etsuko [Universidade de Sao Paulo (USP), SP (Brazil). Hospital Universitario. Dept. de Radiologia

    2009-07-01

    Oral cancers have a tendency to invade the surrounding bone structures, and this has a direct influence on the treatment management and on outcomes. The objective of this study was to correlate the clinical parameters (location, clinical presentation and TNM staging) of oral malignant tumors that can be associated with a potential of bone invasion and determine the accuracy of clinical examination to predict bone involvement, using computed tomography (CT). Twenty five patients, with oral malignant tumors were submitted to clinical and CT examinations. CT was considered the standard parameter to evaluate the presence of bone involvement. Clinical assessment of location, presentation form and TNM staging of the tumors were then compared to the CT findings in predicting bone involvement. Bone involvement was observed in 68% of the cases. It was predicted that tumors located in the retromolar trigone and hard palate, with a clinical aspect of infiltrative ulcer or nodule and classified in stage IV had a high potential to cause bone involvement. The clinical examination assessment of these tumors showed to be a valuable tool to predict bone invasion, with high sensitivity (82%) and specificity (87.5%), based on the results found in the CT images. No statistical significance was found between the CT and clinical examinations regarding bone involvement. The identification of some clinical parameters such as location, clinical presentation, and TNM stage, associated with a detailed clinical examination, was considered a valuable tool for the assessment of bone destruction by oral malignant tumors. (author)

  4. Correlations of theory of mind deficits with clinical patterns and quality of life in schizophrenia

    Directory of Open Access Journals (Sweden)

    Mathieu eUrbach

    2013-05-01

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

  5. A new accurate approach to the anterior ratio with clinical applications. Part 1: a computer program.

    Science.gov (United States)

    Braun, S; Hnat, W P; Kusnoto, B; Hnat, T W

    1999-04-01

    The arcs of the six anterior maxillary and mandibular teeth have recently been described mathematically by the hyperbolic cosine function with a maxillary correlation coefficient (r ) of 0.885 and a mandibular correlation coefficient (r ) of 0.951. Because the geometric relationships of the anterior dental arcs are known when the occlusion is Class I, a computer program has been developed for use in clinical practice. Rapid forecasting of the interrelationships between the maxillary and mandibular arc depths (related to overjet) with variations in the mesiodistal sums of the six maxillary and mandibular anterior teeth for various intercanine widths is now possible with ease and accuracy (+/- 0.1 mm). Clinical applications are illustrated.

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

    Science.gov (United States)

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

    2014-01-01

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

  7. Clinical correlates of first episode early onset psychosis in KwaZulu ...

    African Journals Online (AJOL)

    Background: The study of first episode early onset psychosis can yield many clues to understanding the early development of psychosis and guide interventions to decrease psychosis risk and improve outcome. The aim of the study was to investigate the socio-demographic profile and clinical correlates in early onset ...

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

    Science.gov (United States)

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

    2013-01-01

    This study investigated the phenomenology and clinical correlates of suicidal thoughts and behaviors in youth with ASD (N = 102; range 7-16 years). The presence of suicidal thoughts and behavior was assessed through the Anxiety Disorders Interview Schedule-Child and Parent Versions. Children and parents completed measures of anxiety severity,…

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

    Science.gov (United States)

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

    2012-01-01

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

  10. Trichomonas vaginalis Prevalence and Correlates in Women and Men Attending STI Clinics in Western Canada.

    Science.gov (United States)

    Gratrix, Jennifer; Plitt, Sabrina; Turnbull, LeeAnn; Smyczek, Petra; Brandley, Judith; Scarrott, Ron; Naidu, Prenilla; Bertholet, Lindsay; Chernesky, Max; Read, Ron; Singh, Ameeta E

    2017-10-01

    Trichomonas vaginalis prevalence (2.8%) in female sexually transmitted infection clinic attendees was within the prevalence of chlamydia (5.8%) and gonorrhea (1.8%), while being very low for male attendees (0.2%). Correlates among women were indigenous ethnicity, other ethnicity, and being symptomatic.

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

    Science.gov (United States)

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

    2011-01-01

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

  12. Correlation of who clinical staging with CD4 counts in adult HIV ...

    African Journals Online (AJOL)

    Objective: To determine the degree of correlation between the WHO clinical staging and CD4 T-cell counts in HIV/AIDS adults at Kenyatta National Hospital, Nairobi. Design: Cross-sectional study. Setting: Kenyatta National Hospital, Nairobi. Subjects: One hundread and fifty two newly diagnosed HIV patients were recruited ...

  13. Ultrafast CT scoring system for assessing bronchopulmonary dysplasia. Reproducibility and clinical correlation

    Energy Technology Data Exchange (ETDEWEB)

    Kubota, Jun; Ohki, Yasushi; Inoue, Tomio; Mochizuki, Hiroyuki; Aoki, Jun; Morikawa, Akihiro; Endo, Keigo [Gunma Univ., Maebashi (Japan). School of Medicine; Sakurai, Minako; Shigeta, Makoto

    1998-05-01

    To evaluate the reproducibility of the Ultrafast CT (UFCT) scoring system and assess its usefulness in monitoring clinical severity in infants with bronchopulmonary dysplasia (BPD). UFCT scoring was done in 22 infants (15 boys and 7 girls aged 1 to 37 months) with BPD. A total of 258 lung fields were evaluated for the presence of hyperaeration, linear opacities, triangular subpleural opacities, and bronchovascular bundle distortion or thickening, and UFCT scores were given. Intraobserver and interobserver agreement and reproducibility of UFCT scores were statistically analyzed. In 12 patients, UFCT scores were linearly correlated with clinical severity scores based on respiratory dysfunction and complexity of care. `Hyperaeration,` which was the most frequent (18 of 22, 81.8%) finding, showed high concordance ({kappa}=0.73, p<0.001, {kappa}=0.59, p<0.001), and its UFCT scores significantly correlated with intraobserver and interobserver analyses (r=0.94, p<0.001, r=0.82, p<0.001, respectively). UFCT scores for hyperaeration significantly correlated with clinical scores (r=0.75, p<0.01), whereas those for the others did not. UFCT is useful for assessing BPD. Hyperaeration was the most common and reproducible finding, and its extent significantly correlated with clinical severity. (author)

  14. Striatal Dopamine Transporter Binding Does Not Correlate with Clinical Severity in Dementia with Lewy Bodies

    DEFF Research Database (Denmark)

    Ziebell, Morten; Andersen, Birgitte B; Pinborg, Lars H

    2013-01-01

    Patients who have dementia with Lewy bodies (DLB) show both clinical and histopathologic overlap with Alzheimer disease patients and Parkinson disease patients. In this study, we correlated the core features of DLB (dementia, parkinsonism, hallucinations, and fluctuations) with striatal dopamine......, symptoms are not associated with a reduction in striatal DAT despite its firm involvement in DLB pathology....

  15. Entry correlates and motivations of older adults participating in organized exercise programs

    NARCIS (Netherlands)

    Stiggelbout, M.; Hopman-Rock, M.; Mechelen, W. van

    2008-01-01

    This study reports entry correlates and motivations of older adults participating in organized exercise programs in the Netherlands, as determined in a descriptive explorative study (N = 2,350, response rate 86%). Participants were community-dwelling older adults (50+ years) who enrolled and started

  16. Mock and National Examinations Correlations in a Health Information Associate Degree Program

    Science.gov (United States)

    Jenkins, Neisa R.

    2013-01-01

    Students enrolled in associate degree programs face social and personal challenges that can affect their learning and assessment skills. Social and personal challenges such as unemployment rates, race, age, and gender may affect their employability. The purpose of this quantitative correlational study was to examine the mock and national…

  17. Correlation between microtensile bond strength data and clinical outcome of Class V restorations.

    Science.gov (United States)

    Heintze, Siegward D; Thunpithayakul, Chaiyasri; Armstrong, Steven R; Rousson, V

    2011-02-01

    To determine if the results of resin-dentin microtensile bond strength (μTBS) is correlated with the outcome parameters of clinical studies on non-retentive Class V restorations. Resin-dentin μTBS data were obtained from one test center; the in vitro tests were all performed by the same operator. The μTBS testing was performed 8 h after bonding and after 6 months of storing the specimens in water. Pre-test failures (PTFs) of specimens were included in the analysis, attributing them a value of 1MPa. Prospective clinical studies on cervical restorations (Class V) with an observation period of at least 18 months were searched in the literature. The clinical outcome variables were retention loss, marginal discoloration and marginal integrity. Furthermore, an index was formulated to be better able to compare the laboratory and clinical results. Estimates of adhesive effects in a linear mixed model were used to summarize the clinical performance of each adhesive between 12 and 36 months. Spearman correlations between these clinical performances and the μTBS values were calculated subsequently. Thirty-six clinical studies with 15 adhesive/restorative systems for which μTBS data were also available were included in the statistical analysis. In general 3-step and 2-step etch-and-rinse systems showed higher bond strength values than the 2-step/3-step self-etching systems, which, however, produced higher values than the 1-step self-etching and the resin modified glass ionomer systems. Prolonged water storage of specimens resulted in a significant decrease of the mean bond strength values in 5 adhesive systems (Wilcoxon, p<0.05). There was a significant correlation between μTBS values both after 8 h and 6 months of storage and marginal discoloration (r=0.54 and r=0.67, respectively). However, the same correlation was not found between μTBS values and the retention rate, clinical index or marginal integrity. As μTBS data of adhesive systems, especially after water

  18. Clinical Research, Dental Education, and the NIH Clinical Research Training Program.

    Science.gov (United States)

    Baum, Bruce J.; Davis, Clifford

    1998-01-01

    An expert panel, convened by the National Institutes of Health to address concerns about the future of clinical research, describes a training program at the National Institutes of Health that also included dental students. Possible reasons for low application rates among dental students are ascribed to inadequate dissemination of information,…

  19. [Clinical Study on the Correlation Between Tinnitus and Hearing Loss in 400 Patients].

    Science.gov (United States)

    An, Jun-Nan; Zheng, Yun

    2017-09-01

    To investigate the correlation between tinnitus and hearing loss. Clinical data of 400 patients presented with tinnitus as the first chief complain were analyzed. The relationship between tinnitus and hearing loss was categorized based on sites,onset time of tinnitus and hearing loss,for the purpose of provideing clinical evidence to explore the etiology,treatment and prognosis of tinnitus. Among the 400 patients,61% of them did not show the correlation of tinnitus with hearing loss (52.05% with normal hearing,and 47.95% with hearing loss),while only 39% had the relationship (70.51% related,29.49% possibly related). In this study,no absolute correlation between tinnitus and hearing loss was observed. Tinnitus and hearing loss may not be treated in the same way.

  20. A correlation study of immunophenotypic, cytogenetic, and clinical features of 180 AML patients in China.

    Science.gov (United States)

    Zheng, Jine; Wang, Xingbing; Hu, Yu; Yang, Jing; Liu, Jun; He, Yanli; Gong, Qing; Yao, Junxia; Li, Xiaoqing; Du, Wen; Huang, Shiang

    2008-01-01

    New WHO classification has been widely applied in the diagnosis of leukemia. To elucidate the immunophenotype of acute myeloid leukemia (AML) and characterize the correlation among morphological, immunological, cytogenetic, and clinical features, we studied the bone marrow immunophenotypes of 180 AML patients in China by flow cytometry. The results showed that CD34, CD2, CD14, CD19, CD56, and HLA-DR were correlated with FAB subtypes. Amongst the 180 patients enrolled in this study, 122 cases were also subjected to karyotype analysis by G-banding technology and abnormal karyotypes were detected in 69 out of 122 patients. Correlation assay showed that t(8;21) was only present in 16 AML-M2 patients, and strongly associated with the individual or combinational expressions of CD15/CD19/CD34/CD56. As to M3, although lymphoid lineage antigens were observed in a considerable number of patients, they were never detected in t(15;17) positive patients. The expressions of CD22, CD56, and TdT showed significant correlation with the overall presence of abnormal karyotype. Additionally, the expressions of CD4, CD7, CD14, CD56, and TdT were positively correlated with clinical features such as white blood cell count, platelet count, and patient's age. In conclusion, immunophenotype analysis was useful for AML diagnosis and classification. At the same time, the data also suggested that the karyotype abnormalities and clinical features were tightly linked with abnormal antigen expression characteristics in AML patients. As one of the largest correlative study performed in China, the results highlighted the importance of a morphological, immunological, and cytogenetic classification of AML that might constitute a working basis for future studies aimed at a better definition of clinicopathological features and optimal treatment strategy for these leukemias. (c) 2007 Clinical Cytometry Society

  1. Correlation between self-reported and clinically based diagnoses of bruxism in temporomandibular disorders patients.

    Science.gov (United States)

    Paesani, D A; Lobbezoo, F; Gelos, C; Guarda-Nardini, L; Ahlberg, J; Manfredini, D

    2013-11-01

    The present investigation was performed in a population of patients with temporomandibular disorders (TMD), and it was designed to assess the correlation between self-reported questionnaire-based bruxism diagnosis and a diagnosis based on history taking plus clinical examination. One-hundred-fifty-nine patients with TMD underwent an assessment including a questionnaire investigating five bruxism-related items (i.e. sleep grinding, sleep grinding referral by bed partner, sleep clenching, awake clenching, awake grinding) and an interview (i.e. oral history taking with specific focus on bruxism habits) plus a clinical examination to evaluate bruxism signs and symptoms. The correlation between findings of the questionnaire, viz., patients' report, and findings of the interview/oral history taking plus clinical examination, viz., clinicians' diagnosis, was assessed by means of φ coefficient. The highest correlations were achieved for the sleep grinding referral item (φ = 0·932) and for the awake clenching item (φ = 0·811), whilst lower correlation values were found for the other items (φ values ranging from 0·363 to 0·641). The percentage of disagreement between the two diagnostic approaches ranged between 1·8% and 18·2%. Within the limits of the present investigation, it can be suggested that a strong positive correlation between a self-reported and a clinically based approach to bruxism diagnosis can be achieved as for awake clenching, whilst lower levels of correlation were detected for sleep-time activities. © 2013 John Wiley & Sons Ltd.

  2. Burst fracture of the thoracolumbar spine: correlation between kyphosis and clinical result of the treatment

    Directory of Open Access Journals (Sweden)

    Rodrigo Arnold Tisot

    2015-06-01

    Full Text Available OBJECTIVE: To evaluate the correlation between kyphosis due to burst fractures of thoracic and lumbar spine and clinical outcome in patients undergoing conservative or surgical treatment.METHODS: A retrospective, cross-sectional study was conducted with 29 patients with thoracolumbar burst fractures treated by the Spine Group in a trauma reference hospital between the years 2002 and 2011. Patients were followed-up as outpatients for a minimum of 24 months. All cases were clinically evaluated by Oswestry and SF-36 quality of life questionnaires and the visual analogue scale (VAS of pain. They were also evaluated by X-ray examinations and CT scans of the lumbosacral spine at the time of hospitalization and subsequently as outpatients by Cobb method for measuring the degree of kyphosis.RESULTS: There was no statistically significant correlation between the degree of initial kyphosis and clinical outcome measured by VAS and by most of the SF-36 domains in both patients treated conservatively and the surgically treated. The Oswestry questionnaire showed benefits for patients who received conservative treatment (p=0.047 compared to those surgically treated (p=0.335. The analysis of difference between initial and final kyphosis and final kyphosis alone in relation to clinical outcome showed no statistical correlation in any of the scores used.CONCLUSION: The clinical outcome of treatment of the thoracic and lumbar burst fractures was not influenced by a greater or lesser degree of initial or residual kyphosis, regardless of the type of treatment.

  3. Early clinical exposure program in learning renal physiology

    Directory of Open Access Journals (Sweden)

    ARMAN DEHGHAN

    2017-10-01

    Full Text Available Introduction: Teaching renal physiology for undergraduate medical students in an understandable way using methods which improve their deep learning has always been a problem. In this study, Early Clinical Exposure (ECE was used in teaching renal physiology for the second year medical students in Shiraz Medical School. This article aims to introduce and develop this program and also measure the attitude of medical students toward ECE in learning renal physiology. Methods: This is a mixed method study conducted on 120 second year undergraduate students. After performing the course, both qualitative and quantitative methods were used for measuring the viewpoints of the students. In the qualitative part, 10 high rank medical students were selected. These students participated in brain storming sessions to express their opinion about the program based on the strengths and weaknesses. For trustworthiness of the qualitative part, member check and peer check were done. In the quantitative part, a researcher-made questionnaire was used based on the objectives of the program in a 4 point Likert scale. The validity of questionnaire was determined by medical education experts and reliability was determined after a pilot study. Results: Based on the results of the quantitative part of the study, 98 percent of the students stated that the ECE program was generally a useful program. In the qualitative part, the students’ comments were obtained. The benefits of the program were summarized in 4 main themes. These themes are “understanding of renal physiology”, “Integration of basic and clinical knowledge”, “Improvement of attitude toward importance of physiology”, and “encouragement to study”. In response to the questions about negetive aspects of this program in qualitative part, the two main themes were insufficient time and large grup size. Conclusion: Students reported that ECE was useful, but they stated that they needed to have more

  4. Demographic, clinical, lifestyle-related, and social-cognitive correlates of physical activity in head and neck cancer survivors.

    Science.gov (United States)

    Buffart, Laurien M; de Bree, Remco; Altena, Martine; van der Werff, Sophie; Drossaert, Constance H C; Speksnijder, Caroline M; van den Brekel, Michiel W; Jager-Wittenaar, Harriët; Aaronson, Neil K; Stuiver, Martijn M

    2017-11-18

    The purpose of the study is to identify demographic, clinical, lifestyle-related, and social-cognitive correlates of physical activity (PA) intention and behavior in head and neck cancer (HNC) survivors using the theory of planned behavior (TPB). Data from two cross-sectional studies on correlates of PA in HNC survivors were pooled. Both studies used self-reports to assess PA and social-cognitive correlates. Potential correlates were collected via self-report or medical records. Univariable and multivariable multilevel linear mixed-effects models were built to identify correlates of PA intention and PA behavior (Z scores). Structural equation model analyses were conducted to study the full TPB model in one analysis, taking into account relevant covariates. In total, 416 HNC survivors were surveyed. Their mean (SD) age was 66.6 (9.4) years; 64% were men, and 78% were diagnosed with laryngeal cancer. The structural equation model showed that PA intention was significantly higher in HNC survivors with a history of exercising, who had a more positive attitude, subjective norm, and perceived behavioral control. Patients with higher PA intention, higher PBC, a lower age, and without unintentional weight loss or comorbidities had higher PA behavior. The model explained 22.9% of the variance in PA intention and 16.1% of the variance in PA behavior. Despite significant pathways of the TPB model, the large proportion variance in PA intention and behavior remaining unexplained suggests the need for better PA behavior (change) models to guide the development of PA promotion programs, particularly for the elderly. Such programs should be tailored to comorbidities and nutritional status.

  5. Correlations between supra- and subgingival clinical parameters in smokers and individuals who have never smoked

    Directory of Open Access Journals (Sweden)

    Carolina Righi Alves

    Full Text Available Introduction Smoking is a risk factor for prevalence, severity and progression of periodontal disease and appears to suppress marginal periodontium inflammatory response. Purpose To correlate Visible Plaque Index (VPI and Gingival Bleeding Index (GBI in smokers and never-smokers, as well as GBI and bleeding on probing (BOP in these groups. Material and method We used baseline data of one quasi-experimental study in which 11 smokers and 14 subjects who never smoked were submitted to clinical periodontal examinations between September 2010 and October 2011. Result The correlation between VPI and GBI was positive for both groups, it was strong and statistically significant in subjects who had never smoked and moderate in smokers. Regarding GBI and BOP correlations were moderate for smokers and weaker for individuals who had never smoked. Conclusion Smokers have lower strength correlation between VPI and GBI compared to individuals who had never smoked resulting in a less pronounced marginal gingival bleeding.

  6. Modeling clinical outcome using multiple correlated functional biomarkers: A Bayesian approach.

    Science.gov (United States)

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

    2016-04-01

    In some biomedical studies, biomarkers are measured repeatedly along some spatial structure or over time and are subject to measurement error. In these studies, it is often of interest to evaluate associations between a clinical endpoint and these biomarkers (also known as functional biomarkers). There are potentially two levels of correlation in such data, namely, between repeated measurements of a biomarker from the same subject and between multiple biomarkers from the same subject; none of the existing methods accounts for correlation between multiple functional biomarkers. We propose a Bayesian approach to model a clinical outcome of interest (e.g. risk for colorectal cancer) in the presence of multiple functional biomarkers while accounting for potential correlation. Our simulations show that the proposed approach achieves good performance in finite samples under various settings. In the presence of substantial or moderate correlation, the proposed approach outperforms an existing approach that does not account for correlation. The proposed approach is applied to a study of biomarkers of risk for colorectal neoplasms and our results show that the risk for colorectal cancer is associated with two functional biomarkers, APC and TGF-α, in particular, with their values in the region between the proliferating and differentiating zones of colorectal crypts. © The Author(s) 2012.

  7. Clinical correlates of planned, more lethal suicide attempts in major depressive disorder.

    Science.gov (United States)

    Nakagawa, Atsuo; Grunebaum, Michael F; Oquendo, Maria A; Burke, Ainsley K; Kashima, Haruo; Mann, J John

    2009-01-01

    Assessment of suicide plans is standard in acute psychiatric care, but there is a limited evidence base to guide this routine clinical practice. The purpose of this study was to investigate clinical correlates of suicide planning in depressed patients. 151 patients with major depressive disorder and a lifetime history of suicide attempt were studied. Subjects received a comprehensive evaluation including structured diagnostic interview for Axis I and II disorders, current symptoms, impulsivity, and systematic assessment of suicide planning prior to the most recent suicide attempt. Seriousness of suicide attempt planning correlated with lethality of suicidal acts. Comorbid anxiety disorder and anxiety correlated with less suicide planning. Specifically, this negative correlation was with comorbid panic disorder. Planning did not correlate with severity of depression or aggressive/impulsive traits. Cross-sectional design, retrospective recall of suicide planning data, limited applicability to completed suicide or other psychiatric disorders. In major depression, comorbid panic disorder appears protective against more carefully planned, higher lethality suicide attempts. Surprisingly, severity of depression and aggressive impulsive traits do not predict planning or lethality of suicide attempts. We have previously reported that anxiety severity protects against the probability of a suicide attempt and now extend that observation to show there is protection against lethality of a suicide attempt. Treatment of anxiety without directly treating major depression may place patients at greater risk of suicidal behavior.

  8. Correlation of kidney biopsy findings and clinical manifestations of primary focal and segmental glomerulosclerosis

    Directory of Open Access Journals (Sweden)

    Taheri Diana

    2009-01-01

    Full Text Available To evaluate the correlation of clinical, laboratory, and pathological features at pre-sentation of focal segmental sclerosis (FSGS, we reviewed in a cross sectional study the patholo-gical findings of kidney biopsies in 64 cases of primary FSGS, and correlated them with the clinical and laboratory data obtained at the time of the biopsies. The data included blood pressure, glome-rular filtration rate (GFR, serum albumin, and the level of proteinuria. The mean level of serum crea-tinine was significantly higher in the biopsies′ findings of synechiae (adhesions in the Bowman′s capsule, interstitial fibrosis, and global scars (P< 0.05, and mean level of GFR was significantly lower with the presence of interstitial fibrosis (P< 0.05. Furthermore, there was a positive correlation between the level of serum creatinine and global sclerosis (r= 2.21, P= 0.04, and a negative correlation between the level of GFR and global sclerosis(r= 2.01, P= 0.02. All the patients with renal insufficiency had interstitial fibrosis in their biopsies in comparison of only the 24 patients (48% of the group without renal insufficiency (P< 0.05. There was no significant difference bet-ween patients with and without hypertension and nephritic-ranged proteinuria. We conclude that we found a correlation of renal insufficiency in primary FSGS patients with interstitial fibrosis, global scars and the synechiae of Bowman′s capsule in their biopsies.

  9. The Correlation Between Q-angle (Clinical and TTTGdistance (Axial Computed thomography in Firuzgar Hospital, 2008

    Directory of Open Access Journals (Sweden)

    Ali Yeganeh

    2010-02-01

    Full Text Available Background:The purpose of this study was to evaluate the significance of the Q angle with respect to the patella position. We assess the correlation between the Q angles(calculated by clinical exam in different positions and CT indices (with more impression on TTTG.Method: Atotal number of 68 knee joints of 50 cases entered the study. Clinical examination was used to measure Q angle (in 3 positions of sitting, standing and supine. CT scan performed in 2 axial view of proximal tibia, and distal femor for   measurement of Tibial tuberosity-trochlear groove distance (TTTG and other CT   indices. Correlation between main variables calculated.and analysed with spss.Results: Supine Q angle were strongly correlated with standing Q angles and moderately with sitting Q angle.Sitting Q angle was moderately correlated with supine and standing Q angle and weakly with PTA.we found no other significant correlation between Q angle and CT indexes.Discussion: Our findings suggest that Q angle is not a valuable index for predicting the presence of patelofemoral malalignment.  

  10. Correlations Between Clinical Judgement and Learning Style Preferences of Nursing Students in the Simulation Room.

    Science.gov (United States)

    Hallin, Karin; Haggstrom, Marie; Backstrom, Britt; Kristiansen, Lisbeth Porskrog

    2015-09-28

    Health care educators account for variables affecting patient safety and are responsible for developing the highly complex process of education planning. Clinical judgement is a multidimensional process, which may be affected by learning styles. The aim was to explore three specific hypotheses to test correlations between nursing students' team achievements in clinical judgement and emotional, sociological and physiological learning style preferences. A descriptive cross-sectional study was conducted with Swedish university nursing students in 2012-2013. Convenience sampling was used with 60 teams with 173 nursing students in the final semester of a three-year Bachelor of Science in nursing programme. Data collection included questionnaires of personal characteristics, learning style preferences, determined by the Dunn and Dunn Productivity Environmental Preference Survey, and videotaped complex nursing simulation scenarios. Comparison with Lasater Clinical Judgement Rubric and Non-parametric analyses were performed. Three significant correlations were found between the team achievements and the students' learning style preferences: significant negative correlation with 'Structure' and 'Kinesthetic' at the individual level, and positive correlation with the 'Tactile' variable. No significant correlations with students' 'Motivation', 'Persistence', 'Wish to learn alone' and 'Wish for an authoritative person present' were seen. There were multiple complex interactions between the tested learning style preferences and the team achievements of clinical judgement in the simulation room, which provides important information for the becoming nurses. Several factors may have influenced the results that should be acknowledged when designing further research. We suggest conducting mixed methods to determine further relationships between team achievements, learning style preferences, cognitive learning outcomes and group processes.

  11. Correlations between Clinical Judgement and Learning Style Preferences of Nursing Students in the Simulation Room

    Science.gov (United States)

    Hallin, Karin; Häggström, Marie; Bäckström, Britt; Kristiansen, Lisbeth Porskrog

    2016-01-01

    Background: Health care educators account for variables affecting patient safety and are responsible for developing the highly complex process of education planning. Clinical judgement is a multidimensional process, which may be affected by learning styles. The aim was to explore three specific hypotheses to test correlations between nursing students’ team achievements in clinical judgement and emotional, sociological and physiological learning style preferences. Methods: A descriptive cross-sectional study was conducted with Swedish university nursing students in 2012-2013. Convenience sampling was used with 60 teams with 173 nursing students in the final semester of a three-year Bachelor of Science in nursing programme. Data collection included questionnaires of personal characteristics, learning style preferences, determined by the Dunn and Dunn Productivity Environmental Preference Survey, and videotaped complex nursing simulation scenarios. Comparison with Lasater Clinical Judgement Rubric and Non-parametric analyses were performed. Results: Three significant correlations were found between the team achievements and the students’ learning style preferences: significant negative correlation with ‘Structure’ and ‘Kinesthetic’ at the individual level, and positive correlation with the ‘Tactile’ variable. No significant correlations with students’ ‘Motivation’, ‘Persistence’, ‘Wish to learn alone’ and ‘Wish for an authoritative person present’ were seen. Discussion and Conclusion: There were multiple complex interactions between the tested learning style preferences and the team achievements of clinical judgement in the simulation room, which provides important information for the becoming nurses. Several factors may have influenced the results that should be acknowledged when designing further research. We suggest conducting mixed methods to determine further relationships between team achievements, learning style preferences

  12. Acute traumatic central cord syndrome: analysis of clinical and radiological correlations.

    Science.gov (United States)

    Miranda, P; Gomez, P; Alday, R

    2008-12-01

    In patients with traumatic spinal cord injury, several studies correlate neurological impairment and radiological findings. However, little information is available about this correspondence in the particular group of acute traumatic central cord syndrome. The object of the present work was to describe the clinical and radiological features of a series of patients presenting with acute traumatic central cord syndrome and to analyze clinical and radiological correlations on admission and at last follow-up. Retrospective review of 15 patients diagnosed of acute traumatic central cord syndrome between 1995 and 2005. Global motor score and motor score in upper extremities were determined on admission and at last follow-up (6 months-4 years, mean 16 months). Plain films, cervical computed tomography and magnetic resonance (MR) were performed in every patient and retrieved for the study. In seven patients, serial MR studies were performed during follow-up. Clinical and radiological correlations were statistically analyzed with non-parametric tests. Cervical spondylosis appeared associated with older age, falls, and absence of fracture. Spinal cord edema was the most common finding in MR studies but hemorrhage was also observed. The length of spinal cord edema significantly correlated with initial motor score. The decrease in T2-weighted hyperintensity in serial MR studies correlated with the gain of motor power in upper limbs at last follow-up. Elderly patients with more degenerated cervical spines commonly develop acute traumatic central cord syndrome after incidental falls. Length of spinal cord edema correlates with neurological impairment on admission and may provide significant prognostic information.

  13. Correlation of ultrasonographic measurements, histopathological grading, and clinical staging in oral submucous fibrosis

    Directory of Open Access Journals (Sweden)

    Rashmi Kewal Agarwal

    2017-01-01

    Full Text Available Aims and Objectives: To evaluate the presence and thickness of submucosal fibrosis in oral submucous fibrosis (OSMF patients ultrasonographically and to correlate these findings with the clinical stage and histological grade of OSMF. Materials and Methods: Forty participants (twenty cases and twenty controls were included in the study. The patients diagnosed clinically as having OSMF and consented for biopsy were included in the cases, and completely healthy individuals with no habit history or oral lesions were included in the control group after matching the body mass index. After clinically staging, the patients' transcutaneous ultrasonography (USG was performed and after that punch biopsy was taken and the specimen was graded histopathologically. Results: The data were statistically analyzed using Mann–Whitney test and Spearman's rank correlation. The cases showed increased submucosal thickness as compared to the controls. The USG measurements statistically correlated with the clinical stage and histopathological grade of OSMF. Conclusion: USG proves to be a valuable adjunctive modality in diagnosing, staging and also evaluating the prognosis of OSMF.

  14. Correlating eligibility criteria generalizability and adverse events using Big Data for patients and clinical trials

    Science.gov (United States)

    Sen, Anando; Ryan, Patrick; Goldstein, Andrew; Chakrabarti, Shreya; Wang, Shuang; Koski, Eileen; Weng, Chunhua

    2016-01-01

    Randomized controlled trials can benefit from proactive assessment of how well their participant selection strategies during the design of eligibility criteria can influence the study generalizability. In this paper, we present a quantitative metric called generalizability index for study traits 2.0 (GIST 2.0) to assess the a priori generalizability (based on population representativeness) of a clinical trial by accounting for the dependencies among multiple eligibility criteria. The metric was evaluated on 16 sepsis trials identified from ClinicalTrials.gov, with their adverse event reports extracted from the trial results section. The correlation between GIST scores and adverse events was analyzed. We found that the GIST 2.0 score was significantly correlated with total adverse events and serious adverse events (weighted correlation coefficients of 0.825 and 0.709, respectively, with P < 0.01). This study exemplifies the promising use of Big Data in electronic health records and ClinicalTrials.gov for optimizing eligibility criteria design for clinical studies. PMID:27598694

  15. Correlating eligibility criteria generalizability and adverse events using Big Data for patients and clinical trials.

    Science.gov (United States)

    Sen, Anando; Ryan, Patrick B; Goldstein, Andrew; Chakrabarti, Shreya; Wang, Shuang; Koski, Eileen; Weng, Chunhua

    2017-01-01

    Randomized controlled trials can benefit from proactive assessment of how well their participant selection strategies during the design of eligibility criteria can influence the study generalizability. In this paper, we present a quantitative metric called generalizability index for study traits 2.0 (GIST 2.0) to assess the a priori generalizability (based on population representativeness) of a clinical trial by accounting for the dependencies among multiple eligibility criteria. The metric was evaluated on 16 sepsis trials identified from ClinicalTrials.gov, with their adverse event reports extracted from the trial results sections. The correlation between GIST scores and adverse events was analyzed. We found that the GIST 2.0 score was significantly correlated with total adverse events and serious adverse events (weighted correlation coefficients of 0.825 and 0.709, respectively, with P Big Data in electronic health records and ClinicalTrials.gov for optimizing eligibility criteria design for clinical studies. © 2016 New York Academy of Sciences.

  16. POLYMAT-C: a comprehensive SPSS program for computing the polychoric correlation matrix.

    Science.gov (United States)

    Lorenzo-Seva, Urbano; Ferrando, Pere J

    2015-09-01

    We provide a free noncommercial SPSS program that implements procedures for (a) obtaining the polychoric correlation matrix between a set of ordered categorical measures, so that it can be used as input for the SPSS factor analysis (FA) program; (b) testing the null hypothesis of zero population correlation for each element of the matrix by using appropriate simulation procedures; (c) obtaining valid and accurate confidence intervals via bootstrap resampling for those correlations found to be significant; and (d) performing, if necessary, a smoothing procedure that makes the matrix amenable to any FA estimation procedure. For the main purpose (a), the program uses a robust unified procedure that allows four different types of estimates to be obtained at the user's choice. Overall, we hope the program will be a very useful tool for the applied researcher, not only because it provides an appropriate input matrix for FA, but also because it allows the researcher to carefully check the appropriateness of the matrix for this purpose. The SPSS syntax, a short manual, and data files related to this article are available as Supplemental materials that are available for download with this article.

  17. Sonographic finding of postpartum levator ani muscle injury correlates with pelvic floor clinical examination.

    Science.gov (United States)

    Lipschuetz, M; Valsky, D V; Shick-Naveh, L; Daum, H; Messing, B; Yagel, I; Yagel, S; Cohen, S M

    2014-12-01

    Correlation of the sonographic finding of levator ani muscle (LAM) injuries with clinical examination in primiparous women following vaginal delivery has not been fully described. We aimed to examine the correlation of three-dimensional transperineal ultrasound (3D-TPS) finding of LAM defects with results of clinical examination of the pelvic floor, at intermediate follow-up. Subjects were primiparae 3-21 months following vaginal delivery, who had not become pregnant or delivered in the interim. On 3D-TPS, LAM trauma was diagnosed when discontinuity and distortion were visible in the most anteromedial part of the pubovisceral muscle in the coronal C-plane or rendered image. Clinical examination was performed by a physiotherapist who was blinded to the ultrasound results, and included palpation of the medial and lateral parts of the LAM mass, evaluation of tissue quality and whether there was any palpable gap. Muscle strength was evaluated using the modified Oxford scale. Eighty-seven women were included, 19 (21.8%) of whom were found to have a sonographic LAM injury. Oxford score palpation parameter of asymmetric muscle mass or texture was significantly correlated with the finding of a LAM defect: of 68 women with normal 3D-TPS, 22 (32.4%) were found to have asymmetry of muscle mass or tissue quality on clinical examination vs 12 (63.2%) of 19 women with sonographic evidence of LAM injury (P = 0.016). Muscle strength and endurance parameters did not significantly correlate with the 3D-TPS findings. Our findings suggest that persistent 3D-TPS LAM injury after primary vaginal delivery has clinical expression in changes in mass and texture of the LAM, as assessed by palpation. Copyright © 2014 ISUOG. Published by John Wiley & Sons Ltd.

  18. Perceived knowledge and clinical comfort with genetics among Taiwanese nurses enrolled in a RN-to-BSN program.

    Science.gov (United States)

    Hsiao, Chiu-Yueh; Lee, Shu-Hsin; Chen, Suh-Jen; Lin, Shu-Chin

    2013-08-01

    Advances in genetics have had a profound impact on health care. Yet, many nurses, as well as other health care providers, have limited genetic knowledge and feel uncomfortable integrating genetics into their practice. Very little is known about perceived genetic knowledge and clinical comfort among Taiwanese nurses enrolled in a Registered Nurse to Bachelor of Science in Nursing program. To examine perceived knowledge and clinical comfort with genetics among Taiwanese nurses enrolled in a Registered Nurse to Bachelor of Science in Nursing program and to assess how genetics has been integrated into their past and current nursing programs. The study also sought to examine correlations among perceived knowledge, integration of genetics into the nursing curriculum, and clinical comfort with genetics. A descriptive, cross-sectional study. Taiwanese nurses enrolled in a Registered Nurse to Bachelor of Science in Nursing program were recruited. A total of 190 of 220 nurses returned the completed survey (86.36% response rate). Descriptive statistics and the Pearson product-moment correlation were used for data analysis. Most nurses indicated limited perceived knowledge and clinical comfort with genetics. Curricular hours focused on genetics in a current nursing program were greater than those in past nursing programs. The use of genetic materials, attendance at genetic workshops and conferences, and clinically relevant genetics in nursing practice significantly related with perceived knowledge and clinical comfort with genetics. However, there were no correlations between prior genetic-based health care, perceived knowledge, and clinical comfort with genetics. This study demonstrated the need for emphasizing genetic education and practice to ensure health-related professionals become knowledgeable about genetic information. Given the rapidly developing genetic revolution, nurses and other health care providers need to utilize genetic discoveries to optimize health outcomes

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

    Science.gov (United States)

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

    2014-01-01

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

  20. A comprehensive program to develop correlations for physical properties of kraft black liquor. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Fricke, A.L.; Zaman, A.A.

    1998-05-01

    The overall objective of the program was to develop correlations to predict physical properties within requirements of engineering precision from a knowledge of pulping conditions and of kraft black liquor composition, if possible. These correlations were to include those relating thermodynamic properties to pulping conditions and liquor composition. The basic premise upon which the research was based is the premise that black liquor behaves as a polymer solution. This premise has proven to be true, and has been used successfully in developing data reduction methods and in interpreting results. A three phase effort involving pulping, analysis of liquor composition, and measurement of liquor properties was conducted.

  1. Clinical and genetic correlates of soluble P-selectin in the community.

    Science.gov (United States)

    Lee, D S; Larson, M G; Lunetta, K L; Dupuis, J; Rong, J; Keaney, J F; Lipinska, I; Baldwin, C T; Vasan, R S; Benjamin, E J

    2008-01-01

    P-selectin is a cell adhesion molecule that is involved in atherogenesis, and soluble concentrations of this biomarker reflect cardiovascular risk. However, the clinical correlates and genetic characterization of soluble P-selectin have not been clearly elucidated. To describe clinical and genetic correlates of circulating P-selectin in the community. In Framingham Heart Study Offspring (European descent) and Omni (ethnic/racial minority) participants, we examined the association of cardiovascular risk factors with soluble P-selectin concentrations. In Offspring participants, we evaluated heritability, linkage and association of 29 SELP single-nucleotide polymorphisms (SNPs) with adjusted P-selectin concentrations. In multivariable analysis of 3,690 participants (54% women, mean age 60 +/- 10 years), higher log-transformed P-selectin concentrations were inversely associated with female sex and hormone replacement therapy, and positively associated with age, ethnic/racial minority status, cigarette smoking, waist circumference, systolic blood pressure, fasting glucose, and total/high-density lipoprotein cholesterol and triglyceride concentrations. Clinical factors explained 10.4% of the interindividual variability in P-selectin concentrations. In 571 extended pedigrees (n = 1,841) with >or= 2 phenotyped members per family, multivariable-adjusted heritability was 45.4 +/- 5.8%. Among the SELP SNPs examined, a non-synonymous SNP (rs6136) encoding a threonine-to-proline substitution at position 715 was highly significantly associated with decreased P-selectin concentrations (P = 5.2 x 10(-39)), explaining 9.7% of variation after adjustment for clinical factors. Multiple clinical factors and an SNP in the SELP gene were significantly associated with circulating P-selectin concentrations. One SNP in SELP explained significant variation in circulating P-selectin concentrations, even after accounting for known clinical correlates.

  2. Multilevel correlates for human papillomavirus vaccination of adolescent girls attending safety net clinics.

    Science.gov (United States)

    Tiro, Jasmin A; Pruitt, Sandi L; Bruce, Corinne M; Persaud, Donna; Lau, May; Vernon, Sally W; Morrow, Jay; Skinner, Celette Sugg

    2012-03-16

    Adolescent HPV vaccination in minority and low income populations with high cervical cancer incidence and mortality could reduce disparities. Safety-net primary care clinics are a key delivery site for improving vaccination rates in these populations. To examine prevalence of HPV initiation (≥ 1 dose), completion (receipt of dose 3 within 12 months of initiation), and receipt of 3 doses in four safety-net clinics as well as individual-, household-, and clinic-level correlates of initiation. We used multilevel modeling to investigate HPV initiation among 700 adolescent females who sought primary care in four safety-net clinics in Dallas, Texas from March 2007 to December 2009. Data were abstracted from patients' paper and electronic medical records. HPV vaccine uptake varied significantly by clinic. Across clinics, initiation was 36.6% and completion was 39.7% among those who initiated. In the total study population, only 15.7% received all three doses. In multivariate, two-level logistic regression analyses, initiation was associated with receipt of other adolescent vaccines, influenza vaccination in the year prior to data abstraction, being sexually active, and having more chart documentation (presence of health maintenance questionnaire and/or immunization record). There was no association between initiation and age, race/ethnicity, or insurance status. In four urban safety-net clinics, HPV initiation rates paralleled 2008 national rates. The correlation of HPV initiation with other adolescent vaccines underscores the importance of reviewing vaccination status at every health care visit. HPV vaccine uptake in safety-net clinics should continue to be monitored to understand impact on cervical cancer disparities. Copyright © 2011 Elsevier Ltd. All rights reserved.

  3. Correlation of peri-implant health and myeloperoxidase levels: a cross-sectional clinical study.

    Science.gov (United States)

    Liskmann, Stanislav; Zilmer, Mihkel; Vihalemm, Tiiu; Salum, Olev; Fischer, Krista

    2004-10-01

    At present, there are no diagnostic tools that permit early detection of peri-implantitis. The purpose of this cross-sectional study was to evaluate the correlation of myeloperoxidase (MPO) levels with traditional periodontal clinical parameters around dental implants including peri-implant pocket probing depth (PPD), gingival index (GI) and bleeding on probing (BOP), since MPO has been associated with destruction of periodontal tissues. Twenty-four healthy adult volunteers (9 men and 15 women) with 64 Ankylos Biofunctional implants (DentsplyFriadent, Mannheim, Germany) were recruited from Tallinn Dental Clinic. Biochemical and clinical parameters evaluated were the following ones: the level of MPO in the peri-implant sulcus fluid (PISF) (an analog for gingival crevicular fluid in natural teeth), PPD (mm), GI (0,1,2 or 3), and BOP (0 or 1). In comparison to the clinically healthy implants, total amounts of MPO were significantly higher in PISF collected around implants with inflammatory lesions. In addition, the levels of MPO were correlated with the clinical parameters. The results confirm the similarity of the inflammatory response of tissues surrounding implants and natural teeth, and suggest that MPO could be promising marker of inflammation around dental implants.

  4. Correlation between CAT-findings and clinical course in viral and bacterial meningoencephalitis

    Energy Technology Data Exchange (ETDEWEB)

    Krueger, H.; Drewnitzky, H.; Rohkamm, R.; Grosse, D.

    1983-03-01

    The computed axial tomograms (CAT) of 50 patients with viral or bacterial meningoencephalitis are correlated with the clinical course, the laboratory data, and the EEG changes. The diagnostic value of CAT in the early diagnosis of herpes simplex encephalitis is of specific importance. Hypodense regions are demonstrated after the fifth day of illness in the temporal lobe. All other viral or bacterial meningoencephalitis cases have no specific changes on CAT examination compared with clinical or laboratoy data. However, in localised encephalitis CAT may reveal hypodense regions. For follow-up studies of meningoencephalitis CAT is of important diagnostic value in demonstrating complications such as abscess or occlusive hydrocephalus.

  5. [Correlation between CT findings and clinical course in viral and bacterial meningoencephalitis].

    Science.gov (United States)

    Krüger, H; Grosse, D; Drewnitzky, H; Rohkamm, R

    1983-03-01

    The computed axial tomograms (CAT) of 50 patients with viral or bacterial meningoencephalitis are correlated with the clinical course, the laboratory data, and the EEG changes. The diagnostic value of CAT in the early diagnosis of herpes simplex encephalitis is of specific importance. Hypodense regions are demonstrated after the fifth day of illness in the temporal lobe. All other viral or bacterial meningoencephalitis cases have no specific changes on CAT examination compared with clinical or laboratory data. However, in localised encephalitis CAT may reveal hypodense regions. For follow-up studies of meningoencephalitis CAT is of important diagnostic value in demonstrating complications such as abscess or occlusive hydrocephalus.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1996-12-31

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

  7. Challenges in Measuring Benefit of Clinical Research Training Programs--the ASH Clinical Research Training Institute Example.

    Science.gov (United States)

    Sung, Lillian; Crowther, Mark; Byrd, John; Gitlin, Scott D; Basso, Joe; Burns, Linda

    2015-12-01

    The American Society of Hematology developed the Clinical Research Training Institute (CRTI) to address the lack of training in patient-oriented research among hematologists. As the program continues, we need to consider metrics for measuring the benefits of such a training program. This article addresses the benefits of clinical research training programs. The fundamental and key components are education and mentorship. However, there are several other benefits including promotion of collaboration, job and advancement opportunities, and promotion of work-life balance. The benefits of clinical research training programs need to be measured so that funders and society can judge if they are worth the investment in time and resources. Identification of elements that are important to program benefit is essential to measuring the benefit of the program as well as program planning. Future work should focus on the constructs which contribute to benefits of clinical research training programs such as CRTI.

  8. Tear cytokine and chemokine analysis and clinical correlations in evaporative-type dry eye disease

    Science.gov (United States)

    Castellanos, Evangelina; Stern, Michael E.; Fernández, Itziar; Carreño, Ester; García-Vázquez, Carmen; Herreras, Jose M.; Calonge, Margarita

    2010-01-01

    Purpose Inflammatory molecules have been demonstrated in the tear film of patients with severe dry eye disease (DED). However, little attention has been paid to the most frequent moderate forms of DED. This study analyzes tear cytokine levels and their clinical correlations in patients with moderate evaporative-type DED due to meibomian gland disease (MGD). Methods Twenty three evaporative-type DED patients (46 eyes) of mild-to-moderate intensity and nine healthy subjects (18 eyes) were recruited. Two symptom questionnaires were self-answered and multiple DED-related clinical tests were performed. Unstimulated tears from each eye were isolated and were not pooled. Levels of 15 cytokines and chemokines were measured by multiplex bead analysis, compared with control levels, and correlated with clinical tests. Results Fourteen out of the 15 molecules were reliably detected in 1 μl of unstimulated tears from DED patients. Epidermal growth factor (EGF), fractalkine/CX3CL1, interleukin (IL) 1-receptor antagonist (Ra), IL-8/CXCL8, interferon inducible protein (IP)-10/CXCL10, and vascular endothelial growth factor (VEGF) were found in 94%–100% of samples; IL-6 in 65% (significantly more detected in older patients); IL-1β, interferon gamma (IFN-γ), and IL-10 in 30%–48%; IL-17 in 13%; granulocyte macrophage colony stimulating factor (GM-CSF), IL-13, and tumor necrosis factor alpha (TNF-α) in 2%–9%; and IL-5 was never detected. EGF, fractalkine/CX3CL1, IL-1Ra, IP-10/CXCL10, and VEGF levels were significantly increased compared to normal controls. Pain was correlated with IL-6 and IL-8/CXCL8. Tear break-up time correlated inversely with IL1-Ra. Schirmer test and tear lysozyme levels negatively correlated with IL-1Ra, IL-8/CXCL8, fracktalkine/CX3CL1, IL-6, IP-10/CXCL10, and VEGF had the same tendency. Conjunctival staining correlated negatively with EGF and positively with IL-6. Conclusions In this sample of moderate evaporative-type DED patients, five inflammatory

  9. Anatomic, clinical, and neuropsychological correlates of spelling errors in primary progressive aphasia.

    Science.gov (United States)

    Shim, Hyungsub; Hurley, Robert S; Rogalski, Emily; Mesulam, M-Marsel

    2012-07-01

    This study evaluates spelling errors in the three subtypes of primary progressive aphasia (PPA): agrammatic (PPA-G), logopenic (PPA-L), and semantic (PPA-S). Forty-one PPA patients and 36 age-matched healthy controls were administered a test of spelling. The total number of errors and types of errors in spelling to dictation of regular words, exception words and nonwords, were recorded. Error types were classified based on phonetic plausibility. In the first analysis, scores were evaluated by clinical diagnosis. Errors in spelling exception words and phonetically plausible errors were seen in PPA-S. Conversely, PPA-G was associated with errors in nonword spelling and phonetically implausible errors. In the next analysis, spelling scores were correlated to other neuropsychological language test scores. Significant correlations were found between exception word spelling and measures of naming and single word comprehension. Nonword spelling correlated with tests of grammar and repetition. Global language measures did not correlate significantly with spelling scores, however. Cortical thickness analysis based on MRI showed that atrophy in several language regions of interest were correlated with spelling errors. Atrophy in the left supramarginal gyrus and inferior frontal gyrus (IFG) pars orbitalis correlated with errors in nonword spelling, while thinning in the left temporal pole and fusiform gyrus correlated with errors in exception word spelling. Additionally, phonetically implausible errors in regular word spelling correlated with thinning in the left IFG pars triangularis and pars opercularis. Together, these findings suggest two independent systems for spelling to dictation, one phonetic (phoneme to grapheme conversion), and one lexical (whole word retrieval). Copyright © 2012 Elsevier Ltd. All rights reserved.

  10. Demographic and clinical correlates of autism symptom domains and autism spectrum diagnosis

    OpenAIRE

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

    2013-01-01

    Demographic and clinical factors may influence assessment of autism symptoms. This study evaluated these correlates and also examined whether social communication and interaction and restricted/repetitive behavior provided unique prediction of autism spectrum disorder diagnosis. We analyzed data from 7352 siblings included in the Interactive Autism Network registry. Social communication and interaction and restricted/repetitive behavior symptoms were obtained using caregiver-reports on the So...

  11. Correlation of thermal deficit with clinical parameters and functional status in patients with unilateral lumbosacral radiculopathy.

    Science.gov (United States)

    Dimitrijevic, I M; Kocic, M N; Lazovic, M P; Mancic, D D; Marinkovic, O K; Zlatanovic, D S

    2016-08-01

    Lumbosacral radiculopathy is a pathological process that refers to the dysfunction of one or more spinal nerve roots in the lumbosacral region of the spine. Some studies have shown that infrared thermography can estimate the severity of the clinical manifestation of unilateral lumbosacral radiculopathy. This study aimed to examine the correlation of the regional thermal deficit of the affected lower extremity with pain intensity, mobility of the lumbar spine, and functional status in patients with unilateral lumbosacral radiculopathy. This cross-sectional study was conducted at the Clinic for Physical Medicine and Rehabilitation of the Clinical Center Niš, Serbia. A total of 69 patients with unilateral lumbosacral radiculopathy of discogenic origin were recruited, with the following clinical parameters evaluated: (1) pain intensity by using a visual analogue scale, separately at rest and during active movement; (2) mobility of the lumbar spine by Schober test and the fingertip-to-floor test; and (3) functional status by the Oswestry Disability Index. Temperature differences between the symmetrical regions of the lower extremities were detected by infrared thermography. A quantitative analysis of thermograms determined the regions of interest with maximum thermal deficit. Correlation of maximum thermal deficit with each tested parameter was then determined. A significant and strong positive correlation was found between the regional thermal deficit and pain intensity at rest, as well as pain during active movements (rVAS - rest=0.887, rVAS - activity=0.890; Plumbar spine (Pradiculopathy, the values of regional thermal deficit of the affected lower extremity are correlated with pain intensity, mobility of the lumbar spine, and functional status of the patient.

  12. Correlations between supra- and subgingival clinical parameters in smokers and individuals who have never smoked

    OpenAIRE

    Alves, Carolina Righi; Berlt, Fernanda Abbadie; Mário, Ticiane de Góes; Sfreddo, Camila Silveira; Maier, Juliana; Moreira, Carlos Heitor Cunha

    2015-01-01

    Introduction Smoking is a risk factor for prevalence, severity and progression of periodontal disease and appears to suppress marginal periodontium inflammatory response. Purpose To correlate Visible Plaque Index (VPI) and Gingival Bleeding Index (GBI) in smokers and never-smokers, as well as GBI and bleeding on probing (BOP ) in these groups. Material and method We used baseline data of one quasi-experimental study in which 11 smokers and 14 subjects who never smoked were submitted to clinic...

  13. The Shear Wave Velocity on Elastography Correlates with the Clinical Symptoms and Histopathological Features of Keloids

    OpenAIRE

    Aya, Rino; Yamawaki, Satoko; Yoshikawa, Katsuhiro; Katayama, Yasuhiro; Enoshiri, Tatsuki; Naitoh, Motoko; Suzuki, Shigehiko

    2015-01-01

    Background: Keloids present as red, painful lesions causing serious functional and cosmetic problems; however, there is no consensus regarding tools for objectively evaluating keloids. To demonstrate the utility of shear wave elastography in keloids, we investigated the correlations between clinical symptoms, ultrasound shear wave velocity, and histopathological findings. Methods: Three patients with keloids containing both red hypertrophic and mature areas were evaluated using the shear wave...

  14. Sexual dysfunction in relapsing-remitting multiple sclerosis: magnetic resonance imaging, clinical, and psychological correlates.

    OpenAIRE

    Barak, Y; Achiron, A.; Elizur, A; Gabbay, U; Noy, S; Sarova-Pinhas, I

    1996-01-01

    The purpose of this study was to examine the sexual complaints and severity of sexual dysfunction in relapsing-remitting multiple sclerosis patients and to correlate them with psychological, neurological, and radiological variables. Frequency and characteristics of sexual disturbances were reported by 41 multiple sclerosis patients (32 females, 9 males; mean age 35.4 +/- 10.2 y). Clinical neurologic variables tested were disease duration, exacerbation rate, and disability; psychological varia...

  15. Serologic features of primary Sjögren’s syndrome: clinical and prognostic correlation

    Science.gov (United States)

    García-Carrasco, Mario; Mendoza-Pinto, Claudia; Jiménez-Hernández, César; Jiménez-Hernández, Mario; Nava-Zavala, Arnulfo; Riebeling, Carlos

    2013-01-01

    Sjögren’s syndrome (SS) is a chronic inflammatory systemic autoimmune disease. The disease spectrum extends from sicca syndrome to systemic involvement and extraglandular manifestations, and SS may be associated with malignancies, especially non-Hodgkin’s lymphoma. Patients with SS present a broad spectrum of serologic features. Certain serological findings are highly correlated with specific clinical features, and can be used as prognostic markers. PMID:23525186

  16. Is intrathoracic tracheal collapsibility correlated to clinical phenotypes and sex in patients with COPD?

    Directory of Open Access Journals (Sweden)

    Camiciottoli G

    2015-04-01

    Full Text Available Gianna Camiciottoli,1 Stefano Diciotti,2 Francesca Bigazzi,1 Simone Lombardo,3 Maurizio Bartolucci,4 Matteo Paoletti,1 Mario Mascalchi,3 Massimo Pistolesi1 1Section of Respiratory Medicine, Department of Clinical and Experimental Medicine, University of Florence, Florence, Italy; 2Department of Electrical, Electronic, and Information Engineering “Guglielmo Marconi,” University of Bologna, Cesena, Italy; 3Radiodiagnostic Section, Department of Clinical and Experimental Biomedical Sciences, University of Florence, Florence, Italy; 4Department of Diagnostic Imaging, Careggi University Hospital, Florence, Italy Abstract: A substantial proportion of patients with chronic obstructive pulmonary disease (COPD develops various degree of intrathoracic tracheal collapsibility. We studied whether the magnitude of intrathoracic tracheal collapsibility could be different across clinical phenotypes and sex in COPD. Intrathoracic tracheal collapsibility measured at paired inspiratory–expiratory low dose computed tomography (CT and its correlation with clinical, functional, and CT-densitometric data were investigated in 69 patients with COPD according to their predominant conductive airway or emphysema phenotypes and according to sex. Intrathoracic tracheal collapsibility was higher in patients with predominant conductive airway disease (n=28 and in females (n=27. Women with a predominant conductive airway phenotype (n=10 showed a significantly greater degree of collapsibility than women with predominant emphysema (28.9%±4% versus 11.6%±2%; P<0.001. Intrathoracic tracheal collapsibility was directly correlated with inspiratory–expiratory volume variation at CT and with forced expiratory volume (1 second, and inversely correlated with reduced CT lung density and functional residual capacity. Intrathoracic tracheal collapsibility was not correlated with cough and wheezing; however, intrathoracic tracheal collapsibility and clinical phenotypes of COPD

  17. T1- Thresholds in Black Holes Increase Clinical-Radiological Correlation in Multiple Sclerosis Patients.

    Science.gov (United States)

    Thaler, Christian; Faizy, Tobias; Sedlacik, Jan; Holst, Brigitte; Stellmann, Jan-Patrick; Young, Kim Lea; Heesen, Christoph; Fiehler, Jens; Siemonsen, Susanne

    2015-01-01

    Magnetic Resonance Imaging (MRI) is an established tool in diagnosing and evaluating disease activity in Multiple Sclerosis (MS). While clinical-radiological correlations are limited in general, hypointense T1 lesions (also known as Black Holes (BH)) have shown some promising results. The definition of BHs is very heterogeneous and depends on subjective visual evaluation. We aimed to improve clinical-radiological correlations by defining BHs using T1 relaxation time (T1-RT) thresholds to achieve best possible correlation between BH lesion volume and clinical disability. 40 patients with mainly relapsing-remitting MS underwent MRI including 3-dimensional fluid attenuated inversion recovery (FLAIR), magnetization-prepared rapid gradient echo (MPRAGE) before and after Gadolinium (GD) injection and double inversion-contrast magnetization-prepared rapid gradient echo (MP2RAGE) sequences. BHs (BHvis) were marked by two raters on native T1-weighted (T1w)-MPRAGE, contrast-enhancing lesions (CE lesions) on T1w-MPRAGE after GD and FLAIR lesions (total-FLAIR lesions) were detected separately. BHvis and total-FLAIR lesion maps were registered to MP2RAGE images, and the mean T1-RT were calculated for all lesion ROIs. Mean T1 values of the cortex (CTX) were calculated for each patient. Subsequently, Spearman rank correlations between clinical scores (Expanded Disability Status Scale and Multiple Sclerosis Functional Composite) and lesion volume were determined for different T1-RT thresholds. Significant differences in T1-RT were obtained between all different lesion types with highest T1 values in visually marked BHs (BHvis: 1453.3±213.4 ms, total-FLAIR lesions: 1394.33±187.38 ms, CTX: 1305.6±35.8 ms; p1500 ms (Expanded Disability Status Scale vs. lesion volume: rBHvis = 0.442 and rtotal-FLAIR = 0.497, p<0.05; Multiple Sclerosis Functional Composite vs. lesion volume: rBHvis = -0.53 and rtotal-FLAIR = -0.627, p<0.05). Clinical-radiological correlations in MS patients are

  18. Impact of an After-School Physical Activity Program on Youth's Physical Activity Correlates and Behavior

    Science.gov (United States)

    Huang, Chaoqun; Gao, Zan; Hannon, James C.; Schultz, Barry; Newton, Maria; Jenson, William

    2012-01-01

    The purpose of this investigation was to examine the effect of a sports-based, after-school physical activity (PA) program on youth's physical activity PA levels and PA correlates. After the pretest, 130 youth were assigned to the intervention group (i.e., after-school PA group) or the comparison (i.e., no after-school PA group) group.…

  19. Use of Trichomonas vaginalis clinical isolates to evaluate correlation of gene expression and metronidazole resistance.

    Science.gov (United States)

    Mead, J R; Fernadez, M; Romagnoli, P A; Secor, W E

    2006-02-01

    We investigated whether variations in gene expression of enzymes associated with anaerobic resistance of laboratory-derived strains of Trichomonas vaginalis could be detected in a group of 28 clinical isolates with variations in metronidazole sensitivity. We compared isolates by real-time PCR because this method allows for highly sensitive quantification of mRNA and for evaluation of several genes simultaneously. We found that PFOR gene A mRNA levels were highly correlated with PFOR gene B levels, as well as the D subunit of malic enzyme and ferrodoxin. Ferrodoxin mRNA expression was also significantly correlated with that of malic enzyme and hydrogenase. However, when we evaluated relationships between these enzymes and resistance to metronidazole, we found no significant correlations between aerobic or anaerobic in vitro sensitivity to drug and mRNA levels of any of the enzymes tested. Similarly, using a Student's t-test, no significant differences in enzyme mRNA levels were observed between isolates separated by metronidazole resistance or susceptibility. The lack of correlation between gene expression and resistance or susceptibility could be the result of differences in expression at the protein level or because other biochemical pathways or genes are involved in the resistance observed in clinical settings.

  20. Smoking Prevalence and Its Clinical Correlations in Patients with Narcolepsy-cataplexy

    Directory of Open Access Journals (Sweden)

    Pavla Peřinová

    2016-01-01

    Full Text Available Narcolepsy-cataplexy (NC is a chronic neurological disease with suggested autoimmune etiopathogenesis. Nicotine stimulates central nervous system and smoking increases the risk of autoimmune diseases. Assessment of smoking habits and its correlation to clinical parameters among 87 adult NC patients (38 male, 49 female included night polysomnography and multiple sleep latency test. In our sample, 43.7% NC patients were regular smokers, and 19.5% former smokers compared to 22.2%, and 12.6%, respectively, in the general population. Patients started to smoke in the mean age of 20.0 (SD ±6.0 years. 72.2% of NC smokers started to smoke before the onset of NC and the mean of the delay between smoking onset and NC onset was 9.1 (±5.8 years. We found a direct correlation between smoking duration and the number of awakenings, duration of N1 sleep, REM sleep latency, and apnoea/hypopnoea index (AHI, and, on the contrary, indirect correlation between smoking duration and N3 sleep duration, showing that smoking duration consistently correlates with sleep macrostructure. Smoking is highly prevalent in NC and has relationship with clinical features of NC.

  1. Publishing history does not correlate with clinical performance among internal medicine residents.

    Science.gov (United States)

    Cavalcanti, Rodrigo B; Detsky, Allan S

    2010-05-01

    OBJECTIVES Selection criteria for applicants to the internal medicine programme at the University of Toronto have included the number and quality of scholarly items published. We sought to determine whether previous publishing record correlated with resident performance as measured by in-training evaluation reports (ITERs) and global impressions of clinical competency by site programme directors and senior educators (global impression). METHODS Data on the total number, quality and type of items published, as well as the timing of publishing with regard to pre-MD training, were abstracted from the curricula vitae of individuals who applied for residency during 2001-2005. These were correlated with overall, Expert and Scholar role ITER scores, and with global impression, using Spearman rank correlation scores. RESULTS We gathered publishing history data on 181 residents, for 162 of whom ITER data were available. Overall, 68.5% of residents had published, but only 14.9% had published during medical school. There was a weak correlation of borderline significance (rho = 0.15, P = 0.055) between overall ITER score and number of items published. No such correlation was found with CanMEDS Medical Expert and Scholar role scores. Global impression classified 33.9% of residents as top-rated. More top-rated residents had published (76.7% versus 65.1%; P = 0.07), but the number of items published during medical school were similar between top-rated and non-top-rated residents (16.1% versus 12.3%; P = 0.46). CONCLUSIONS Our results do not support publishing record as a predictor of residents' clinical performance. Surprisingly, the correlation between publishing record and Scholar role scores was also weak, possibly indicating an inability of the ITER to capture this competency. Further research is needed to identify predictors and measures of performance in scholarly activities.

  2. Temporomandibular joint osteoarthritis: cone beam computed tomography findings, clinical features, and correlations.

    Science.gov (United States)

    Cömert Kiliç, S; Kiliç, N; Sümbüllü, M A

    2015-10-01

    The aim of this study was to determine the prevalence of and associations between clinical signs and symptoms and cone beam computed tomography (CBCT) findings of temporomandibular joint osteoarthritis (TMJ-OA). Seventy-six patients (total 117 TMJ) with osteoarthritis were included in this study. Clinical signs and symptoms and CBCT findings were reviewed retrospectively. A considerable decrease in mandibular motions and mastication efficiency, and considerable increase in joint sounds and general pain complaints were observed. The most frequent condylar bony changes were erosion (110 joints, 94.0%), followed by flattening (108 joints, 92.3%), osteophytes (93 joints, 79.5%), hypoplasia (22 joints, 18.8%), sclerosis (14 joints, 12.0%), and subchondral cyst (four joints, 3.4%). Flattening of the articular eminence and pneumatization were each observed in five joints. Forty-one patients had bilateral degeneration and 35 had unilateral degeneration. Hypermobility was detected in 47 degenerative joints. Masticatory efficiency was negatively correlated with both condylar flattening and sclerosis, and general pain complaints was positively correlated with condylar flattening. Condylar erosion, flattening, osteophytes, pain, joint sounds, reduced jaw movements, and worsened mastication were common findings in TMJ-OA in the present study. Poor correlations were found between osseous changes and clinical signs and symptoms of TMJ-OA. CBCT is a powerful diagnostic tool for the diagnosis of TMJ-OA. Copyright © 2015 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  3. Correlation of quantitative sensorimotor tractography with clinical grade of cerebral palsy

    Energy Technology Data Exchange (ETDEWEB)

    Trivedi, Richa; Gupta, Rakesh K. [Sanjay Gandhi Postgraduate Institute of Medical Sciences, Department of Radiodiagnosis, Lucknow (India); Agarwal, Shruti; Rathore, Ram K.S. [Indian Institute of Technology, Department of Mathematics and Statistics, Kanpur (India); Shah, Vipul [Bhargava Nursing Home, Pediatric Orthopedic Surgery unit, Lucknow (India); Goyel, Puneet [Sanjay Gandhi Postgraduate Institute of Medical Sciences, Department of Anesthesiology, Lucknow (India); Paliwal, Vimal K. [Sanjay Gandhi Postgraduate Institute of Medical Sciences, Department of Neurology, Lucknow (India)

    2010-08-15

    The purpose of this study was to determine whether tract-specific diffusion tensor imaging measures in somatosensory and motor pathways correlate with clinical grades as defined using the Gross Motor Function Classification System (GMFCS) in cerebral palsy (CP) children. Quantitative diffusion tensor tractography was performed on 39 patients with spastic quadriparesis (mean age = 8 years) and 14 age/sex-matched controls. All patients were graded on the basis of GMFCS scale into grade II (n = 12), grade IV (n = 22), and grade V (n = 5) CP and quantitative analysis reconstruction of somatosensory and motor tracts performed. Significant inverse correlation between clinical grade and fractional anisotropy (FA) was observed in both right and left motor and sensory tracts. A significant direct correlation of mean diffusivity values from both motor and sensory tracts was also observed with clinical grades. Successive decrease in FA values was observed in all tracts except for left motor tracts moving from age/sex-matched controls to grade V through grades II and IV. We conclude that white matter tracts from both the somatosensory and the motor cortex play an important role in the pathophysiology of motor disability in patients with CP. (orig.)

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

    Science.gov (United States)

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

    2014-10-01

    The flexor digitorum accessorius longus (FDAL), a variant leg muscle, can cause tarsal tunnel syndrome. This study was performed to classify the variants of the FDAL by dissection and to correlate the dissection results with clinical cases of tarsal tunnel syndrome caused by this muscle. Eighty lower limbs of embalmed Korean cadavers were dissected. MR images of two clinical cases of tarsal tunnel syndrome caused by the FDAL were correlated with the dissection results. The FDAL was observed in nine out of 80 specimens (11.3%) and it was classified into three types depending on its site of origin and its relationship to the posterior tibial neurovascular bundle (PTNV) in the leg. In Type I (6.3%), the FDAL originated in the leg and ran superficially along the PTNV, either not crossing (Type Ia, 3.8%) or crossing (Type Ib, 2.5%) the neurovascular bundle. In Type II (6.3%), it originated in the tarsal tunnel. Most FDALs followed a similar course in the tarsal tunnel and the plantar pedis. On correlating the MR images of the clinical cases with this classification, the FDAL corresponded to Types Ia and II. All three types of FDAL can compress the tibial nerve in the tarsal tunnel or the distal leg. Clarification of the topographical relationship between this muscle and the PTNV would help to improve the results of surgery for tarsal tunnel syndrome caused by the FDAL. © 2014 Wiley Periodicals, Inc.

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

    Science.gov (United States)

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

    2015-01-01

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

  6. CT findings of transfusional hemosiderosis in patients with chronic renal failure : clinical correlation

    Energy Technology Data Exchange (ETDEWEB)

    Park, Tae Joon; Lee, Hae Kyung; Hong, Hyun Sook; Kim, Gun Woo; Kim, Hyung Hwan; Choi, Gyo Chang; Kwon, Kui Hyang; Choi, Deuk Lin [Soonchunhyang University Hospital, Seoul (Korea, Republic of)

    1997-12-01

    The purpose of this study is to evaluate whether there is any correlation between the CT features of hemosiderosis and clinical findings in patients with chronic renal failure who have received multiple blood transfusion. Among chronic renal failure patients who had undergone long-tern dialysis and received multiple blood transfusions, CT findings in 16 cases in which increased liver attenuation was seen on images obtained for other purpose, were analyzed by three radiologic specialists. The attenuation values of liver, spleen and pancreas compared with that of back muscle were correlated with the amount and duration of transfusion, and blood ferritin level. There is no correlation between the CT features of hemosiderosis and clinical findings. In patients with chronic renal failure and no clinical symptoms, the status of iron overload was relatively easily detected on CT. Close observation of CT findings is thus thought to prevent significant permanent functional deformity of organs in patients with chronic renal failure who have received multiple blood transfusions. (author). 14 refs., 1 tab., 1 fig.

  7. Disease activity in Graves' ophthalmopathy: diagnosis with orbital MR imaging and correlation with clinical score.

    Science.gov (United States)

    Tortora, Fabio; Cirillo, Mario; Ferrara, Marco; Belfiore, Maria Paola; Carella, Carlo; Caranci, Ferdinando; Cirillo, Sossio

    2013-10-01

    In Graves' ophthalmopathy (GO) it is important to distinguish acute inflammation at an early stage, responsive to immunosuppressive treatment, from inactive fibrotic end stage disease, unresponsive to the same treatment. The purpose of this study was to identify the most relevant signal intensities on orbital MR imaging with contrast administration both to classify patients according to their clinical activity score (defined by a cut-off value of 3) and to make a prediction of patient's CAS. Such threshold was considered as widely used in literature. Sixteen consecutive patients with a diagnosis of GO in different phases of thyroid disease based on clinical and orbital MR imaging signs, and six normal volunteers were examined. Orbital MR imaging was performed on a 1.5 Tesla MR Unit. MR scans were assessed by an experienced neuroradiologist, blinded to the clinical examinations. We found a statistical correlation between CAS and both STIR and contrast enhanced T1-weighted sequences. There was also a statistically significant correlation between STIR and contrast-enhanced T1 images disclosing the possibility of avoiding the injection of contrast medium. Our study proved that signal intensity values on STIR sequence increase in the inflammatory oedematous phase of disease. We confirmed the correlation between signal intensities on this sequence and CAS, showing an increase in signal intensity proportional to the CAS value. So we validated MRI use to establish the activity phase of disease more sensitively than CAS alone.

  8. MRI for clinically suspected pediatric appendicitis: an implemented program

    Energy Technology Data Exchange (ETDEWEB)

    Moore, Michael M.; Gustas, Cristy N.; Choudhary, Arabinda K.; Methratta, Sosamma T.; Hulse, Michael A.; Eggli, Kathleen D.; Boal, Danielle K.B. [Penn State Milton S. Hershey Medical Center, Department of Radiology, Mail Code H066, 500 University Drive, P.O. Box 850, Hershey, PA (United States); Geeting, Glenn [Penn State Milton S. Hershey Medical Center, Department of Emergency Medicine, Hershey, PA (United States)

    2012-09-15

    Emergent MRI is now a viable alternative to CT for evaluating appendicitis while avoiding the detrimental effects of ionizing radiation. However, primary employment of MRI in the setting of clinically suspected pediatric appendicitis has remained significantly underutilized. To describe our institution's development and the results of a fully implemented clinical program using MRI as the primary imaging evaluation for children with suspected appendicitis. A four-sequence MRI protocol consisting of coronal and axial single-shot turbo spin-echo (SS-TSE) T2, coronal spectral adiabatic inversion recovery (SPAIR), and axial SS-TSE T2 with fat saturation was performed on 208 children, ages 3 to 17 years, with clinically suspected appendicitis. No intravenous or oral contrast material was administered. No sedation was administered. Data collection includes two separate areas: time parameter analysis and MRI diagnostic results. Diagnostic accuracy of MRI for pediatric appendicitis indicated a sensitivity of 97.6% (CI: 87.1-99.9%), specificity 97.0% (CI: 93.2-99.0%), positive predictive value 88.9% (CI: 76.0-96.3%), and negative predictive value 99.4% (CI: 96.6-99.9%). Time parameter analysis indicated clinical feasibility, with time requested to first sequence obtained mean of 78.7 +/- 52.5 min, median 65 min; first-to-last sequence time stamp mean 14.2 +/- 8.8 min, median 12 min; last sequence to report mean 57.4 +/- 35.2 min, median 46 min. Mean age was 11.2 +/- 3.6 years old. Girls represented 57% of patients. MRI is an effective and efficient method of imaging children with clinically suspected appendicitis. Using an expedited four-sequence protocol, sensitivity and specificity are comparable to CT while avoiding the detrimental effects of ionizing radiation. (orig.)

  9. Ascitic microbiota composition is correlated with clinical severity in cirrhosis with portal hypertension.

    Directory of Open Access Journals (Sweden)

    Geraint B Rogers

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

  10. CT abnormality in multiple sclerosis analysis based on 28 probable cases and correlation with clinical manifestations

    Energy Technology Data Exchange (ETDEWEB)

    Kakigi, R.; Shibasaki, H.; Tabira, T.; Kuroiwa, Y. (Kyushu Univ., Fukuoka (Japan). Faculty of Medicine); Numaguchi, Y.

    1981-10-01

    In order to investigate the occurrence and nature of CT abnormality and its correlation with clinical manifestations in multiple sclerosis, 34 CT records obtained from 28 consecutive patients with probable multiple sclerosis were reviewed. Forty-six percent of all cases showed abnormal CT. Dilatation of cortical sulci was found in 39%; dilatation of the lateral ventricle in 36%; dilatation of prepontine or cerebello-pontine cistern and the fourth ventricle, suggesting brainstem atrophy, in 18%; dilatation of cerebellar sulci, superior cerebellar cistern and cisterna magna, suggesting cerebellar atrophy, in 11%. Low density area was found in the cerebral hemisphere in 11% of cases. Contrast enhancement, performed on 25 CT records, did not show any change. There was no correlation between CT abnormality and duration of the illness. Although abnormal CT tended to occur more frequently during exacerbations and chronic stable state than during remissions, the difference was not statistically significant. CT abnormalities suggesting brainstem atrophy, cerebellar atrophy or plaques were found exclusively during exacerbations and chronic stable state. The occurrence of CT abnormalities was not significantly different among various clinical forms which were classified based on clinically estimated sites of lesion, except that abnormal CT tended to occur less frequently in cases classified as the optic-spinal form. It is noteworthy that cerebral cortical atrophy and/or dilatation of the lateral ventricle were found in 31% of cases who did not show any clinical sign of cerebral involvement. There was a statistically significant correlation between CT abnormalities and levels of clinical disability. Eighty percent of the bedridden or severely disabled patients showed abnormal CT, in contrast with only 29% of those with moderate, slight or no disability.

  11. Clinical skills assessment of procedural and advanced communication skills: performance expectations of residency program directors

    Directory of Open Access Journals (Sweden)

    Erik E. Langenau

    2012-07-01

    Full Text Available Background: High stakes medical licensing programs are planning to augment and adapt current examinations to be relevant for a two-decision point model for licensure: entry into supervised practice and entry into unsupervised practice. Therefore, identifying which skills should be assessed at each decision point is critical for informing examination development, and gathering input from residency program directors is important. Methods: Using data from previously developed surveys and expert panels, a web-delivered survey was distributed to 3,443 residency program directors. For each of the 28 procedural and 18 advanced communication skills, program directors were asked which clinical skills should be assessed, by whom, when, and how. Descriptive statistics were collected, and Intraclass Correlations (ICC were conducted to determine consistency across different specialties. Results: Among 347 respondents, program directors reported that all advanced communication and some procedural tasks are important to assess. The following procedures were considered ‘important’ or ‘extremely important’ to assess: sterile technique (93.8%, advanced cardiovascular life support (ACLS (91.1%, basic life support (BLS (90.0%, interpretation of electrocardiogram (89.4% and blood gas (88.7%. Program directors reported that most clinical skills should be assessed at the end of the first year of residency (or later and not before graduation from medical school. A minority were considered important to assess prior to the start of residency training: demonstration of respectfulness (64%, sterile technique (67.2%, BLS (68.9%, ACLS (65.9% and phlebotomy (63.5%. Discussion: Results from this study support that assessing procedural skills such as cardiac resuscitation, sterile technique, and phlebotomy would be amenable to assessment at the end of medical school, but most procedural and advanced communications skills would be amenable to assessment at the end of the

  12. Clinical skills assessment of procedural and advanced communication skills: performance expectations of residency program directors

    Science.gov (United States)

    Langenau, Erik E.; Zhang, Xiuyuan; Roberts, William L.; DeChamplain, Andre F.; Boulet, John R.

    2012-01-01

    Background High stakes medical licensing programs are planning to augment and adapt current examinations to be relevant for a two-decision point model for licensure: entry into supervised practice and entry into unsupervised practice. Therefore, identifying which skills should be assessed at each decision point is critical for informing examination development, and gathering input from residency program directors is important. Methods Using data from previously developed surveys and expert panels, a web-delivered survey was distributed to 3,443 residency program directors. For each of the 28 procedural and 18 advanced communication skills, program directors were asked which clinical skills should be assessed, by whom, when, and how. Descriptive statistics were collected, and Intraclass Correlations (ICC) were conducted to determine consistency across different specialties. Results Among 347 respondents, program directors reported that all advanced communication and some procedural tasks are important to assess. The following procedures were considered ‘important’ or ‘extremely important’ to assess: sterile technique (93.8%), advanced cardiovascular life support (ACLS) (91.1%), basic life support (BLS) (90.0%), interpretation of electrocardiogram (89.4%) and blood gas (88.7%). Program directors reported that most clinical skills should be assessed at the end of the first year of residency (or later) and not before graduation from medical school. A minority were considered important to assess prior to the start of residency training: demonstration of respectfulness (64%), sterile technique (67.2%), BLS (68.9%), ACLS (65.9%) and phlebotomy (63.5%). Discussion Results from this study support that assessing procedural skills such as cardiac resuscitation, sterile technique, and phlebotomy would be amenable to assessment at the end of medical school, but most procedural and advanced communications skills would be amenable to assessment at the end of the first

  13. Correlation between clinical and imaging findings in patients with temporomandibular disorders

    Energy Technology Data Exchange (ETDEWEB)

    Cozzolino, Fabio Augusto; Rapoport, Abrao; Frazni, Sergio Altino; Souza, Ricardo Pires de; Pereira, Clemente Augusto de Brito; Dedivitis, Rogerio Aparecido [Hospital Heliopolis (Hosphel), Sao Paulo, SP (Brazil). Course of Post-graduation in Health Sciences]. E-mail: arapoport@terra.com.br

    2008-01-15

    Objective: To correlate the signals and symptoms observed on clinical examination of patients with temporomandibular disorder with the results demonstrated by magnetic resonance imaging. Materials and methods: Thirty patients presenting with signs and symptoms of temporomandibular disorders underwent clinical evaluation and subsequent magnetic resonance imaging. The magnetic resonance imaging studies were independently evaluated by two experienced radiologists. Magnetic resonance imaging studies consisted of 12 images in coronal, T1-weighted sequences with 3 mm-thick slices with the mouth closed, sagittal, T1- and T2-weighted sequences with both open and closed mouth positions, and on progressive opening/closing movement at 5 mm intervals, in order to demonstrate the full mandibular movement. The statistical significance between the clinical findings in the evaluation of the patients and results found on the magnetic resonance imaging studies was analyzed by means the kappa test. Results: Interobserver agreement was respectively 56.7% (kappa = 0.1) and 56.7 (kappa = 0) for the left and right sides. Conclusion: No correlation was found between the clinical and magnetic resonance imaging findings in the diagnoses of disc displacement. (author)

  14. Oral leukoplakia: Transmission electron microscopic correlation with clinical types and light microscopy

    Science.gov (United States)

    Tamgadge, Sandhya Avinash; Ganvir, Sindhu Milind; Hazarey, Vinay Krishnarao; Tamgadge, Avinash

    2012-01-01

    Background: Leukoplakia, is a precancerous lesion that is most commonly encountered in the oral cavity. The grade of dysplasia is presumed to be the most important indicator of malignant potential. There are many promising aspects in advanced methods for the evaluation of oral precancer and cancer. Among these methods, electron microscopic examination predicts the true biologic potential more accurately than conventional histology and has some success in the early detection of potentially malignant lesions. It has been reported in the literature that there is some correlation between clinical, histopathological, and transmission electron microscopic features. Materials and Methods: In this cohort study (prospective research), from the total of 9 subjects, 3 had homogenous leukoplakia, 3 had ulcerative type of oral leukoplakia, and 3 had nodular type of oral leukoplakia. Two patients were selected as control patients. Transmission electron microscopic examination was carried for all the cases and controls. All the findings were correlated with clinical features and light microscopy. Results: Clinically and histologically, mild leukoplakia showed break in basement membrane, which can only be observed under transmission electron microscope (TEM). Additional dysplastic features were observed under transmission electron microscope, which are indicative of neoplastic process. Conclusions: Thus, it is finally concluded that nodular leukoplakia seems to be the most severe clinical type of leukoplakia showing highest risk of malignant transformation. Homogenous leukoplakia might show break in basement membrane under TEM. PMID:23814570

  15. Correlation of alkaline phosphatase activity to clinical parameters of inflammation in smokers suffering from chronic periodontitis

    Directory of Open Access Journals (Sweden)

    Vishakha Grover

    2016-01-01

    Full Text Available Context: Current clinical periodontal diagnostic techniques emphasize the assessment of clinical and radiographic signs of periodontal diseases which can provide a measure of history of disease. Hence, new methodologies for early identification and determination of periodontal disease activity need to be explored which will eventually result in expedited treatment. Aim: To evaluate the correlation of alkaline phosphatase (ALP activity in gingival crevicular fluid (GCF to clinical parameters of periodontal inflammation in smokers with chronic periodontitis. Materials and Methods: Study population included 15 smoker male patients in the age group of 35–55 years suffering from moderate generalized chronic periodontitis with history of smoking present. Following parameters were evaluated at baseline, 1 month and 3 months after scaling and root planing: plaque index, bleeding index, probing pocket depth (PD, relative attachment level (RAL, and GCF ALP activity. Statistical Analysis Used: Independent variables for measurements over time were analyzed by using Wilcoxon signed rank test. Results: A statistically significant reduction in all the clinical parameters and GCF ALP activity was observed from baseline to 1 month and 3 months. A correlation was observed between change in GCF ALP activity and PD reduction as well as gain in RAL at 3 months. Conclusion: The present study emphasizes that total ALP activity could be used as a marker for periodontal disease activity in smokers. Estimation of changes in the levels of this enzyme has a potential to aid in the detection of progression of periodontal disease and monitoring the response to periodontal therapy.

  16. Genetic heterogeneity in hereditary hemorrhagic telangiectasia: Possible correlation with clinical phenotype

    Energy Technology Data Exchange (ETDEWEB)

    Papenberg, K.A.; Lennon, F.; Helmbold, E.A. [and others

    1994-09-01

    Hereditary hemorrhagic telangiectasia (HHT) is an autosomal dominant generalized vascular dysplasia characterized by recurrent hemorrhage. Our initial linkage studies found an HHT gene to be localized to 9q3 in two large kindreds. In the present study, we have examined an additional five unrelated HHT families. The multipoint linkage analysis in this region resulted in a peak multipoint lod score of 13.03. Two additional proximal crossovers in affected individuals in one of these families have now further defined the candidate region on 9q3. In addition, significant evidence for heterogeneity of HHT found. The multipoint analysis supported the two-point studies with the odds of 3,000,000: 1 showing linkage and heterogeneity over linkage and homogeneity. Four of the seven families gave a posterior probability of > 99% of being of the linked type, while three families are unlinked to this region of 9q. The multipoint lod score using only the linked families is 21.70. Finally, a possible correlation in clinical phenotype between the 9q3-linked families and unlinked families is described. Although six of the seven families clearly meet the clinical criteria for HHT diagnosis, a significant absence of PAVMs is seen in all 9q3-unlinked families. This genetic heterogeneity and possible correlation to a clinical phenotype may have a significant impact on the clinical management and treatment of HHT patients.

  17. Correlation between sonographic diagnosis and histopathological results ofgallbladder poliposis in Good Hope Clinic 2008-2014

    Directory of Open Access Journals (Sweden)

    Emiliano Contreras Castro

    2016-02-01

    Full Text Available Objective: To determine the correlation between sonographic diagnosis and histopathological results of gallbladder polyposis and find the positive predictive value of ultrasound in the diagnosis of this pathology. Material and Methods: It is a non experimental, transversal, descriptive and correlational study with a sample composed of all patients operated with a diagnosis of gallbladder polyps in the Good Hope Clinic between the years 2008 and 2014. A total of 128 patients were observed. Histopathological and sonographic reports of these patients were reviewed and the statistical correlation of both studies was sought by the test of Spearman. Results: Reveals that 67,2% were females and 32,8% were males; the average age was 43,4 years; 74,2% presented polyps by histopathological examination, of which 94,7% were pseudopolyps, with 82 % cases of cholesterolpolyps, only 5,3% were true polyps (adenomas and none of them were malignant. The positive predictive value of ultrasound in the diagnosis of gallbladder polyposis was 74,21%. According to the Spearman coefficient the correlation between the number of polyps by ultrasonography and histopathology was low, direct and significant (Rho = 0,189; p = 0,032. Conclusions: We conclude that there is a correlation between the ultrasound diagnosis and histopathological result of gallbladder polyps and ultrasound can be considered a reliable method for the diagnosis of gallbladder polyps.

  18. A report on the clinical-pathological correlations of 788 gingival lesion.

    Science.gov (United States)

    Gambino, A; Carbone, M; Broccoletti, R; Carcieri, P; Conrotto, D; Carrozzo, M; Arduino, P-G

    2017-11-01

    The diagnosis and treatment of a variety of non-plaque related gingival diseases have become an integrated aspect of everyday dentistry. The aim of this study was to analyse the relationship between clinical appearance and histopathological features of gingival lesions in a large Northern Italian population. A retrospective study of 788 cases of gingival and alveolar mucosal biopsies was set up. Statistical analysis was performed by calculating the odds ratio and 95% confidence interval (C.I.), in order to assess the degree of association between the clinical parameters considered (primary lesions) and the single pathologies, statistically evaluated by Mantel-Haenszel tests. The correlation between clinical and histological diagnosis was classified as follow: 1) expected data (ED): provisional clinical diagnosis; 2) real data (RD): final histopathology diagnosis; 3) concordant data (CD): correspondence between the expected data and real data. The correlation was calculated as follow: CC (complete concordance) = CD x 100 / ED, this expressing the percentage in which the clinical and the histological diagnosis overlapped. The most frequently observed and biopsied primary lesions resulted to be exophytic, followed by mucosal colour changes and finally by losses of substance. The statistically significant association between primary lesion and their manifestation in gingival pathologies was reported. Volume increases, for instance, were positively correlated to plasma cell epulis, pyogenic granuloma, fibrous reactive hyperplasia and hemangioma. Verrucous-papillary lesions were most often seen in verrucous carcinoma, verrucous leukoplakia and mild dysplasia. White lesion resulted to be related to leukoplakia or oral lichen planus. Red lesions resulted to be related only oral lichen planus. Erosive vesicle-bullous lesions were linked to disimmune pathologies. Ulcerative lesions were positively associated to oral squamous cell cancer. Finally, potentially malignant

  19. Entry correlates and motivations of older adults participating in organized exercise programs.

    Science.gov (United States)

    Stiggelbout, Maarten; Hopman-Rock, Marijke; van Mechelen, Willem

    2008-07-01

    This study reports entry correlates and motivations of older adults participating in organized exercise programs in the Netherlands, as determined in a descriptive explorative study (N = 2,350, response rate 86%). Participants were community-dwelling older adults (50+ years) who enrolled and started in 10 different exercise programs. Entry features were analyzed for differences in age, sex, marital status, education, living situation, body-mass index, lifestyle, and health status. Motivations for entering an exercise program were determined using homogeneity analyses. More Exercise for Seniors (MBvO) attracted relatively older seniors, whereas organized sports mainly attracted younger ones. Walking, MBvO, and gymnastics attracted more women, whereas skating and table tennis were reported to attract more male participants. Badminton and cycling attracted relatively higher educated participants, whereas MBvO attracted relatively lower educated participants. Three distinct motivational constructs were found: relax and enjoy, care and cure, and competition. Public health and recruitment implications of these findings are discussed.

  20. Mild thyroid peroxidase deficiency caused by TPO mutations with residual activity: Correlation between clinical phenotypes and enzymatic activity.

    Science.gov (United States)

    Narumi, Satoshi; Fox, Larry A; Fukudome, Keisuke; Sakaguchi, Zenichi; Sugisawa, Chiho; Abe, Kiyomi; Kameyama, Kaori; Hasegawa, Tomonobu

    2017-11-29

    Thyroid peroxidase (TPO) deficiency, caused by biallelic TPO mutations, is a well-established genetic form of congenital hypothyroidism (CH). More than 100 patients have been published, and the patients have been diagnosed mostly in the frame of newborn screening (NBS) programs. Correlation between clinical phenotypes and TPO activity remains unclear. Here, we report clinical and molecular findings of two unrelated TPO mutation-carrying mildly hypothyroid patients. The two patients were born at term after an uneventful pregnancy and delivery, and were NBS negative. They sought medical attention due to goiter at age 8 years. Evaluation of the thyroid showed mild elevation of serum TSH levels, normal or slightly low serum T 4 levels, high serum T 3 to T 4 molar ratio, high serum thyroglobulin levels, and high thyroidal 123 I uptake. We performed next-generation sequencing-based genetic screening, and found that one patient was compound heterozygous for two novel TPO mutations (p.Asp224del; c.820-2A>G), and the other was homozygous for a previously known mutation (p.Trp527Cys). In vitro functional analyses using HEK293 cells showed that the two amino acid-altering mutations (p.Asp224del and p.Trp527Cys) caused partial loss of the enzymatic activity. In conclusion, we report that TPO mutations with residual activity are associated with mild TPO deficiency, which is clinically characterized by marked goiter, mild TSH elevation, high serum T 3 to T 4 molar ratio, and high serum thyroglobulin levels. Our findings illuminate the hitherto under-recognized correlation between clinical phenotypes and residual enzymatic activity among patients with TPO deficiency.

  1. Correlation of clinical observation and CT findings in patients with childhood hemiplegia

    Energy Technology Data Exchange (ETDEWEB)

    Fujita, Masaaki; Eda, Isematsu; Takashima, Sachio; Yamaguchi, Tomomasa (Tottori Univ., Yonago (Japan). School of Medicine); Sugitani, Akitoshi

    1984-02-01

    Of 64 cases of hemiplegia, 33 were congenital and 31 acquired. CT revealed abnormality at a high incidence, 29 cases of congenital hemiplegia (87.8%) and 29 of acquired hemiplegia (93.5%). The side with abnormal CT findings and clinical hemiplegic side were identical in 25 cases of congenital hemiplegia (86.2%) and 24 of acquired hemiplegia (82.8%), the both rates being high. With respect to the correlation between CT and clinical findings, the low density area in the cortex, rather than lateral ventricular dilatation, was more closely related to clinical findings, indicating the tendency that the more extensive the low density area, the more severe were both hemiplegia and intellectual disturbance.

  2. Magnetic resonance imaging of sacroiliitis in early seronegative spondylarthropathy. Abnormalities correlated to clinical and laboratory findings

    DEFF Research Database (Denmark)

    Puhakka, K B; Jurik, A G; Schiøttz-Christensen, Berit

    2004-01-01

    OBJECTIVE: To compare a new MRI scoring system of the sacroiliac joints (SIJs) in early spondylarthropathy (SpA) with clinical and laboratory parameters. METHODS: Forty-one patients (24 males, 17 females) with a median age of 26 yr and a median duration of inflammatory low back pain of 19 months...... were included. They all fulfilled the ESSG-criteria for SpA. The patients were examined by MRI of the SIJs using a new scoring system. Clinical examinations, biochemical tests, functional score (BASFI), and pain score (BASDAI) were also performed. RESULTS: 95% of the patients had inflammation and....../or destructive bone changes of the SIJs at MRI. No correlation was found between MRI pathology and clinical findings. MRI demonstrated significantly greater severity of both inflammation and destruction of the SIJs in HLA B27 positive patients than in the HLA B27 negative patients. CONCLUSIONS: In patients...

  3. STUDY OF THYROID DYSFUNCTION IN ELDERLY PATIENTS AND ITS CLINICAL CORRELATION IN TERTIARY CARE HOSPITAL

    Directory of Open Access Journals (Sweden)

    Vidyasagar

    2016-03-01

    Full Text Available INTRODUCTION Thyroid dysfunction in elderly is not uncommon. Thyroid abnormalities were more among females than in males. Clinical diagnosis is difficult to make but Thyroid Function Tests always help in diagnosing the disease. Subclinical state is equally common as clinical state in elderly population. As the age advances the incidence of thyroid disorders increase. The study was undertaken with an objective to study the spectrum of thyroid dysfunction in elderly and to correlate clinical symptoms with abnormal thyroid function. Thyroid disorders were present in 26%, overt hypothyroidism in 12%, subclinical hypothyroidism in 8% cases, hyperthyroidism in 3% and subclinical hyperthyroidism in 3% patients was noted. In this study, 36 patients were males and 64 were females. Females (20% had high incidence of thyroid disorders than males (6%.

  4. Automated EEG detection algorithms and clinical semiology in epilepsy: importance of correlations.

    Science.gov (United States)

    Hogan, R Edward

    2011-12-01

    With advances in technological innovation, electroencephalography has remained the gold standard for classification and localization of epileptic seizures. Like other diagnostic modalities, technological advances have opened new avenues for assessment of data, and hold great promise to improve interpretive capabilities. However, proper overall interpretation and application of electroencephalographic findings relies on valid correlations of associated clinical semiology. This article addresses interpretation of clinical signs and symptoms in the context of the diagnostic predictive value of electroencephalographic, clinical, and electrographic definitions of seizures, and upcoming challenges of interpreting intracranial high-frequency electroencephalographic data. This article is part of a Supplemental Special Issue entitled The Future of Automated Seizure Detection and Prediction. Copyright © 2011 Elsevier Inc. All rights reserved.

  5. Ten-year study on the correlation of clinical and pathohistological diagnosis of dysplastic nevi.

    Science.gov (United States)

    Situm, Mirna; Bolanca, Zeljana; Kolić, Maja; Gulin, Sanda Jerković; Gulin, Damir

    2011-09-01

    The aim of the study was to analyze the clinical prevalence and pathohistological correlation of dysplastic nevi. In the period between 2000 and 2009, in the Outpatient Clinic of Referral Centre for Melanoma of the Ministry of Health and Social Welfare of the Republic of Croatia, 12,344 patients were examined, and 35.07% of them were surgically removed in the same institution. Among the patients, 69.16% had clinically diagnosed melanocytic tumor. Out of them, 28.39% were dysplastic. Dysplastic nevus was pathohistologically diagnosed in 20.02% of pathohistologically diagnosed melanocytic tumors. There was women predominace among patients with clinically diagnosed dysplastic nevi (65.22%). The most frequent localization was the trunk in both sexes, women 78.18%, men 76.75%. The coincidence of clinical and pathohistological diagnosis of dysplastic nevus was 30.70%. The results of this study, based on a large number of patients could be a significant contribution in understanding characteristics of dysplastic nevus, its clinical and pathohistological complexity. We hope that the data will contribute to the creation of general accepted protocols in the diagnostics of dysplastic nevus.

  6. Brain functional networks. Correlation analysis with clinical indexes in patients with diabetic retinopathy

    Energy Technology Data Exchange (ETDEWEB)

    Dai, Hui; Zhang, Yu; Hu, Su; Wang, Ximing; Li, Yonggang; Hu, Chunhong [The First Affiliated Hospital of Soochow University, Department of Radiology, Suzhou, Jiangsu (China); Lai, Lillian [LAC+USC Medical Center, Department of Neuroradiology, Los Angeles, CA (United States); Shen, Hailin [Suzhou Kowloon Hospital, Shanghai Jiao Tong University Medical School, Department of Radiology, Suzhou, Jiangsu (China)

    2017-11-15

    The relationship between parameters of brain functional networks and clinical indexes is unclear so far in patients with diabetic retinopathy (DR). This paper is to investigate this. Twenty-one patients with different grades of DR and 21 age- and sex-matched healthy controls were enrolled from August 2012 to September 2014. The clinical indexes recorded included DR grade, duration of diabetes, HbA1c, diabetic foot screen, fasting plasma glucose, insulin, Homa-β, Homa-IR, insulin sensitive index (ISI), Mini-Mental State Examination (MMSE), and patient sex and age. Subjects were scanned using 3-T MR with blood-oxygen-level-dependent and 3D-FSPGR sequences. MR data was analyzed via preprocessing and functional network construction, and quantified indexes of network (clustering coefficient, characteristic path length, global efficiency, degree distribution, and small worldness) were evaluated. Statistics consisted of ANOVA and correlation. There were significant differences between patients and controls among clustering coefficient, characteristic path length, degree distribution, and small worldness parameters (P < 0.05). MMSE scores negatively correlated with characteristic path length, and Hb1Ac negatively correlated with small worldness. MMSE, duration of diabetes, diabetic foot screen, fasting plasma glucose, insulin, Homa-β, Homa-IR, ISI, DR grade, and patient age, except from Hb1Ac, correlated with degree distribution in certain brain areas. Brain functional networks are altered, specifically in the areas of visual function and cognition, and these alterations may reflect the severity of visual weakness and cognitive decline in DR patients. Moreover, the brain networks may be affected both by long-standing and instant clinical factors. (orig.)

  7. Correlation of Diffusion and Metabolic Alterations in Different Clinical Forms of Multiple Sclerosis

    Science.gov (United States)

    Hannoun, Salem; Bagory, Matthieu; Durand-Dubief, Francoise; Ibarrola, Danielle; Comte, Jean-Christophe; Confavreux, Christian; Cotton, Francois; Sappey-Marinier, Dominique

    2012-01-01

    Diffusion tensor imaging (DTI) and MR spectroscopic imaging (MRSI) provide greater sensitivity than conventional MRI to detect diffuse alterations in normal appearing white matter (NAWM) of Multiple Sclerosis (MS) patients with different clinical forms. Therefore, the goal of this study is to combine DTI and MRSI measurements to analyze the relation between diffusion and metabolic markers, T2-weighted lesion load (T2-LL) and the patients clinical status. The sensitivity and specificity of both methods were then compared in terms of MS clinical forms differentiation. MR examination was performed on 71 MS patients (27 relapsing remitting (RR), 26 secondary progressive (SP) and 18 primary progressive (PP)) and 24 control subjects. DTI and MRSI measurements were obtained from two identical regions of interest selected in left and right centrum semioval (CSO) WM. DTI metrics and metabolic contents were significantly altered in MS patients with the exception of N-acetyl-aspartate (NAA) and NAA/Choline (Cho) ratio in RR patients. Significant correlations were observed between diffusion and metabolic measures to various degrees in every MS patients group. Most DTI metrics were significantly correlated with the T2-LL while only NAA/Cr ratio was correlated in RR patients. A comparison analysis of MR methods efficiency demonstrated a better sensitivity/specificity of DTI over MRSI. Nevertheless, NAA/Cr ratio could distinguish all MS and SP patients groups from controls, while NAA/Cho ratio differentiated PP patients from controls. This study demonstrated that diffusivity changes related to microstructural alterations were correlated with metabolic changes and provided a better sensitivity to detect early changes, particularly in RR patients who are more subject to inflammatory processes. In contrast, the better specificity of metabolic ratios to detect axonal damage and demyelination may provide a better index for identification of PP patients. PMID:22479330

  8. [Classification of results of studying blood plasma with laser correlation spectroscopy based on semiotics of preclinical and clinical states].

    Science.gov (United States)

    Ternovoĭ, K S; Kryzhanovskiĭ, G N; Musiĭchuk, Iu I; Noskin, L A; Klopov, N V; Noskin, V A; Starodub, N F

    1998-01-01

    The usage of laser correlation spectroscopy for verification of preclinical and clinical states is substantiated. Developed "semiotic" classifier for solving the problems of preclinical and clinical states is presented. The substantiation of biological algorithms as well as the mathematical support and software for the proposed classifier for the data of laser correlation spectroscopy of blood plasma are presented.

  9. Outcomes from a medical weight loss program: primary care clinics versus weight loss clinics.

    Science.gov (United States)

    Haas, William C; Moore, Justin B; Kaplan, Michael; Lazorick, Suzanne

    2012-06-01

    Few studies have focused on weight loss programs implemented in community-based primary care settings. The objective of this analysis was to evaluate the effectiveness of a weight loss program and determine whether physicians in primary care practices could achieve reductions in body weight and body fat similar to those obtained in weight loss clinics. Analyses were performed on chart review data from 413 obese participants who underwent weight loss at a primary care (n=234) or weight loss (n=179) clinic. Participants received physician-guided behavioral modification sessions and self-selected a diet plan partially or fully supplemented by meal replacements. A repeated-measures analysis of covariance was conducted with age and sex serving as covariates; significance was set at P≤.05. In 178 subjects (43%) completing 12 weeks of the program, primary care clinics were as effective as weight loss clinics at achieving reductions in body weight (12.4 vs 12.1 kg) but better with regard to reduction in body fat percentage (3.8% vs 2.7%; P≤.05). Regardless of location, participants completing 12 weeks lost an average of 11.1% of their body weight. Participants selecting full meal replacement had greater reductions in weight and body fat percentage (12.7 kg, 3.5%) compared with participants selecting a partial meal replacement plan (8.3 kg, 2.3%). Primary care physicians can successfully manage and treat obese patients using behavioral modification techniques coupled with meal replacement diets. Copyright © 2012 Elsevier Inc. All rights reserved.

  10. Pattern of pseudoexfoliation deposits on the lens and their clinical correlation--clinical study and review of literature.

    Directory of Open Access Journals (Sweden)

    Aparna Rao

    Full Text Available PURPOSE: To study the clinical correlates of pattern of deposits over the lens in patients with pseudoexfoliation syndrome (PXF or pseudoexfoliation glaucoma. METHODS: This retrospective observational study screened 346 patients with PXF seen in glaucoma clinic of a tertiary hospital from 2011-2013. Details like pattern of deposits, location on the lens surface and pupillary abnormalities in slit lamp photographs and their correlation with clinical and demographic variables, were analysed. RESULTS: A total of 84 eyes of 42 patients with bilateral PXF were included for the study. Glaucoma was seen in 30 eyes with baseline IOP of 24+3.8 mm Hg. Comparing the type of deposits, namely classical (n = 39 eyes, radial pigmentary (RP form (n = 39 eyes and combined classical and radial pigmentary (CR forms (n = 6 eyes of deposits, pupillary ruff atrophy was common in all forms while poor dilatation was rare in the RP type (n = 5 vs n = 25 in classical forms, p < 0.001. Mean deviation (MD was worse in the classical and CR form as compared to RP type with the latter presenting much earlier, 43 ± 3.2 years vs 48 ± 4.1 years in CR and 56 ± 5.7 years in classical form, p < 0.001. The baseline IOP in the RP group (18 ± 2.3 mm Hg was significantly lower than the other two forms (CR 20 ± 3.2 mm Hg, classical 28 ± 2.3 mm Hg, p < 0.001, with only 2 eyes on anti-glaucoma drugs at presentation. CONCLUSION: Pattern of exfoliation deposits may indicate the stage and severity of the disease process in evolution with the RP representing an earlier/less severe form of pseudoexfoliation syndrome.

  11. Human melanoma metastasis in NSG mice correlates with clinical outcome in patients

    Science.gov (United States)

    Quintana, Elsa; Piskounova, Elena; Shackleton, Mark; Weinberg, Daniel; Eskiocak, Ugur; Fullen, Douglas R.; Johnson, Timothy M.; Morrison, Sean J.

    2015-01-01

    Studies of human cancer metastasis have been limited by a lack of experimental assays in which cancer cells from patients metastasize in vivo in a way that correlates with clinical outcome. This makes it impossible to study intrinsic differences in the metastatic properties of cancers from different patients. We recently developed an assay in which human melanomas readily engraft in NOD/SCID IL2Rγnull (NSG) mice (1, 2). Here we show that melanomas from 25 patients exhibited reproducible differences in the rate of spontaneous metastasis after transplantation into NSG mice and that these differences correlated with clinical outcome in the patients. Stage IIIB/C melanomas that formed distant metastases within 22 months in patients also formed tumors that metastasized widely in NSG mice, while stage IIIB/C melanomas that did not form distant metastases within 22–50 months in patients metastasized more slowly in NSG mice. These differences in the efficiency of metastasis correlated with the frequency of circulating melanoma cells in the blood of NSG mice, suggesting that the rate of entry into the blood is one factor that limits the rate of metastasis. NSG mice can therefore be used to study the metastasis of human melanomas in vivo, revealing intrinsic differences among stage III melanomas in their ability to circulate/survive in the blood and metastasize. PMID:23136044

  12. Intraoperative dynamic pressure measurements in carpal tunnel syndrome: Correlations with clinical signs.

    Science.gov (United States)

    Lee, Ho Jin; Kim, Il Sup; Sung, Jae Hoon; Lee, Sang Won; Hong, Jae Taek

    2016-01-01

    This study was designed to evaluate the correlations between dynamic carpal tunnel pressure and clinical signs. From December 2008 to May 2010, open carpal tunnel release (OCTR) was performed on a total of 90 hands (83 patients). All patients completed neurological and provocation tests (two-point discrimination, Tinel test, Phalen test, reverse-Phalen test and assessment of thenar muscle atrophy). Carpal tunnel pressure (CTP) was measured in two parts of carpal tunnel (proximal and distal carpal tunnel) and in three different postures (neutral, wrist flexion and wrist extension). There were 74 females and nine males aged 36 to 86 years (mean age 54). CTP values were more elevated in the wrist extension than wrist flexion in the proximal carpal tunnel but not at the distal carpal tunnel. There was no statistically significant correlation among CTP, provocation testing, and clinical signs. However, two-point discrimination (2-PD) showed a statistically significant correlation with CTP, especially in the proximal area in the wrist extension posture (Pcarpal tunnel in the neutral posture (Pcarpal tunnel lesion since CTP values appear to vary within the carpal tunnel space and according to hand posture. Copyright © 2015 Elsevier B.V. All rights reserved.

  13. Depressive Symptoms during an Acute Schizophrenic Episode: Frequency and Clinical Correlates

    Directory of Open Access Journals (Sweden)

    Ravi Philip Rajkumar

    2015-01-01

    Full Text Available Introduction. Depressive symptoms are common in schizophrenia and are associated with poorer functioning, lower quality of life, and an elevated risk of suicidal behaviour. There are few studies on the occurrence and correlates of these symptoms in acutely ill patients with schizophrenia. Method. 72 acutely ill patients with schizophrenia were assessed for depression using the Calgary Depression Scale for Schizophrenia (CDSS. A cut-off score of ≥6 on the CDSS was used to identify clinically significant depressive symptoms. The relationship between depression and illness variables, including psychotic symptom dimensions as measured by the Positive and Negative Syndrome Scale for Schizophrenia (PANSS, was examined. Results. Eleven (15.3% patients had clinically significant depressive symptoms. These patients scored higher on the positive and general psychopathology scales of the PANSS and had higher rates of suicidal behavior and poorer functioning. The severity of depressive symptoms was positively correlated with the PANSS positive subscale and negatively correlated with the PANSS negative subscale. Discussion. These findings confirm previous reports that depressive symptoms in active schizophrenia is related to the severity of positive psychotic symptoms and is a risk factor for suicidal behaviour in these patients.

  14. Mammographic density in asymptomatic menopausal women: correlation with clinical and sonographic findings

    Directory of Open Access Journals (Sweden)

    Beatriz Regina Alvares

    2012-06-01

    Full Text Available OBJECTIVE: To evaluate mammographic breast density in asymptomatic menopausal women in correlation with clinical and sonographic findings. MATERIALS AND METHODS: Mammograms and clinical and sonographic findings of 238 asymptomatic patients were retrospectively reviewed in the period from February/2022 to June/2006. The following variables were analyzed: mammographic density patterns, sonographic findings, patients' age, parity, body mass index and use of hormone replacement therapy. RESULTS: Age, parity and body mass index showed a negative correlation with breast density pattern, while use of hormone replacement therapy showed a positive correlation. Supplementary breast ultrasonography was performed in 103 (43.2% patients. Alterations which could not be visualized at mammography were found in 34 (33% of them, most frequently in women with breast density patterns 3 and 4. CONCLUSION: The authors concluded that breast density patterns were influenced by age, parity, body mass index and time of hormone replacement therapy. Despite not having found any malignant abnormality in the studied cases, the authors have observed a predominance of benign sonographic abnormalities in women with high breast density patterns and without mammographic abnormalities, proving the relevance of supplementary ultrasonography to identify breast lesions in such patients.

  15. Knee Osteochondral Autologous Transplantation: Long-term MR findings and clinical correlations

    Energy Technology Data Exchange (ETDEWEB)

    Tetta, Cecilia, E-mail: cecilia.tetta@ior.i [Radiology, Rizzoli Orthopedic Institute, Bologna (Italy); Busacca, Maurizio; Moio, Antonio; Rinaldi, Raffaella [Radiology, Rizzoli Orthopedic Institute, Bologna (Italy); Delcogliano, Marco; Kon, Elizaveta; Filardo, Giuseppe; Marcacci, Maurilio [Biomechanics Laboratory, Rizzoli Orthopedic Institute, Bologna (Italy); Albisinni, Ugo [Radiology, Rizzoli Orthopedic Institute, Bologna (Italy)

    2010-10-15

    We evaluated long-term magnetic resonance imaging (MRI) features of Knee Osteochondral Autologous Transplantation (OAT)-Mosaicplasty and correlated MRI findings and clinical outcome. Twenty-four patients (mean age 29.9 {+-} 8.7, 70.8% male) undergoing arthroscopic OAT between 1997 and 2000 were prospectively enrolled. The International Cartilage Repair Society (ICRS)/International Knee Documentation Committee (IKDC) scores and Tegner scores were employed for clinical evaluation. The magnetic resonance observation of cartilage repair tissue (MOCART) was utilized for description and assessment of the repair tissue. Median follow up was 113 months (interquartile range [IQR] 106-122). MRI showed good survival of grafted cartilage in 62.5% of patients. The integration of the graft was complete in 75% of cases, while the repaired tissue was intact in 62.5% and had an homogeneous structure in 70.8%. The MOCART score significantly correlated with objective and subjective scores (p = 0.003 and p = 0.002). Contrastingly, overall MOCART showed no correlation with the Tegner score. MRI revealed to be a powerful tool for non-invasive long-term assessment of OAT.

  16. A Study of the Correlation between VEP and Clinical Severity in Children with Autism Spectrum Disorder

    Directory of Open Access Journals (Sweden)

    Winai Sayorwan

    2018-01-01

    Full Text Available Visual evoked potential (VEP is a technique used to assess the brain’s electrical response to visual stimuli. The aims of this study were to examine neural transmission within the visual pathway through VEP testing in preschool children with autism spectrum disorder (ASD and compare it to age-matched controls, as well as search for a correlation between the VEP parameters and the symptoms of ASD. Participants were composed of ASD children (9 males and typically developing children (8 males and 4 females, aged between 3 and 5 years. Checkerboards were chosen as the pattern-reversal VEP. The clinical severity of ASD was assessed using the Autism Treatment Evaluation Checklist (ATEC and the Vineland Adaptive Behavior Scales 2nd edition (VABS-II. Our findings demonstrated that children with ASD had significantly longer N145 latency compared to the controls. A longer N145 latency correlated with a higher score of ATEC within the sensory/cognitive awareness subdomain. In addition, a slower N145 response was also associated with a lower VABS-II score within the socialization domain. The correlation between longer VEP latency and abnormal behaviors in children with ASD suggests a delayed neural communication within other neural circuits, apart from the visual pathway. These lines of evidence support the possibility of using VEP, along with clinical parameters, for the assessment of ASD severity.

  17. Sexual dysfunction in relapsing-remitting multiple sclerosis: magnetic resonance imaging, clinical, and psychological correlates.

    Science.gov (United States)

    Barak, Y; Achiron, A; Elizur, A; Gabbay, U; Noy, S; Sarova-Pinhas, I

    1996-01-01

    The purpose of this study was to examine the sexual complaints and severity of sexual dysfunction in relapsing-remitting multiple sclerosis patients and to correlate them with psychological, neurological, and radiological variables. Frequency and characteristics of sexual disturbances were reported by 41 multiple sclerosis patients (32 females, 9 males; mean age 35.4 +/- 10.2 y). Clinical neurologic variables tested were disease duration, exacerbation rate, and disability; psychological variables tested were anxiety and depression. All patients underwent a brain magnetic resonance imaging (MRI) scan at the time of this study. The sexual dysfunction questionnaire included items based on the 3 phases of human sexual response: loss of libido, excitement (arousal difficulties, impotence, premature ejaculation), and anorgasmia. Five males (55.5%) and 16 females (50.0%) reported at least 1 sexual disturbance. The most frequent dysfunctions were loss of libido (26.8%) and arousal difficulties (19.5%). Females rated their difficulties as more severe. Sexual dysfunctions correlated with depression, (r = 0.68, P = 0.001). No correlation between MRI score and depression was found. Anorgasmia correlated with brain stem and pyramidal abnormalities (r = 0.56, P = 0.011; r = 0.56, P = 0.012, respectively). The total area of lesions (plaques) on the brain MRI scan also correlated with anorgasmia (r = 0.41, P = 0.02). Sexual dysfunctions in multiple sclerosis patients are frequent, are mild to moderate in severity, correlate with depression and in some cases central nervous system (CNS) demyelinating process, and thus may be related either to the psychological impact of this disease or to specific organic lesions in the brain. PMID:8754594

  18. A Study of Leprosy Cases: Correlation of Clinical Features, Histopathology and Demonstration of Lepra Bacilli.

    Directory of Open Access Journals (Sweden)

    Dr. Shilpa Taviyad

    2017-12-01

    Full Text Available Introduction: The clinical manifestations of leprosy are too varied and diverse and can mimic variety of unrelated diseases. In patients of leprosy the treatment plan differs depending on histopathological subtype and bacillary load. This study aims to decide the incidence of various histopathological subtypes of leprosy and to correlate the clinical subtyping of all suspected cases of leprosy, with their histopathological subtyping &findings of modified Fite Faraco staining to demonstrate Lepra bacilli. Materials and Methods: The present study was conducted at Department of Pathology, P. D. U Medical College, Rajkot, Gujarat, for the period of 2 years from August 2014 to Sept 2016.Skinbiopsies from all patients clinically suspected as leprosy were studied to confirm the diagnosis, to classify histopathologically, and to know bacillary load by Fite Faraco staining. The clinical features, histopathological features and Fite Faraco stain findings were then correlated. Results: Out of 182 Biopsies from suspected cases of leprosy, 171 were confirmed as leprosy on histopathology. Peak incidence was in 21- 30 years of age group, while M: F ratio was 1.75:1.Maximum number [24.7%] of cases were of lepromatous leprosy (LL. Overall clinicopathological parity in various types of leprosy was observed in 67.4% of cases. Modified Fite Faraco stain positivity was observed in64.3 % cases. Conclusion: Leprosy is still prevalent in the region of study, Lepromatous Leprosy being the commonest. Proper histopathological diagnosis with subtyping and demonstration of lepra bacilli on tissue sections are very important in clinical management of all leprosy cases.

  19. Correlates of adherence to a physical activity program in young African-American girls.

    Science.gov (United States)

    Lemmon, Christian R; Ludwig, David A; Howe, Cheryl A; Ferguson-Smith, Ayanay; Barbeau, Paule

    2007-03-01

    The goal was to identify correlates of adherence to a structured physical activity (PA) program. Subjects were 136 8- to 12-year-old African-American girls. Potential correlates at baseline were: 1) fitness index (FI: % body fat from DXA and cardiovascular fitness from treadmill test), and 2) self-esteem, anxiety, attitude to school and teachers, relationship with parents, and interpersonal relations (Behavioral Assessment System for Children). The 10-month PA program included 80 minutes of PA offered 5 days/wk. Regression tree classification was used to model attendance. Six splits occurred (34% total variance explained). Less anxious subjects attended more often than highly anxious subjects (3 days/wk vs. 1.5 days/wk) did. Subjects with a healthier FI attended more often than those with a less healthy FI (3 days/wk vs. 0.5 days/wk) did. Younger subjects attended more often than older ones (3 days/wk vs. 2.5 days/wk) did. The next two splits were again with anxiety (3.5 days/wk vs. 3 days/wk) and FI (3 days/wk vs. 2.5 days/wk). Finally, subjects with higher levels of self-esteem attended more often than those with lower levels (3.5 days/wk vs. 2 days/wk) did. Subjects who were self-confident, younger, fitter, and less anxious were more likely to participate regularly. This suggests that children who may be more likely to benefit from a PA program are less likely to participate. To enhance participation in PA programs, especially in older African-American girls: 1) psychological concerns should be identified and addressed before enrollment, and 2) programs should be designed to be appealing to children of all fitness levels.

  20. Ganglion cysts of the cruciate ligaments. MR findings with clinical correlation

    Energy Technology Data Exchange (ETDEWEB)

    Huang, G.S.; Hsueh, C.-J.; Juan, C.J.; Chen, C.Y. [Tri-Service General Hospital and National Defense Medical Center, Taipei (China). Dept. of Radiology; Lee, C.H. [Tri-Service General Hospital and National Defense Medical Center, Taipei (China). Dept. of Orthopedic Surgery; Chan, W.P. [Taipei Medical Univ., Wan Fang Hospital, Taipei (China). Dept. of Radiology; Taylor, J.A.M. [New York Chiropractic College, Seneca Falls, NY (United States). Dept. of Diagnosis; Yu, J.S. [Ohio State Univ. Medical Center, Columbus, OH (United States). Dept. of Radiology

    2002-07-01

    Purpose: To evaluate the MR findings of ganglion cysts of the cruciate ligaments in correlation with clinical findings. Material and Methods:We reviewed 12 patients with ganglion cysts of the cruciate ligaments obtained from a medical record of 4153 consecutive patients referred for knee MR examinations. All patients presented with chronic knee pain and 4 had restriction of knee motion. The MR imaging findings of the cysts were evaluated and correlated with clinical manifestations. Results:Seven ganglion cysts were found in the posterior cruciate ligaments and 5 in the anterior cruciate ligaments. All cysts were lobulated (n=7) or fusiform (n=5) in shape, 1.8-4.5 cm in size, along the posterior surface in the proximal or distal end of the ligaments. Ten patients had arthroscopic resection or aspiration of their cysts, became symptom free and had no recurrence on follow-up MR examinations. Two cysts reduced in size spontaneously by conservative treatment. Conclusion:MR imaging can offer useful information in detection and diagnosis of patients with chronic knee pain due to ganglion cysts of the cruciate ligaments. The size and location of the ganglion cysts can attribute to the clinical manifestations.

  1. Dynamic MR imaging of internal derangements of the temporomandibular joint: correlation with clinical signs and symptoms

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Young Ah; Chun, Eun Ju; Kim, Yoo Kyung; Yoo, Jeong Hyun; Choi, Hae Young; Kim, Hyun Jin [Ewha Womans Univ. College of Medicine, Seoul (Korea, Republic of); Chung, Eun Chul [Sungkyunkwan Univ. College of Medicine, Seoul (Korea, Republic of)

    1999-01-01

    To evaluate the correlation between findings of dynamic magnetic resonance (MR) imaging of the temporomandibular joint (TMJ) and clinical findings in patients with internal derangement of the TMJ. Dynamic MR images of 130 joints of 65 patients (17 men and 48 women aged 14 to 74; mean age, 34) with internal derangement of the TMJ were obtained using a 1.5-T MR imaging system. MR findings of anterior displacement, disc deformity and degenerative change were correlated with clinical findings including joint pain, clicking sound, crepitation and maximal mouth opening (MMO). Among 62 joints with TMJ pain, 32 showed anterior displacement without reduction, 15 showed disc deformity and 19 showed degenerative change. Among 49 joints in which there was a clicking sound, 24, 8 and 12 joints, respectively, showed the above-mentioned findings, while in seven with crepitation, these same findings were evident in five, six and four joints, respectively. Bilateral and unilateral joint disorders were observed in 17 and five patients, respectively, among 22 with MMO less than 30mm and in 11 and 18 of 42 patients with MMO between 30mm and 60mm. On MR imaging, patients with MMO less than 30mm usually showed bilateral joint disorders and those with crepitation showed chronic change. This indicates that there is high association between clinical findings of internal derangement of TMJ and MR findings.

  2. Prevalence and clinical correlates of Schistosoma mansoni co-infection among malaria infected patients, Northwest Ethiopia.

    Science.gov (United States)

    Getie, Sisay; Wondimeneh, Yitayih; Getnet, Gebeyaw; Workineh, Meseret; Worku, Ligabaw; Kassu, Afework; Moges, Beyene

    2015-09-28

    In Ethiopia, where malaria and schistosomiasis are co-endemic, co-infections are expected to be high. However, data about the prevalence of malaria-schistosomiasis co-infection and their clinical correlation is lacking. Therefore, the aim of this study was to assess prevalence of Schistosoma mansoni co-infection and associated clinical correlates in malaria patients. A cross-sectional study was conducted in 2013 at Chwahit Health Center, in northwest Ethiopia. Blood film positive malaria patients (N = 205) were recruited for the study. Clinical, parasitological, hematological, and biochemical parameters were assessed from every study participant. Stool samples were also collected and processed with Kato-Katz technique to diagnose and classify intensity of Schistosoma mansoni. The prevalence of Schistosoma mansoni and malaria co-infection was 19.5%. The age group of 16-20 years old was significantly associated with co-infection. Co-infected patients with a moderate-heavy egg burden of Schistosoma mansoni had significantly high mean Plasmodium parasitemia. On the other hand, age group of 6-10 years old and moderate-heavy Schistosoma mansoni co-infection were significantly associated with severe malaria. Prevalence of malaria and Schistosoma mansoni co-infection in the study area was considerably high. Severity of malaria and parasitemia of Plasmodium were associated with certain age groups and intensity of concurrent Schistosoma mansoni. Further study is needed to explore the underlying mechanisms of interaction between malaria and Schistosoma mansoni.

  3. Medically uncontrolled conjunctival pyogenic granulomas: correlation between clinical characteristics and histological findings

    Science.gov (United States)

    Nakao, Takeshi; Xu, Jianjiang; Liu, Zuguo; Sun, Xinghuai; Chu, Yiwei; Hong, Jiaxu

    2017-01-01

    Background Conjunctival pyogenic granulomas are commonly seen after ocular surgeries or at an ocular wound site. The aim of this study is to describe a novel histological classification for medically uncontrolled conjunctival pyogenic granulomas (MUCPG), and to explore whether the diversity in clinical features correlates to different histological subtypes of MUCPG. Methods This is an observational cross-section case series. We reviewed 46 consecutive patients with conjunctival pyogenic granulomas who did not respond to topical corticosteroids and underwent surgical excision from January 1, 2006 through December 31, 2015. Clinical features and histological findings were presented and analyzed. Results Ocular surgery, accidental injury, and chalazion were the main predisposing causes of MUCPG. The lesions tended to occur unilaterally on the bulbar conjunctiva. Forty patients (87%) presented an enrichment of inflammatory cells and proliferated capillaries in their pathological sections (inflammatory pattern). Six patients (13%) showed relatively few inflammatory cells and capillaries within fibrous stroma (fibrous pattern). Patients with the inflammatory pattern were older (p = 0.025) and tended to be located in bulbar conjunctiva (p = 0.002). The predisposing causes were also different between two histological subtypes (p = 0.007). Conclusions We found the correlation between clinical presentation and histological subtypes in patients with MUCPG, indicating this disease may need a new classification scheme. PMID:28008138

  4. The prevalence, risk factors and clinical correlates of obesity in Chinese patients with schizophrenia.

    Science.gov (United States)

    Li, Qiongzhen; Du, Xiangdong; Zhang, Yingyang; Yin, Guangzhong; Zhang, Guangya; Walss-Bass, Consuelo; Quevedo, João; Soares, Jair C; Xia, Haishen; Li, Xiaosi; Zheng, Yingjun; Ning, Yuping; Zhang, Xiang Yang

    2017-05-01

    Obesity is a common comorbidity in schizophrenia. Few studies have addressed obesity in Chinese schizophrenia patients. The aims of this current study were to evaluate the prevalence, risk factors and clinical correlates of obesity in Chinese patients with schizophrenia. A total of 206 patients were recruited from a hospital in Beijing. Their clinical and anthropometric data together with plasma glucose and lipid parameters were collected. Positive and Negative Syndrome Scale (PANSS) was rated for all patients. Overall, 43 (20.9%) patients were obese and 67 (32.5%) were overweight. The obese patients had significantly higher glucose levels, triglyceride levels than non-obese patients. Females and patients with type 2 diabetes mellitus had increased risk for obesity. Correlation analysis showed that BMI was associated with sex, education levels, negative symptoms, total PANSS score, triglyceride levels and type 2 diabetes mellitus. Further stepwise regression analysis showed that sex, type 2 diabetes, education level, triglyceride and amount of smoking/day were significant predictors for obesity. Our study showed that the prevalence of obesity in Chinese patients with schizophrenia is higher than that in the general population. Some demographic and clinical variables are risk factors for obesity in schizophrenia. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  5. Mutation distributions and clinical correlations of PIK3CA gene mutations in breast cancer.

    Science.gov (United States)

    Dirican, Ebubekir; Akkiprik, Mustafa; Özer, Ayşe

    2016-06-01

    Breast cancer (BCa) is the most common cancer and the second cause of death among women. Phosphoinositide 3-kinase (PI3K) signaling pathway has a crucial role in the cellular processes such as cell survival, growth, division, and motility. Moreover, oncogenic mutations in the PI3K pathway generally involve the activation phosphatidylinositol-4,5-bisphosphate 3-kinase-catalytic subunit alpha (PIK3CA) mutation which has been identified in numerous BCa subtypes. In this review, correlations between PIK3CA mutations and their clinicopathological parameters on BCa will be described. It is reported that PIK3CA mutations which have been localized mostly on exon 9 and 20 hot spots are detected 25-40 % in BCa. This relatively high frequency can offer an advantage for choosing the best treatment options for BCa. PIK3CA mutations may be used as biomarkers and have been major focus of drug development in cancer with the first clinical trials of PI3K pathway inhibitors currently in progress. Screening of PIK3CA gene mutations might be useful genetic tests for targeted therapeutics or diagnosis. Increasing data about PIK3CA mutations and its clinical correlations with BCa will help to introduce new clinical applications in the near future.

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

    Science.gov (United States)

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

    2013-10-15

    Brain development follows a different trajectory in children with autism spectrum disorders (ASD) than in typically developing children. A proxy for neurodevelopment could be head circumference (HC), but studies assessing HC and its clinical correlates in ASD have been inconsistent. This study investigates HC and clinical correlates in the Simons Simplex Collection cohort. We used a mixed linear model to estimate effects of covariates and the deviation from the expected HC given parental HC (genetic deviation). After excluding individuals with incomplete data, 7225 individuals in 1891 families remained for analysis. We examined the relationship between HC/genetic deviation of HC and clinical parameters. Gender, age, height, weight, genetic ancestry, and ASD status were significant predictors of HC (estimate of the ASD effect = .2 cm). HC was approximately normally distributed in probands and unaffected relatives, with only a few outliers. Genetic deviation of HC was also normally distributed, consistent with a random sampling of parental genes. Whereas larger HC than expected was associated with ASD symptom severity and regression, IQ decreased with the absolute value of the genetic deviation of HC. Measured against expected values derived from covariates of ASD subjects, statistical outliers for HC were uncommon. HC is a strongly heritable trait, and population norms for HC would be far more accurate if covariates including genetic ancestry, height, and age were taken into account. The association of diminishing IQ with absolute deviation from predicted HC values suggests HC could reflect subtle underlying brain development and warrants further investigation. © 2013 Society of Biological Psychiatry.

  7. Histological evaluation of pulp tissue from second primary molars correlated with clinical and radiographic caries findings

    Directory of Open Access Journals (Sweden)

    Vellore Kannan Gopinath

    2014-01-01

    Full Text Available Background: Managing dental caries in young children is demanding due to the elusions present on the right diagnostic criteria for treatment. The present study evaluated the histological status of pulp tissues extracted from primary second molar with caries involvement. Histological findings are correlated with clinical and radiographic assessment. Materials and Methods: Simple experimental study was conducted on upper or lower second primary molars with occlusal (22 teeth or proximal (22 teeth dental caries. Selected children were below 6 years of age. Percentage of caries involvement, residual dentin thickness (RDT, radiographic assessment of interradicular and periapical areas, clinical caries depth and signs and symptoms are the parameters considered for comparing with the histological findings. The specimens were grouped based on the nature of the inflammatory process as acute or chronic. The data were analyzed by Student t-test to compare histological types of inflammation with clinical parameters. P value < 0.05 was considered as significant. Results: Four cases revealed severe acute inflammation in coronal and relatively mild acute inflammation in radicular pulp. In the rest of the specimen coronal and radicular pulp had similar acute or chronic inflammatory changes. Histological evidence of pulpitis correlated with dental caries depth of ≥80%, RDT of ≤1 mm, radiographic rarefactions in the interradicular regions and symptoms of pain. Conclusion: Primary second molars with more than two-third caries involvement with symptoms of pain histologically showed inflammation of both coronal and radicular pulp tissues in all cases.

  8. Correlation between p53 expression and clinical-pathological characteristics of gastric cancer

    Directory of Open Access Journals (Sweden)

    Radovanović Dragče

    2011-01-01

    Full Text Available Backgraund/Aim. Gene p53, or “cell genome keeper”, has a preventive effect on the occurrence of genetic aberrations and prevents abnormal expansion of (tumor cells. In gastric cancer cells in most cases we register high expression of mutated p53 gene, which correlates with prognosis and specific clinicalpathological characteristics of gastric cancer. Methods. Using the imunohistochemical method we determined the level of expression of p53 protein in 62 gastric cancers and 30 precancerous conditions (intestinal metaplasia of the stomach. We analyzed the relationship of the level of p53 expression and clinical pathological characteristics of gastric cancer. Results. Expression of p53 was positive in 42 (67.7% tumor cases and in 7 (14.3% cases of intestinal metaplasia. Expression of P53 and stomach cancer were in direct correlation (p = 0.000. Sensitivity for p53 in stomach cancer cases was 67.7% (42/62, and specifility was 76.7% (23/30. Expression of mutated p53 protein was in direct correlation with the invasion of lymph nodes (p = 0.034 and with invasion of blood vessels by carcinoma cells (p = 0.042. Conclusion. There is a direct correlation between p53 expression and gastric cancer and it indicates the ability of carcinoma cells to invade blood vessels.

  9. Grepafloxacin Clinical Program for Lower Respiratory Tract Infections

    Directory of Open Access Journals (Sweden)

    Arne C Rodloff

    1998-01-01

    Full Text Available The present paper evaluates the clinical trial program in lower respiratory tract infections treated with a new fluoroquinolone antibiotic, grepafloxacin. Unlike older quinolones, grepafloxacin has excellent activity against Gram-positive organisms, which include Streptococcus pneumoniae and “atypical” pathogens Legionella species. Mycoplasma pneumoniae and Chlamydia pneumoniae. Grepafloxacin has a long half-life of 12 to 15 h, which allows once daily dosing. Six studies have been conducted regarding community-acquired lower respiratory tract infections (LRTls, four about community-acquired pneumonia (CAP and two about acute bacterial exacerbations of chronic bronchitis (ABECB . In these studies, grepafloxacin demonstrated clinical equivalence with standard therapies. but, in patients with documented infections. grepafloxacin was statistically superior to amoxycillin in both CAP and ABECB. The new fluoroquinolone has a good safety profile, comparable with that of ciprofloxacin. The most common adverse effects of grepafloxacin were nausea and a metallic taste; however, these effects resulted in only a few discontinuations of therapy. With the increasing prevalence of resistance in pathogens isolated from community-acquired LRTIs, grepafloxacin offers a good alternative for monotherapy in these patients.

  10. Correlation of reduction and clinical outcome in patients with degenerative spondylolisthesis.

    Science.gov (United States)

    Wegmann, K; Gundermann, S; Siewe, J; Eysel, P; Delank, K-S; Sobottke, R

    2013-12-01

    Prospective cohort study. Operative treatment is increasingly implemented for the treatment of degenerative lumbar listhesis, with lumbar fusion the most common intervention. Prediction of clinical outcomes after such procedures is of ongoing relevance, and the correlation of radiologic parameters with clinical outcome remains controversial. In particular, clinical studies have not determined conclusively whether reduction of slipped vertebrae is beneficial. We performed a monocenter prospective analysis of a comprehensive set of quality of life scores (QLS) (Core Outcome Measure Index, Oswestry Low Back Pain Disability Index, SF-36) of 40 patients, who underwent a standardized PLIF procedure for symptomatic, Spondylolisthesis. Follow-up was 24 months. The correlations between the radiologic parameters (degree of slippage, sagittal rotation) and the clinical scores before surgery as well as 12 and 24 months post-operatively were examined. All QLS showed a statistically significant improvement after 12 and 24 months post-operatively (p < 0.05). The mean amount of the anterior slippage was 34.2 ± 14.7 % (minimum 12 %, maximum 78 %). After 12 months, there was an average 19.1 % decrease to 15.1 ± 8.3 % (minimum 2 %, maximum 38 %, p < 0.000) and after 24 months it was decreased by 18.0-16.2 ± 9.0 % (minimum 2.9 %, maximum 40 %, p < 0.000). Average sagittal rotation measured 67.3° ± 16.6° initially (minimum 35°, maximum 118) and decreased by 4.3° to an average of 63.0° ± 15.2° at 12 months post-surgery (minimum 15°, maximum 101°, p = 0.065,), and by 5.7° to an average of 61.6° ± 13.0° at 24 months (minimum 15°, maximum 90°, p = 0.044). The data show positive correlations between the amount of reduction of the slipped vertebra as well as the amount of correction of the sagittal rotation and the improvement of the clinical outcomes(r = 0.31-0.54, p < 0.05). The current study indicates a modest advantage for the best possible reposition in respect of the

  11. Hyponatremia in peritoneal dialysis: epidemiology in a single center and correlation with clinical and biochemical parameters.

    Science.gov (United States)

    Dimitriadis, Chrysostomos; Sekercioglu, Nigar; Pipili, Chrysoula; Oreopoulos, Dimitrios; Bargman, Joanne M

    2014-05-01

    Hyponatremia in peritoneal dialysis (PD) patients has previously been associated with water overload and weight gain, or with malnutrition and intracellular potassium depletion. Although there is a sizable literature about transmembrane sodium and water removal in PD, there are few reports about the incidence and characteristics of hyponatremia in the clinical setting. We evaluated the incidence and factors associated with hyponatremia in PD patients in a single PD unit. We retrospectively evaluated the records of all patients (n = 198) who were treated with PD in the Home PD Unit of the University Health Network at Toronto General Hospital during 2010. We identified 166 patients who had a minimum follow-up of 60 days during 2010 and at least 2 consecutive sodium measurements at least a month apart. We examined baseline differences between patients who developed hyponatremia and those who did not, and clinical and biochemical factors that correlated with mean sodium values. In the 24 patients who developed hyponatremia, we examined paired differences between the normonatremic and hyponatremic periods. Finally, we investigated any possible correlations of change in serum sodium with clinical and biochemical characteristics before and during the hyponatremic period. The incidence of hyponatremia was 14.5%. In multivariate analysis, serum sodium correlated significantly and independently with residual renal function (RRF: r = 0.463, p = 0.0001) and negatively with the daily volume of instilled icodextrin (r = -0.476, p = 0.0001). Residual renal function was significantly lower in patients with hyponatremia than in those with normal serum sodium (1.97 ± 2.3 mL/min vs 4.31 ± 5.01 mL/min, p = 0.033). The mean paired difference in body weight was -1.113 kg and the median difference was -0.55 kg (range: -8.5 kg to +4.2 kg). Impressively, hyponatremia was not associated with an increase in body weight in most patients who developed this complication (13 of 16 for whom

  12. Clinically guided pacemaker choice and setting: pacemaker expert programming study.

    Science.gov (United States)

    Ziacchi, Matteo; Palmisano, Pietro; Ammendola, Ernesto; Dell'era, Gabriele; Guerra, Federico; Aquilani, Stefano; Aspromonte, Vittorio; Boriani, Giuseppe; Accogli, Michele; Del Giorno, Giuseppe; Occhetta, Eraldo; Capucci, Alessandro; Ricci, Renato Pietro; Maglia, Giampiero; Biffi, Mauro

    2017-09-01

    The aim of this multicentre, observational, transversal study was to evaluate pacemaker (PM) choice and setting in a large number of patients, in order to understand their relationship with the patients' clinical characteristics. The study enrolled a total of 1858 patients (71 ± 14 years, 54% male), consecutively evaluated during scheduled PM follow-up visits in 7 Italian cardiac arrhythmia centres. To evaluate the appropriateness of PM choice in relation to the patients' clinical characteristics, we analysed their rhythm disorders at the time of device implantation and the characteristics of the devices implanted. To evaluate the appropriateness of device setting, current rhythm disorders and device setting at the time of enrolment were analysed. In the overall study population, 64.3% of the patients received a PM with all of the features required for their rhythm disorder [80.8% in persistent atrioventricular (AV) block, 76.5% in atrial fibrillation needing pacing, 71.0% in sinus node disease, 58.7% in non-persistent atrioventricular block (AVB), 52.7% in neuro-mediated syncope]. The most frequent cause of inappropriate PM choice was the lack of an algorithm to promote intrinsic AV conduction in non-persistent AVB patients (38.1%). In 76.2% of the patients with an appropriate PM (n = 1301), the PM was optimally set for their rhythm disorder. In the present 'real-world' registry, a large number of patients (35.7%) did not receive an optimal PM for their rhythm disorders. Moreover, one-fourth of appropriate PMs were not programmed according to the patients' clinical characteristics.

  13. Clinical correlation of radiological spinal stenosis after standardization for vertebral body size

    Energy Technology Data Exchange (ETDEWEB)

    Athiviraham, A. [Department of Surgery, Division of Orthopaedic Surgery, Queen' s University, Kingston, Ontario (Canada); Yen, D. [Department of Surgery, Division of Orthopaedic Surgery, Queen' s University, Kingston, Ontario (Canada)]. E-mail: yend@kgh.kari.net; Scott, C. [Department of Radiology, Queen' s University, Kingston, Ontario (Canada); Soboleski, D. [Department of Radiology, Queen' s University, Kingston, Ontario (Canada)

    2007-08-15

    Aim: To determine the relationship between the degree of radiographic lumbar spinal stenosis, adjusted with an internal control for vertebral body size, and disability from lumbar stenosis. Materials and methods: one hundred and twenty-three consecutive patients with clinical and radiological confirmation of neural impingement secondary to lumbar stenosis were enrolled prospectively. Thecal sac anteroposterior (AP) diameter (TSD) and cross-sectional area (CSA), and vertebral body AP dimension (VBD) were determined. These parameters were then correlated with patients' symptoms using the modified Roland-Morris questionnaire (RMQ) disability score. Results: No statistically significant inverse correlation was found between the TSD and RMQ score (p = 0.433), between the CSA and RMQ score (p = 0.124), or between the TSD:VBD ratio and RMQ score (p = 0.109). There was a significant positive correlation between the CSA:VBD ratio and RMQ score (p = .036), and therefore, there was no statistical support for an inverse relationship between the two. There was a significant difference in mean RMQ scores when the patients were divided into those with CSA greater than or equal to 70 mm{sup 2} and those less than 70 mm{sup 2}, with T = -2.104 and p = 0.038. Conclusion: The degree of radiographic lumbar spinal stenosis, even with the use of an internal control of vertebral body size and standardized disability questionnaires, does not correlate with clinical symptoms. However, patients with more severe stenosis below a CSA critical threshold of 70 mm{sup 2}, have significantly greater functional disability.

  14. Clinical significance of pneumatosis intestinalis - correlation of MDCT-findings with treatment and outcome

    Energy Technology Data Exchange (ETDEWEB)

    Treyaud, Marc-Olivier; Duran, Rafael; Knebel, Jean-Francois; Meuli, Reto A.; Schmidt, Sabine [Lausanne University Hospital, Department of Diagnostic and Interventional Radiology, Lausanne (Switzerland); Zins, Marc [Fondation Hopital St Joseph, Department of Radiology, Paris (France)

    2017-01-15

    To evaluate the clinical significance of pneumatosis intestinalis (PI) including the influence on treatment and outcome. Two radiologists jointly reviewed MDCT-examinations of 149 consecutive emergency patients (53 women, mean age 64, range 21-95) with PI of the stomach (n = 4), small (n = 68) and/or large bowel (n = 96). PI extension, distribution and possibly associated porto-mesenteric venous gas (PMVG) were correlated with other MDCT-findings, risk factors, clinical management, laboratory, histopathology, final diagnosis and outcome. The most frequent cause of PI was intestinal ischemia (n = 80,53.7 %), followed by infection (n = 18,12.1 %), obstructive (n = 12,8.1 %) and non-obstructive (n = 10,6.7 %) bowel dilatation, unknown aetiologies (n = 8,5.4 %), drugs (n = 8,5.4 %), inflammation (n = 7,4.7 %), and others (n = 6,4 %). Neither PI distribution nor extension significantly correlated with underlying ischemia. Overall mortality was 41.6 % (n = 62), mostly related to intestinal ischemia (p = 0.003). Associated PMVG significantly correlated with underlying ischemia (p = 0.009), as did the anatomical distribution of PMVG (p = 0.015). Decreased mural contrast-enhancement was the only other MDCT-feature significantly associated with ischemia (p p < 0.001). Elevated white blood count significantly correlated with ischemia (p = 0.03). In emergency patients, ischemia remains the most common aetiology of PI, showing the highest mortality. PI with associated PMVG is an alerting sign. PI together with decreased mural contrast-enhancement indicates underlying ischemia. (orig.)

  15. MR imaging in Bell's palsy and herpes zoster opticus: correlation with clinical findings

    Energy Technology Data Exchange (ETDEWEB)

    Kwon, Jung Ho; Mo, Jong Hyun; Moon, Sung Hee; Lee, Sang Sun; Park, Yang Hee; Lee, Kyung Hee [National Police Hospital, Seoul (Korea, Republic of); Choi, Ik Joon [Sejong General Hospital, Seoul (Korea, Republic of)

    1998-09-01

    To evaluate the MRI findings of acute facial nerve paralysis in Bell's palsy and herpes zoster opticus, and to correlate these with the clinical findings. We retrowspectively reviewed the MRI findings in six cases of BEll's palsy(BP) and two of herpes zoster oticus(HZO), and compared them with the findings for 30 normal facial nerves. This nerve was considered abnormal when its signal intensity was greater than that of brain parenchyma or the contralateral normal side on Gd-enhanced T1-weighted axial and coronal MR images. We analysed the location and degree of contrast enhancement, interval change, and clinical progression in correlation with House-Brackmann(HB) grade and electroneuronography (ENoG) findings. Fifteen of 30 normal facial nerves(50%) seen on Gd-enhanced MRI were mildly enhanced in the geniculate ganglion, the proximal tympanic, and the proximal mastoid segment of the facial nerve. No enhancement of the internal auditory canal(IAC) or labyrinthine segment of the facial nerve was noted, however. In BP and HZO, Gd-enhanced MR images revealed fair to marked enhancement for more than two segments from the internal auditory canal to the mastoid segment of the facial nerve. During follow-up MRI, enhancement of the facial nerve varied in location and signal intensity, though gradually decreased in intensity approximately eight weeks after the onset of facial nerve palsy. No correlation between clinical HB grade, ENoG, and follow up MRI findings was noted. Except in the internal auditory canal and labyrinthine segment, normal facial nevemay show mild and relatively symmetrical enhancement. In BP and HZO, the facial nerve showed diffuse enhancement from the IAC to the mastoid segment.=20.

  16. Challenges in Measuring Benefit of Clinical Research Training Programs – the ASH Clinical Research Training Institute Example

    OpenAIRE

    Sung, Lillian; Crowther, Mark; Byrd, John; Gitlin, Scott; Basso, Joe; Burns, Linda

    2015-01-01

    The American Society of Hematology developed the Clinical Research Training Institute (CRTI) to address the lack of training in patient oriented research among hematologists. As the program continues, we need to consider metrics for measuring the benefits of such a training program. This article addresses the benefits of clinical research training programs. The fundamental and key components are education and mentorship. However, there are several other benefits including promotion of collabo...

  17. Clinical-Radiological Correlation of Retained Silicone Sponge Presenting as Orbital Inflammation

    Directory of Open Access Journals (Sweden)

    Tal J. Rubinstein

    2016-01-01

    Full Text Available A 32-year-old female who underwent scleral buckle removal presented 5 weeks postoperatively with a red, fluctuant subconjunctival mass. CT scan identified an irregularly bordered, hypoattenuated lesion next to the globe with the density of air. Ophthalmic plastic and reconstructive surgeons were consulted to evaluate orbital cellulitis with intraorbital gas, at which point it was deemed that the hypoattenuated mass was likely a retained sponge element based on its radiological features. Additional surgical exploration identified the retained silicone sponge. This clinical photographic-radiological correlation of retained silicone sponges presenting as orbital inflammation reminds surgeons to meticulously explant buckle material.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1985-01-01

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

  19. CORRELATION BETWEEN CLINICAL CHARACTERISTICS OF ANKYLOSING SPONDYLITIS AND WORK CAPACITY AND PRODUCTIVITY

    Directory of Open Access Journals (Sweden)

    M. V. Podryadnova

    2014-01-01

    Full Text Available Objective: to study how clinical characteristics of ankylosing spondylitis (AS affect working efficiency.Subjects and methods. Authors examined 220 patients with AS (162 males and 58 females. Mean age was 35.1±9.5 years, mean age of the disease manifestation – 30.0±9.7 years. Median duration of AS was 73 [5; 396] months. Activity of the disease was high (BASDAI and ASDAS values 4.6±2.1 and 3.3±1.3 respectively. BASFI was increased to 4.1±2.6, HAQ – 0.98±0.64. Work productivity was assessed with WPAI (Work Productivity and ActivityImpairment questionnaire by four aspects: absenteeism, presenteeism, general reduction in productivity (GRP and activities of daily living (ADL.Results. Among 220 patients with AS, 133 were employed (60%. Median value of absenteeism comprised 0 [0; 85] %, presenteeism – 40.3±24.4%, GRP – 59.1±32.9%. Mean ADL was 49.8±26.6% less than normal. Inverse correlation was observed between absenteeism and AS duration (R=-0.22. BASDAI correlated with WPAI aspects: absenteeism (R=0.21, presenteeism (R=0.70, GRP (R=0.37 and reduction in ADL (R=0.73. The strongest correlation detected was that between WPAI aspects (R>0.5 and the intensity of pain assessed by visual analogue scale. BASFI index showed moderate correlation – with GRP (R=0.30 and close – with presenteeism and reduction in ADL (R=0.56 and R=0.71 respectively and did not correlatewith absenteeism.Conclusion. AS activity was the main factor influencing work productivity. Presenteeism correlates with clinical characteristicsof AS considerably stronger than absenteeism. All WPAI aspects correlated with the disease activity and degree of functional impairment.

  20. Correlation of accelerometry with clinical balance tests in older fallers and non-fallers.

    LENUS (Irish Health Repository)

    O'Sullivan, Maura

    2012-02-01

    BACKGROUND: falls are a common cause of injury and decreased functional independence in the older adult. Diagnosis and treatment of fallers require tools that accurately assess physiological parameters associated with balance. Validated clinical tools include the Berg Balance Scale (BBS) and the Timed Up and Go test (TUG); however, the BBS tends to be subjective in nature, while the TUG quantifies an individuals functional impairment but requires further subjective evaluation for balance assessment. Other quantitative alternatives to date require expensive, sophisticated equipment. Measurement of the acceleration of centre of mass, with relatively inexpensive, lightweight, body-mounted accelerometers is a potential solution to this problem. OBJECTIVES: to determine (i) if accelerometry correlates with standard clinical tests (BBS and TUG), (ii) to characterise accelerometer responses to increasingly difficult challenges to balance and (iii) to characterise acceleration patterns between fallers and non-fallers. Study design and setting: torso accelerations were measured at the level of L3 using a tri-axial accelerometer under four conditions; standing unsupported with eyes open (EO), eyes closed (EC) and on a mat with eyes open (MAT EO) and closed (MAT EC). Older patients (n = 21, 8 males, 13 females) with a mean age of 78 (SD +\\/- 7.6) years who attended a day hospital were recruited for this study. Patients were identified as fallers or non-fallers based on a comprehensive falls history. MEASUREMENTS: Spearman\\'s rank correlation analysis examined the relationship between acceleration root mean square (RMS) data and the BBS while Pearson\\'s correlation was used with TUG scores. Differences in accelerometer RMS between fallers and non-fallers and between test conditions were examined using t-test and non-parametric alternatives where appropriate. RESULTS: there was a stepwise increase in accelerometer RMS with increasing task complexity, and the accelerometer

  1. [Pathological and clinical correlations in renal AA amyloidosis: A Moroccan series of 30 cases].

    Science.gov (United States)

    Bziz, Asmae; Rouas, Lamia; Lamalmi, Najat; Malihy, Abderrahmane; Cherradi, Nadia; Ouzeddoun, Naima; Bayahia, Rabia; Flayou, Kaoutar; Chala, Sanae; Bouclouze, Aziz; Benomar, Ali; Abouqal, Redouan; Alhamany, Zaitouna

    2015-12-01

    Study of histological and clinical correlations of 30 cases of renal amyloidosis AA diagnosed between November 2010 and December 2012. The main causes associated with amyloidosis AA were represented by chronic infectious diseases (60%). Nephrotic syndrome and renal failure were observed in 94% and 73% respectively. The distribution of amyloid deposits: 90% of patients had a glomerular form and 10% had a vascular form. Inflammatory reaction associated with AA renal amyloidosis was present in 50% of cases. This inflammation was observed near amyloid deposits associated with a deposition of immunoglobulin chains and/or complement factors. Our study confirms the predominance of AA amyloidosis complicating chronic infectious diseases, especially tuberculosis. Our data point out a relationship between the morphology of renal AA amyloidosis, its clinical presentation and prognosis. Copyright © 2015 Association Société de néphrologie. Published by Elsevier SAS. All rights reserved.

  2. Correlation of clinical, cytological and histological findings in oral squamous cell carcinomas.

    Science.gov (United States)

    Sousa, Michele Cardoso; Alves, Monica Ghislaine Oliveira; Souza, Luciano Albino; Brandão, Adriana Aigotti Haberbeck; Almeida, Janete Dias; Cabral, Luiz Antonio Guimarães

    2014-08-01

    The present study aimed to investigate the efficiency of exfoliative cytology by correlating the clinical lesions of oral squamous cell carcinoma (OSCC) with exfoliative cytology and histopathological findings. Cases of OSCC diagnosed between 1984 and 2010 were analyzed. The inclusion criteria for the present study were the availability of detailed clinical findings and a diagnosis of the disease through exfoliative cytology and histopathology. The cases were assessed and assigned scores, which were then submitted to modal expression analysis, which considers the higher frequency scores, thus relating the variables. The cytological findings demonstrated that the majority of the cases had malignant potential. Exfoliative cytology should be used as a supplementary tool for the diagnosis of OSCC, as it enables the early detection of these lesions. However, cytology should not be used as a substitute for histopathological examination.

  3. Clinical and neuropsychiatric correlates of lumbar spinal surgery in older adults: results of a pilot study.

    Science.gov (United States)

    Karp, Jordan F; McGovern, Jonathan; Marron, Megan M; Gerszten, Peter; Weiner, Debra K; Okonkwo, David; Kanter, Adam S

    2016-11-01

    To improve selection of older lumbar surgical candidates, we surveyed correlates of functioning and satisfaction with surgery. Prospective sample at lumbar spine surgery clinic. Patients (n = 48) were evaluated before surgery and after 3 months. Dependent variables were functioning and surgical satisfaction. Baseline variables associated with disability at 3 months included cognitive status and widespread pain. There was clinically significant improvement with moderate effects sizes for anxiety and depression at follow-up. Patients with at least a 30% improvement in disability had better physical health-related quality of life and were less likely to report widespread pain before surgery. Although preliminary, two novel potential predictors of lumbar surgery outcome include diminished cognitive functioning and widespread pain. Further study of these variables on post-surgical functioning and satisfaction may improve patient selection.

  4. Clinical and psychological correlates of two domains of hopelessness in schizophrenia.

    Science.gov (United States)

    Lysaker, Paul H; Salyers, Michelle P; Tsai, Jack; Spurrier, Linda Yorkman; Davis, Louanne W

    2008-01-01

    Hopelessness is a widely observed barrier to recovery from schizophrenia spectrum disorders. Yet little is known about how clinical, social, and psychological factors independently affect hope. Additionally, the relationships that exist between these factors and different kinds of hope are unclear. To explore both issues, we correlated two aspects of hope, expectations of the future and agency, with stigma, clinical symptoms, anxiety, and coping preferences in 143 persons with a schizophrenia spectrum disorder. Multiple regressions revealed that hope for the future was predicted by lesser alienation, lesser preference for ignoring stressors, and lesser emotional discomfort and negative symptoms, accounting for 43% of the variance. A greater sense of agency was linked to lesser endorsement of mental illness stereotypes, fewer negative symptoms, lesser social phobia, and lesser preference for ignoring stressors, accounting for 44% of the variance. Implications for research and interventions are discussed.

  5. Misophonia: incidence, phenomenology, and clinical correlates in an undergraduate student sample.

    Science.gov (United States)

    Wu, Monica S; Lewin, Adam B; Murphy, Tanya K; Storch, Eric A

    2014-10-01

    Individuals with misophonia display extreme sensitivities to selective sounds, often resulting in negative emotions and subsequent maladaptive behaviors, such as avoidance and anger outbursts. While there has been increasing interest in misophonia, few data have been published to date. This study investigated the incidence, phenomenology, correlates, and impairment associated with misophonia symptoms in 483 undergraduate students through self-report measures. Misophonia was a relatively common phenomenon, with nearly 20% of the sample reporting clinically significant misophonia symptoms. Furthermore, misophonia symptoms demonstrated strong associations with measures of impairment and general sensory sensitivities, and moderate associations with obsessive-compulsive, anxiety, and depressive symptoms. Anxiety mediated the relationship between misophonia and anger outbursts. This investigation contributes to a better understanding of misophonia and indicates potential factors that may co-occur and influence the clinical presentation of a person with misophonia symptoms. © 2014 Wiley Periodicals, Inc.

  6. Correlation between clinical features, imaging and pathologic findings in recurrent solitary fibrous tumor of the orbit.

    Science.gov (United States)

    Graue, Gerardo F; Schubert, Hermann D; Kazim, Michael

    2013-12-01

    To correlate clinical features, imaging and pathologic findings in recurrent Solitary Fibrous Tumor of the orbit (SFT) in order to predict long-term behavior. Clinical features, imaging and pathologic findings of three patients with biopsy proven SFT are reported. Demographic and clinical features were recorded at presentation and at each consultation; imaging was performed as a diagnostic tool and for follow-up. A biopsy was performed at presentation and subsequently when symptoms worsened. Pathology specimens were reviewed retrospectively to corroborate diagnosis. Intraoperative and histopathologic features were recorded. A correlation was made between clinical, imaging and pathologic results to identify outcome predictors of recurrence, locally aggressive behavior and malignant transformation. All cases presented recurrent tumors with locally aggressive behavior over time. All were women in the fifth decade of life. Tumors induced proptosis, swelling of the lids and eye displacement at presentation and were diagnosed as other types of collagen-rich tumors before CD34 immunohistochemistry was available. Mean follow-up was 26.6 years (range 12-37). Relevant findings for all cases included a heterogeneous, irregular tumor containing cystoid spaces filled with mucoid material diffusely enhancing with imaging techniques. Intraoperative findings included a gelatinous matrix within the center of the tumor mass, which was not present at primary resection. Histopathology could not detect specific cellular patterns or immunological markers related to these changes. Recurrence and locally aggressive behavior was better predicted by imaging and surgical findings rather than histopathological characteristics. Cystoid degeneration in recurrent tumors may suggest malignant transformation over time.

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

    Science.gov (United States)

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

    2012-01-01

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

  8. Oxidative Stress Correlates with Headache Symptoms in Fibromyalgia: Coenzyme Q10 Effect on Clinical Improvement

    Science.gov (United States)

    Cordero, Mario D.; Cano-García, Francisco Javier; Alcocer-Gómez, Elísabet; De Miguel, Manuel; Sánchez-Alcázar, José Antonio

    2012-01-01

    Background Fibromyalgia (FM) is a chronic pain syndrome with unknown etiology and a wide spectrum of symptoms such as allodynia, debilitating fatigue, joint stiffness and migraine. Recent studies have shown some evidences demonstrating that oxidative stress is associated to clinical symptoms in FM of fibromyalgia. We examined oxidative stress and bioenergetic status in blood mononuclear cells (BMCs) and its association to headache symptoms in FM patients. The effects of oral coenzyme Q10 (CoQ10) supplementation on biochemical markers and clinical improvement were also evaluated. Methods We studied 20 FM patients and 15 healthy controls. Clinical parameters were evaluated using the Fibromyalgia Impact Questionnaire (FIQ), visual analogues scales (VAS), and the Headache Impact Test (HIT-6). Oxidative stress was determined by measuring CoQ10, catalase and lipid peroxidation (LPO) levels in BMCs. Bioenergetic status was assessed by measuring ATP levels in BMCs. Results We found decreased CoQ10, catalase and ATP levels in BMCs from FM patients as compared to normal control (P<0.05 and P<0.001, respectively) We also found increased level of LPO in BMCs from FM patients as compared to normal control (P<0.001). Significant negative correlations between CoQ10 or catalase levels in BMCs and headache parameters were observed (r = −0.59, P<0.05; r = −0.68, P<0.05, respectively). Furthermore, LPO levels showed a significant positive correlation with HIT-6 (r = 0.33, P<0.05). Oral CoQ10 supplementation restored biochemical parameters and induced a significant improvement in clinical and headache symptoms (P<0.001). Discussion The results of this study suggest a role for mitochondrial dysfunction and oxidative stress in the headache symptoms associated with FM. CoQ10 supplementation should be examined in a larger placebo controlled trial as a possible treatment in FM. PMID:22532869

  9. Oxidative stress correlates with headache symptoms in fibromyalgia: coenzyme Q₁₀ effect on clinical improvement.

    Directory of Open Access Journals (Sweden)

    Mario D Cordero

    Full Text Available BACKGROUND: Fibromyalgia (FM is a chronic pain syndrome with unknown etiology and a wide spectrum of symptoms such as allodynia, debilitating fatigue, joint stiffness and migraine. Recent studies have shown some evidences demonstrating that oxidative stress is associated to clinical symptoms in FM of fibromyalgia. We examined oxidative stress and bioenergetic status in blood mononuclear cells (BMCs and its association to headache symptoms in FM patients. The effects of oral coenzyme Q(10 (CoQ(10 supplementation on biochemical markers and clinical improvement were also evaluated. METHODS: We studied 20 FM patients and 15 healthy controls. Clinical parameters were evaluated using the Fibromyalgia Impact Questionnaire (FIQ, visual analogues scales (VAS, and the Headache Impact Test (HIT-6. Oxidative stress was determined by measuring CoQ(10, catalase and lipid peroxidation (LPO levels in BMCs. Bioenergetic status was assessed by measuring ATP levels in BMCs. RESULTS: We found decreased CoQ(10, catalase and ATP levels in BMCs from FM patients as compared to normal control (P < 0.05 and P < 0.001, respectively We also found increased level of LPO in BMCs from FM patients as compared to normal control (P < 0.001. Significant negative correlations between CoQ(10 or catalase levels in BMCs and headache parameters were observed (r  = -0.59, P < 0.05; r  =  -0.68, P < 0.05, respectively. Furthermore, LPO levels showed a significant positive correlation with HIT-6 (r = 0.33, P<0.05. Oral CoQ(10 supplementation restored biochemical parameters and induced a significant improvement in clinical and headache symptoms (P < 0.001. DISCUSSION: The results of this study suggest a role for mitochondrial dysfunction and oxidative stress in the headache symptoms associated with FM. CoQ10 supplementation should be examined in a larger placebo controlled trial as a possible treatment in FM.

  10. Corneal Sensitivity in Tear Dysfunction and its Correlation With Clinical Parameters and Blink Rate.

    Science.gov (United States)

    Rahman, Effie Z; Lam, Peter K; Chu, Chia-Kai; Moore, Quianta; Pflugfelder, Stephen C

    2015-11-01

    To compare corneal sensitivity in tear dysfunction due to a variety of causes using contact and noncontact esthesiometers and to evaluate correlations between corneal sensitivity, blink rate, and clinical parameters. Comparative observational case series. Ten normal and 33 subjects with tear dysfunction (meibomian gland disease [n = 11], aqueous tear deficiency [n = 10]-without (n = 7) and with (n = 3) Sjögren syndrome (SS)-and conjunctivochalasis [n = 12]) were evaluated. Corneal sensitivity was measured with Cochet-Bonnet and air jet esthesiometers and blink rate by electromyography. Eye irritation symptoms, tear meniscus height, tear break-up time (TBUT), and corneal and conjunctival dye staining were measured. Between-group means were compared and correlations calculated. Compared with control (Cochet-Bonnet 5.45 mm, air esthesiometer 3.62 mg), mean sensory thresholds were significantly higher in aqueous tear deficiency using either Cochet-Bonnet (3.6 mm; P = .003) or air (11.7 mg; P = .046) esthesiometers, but were not significantly different in the other groups. Reduced corneal sensitivity significantly correlated with more rapid TBUT and blink rate and greater irritation and ocular surface dye staining with 1 or both esthesiometers. Mean blink rates were significantly higher in both aqueous tear deficiency and conjunctivochalasis compared with control. Among all subjects, blink rate positively correlated with ocular surface staining and irritation and inversely correlated with TBUT. Among conditions causing tear dysfunction, reduced corneal sensitivity is associated with greater irritation, tear instability, ocular surface disease, and blink rate. Rapid blinking is associated with worse ocular surface disease and tear stability. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. Correlation of the NBME advanced clinical examination in EM and the national EM M4 exams.

    Science.gov (United States)

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

    2015-01-01

    Since 2011 two online, validated exams for fourth-year emergency medicine (EM) students have been available (National EM M4 Exams). In 2013 the National Board of Medical Examiners offered the Advanced Clinical Examination in Emergency Medicine (EM-ACE). All of these exams are now in widespread use; however, there are no data on how they correlate. This study evaluated the correlation between the EM-ACE exam and the National EM M4 Exams. From May 2013 to April 2014 the EM-ACE and one version of the EM M4 exam were administered sequentially to fourth-year EM students at five U.S. medical schools. Data collected included institution, gross and scaled scores and version of the EM M4 exam. We performed Pearson's correlation and random effects linear regression. 305 students took the EM-ACE and versions 1 (V1) or 2 (V2) of the EM M4 exams (281 and 24, respectively) [corrected].The mean percent correct for the exams were as follows: EM-ACE 74.9 (SD-9.82), V1 83.0 (SD-6.39), V2 78.5 (SD-7.70) [corrected]. Pearson's correlation coefficient for the V1/EM-ACE was 0.53 (0.43 scaled) and for the V2/EM-ACE was 0.58 (0.41 scaled) [corrected]. The coefficient of determination for V1/ EM-ACE was 0.73 and for V2/EM-ACE 0.71 (0.65 and .49 for scaled scores) [ERRATUM]. The R-squared values were 0.28 and 0.30 (0.18 and 0.13 scaled), respectively [corrected]. There was significant cluster effect by institution. There was moderate positive correlation of student scores on the EM-ACE exam and the National EM M4 Exams.

  12. Clinical and functional correlates of posttraumatic stress disorder in urban adolescent girls at a primary care clinic.

    Science.gov (United States)

    Lipschitz, D S; Rasmusson, A M; Anyan, W; Cromwell, P; Southwick, S M

    2000-09-01

    To identify clinical and functional correlates of posttraumatic stress disorder (PTSD) in trauma-exposed urban adolescent girls. Ninety female adolescents aged 12 to 21 years (mean 17.3 years) who presented for routine medical care at an adolescent primary care clinic were assessed with self-report questionnaires and interviews for trauma exposure, posttraumatic stress symptoms, other psychopathology, and psychosocial, family, and school function. Ninety-two percent (n = 83) endorsed at least one trauma. Witnessing community violence (85.6%) and hearing about a homicide (67.8%) were the most common traumatic events endorsed. Twelve (14.4%) and 10 (11.6%) traumatized girls met DSM-IV symptom criteria for full and partial PTSD, respectively. Compared with traumatized girls without PTSD, girls with PTSD were significantly more depressed, used more cigarettes and marijuana, and were more likely to have failed a school grade, been suspended from school, or been arrested. Urban adolescent girls are exposed to multiple types of trauma. Whereas most develop at least one posttraumatic stress symptom, girls who meet full symptom criteria for PTSD show evidence of other psychopathology, increased cigarette and marijuana use, and poorer school performance. Further research is needed to identify and treat inner-city girls with PTSD.

  13. Non-Constant Learning Rates in Retrospective Experience Curve Analyses and their Correlation to Deployment Programs

    Energy Technology Data Exchange (ETDEWEB)

    Wei, Max [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Smith, Sarah J. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Sohn, Michael D. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2015-07-16

    A key challenge for policy-makers and technology market forecasters is to estimate future technology costs and in particular the rate of cost reduction versus production volume. A related, critical question is what role should state and federal governments have in advancing energy efficient and renewable energy technologies? This work provides retrospective experience curves and learning rates for several energy-related technologies, each of which have a known history of federal and state deployment programs. We derive learning rates for eight technologies including energy efficient lighting technologies, stationary fuel cell systems, and residential solar photovoltaics, and provide an overview and timeline of historical deployment programs such as state and federal standards and state and national incentive programs for each technology. Piecewise linear regimes are observed in a range of technology experience curves, and public investments or deployment programs are found to be strongly correlated to an increase in learning rate across multiple technologies. A downward bend in the experience curve is found in 5 out of the 8 energy-related technologies presented here (electronic ballasts, magnetic ballasts, compact fluorescent lighting, general service fluorescent lighting, and the installed cost of solar PV). In each of the five downward-bending experience curves, we believe that an increase in the learning rate can be linked to deployment programs to some degree. This work sheds light on the endogenous versus exogenous contributions to technological innovation and highlights the impact of exogenous government sponsored deployment programs. This work can inform future policy investment direction and can shed light on market transformation and technology learning behavior.

  14. Correlation between presence of Leishmania RNA virus 1 and clinical characteristics of nasal mucosal leishmaniosis.

    Science.gov (United States)

    Ito, Marcos Massayuki; Catanhêde, Lilian Motta; Katsuragawa, Tony Hiroshi; Silva Junior, Cipriano Ferreira da; Camargo, Luis Marcelo Aranha; Mattos, Ricardo de Godoi; Vilallobos-Salcedo, Juan Miguel

    2015-01-01

    Mucosal leishmaniosis (ML) is a severe clinical form of leishmaniosis. Complex factors related to the parasite and the host are attributed to the development of mucosal lesions. Leishmania RNA virus 1 (LRV1) can disrupt immune response, and may be the main determinant of severity of the disease; it should be investigated. To study the existence of clinical differences between patients with ML with endosymbiosis by LRV1 and. those without it. A cross-sectional cohort study with clinical evaluation, polymerase chain reaction (PCR) detection of Leishmania, species classification, and search of LRV1 was performed. Only patients with confirmed diagnosis of ML by positive PCR and with nasal mucosa injuries were included in this analysis. Out of 37 patients, 30 (81.1%) were diagnosed with Leishmania braziliensis, five (13.5%) with Leishmania guyanensis, and two (5.4%) with mixed infection of L. braziliensis and L. guyanensis. LVR1 virus was present in 26 (70.3%) of the cases. Correlation between clinical phenotype and presence of LRV1 was not observed, although the frequency of the virus is two-fold higher in mucosal lesions than that found in the literature on skin lesions in the same geographical area. Copyright © 2015 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  15. Incidence, clinical correlates and treatment effect of rage in anxious children.

    Science.gov (United States)

    Johnco, Carly; Salloum, Alison; De Nadai, Alessandro S; McBride, Nicole; Crawford, Erika A; Lewin, Adam B; Storch, Eric A

    2015-09-30

    Episodic rage represents an important and underappreciated clinical feature in pediatric anxiety. This study examined the incidence and clinical correlates of rage in children with anxiety disorders. Change in rage during treatment for anxiety was also examined. Participants consisted of 107 children diagnosed with an anxiety disorder and their parents. Participants completed structured clinical interviews and questionnaire measures to assess rage, anxiety, functional impairment, family accommodation and caregiver strain, as well as the quality of the child's relationship with family and peers. Rage was a common feature amongst children with anxiety disorders. Rage was associated with a more severe clinical profile, including increased anxiety severity, functional impairment, family accommodation and caregiver strain, as well as poorer relationships with parents, siblings, extended family and peers. Rage was more common in children with separation anxiety, comorbid anxiety, attention deficit/hyperactivity disorder and behavioral disorders, but not depressive symptoms. Rage predicted higher levels of functional impairment, beyond the effect of anxiety severity. Rage severity reduced over treatment in line with changes in anxiety symptoms. Findings suggest that rage is a marker of greater psychopathology in anxious youth. Standard cognitive behavioral treatment for anxiety appears to reduce rage without adjunctive treatment. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  16. Phenomenology and clinical correlates of family accommodation in pediatric anxiety disorders.

    Science.gov (United States)

    Storch, Eric A; Salloum, Alison; Johnco, Carly; Dane, Brittney F; Crawford, Erika A; King, Morgan A; McBride, Nicole M; Lewin, Adam B

    2015-10-01

    Despite evidence documenting high prevalence of family accommodation in pediatric obsessive-compulsive disorder, examination in other pediatric anxiety disorders is limited. Preliminary evidence suggests that family accommodation is common amongst children with anxiety disorders; however, the impact on clinical presentation and functional impairment has not been addressed. This study assessed the nature and clinical correlates of family accommodation in pediatric anxiety, as well as validating a mechanistic model. Participants included 112 anxious youth and their parents who were administered a diagnostic clinical interview and measure of anxiety severity, as well as questionnaires assessing internalizing and externalizing symptoms, family accommodation and functional impairment. Some form of accommodation was present in all families. Family accommodation was associated with increased anxiety severity and externalizing behaviors, having a diagnosis of separation anxiety, and increased functional impairment. Family accommodation partially mediated the relationship between anxiety severity and functional impairment, as well as externalizing behaviors and functional impairment. Family accommodation is common in pediatric anxiety disorders, and is associated with more severe clinical presentations and functional impairment. These findings highlight the importance of parental involvement in treatment and the need to specifically target accommodation practices during interventions to mitigate negative outcomes in anxious youth. Further studies utilizing longitudinal data are needed to validate mechanistic models. Copyright © 2015 Elsevier Ltd. All rights reserved.

  17. Correlation of placental microbiota with fetal macrosomia and clinical characteristics in mothers and newborns.

    Science.gov (United States)

    Zheng, Jia; Xiao, Xin-Hua; Zhang, Qian; Mao, Li-Li; Yu, Miao; Xu, Jian-Ping; Wang, Tong

    2017-10-10

    Substantial studies indicated that fetal macrosomia was associated with detrimental pregnancy outcomes, and increased susceptibility to metabolic diseases in later life. However, investigations into the association between placental microbiota and fetal macrosomia are limited. We aimed to profile the placental microbiota of fetal macrosomia and study whether they relate to clinical characteristics. Placenta samples were collected from fetal macrosomias and newborns with normal birth weight. The clinical characteristics, umbilical cord blood parameters were measured, and placental microbiota were sequenced and further analysed. The clinical characteristics of infants and mothers and umbilical cord blood parameters were significantly different between macrosomias and controls. The relative abundance of microbiota sequences revealed that microbial structures of the placenta differed significantly between macrosomia and controls. Regression analysis showed a cluster of key operational taxonomic unit (OTUs), phyla and genera were significantly correlated with body length, ponderal index and placenta weight, body weight increase during pregnancy of mothers, and cord blood IGF-1 and leptin concentrations. In conclusion, our study for the first time explored the relationship between placental microbiota profile and fetal macrosomia. It is novel in showing that a distinct placental microbiota profile is present in fetal macrosomia, and is associated with clinical characteristics of mothers and newborns.

  18. Correlation between presence of Leishmania RNA virus 1 and clinical characteristics of nasal mucosal leishmaniosis

    Directory of Open Access Journals (Sweden)

    Marcos Massayuki Ito

    2015-10-01

    Full Text Available ABSTRACT INTRODUCTION: Mucosal leishmaniosis (ML is a severe clinical form of leishmaniosis. Complex factors related to the parasite and the host are attributed to the development of mucosal lesions. Leishmania RNA virus 1 (LRV1 can disrupt immune response, and may be the main determinant of severity of the disease; it should be investigated. OBJECTIVE: To study the existence of clinical differences between patients with ML with endosymbiosis by LRV1 and. those without it. METHODS: A cross-sectional cohort study with clinical evaluation, polymerase chain reaction (PCR detection of Leishmania, species classification, and search of LRV1 was performed. Only patients with confirmed diagnosis of ML by positive PCR and with nasal mucosa injuries were included in this analysis. RESULTS: Out of 37 patients, 30 (81.1% were diagnosed with Leishmania braziliensis, five (13.5% with Leishmania guyanensis, and two (5.4% with mixed infection of L. braziliensis and L. guyanensis. LVR1 virus was present in 26 (70.3% of the cases. CONCLUSION: Correlation between clinical phenotype and presence of LRV1 was not observed, although the frequency of the virus is two-fold higher in mucosal lesions than that found in the literature on skin lesions in the same geographical area.

  19. Level of evidence of clinical spinal research and its correlation with journal impact factor.

    Science.gov (United States)

    Amiri, Amir Reza; Kanesalingam, Kavitha; Cro, Suzie; Casey, Adrian T H

    2013-09-01

    Over the past two decades, there has been a growing recognition and emphasis on the practice of evidence-based medicine (EBM). The level of evidence (LOE) is used to classify clinical studies based on their quality and design. To compare the quality of scientific journals, the impact factor (IF) is the most widely used ranking measure. However, the calculation of IF is not directly dependent on the quality or LOE of clinical articles published in a journal. The primary aim of this study was to evaluate the current LOE for clinical research in leading spinal journals and assess the relationship between LOE and IF. We hypothesized that most clinical research would provide level IV evidence, and that a positive correlation would exist between the proportion of high LOE articles and the journal IF. A systematic review of all the articles in five general spinal journals was undertaken during 2010. All online articles in The Spine Journal, Spine, European Spine Journal, Journal of Neurosurgery: Spine, and Journal of Spinal Disorders and Techniques during 2010, as well as supplements were included. The LOE for each clinical study was assessed using guidelines produced by the Oxford Centre for Evidence-Based Medicine. Two reviewers independently assessed all articles. Overall 703 articles were suitable for LOE grading. Of these, 4.7% provided level I evidence, 23.2% level II, 12.5% level III, and 59.6% level IV. There was a significant association between LOE and type of study (pimpact factor (ρ=0.9; 95% confidence interval 0.1 to 0.99; p=.037). Spinal surgery journals with a higher IF contain a larger proportion of studies with high LOE, however most clinical articles provide level IV evidence of which the highest proportion are therapeutic studies. Clinicians, researchers, and journal editors should work hand in hand to enhance evidence-based practice in spinal care. Copyright © 2013 Elsevier Inc. All rights reserved.

  20. The Prevalence and Clinical Correlates of an Auscultatory Gap in Systemic Sclerosis Patients

    Directory of Open Access Journals (Sweden)

    Tracy M. Frech

    2012-01-01

    Full Text Available Introduction. Accurate blood pressure (BP measurement is essential to the diagnosis and management of hypertension in patients with systemic sclerosis (SSc to help prevent renal and cardiovascular complications. The presence of an auscultatory gap during manual BP measurement—the temporary disappearance of the Korotkoff sounds during cuff deflation—leads to a potentially important underestimate of systolic BP if undetected. Objectives. Since the presence of an auscultatory gap is frequently associated with increased vascular stiffness, we investigated its presence and correlates in 50 consecutive SSc patients. Methods. For each patient, BP was measured sequentially using three different approaches performed in the same order. Results. Sixteen of 50 patients (32% had an auscultatory gap which if undetected would have resulted in clinically important underestimates of systolic BP in 4 patients. The presence of an auscultatory gap was statistically associated with the presence of antibodies to RNA polymerase III (<0.0068 and SSc diagnosis type (<0.01. Conclusions. Our study demonstrates that auscultatory gaps are relatively common in SSc and correlate with markers for SSc vasculopathy. If undetected auscultatory gaps may result in clinically important underestimation of BP. Thus, electronic oscillometric BP may be preferred in SSc patients.

  1. Clinical, psychopathological and personality correlates of interoceptive awareness in anorexia nervosa, bulimia nervosa and obesity.

    Science.gov (United States)

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

    2004-01-01

    To determine the levels of interoceptive awareness (IA), which measures the ability of an individual to discriminate between sensations and feelings, and between the sensations of hunger and satiety, in eating disorder patients and to identify the clinical, psychopathological and personal variables correlated with IA. Sixty-one restrictor anorectics, 61 binge-purging anorectics, 104 purging bulimics, 49 obese subjects with binge eating disorder (BED) and 47 obese subjects without BED were compared. They were assessed with the Eating Disorder Inventory-2, the Temperament and Character Inventory, and the Beck Depression Inventory, and their clinical and sociodemographic features were recorded. In all patients, the levels of IA were higher than the 'normal' ones; in bulimia nervosa, they were higher than in anorexia nervosa and obesity. Similar personal features and eating attitudes are shared by patients with bulimia nervosa and BED. In the total sample, the following variables independently correlate with IA: the Beck Depression Inventory, self- directedness and persistence. The importance of an altered IA in eating disorders is supported. Both depression and a perfectionist and poorly self-directive personality can lead to greater difficulties in discriminating hunger and satiety. Copyright 2004 S. Karger AG, Basel

  2. Magnetic resonance imaging findings of postresuscitation encephalopathy. Sequential change and correlation with clinical outcome

    Energy Technology Data Exchange (ETDEWEB)

    Goto, Yasunobu; Wataya, Takafumi; Arakawa, Yoshiki; Hojo, Masato; Chin, Masaki; Yamagata, Sen; Kikuta, Kenichiro; Ishii, Akira [Kurashiki Central Hospital, Okayama (Japan)

    2001-06-01

    The purpose of this study was to describe the findings of sequential magnetic resonance imaging (MRI) in postresuscitation encephalopathy. Although its outcome is known to be overwhelming, but its acute findings by variable imaging methods are subtle and show only limited values. The correlation of the findings of MRI with clinical outcome were also analyzed. Twelve patients with global cerebral anoxia who underwent MRI with conventional and diffusion-weighted imaging were enrolled in this study. Compared with normal MRI images, abnormal signal regions were checked and described in cortex, basal ganglia and white matter. Also medical records were carefully reviewed to study the cause, the time necessary for resuscitation and long term clinical outcome. The earliest finding was obtained by diffusion-weighted image less than 24 hours (acute period) in bilateral cerebral cortex as bright high signal intensity regions. Similar abnormality of bright high signal area in FLAIR and T2 was followed according to the time elapsed in early subacute period (1-13 days). Succeedingly, white matter was involved and laminar necrosis in cortical area was observed in late subacute period (14-20 days). Finally, diffuse brain atrophy and obtundation of gray-white matter junction were seen in chronic stage (after 21 days). These MR findings were coincided well with histopathological findings reported in literatures. The poor outcome was closely and significantly correlated with abnormality in MR images. MRI was a useful diagnostic modality to diagnose the whole brain ischemic encephalopathy and to predict the prognosis. (author)

  3. A Study on the Prevalence and Correlates of Academic Dishonesty in Four Undergraduate Degree Programs

    Directory of Open Access Journals (Sweden)

    Mark Anthony Mujer Quintos

    2017-02-01

    Full Text Available With college students from four different disciplines representing the humanities as well as the natural, mathematical, and social sciences as respondents, this study determined the degree of prevalence and correlates of academic dishonesty among students. A survey questionnaire about the respondents’ personal characteristics and their frequency of engagement in academic dishonesty during one whole academic year (two semesters was used as the research instrument. A Wilcoxon Signed-Ranks test was used to determine which between cheating on examinations, quizzes and/or exercises and cheating on papers and/or projects was committed more often. Spearman’s Rank Correlation tests were conducted to determine significant correlations between the students’ characteristics and academic dishonesty. The study found that within an academic year, nine out of ten students have engaged in at least one act of academic dishonesty. Furthermore, students engaged in more types of academic cheating on papers/projects than on exams/quizzes/exercises. The most prevalent form of academic dishonesty was connivance through the sharing between students of answers and questions to an exam/quiz/exercise that a student has taken before and the others are just about to take. Cheating on papers/projects was committed more often than on exams/quizzes/exercises for all degree programs except for mathematical science students. Only two variables, (1 perception of one’s classmates’ and peers’ frequency of academic cheating and (2 frequency of academic cheating during high school, have moderately strong positive correlations with academic dishonesty. The attitude that academic cheating is never justified, on the other hand, was found to have a moderately strong negative correlation with academic dishonesty

  4. Biomechanical and Clinical Correlates of Stance-Phase Knee Flexion in Persons With Spastic Cerebral Palsy.

    Science.gov (United States)

    Rha, Dong-wook; Cahill-Rowley, Katelyn; Young, Jeffrey; Torburn, Leslie; Stephenson, Katherine; Rose, Jessica

    2016-01-01

    To identify biomechanical and clinical parameters that influence knee flexion (KF) angle at initial contact (IC) and during single limb stance phase of gait in children with spastic cerebral palsy (CP) who walk with flexed-knee gait. Retrospective analysis of gait kinematics and clinical data collected from 2010-2013. Motion & Gait Analysis Laboratory at Lucile Packard Children's Hospital, Stanford, CA. Gait analysis data from persons with spastic CP (Gross Motor Function Classification System [GMFCS] I-III) who had no prior surgery were analyzed. Participants exhibiting KF ≥20° at IC were included; the more-involved limb was analyzed. Outcome measures were analyzed with respect to clinical findings, including passive range of motion, Selective Motor Control Assessment for the Lower Extremity (SCALE), gait kinematics, and musculoskeletal models of muscle-tendon lengths during gait. KF at IC (KFIC) and minimum KF during single-limb support (KFSLS) were investigated. Thirty-four participants met the inclusion criteria, and their data were analyzed (20 males and 14 females, mean age 10.1 years, range 5-20 years). Mean KFIC was 34.4 ± 8.4 degrees and correlated with lower SCALE score (ρ = -0.530, P = .004), later peak KF during swing (ρ = 0.614, P < .001), and shorter maximal muscle length of the semimembranosus (ρ = -0.359, P = .037). Mean KFSLS was 18.7 ± 14.9 and correlated to KF contracture (ρ = 0.605, P < .001) and shorter maximal muscle length of the semimembranosus (ρ = -0.572, P < .001) and medial gastrocnemius (ρ = -0.386, P = .024). GMFCS correlated more strongly to KFIC (ρ = 0.502, P = .002) than to KFSLS (ρ = 0.371, P = .031). Linear regression found that both the SCALE score (P = .001) and delayed timing of peak KF during swing (P = .001) independently predicted KFIC. KF contracture (P = .026) and maximal length of the semimembranosus (P = .043) independently predicted KFSLS. Correlates of KFIC differed from those for KFSLS and suggest that

  5. Clinical and cognitive correlates of unsheltered status in homeless persons with psychotic disorders.

    Science.gov (United States)

    Llerena, Katiah; Gabrielian, Sonya; Green, Michael F

    2018-02-24

    Homeless persons with psychosis are particularly susceptible to unsheltered homelessness, which includes living on the streets, in cars, and other places not meant for human habitation. Homeless persons with psychosis have distinct barriers to accessing care and comprise a high-need and hard-to-serve homeless subpopulation. Therefore, this study sought to understand unsheltered homelessness in persons with psychosis and its relationship to cognitive impairment, clinical symptoms, and community functioning, examined both categorically and dimensionally. This study included 76 homeless participants with a history of a psychotic diagnosis who were enrolled in a supported housing program but had not yet received housing. This study used two different housing stability thresholds (literally homeless at any point vs. literally homeless >20% of days) for comparing homeless Veterans with psychosis living in sheltered versus unsheltered situations on cognition, clinical symptoms, and community integration. Dimensional analyses also examined the relationship between percentage of days spent in unsheltered locations and cognition, clinical symptoms, and community integration. Sheltered and unsheltered Veterans with psychosis did not differ on clinical symptoms or community integration, but there was an inconsistent group difference on cognition depending on the threshold used for determining housing stability. In the unsheltered group, cognitive deficits in overall cognition, visual learning, and social cognition were related to more days spent in unsheltered locations. Rehabilitation efforts targeting specific cognitive deficits may be useful to facilitate greater access to care and successful interventions in this population. Copyright © 2018 Elsevier B.V. All rights reserved.

  6. Expression of Cyr61, CTGF, and WISP-1 correlates with clinical features of lung cancer.

    Science.gov (United States)

    Chen, Ping-Ping; Li, Wen-Jie; Wang, Yan; Zhao, Song; Li, De-Yun; Feng, Li-Yun; Shi, Xiang-Lin; Koeffler, H Phillip; Tong, Xiang-Jun; Xie, Dong

    2007-06-20

    CCN family, comprising six members (Cyr61, CTGF, Nov, WISP-1, WISP-2, WISP-3), is involved in the stimulation of cell proliferation, migration, adhesion, angiogenesis, and tumorigenesis. Several studies have shown that expression of Cyr61, CTGF, and WISP-1 affects the tumorigenic potential of lung cancer cells in vitro. However, the correlation of expression of CCN family proteins and clinical features of lung cancer remains unknown. In the present work, we quantified the mRNA levels of Cyr61, CTGF, and WISP-1 in samples from 60 primary lung cancers and their matched normal lung tissues by quantitative real-time PCR assay. Downregulation of the Cyr61 and CTGF genes and upregulation of the WISP-1 gene were found in primary lung cancers compared to the paired normal lung tissues. Immunohistochemistry analysis also disclosed a similar expression pattern of Cyr61, CTGF, and WISP-1 protein in paired lung cancer tissues. Statistical analysis revealed significant associations between expression of either Cyr61 or CTGF with tumor stage, tumor histology, metastasis, smoking, and family history at diagnosis. A significant correlation also existed between WISP-1 expression with tumor histology, and patient age. Moreover, expression levels of Cyr61 and CTGF correlated with survival of the lung-cancer patients. Our results suggest that Cyr61, CTGF, and WISP-1 might be implicated in the development and progression of primary lung cancers, and their levels might serve as valuable prognostic markers, as well as potential targets for therapeutic intervention.

  7. Bone biopsy findings and correlation with clinical, radiological, and biochemical parameters in children with fractures.

    Science.gov (United States)

    Mäyränpää, Mervi K; Tamminen, Inari S; Kröger, Heikki; Mäkitie, Outi

    2011-08-01

    In children the diagnosis of osteoporosis is based on fracture history and DXA-derived BMD. Bone biopsy is an invasive but accurate method for studying bone characteristics. In this study we evaluated bone biopsy findings and their correlation with noninvasive measures of bone health. Transiliac bone biopsy was performed on 24 consecutive children (17 boys, median age 12 years, range 6 to 16 years) evaluated for suspected primary osteoporosis. Biopsy findings were compared with normative data and correlated with clinical, radiological, biochemical, and densitometric findings. The patients had sustained altogether 64 nonvertebral fractures (median 2.5) from low- or moderate-energy traumas, and 14 patients (58%) had vertebral fractures. The median lumbar spine BMD Z-score was -1.2 (range -3.1 to +1.0). Hypovitaminosis D was present in 58%. Histomorphometry showed low bone volume in 7 patients and normal bone volume in 17. Bone turnover was high in 7, low in 7, and normal in 10 patients. Histomorphometric findings correlated poorly with fracture history, serum bone turnover markers, and DXA findings. Vitamin D deficiency and low lumbar BMD were associated with high bone turnover in the biopsy. These findings underscore the difficulties in diagnosing pediatric osteoporosis. Bone histomorphometry gives additional information and may be useful when considering bisphosphonate treatment in children with suspected primary osteoporosis. Copyright © 2011 American Society for Bone and Mineral Research.

  8. NON-COMMUNICABLE DISEASE PROGRAM IN AMPANGAN HEALTH CLINIC

    Directory of Open Access Journals (Sweden)

    MASTURA I

    2010-01-01

    Full Text Available Non-communicable diseases (NCDs represent among the most common and debilitating conditions seen in primary care. Patients’ care will often involves multiple providers and follow-up requires persistence by patients and clinicians alike, therefore ideal outcomes are often difficult to achieve. The need for better disease management policies and practice is growing. This is due to the changing demographic profile of the population, the increasing cost of managing people in acute care hospitals and the availability of new technologies and services. All these changes enable a different care paradigm which is more cost effective and provides people with chronic conditions an improved quality of life. Management of the NCDs therefore offers an excellent opportunity to practice chronic disease management - a systems approach designed to ensure excellent care. The NCD team has developed a comprehensive approach to chronic disease care. We would like to describe the NCD Program in Ampangan Health Clinic which represents many typical government health clinics in Malaysia and the processes by which it was developed. Included are specific examples of the tools and how they can be used by individual clinicians incaring for patients. The integration of Chronic Disease Management Services into health care systems is the direction being undertaken to tackle the burden of chronic disease. Disease management supports the shift in healthcare from an emphasis on managing the acute episode to managing the entire disease course, highlighting both prevention and maintenance of wellbeing for patients with chronic diseases. Disease management promotes better integration and coordination of care across all aspects of the health sector.

  9. Correlation of Creatine Kinase Levels with Clinical Features and Survival in Amyotrophic Lateral Sclerosis

    Directory of Open Access Journals (Sweden)

    Hongfei Tai

    2017-07-01

    Full Text Available ObjectiveTo evaluate serum creatine kinase (CK levels of amyotrophic lateral sclerosis (ALS patients and to explore the relationship between CK levels and the clinical characteristics and survival prognosis of ALS patients.MethodsWe analyzed the CK levels of 185 ALS patients who underwent long-term follow-up. The relationship between CK levels and clinical features including sex, age, disease duration, site of onset, body mass index (BMI, serum creatinine (Cr, and spontaneous electromyographic activity was analyzed by univariate analysis and multiple linear regression. Kaplan–Meier and Cox proportional hazards models were used to explore whether CK levels were independently correlated with survival prognosis of ALS.ResultsBaseline serum CK was raised in 43% of participants. The median CK level was 160 U/L (range: 20–2,574 U/L, and 99% of patients had a baseline serum CK level less than 1,000 U/L. CK levels were significantly higher in male patients than in female patients [204 (169 versus 117 (111 U/L, p < 0.001] and in patients with limb onset ALS than with bulbar onset ALS (p < 0.001. CK levels were also correlated with serum Cr (p = 0.011 and the spontaneous potential score of electromyography (EMG (p = 0.037 but not correlated with age (p = 0.883, disease duration (p = 0.116, or BMI (p = 0.481. Log CK was independently correlated with survival of ALS patients (HR = 0.457, 95% confidence interval 0.221–0.947, p = 0.035 after adjusting for age, sex, site of onset, serum Cr, and BMI.ConclusionSerum CK levels of ALS patients were correlated with sex, site of onsite, serum Cr, and spontaneous activity in EMG. Serum CK could be an independent prognostic factor for survival of ALS patients.

  10. Hippocampal microstructural damage correlates with memory impairment in clinically isolated syndrome suggestive of multiple sclerosis.

    Science.gov (United States)

    Planche, Vincent; Ruet, Aurélie; Coupé, Pierrick; Lamargue-Hamel, Delphine; Deloire, Mathilde; Pereira, Bruno; Manjon, José V; Munsch, Fanny; Moscufo, Nicola; Meier, Dominik S; Guttmann, Charles Rg; Dousset, Vincent; Brochet, Bruno; Tourdias, Thomas

    2017-08-01

    We investigated whether diffusion tensor imaging (DTI) could reveal early hippocampal damage and clinically relevant correlates of memory impairment in persons with clinically isolated syndrome (CIS) suggestive of multiple sclerosis (MS). A total of 37 persons with CIS, 32 with MS and 36 controls prospectively included from 2011 to 2014 were tested for cognitive performances and scanned with 3T-magnetic resonance imaging (MRI) to assess volumetric and DTI changes within the hippocampus, whole brain volume and T2-lesion load. While there was no hippocampal atrophy in the CIS group, hippocampal fractional anisotropy (FA) was significantly decreased compared to controls. Decrease in hippocampal FA together with increased mean diffusivity (MD) was even more prominent in MS patients. In CIS, hippocampal MD was correlated with episodic verbal memory performance ( r = -0.57, p = 0.0002 and odds ratio (OR) = 0.058, 95% confidence interval (CI) = 0.0057-0.59, p = 0.016 adjusted for age, gender, depression and T2-lesion load), but not with cognitive tasks unrelated to hippocampal functions. Hippocampal MD was the only variable discriminating memory-impaired from memory-preserved persons with CIS (area under the curve (AUC) = 0.77, sensitivity = 90.0%, specificity = 70.3%, positive predictive value (PPV) = 52.9%, negative predictive value (NPV) = 95.0%). DTI alterations within the hippocampus might reflect early neurodegenerative processes that are correlated with episodic memory performance, discriminating persons with CIS according to their memory status.

  11. Bone Mineral Density in Patients with Ankylosing Spondylitis: Incidence and Correlation with Demographic and Clinical Variables

    Directory of Open Access Journals (Sweden)

    Laura MUNTEAN

    2009-12-01

    Full Text Available Objective: To evaluate bone mineral density (BMD in patients with ankylosing spondylitis (AS and determine its correlation with the demographic and clinical characteristics of AS. Patients and Methods: Demographic, clinical and osteodensitometric data were evaluated in a cross-sectional study that included 136 patients with AS. Spine and hip BMD were measured by means of dual energy X-ray absorptiometry (DXA. Using the modified Schober’s test we assessed spine mobility. We examined the sacroiliac, anteroposterior and lateral dorso-lumbar spine radiographs in order to grade sacroiliitis and assess syndesmophytes. Disease activity was evaluated using C-reactive protein (CRP levels and erythrocyte sedimentation rate (ESR. Demographic data and BMD measurements were compared with those of 167 age- and sex-matched healthy controls. Results: Patients with AS had a significantly lower BMD at the spine, femoral neck, trochanter and total hip as compared to age-matched controls (all p<0.01. According to the WHO classification, osteoporosis was present in 20.6% of the AS patients at the lumbar spine and in 14.6% at the femoral neck. There were no significant differences in BMD when comparing men and women with AS, except for trochanter BMD that was lower in female patients. No correlations were found between disease activity markers (ESR, CRP and BMD. Femoral neck BMD was correlated with disease duration, Schober’s test and sacroiliitis grade. Conclusion: Patients with AS have a lower spine and hip BMD as compared to age- and sex-matched controls. Bone loss at the femoral neck is associated with disease duration and more severe AS.

  12. Sociodemographic and clinical correlates of psychotic symptoms in the general population: Findings from the MHGP survey.

    Science.gov (United States)

    Pignon, Baptiste; Schürhoff, Franck; Szöke, Andrei; Geoffroy, Pierre A; Jardri, Renaud; Roelandt, Jean-Luc; Rolland, Benjamin; Thomas, Pierre; Vaiva, Guillaume; Amad, Ali

    2017-07-06

    We aimed to explore the sociodemographic and psychiatric correlates of psychotic symptoms in a large general population sample. The French Mental Health in the General Population cross-sectional survey interviewed 38,694 individuals using the Mini International Neuropsychiatric Interview. We looked for associations between the presence of lifetime psychotic symptoms, sociodemographic characteristics (including migrant status over three generations) and clinical characteristics. We then looked for associations regarding only hallucinations, delusional symptoms, and the co-occurrence of both hallucinations and delusional symptoms. To test the psychosis continuum hypothesis, associations with sociodemographic characteristics were compared with the characterized psychotic disorders' associations. We found that 22.3% of the population declared psychotic symptoms without psychotic disorders, including 5.7% who declared hallucinations, 20.5% delusional symptoms, 4.0% both hallucinations and delusional symptoms, and 2.8% characterized psychotic disorders. The presence of psychotic symptoms was associated with young age, migrant status (over three generations), secondary education level, low-income level and never-married and separated marital status. Hallucinations, delusional symptoms and the co-occurrence of both hallucinations and delusional symptoms showed the same correlates, and hallucinations were also associated with elementary education level. Characterized psychotic disorders showed the same correlates. Concerning clinical outcomes, the presence of psychotic symptoms, hallucinations and delusional symptoms was associated with all non-psychotic disorders, i.e., bipolar, depressive, alcohol use, generalized anxiety, social phobia, panic and post-traumatic stress disorders and dysthymia (except dysthymia, which was not associated with hallucinations). Our results indicate that psychotic symptoms are associated with broad psychopathologies and support the continuum

  13. [The correlation factor analysis for conversion of clinically isolated syndrome to multiple sclerosis and neuromyelitis optica].

    Science.gov (United States)

    Bi, C F; Qian, H R; Peng, L J; Mao, L L; Huang, X; Xia, D Y; Lei, X; Qi, X K

    2016-06-01

    To analyze the features of patients who converted from clinically isolated syndrome (CIS) to multiple sclerosis (MS) and neuromyelitis optica (NMO) and explore the correlated factors. A total of 151 patients admitted in our unit as CIS from January 2009 to December 2014 were enrolled in the study. All patients were divided into the following four groups by locations of the initial lesion, which were the spinal cord, the optic nerve, the brain stem and the multifocal lesions. Data were collected at the baseline including demographics, expanded disability status scale (EDSS) score, site of CIS, presence or absence of cerebrospinal fluid (CSF) oligoclonal bands (OB) and serum aquaporin-4 antibody (AQP4-Ab), evoked potential (EP) and MRI lesions. The conversion rates from CIS to clinically definite MS or NMO were calculated and the correlated factors were explored. With a mean follow-up period of (44.11±17.62)months, 46/151(30.5%) patients converted to MS, 28/151 (18.5%) to definite NMO and 66/151 patients(43.7%)remained as CIS. Other patients were converted to optic neuritis(4/151), one-time transverse myelitis(3/151), acute disseminated encephalomyelitis (1/151) and Balo concentric sclerosis(3/151) . The EDSS score was significantly higher in patients converted to NMO than those converted to MS (P=0.003). The initial manifestation of optic neuritis significantly correlated with the conversion to NMO (P=0.000), while the initial manifestation of CIS with multifocal lesions significantly correlated with the conversion to MS (P=0.000). Neither the isolated BAEP (P=0.703), VEP (P=0.076), SEP (P=0.915) nor the combination of two (P=0.546)or three (P=1.000) of the above parameters could help to distinguish the conversion to MS or NMO. More patients with positive CSF-OB converted to MS (P=0.001), while more patients with positive serum AQP4-Ab converted to NMO (P=0.001). More patients were serum AQP4-Ab positive in those converted to NMO than those converted to MS (P=0

  14. Correlation of serotype-specific dengue virus infection with clinical manifestations.

    Directory of Open Access Journals (Sweden)

    Eric S Halsey

    Full Text Available Disease caused by the dengue virus (DENV is a significant cause of morbidity throughout the world. Although prior research has focused on the association of specific DENV serotypes (DENV-1, DENV-2, DENV-3, and DENV-4 with the development of severe outcomes such as dengue hemorrhagic fever and dengue shock syndrome, relatively little work has correlated other clinical manifestations with a particular DENV serotype. The goal of this study was to estimate and compare the prevalence of non-hemorrhagic clinical manifestations of DENV infection by serotype.Between the years 2005-2010, individuals with febrile disease from Peru, Bolivia, Ecuador, and Paraguay were enrolled in an outpatient passive surveillance study. Detailed information regarding clinical signs and symptoms, as well as demographic information, was collected. DENV infection was confirmed in patient sera with polyclonal antibodies in a culture-based immunofluorescence assay, and the infecting serotype was determined by serotype-specific monoclonal antibodies. Differences in the prevalence of individual and organ-system manifestations were compared across DENV serotypes. One thousand seven hundred and sixteen individuals were identified as being infected with DENV-1 (39.8%, DENV-2 (4.3%, DENV-3 (41.5%, or DENV-4 (14.4%. When all four DENV serotypes were compared with each other, individuals infected with DENV-3 had a higher prevalence of musculoskeletal and gastrointestinal manifestations, and individuals infected with DENV-4 had a higher prevalence of respiratory and cutaneous manifestations.Specific clinical manifestations, as well as groups of clinical manifestations, are often overrepresented by an individual DENV serotype.

  15. Correlation of serotype-specific dengue virus infection with clinical manifestations.

    Science.gov (United States)

    Halsey, Eric S; Marks, Morgan A; Gotuzzo, Eduardo; Fiestas, Victor; Suarez, Luis; Vargas, Jorge; Aguayo, Nicolas; Madrid, Cesar; Vimos, Carlos; Kochel, Tadeusz J; Laguna-Torres, V Alberto

    2012-01-01

    Disease caused by the dengue virus (DENV) is a significant cause of morbidity throughout the world. Although prior research has focused on the association of specific DENV serotypes (DENV-1, DENV-2, DENV-3, and DENV-4) with the development of severe outcomes such as dengue hemorrhagic fever and dengue shock syndrome, relatively little work has correlated other clinical manifestations with a particular DENV serotype. The goal of this study was to estimate and compare the prevalence of non-hemorrhagic clinical manifestations of DENV infection by serotype. Between the years 2005-2010, individuals with febrile disease from Peru, Bolivia, Ecuador, and Paraguay were enrolled in an outpatient passive surveillance study. Detailed information regarding clinical signs and symptoms, as well as demographic information, was collected. DENV infection was confirmed in patient sera with polyclonal antibodies in a culture-based immunofluorescence assay, and the infecting serotype was determined by serotype-specific monoclonal antibodies. Differences in the prevalence of individual and organ-system manifestations were compared across DENV serotypes. One thousand seven hundred and sixteen individuals were identified as being infected with DENV-1 (39.8%), DENV-2 (4.3%), DENV-3 (41.5%), or DENV-4 (14.4%). When all four DENV serotypes were compared with each other, individuals infected with DENV-3 had a higher prevalence of musculoskeletal and gastrointestinal manifestations, and individuals infected with DENV-4 had a higher prevalence of respiratory and cutaneous manifestations. Specific clinical manifestations, as well as groups of clinical manifestations, are often overrepresented by an individual DENV serotype.

  16. Pituitary adenoma after the gamma-knife radiosurgery : correlation of MRI findings with clinical manifestation

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Young Chan; Choi, Woo Suk; Kim, Eui Jong; Lim, Young Jin; Oh, Joo Hyeong; Yoon, Yup [Kyung Hee University Hospital, Seoul (Korea, Republic of)

    1998-06-01

    The purpose of this study is to evaluate changes in the MRI findings of pituitary adenoma after gamma-knife radiosurgery, and to correlate these with the clinical outcome. We evaluated the MRI findings of 27 patients with pituitary adenoma before and after gamma-knife radiosurgery. Their ages ranged from 16 to 69 years (M:F=8:19), and there were seven cases of microadenoma and 20 of macroadenoma. In 11 cases, the tumor was partially removed before radiosurgery. The follow-up period ranged from three to 43 months. In two cases of microadenoma, complete regression was seen after three and 12 months, respectively, with normalization of hormone levels and the improvement of symptoms. Among the remaining cases, in which no volume change was noted, hormone levels normalized in four. Among 20 cases of macroadenoma, volume reduction was reduced by 20 %, the mean follow-up period was 6.6 months, and in cases in which this was 50 %, the period was 15.3 months. On postenhanced T1W images, the most frequent patterns were rim enhancement (n=10; 50%) and homogeneous enhancement changed to rim enhancement (n=4; 20%). In six of nine cases (66.7%) of nonfunctioning macroadenomas, symptom improvement was noted. In six of 20 cases in which the enhancement pattern changed after gamma knife radiosurgery, there was clinical improvement. Among 14 cases in which there was no changes in the enhancement pattern, nine showed clinical improvement but five did not. The former showed a mean volume reduction of 62.5 % and the latter, 16.5 %. After gamma-knife radiosurgery, clinical improvement in microadenomas can be expected, regardless of volume change. The volume of macroadenomas decreased and a rim enhancement pattern was observed after gamma-knife radiosurgery. A marked reduction in the volume of a tumor, or a change in its enhancement pattern may indicate clinical improvement. (author). 12 refs., 4 figs.

  17. Correlation of Serotype-Specific Dengue Virus Infection with Clinical Manifestations

    Science.gov (United States)

    Halsey, Eric S.; Marks, Morgan A.; Gotuzzo, Eduardo; Fiestas, Victor; Suarez, Luis; Vargas, Jorge; Aguayo, Nicolas; Madrid, Cesar; Vimos, Carlos; Kochel, Tadeusz J.; Laguna-Torres, V. Alberto

    2012-01-01

    Background Disease caused by the dengue virus (DENV) is a significant cause of morbidity throughout the world. Although prior research has focused on the association of specific DENV serotypes (DENV-1, DENV-2, DENV-3, and DENV-4) with the development of severe outcomes such as dengue hemorrhagic fever and dengue shock syndrome, relatively little work has correlated other clinical manifestations with a particular DENV serotype. The goal of this study was to estimate and compare the prevalence of non-hemorrhagic clinical manifestations of DENV infection by serotype. Methodology and Principal Findings Between the years 2005–2010, individuals with febrile disease from Peru, Bolivia, Ecuador, and Paraguay were enrolled in an outpatient passive surveillance study. Detailed information regarding clinical signs and symptoms, as well as demographic information, was collected. DENV infection was confirmed in patient sera with polyclonal antibodies in a culture-based immunofluorescence assay, and the infecting serotype was determined by serotype-specific monoclonal antibodies. Differences in the prevalence of individual and organ-system manifestations were compared across DENV serotypes. One thousand seven hundred and sixteen individuals were identified as being infected with DENV-1 (39.8%), DENV-2 (4.3%), DENV-3 (41.5%), or DENV-4 (14.4%). When all four DENV serotypes were compared with each other, individuals infected with DENV-3 had a higher prevalence of musculoskeletal and gastrointestinal manifestations, and individuals infected with DENV-4 had a higher prevalence of respiratory and cutaneous manifestations. Conclusions/Significance Specific clinical manifestations, as well as groups of clinical manifestations, are often overrepresented by an individual DENV serotype. PMID:22563516

  18. Secondary caries in crowned teeth: correlation of clinical and radiographic findings.

    Science.gov (United States)

    Zoellner, Axel; Heuermann, Max; Weber, Hans-Peter; Gaengler, Peter

    2002-09-01

    The diagnostic value of radiographs for interproximal caries detection on nonrestored teeth is well investigated. However, little is known about the use of radiographs in the diagnosis of secondary caries localized at crown margins. The aim of this study was to correlate clinical findings with regard to secondary caries with the findings of a radiographic evaluation. One hundred randomly selected patients who underwent restorations with fixed prostheses and were exhibiting at least one secondary carious lesion were included in the study. A total of 820 restorations (test group, 730 interproximal surfaces of 365 single crowns and 910 interproximal surfaces of 455 fixed partial denture retainer crowns) and 1024 interproximal surfaces of 512 nonrestored teeth (control group) were investigated clinically, with the use of modified California Dental Association criteria, and radiographically for interproximal carious lesions. The extension of the lesions was rated to be initial (with no cavitation), early (with cavitation limited to orthodentin), or deep (with cavitation). The data were statistically analyzed for normal distribution, and the frequency of the findings was calculated in absolute numbers and as a percentage. Statistically significant differences were determined by use of the chi(2) test (Pcaries and the duration of the crowns in situ. Secondary caries was diagnosed clinically in 11.2% of 1640 interproximal surfaces but only in 8.3% radiographically. In contrast, the frequency of interproximal carious lesions diagnosed clinically in nonrestored teeth increased with the use of radiographs from 3.3% to 4.1%. Within the limits of this study, the results confirm that radiographs improve the diagnostic sensitivity for interproximal caries in nonrestored teeth. However, for the diagnosis of secondary caries in crowned teeth, the clinical examination is more reliable than the radiographic evaluation.

  19. Determination and clinical correlation of markers of inflammation in unvaccinated patients with varicella-zoster infection.

    Science.gov (United States)

    Karadag Oncel, E; Kara, A; Celik, M; Karahan, S; Cengiz, A B; Ceyhan, M

    2013-01-01

    Chicken pox is commonly known as a benign exenthamatous disease of childhood, occasionally neurologic or hemorrhagic complications, or even death may ensue. Early predictors of severity of disease have yet to be identified. TNF-alpha and IL-6 stimulate virus-specific immunoglobulin production and it has been postulated that determination of levels of these cytokines may be useful as a prognostic factor. Patients who were diagnosed with a varicella-zoster virus (VZV) infection in the Outpatient Clinic of the Department of Pediatric Infectious Diseases were evaluated for eligibility. Laboratory assays included an evaluation of complete blood counts, erythrocyte-sedimentation rate (ESR), c reactive protein (CRP), and the number of tumor necrosis factor-alpha/interleukin-6-(TNF-alpha/IL-6-) producing mononuclear cells as determined by flow cytometry. A total of 339 patients (320 with chickenpox and 19 with shingles) were enrolled. Blood samples could only be obtained from 81 of the 320 patients with chickenpox. Patients were also divided into three groups depending on the number of skin (vesicular) lesions. (group 1, ≤ 50 lesions; group 2, 51-100 lesions; group 3, >100 lesions). Correlation analyses did not reveal the presence of a statistically significant correlation between number of skin lesions with either of white blood cells (WBC) count (p = 0.231), ESR (p = 0.879) or CRP (p = 0.373). The mean percentage of TNF-alpha-producing mononuclear cells was significantly higher in group 2 compared to group 3 (p = 0.003). A similar difference was observed with regard to IL-6-producing mononuclear cells, albeit bordering on statistical significance (p = 0.058). Decreased expression of the cytokines TNF-alpha and IL-6 may be responsible for the development of a more severe clinical picture in patients with VZV infection, and determination of intracellular levels of these cytokines may be of benefit for early identification of patients who may have a more severe clinical

  20. Undiagnosed depression and its correlates in a predominantly immigrant Hispanic neurology clinic.

    Science.gov (United States)

    Sahai-Srivastava, Soma; Zheng, Ling

    2011-10-01

    Previous studies have reported a high incidence of depression in neurology clinics, however areas where there are predominantly underserved immigrants have not been studied. Retrospective cohort study in an academic outpatient neurology clinic in Los Angeles, California. Newly referred patients (N=318) were assessed consecutively for depression using a PHQ-9 questionnaire, accompanied by review of the assessment of the depressive disorder. The patient cohort consisted of 190 females (59%) and 130 males (41%), primarily of Hispanic descent (72%), with 8% Asian 11% white, and 5% African-American. Sixty-eight percent (68%) had depression, with 40% exhibiting moderate to severe depression. Patients who had moderate to severe depression (based on PHQ-9) were more likely to be unemployed (75.2% vs. 60.7%, p=0.008), dependent on government income (29.5% vs. 20.4%, p=0.06), and have headache or pain as the reason for referral (42.4% vs. 28.5%, p=0.03). Severity of depression also significantly correlated with current treatment by psychiatrist, current antidepressant use, and less independent living. Patients with moderate to severe depression were more likely to have made ER visits in the last 12 months (0.9 vs. 0.7, p=0.01) and were taking more medications (3.3 vs. 2.5, p=0.03), compared to patient with mild or no depression. The presence of moderate to severe depression significantly correlated with socioeconomic status, use of emergency room, and presence of headache/pain. Neurology clinics with predominantly underserved immigrant patients have a disproportionate amount of depression, which may be related to socioeconomic factors resulting in overutilization of scarce healthcare resources. Copyright © 2011 Elsevier B.V. All rights reserved.

  1. Clinical correlates of social adjustment in patients with obsessive-compulsive disorder.

    Science.gov (United States)

    Rosa, Ana Carolina; Diniz, Juliana Belo; Fossaluza, Victor; Torres, Albina Rodrigues; Fontenelle, Leonardo Franklin; De Mathis, Alice Simões; da Conceição Rosário, Maria; Miguel, Eurípedes Constantino; Shavitt, Roseli Gedanke

    2012-10-01

    Patients with obsessive-compulsive disorder (OCD) frequently show poor social adjustment, which has been associated with OCD severity. Little is known about the effects that age at symptom onset, specific OCD symptoms, and psychiatric comorbidities have on social adjustment. The objective of this study was to investigate the clinical correlates of social functioning in OCD patients. Cross-sectional study involving 815 adults with a primary DSM-IV diagnosis of OCD participating in the Brazilian Research Consortium on Obsessive-Compulsive Spectrum Disorders. Patients were assessed with the Social Adjustment Scale, the Medical Outcomes Study 36-item Short-Form Health Survey, the Yale-Brown Obsessive-Compulsive Scale, the Dimensional Yale-Brown Obsessive-Compulsive Scale, and the Structured Clinical Interview for DSM-IV Axis I Disorders. Clinical correlates of social adjustment were assessed with generalized linear models with gamma distribution. Poor overall social functioning was associated with greater OCD severity (p = 0.02); hoarding symptoms (p = 0.004); sexual/religious obsessions (p = 0.005); current major depressive disorder (p = 0.004); current post-traumatic stress disorder (p = 0.002); and current eating disorders (p = 0.02). Poor social adjustment was also associated with impaired quality of life. Patients with OCD have poor social functioning in domains related to personal relationships and professional performance. Hoarding symptoms and sexual/religious obsessions seem to have the strongest negative effects on social functioning. Early age at OCD symptom onset seems to be associated with professional and academic underachievement and impairment within the family unit, whereas current psychiatric comorbidity worsen overall social functioning. In comparison with quality of life, social adjustment measures seem to provide a more comprehensive overview of the OCD-related burden. Copyright © 2012 Elsevier Ltd. All rights reserved.

  2. Temporal bone trauma: correlative study between CT findings and clinical manifestations

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jung Hee; Kim, Hyung Jin; Kim, Jae Hyoung [College of Medicine, Gyeongsang National University, Jinju (Korea, Republic of)

    1994-11-15

    To assess how accurately computed tomography (CT) can demonstrate the abnormal findings which are believed to cause the clinical signs and symptoms of hearing loss (HL), vertigo and facial paralysis (FP) in patients with temporal bone trauma. The authors studied CT scans of 39 ears in 35 patients with temporal bone trauma. CT scans were performed with 1-1.5 mm slice thickness and table incrementation. Both axial and coronal scans were obtained in 32 patients and in three patients only axial scans were obtained. We analyzed CT with special reference to the structural abnormalities of the external auditory canal, middle ear cavity, bony labyrinth, and facial nerve canal, and correlated these findings with the actual clinical signs and symptoms. As to hearing loss, we evaluated 32 ears in which pure tone audiometry or brainstem evoked response audiometry had been performed. With respect to the specific types of HL, CT accurately showed the abnormalities in 84% (16/19) in conductive HL, 100% (2/2) in sensorineural HL, and 25% (2/8) for mixed HL. When we categorized HL simply as conductive and sensorineural, assuming that mixed be the result of combined conductive and sensorineural HL, CT demonstrated the abnormalities in 89% (24/27) for conductive HL and 50% (5/10) for sensorineural HL. Concerning vertigo and FP, CT demonstrated abnormalities in 67%(4/6), and 29% (4/14), respectively. Except for conductive HL, CT seems to have a variable degree of limitation for the demonstration of the structural abnormalities resulting sensorineural HL, vertigo or facial paralysis. It is imperative to correlate the CT findings with the signs and symptoms in those clinical settings.

  3. Polysomnographic Findings and Clinical Correlates in Huntington Disease: A Cross-Sectional Cohort Study

    Science.gov (United States)

    Piano, Carla; Losurdo, Anna; Della Marca, Giacomo; Solito, Marcella; Calandra-Buonaura, Giovanna; Provini, Federica; Bentivoglio, Anna Rita; Cortelli, Pietro

    2015-01-01

    Study Objectives: To evaluate the sleep pattern and the motor activity during sleep in a cohort of patients affected by Huntington disease (HD). Design: Cross-sectional cohort study. Setting: Sleep laboratory. Patients: Thirty HD patients, 16 women and 14 men (mean age 57.3 ± 12.2 y); 30 matched healthy controls (mean age 56.5 ± 11.8 y). Interventions: Subjective sleep evaluation: Epworth Sleepiness Scale (ESS); Berlin's Questionnaire, interview for restless legs syndrome (RLS), questionnaire for REM sleep behavior disorder (RBD). Clinical evaluation: disease duration, clinical severity (unified Huntington disease motor rating scale [UHDMRS]), genetic tests. Laboratory-based full-night attended video-polysomnography (V-PSG). Measurements and Results: The duration of the disease was 9.4 ± 4.4 y, UHMDRS score was 55.5 ± 23.4, CAG repeats were 44.3 ± 4.1. Body mass index was 21.9 ± 4.0 kg/m2. No patients or caregivers reported poor sleep quality. Two patients reported symptoms of RLS. Eight patients had an ESS score ≥ 9. Eight patients had high risk of obstructive sleep apnea. At the RBD questionnaire, two patients had a pathological score. HD patients, compared to controls, showed shorter sleep, reduced sleep efficiency index, and increased arousals and awakenings. Four patients presented with sleep disordered breathing (SDB). Periodic limb movements (PLMs) during wake and sleep were observed in all patients. No episode of RBD was observed in the V-PSG recordings, and no patients showed rapid eye movement (REM) sleep without atonia. The disease duration correlated with ESS score (P Marca G, Solito M, Calandra-Buonaura G, Provini F, Bentivoglio AR, Cortelli P. Polysomnographic findings and clinical correlates in Huntington disease: a cross-sectional cohort study. SLEEP 2015;38(9):1489–1495. PMID:25845698

  4. Paediatric Obsessive-Compulsive Disorder and Depressive Symptoms: Clinical Correlates and CBT Treatment Outcomes.

    Science.gov (United States)

    Brown, H M; Lester, K J; Jassi, A; Heyman, I; Krebs, G

    2015-07-01

    Depression frequently co-occurs with paediatric obsessive-compulsive disorder (OCD), yet the clinical correlates and impact of depression on CBT outcomes remain unclear. The prevalence and clinical correlates of depression were examined in a paediatric specialist OCD-clinic sample (N = 295; Mean = 15 [7 - 18] years, 42 % female), using both dimensional (Beck Depression Inventory-youth; n = 261) and diagnostic (Development and Wellbeing Assessment; n = 127) measures of depression. The impact of depressive symptoms and suspected disorders on post-treatment OCD severity was examined in a sub-sample who received CBT, with or without SSRI medication (N = 100). Fifty-one per-cent of patients reported moderately or extremely elevated depressive symptoms and 26 % (95 % CI: 18 - 34) met criteria for a suspected depressive disorder. Depressive symptoms and depressive disorders were associated with worse OCD symptom severity and global functioning prior to CBT. Individuals with depression were more likely to be female, have had a psychiatric inpatient admission and less likely to be attending school (ps depressive symptom severity significantly decreased after CBT. Depressive symptoms and depressive disorders predicted worse post-treatment OCD severity (βs = 0.19 and 0.26, ps Depression is common in paediatric OCD and is associated with more severe OCD and poorer functioning. However, depression severity decreases over the course of CBT for OCD and is not independently associated with worse outcomes, supporting the recommendation for treatment as usual in the presence of depressive symptoms.

  5. Prevalence of insomnia and its clinical correlates in a general population in Turkey.

    Science.gov (United States)

    Benbir, Gulcin; Demir, Ahmet Ugur; Aksu, Murat; Ardic, Sadik; Firat, Hikmet; Itil, Oya; Ozgen, Fuat; Yılmaz, Hikmet; Karadeniz, Derya

    2015-09-01

    The prevalence of insomnia is influenced by environmental factors. This study aimed to investigate the prevalence of insomnia and its sociodemographic and clinical correlates in a general population-based survey in Turkey. This population-based study included 4758 subjects among 5021 who participated in the Turkish Adult Population Epidemiology of Sleep Disorders study. Questionnaire items evaluating insomnia were adapted from the International Classification of Sleep Disorders II and the DSM-IV-TR. Subjects with restless legs syndrome were excluded. Insomnia was found to be associated with older age (18-24 years, 9.8%; 25-44 years, 11.7%; 45-64 years, 13.8%; 65 years or older, 13.9%), lower income level (<500 USD, 16.5%), time spent watching TV (6-8 h or more, 18.4%), tea consumption in the evening (≥6 glasses, 14.5%) and smoking status (current and ex-smoker, both 14.2%) in multiple logistic regression analysis. In respect to other medical disorders, insomnia was significantly associated with the presence of hypertension, diabetes and heart diseases after the adjustment for relevant risk factors for each disease, across all age and sex groups. Insomnia is a major health problem in our population, affecting subjects in the working age group and those of lower socioeconomic status. It should especially be screened in patients with chronic diseases. A relatively low proportion of insomnia diagnosed as a sleep disorder suggests that this condition and its clinical correlates are possibly under-recognized. © 2014 The Authors. Psychiatry and Clinical Neurosciences © 2014 Japanese Society of Psychiatry and Neurology.

  6. 77 FR 59911 - Request To Make Special Program for the Law School Clinic Certification Patent Pilot Program

    Science.gov (United States)

    2012-10-01

    ...The United States Patent and Trademark Office (USPTO) is implementing a pilot program in which a law school clinic participating in the USPTO Law School Clinic Certification Pilot Program may file an application for a pro bono client of the law school clinic and that applicant's application may be advanced out of turn (accorded special status) for examination. Each school participating in the patent pilot program would be allotted up to two applications to be examined out of turn per semester. The total number of applications to be examined out of turn by law school clinics participating in the USPTO Law School Clinic Certification Pilot Program is limited to sixty-four per year.

  7. Serial blood T cell repertoire alterations in multiple sclerosis patients; correlation with clinical and MRI parameters.

    Science.gov (United States)

    Laplaud, David-Axel; Berthelot, Laureline; Miqueu, Patrick; Bourcier, Kasia; Moynard, Julien; Oudinet, Yannick; Guillet, Marina; Ruiz, Catherine; Oden, Neal; Brouard, Sophie; Guttmann, Charles R G; Weiner, Howard L; Khoury, Samia J; Soulillou, Jean-Paul

    2006-08-01

    A significant skewing of the peripheral T cell repertoire has been shown in relapsing-remitting multiple sclerosis (MS). Most of the studies already performed in this field are cross-sectional and therefore, little is known of the T cell repertoire evolution over time in MS and the correlation of T cell repertoire variation with clinical and MRI parameters. This study was performed on serially harvested frozen PBMC from nine untreated MS patients (27 samples) and 14 healthy individuals. The blood T cell repertoire of each patient was analysed at the complementarity determining region 3 (CDR3) level and compared with a monthly MRI scan performed over a six month period with assessment of T2 lesion load and gadolinium enhancing lesions. A highly significant blood T cell repertoire skewing was observed in MS patients as compared with healthy controls (p<0.01). In addition, the number of altered Vbeta families correlated significantly with both the T2 lesion volume and the number of gadolinium enhancing lesions as assessed by MRI (Spearman correlation tests, r=0.51 and r=0.44, p<0.01 and p<0.05 respectively). Furthermore, the variation of the number of altered Vbeta families over time also correlated with the appearance of new gadolinium enhancing lesions (r=0.36, p=0.05). These findings which need confirmation on larger serial cohorts, suggest an association between the magnitude of TCRBV CDR3 length distribution alterations in the peripheral blood of MS patients and the disease process.

  8. Genotypic Diversity of Clinical Actinomyces Species: Phenotype, Source, and Disease Correlation among Genospecies

    Science.gov (United States)

    Clarridge III, Jill E.; Zhang, Qing

    2002-01-01

    We determined the frequency distribution of Actinomyces spp. recovered in a routine clinical laboratory and investigated the clinical significance of accurate identification to the species level. We identified 92 clinical strains of Actinomyces, including 13 strains in the related Arcanobacterium-Actinobaculum taxon, by 16S rRNA gene sequence analysis and recorded their biotypes, sources, and disease associations. The clinical isolates clustered into 21 genogroups. Twelve genogroups (74 strains) correlated with a known species, and nine genogroups (17 strains) did not. The individual species had source and disease correlates. Actinomyces turicensis was the most frequently isolated species and was associated with genitourinary tract specimens, often with other organisms and rarely with inflammatory cells. Actinomyces radingae was most often associated with serious, chronic soft tissue abscesses of the breast, chest, and back. Actinomyces europaeus was associated with skin abscesses of the neck and genital areas. Actinomyces lingnae, Actinomyces gravenitzii, Actinomyces odontolyticus, and Actinomyces meyeri were isolated from respiratory specimens, while A. odontolyticus-like strains were isolated from diverse sources. Several of the species were commonly coisolated with a particular bacterium: Actinomyces israelii was the only Actinomyces spp. coisolated with Actinobacillus (Haemophilus) actinomycetemcomitans; Actinomyces meyeri was coisolated with Peptostreptococcus micros and was the only species other than A. israelii associated with sulfur granules in histological specimens. Most genogroups had consistent biotypes (as determined with the RapID ANA II system); however, strains were misidentified, and many codes were not in the database. One biotype was common to several genogroups, with all of these isolates being identified as A. meyeri. Despite the recent description of new Actinomyces spp., 19% of the isolates recovered in our routine laboratory belonged to

  9. Clinical evidence of parietal cortex dysfunction and correlation with extent of allodynia in CRPS type 1.

    Science.gov (United States)

    Cohen, H; McCabe, C; Harris, N; Hall, J; Lewis, J; Blake, D R

    2013-04-01

    Unusual symptoms such as digit misidentification and neglect-like phenomena have been reported in complex regional pain syndrome (CRPS), which we hypothesized could be explained by parietal lobe dysfunction. Twenty-two patients with chronic CRPS attending an in-patient rehabilitation programme underwent standard neurological examination followed by clinical assessment of parietal lobe function and detailed sensory testing. Fifteen (68%) patients had evidence of parietal lobe dysfunction. Six (27%) subjects failed six or more test categories and demonstrated new clinical signs consistent with their parietal testing impairments, which were impacting significantly on activities of daily living. A higher incidence was noted in subjects with >1 limb involvement, CRPS affecting the dominant side and in left-handed subjects. Eighteen patients (82%) had mechanical allodynia covering 3-57.5% of the body surface area. Allochiria (unilateral tactile stimulation perceived only in the analogous location on the opposite limb), sensory extinction (concurrent bilateral tactile stimulation perceived only in one limb), referred sensations (unilateral tactile stimulation perceived concurrently in another discrete body area) and dysynchiria (unilateral non-noxious tactile stimulation perceived bilaterally as noxious) were present in some patients. Greater extent of body surface allodynia was correlated with worse parietal function (Spearman's rho = -0.674, p = 0.001). In patients with chronic CRPS, detailed clinical examination may reveal parietal dysfunction, with severity relating to the extent of allodynia. © 2012 European Federation of International Association for the Study of Pain Chapters.

  10. Clinically Distinct Phenotypes of Canavan Disease Correlate with Residual Aspartoacylase Enzyme Activity.

    Science.gov (United States)

    Mendes, Marisa I; Smith, Desirée Ec; Pop, Ana; Lennertz, Pascal; Fernandez Ojeda, Matilde R; Kanhai, Warsha A; van Dooren, Silvy Jm; Anikster, Yair; Barić, Ivo; Boelen, Caroline; Campistol, Jaime; de Boer, Lonneke; Kariminejad, Ariana; Kayserili, Hulya; Roubertie, Agathe; Verbruggen, Krijn T; Vianey-Saban, Christine; Williams, Monique; Salomons, Gajja S

    2017-05-01

    We describe 14 patients with 12 novel missense mutations in ASPA, the gene causing Canavan disease (CD). We developed a method to study the effect of these 12 variants on the function of aspartoacylase-the hydrolysis of N-acetyl-l-aspartic acid (NAA) to aspartate and acetate. The wild-type ASPA open reading frame (ORF) and the ORFs containing each of the variants were transfected into HEK293 cells. Enzyme activity was determined by incubating cell lysates with NAA and measuring the released aspartic acid by LC-MS/MS. Clinical data were obtained for 11 patients by means of questionnaires. Four patients presented with a non-typical clinical picture or with the milder form of CD, whereas seven presented with severe CD. The mutations found in the mild patients corresponded to the variants with the highest residual enzyme activities, suggesting that this assay can help evaluate unknown variants found in patients with atypical presentation. We have detected a correlation between clinical presentation, enzyme activity, and genotype for CD. © 2017 The Authors. **Human Mutation published by Wiley Periodicals, Inc.

  11. Bacterial meningitis in newborn and infant: correlation between organism, CT findings and clinical outcome

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Hye Young; Park, Young Seo; Yoo, Shi Joon; Suh, Dae Chul; Chung, Young Kyo [College of Medicine, University of Ulsan, Seoul (Korea, Republic of)

    1993-03-15

    Acute bacterial meningitis often results in significant neurologic complications regardless of the antibiotics treatment Computed tomographic (CT) finding of tuberculous meningitis is fairly well known but not the findings of bacterial meningitis. This study was performed to determine the incidence of causative organisms and to correlate between the organisms and computed tomographic (CT) findings with clinical outcome of bacterial meningitis in newborns and infants. We analyzed the brain CT and clinical records of 15 infants who had been diagnosed as bacterial meningitis by CSF culture. We found that the most common organisms were Group B streptococcus in neonates without no neurologic complications in all but one and Hemophilus influenza in infants whose clinical outcomes were poor in all except one. CT findings related with poor prognosis in this study were cerebral edema, basal cisternal obliteration and enhancement, and cerebral infarction on initial CT and ventriculomegaly on follow-up CT. We concluded that CT diagnosed intracranial complications of bacterial meningitis well and could contributed to better treatment of bacterial meningitis.

  12. Correlation of technical difficulty during embryo transfer with rate of clinical pregnancy

    Directory of Open Access Journals (Sweden)

    Neeta Singh

    2012-01-01

    Full Text Available Aim: To correlate the ease or difficulty of embryo transfer and blood at catheter tip with pregnancy rate when embryo transfer (ET was performed by the same operator using soft catheter. Materials and Methods: A retrospective analysis of 342 patients who underwent in vitro fertilization or ICSI cycle from January 2008 to December 2010 in a single centre was done. The type of transfer was divided into two groups: ′easy′ or ′difficult′. Transfer was considered difficult when additional instrumentation was required or firmer catheter was used or required changing of catheter. Patients undergoing cryo-preserved ET were excluded from the study. Results: On the day of transfer in 284 (83% patients, ET was easy and difficulty was encountered in 58 (17% patients. Blood at catheter was seen in 101 (29.53% patients. In the group of 58 difficult transfers, 10 pregnancies resulted with a clinical pregnancy rate of 17.2%, while 67 pregnancies resulted in 284 cycles of easy transfer with clinical pregnancy rate of 23.6% (P value = 0.045. While no significant difference was seen in pregnancies with blood on outer catheter and blood less transfer, there was significant reduction in pregnancy rate when blood was present on catheter tip compared to bloodless transfer (13.3% v/s 24.1; P value = 0.032. Conclusion: Reduction in clinical pregnancy rate is seen with difficult ETs, more when blood is present at the catheter tip.

  13. Clinical correlates of oppositional defiant disorder and attention-deficit/hyperactivity disorder in adults.

    Science.gov (United States)

    Weiss, Margaret D; Wasdell, Michael; Gadow, Kenneth D; Greenfield, Brian; Hechtman, Lily; Gibbins, Chris

    2011-03-01

    Oppositional defiant disorder (ODD) is a common comorbidity of attention-deficit/hyperactivity disorder (ADHD) in both children and adolescents. Although there is research demonstrating that ADHD persists into adulthood, less is known about the frequency of its persistence, clinical characteristics, and impairment when associated with comorbid ODD in adults with ADHD. Data from a randomized clinical trial of adults with ADHD were analyzed to determine the prevalence and clinical correlates of comorbid ODD. As per the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria, patients who reported having ≥ 4 symptoms "often" or "very often" were classified as meeting the symptom criteria for the disorder. Forty percent of this sample met symptom criteria for ODD. Subjects with ODD were more likely to have other comorbid disorders, lower investigator ratings of overall functioning, and lower patient life satisfaction (P < 0.05). A regression analysis using these variables predicted 40% of the variance of ODD as a comorbid condition in addition to ADHD. Although the presence or absence of ODD at baseline does not moderate response of ADHD symptoms with treatment, improvement in ODD symptoms was mediated by improvement in ADHD symptoms (P < 0.0001). Oppositional defiant disorder treatment was more responsive to dextroamphetamine than paroxetine, despite the contribution of irritability and reactive tantrums, as symptoms of the disorder. Oppositional defiant disorder is a valid and impairing disorder requiring evaluation and treatment in adults.

  14. Correlation between the severity of critically ill patients and clinical predictors of bronchial aspiration

    Science.gov (United States)

    de Medeiros, Gisele Chagas; Sassi, Fernanda Chiarion; Zambom, Lucas Santos; de Andrade, Claudia Regina Furquim

    2016-01-01

    Objective: To determine whether the severity of non-neurological critically ill patients correlates with clinical predictors of bronchial aspiration. Methods: We evaluated adults undergoing prolonged orotracheal intubation (> 48 h) and bedside swallowing assessment within the first 48 h after extubation. We collected data regarding the risk of bronchial aspiration performed by a speech-language pathologist, whereas data regarding the functional level of swallowing were collected with the American Speech-Language-Hearing Association National Outcome Measurement System (ASHA NOMS) scale and those regarding health status were collected with the Sequential Organ Failure Assessment (SOFA). Results: The study sample comprised 150 patients. For statistical analyses, the patients were grouped by ASHA NOMS score: ASHA1 (levels 1 and 2), ASHA2 (levels 3 to 5); and ASHA3 (levels 6 and 7). In comparison with the other patients, those in the ASHA3 group were significantly younger, remained intubated for fewer days, and less severe overall clinical health status (SOFA score). The clinical predictors of bronchial aspiration that best characterized the groups were abnormal cervical auscultation findings and cough after swallowing. None of the patients in the ASHA 3 group presented with either of those signs. Conclusions: Critically ill patients 55 years of age or older who undergo prolonged orotracheal intubation (≥ 6 days), have a SOFA score ≥ 5, have a Glasgow Coma Scale score ≤ 14, and present with abnormal cervical auscultation findings or cough after swallowing should be prioritized for a full speech pathology assessment. PMID:27167432

  15. Clinical correlates of tuberculosis co-infection in HIV-infected children hospitalized in Peru.

    Science.gov (United States)

    Ramírez-Cardich, María E; Kawai, Vivian; Oberhelman, Richard A; Bautista, Christian T; Castillo, María E; Gilman, Robert H

    2006-07-01

    In developing countries, tuberculosis (TB) is responsible for almost 250,000 deaths among children yearly. Active TB in children with human immunodeficiency virus (HIV) infection is difficult to diagnose and progresses rapidly to death. The aim of this preliminary study was to investigate the prevalence and clinical correlates of TB-related illness among HIV-infected children admitted to an infectious diseases ward in Peru, a country where TB is highly endemic. Forty-seven HIV-infected children admitted for a suspected infectious process in a Peruvian hospital were investigated for evidence of clinical tuberculosis by auramine stain, culture, and polymerase chain reaction (PCR) of clinical specimens. Eight children (17%) had evidence of tuberculosis, including five with positive cultures and three with positive PCR tests only. Weight loss was the only feature associated with a positive test for tuberculosis. Radiological changes were very common in both TB-positive and TB-negative groups and these changes were not useful to identify TB-positive cases. Weight loss may be used to identify high-risk HIV positive children who require more aggressive evaluation for tuberculosis. Radiological changes were common in both TB-positive and TB-negative groups.

  16. [Dilatation of Virchow-Robin perivascular spaces (types III cerebral lacunae): radio-clinical correlations].

    Science.gov (United States)

    Marnet, D; Noudel, R; Peruzzi, P; Bazin, A; Bernard, M H; Scherpereel, B; Pluot, M; Rousseaux, P

    2007-05-01

    Virchow-Robin spaces are pia-lined extensions of the subarachnoid space surrounding the path of brain vessels. When enlarged, such dilated perivascular spaces are often seen as foci of cerebrospinal fluid signal on MRI or CT scan. These foci are found in patients with miscellaneous clinical status. It is necessary to determine the radiological significance and clinical associations, if any, in such patients in order to give them the appropriate treatment. We describe the clinical and radiological findings of five patients and review the literature on perivascular Virchow-Robin spaces. The mechanisms of dilated Virchow-Robin spaces are still not well understood. Such dilated perivascular spaces are found in two locations: typically in the high-convexity white matter of healthy elderly subjects, or surrounding the lenticulostriate vessels as they enter the basal ganglia. On MR images, they may be confused with lacunar infarcts. Most of the patients present with no symptoms: small dilatations located in the high convexity actually represent an anatomic variant, also called "état criblé". Sometimes, giant dilatations, or Poirier's type IIIb "expanding lacunae", found in the basal ganglia and midbrain may result in symptomatic hydrocephalus needing appropriate treatment. For other miscellaneous symptoms as headache, generalized epilepsy, dysmorphy, macrocephaly, there is no reliable correlation with enlarged perivascular spaces seen on MR images. The real symptomatic dilated perivascular spaces need appropriate and quick treatment. Most of the other patients present with no symptoms and will remain asymptomatic.

  17. Correlation between the ossification of nuchal ligament and clinical cervical disorders

    Directory of Open Access Journals (Sweden)

    Yu-Lin Tsai

    2012-10-01

    Full Text Available This is a correlation analysis between severity of the ossification of the nuchal ligament (ONL and clinical cervical disorders including neck dysfunction, cervical malalignment, and morphologic changes of the cervical neural foramen (CNF. The clinical effects of ONL on active range of motion (AROM of neck, cervical radiculopathy, abnormal cervical curvature, and the degree of CNF stenosis in patients with painful neck stiffness are investigated. Studies have investigated the predisposing factors to cervical dysfunction and degenerative disorders; however, few studies have examined the influence of the ONL on neck function and cervical spine. A total of 31 participants with painful neck stiffness were recruited. They accepted measurement of cervical AROM and serial cervical radiographs at anterior–posterior view, lateral view, and bilateral oblique views. Parameters of radiographs measurement included cervical lordotic curve, and cross-sectional areas (CSA of the ONL and CNF (C2–C3, C4–C5, C5–C6, and C6–C7 levels. The ratio of CSA of the lower CNF (C4–C5, C5–C6, C6–C7 to CSA of the upper CNF (C2–C3 was used as a CNF stenosis ratio. The correlations of ONL size, neck symptoms, cervical AROM, lordotic curve, and CNF stenosis ratio were analyzed. More than half of all patients were positive in cervical root signs and prone to have larger ONL. Neck AROM of all participants was significantly below normal average in all directions, and a moderate negative association was found between the ONL CSA and AROM in flexion–extension. Most patients had moderate loss of cervical lordotic curve despite there being no significant correlation between ONL CSA and cervical curvature. Moreover, CNF stenosis ratio significantly negatively correlated with ONL CSA. Patients with larger ONL had more severe cervical radiculopathy, more stiffness in flexion–extension direction, more complex degenerative change of spine, and worse CNF stenosis.

  18. Improved clinical outcomes using a culturally sensitive diabetes education program in a Hispanic population.

    Science.gov (United States)

    Metghalchi, Shiva; Rivera, Maribet; Beeson, Larry; Firek, Anthony; De Leon, Marino; Balcazar, Hector; Cordero-MacIntyre, Zaida R

    2008-01-01

    The purpose of this study was to evaluate the effects of a culturally sensitive diabetes education program for Hispanics with type 2 diabetes. This study is a prospective cohort study to test the impact of a comprehensive diabetes education program on blood glucose control on Hispanics with type 2 diabetes. The educational program focused on maintaining glycemic control and general aspects of managing diabetes and complications. The study participants were recruited by flyers placed in Hispanic markets and in ambulatory care clinics. A total of 34 Hispanic male and female subjects with type 2 diabetes participated in the study. The concentrations of glucose, insulin, hemoglobin A1c (HbA1c), total cholesterol, triglycerides, low-density lipoprotein and high-density lipoprotein (HDL) cholesterol were analyzed at baseline and at 3 months. A significant mean change was observed for HbA1c, fasting plasma glucose, cholesterol/HDL ratio, and HDL after 3 months of education compared with baseline. There were significant reductions in weight, total fat, percent fat, trunk fat, and waist-to-hip ratio compared with baseline. After 3 months, subjects showed a significant positive correlation between changes in body mass index and insulin and weight, total fat, trunk fat, and fat free mass and insulin. A culturally sensitive program conducted in Spanish had a significant impact on important clinical parameters in Hispanic subjects with diabetes in a relatively short time period. The study demonstrates the importance of designing education intervention studies that are sensitive to cultural diversity, particularly in at-risk diabetic subjects.

  19. High Plasma Levels of Neuropeptide Y Correlate With Good Clinical Outcome But are not Correlated to Cerebral Blood Flow or Vasospasm After Subarachnoid Hemorrhage

    DEFF Research Database (Denmark)

    Rasmussen, Rune; Stavngaard, Trine; Jessing, Iben R

    2016-01-01

    and a role of NPY in the development of DCI has been proposed. This study investigated the relationship between plasma-NPY and cerebral blood flow (CBF), cerebral vasospasm, DCI, and clinical outcome. METHODS: In 90 patients with subarachnoid hemorrhage, NPY was measured in peripheral blood days 2 to 11. Any...... reduced plasma-NPY and DCI reached borderline statistical significance (P=0.05). Increased levels of NPY measured on days 2 to 4 were correlated to good outcome (P=0.006). CONCLUSIONS: Our findings in peripheral blood were not supportive of a causal relationship between NPY secretion and DCI. Although...... high levels of plasma-NPY were correlated with good clinical outcome, NPY did not show promise as a clinically useful biomarker....

  20. Correlates of symptoms of depression and anxiety among clinic patients in western Jamaica.

    Science.gov (United States)

    Monroe, C E; Affuso, O; Martin, M Y; Aung, M; Crossman, L; Jolly, P E

    2013-07-01

    There is a paucity of studies on psychosocial disorders in clinic populations in Jamaica. Therefore, we sought to determine the prevalence and correlates of symptoms of depression and anxiety in a clinic population in western Jamaica. A total of 338 participants from four outpatient clinics of : A total of 338 participants from four outpatient clinics of the Western Regional Health Authority (WRHA) were screened for symptoms of depression and anxiety using questions from the Beck Depression Inventory-II and the Beck Anxiety Inventory. The Chi-square test was used to examine differences in symptoms of anxiety and depression by gender. Multivariate linear and logistic regression were used to examine the associations between symptoms and sociodemographic variables with significance set at p<0.05. Approximately 30% of participants had moderate or severe depression symptoms while 18.6% had moderate or severe anxiety symptoms. Participants aged 30-39 years were more likely than older participants to have moderate or severe anxiety symptoms (odds ratio [OR]: 2.0, 95% confidence interval [CI]: 1.39, 5.56). Women reported a statistically significant higher prevalence of anxiety symptoms (10.0% vs 7.1%, p = 0.003). There was also a statistically significant difference between anxiety means by gender. Furthermore, income was found to be a significant predictor of anxiety for women only (p = 0.0113). Married persons were more likely than those who had never married to have moderate or severe anxiety symptoms (OR: 2.57, 95% CI: 1.14, 5.76). Our findings suggest that the prevalence of depression may be higher than global estimates in similar outpatient settings. Screening and intervention efforts may need to focus on younger persons, women, and married persons.

  1. Real-time polymerase chain reaction correlates well with clinical diagnosis of Clostridium difficile infection.

    Science.gov (United States)

    Berry, N; Sewell, B; Jafri, S; Puli, C; Vagia, S; Lewis, A M; Davies, D; Rees, E; Ch'ng, C L

    2014-06-01

    To determine the clinical utility of a rapid molecular assay for Clostridium difficile infection (CDI) in an acute hospital setting. From March to September 2011, stool specimens from inpatients in two acute hospitals with suspected CDI were tested prospectively by routine cell culture cytotoxin neutralization assay (CCNA), real-time polymerase chain reaction (PCR) using the GeneXpert (Cepheid Inc., Sunnyvale, CA, USA), and a dual testing algorithm [glutamate dehydrogenase (GDH)/toxin enzyme immuno-assay, Premier, Launch Diagnostics, Longfield, UK]. All patients with positive PCR, CCNA or discrepant results were reviewed by a multi-disciplinary team (treating clinician, gastroenterologist, microbiologist and infection control nurse). C. difficile detection rates were 11.7% (PCR), 6% (CCNA) and 13.8% (GDH). Out of 1034 stool specimens included in the study, 974 (94.1%) had concordant CCNA and PCR results. Eighty-nine percent (886/985) had concordant CCNA, PCR and GDH results, and 94.4% (930/985) had concordant GDH and PCR results. Using clinical diagnosis as the reference, PCR had sensitivity of 99.1%, specificity of 98.9%, positive predictive value (PPV) of 91.9% and negative predictive value (NPV) of 99.9%. CCNA on a single sample had sensitivity of 51%, specificity of 99.4%, PPV of 91.9% and NPV of 94.3%. GDH had sensitivity of 83.8%, specificity of 94.5%, PPV of 64.7% and NPV of 97.9%. Almost twice as many patients were positive by PCR compared with CCNA (121 vs 62); 54/59 of those with discrepant results were clinically confirmed as CDI. Rapid diagnosis of CDI using PCR was timely, accurate and correlated well with clinical diagnosis. Copyright © 2014 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  2. A geometric analysis of hallux valgus: correlation with clinical assessment of severity

    Directory of Open Access Journals (Sweden)

    Vila Joan

    2009-05-01

    Full Text Available Abstract Background Application of plane geometry to the study of bunion deformity may represent an interesting and novel approach in the research field of hallux valgus. For the purpose of contributing to development of a different perspective in the assessment of hallux valgus, this study was conducted with three objectives: a to determine the position on the intersection point of the perpendicular bisectors of the longitudinal axes of the first metatarsal and proximal phalanx (IP, b to correlate the location of this point with hallux valgus deformity according to angular measurements and according to visual assessment of the severity carried out by three independent observers, and c to assess whether this IP correlated with the radius of the first metatarsophalangeal arc circumference. Methods Measurements evaluated were intermetatarsal angle (IMA, hallux valgus angle (HVA, and proximal phalangeal articular angle (PPAA. The Autocad® program computed the location of the IP inside or outside of the foot. Three independent observers rated the severity of hallux valgus in photographs using a 100-mm visual analogue scale (VAS. Results Measurements of all angles except PPAA showed significantly lower values when the IP was located out of the foot more distantly and vice versa, significantly higher values for severe deformities in which the IP was found inside the foot (p p Conclusion The IP is a useful indicator of hallux valgus deformity because correlated significantly with IMA and HVA measurements, VAS scores obtained by visual inspection of the degree of deformity, and location of the center of the first metatarsophalangeal arc circumference.

  3. The University of Utah Clinical Genetics Research Program as an NF1 Consortium Site

    National Research Council Canada - National Science Library

    Viskochil, David H; Stevenson, David; Carey, John

    2007-01-01

    The University of Utah Clinical Genetics Research Program (CGRP) provided the infrastructure for our site to perform clinical trials within the scope of a consortium to treat multiple medical complications of neurofibromatosis type 1...

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

    Science.gov (United States)

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

    2014-04-01

    Episodic ataxia type 1 is considered a rare neuronal ion channel disorder characterized by brief attacks of unsteadiness and dizziness with persistent myokymia. To characterize the natural history, develop outcome measures for future clinical trials, and correlate genotype with phenotype, we undertook an international, prospective, cross-sectional study. Thirty-nine individuals (51% male) were enrolled: median age 37 years (range 15-65 years). We identified 10 different pathogenic point mutations in KCNA1 that accounted for the genetic basis of 85% of the cohort. Participants with KCNA1 mutations were more likely to have a positive family history. Analysis of the total cohort showed that the first episode of ataxia occurred before age 20 in all but one patient, with an average age of onset of 7.9 years. Physical exertion, emotional stress and environmental temperature were the most common triggers for attacks. Attack frequency ranged from daily to monthly, even with the same KCNA1 genotype. Average attack duration was in the order of minutes. Ten participants (26%) developed permanent cerebellar signs, which were related to disease duration. The average Scale for the Assessment and Rating of Ataxia score (SARA, a standardized measure of cerebellar dysfunction on clinical examination, scores range from 0-40) was an average of 3.15 for all participants (range 0-14), but was only 2 in those with isolated episodic ataxia compared with 7.7 in those with progressive cerebellar ataxia in addition to episodic ataxia. Thirty-seven participants completed the SF-36, a quality of life survey; all eight domain norm-based average scores (mean=50) were below normal with mental health being the lowest (41.3) in those with mutation positive episodic ataxia type 1. Scores on SF-36 correlated negatively with attack frequency. Of the 39 participants in the study, 33 harboured mutations in KCNA1 whereas the remaining six had no mutation identified. Episodic ataxia type 1 phenocopies

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

    Science.gov (United States)

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

    2014-01-01

    Episodic ataxia type 1 is considered a rare neuronal ion channel disorder characterized by brief attacks of unsteadiness and dizziness with persistent myokymia. To characterize the natural history, develop outcome measures for future clinical trials, and correlate genotype with phenotype, we undertook an international, prospective, cross-sectional study. Thirty-nine individuals (51% male) were enrolled: median age 37 years (range 15–65 years). We identified 10 different pathogenic point mutations in KCNA1 that accounted for the genetic basis of 85% of the cohort. Participants with KCNA1 mutations were more likely to have a positive family history. Analysis of the total cohort showed that the first episode of ataxia occurred before age 20 in all but one patient, with an average age of onset of 7.9 years. Physical exertion, emotional stress and environmental temperature were the most common triggers for attacks. Attack frequency ranged from daily to monthly, even with the same KCNA1 genotype. Average attack duration was in the order of minutes. Ten participants (26%) developed permanent cerebellar signs, which were related to disease duration. The average Scale for the Assessment and Rating of Ataxia score (SARA, a standardized measure of cerebellar dysfunction on clinical examination, scores range from 0–40) was an average of 3.15 for all participants (range 0–14), but was only 2 in those with isolated episodic ataxia compared with 7.7 in those with progressive cerebellar ataxia in addition to episodic ataxia. Thirty-seven participants completed the SF-36, a quality of life survey; all eight domain norm-based average scores (mean = 50) were below normal with mental health being the lowest (41.3) in those with mutation positive episodic ataxia type 1. Scores on SF-36 correlated negatively with attack frequency. Of the 39 participants in the study, 33 harboured mutations in KCNA1 whereas the remaining six had no mutation identified. Episodic ataxia type 1

  6. Clinical correlative evaluation of an iterative method for reconstruction of brain SPECT images

    Energy Technology Data Exchange (ETDEWEB)

    Nobili, Flavio E-mail: fnobili@smartino.ge.it; Vitali, Paolo; Calvini, Piero; Bollati, Francesca; Girtler, Nicola; Delmonte, Marta; Mariani, Giuliano; Rodriguez, Guido

    2001-08-01

    Background: Brain SPECT and PET investigations have showed discrepancies in Alzheimer's disease (AD) when considering data deriving from deeply located structures, such as the mesial temporal lobe. These discrepancies could be due to a variety of factors, including substantial differences in gamma-cameras and underlying technology. Mesial temporal structures are deeply located within the brain and the commonly used Filtered Back-Projection (FBP) technique does not fully take into account either the physical parameters of gamma-cameras or geometry of collimators. In order to overcome these limitations, alternative reconstruction methods have been proposed, such as the iterative method of the Conjugate Gradients with modified matrix (CG). However, the clinical applications of these methods have so far been only anecdotal. The present study was planned to compare perfusional SPECT data as derived from the conventional FBP method and from the iterative CG method, which takes into account the geometrical and physical characteristics of the gamma-camera, by a correlative approach with neuropsychology. Methods: Correlations were compared between perfusion of the hippocampal region, as achieved by both the FBP and the CG reconstruction methods, and a short-memory test (Selective Reminding Test, SRT), specifically addressing one of its function. A brain-dedicated camera (CERASPECT) was used for SPECT studies with {sup 99m}Tc-hexamethylpropylene-amine-oxime in 23 consecutive patients (mean age: 74.2{+-}6.5) with mild (Mini-Mental Status Examination score {>=}15, mean 20.3{+-}3), probable AD. Counts from a hippocampal region in each hemisphere were referred to the average thalamic counts. Results: Hippocampal perfusion significantly correlated with the MMSE score with similar statistical significance (p<0.01) between the two reconstruction methods. Correlation between hippocampal perfusion and the SRT score was better with the CG method (r=0.50 for both hemispheres, p<0

  7. Tissue factor activated thromboelastography correlates to clinical signs of bleeding in dogs

    DEFF Research Database (Denmark)

    Wiinberg, Bo; Jensen, Asger Lundorff; Rozanski, Elizabeth

    2009-01-01

    and may well be of value in the workup of dogs suspected of having a haemostatic disorder. This study was undertaken to evaluate prospectively how tissue factor (TF) activated TEG correlated to clinical signs of bleeding in dogs, compared to a routine coagulation profile. A prospective case-control study...... was performed over a 2 year period from 2004-2006. Eligible dogs were those where the primary clinician requested a coagulation profile to evaluate haemostasis. The dogs were simultaneously evaluated with a TF-activated TEG assay. Twenty-seven dogs, characterised as hypo-coagulable based on the TEG parameter G......, the coagulation profile had a PPV between 50-81% and a NPV between 92-93% for detection of bleeding, depending on the observer. In conclusion, a TF-activated TEG G value 

  8. Correlation of clinical and biological evidence - a dominant therapeutic element of succeeding in ectopic pregnancy.

    Science.gov (United States)

    NeamŢu, Simona Daniela; DiŢescu, Damian; ForŢofoiu, Maria; Stanca, Liliana; Tigae, Cristian; Niculescu, Mihaela; NeamŢu, Cristian Ovidiu; Manolea, Maria Magdalena; Siminel, Mirela Anişoara; Şurtea, Leontina Eugenia; NeamŢu, Adela Valeria; Novac, Marius Bogdan; Vasile, Liviu; Gluhovschi, Adrian

    2017-01-01

    Tubal pathology, smoking, pelvic inflammatory disease, miscarriage, medical or surgical abortion, usage of intrauterine devices (IUDs) for women with salpingitis latent injuries, older than 40 years, are risk factors for ectopic pregnancy. The objective of this study concerns the correlation of the clinical and biological evidence for the early diagnosis of the ectopic pregnancy and, as soon as possible, for the estimation for eventual risk of complications that may appear. The transvaginal ultrasound test, minimal increases in serum beta-human chorionic gonadotropin (β-hCG) dynamics and blood counts are investigations of choice in achieving our objective. Overcoming β-hCG critical level (>1198 IU÷mL), the decrease of platelets and changes in platelet constants announce the imminent risk of ectopic pregnancy rupture and the need to take a quick decision on the course of treatment.

  9. Correlating MRI with clinical evaluation in the assessment of disease activity of Takayasu's arteritis.

    Science.gov (United States)

    John, Reetu A; Keshava, Shyamkumar N; Danda, Debashish

    2017-07-01

    To correlate magnetic resonance imaging (MRI) assessment of disease activity in patients with Takayasu's arteritis with the Indian Takayasu's activity score (ITAS). We prospectively assessed 20 patients with Takayasu's arteritis from November 2010 to September 2011. We found a statistically significant association between MRI assessment of disease activity and ITAS with a P-value of 0.01. The MRI features suggesting active disease included wall thickening and enhancement. We also analyzed the association between MRI and clinical assessment which was also statistically significant at P = 0.037. Our study suggests that there is an association between MRI assessment of disease activity and the ITAS. MRI evaluation of disease activity of Takayasu's arteritis therefore goes hand in hand with ITAS 2010, ITAS - A, erythrocyte sedimentation rate and C-reactive protein. However this needs further investigation from future studies using serial assessments. © 2017 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd.

  10. Cryoglobulinemia and its correlation with clinical extrahepatic manifestations in chronic hepatitis C

    Directory of Open Access Journals (Sweden)

    Joanna Jabłońska

    2017-12-01

    Results: Cryoglobulins were found in 93 persons (37.8%. Type II cryoglobulinemia was detected in 28 persons. Patients with cryoglobulinemia were elder (p<0.0004. 54 patients (21.95% manifested clinical extrahepatic symptoms. Arthralgia was found in 27 cases (10.98%. Skin changes were found in 22 patients (8.94%. 12 persons had glomerulonephritis (4.88%. 11 patients (4.47% had sicca syndrome. 6 patients developed peripheral polyneuropathy (2.4%. 4 persons developed B cell lymphoma (1.63%. There was no correlation between presence of symptoms and grading, staging, age, HCV genotype, and the presence of autoantibodies. Extrahepatic manifestations were present more frequently in women (p<0.0008.

  11. Correlation of muscle biopsy, clinical course, and outcome in PM and sporadic IBM.

    Science.gov (United States)

    Chahin, Nizar; Engel, Andrew G

    2008-02-05

    To correlate muscle biopsy findings with prebiopsy and postbiopsy clinical course and response to therapy in polymyositis (PM) and sporadic inclusion body myositis (IBM). Existence of pure PM has recently been questioned; subsequently, the definition and criteria for diagnosing PM were debated. Patient records, follow-up information, and muscle biopsies were analyzed in 107 patients whose biopsies were initially read as PM and IBM. The patients fell into three groups by combined biopsy and clinical criteria: PM, 27 patients; IBM, 64 patients; PM/IBM, 16 patients with biopsy diagnosis of PM but clinical features of IBM. For the three groups, the respective mean periods from disease onset to end of follow-up were 5.9, 8.5, and 9.6 years. Another autoimmune disease was present in 4 of 27 PM, 8 of 64 IBM, and 1 of 16 PM/IBM cases. An autoimmune serologic marker occurred in one-third of each group. Nineteen PM patients had no associated autoimmune disease or marker. Nonnecrotic fiber invasion by mononuclear cells appeared in all IBM, 17 of 27 PM, and 13 of 16 PM/IBM patients. The density of both invaded fibers and cytochrome-c oxidase-negative fibers was higher in IBM and PM/IBM than in PM. Immunotherapy improved 22 of 27 PM patients but had only transient beneficial effects in 2 of 32 IBM and 1 of 14 PM/IBM patients. 1) Sixteen of 43 patients (37%) with biopsy features of polymyositis (PM) had clinical features of inclusion body myositis (IBM). 2) Absence of canonical biopsy features of IBM from clinically affected muscles of IBM patients challenges biopsy criteria for IBM, or the IBM markers appear late in some patients, or their distribution in muscle is patchy and restricted compared with that of the inflammatory exudate. 3) The muscle biopsy is a reliable instrument in the diagnosis of PM and IBM in close to 85% of the patients. Errors of diagnosis in the remaining 15% can be avoided or reduced by combined evaluation of the clinical and pathologic findings.

  12. Neuropathological diagnoses and clinical correlates in older adults in Brazil: A cross-sectional study.

    Directory of Open Access Journals (Sweden)

    Claudia K Suemoto

    2017-03-01

    Full Text Available Clinicopathological studies are important in determining the brain lesions underlying dementia. Although almost 60% of individuals with dementia live in developing countries, few clinicopathological studies focus on these individuals. We investigated the frequency of neurodegenerative and vascular-related neuropathological lesions in 1,092 Brazilian admixed older adults, their correlation with cognitive and neuropsychiatric symptoms, and the accuracy of dementia subtype diagnosis.In this cross-sectional study, we describe clinical and neuropathological variables related to cognitive impairment in 1,092 participants (mean age = 74 y, 49% male, 69% white, and mean education = 4 y. Cognitive function was investigated using the Clinical Dementia Rating (CDR and the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE; neuropsychiatric symptoms were evaluated using the Neuropsychiatric Inventory (NPI. Associations between neuropathological lesions and cognitive impairment were investigated using ordinal logistic regression. We developed a neuropathological comorbidity (NPC score and compared it to CDR, IQCODE, and NPI scores. We also described and compared the frequency of neuropathological diagnosis to clinical diagnosis of dementia subtype. Forty-four percent of the sample met criteria for neuropathological diagnosis. Among these participants, 50% had neuropathological diagnoses of Alzheimer disease (AD, and 35% of vascular dementia (VaD. Neurofibrillary tangles (NFTs, hippocampal sclerosis, lacunar infarcts, hyaline atherosclerosis, siderocalcinosis, and Lewy body disease were independently associated with cognitive impairment. Higher NPC scores were associated with worse scores in the CDR sum of boxes (β = 1.33, 95% CI 1.20-1.46, IQCODE (β = 0.14, 95% CI 0.13-0.16, and NPI (β = 1.74, 95% CI = 1.33-2.16. Compared to neuropathological diagnoses, clinical diagnosis had high sensitivity to AD and high specificity to dementia with

  13. Nephrotic Range Proteinuria in Renal Transplantation: Clinical and Histologic Correlates in a 10-year Retrospective Study.

    Science.gov (United States)

    Leal, R; Pinto, H; Galvão, A; Santos, L; Romãozinho, C; Macário, F; Alves, R; Pratas, J; Sousa, V; Marinho, C; Prado E Castro, L; Campos, M; Mota, A; Figueiredo, A

    2017-05-01

    There is a high incidence of nephrotic proteinuria in renal transplant recipients, which is an accurate predictor of graft loss. Despite this, its histologic correlates and prognostic implications are still not well characterized. We assessed the clinical and histological correlates of kidney transplantation patients with nephrotic range proteinuria. We have retrospectively analyzed clinical and histological data from 50 kidney transplantation biopsy specimens from 44 renal transplant recipients with nephrotic range proteinuria between 2006 and 2015. The median follow-up time was 93 months (range, 14 months to 190 months). The mean age of the patients was 45.2 ± 13.7 years and our cohort included 86% recipients of deceased-donor grafts. The maintenance immunosuppressive regimen included calcineurin inhibitors in 68% and mammalian target of rapamycin inhibitors in 32% of patients. The average proteinuria was 6.9 ± 3.8 g/d and 52% of patients presented with nephrotic syndrome. The main histological findings were transplant glomerulopathy (22%), de novo glomerular disease (22%), and recurrence of primary disease (22%). Tubular atrophy and interstitial fibrosis was present in 78% of the biopsy specimens. Thirty-one patients (62%) lost the graft at follow-up. There was no statistically significant difference between the histologic diagnosis nor the proteinuria levels and the outcome of the graft. The main causes of nephrotic range proteinuria in patients undergoing biopsy were transplant glomerulopathy, recurrence of the underlying disease, and de novo glomerulonephritis. Nephrotic range proteinuria was related to a high rate of graft loss. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Cervical myelopathy: a clinical and radiographic evaluation and correlation to cervical spondylotic myelopathy.

    Science.gov (United States)

    Harrop, James S; Naroji, Swetha; Maltenfort, Mitchell; Anderson, D Greg; Albert, Todd; Ratliff, John K; Ponnappan, Ravi K; Rihn, Jeffery A; Smith, Harvey E; Hilibrand, Alan; Sharan, Ashwini D; Vaccaro, Alexander

    2010-03-15

    Retrospective analysis of a cohort of patients treated between April 2006 and January 2008, and diagnosed with cervical degenerative disease. To determine the correlation of the clinical findings associated with cervical myelopathy to the presence of spinal cord compression or cord signal abnormalities on magnetic resonance imaging (MRI). There are numerous reports describing the radiographic features of cervical spondylosis, however, no publication specifically describes the association between the physical signs of cervical myelopathy and the presenting imaging findings. Myelopathy was defined as the presence of greater than one long-tract sign localized to the cervical spinal cord (Hoffman or Babinski signs, clonus, hyper-reflexia, crossed abductor sign, and/or gait dysfunction) on physical examination in the absence of other neurologic condition(s). The presence of these signs, MRI imaging features of spinal cord compression and hyperintense T2 intraparenchymal cord signal abnormality, and patient demographics were recorded. One hundred three patients met inclusion criteria (age >18, symptomatic cervical degenerative disease and complete neurologic assessment). Of these, 54 had clinical findings of cervical myelopathy. Radiographic features of cord compression were present in 62% of patients, and 84% had myelopathy on examination. No patients without cord compression presented with myelopathy (P myelopathy (P myelopathy increased with the presence of cord signal hyperintensity (odds ratio [OR], 11.4), sensory loss (OR, 16.9), and age (OR, 1.10 per year). The diagnosis of cervical myelopathy is based on presenting symptoms and physical examination. This analysis illustrates that radiographic cervical spinal cord compression and hyperintense T2 intraparen chymal signal abnormalities correlate with the presence of myelopathic findings on physical examination.

  15. MRI assessment program. Consensus statement on clinical efficacy of MRI

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-05-01

    This consensus statement is largely based on the experience gained at the MRI units at the four hospitals which have operated scanners in the MRI program. It reflects the considered opinion of the radiologists responsible for the MRI services at those hospitals. Account has also been taken of relevant overseas data. This collection of opinion relates particularly to comparison with other imaging modalities. The specific comments will require further consideration as technical developments with MRI become available, additional experience is gained with gadolinium contrast material and additional data are obtained on the influence of MRI on patient management. MRI, at present, is used either to improve diagnostic accuracy when other tests are negative or equivocal, when there is strong clinical suspicion of disease, or to improve surgical or other management planning when the diagnosis known. In some situations (eg syringomyelia, congenital spinal disease, posterior fossa/cerebello-pontine angle tumours) it may entirely replace other tests (eg myelography, air contrast, CT) which are substantially less accurate and/or more invasive. In other situations (eg hemispheric brain tumours, lumbar disc protrusions) when other tests, such as CT, can be as accurate, MRI is not usually or initially indicated because it is currently more expensive and of limited availability. However, balanced against this is the fact that it does not expose the patient to potentially harmful ionising radiation. It is also stressed that MRI images depend on complex, widely variable and, as yet, incompletely understood parameters. There is concern that this may result in false positive diagnoses, especially where MRI is used alone as a screening test, or used as the initial test. For several reasons (availability, cost, medical and diagnostic efficacy), the specific comments on indications for MRI presented are based upon the assumption that MRI is a tertiary and complementary imaging examination

  16. Psychobiological correlates of improved mental health in patients with musculoskeletal pain after a mindfulness-based pain management program.

    Science.gov (United States)

    Brown, Christopher A; Jones, Anthony K P

    2013-03-01

    Mindfulness-based pain management programs (MBPMs) aim to improve mental and physical health in individuals with chronic pain. In this study, we investigated whether improvement in mental health might require (1) reduction in the sensory pain experience and brain correlates of that experience, and/or (2) improved perceptions of the controllability of pain and corresponding brain activity related to cognitive control and emotional regulation. Twenty-eight patients with chronic pain were assessed and randomized into an intervention group (who attended an 8-wk MBPM) or a control group (treatment-as-usual), before being reassessed after 8 weeks. Outcome measures included clinical pain, perceived control over pain, mental and physical health, and mindfulness. Neural activity was measured during the anticipation and experience of acute experimental pain, using electroencephalography with source reconstruction. Improvements were found in the MBPM group relative to the control group in mental health, which related to greater perceived control of pain, but not to reductions in clinical or experimental pain ratings. Anticipatory and pain-evoked event-related potentials to acute experimental pain were decreased, but sources of these event-related potentials were estimated to be in regions that modulate emotional responses rather than pain intensity. Mental health and perceived control outcomes correlated with reduced anticipatory deactivations of dorsolateral prefrontal and somatosensory cortices. Increased activity in cognitive control regions of the brain during pain anticipation related to improved mental health and perceived control over pain, but not to decreased pain experience. Greater perceived control may therefore result from improved regulation of the emotional response to pain.

  17. Clinical and metabolic correlates of cerebral calcifications in Sturge-Weber syndrome.

    Science.gov (United States)

    Pilli, Vinod K; Behen, Michael E; Hu, Jiani; Xuan, Yang; Janisse, James; Chugani, Harry T; Juhász, Csaba

    2017-09-01

    To evaluate clinical and metabolic correlates of cerebral calcifications in children with Sturge-Weber syndrome (SWS). Fifteen children (11 females, four males; age range 7mo-9y, mean 4y 1mo) with unilateral SWS underwent baseline and follow-up magnetic resonance imaging (MRI) with susceptibility weighted imaging (SWI), glucose metabolism positron emission tomography (PET), and neurocognitive assessment (mean follow-up 1y 8mo). Calcified brain volumes measured on SWI were correlated with areas of abnormal glucose metabolism, seizure variables, and cognitive function (IQ). Ten children had brain calcification at baseline and 11 at follow-up. Mean calcified brain volume increased from 1.69 to 2.47cm3 (p=0.003) in these children; the rate of interval calcified volume increase was associated with early onset of epilepsy (Spearman's rho [rs ]=-0.63, p=0.036). Calcified brain regions showed a variable degree of glucose hypometabolism with the metabolic abnormalities often extending to non-calcified cerebral lobes. Larger calcified brain volumes at baseline were associated with longer duration of epilepsy (rs =0.69, p=0.004) and lower outcome IQ (rs =-0.53, p=0.042). Brain calcifications are common and progress faster in children with SWS with early epilepsy onset, and are associated with a variable degree of hypometabolism, which is typically more extensive than the calcified area. Higher calcified brain volumes may indicate a risk for poorer neurocognitive outcome. © 2017 Mac Keith Press.

  18. MRI in temporal lobe epilepsy. Correlation between EEG, SPECT and clinical features

    Energy Technology Data Exchange (ETDEWEB)

    Uesugi, Hideji; Onuma, Teiichi; Matsuda, Hiroshi; Ishida, Shiro [National Center Hospital for Mental, Nervous and Muscular Disorders, National Center of Neurology and Psychiatry, Kodaira, Tokyo (Japan)

    1996-02-01

    The relationship between MRI, SPECT, EEG and clinical features in temporal lobe epilepsy was investigated. Subjects were 162 patients (84 males, 78 females) whose average age was 38.1{+-}12.1 years. SPECT was carried out in 45 patients. The results were as follows: abnormal MR images were obtained in 36% of the group without epileptic discharge, and in 42% of the group with temporal spikes. There was no correlation between epileptic discharge in EEG and MRI abnormality. The lateralities of epileptic discharge and MRI were in disagreement in 9 of 39 patients (23%), indicating that determining the epileptic focus from scalp EEG was difficult. There was no correlation between the basic activity in EEG and abnormality in MRI. The rate of abnormal SPECT (89%) was higher than that of abnormal MRI (40%). The rate of the group with ictal automatism (52%) was higher than that of the group without ictal automatism (35%). The rate of abnormal MR images was high in the group with encephalitis (73%). The rate was higher in the group with febrile convulsion (62%) than in the group without it (28%). The rate of the abnormal MR images was higher in the group with a seizure frequency of at least several mal/month (48%) than in the group with a seizure frequency of less than several mal/year (29%). (author).

  19. CORRELATION BETWEEN SERUM TESTOSTERONE, BIOCHEMICAL AND CLINICAL MARKERS IN PROSTATE CANCER PATIENTS

    Directory of Open Access Journals (Sweden)

    Bogdan Roussev

    2016-09-01

    Full Text Available Purpose: Androgens seems to play an important role in prostate cancer (PCa pathogenesis. Some studies reveal that possible testosterone deficiency could be involved in PCa development and progress. Others indicate that men with high testosterone levels have increased risk in developing more aggressive PCa and poor response to therapy. The objective of the present study is to establish a possible correlation between serum total testosterone levels (TT, prostate specific antigen (PSA and clinical markers evaluating the aggressiveness of the tumor process in PCa patients. Material/Methods: A total of eighty males, aged from 52 to 84 years (mean age 66.28 ± 6.015 years, with histologically confirmed PCa, entered the study. Diagnosis of PCa was established by systemic transrectal ultrasound-guided tru-cut prostate biopsies (10 cores at least. Detected tumors were graded using the Gleason grading system. Serum TT and PSA were analyzed immunochemically. Pearson correlation statistics with a level of significance set at p 7. Conclusions: Our results confirm the hypothesis that low testosterone levels are related to poor prognosis and increased severity of PCa.

  20. Clinical correlation of prostatic lithiasis with chronic pelvic pain syndromes in young adults.

    Science.gov (United States)

    Geramoutsos, Ioannis; Gyftopoulos, Kostis; Perimenis, Petros; Thanou, Vasiliki; Liagka, Dimitra; Siamblis, Dimitrios; Barbalias, George

    2004-03-01

    To investigate the incidence, morphology and clinical presentation of prostatic calculi in a selected population of young adults and to examine any possible correlation with chronic prostatitis/chronic pelvic pain syndromes (CP/CPPS). A population of 1374 young adults was screened with ultrasound imaging of the prostate and 101 cases with prostatic lithiasis were selected. Patients were divided in two groups, according to the type of prostatic calculi (type A: small, multiple or type B: larger, coarser calculi). Further evaluation included history and physical examination, recording of lower urinary tract symptoms and the Meares-Stamey test. Calculi were type A in 71.3% and type B in 28.7% of cases. Localization (central/periurethral) was not correlated with other parameters. Age was closely related to calculus burden ( p =0.034 ). Type B calculi were more often associated with symptoms and chronic prostatitis/CPPS (chi(2)-test, p=0.007 and 0.018 respectively). Small, multiple calcifications are a normal, often incidental ultrasonographic finding in the prostate and represent a result of age rather than a pathologic entity. However, larger prostatic calculi may be related to underlying inflammation and require further evaluation and possibly, treatment.

  1. Correlates of intimate partner psychological aggression perpetration in a clinical sample of alcoholic men.

    Science.gov (United States)

    Kachadourian, Lorig K; Taft, Casey T; O'Farrell, Timothy J; Doron-Lamarca, Susan; Murphy, Christopher M

    2012-04-01

    This study longitudinally examined correlates of intimate partner psychological aggression in a sample of 178 men seeking treatment for alcoholism and their partners, building on a previous investigation examining correlates of intimate partner physical aggression (Taft et al., 2010). The men were largely Caucasian; average age was 41.0 years. Participants completed a battery of questionnaires that assessed distal and proximal predictors of psychological aggression perpetration. Distal factors, assessed at baseline, included initial alcohol problem severity, beliefs about alcohol, and antisocial personality characteristics. Proximal factors, assessed at baseline and at follow-ups 6 and 12 months later, included alcohol and drug use, relationship adjustment, and anger. Psychological aggression was assessed at all three time points. Findings showed that both groups of variables were associated with psychological aggression perpetration. Beliefs that drinking causes relationship problems and variables related to alcohol consumption exhibited the strongest associations with psychological aggression. The findings are consistent with theoretical models that emphasize both distal and proximal effects of drinking on intimate partner aggression. Implications for clinical interventions and directions for future research are discussed. (c) 2012 APA, all rights reserved.

  2. Correlates of Intimate Partner Psychological Aggression Perpetration in a Clinical Sample of Alcoholic Men

    Science.gov (United States)

    Kachadourian, Lorig K.; Taft, Casey T.; O’Farrell, Timothy J.; Doron-LaMarca, Susan; Murphy, Christopher M.

    2012-01-01

    This study longitudinally examined correlates of intimate partner psychological aggression in a sample of 178 men seeking treatment for alcoholism and their partners, building on a previous investigation examining correlates of intimate partner physical aggression (Taft et al., 2010). The men were largely Caucasian; average age was 41.0 years. Participants completed a battery of questionnaires that assessed distal and proximal predictors of psychological aggression perpetration. Distal factors, assessed at baseline, included initial alcohol problem severity, beliefs about alcohol, and antisocial personality characteristics. Proximal factors, assessed at baseline and at follow-ups 6 and 12 months later, included alcohol and drug use, relationship adjustment, and anger. Psychological aggression was assessed at all three time points. Findings showed that both groups of variables were associated with psychological aggression perpetration. Beliefs that drinking causes relationship problems and variables related to alcohol consumption exhibited the strongest associations with psychological aggression. The findings are consistent with theoretical models that emphasize both distal and proximal effects of drinking on intimate partner aggression. Implications for clinical interventions and directions for future research are discussed. PMID:22409160

  3. Differences in correlates of condom use between young adults and adults attending sexually transmitted infection clinics.

    Science.gov (United States)

    Wallace, Amanda R; Blood, Emily A; Crosby, Richard A; Shrier, Lydia A

    2015-07-01

    Despite developmental differences between young adults and adults, studies of condom use have not typically considered young adults as a distinct age group. This study sought to examine how condom use and its correlates differed between high-risk young adults and adults. Sexually transmitted infection (STI) clinic patients (n = 763) reported STI history, contraception, negative condom attitudes, fear of partner reaction to condom use and risky behaviours. Past 3-month condom use was examined as unprotected vaginal sex (UVS) acts, proportional condom use and consistent condom use. Regression models tested associations of age group and potential correlates with each condom use outcome. Interaction models tested whether associations differed by age group. Proportional condom use was greater in young adults than adults (mean 0.55 vs. 0.47); UVS and consistent condom use were similar between age groups. Young adults with a recent STI reported less condom use, whereas for older adults, a distant STI was associated with less condom use, compared to others in their age groups. Negative condom attitudes were more strongly linked to UVS acts for younger versus older adults. STI prevention efforts for younger adults may be improved by intensifying counselling about condom use immediately following STI diagnosis and targeting negative condom attitudes. © The Author(s) 2014.

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

    Science.gov (United States)

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

    2012-06-01

    Promoter methylation of O6-methylguanine-DNA methyltransferase (MGMT) gene has been considered as a prognostic maker and increasingly emphasized in the treatment of glioblastoma multiforme (GBM). Contrastingly, the correlation of MGMT with clinical outcomes in Chinese glioblastoma patients has not been elucidated systematically. In the present study, tumor tissues from 172 GBM patients were analyzed for MGMT protein expression by immunohistochemistry. Of these, 79 were also subjected to pyrosequencing for MGMT promoter methylation analysis. MGMT protein overexpression was found in 109/172 (63.4%) GBM samples. And no significant survival difference was observed between the patients with MGMT overexpression and low expression in terms of progression-free survival or overall survival (P = 0.605 and P = 0.565, respectively). Meanwhile, MGMT promoter methylation was detected in 26/79 cases (32.9%), whereas 53/79 (67.1%) samples were unmethylated. Further survival analysis also revealed that MGMT promoter methylation status cannot predict patients progression-free survival and overall survival (P = 0.906 and P = 0.548, respectively). The integrated analysis showed that there was significant negative correlation between MGMT protein expression and promoter methylation (P = 0.004). These results underscore that, in Chinese GBM patients, (a) MGMT protein expression level was not a prognostic factor, (b) overall survival but not progression-free survival showed a trend toward increase in patients with MGMT promoter methylation, although the difference was not significant statistically and this observation has to be validated in larger patients cohort, (c) there was a significant correlation between MGMT protein expression in immunohistochemistry and MGMT promoter methylation by pyrosequencing.

  5. Correlates of clinical breast examination among lesbian, gay, bisexual, and queer women.

    Science.gov (United States)

    Lacombe-Duncan, Ashley; Logie, Carmen H

    2016-12-27

    Lesbian, gay, bisexual, and queer (LGBQ) women have increased risk of breast cancer yet lower use of early detection screening than heterosexual women. This lower use may be due in part to sexual stigma. The study purpose was to explore correlates of past two-year clinical breast examination (CBE) among LGBQ women to better understand screening disparities, particularly among gender non-conforming LGBQ women. A cross-sectional Internet-based survey was conducted with LGBQ women in 2011-2012. We conducted multivariate logistic regression to assess the associations between individual, social/structural and health care factors and past two-year CBE among LGBQ women (n = 414), including a subsample of gender non-conforming LGBQ women (n = 148). In multivariate analyses, significant correlates of past two-year CBE among the full sample included sexually transmitted infection knowledge (OR: 1.12, 95% CI: 1.05, 1.19), sexual risk practices (OR: 0.92, 95% CI: 0.87, 0.98), past two-year Papanicolaou test (OR: 8.36, 95% CI: 4.24, 16.45), having a regular source of health care (OR: 4.84, 95% CI: 2.60, 9.01), and health care provider knowing one's sexual orientation (OR: 3.60, 95% CI: 2.29, 5.81). Among gender non-conforming LGBQ women, perceived gender non-conformity stigma (OR: 0.85, 95% CI: 0.74, 0.99) and belief that one's health care provider is uncomfortable with one's sexual orientation (OR: 0.33, 95% CI: 0.11, 1.00) were also associated with lower screening. These findings enhance understanding of individual, social/structural, and health care factors correlated with CBE among LGBQ women. More research is needed to understand the complex interplay of these factors to inform multi-level interventions to address screening disparities for diverse LGBQ women.

  6. Analysis of angiogenic factors and cyclooxygenase-2 expression in cartilaginous tumors: clinical and histological correlation

    Directory of Open Access Journals (Sweden)

    Francisco Fontes Cintra

    2011-01-01

    Full Text Available OBJECTIVES: To study the role of angiogenesis and cyclooxygenase-2 expression in cartilaginous tumors and correlate these factors with prognosis. INTRODUCTION: For chondrosarcoma, the histological grade is the current standard for predicting tumor outcome. However, a low-grade chondrosarcoma can follow an aggressive course-as monitored by sequential imaging techniques-even when it is histologically indistinguishable from an enchondroma. Therefore, additional tools are needed to help identify the biological potential of these tumors. The degree of angiogenesis that is induced by the tumor could assist in this task. Angiogenesis can be quantified by measuring the expression of vascular endothelial growth factor and CD34, and cyclooxygenase-2 can induce angiogenesis by stimulating the production of proangiogenic factors. METHODS: In total, 21 enchondromas and 58 conventional chondrosarcomas were studied by examining the clinical and histopathological findings in conjunction with the immunostaining markers of angiogenesis and cyclooxygenase- 2 expression. RESULTS: The significant variables that were associated with poor outcome were 1 higher-grade chondrosarcomas, 2 tumors that developed in flat bones, and 3 over-expression of CD34 (with a median count that was higher than 5.9 vessels in 5 high power fields. Moreover, CD34 expression (measured using the Chalkley method revealed significantly higher microvessel density in flat bone chondrosarcomas. DISCUSSION: Previous studies have shown a positive correlation between Chalkley microvessel density and histological grade; however, in our sample, we found that the former is predictive of the outcome. Chondrosarcomas in flat bones have been shown to correlate with a poor prognosis. We also found that CD34 microvessel density values were significantly higher in flat-bone chondrosarcomas. This could explain-at least in part-the more aggressive biological course that is taken by these tumors. CONCLUSIONS

  7. Expression of Cyr61, CTGF, and WISP-1 correlates with clinical features of lung cancer.

    Directory of Open Access Journals (Sweden)

    Ping-Ping Chen

    Full Text Available BACKGROUND: CCN family, comprising six members (Cyr61, CTGF, Nov, WISP-1, WISP-2, WISP-3, is involved in the stimulation of cell proliferation, migration, adhesion, angiogenesis, and tumorigenesis. Several studies have shown that expression of Cyr61, CTGF, and WISP-1 affects the tumorigenic potential of lung cancer cells in vitro. However, the correlation of expression of CCN family proteins and clinical features of lung cancer remains unknown. METHODOLOGY AND PRINCIPAL FINDINGS: In the present work, we quantified the mRNA levels of Cyr61, CTGF, and WISP-1 in samples from 60 primary lung cancers and their matched normal lung tissues by quantitative real-time PCR assay. Downregulation of the Cyr61 and CTGF genes and upregulation of the WISP-1 gene were found in primary lung cancers compared to the paired normal lung tissues. Immunohistochemistry analysis also disclosed a similar expression pattern of Cyr61, CTGF, and WISP-1 protein in paired lung cancer tissues. Statistical analysis revealed significant associations between expression of either Cyr61 or CTGF with tumor stage, tumor histology, metastasis, smoking, and family history at diagnosis. A significant correlation also existed between WISP-1 expression with tumor histology, and patient age. Moreover, expression levels of Cyr61 and CTGF correlated with survival of the lung-cancer patients. CONCLUSIONS: Our results suggest that Cyr61, CTGF, and WISP-1 might be implicated in the development and progression of primary lung cancers, and their levels might serve as valuable prognostic markers, as well as potential targets for therapeutic intervention.

  8. Frequency, clinical correlates and rating of behavioural changes in primary brain tumour patients: A preliminary investigation.

    Directory of Open Access Journals (Sweden)

    Grahame K Simpson

    2015-04-01

    Full Text Available PurposeFew studies have addressed the specific behavioural changes associated with primary brain tumour (PBT. This paper will report on the frequency and demographic/clinical correlates of such behaviours, and the reliability of rating such behaviours amongst people with PBT, family informants and clinicians. The association of behavioural changes and patient functional status will also be discussed.MethodsA total of 57 patients with 37 family informants were recruited from two large Australian metropolitan hospitals. Each completed three neuro-behavioural self-report measures. Patients also completed a depression symptom measure. Functional status was defined by clinician-rated Karnofsky Performance Status.ResultsPatients were on average 52 years old, a median of four months (range 1-82 post-diagnosis, with high grade (39%, low grade (22% or benign tumours (39%. Patients reported frequency rates of 7-40% across various behavioural domains including anger, inappropriate behaviour, apathy, inertia and executive impairment. The presence of epileptic seizures was associated with significantly higher levels of behavioural changes. Notably, behaviour did not correlate with tumour grade or treatment modality. There was moderate agreement between patients and relatives on the presence or absence of behavioural changes, and substantial agreement between relative and clinician ratings. Depressed patients did not generally report more changes than non-depressed patients. Increases in the relative and clinician-rated behaviour scores were significantly correlated with decreasing functional status in the patient.ConclusionsBehavioural changes were a common sequela of both benign and malignant PBT. Larger scale studies are required to confirm these results. The results suggest the importance of including behaviour in brain cancer psychosocial assessments and the need to develop interventions to treat these patients and reduce the burden of care on families.

  9. Correlation between clinical symptoms and peripheral immune response in HAM/TSP.

    Science.gov (United States)

    da Silva Dias, George Alberto; Sousa, Rita Catarina Medeiros; Gomes, Letícia Figueiredo; Caldas, Cezar Augusto Muniz; Nassiri, Reza; Quaresma, Juarez Antônio Simões; Fuzii, Hellen Thais

    2016-03-01

    HTLV-1 infects principally CD4+ T cells that are the main reservoirs of the virus in vivo, which play an important role in the immunological response. Most of the infected patients are asymptomatic. However, 2-3% of patients will develop HAM/TSP or Adult T lymphoma. HAM/TSP is a chronic inflammatory disease of the central nervous system, which is characterized by unremitting myelopathic symptoms. Studies have shown that cytokines levels alterations (IFN-γ and TNF-α) were associated with tissue injury in HAM/TSP. The aims of this study were to compare the gene expression of IFN-γ, IL-4 and IL-10 of asymptomatic and HAM/TSP HTLV-1 infected patients, and to correlate the gene expression with those of clinical symptoms. 28 subjects were included, 20 asymptomatic HTLV-1 and 8 with HAM/TSP. Spasticity was evaluated using the Modified Ashworth Scale and the degree of walking aid was classified on a progressive scale. The relative gene expression of IFN-γ, IL-4, and IL-10 was measured by Real-Time PCR. Results showed high gene expression of IFN-γ for all patients, but it was higher among HAM/TSP. A significant correlation was observed between IFN-γ gene expression and the degree of walking aid, and IFN-γ gene expression was higher among wheelchair users compared to non-wheelchair users. No association was found with IL-4 and IL-10. These findings indicate that HAM/TSP patients express higher amounts of IFN-γ than asymptomatic patients, and more importantly, the expression of this cytokine was strongly correlated with the need of walking aid. Copyright © 2015 Elsevier Ltd. All rights reserved.

  10. Expression of the Arabidopsis high-affinity hexose transporter STP13 correlates with programmed cell death

    DEFF Research Database (Denmark)

    Nørholm, Morten Helge Hauberg; Nour-Eldin, Hussam H; Brodersen, Peter

    2006-01-01

    We report the biochemical characterization in Xenopus oocytes of the Arabidopsis thaliana membrane protein, STP13, as a high affinity, hexose-specific H(+)-symporter. Studies with kinase activators suggest that it is negatively regulated by phosphorylation. STP13 promoter GFP reporter lines show ......13 in PCD is supported by microarray data from e.g. plants undergoing senescence and a strong correlation between STP13 transcripts and the PCD phenotype in different accelerated cell death (acd11) mutants....... GFP expression only in the vascular tissue in emerging petals under non-stressed conditions. Quantitative PCR and the pSTP13-GFP plants show induction of STP13 in programmed cell death (PCD) obtained by treatments with the fungal toxin fumonisin B1 and the pathogen Pseudomonas syringae. A role for STP...

  11. SPSS and SAS programs for comparing Pearson correlations and OLS regression coefficients.

    Science.gov (United States)

    Weaver, Bruce; Wuensch, Karl L

    2013-09-01

    Several procedures that use summary data to test hypotheses about Pearson correlations and ordinary least squares regression coefficients have been described in various books and articles. To our knowledge, however, no single resource describes all of the most common tests. Furthermore, many of these tests have not yet been implemented in popular statistical software packages such as SPSS and SAS. In this article, we describe all of the most common tests and provide SPSS and SAS programs to perform them. When they are applicable, our code also computes 100 × (1 - α)% confidence intervals corresponding to the tests. For testing hypotheses about independent regression coefficients, we demonstrate one method that uses summary data and another that uses raw data (i.e., Potthoff analysis). When the raw data are available, the latter method is preferred, because use of summary data entails some loss of precision due to rounding.

  12. Clinical and cognitive correlates of employment among patients with schizophrenia: a cross-sectional study in Malaysia

    Directory of Open Access Journals (Sweden)

    Radzi Rozhan SM

    2011-05-01

    Full Text Available Abstract Background Gainful employment is one major area of functioning which is becoming an important goal in psychiatric rehabilitation of patients with schizophrenia. Studies in western countries are pointing to evidence that certain sociodemographic and clinical factors may contribute to employment outcomes in this group of people. However, the area is still largely unexplored in Malaysia. The aim of this study was to examine the sociodemographic, clinical and cognitive correlates of employment status among patients with Schizophrenia. Methods This was a cross-sectional study. All participants who fulfilled the requirements of the study according to the inclusion and exclusion criteria were enrolled. Study instruments included a demographic data questionnaire, Positive and Negative Symptom Scale (PANSS, Trail Making Tests, Rey's Auditory Verbal Learning Test (RAVLT and Digit Span. Bivariate analyses were done using chi-square for categorical data and t-test for continuous data and multiple logistic regression analysis was done to identify predictors of employment status. Results A total of 95 participants who fulfilled the inclusion criteria were enrolled into the study. Among the sociodemographic, clinical and cognitive variables studied marital status, educational level, mean scores of negative symptoms, Digit Span and RAVLT and Trail Making Tests were found to show significant association with employment status on bivariate analyses. However, when entered into a logistic regression model, only cognitive variables ie. Trail A and B, Digit Span and RAVLT were significant predictors of employment status. Conclusions The results from this study support the role of cognitive function, particularly, attention, working memory and executive functioning on attaining and maintaining employment in persons with schizophrenia as measured by the RAVLT, Digit Span and Trail Making Tests. These findings may act as preliminary evidence suggesting the

  13. Clinical decision-making among new graduate nurses attending residency programs in Saudi Arabia.

    Science.gov (United States)

    Al-Dossary, Reem Nassar; Kitsantas, Panagiota; Maddox, P J

    2016-02-01

    This study examined the impact of residency programs on clinical decision-making of new Saudi graduate nurses who completed a residency program compared to new Saudi graduate nurses who did not participate in residency programs. This descriptive study employed a convenience sample (N=98) of new graduate nurses from three hospitals in Saudi Arabia. A self-administered questionnaire was used to collect data. Clinical decision-making skills were measured using the Clinical Decision Making in Nursing Scale. Descriptive statistics, independent t-tests, and multiple linear regression analysis were utilized to examine the effect of residency programs on new graduate nurses' clinical decision-making skills. On average, resident nurses had significantly higher levels of clinical decision-making skills than non-residents (t=23.25, p=0.000). Enrollment in a residency program explained 86.9% of the variance in total clinical decision making controlling for age and overall grade point average. The findings of this study support evidence in the nursing literature conducted primarily in the US and Europe that residency programs have a positive influence on new graduate nurses' clinical decision-making skills. This is the first study to examine the impact of residency programs on clinical decision-making among new Saudi graduate nurses who completed a residency program. The findings of this study underscore the need for the development and implementation of residency programs for all new nurses. Copyright © 2015 Elsevier Inc. All rights reserved.

  14. Prevalence of triceps tendon tears on MRI of the elbow and clinical correlation

    Energy Technology Data Exchange (ETDEWEB)

    Koplas, Monica C. [University of Mississippi Medical Center, Section of Musculoskeletal Radiology, Department of Radiology, Jackson, MS (United States); Schneider, Erika [Cleveland Clinic, Imaging Institute, Cleveland, OH (United States); Sundaram, Murali [Cleveland Clinic, Section of Musculoskeletal Radiology, Imaging Institute, Cleveland, OH (United States)

    2011-05-15

    Triceps tendon injuries are reported to be very rare. To our knowledge, there have been no studies describing its prevalence or injury patterns on MR imaging. The purpose of this retrospective study was to determine the prevalence and patterns of triceps injuries based on a large series of consecutive MR examinations. Clinical correlation was obtained. From 801 consecutive elbow MR examinations over a 15-year period, 28 patients with 30 triceps tendon injuries were identified and graded as partial tendon tear and complete tendon tear. The patients' medical records were reviewed to determine age, gender, cause of tears, and management. The prevalence of triceps tendon injuries was 3.8%. There were 5 women and 23 men with partial or complete tears (mean age: 46.6 years; range: 2.7 to 75.1 years). The most common injury was partial tear, found in 18 patients. There were 10 patients with 12 complete tears (2 had re-torn following surgical repair). A tear was suspected in 12 out 28 (43%) patients prior to the MRI. The most common presenting symptom was pain. The most common cause was athletic injury (8 patients [29%], including weightlifting [2 patients]). Tendon tear was found to be a complication of infection in 6 patients, and in 3 patients the tears were a complication of steroid use. Thirteen tendon tears were surgically repaired (8 of these were complete tears). Triceps tendon injury is not as rare as commonly reported and may often be clinically underdiagnosed. (orig.)

  15. Cool and menthol receptor TRPM8 in human urinary bladder disorders and clinical correlations

    Directory of Open Access Journals (Sweden)

    Benham Christopher D

    2006-03-01

    Full Text Available Abstract Background The recent identification of the cold-menthol sensory receptor (TRPM8; CMR1, provides us with an opportunity to advance our understanding of its role in the pathophysiology of bladder dysfunction, and its potential mediation of the bladder cooling reflex. In this study, we report the distribution of the cool and menthol receptor TRPM8 in the urinary bladder in patients with overactive and painful bladder syndromes, and its relationship with clinical symptoms. Methods Bladder specimens obtained from patients with painful bladder syndrome (PBS, n = 16, idiopathic detrusor overactivity (IDO, n = 14, and asymptomatic microscopic hematuria (controls, n = 17, were immunostained using specific antibodies to TRPM8; nerve fibre and urothelial immunostaining were analysed using fibre counts and computerized image analysis respectively. The results of immunohistochemistry were compared between the groups and correlated with the Pain, Frequency and Urgency scores. Results TRPM8-immunoreactive staining was observed in the urothelium and nerve fibres scattered in the suburothelium. The nerve fibre staining was seen in fine-calibre axons and thick (myelinated fibres. There was marked increase of TRPM8-immunoreactive nerve fibres in IDO (P = 0.0249 and PBS (P Conclusion This study demonstrates increased TRPM8 in nerve fibres of overactive and painful bladders, and its relationship with clinical symptoms. TRPM8 may play a role in the symptomatology and pathophysiology of these disorders, and may provide an additional target for future overactive and painful bladder pharmacotherapy.

  16. Clinical Correlates and Mediators of Self-Concept in Youth with Chronic Tic Disorders.

    Science.gov (United States)

    Hanks, Camille E; McGuire, Joseph F; Lewin, Adam B; Storch, Eric A; Murphy, Tanya K

    2016-02-01

    This study investigated the clinical correlates and mediators of self-concept in youth with Chronic Tic Disorders (CTD). Ninety-seven youth aged 6-17 (M = 11.1 ± 2.89; 79.4 % male) with CTD were administered the Yale Global Tic Severity Scale, the Piers-Harris Children's Self-Concept Scale-Second Edition, and self-report and clinician-administered measures assessing behavioral and psychological difficulties and comorbid conditions. Youth with CTD had a slightly below average level of self-concept, with 20 % (n = 19) exhibiting low self-concept. Youth with CTD-only had greater self-concept relative to youth with CTD and obsessive-compulsive disorder (OCD) (p = 0.04) or CTD, OCD, and attention deficit hyperactivity disorder (ADHD) combined (p = 0.009). Medium-to-large-sized associations were observed between youth's self-concept and clinical characteristics (e.g., severity of ADHD, OCD and depressive symptoms). Youth's self-concept partially mediated the relationship between tic severity and depressive symptom severity, and the interaction between tic impairment and youth's reliance on avoidant coping strategies moderated youth's self-concept. Implications, limitations, and recommendations for future interventions are discussed.

  17. Family functioning in bipolar disorder: Characteristics, congruity between patients and relatives, and clinical correlates.

    Science.gov (United States)

    Reinares, María; Bonnín, C Mar; Hidalgo-Mazzei, Diego; Colom, Francesc; Solé, Brisa; Jiménez, Esther; Torrent, Carla; Comes, Mercè; Martínez-Arán, Anabel; Sánchez-Moreno, José; Vieta, Eduard

    2016-11-30

    Functional improvement has become one of the aims of the treatment of bipolar disorder. However, scant attention has been given to family functioning, even though it has a role in the illness outcome and is affected by the disorder. The aims of this study were to compare family functioning reported by euthymic patients with bipolar disorder and healthy controls; explore the level of congruence in the perception of family environment between patients with bipolar disorder and their relatives; and analyse the relationship between clinical variables and family functioning. The sample comprised 82 adult euthymic subjects with bipolar disorder, 82 family caregivers of these patients and 47 healthy controls. Participants completed the Family Environment Scale. Results showed moderate correlations and a mean pattern almost identical between relatives' and patients' reported scores in family functioning subscales. There were significant differences between patients and controls, favourable for the latter, in the subscales cohesion (pfamily environment and clinical variables of severity. These findings contribute to increasing the understanding of family functioning in bipolar disorder and highlight the importance of family work. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  18. Shock complicating type A acute aortic dissection: Clinical correlates, management, and outcomes.

    Science.gov (United States)

    Bossone, Eduardo; Pyeritz, Reed E; Braverman, Alan C; Peterson, Mark D; Ehrlich, Marek; O'Gara, Patrick; Suzuki, Toru; Trimarchi, Santi; Gilon, Dan; Greason, Kevin; Desai, Nimesh D; Montgomery, Daniel G; Isselbacher, Eric M; Nienaber, Christoph A; Eagle, Kim A

    2016-06-01

    Shock is among the most dreaded and common complications of type A acute aortic dissection (TAAAD). However, clinical correlates, management, and short- and long-term outcomes of TAAAD patients presenting with shock in real-world clinical practice are not known. We evaluated 2,704 patients with TAAAD enrolled in the International Registry of Acute Aortic Dissection between January 1, 1996, and August 18, 2012. On admission, 407 (15.1%) TAAAD patients presented with shock. Most in-hospital complications (coma, myocardial or mesenteric ischemia or infarction, and cardiac tamponade) were more frequent in shock patients. In-hospital mortality was significantly higher in TAAAD patients with than without shock (30.2% vs 23.9%, P=.007), regardless of surgical or medical treatment. Most shock patients underwent surgical repair, with medically managed patients demonstrating older age and more complications at presentation. Estimates using Kaplan-Meier survival analysis indicated that most (89%) TAAAD patients with shock discharged alive from the hospital survived 5years, a rate similar to that of TAAAD patients without shock (82%, P=.609). Shock occurred in 1 of 7 TAAAD patients and was associated with higher rates of in-hospital adverse events and mortality. However, TAAAD survivors with or without shock showed similar long-term mortality. Successful early and aggressive management of shock in TAAAD patients has the potential for improving long-term survival in this patient population. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Neuroendocrine differentiated breast carcinoma: imaging features correlated with clinical and histopathological findings

    Energy Technology Data Exchange (ETDEWEB)

    Guenhan-Bilgen, Isil; Ustuen, Esin Emin; Memis, Aysenur [Department of Radiology, Ege University Hospital, Bornova, 35100 Izmir (Turkey); Zekioglu, Osman; Erhan, Yildiz [Department of Pathology, Ege University Hospital, Bornova, 35100 Izmir (Turkey)

    2003-04-01

    The aim of this study was to describe the imaging features of neuroendocrine differentiated breast carcinoma (NEDBC) and to correlate the radiological findings with the clinical and histopathological findings. A retrospective review of the mammograms of 1845 histopathologically proven breast cancer cases revealed five NEDBC. The clinical, imaging, and histopathological findings were analyzed. On mammography, a high-density mass was seen in all patients. The shape of the mass was round in 4 and irregular in 1 patient. The margins were spiculated in 2, indistinct in 1, microlobulated in 1, and partially obscured in 1 patient. On sonography, 4 patients had homogeneously hypoechoic masses with normal sound transmission. In 1 patient the mass was heterogeneously hypoechoic with mild posterior acoustic enhancement. The margins were microlobulated in 2, irregular in 2, and well-circumscribed in 1 patient. Neuroendocrine differentiated breast carcinoma should be included in the differential diagnosis of mammographically dense, round masses with predominantly spiculated or lobulated margins. Sonographically, they mostly present as irregular or microlobulated, homogeneously hypoechoic masses with normal sound transmission. (orig.)

  20. Iliopsoas injury: an MRI study of patterns and prevalence correlated with clinical findings

    Energy Technology Data Exchange (ETDEWEB)

    Bui, Kimmie L.; Ilaslan, Hakan; Recht, Michael; Sundaram, Murali [Cleveland Clinic, Department of Radiology, Cleveland, OH (United States)

    2008-03-15

    The objective was to retrospectively determine the prevalence and patterns of iliopsoas injuries based on consecutive MRI examinations, correlated with clinical findings. From 4,862 consecutive MRI examinations of the hips and pelvis, 32 patients with 33 iliopsoas injuries were identified and graded as muscle strain, partial tendon tear, and complete tendon tears. These patients' medical records were reviewed to determine age, gender, and cause of symptoms. The prevalence of iliopsoas tendon and myotendinous injuries was 0.66% (95% CI: 0.44-0.89). There were 18 females and 14 males whose ages ranged from 7 to 95 years (mean, 54 years). The most frequent presenting symptom was hip pain and the most frequent clinical diagnosis, an occult fracture. The most common injuries in patients under 65 years (16 patients) were muscle strains and partial tendon tears, most often due to an athletic injury. The most common injury in patients 65 years and older (16 patients) was a complete tear (8 patients, all females), 2 of which were spontaneous in origin. Each grade of iliopsoas injury occurred with similar frequency. The more advanced the age of the patient, the more severe the injury. Non-athletic injuries predominated in patients 65 years and older; athletic injuries were the most common cause of iliopsoas injury in patients under 65 years. (orig.)

  1. HBXIP overexpression is correlated with the clinical features and survival outcome of ovarian cancer.

    Science.gov (United States)

    Wang, Yixuan; Sun, Jie; Li, Nan; Che, Shuanlong; Jin, Tiefeng; Liu, Shuangping; Lin, Zhenhua

    2017-04-07

    Accumulated evidence has demonstrated that Mammalian hepatitis B X-interacting protein (HBXIP) has broad roles in cancer. Although HBXIP is associated with a variety of cancers, the HBXIP protein expression level and its clinical significance in ovarian cancer have not yet been determined. The aim of this study is to investigate the association between HBXIP expression and the clinicopathological features of ovarian cancer patients to determine whether HBXIP may be correlated with a poor prognosis in ovarian cancer patients. HBXIP protein expression was assessed in a well-characterized series of ovarian cancer tissue samples (n = 120) with long-term follow-up, using immunohistochemistry to determine the location pattern and expression of HBXIP in ovarian cancer. The localization of HBXIP was detected in SKOV-3 ovarian cancer cells using immunofluorescence (IF) staining. The relationship between high HBXIP expression and the clinicopathological features of ovarian cancer patients was analyzed by Chi-square and Fisher's exact test. Overall survival (OS) rates of all the ovarian cancer patients were calculated using the Kaplan-Meier method, and univariate and multivariate analyses were performed using the Cox proportional hazards regression model. IF staining revealed strongly positive signals for HBXIP in both cytoplasm and nucleus, but mainly in the cytoplasm of SKOV-3 ovarian cancer cells. High HBXIP expression was predominantly observed in ovarian cancer tissues but not the adjacent non-tumor ovarian tissues. The strongly positive rate of HBXIP expression was 60.0% (72/120) in ovarian cancer and was significantly higher than in adjacent non-tumor tissues (17.4%, 4/23) (P = 0.000). High HBXIP expression was positively correlated with the occurrence of lymph node metastases (P = 0.025), histological grade (P = 0.036) and clinical stage (P = 0.003). The patients with high HBXIP expression had lower overall survival (OS) rates. Moreover

  2. The evolution of the major hepatitis C genotypes correlates with clinical response to interferon therapy.

    Directory of Open Access Journals (Sweden)

    Phillip S Pang

    2009-08-01

    Full Text Available Patients chronically infected with hepatitis C virus (HCV require significantly different durations of therapy and achieve substantially different sustained virologic response rates to interferon-based therapies, depending on the HCV genotype with which they are infected. There currently exists no systematic framework that explains these genotype-specific response rates. Since humans are the only known natural hosts for HCV-a virus that is at least hundreds of years old-one possibility is that over the time frame of this relationship, HCV accumulated adaptive mutations that confer increasing resistance to the human immune system. Given that interferon therapy functions by triggering an immune response, we hypothesized that clinical response rates are a reflection of viral evolutionary adaptations to the immune system.We have performed the first phylogenetic analysis to include all available full-length HCV genomic sequences (n = 345. This resulted in a new cladogram of HCV. This tree establishes for the first time the relative evolutionary ages of the major HCV genotypes. The outcome data from prospective clinical trials that studied interferon and ribavirin therapy was then mapped onto this new tree. This mapping revealed a correlation between genotype-specific responses to therapy and respective genotype age. This correlation allows us to predict that genotypes 5 and 6, for which there currently are no published prospective trials, will likely have intermediate response rates, similar to genotype 3. Ancestral protein sequence reconstruction was also performed, which identified the HCV proteins E2 and NS5A as potential determinants of genotype-specific clinical outcome. Biochemical studies have independently identified these same two proteins as having genotype-specific abilities to inhibit the innate immune factor double-stranded RNA-dependent protein kinase (PKR.An evolutionary analysis of all available HCV genomes supports the hypothesis

  3. Comprehensive Clinical Staging for Resectable Lung Cancer: Clinicopathological Correlations and the Role of Brain MRI.

    Science.gov (United States)

    Vernon, Jordyn; Andruszkiewicz, Nicole; Schneider, Laura; Schieman, Colin; Finley, Christian J; Shargall, Yaron; Fahim, Christine; Farrokhyar, Forough; Hanna, Waël C

    2016-11-01

    In our model of comprehensive clinical staging (CCS) for lung cancer, patients with a computerized tomography scan of the chest and upper abdomen not showing distant metastases will then routinely undergo whole body positron emission tomography/computerized tomography and magnetic resonance imaging (MRI) of the brain before any therapeutic decision. Our aim was to determine the accuracy of CCS and the value of brain MRI in this population. A retrospective analysis of a prospectively entered database was performed for all patients who underwent lung cancer resection from January 2012 to June 2014. Demographics, clinical and pathological stage (seventh edition of the American Joint Committee on Cancer/Union for International Cancer Control tumor, node, and metastasis staging manual), and costs of staging were collected. Correlation between clinical and pathological stage was determined. Of 315 patients with primary lung cancer, 55.6% were female and the mean age was 70 ± 9.6 years. When correlation was analyzed without consideration for substages A and B, 49.8% of patients (158 of 315) were staged accurately, 39.7% (125 of 315) were overstaged, and 10.5% (32 of 315) were understaged. Only 4.7% of patients (15 of 315) underwent surgery without appropriate neoadjuvant treatment. Preoperative brain MRI detected asymptomatic metastases in four of 315 patients (1.3%). At a median postoperative follow-up of 19 months (range 6-43), symptomatic brain metastases developed in seven additional patients. The total cost of CCS in Canadian dollars was $367,292 over the study period, with $117,272 (31.9%) going toward brain MRI. CCS is effective for patients with resectable lung cancer, with less than 5% of patients being denied appropriate systemic treatment before surgery. Brain MRI is a low-yield and high-cost intervention in this population, and its routine use should be questioned. Copyright © 2016 International Association for the Study of Lung Cancer. Published by

  4. CORRELATIONS BETWEEN INTER-IMPLANT DISTANCE AND CLINICAL ASPECTS IN TWO IMPLANT MANDIBULAR OVERDENTURES

    Directory of Open Access Journals (Sweden)

    Mihaela Marin

    2011-09-01

    Full Text Available The aim of this study is to assess the influence of different interimplant distances on prosthetic complications in two implant mandibular overdenture treatments, as well as the possible correlations between such complications and some anatomic and functional individual aspect of the patients. Materials and method. An observational clinical study was conducted – between October 2008 – March 2010 - in the Clinics of Dental Prosthetics of the “Carol Davila” UMF of Bucuresti – on 32 completely edentulous patients, treated with 2 implant mandibular overdentures. The patients (24 women and 8 men, with ages between 49 and 83 years were divided into 2 groups, according to the position of the implants, inserted at the level of the lateral incisor (group 1 or in posterior position versus the canine (group 2. The prosthetic aspects, the peri-implant tissues and the anchoring systems were evaluated after 6 months and, respectively, 1 year of treatment, all prosthetic or biological complications, as well as the number of visits necessary for solving them being recorded. Results. As to the general characteristics of the group of patients, the observation was made that the average age of patients was of 63.8 years, most of them demonstrated a severe resorbtion of the crest, oval in shape in the mandibular frontal area, belonging mostly to the IInd hypo or hyper-divergent skeletal class, proportionally with and without a tendency towards propulsion. For both groups of patients, a total number of 114 prosthetic complications were registered after one year, the most frequent ones being occlusal problems (23.68%, the presence of decubitus lesions (21.05% and deactivation of matrices, accompanied by reduced retention (19.29%. Lower ratios were recorded for: the necessity of prosthesis relining (14%, loss of matrices (12.28%, fracturing of the prosthesis (8.77%, presence of peri-implant gingival hyperplasies (7% and loosening of the patrix screw (5

  5. Correlates of symptoms of depression and anxiety among clinic outpatients in Western Jamaica

    Science.gov (United States)

    Monroe, Cara E.; Affuso, Olivia; Martin, Michelle Y.; Aung, Maung; Crossman, Lisbeth; Jolly, Pauline E.

    2012-01-01

    Objectives There is a paucity of studies on psychosocial disorders in a clinic population in Jamaica. Therefore, we sought to determine the prevalence and correlates of symptoms of depression and anxiety in a clinic population in western Jamaica. Methods A total of 338 participants from four outpatient clinics of the Western Regional Health Authority (WRHA) were screened for symptoms of depression and anxiety using questions from the Beck Depression Inventory-II and the Beck Anxiety Inventory. The chi-square test was used to examine differences in symptoms of anxiety and depression by gender. Multivariate linear and logistic regression were used to examine the associations between symptoms and socio-demographic variables with significance set at p<0.05. Results Approximately 30% of participants had moderate or severe depression symptoms while 18.6% had moderate or severe anxiety symptoms. Participants aged 30–39 years were more likely than older participants to have moderate or severe anxiety symptoms (odds ratio [OR]: 2.0, 95% confidence interval [CI]:1.39–5.56). Women reported a statistically significant higher prevalence of anxiety symptoms (10.0% vs. 7.1%, p=0.003). There was also a statistically significant difference between anxiety means by gender. Furthermore, income was found to be a significant predictor of anxiety for women only (p=0.0113). Married persons were more likely than those who had never married to have moderate or severe anxiety symptoms (OR: 2.57, 95% CI: 1.14–5.76). Conclusions Our findings suggest that the prevalence of depression may be higher than global estimates in similar outpatient settings. Screening and intervention efforts may need to focus on younger persons, women, and married persons. PMID:24756741

  6. Estimation of T2 relaxation time of breast cancer: Correlation with clinical, imaging and pathological features

    Energy Technology Data Exchange (ETDEWEB)

    Seo, Mirinae; Sohn, Yu Mee [Dept. of Radiology, Kyung Hee University Hospital, College of Medicine, Kyung Hee University, Seoul (Korea, Republic of); Ryu, Jung Kyu; Jahng, Geon Ho; Rhee, Sun Jung; Oh, Jang Hoon; Won, Kyu Yeoun [Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul (Korea, Republic of)

    2017-01-15

    The purpose of this study was to estimate the T2* relaxation time in breast cancer, and to evaluate the association between the T2* value with clinical-imaging-pathological features of breast cancer. Between January 2011 and July 2013, 107 consecutive women with 107 breast cancers underwent multi-echo T2*-weighted imaging on a 3T clinical magnetic resonance imaging system. The Student's t test and one-way analysis of variance were used to compare the T2* values of cancer for different groups, based on the clinical-imaging-pathological features. In addition, multiple linear regression analysis was performed to find independent predictive factors associated with the T2* values. Of the 107 breast cancers, 92 were invasive and 15 were ductal carcinoma in situ (DCIS). The mean T2* value of invasive cancers was significantly longer than that of DCIS (p = 0.029). Signal intensity on T2-weighted imaging (T2WI) and histologic grade of invasive breast cancers showed significant correlation with T2* relaxation time in univariate and multivariate analysis. Breast cancer groups with higher signal intensity on T2WI showed longer T2* relaxation time (p = 0.005). Cancer groups with higher histologic grade showed longer T2* relaxation time (p = 0.017). The T2* value is significantly longer in invasive cancer than in DCIS. In invasive cancers, T2* relaxation time is significantly longer in higher histologic grades and high signal intensity on T2WI. Based on these preliminary data, quantitative T2* mapping has the potential to be useful in the characterization of breast cancer.

  7. Effectiveness of bronchial thermoplasty in patients with severe refractory asthma: Clinical and histopathologic correlations.

    Science.gov (United States)

    Pretolani, Marina; Bergqvist, Anders; Thabut, Gabriel; Dombret, Marie-Christine; Knapp, Dominique; Hamidi, Fatima; Alavoine, Loubna; Taillé, Camille; Chanez, Pascal; Erjefält, Jonas S; Aubier, Michel

    2017-04-01

    The effectiveness of bronchial thermoplasty (BT) has been reported in patients with severe asthma, yet its effect on different bronchial structures remains unknown. We sought to examine the effect of BT on bronchial structures and to explore the association with clinical outcome in patients with severe refractory asthma. Bronchial biopsy specimens (n = 300) were collected from 15 patients with severe uncontrolled asthma before and 3 months after BT. Immunostained sections were assessed for airway smooth muscle (ASM) area, subepithelial basement membrane thickness, nerve fibers, and epithelial neuroendocrine cells. Histopathologic findings were correlated with clinical parameters. BT significantly improved asthma control and quality of life at both 3 and 12 months and decreased the numbers of severe exacerbations and the dose of oral corticosteroids. At 3 months, this clinical benefit was accompanied by a reduction in ASM area (median values before and after BT, respectively: 19.7% [25th-75th interquartile range (IQR), 15.9% to 22.4%] and 5.3% [25th-75th IQR], 3.5% to 10.1%, P Asthma Control Test scores, numbers of exacerbations, and visits to the emergency department (all P ≤ .02) 3 and 12 months after BT. BT is a treatment option in patients with severe therapy-refractory asthma that downregulates selectively structural abnormalities involved in airway narrowing and bronchial reactivity, particularly ASM, neuroendocrine epithelial cells, and bronchial nerve endings. Copyright © 2016 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  8. A clinical clerkship collaborative program in Taiwan: Acquiring core clinical competencies through patient care responsibility

    Directory of Open Access Journals (Sweden)

    Yong A. Wang

    2016-06-01

    Conclusion: This pilot collaborative program presented a successful model for clinical education in the teaching of core clinical competencies through direct patient care responsibilities at the clerkship stage. It is hoped that the project will become a catalyst for medical education reform in Taiwan and regions with similar traditions.

  9. Retrospective North American CFL Experience Curve Analysis and Correlation to Deployment Programs

    Energy Technology Data Exchange (ETDEWEB)

    Smith, Sarah J. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Wei, Max [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Sohn, Michael D. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2015-07-01

    Retrospective experience curves are a useful tool for understanding historic technology development, and can contribute to investment program analysis and future cost estimation efforts. This work documents our development of an analysis approach for deriving retrospective experience curves with a variable learning rate, and its application to develop an experience curve for compact fluorescent lamps for the global and North American markets over the years 1990-2007. Uncertainties and assumptions involved in interpreting data for our experience curve development are discussed, including the processing and transformation of empirical data, the selection of system boundaries, and the identification of historical changes in the learning rate over the course of 15 years. In the results that follow, we find that that the learning rate has changed at least once from 1990-2007. We also explore if, and to what degree, public deployment programs may have contributed to an increased technology learning rate in North America. We observe correlations between the changes in the learning rate and the initiation of new policies, abrupt technological advances, including improvements to ballast technology, and economic and political events such as trade tariffs and electricity prices. Finally, we discuss how the findings of this work (1) support the use of segmented experience curves for retrospective and prospective analysis and (2) may imply that investments in technological research and development have contributed to a change in market adoption and penetration.

  10. Correlates of maternal depressive symptoms in a national Head Start program sample.

    Science.gov (United States)

    Lanzi, R G; Pascoe, J M; Keltner, B; Ramey, S L

    1999-08-01

    To examine correlates of maternal depressive symptoms in a diverse, national sample of mothers whose kindergarten-aged children attended a Head Start program. A cross-sectional study of 5820 mothers was conducted during their child's kindergarten year. Rates of maternal depressive symptoms were assessed by a validated 3-item depression screen. The ethnic makeup of the group of mothers was non-Hispanic white, 46%; African American, 30%; Hispanic, 13%; American Indian, 6%; Asian American, 1%; and other, 4%. The mean (SD) age of the mothers was 30.1 (5.55) years, 57% were unemployed, and 68% had at least a high school diploma or had earned a high school equivalency diploma. More than 40% of the mothers screened positive for depressive symptoms. The strongest associations after controlling for several biological and demographic variables were maternal chronic health problem (adjusted odds ratio, 2.77; 95% confidence interval, 1.98-3.87), homelessness (adjusted odds ratio, 2.00; 95% confidence interval, 1.45-2.77), and lowest income level (adjusted odds ratio, 1.56; 95% confidence interval, 1.30-1.88). Depressive symptoms were common among mothers of young children in this national sample. Interventions must be targeted at alleviating maternal depressive symptoms by decreasing poverty, providing support programs for single parents, and establishing accessible and affordable medical care for all parents and their children. Primary care physicians can play a key role in early identification and intervention.

  11. Combining a clinical ladder and performance appraisal system as a reward strategy: the EXCEL clinical ladder program.

    Science.gov (United States)

    Moe, J K; Lonowski, L R; Yancer, D A

    1994-09-01

    In response to the dramatic changes occurring in health care today and a desire to reward professional nurses for clinical behaviors that would be valued in the future, Bergan Mercy Medical Center (BMMC) has developed an innovative clinical ladder/performance appraisal system. The BMMC EXCEL Clinical Ladder program, which is based on the developmental model of Patricia Benner, is a competency-based system that uniquely combines a clinical ladder and performance appraisal system. The program is clinically focused and contains optional components in which registered nurses (RNs) can receive additional credit for participation in professional growth and leadership activities. Nurses document examples of their practice through nursing narratives that describe actual clinical situations. The development and implementation processes, challenges encountered, and recommendations for alternative approaches to the implementation of such a unique system are discussed.

  12. Prevalence, clinical features, and correlates of inappropriate sexual behavior after traumatic brain injury: a multicenter study.

    Science.gov (United States)

    Simpson, Grahame K; Sabaz, Mark; Daher, Maysaa

    2013-01-01

    Investigate the prevalence and clinical features of inappropriate sexual behavior (ISB) among a community-based cohort of clients of the New South Wales Brain Injury Rehabilitation program. All 11 community-based rehabilitation services of the statewide network. Five hundred seven clients with severe traumatic brain injury. Cross-sectional multicentre study. Overt Behavior Scale, Disability Rating Scale, Sydney Psychosocial Reintegration Scale-2, Health of the Nation Outcome Scale-Acquired Brain Injury, Care and Needs Scale. The point prevalence rate of ISBs was 8.9% (45/507) over the previous 3 months. Inappropriate sexual talk comprised 57.9% of all ISBs, followed by genital and nongenital touching behaviors (29.8%) and exhibitionism/public masturbation (10.5%). In 43 of 45 cases, ISBs were accompanied by other challenging behaviors, most often inappropriate social behavior, and/or aggression. Individuals who sustained more severe injuries and who were younger were significantly more likely to display ISBs. People displaying ISBs were more likely to display higher levels of challenging behaviors overall, lower levels of social participation, and more neuropsychiatric sequelae than 2 other groups: people displaying no challenging behaviors and people displaying challenging behaviors but no ISBs respectively. ISBs pose a complex clinical challenge among a minority of individuals with severe TBI.

  13. Kinematic measures for upper limb robot-assisted therapy following stroke and correlations with clinical outcome measures: A review.

    Science.gov (United States)

    Tran, Vi Do; Dario, Paolo; Mazzoleni, Stefano

    2018-01-17

    This review classifies the kinematic measures used to evaluate post-stroke motor impairment following upper limb robot-assisted rehabilitation and investigates their correlations with clinical outcome measures. An online literature search was carried out in PubMed, MEDLINE, Scopus and IEEE-Xplore databases. Kinematic parameters mentioned in the studies included were categorized into the International Classification of Functioning, Disability and Health (ICF) domains. The correlations between these parameters and the clinical scales were summarized. Forty-nine kinematic parameters were identified from 67 articles involving 1750 patients. The most frequently used parameters were: movement speed, movement accuracy, peak speed, number of speed peaks, and movement distance and duration. According to the ICF domains, 44 kinematic parameters were categorized into Body Functions and Structure, 5 into Activities and no parameters were categorized into Participation and Personal and Environmental Factors. Thirteen articles investigated the correlations between kinematic parameters and clinical outcome measures. Some kinematic measures showed a significant correlation coefficient with clinical scores, but most were weak or moderate. The proposed classification of kinematic measures into ICF domains and their correlations with clinical scales could contribute to identifying the most relevant ones for an integrated assessment of upper limb robot-assisted rehabilitation treatments following stroke. Increasing the assessment frequency by means of kinematic parameters could optimize clinical assessment procedures and enhance the effectiveness of rehabilitation treatments. Copyright © 2018 IPEM. Published by Elsevier Ltd. All rights reserved.

  14. Relationship between reflection ability and clinical performance: a cross-sectional and retrospective-longitudinal correlational cohort study in midwifery.

    Science.gov (United States)

    Embo, M; Driessen, E; Valcke, M; van der Vleuten, C P M

    2015-01-01

    increasingly, reflection is highlighted as integral to core practice competencies but empirical research into the relationship between reflection and performance in the clinical workplace is scarce. this study investigated the relationship between reflection ability and clinical performance. we designed a cross-sectional and a retrospective-longitudinal cohort study. Data from first, second and third year midwifery students were collected to study the variables 'clinical performance' and 'reflection ability'. Data were analysed with SPSS for Windows, Release 20.0. Descriptive statistics, Pearson׳s Product Moment Correlation Coefficients (r) and r² values were computed to investigate associations between the research variables. the results showed a moderate observed correlation between reflection ability and clinical performance scores. When adopting a cross-sectional perspective, all correlation values were significant (pperformance (>0.6). The results based on the retrospective-longitudinal data set explained a moderate proportion of the variance after correction for attenuation. Finally, the results indicate that 'reflection ability' scores of earlier years are significant related with 'clinical performance' scores of subsequent years. These results suggest that (1) reflection ability is linked to clinical performance; (2) that written reflections are an important, but not the sole way to assess professional competence and that (3) reflection is a contributor to clinical performance improvement. the data showed a moderate but significant relationship between 'reflection ability' and 'clinical performance' scores in clinical practice of midwifery students. Reflection therefore seems an important component of professional competence. Copyright © 2014 Elsevier Ltd. All rights reserved.

  15. Evaluation of the Military Functional Assessment Program: Preliminary Assessment of the Construct Validity Using an Archived Database of Clinical Data.

    Science.gov (United States)

    Kelley, Amanda M; Ranes, Bethany M; Estrada, Art; Grandizio, Catherine M

    2015-01-01

    Several important factors must be considered when deciding to return a soldier to duty after a traumatic brain injury (TBI). Premature return increases risk for not only second-impact syndrome during the acute phase but also permanent changes from repetitive concussions. Thus, there is a critical need for return-to-duty (RTD) assessment criteria that encompass the spectrum of injury and disease experienced by US soldiers, particularly TBI. To provide evidence-based standards to eventually serve as criteria for operational competence and performance of a soldier after injury. Specifically, the relationships between clinical assessments and novel military-specific tasks were evaluated. Exploratory analyses (including nonparametric tests and Spearman rank correlations) of an archived database. A total of 79 patients with TBI who participated in an RTD assessment program at a US Army rehabilitation and recovery center. Military Functional Assessment Program (to determine a soldier's operational competence and performance after TBI) tasks; Dizziness Handicap Inventory; Dynamic Visual Acuity (vestibular function); Sensory Organization Test (postural control); Repeatable Battery for the Assessment of Neuropsychological Status (neuropsychological screening test); Beck Depression Inventory-II; Beck Anxiety Inventory; Comprehensive Trail Making Test (visual search and sequencing); posttraumatic stress disorder checklist military version; Alcohol Use Disorders Identification Test; Epworth Sleepiness Scale; Patient Health Questionnaire; and Military Acute Concussion Evaluation. Selected military operational assessment tasks correlated significantly with clinical measures of vestibular function, psychological well-being, and cognitive function. Differences on occupational therapy assessments, a concussion screening tool, and a self-report health questionnaire were seen between those who passed and those who failed the RTD assessment. Specifically, those who passed the RTD

  16. Clinically speaking: A communication skills program for students from non-English speaking backgrounds.

    Science.gov (United States)

    Miguel, Caroline San; Rogan, Fran; Kilstoff, Kathleen; Brown, Di

    2006-09-01

    This paper reports on the design, delivery and evaluation of an innovative oral communication skills program for first year students in a Bachelor of Nursing degree at an Australian university. This program was introduced in 2004 to meet the needs of first year undergraduate students from non-English speaking backgrounds who had experienced difficulties with spoken English while on clinical placement. The program consisted of early identification of students in need of communication development, a series of classes incorporated into the degree program to address students' needs, followed by a clinical placement block. This paper describes the structure of the program, discusses some of the major problems encountered by students in the clinical setting and presents some of the teaching strategies used to address these problems. Evaluations of the program suggest that students' communication skills and confidence improved, resulting in a more positive clinical experience for the majority of students.

  17. New graduate nurses, new graduate nurse transition programs, and clinical leadership skill: a systematic review.

    Science.gov (United States)

    Chappell, Kathy B; Richards, Kathy C

    2015-01-01

    This systematic review evaluated the relationship between new graduate nurses and clinical leadership skill, and between new graduate nurse transition programs and clinical leadership skill. New graduate nurse transition programs have been cited as one strategy to improve clinical leadership skill, but to our knowledge, no one has synthesized the evidence on new graduate nurse transition programs and clinical leadership skill. Results of this review showed that new graduate nurse transition programs that were at least 24 weeks in length had a positive impact on clinical leadership skill. New graduate nurse transition programs using the University HealthSystem Consortium/American Association of Colleges of Nursing Nurse Residency curriculum had the greatest impact, followed by curriculum developed by the Versant New Graduate RN Residency, an important finding for nursing professional development specialists.

  18. Lateral lumbar disc herniation: MR imaging findings and correlation with clinical symptoms

    Energy Technology Data Exchange (ETDEWEB)

    Park, So Young; Park, Ji Seon; Jin, Wook; Ryu, Kyung Nam [KyungHee University Medical Center, Seoul (Korea, Republic of)

    2008-03-15

    To evaluate MRI findings of lateral lumbar disc herniations (LLDHs) and to determine whether those correlate with clinical symptoms. The study included 105 patients with LLDHs that were diagnosed by MRI. The distribution and location of the LLDHs (foraminal, extraforaminal, and foraminal and extraforaminal), the displacement of adjacent nerves, and the detection rate of LLDHs from axial and sagittal images were reviewed retrospectively by two radiologists. 36 patients were included in evaluating whether location of LLDHs and displacement of adjacent nerve correlate with radiculopathy. The distribution of the LLDHs were 3.4% at L1-2, 14.4% at L2-3, 33% at L3-4, 33% at L4-5, and 16.9% at L5-S1. The locations were foraminal in 38.6% of cases, extraforaminal in 45.4% of cases, and foraminal and extraforaminal in 16% of cases. In addition, 77.3% of the diagnosed LLDH cases displaced the adjacent nerve. The detection rates of LLDHs in the axial and sagittal images were 100% and 77.3%, respectively. In 36 patients, 47.4% had radiculopathy related to LLDHs. Location of LLDHs and displacement of adjacent nerve had no statistically significant difference between patients with or without radiculopathy. MRI is an effective method for evaluating the location of LLDHs and their influence on adjacent nerves. The axial image is more important than the sagittal image in diagnosing LLDHs. The location of LLDHs and the displacement of adjacent nerve were not found to be related to radiculopathy.

  19. Intradialytic hypotension: frequency, sources of variation and correlation with clinical outcome.

    Science.gov (United States)

    Sands, Jeffrey J; Usvyat, Len A; Sullivan, Terry; Segal, Jonathan H; Zabetakis, Paul; Kotanko, Peter; Maddux, Franklin W; Diaz-Buxo, Jose A

    2014-04-01

    Intradialytic hypotension (IH) is a frequent complication of hemodialysis (HD) and is associated with increased patient mortality and cardiovascular events. We studied IH to determine its variability, correlates, and clinical impact in 13 outpatient HD facilities. Blood pressure was captured by machine download. IH was defined as >30 mmHg decrease in systolic blood pressure to 20 HD treatments. We studied IH in 44,801 treatments (Tx) in 1137 patients. IH was frequent (17.2% of treatments) and highly variable by patient (0-100% Tx) and dialysis facility (11.1-25.8% Tx). 25.1% of patients had no IH (0% Tx) and 16.2% had IH on >35% Tx. Increased IH frequency was associated with age, female gender, diabetes, Hispanic origin, longer end stage renal disease vintage, higher body mass index, higher ultrafiltration volume, the second and third weekly Tx, lower pre-HD systolic blood pressure, higher difference between prescribed and achieved post-HD weight, and higher dialysate temperature. Dialysis facility was an independent predictor of IH frequency. Patients with >35% IH treatments had poorer survival (P = 0.036), and more frequent and longer hospitalization (P = 0.04, P = 0.002, respectively) than patients without IH. In conclusion, IH frequency was highly variable, associated with individual facilities, patient and treatment characteristics, and correlated with mortality and hospitalization. Identifying practice patterns associated with IH coupled with routine reporting of IH will facilitate medical management and may result in the prevention of IH, decreased mortality, and decreased hospitalization. © 2014 International Society for Hemodialysis.

  20. Clinical correlates to assist with CTE diagnosis: Insights from a novel rodent repeat concussion model.

    Science.gov (United States)

    Thomsen, Gretchen M; Ko, Ara; Harada, Megan Y; Ma, Annie; Wyss, Livia; Haro, Patricia; Vit, Jean-Philippe; Avalos, Pablo; Dhillon, Navpreet; Cho, Noell; Shelest, Oksana; Ley, Eric J

    2017-03-23

    Chronic traumatic encephalopathy (CTE) is a neurodegenerative disease linked to repetitive head injuries. CTE symptoms include changes in mood, behavior, cognition and motor function, however CTE is only currently diagnosed post-mortem. Using a rat model of recurrent traumatic brain injury (TBI) we demonstrate rodent deficits that predict the severity of CTE-like brain pathology. Bilateral, closed skull, mild TBI was administered once per week to 35 WT rats, 8 rats received 2 injuries ('2xTBI'), 27 rats received 5 injuries ('5xTBI') and 13 rats were sham controls. To determine clinical correlates for CTE diagnosis, TBI rats were separated based on the severity of rotarod deficits and classified as "mild" or "severe" and further separated into "acute", "short" and "long" based on age at euthanasia (90, 144 and 235 days, respectively). Brain atrophy, phosphorylated tau (p-tau), and inflammation were assessed. All eight 2xTBI had mild rotorod deficiency, 11 5xTBI had mild deficiency and 16 had severe. In one cohort of rats, tested at ~235 days of age, balance, rearing, and grip strength were significantly worse in the severe group relative to both sham and mild groups. At the acute time period, cortical thinning, p-tau and inflammation were not observed in either TBI group, whereas corpus callosum thinning was observed in both TBI groups. At later time points, atrophy, tau pathology and inflammation were increased in mild and severe TBI groups in the cortex and corpus callosum, relative to sham controls. These injury effects were exacerbated over time in the severe TBI group in the corpus callosum. Our model of repeat mild TBI suggests that permanent deficits in specific motor function tests correlate with CTE-like brain pathology. Assessing balance and motor coordination over time may predict CTE diagnosis.

  1. Correlations between clinical presentations of adult trigger digits and histologic aspects of the A1 pulley.

    Science.gov (United States)

    Drossos, K; Remmelink, M; Nagy, N; de Maertelaer, V; Pasteels, J L; Schuind, F

    2009-10-01

    We aimed to report by light microscopy the normal histology of the A1 pulley, describe the histologic abnormalities of A1 pulleys in trigger digits, and look for possible correlations between these findings and the severity of the disease. In a series of 104 trigger digits operated on in 80 adult patients, the A1 pulleys were removed and histologically studied. The findings were compared with 55 normal A1 pulleys obtained from fresh-frozen cadaveric specimens. The normal A1 pulley was composed of 3 layers: layer I, an inner, avascular, concave unicellular or bicellular gliding layer containing cartilage-like cells; layer II, a middle layer, also avascular, characterized by spindle-shaped fibroblasts; and layer III, an outer, richly vascularized layer, continuous with the membranous tendons sheath. We used a 3-grade classification, increasing in severity, to describe the histologic abnormalities observed in trigger digit A1 pulleys. Mild abnormalities (grade 1) were those with a fibrocartilaginous gliding surface almost intact. The margin between the fibrocartilaginous and membranous portions of the pulley was well delineated. In moderate abnormalities (grade 2), the avascular fibrocartilaginous gliding surface appeared fissured and thinner. The inner layer (I) was interrupted and replaced by fibrous tissue, with fissures that did not cross through the middle layer (II). A mild vascular network hyperplasia was observed in the outer layer (III), which began to invade the fibrocartilage. In severe abnormalities (grade 3), the fibrocartilaginous gliding surface was thin, discontinuous, or even completely destroyed. The vascular network hyperplasia became excessive and reached the synovial space of the flexor tendon sheath. The histologic features were correlated with the severity of the clinical symptoms (p pulley of trigger digits are characteristic and not related to inflammation. As the trigger digit worsens, the gliding surface begins to wear and is gradually

  2. Clinical and socio-behavioral correlates of tooth loss: a study of older adults in Tanzania

    Directory of Open Access Journals (Sweden)

    Åstrøm Anne N

    2006-03-01

    Full Text Available Abstract Background Focusing 50 year olds and above, this study assessed the frequency, extent and correlates of tooth loss due to various reasons. Frequency and correlates of posterior occluding support was also investigated. Method A cross-sectional household survey was conducted in Pwani region and in Dar es Salaam in 2004/2005. One thousand and thirty-one subjects, mean age 62.9 years participated in a clinical examination and completed interviews. Results The prevalence of tooth loss due to any reason was 83.5 %, due to caries 63.4% and due to other reasons than caries, 32.5%. A total of 74.9% had reduced number of posterior occluding units. Compared to subjects having less than 5 teeth lost due to caries, those with 5 or more lost teeth were more likely to be females, having decayed teeth, confirming dental attendance and to be among the least poor residents. Compared to subjects who had lost less than 5 teeth due to reasons other than caries, those who had lost 5 or more teeth were more likely to be of higher age, having mobile teeth, being males, being very poor and to disconfirm dental attendance when having problems. Predictors of prevalence of tooth loss (1 or more lost tooth due to various reasons and reduced number of occluding units followed similar patterns of relationships. Conclusion The results are consistent with prevalence and extent of tooth loss due to caries and due to reasons other than caries being differently related to disease- and socio- behavioral risk indicators. Caries was the principle cause of tooth loss and molar teeth were the teeth most commonly lost.

  3. Insider's Guide to Graduate Programs in Clinical and Counseling Psychology. 2006/2007 Edition

    Science.gov (United States)

    Mayne, Tracy J.; Norcross, John C.; Sayette, Michael A.

    2006-01-01

    Now in its 2006-2007 edition, this perennial bestseller is the resource students count on for the most current information on applying to doctoral programs in clinical or counseling psychology. The Insider's Guide presents up-to-date facts on 300 accredited programs in the United States and Canada. Each program's profile includes admissions…

  4. Correlation between endogenous polyamines in human cardiac tissues and clinical parameters in patients with heart failure.

    Science.gov (United States)

    Meana, Clara; Rubín, José Manuel; Bordallo, Carmen; Suárez, Lorena; Bordallo, Javier; Sánchez, Manuel

    2016-02-01

    Polyamines contribute to several physiological and pathological processes, including cardiac hypertrophy in experimental animals. This involves an increase in ornithine decarboxylase (ODC) activity and intracellular polyamines associated with cyclic adenosine monophosphate (cAMP) increases. The aim of the study was to establish the role of these in the human heart in living patients. For this, polyamines (by high performance liquid chromatography) and the activity of ODC and N(1)-acetylpolyamine oxidases (APAO) were determined in the right atrial appendage of 17 patients undergoing extracorporeal circulation to correlate with clinical parameters. There existed enzymatic activity associated with the homeostasis of polyamines. Left atria size was positively associated with ODC (r = 0.661, P = 0.027) and negatively with APAO-N(1) -acetylspermine (r = -0.769, P = 0.026), suggesting that increased levels of polyamines are associated with left atrial hemodynamic overload. Left ventricular ejection fraction (LVEF) and heart rate were positively associated with spermidine (r = 0.690, P = 0.003; r = 0.590, P = 0.021) and negatively with N(1)-acetylspermidine (r = -0.554, P = 0.032; r = -0.644, P = 0.018). LVEF was negatively correlated with cAMP levels (r = -0.835, P = 0.001) and with cAMP/ODC (r = -0.794, P = 0.011), cAMP/spermidine (r = -0.813, P = 0.001) and cAMP/spermine (r = -0.747, P = 0.003) ratios. Abnormal LVEF patients showed decreased ODC activity and spermidine, and increased N(1) -acetylspermidine, and cAMP. Spermine decreased in congestive heart failure patients. The trace amine isoamylamine negatively correlated with septal wall thickness (r = -0.634, P = 0.008) and was increased in cardiac heart failure. The results indicated that modifications in polyamine homeostasis might be associated with cardiac function and remodelling. Increased cAMP might have a deleterious effect on function. Further studies should confirm these findings and the involvement of

  5. Integrating research and education into clinical practice: the multi-organ transplant student research training program.

    Science.gov (United States)

    Famure, Olusegun; Li, Anna; Ross, Heather; Kim, S Joseph

    2012-01-01

    Given the increased student interest in health research and the need to implement health research initiatives, the Multi-Organ Transplant Student Research Training Program provides student trainees with the opportunity to contribute to health research initiatives in transplant care. Program quality initiatives achieved include the development of a clinical research database, knowledge exchange, performance measurement tools, and health research projects. The program promotes collaboration between academic and healthcare institutions to integrate research and education into clinical practice.

  6. The correlation between anti phospholipase A 2 specific IgE and clinical symptoms after a bee sting in beekeepers

    Directory of Open Access Journals (Sweden)

    Jan Matysiak

    2016-06-01

    Full Text Available Introduction: Beekeepers are a group of people with high exposure to honeybee stings and with a very high risk of allergy to bee venom. Therefore, they are a proper population to study the correlations between clinical symptoms and results of diagnostic tests. Aim: The primary aim of our study was to assess the correlations between total IgE, venom- and phospholipase A 2 -specific IgE and clinical symptoms after a bee sting in beekeepers. The secondary aim was to compare the results of diagnostic tests in beekeepers and in individuals with standard exposure to bees. Material and methods: Fifty-four individuals were divided into two groups: beekeepers and control group. The levels of total IgE (tIgE, venom-specific IgE (venom sIgE, and phospholipase A 2 -specific IgE (phospholipase A 2 sIgE were analyzed. Results: Our study showed no statistically significant correlation between the clinical symptoms after a sting and tIgE in the entire analyzed group. There was also no correlation between venom sIgE level and clinical symptoms either in beekeepers or in the group with standard exposure to bees. We observed a statistically significant correlation between phospholipase A 2 sIgE level and clinical signs after a sting in the group of beekeepers, whereas no such correlation was detected in the control group. Significantly higher venom-specific IgE levels in the beekeepers, as compared to control individuals were shown. Conclusions : In beekeepers, the severity of clinical symptoms after a bee sting correlated better with phospholipase A 2 sIgE than with venom sIgE levels.

  7. Clinical Faculty in Educational Leadership Programs: A Growing Force

    Science.gov (United States)

    Hackmann, Donald G.; McCarthy, Martha M.

    2011-01-01

    This study was conducted to develop a demographic profile of full-time educational leadership clinical faculty, to identify their professional responsibilities, and to compare their job satisfaction and perceptions of the educational leadership field with those of tenure-line faculty. Utilizing an online questionnaire, 140 clinical faculty and 755…

  8. Connecting classroom to clinical practice: a comparison of programs.

    Science.gov (United States)

    Fortsch, Peggy; Henning, John E; Nielsen, Lynn E

    2009-01-01

    To compare student perceptions of their clinical field experiences in 3 distinct settings: the external model, in which course work and clinical experience are taught in separate institutions; the internal model, in which course work and clinical experience are taught within the same institution; and the bridging model, in which course work and clinical experience are taught in associated institutions. Qualitative data were collected for 9 participants at 3 clinical sites through individual interviews, observations and focus group interviews. Findings indicated that the participants appreciated the value of integrating their course work with their clinical experience, supervision that allowed freedom while providing support, frequent and honest feedback, recognition for their efforts (especially from patients) and the importance of interpersonal relationships for establishing trust. Students from the external model noted initial problems stemming from a lack of communication between the community college instructors and the clinical faculty. Students from the internal model noted a lack of conceptual preparation for the clinical experience. Results from the internal and external models stressed interpersonal relationships and cited a perceived lessening of the learning experience. A perceived lessening of the learning experience was not observed in the bridging model.

  9. Developing students' clinical reasoning skills: correlates of perceived relevance of two teaching and learning approaches.

    Science.gov (United States)

    Postma, T C; White, J G

    2017-02-01

    'Relevance' is a key concept in adult learning. Hence, this study sought to examine students' perceptions of relevance of the teaching and learning in relation to different instructional designs employed in a Comprehensive Patient Care (CPC) course that aims to develop integrated clinical reasoning skills. Third to fifth year students (2009-2011) were asked to anonymously rate the relevance of the instructional design (RELID) they participated in by means of visual analogue scales at the School of Dentistry, University of Pretoria. They were also asked to rate their perceptions of the alignment between teaching and learning and outcomes (ATLO), assessments' contribution to learning (ACL), course organisation (CO) and teacher competence (TC). RELID served as the outcome measure in stepwise linear regression analyses. ATLO, ACL, CO, TC and the instructional design (case-based learning (CBL = 1) and the combination of discipline-based and lecture-based teaching in CPC (DB-LBT = 0)) served as the co-variables for each of the years of study. The analyses showed positive correlations between RELID and ATLO and between RELID and ACL for all the years of study. RELID was associated with TC in year three and four and CO was associated with RELID in year four and five. CBL outperformed DB-LBT in terms of perceived relevance of the teaching and learning. The results suggest that students' perceptions of the relevance of the instructional design may be enhanced when outcomes, teaching, learning and assessment are constructively aligned during the development of clinical reasoning skills. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  10. Anxiety and depression in hyperemesis gravidarum: prevalence, risk factors and correlation with clinical severity.

    Science.gov (United States)

    Tan, Peng Chiong; Vani, Subramaniam; Lim, Boon Kiong; Omar, Siti Zawiah

    2010-04-01

    To evaluate prevalence, risk factors and clinical severity correlates of anxiety and depression caseness in hyperemesis gravidarum (HG). A prospective study of self-assessment using the Hospital Anxiety and Depression Scale (HADS) was performed. Women at their first hospitalization for HG were recruited as soon as possible after hospital admission. Cut-off at the score of 7/8 was used for both the anxiety and depression subscales of HADS to denote anxiety and depression caseness respectively. Risk factors for anxiety and depression caseness were identified using Chi-square test, Fisher's exact test, Mann-Whitney's U-test or the Student's t-test. Multivariable logistic regression analysis incorporating all co-variables with crude Pdepression caseness. Prolonged hospitalization and a number of biochemical and hematological abnormalities were used as clinical markers of HG severity. Criteria for anxiety and depression caseness were fulfilled in 98/209 (46.9%) and 100/209 (47.8%) women respectively. 78 (37.3%) participants fulfilled the criteria for both anxiety and depression caseness, 89 (42.6%) neither, 20 (9.6%) anxiety caseness only and 22 (10.5%) depression caseness only. Gestational age at commencement of vomiting, duration of vomiting leading up to hospitalization and paid employment status had crude Pdepression caseness. After adjustment, only previous miscarriage was negatively associated with depression caseness (AOR 0.4 95% CI 0.2-0.9; P=0.022). There was no marker of HG severity associated with anxiety caseness on bivariate analysis. High hematocrit was associated with depression caseness (OR 2.1 95% CI 1.1-3.9; P=0.027). Anxiety and depression caseness is common in HG and risk factors can be identified. There is no convincing association between anxiety and depression and more severe illness. Psychological symptoms may be a response to physical illness but further studies are needed. Copyright (c) 2009 Elsevier Ireland Ltd. All rights reserved.

  11. Correlation of anti-fungal susceptibility with clinical outcomes in patients with cryptococcal meningitis

    Directory of Open Access Journals (Sweden)

    Lee Chen-Hsiang

    2012-12-01

    Full Text Available Abstract Background This study aimed to investigate the correlation of minimum inhibiting concentrations (MICs, obtained by broth micro-dilution, and clinical response in patients with cryptococcal meningitis. Methods Using retrospective analyses covering the period 2001–2010, factors affecting clinical therapeutic cure in patients with cryptococcal meningitis 10 weeks after the start of anti-fungal therapy were identified. Specific emphasis was placed on the role of anti-fungal susceptibility. Results Of 46 patients with cryptococcal meningitis identified, 21 were cured after 10 weeks of treatment. Overall, 12 strains (26.1% were resistant to fluconazole (>8 μg/ml and 8 (17.4% had an MIC >1 μg/ml for amphotericin B. Twenty-three patients received combination amphotericin B and fluconazole as their initial antifungal therapy, 17 were given amphotericin B only, five received fluconazole only, and one received a combination of amphotericin B and flucytosine. After 2 weeks, all patients received fluconazole (400–600 mg daily for 8 weeks at least, then 200 mg daily thereafter. The presence of isolates resistant to fluconazole (MIC >8 μg/ml; 4.8% vs. 44%, p 8 μg/ml, was an independent predictor of therapeutic cure at 10-week evaluation (OR = 15.7; 95% CI: 1.8-135.9; p = 0.01, but higher MIC of amphotericin B (>1 μg/ml was not. Conclusions The MICs of fluconazole, determined by the CLSI method, may be a potential predictor of therapeutic cure in patients with cryptococcal meningitis.

  12. Estimation of Thyroid Hormone in Early Pregnancy and it's Clinical Correlation.

    Science.gov (United States)

    Jahan, M K; Nahar, K; Islam, M; Shafiquzzaman, M; Nahar, S; Easmin, S; Mohsin, M; Sarkar, S K; Hossain, M A

    2016-04-01

    This descriptive cross sectional study was done for the estimation of thyroid hormone in early pregnancy and it's clinical correlation. It was conducted at the Antenatal Clinic of Mymensingh Medical College Hospital, Mymensingh from December 2010 to November 2011. Total 185 cases in early pregnancy were taken purposively and randomly. Among the pregnant women, age ranged from 18-42 years with the Mean±SD age 25.77±4.96 years, the gestational weeks ranged 6±1 to 13±1weeks having Mean±SD 9.06± 2.49 weeks. The gravida ranged from primi to 8th gravida Mean±SD 1.89±1.10. Haemoglobin level ranged from 9.0 to 13.2gm/dl; Mean±SD 10.90±0.99gm/dl. Mean±SD of serum FT4 was 17.77±7.25 and Mean±SD of TSH was 3.95±2.94mIU/L. In present study, 5.40% (n=10) of the respondents had hypothyroidism and 0.54% (n=1) showed hyperthyroidism. The present study showed that, the incidence of hypothyroidism had relatively increased then the reference ranges but not statistically significant. But hyperthyroidism was within the reference range. This study showed slightly higher percentage of hypothyroidism in both ≤30 (4.52%) and ≥30 (10%) years of age groups especially a bit higher percentage in the elderly group. In present study, hypothyroidism was common among women of lower income group. Present study showed a higher percentage of stillbirth &miscarriage among study population. This study showed a relatively higher prevalence of abnormal thyroid function (especially hypothyroidism) in the study population and suggests the routine screening of thyroid hormone in early pregnancy in addition to routine antenatal care.

  13. Olfactory Function and Associated Clinical Correlates in Former National Football League Players.

    Science.gov (United States)

    Alosco, Michael L; Jarnagin, Johnny; Tripodis, Yorghos; Platt, Michael; Martin, Brett; Chaisson, Christine E; Baugh, Christine M; Fritts, Nathan G; Cantu, Robert C; Stern, Robert A

    2017-02-15

    Professional American football players incur thousands of repetitive head impacts (RHIs) throughout their lifetime. The long-term consequences of RHI are not well characterized, but may include olfactory dysfunction. RHI has been associated with changes to brain regions involved in olfaction, and olfactory impairment is common after traumatic brain injury. Olfactory dysfunction is a frequent early sequelae of neurodegenerative diseases (e.g., Alzheimer's disease), and RHI is associated with the neurodegenerative disease, chronic traumatic encephalopathy (CTE). We examined olfaction, and its association with clinical measures, in former National Football League (NFL) players. Ninety-five former NFL players (ages 40-69) and 28 same-age controls completed a neuropsychological and neuropsychiatric evaluation as part of a National Institutes of Health-funded study. The Brief Smell Identification Test (B-SIT) assessed olfaction. Principal component analysis generated a four-factor structure of the clinical measures: behavioral/mood, psychomotor speed/executive function, and verbal and visual memory. Former NFL players had worse B-SIT scores relative to controls (p = 0.0096). A B-SIT cutoff of 11 had the greatest accuracy (c-statistic = 0.61) and specificity (79%) for discriminating former NFL players from controls. In the former NFL players, lower B-SIT scores correlated with greater behavioral/mood impairment (p = 0.0254) and worse psychomotor speed/executive functioning (p = 0.0464) after controlling for age and education. Former NFL players exhibited lower olfactory test scores relative to controls, and poorer olfactory test performance was associated with worse neuropsychological and neuropsychiatric functioning. Future work that uses more-comprehensive tests of olfaction and structural and functioning neuroimaging may improve understanding on the association between RHI and olfaction.

  14. Surgical Outcome for Moyamoya Disease: Clinical and Perfusion Computed Tomography Correlation.

    Science.gov (United States)

    Cheung, Alvin Ho-Kwan; Lam, Angus Ka-Cheong; Ho, Wai-Shing Wilson; Tsang, Chun-Pong; Tsang, Anderson Chun-On; Lee, Raymond; Lui, Wai-Man; Leung, Gilberto Ka-Kit

    2017-02-01

    To compare surgical outcome both radiologically and clinically after interventions for patients with Moyamoya disease. This retrospective observational study included 25 patients who were treated surgically for Moyamoya disease in the past 14 years. Clinical outcomes were analyzed by subgroups stratified by age, disease presentation, and surgical intervention. Serial postoperative brain computed tomography perfusion records were analyzed with respect to the cerebral blood flow and cerebrovascular reserve capacity (CVRC) of the middle cerebral artery territory. Changes in both the intervention (n = 23) and nonintervtion (n = 9) cerebral hemispheres were compared. All children treated by synangiosis (n = 9), all adults receiving synangiosis (n = 5), and 88.9% of adults undergoing bypass (n = 9) had no neurologic deterioration, with a duration of at least 50.6 months, 85.7 months, and 27.7 months, respectively. Radiologically, CVRC improved more markedly after bypass surgery than synangiosis, particularly 12-24 months postoperatively (51.1% vs. -2.86%). The hemispheres that did not undergo intervention showed similar improvement in cerebral blood flow over time compared with the hemispheres that did undergo intervention, after surgery was performed. Bypass surgery improved CVRC greater than synangiosis, which may correlate with decreased future stroke risks. The decision for bypass is to be balanced with a greater risk of postoperative neurologic deterioration in adults after this procedure. The hemisphere that did not undergo intervention also appeared to benefit from surgery performed on the contralateral brain. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. [Significance of clinical laboratory accreditation based on ISO 15189, and recent trend of international clinical laboratory accreditation program].

    Science.gov (United States)

    Kawai, Tadashi

    2014-06-01

    ISO 15189 was first published in 2003, its second edition in 2007, and its third edition in 2012 by the ISO. Since 2003, through the approval of ILAC, ISO 15189 has been used for the accreditation of clinical/medical laboratories throughout the world, and approximately 5,000 clinical laboratories have now been accredited. In Japan, the JAB, in cooperation with the JCCLS, introduced the clinical laboratory accreditation program based on ISO 15189 in 2005, and 70 labs had been accredited by January 2014. It has been purely voluntary, without any governmental or regulatory involvement so far. However, it has been gradually accepted to be significant for maintaining quality management and for the improvement of clinical laboratory efficiency. The program will expand widely throughout the world in order to accomplish "one-stop testing" among clinical laboratories, at least regarding frequently-used routine laboratory tests.

  16. Sperm chromatin maturity and integrity correlated to zygote development in ICSI program.

    Science.gov (United States)

    Asmarinah; Syauqy, Ahmad; Umar, Liya Agustin; Lestari, Silvia Werdhy; Mansyur, Eliza; Hestiantoro, Andon; Paradowszka-Dogan, Agnieszka

    2016-10-01

    This study aimed to evaluate sperm chromatin maturity and integrity of that injected into good-quality oocytes in an in vitro fertilization-intra cytoplasmic sperm injection (IVF-ICSI) program. A cut-off value of sperm chromatin maturity and integrity was developed as a function of their correlation to the zygote development, i.e., embryo formation and cleavage rate. The study assessed sperm chromatin maturity using aniline blue (AB) staining, whereas toluidine blue (TB) staining was used to assess sperm chromatin integrity. Ejaculates from 59 patients undergoing ICSI and 46 fertile normozoospermic donors for determination of normal values of sperm chromatin status were used in this study. Embryo formation and cleavage rates were observed for the period of 3 days after ICSI. There was a significant difference in the percentage of sperm with mature chromatin between ejaculate from ICSI patients and fertile donor (p=0.020); while there was no significant difference in sperm chromatin integrity of both samples (p=0.120). There was no significant correlation between sperm chromatin maturity and either embryo formation or cleavage rate; as well as sperm chromatin integrity to both parameters of zygote development (p>0.05). Furthermore, we found that the cut-off value of sperm chromatin maturity and integrity of the fertile normozoospermic ejaculates were 87.2% and 80.2%, respectively. Using the cut-offs, we found that low sperm chromatin maturity at the level of chromatin integrity at the level of chromatin (AB<87% and TB<80%, respectively), could affect zygote development following ICSI. AB: aniline blue; CMA3: chromomycin A3; ICSI: intra cytoplasmic sperm injection; IVF: in vitro fertilization; PBS: phosphate buffer saline; SPSS: Statistical Package for Social Science; TB: toluidine blue; WHO: World Health Organization.

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

    Directory of Open Access Journals (Sweden)

    Olumayowa Abimbola Oninla

    2014-01-01

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

  18. SUSCEPTIBILITY TEST FOR FUNGI: CLINICAL AND LABORATORIAL CORRELATIONS IN MEDICAL MYCOLOGY

    Directory of Open Access Journals (Sweden)

    Ana ALASTRUEY-IZQUIERDO

    2015-09-01

    Full Text Available SUMMARYDuring recent decades, antifungal susceptibility testing has become standardized and nowadays has the same role of the antibacterial susceptibility testing in microbiology laboratories. American and European standards have been developed, as well as equivalent commercial systems which are more appropriate for clinical laboratories. The detection of resistant strains by means of these systems has allowed the study and understanding of the molecular basis and the mechanisms of resistance of fungal species to antifungal agents. In addition, many studies on the correlation of in vitro results with the outcome of patients have been performed, reaching the conclusion that infections caused by resistant strains have worse outcome than those caused by susceptible fungal isolates. These studies have allowed the development of interpretative breakpoints for Candida spp. and Aspergillus spp., the most frequent agents of fungal infections in the world. In summary, antifungal susceptibility tests have become essential tools to guide the treatment of fungal diseases, to know the local and global disease epidemiology, and to identify resistance to antifungals.

  19. Is it justifiable to assert that clinical lycanthropy may be correlated to porphyria cutanea tarda?

    Directory of Open Access Journals (Sweden)

    Lorenzo Martini

    2017-10-01

    Full Text Available Scope of this study is to demonstrate an old theory expressed in 1963, when Illis (Guy’s Hospital in London established a correlation between the clinical lycanthropy and congenital porphyria cutanea tarda. We had the fortune to live in a village where they say a lycanthrope lives too and is accustomed to hid himself at home for the 3 days when on the full moon, when he becomes (and behaves as a werewolf. Werewolves like to walk around before dawn craving for water and since We love to walk very early in the morning (as philosopher Emanuel Kant used to do, We have had this chance to encounter this mysterious man, who is a normal man with a regular lifestyle according to lunar cycle. He presents a very pale face with scares and blisters and generally when somebody asks him about this cutaneous manifestations he says he detests sun and light and his skin reacts by this way. We attempted to treat this individual by a pomade containing rutin, diosmin,Centella asiatica,niacinamide and escin. Results are encouraging as well.

  20. Cognitive impairment is correlated with reduced quality of life in patients with clinically isolated syndrome

    Directory of Open Access Journals (Sweden)

    Carolina Fiorin Anhoque

    Full Text Available OBJECTIVE: To evaluate the quality of life (QoL and potential QoL determinants in patients with clinically isolated syndrome (CIS. METHODS: Eighteen CIS patients and eighteen controls were submitted to QoL evaluation with Functional Assessment of Multiple Sclerosis QoL instrument (FAMS. Cognition was evaluated with specific battery tests; Anxiety and depression with Beck Anxiety (BAI and Depression (BDI Inventories and Neurological disability with Guy's Neurological Disability Scale (GNDS. RESULTS: There was a significant difference in QoL between CIS patients and controls. CIS patients had worse performance in Paced Auditory Serial Addition 2 seconds (p=0.009 and fluency tests (p=0.0038. There was a significant difference in BAI (p=0.003, but no significant difference in BDI between patients and controls. There were significant correlations between QoL measure and verbal fluency and Stroop's test. CONCLUSIONS: Cognition, but not anxiety, depression and disability, was associated with reduced quality of life.

  1. Clinical correlates of hippocampus volume and shape in antipsychotic-naïve schizophrenia.

    Science.gov (United States)

    Kalmady, Sunil Vasu; Shivakumar, Venkataram; Arasappa, Rashmi; Subramaniam, Aditi; Gautham, S; Venkatasubramanian, Ganesan; Gangadhar, Bangalore N

    2017-05-30

    While volume deficit of hippocampus is an established finding in schizophrenia, very few studies have examined large sample of patients without the confounding effect of antipsychotic treatment. Concurrent evaluation of hippocampus shape will offer additional information on the hippocampal aberrations in schizophrenia. In this study, we analyzed the volume and shape of hippocampus in antipsychotic-naïve schizophrenia patients (N=71) in comparison to healthy controls (N=82). Using 3-T MRI data, gray matter (GM) volume (anterior and posterior sub-divisions) and shape of the hippocampus were analyzed. Schizophrenia patients had significant hippocampal GM volume deficits (specifically the anterior sub-division) in comparison to healthy controls. There were significant positive correlations between anterior hippocampus volume and psychopathology scores of positive syndrome. Shape analyses revealed significant inward deformation of bilateral hippocampal surface in patients. In conclusion, our study findings add robust support for volume deficit in hippocampus in antipsychotic-naïve schizophrenia. Hippocampal shape deficits in schizophrenia observed in this study map to anterior CA1 sub-region. The differential relationship of anterior hippocampus (but not posterior hippocampus) with clinical symptoms is in tune with the findings in animal models. Further systematic studies are needed to evaluate the relationship between these hippocampal gray matter deficits with white matter and functional connectivity to facilitate understanding the hippocampal network abnormalities in schizophrenia. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  2. Correlations between genotype, ultrastructural morphology and clinical phenotype in the neuronal ceroid lipofuscinoses.

    Science.gov (United States)

    Mole, Sara E; Williams, Ruth E; Goebel, Hans H

    2005-09-01

    The neuronal ceroid lipofuscinoses (NCLs) are a group of severe neurodegenerative diseases with onset usually in childhood and characterised by the intracellular accumulation of autofluorescent storage material. Within the last decade, mutations that cause NCL have been found in six human genes (CLN1, CLN2, CLN3, CLN5, CLN6 and CLN8). Mutations in two additional genes cause disease in animal models that share features with NCL-CTSD in sheep and mice and PPT2 in mice. Approximately 160 NCL disease-causing mutations have now been described (listed and fully cited in the NCL Mutation Database, http://www.ucl.ac.uk/ncl/ ). Most mutations result in a classic morphology and disease phenotype, but some mutations are associated with disease that is of later onset, less severe or protracted in its course, or with atypical morphology. Seven common mutations exist, some having a worldwide distribution and others associated with families originating from specific geographical regions. This review attempts to correlate the gene, disease-causing mutation, morphology and clinical phenotype for each type of NCL.

  3. Correlation of serum HIV antigen and antibody with clinical status in HIV-infected patients.

    Science.gov (United States)

    Paul, D A; Falk, L A; Kessler, H A; Chase, R M; Blaauw, B; Chudwin, D S; Landay, A L

    1987-08-01

    An enzyme immunoassay (EIA) has been developed which detects antigen(s) (Ag) of the human immunodeficiency virus (HIV) in the serum of patients with the acquired immunodeficiency syndrome (AIDS), AIDS-related complex (ARC), and patients at high risk for HIV infection. The test has a sensitivity of approximately 50 pg/ml of HIV protein. The specificity of the assay was determined with various virus infected cell lines, normal human sera/plasma, and serum from patients not known to be at risk for HIV infection. No false-positive HIV-Ag results were seen. Sera from 69% of patients with AIDS were positive for HIV-Ag as were 46% of patients with ARC and 19% of asymptomatic, HIV-antibody-positive individuals. There were significant associations between the stage of HIV infection--ie, AIDS vs ARC vs asymptomatic--and the detection of HIV-Ag in serum (p less than 0.0001) and the lack of detection of antibody to HIV core Ag (p less than 0.0001). HIV-Ag was also found in the serum of two asymptomatic antibody-negative individuals who were at high risk for AIDS and who later developed HIV antibody. The presence of HIV-Ag in sera was confirmed by an inhibition procedure. Thus, HIV-Ag can be detected in the serum of infected individuals prior to antibody production and correlates with the clinical stage of HIV infection.

  4. CT saber-sheath trachea. Correlation with clinical, chest radiographic and functional findings

    Energy Technology Data Exchange (ETDEWEB)

    Trigaux, J.P. (Services de Radiologie, de Pneumologie, Cliniques Universitaires UCL Mont-Godinne, Yvoir (Belgium)); Hermes, G. (Services de Radiologie, de Pneumologie, Cliniques Universitaires UCL Mont-Godinne, Yvoir (Belgium)); Dubois, P. (Services de Radiologie, de Pneumologie, Cliniques Universitaires UCL Mont-Godinne, Yvoir (Belgium)); Beers, B. van (Services de Radiologie, de Pneumologie, Cliniques Universitaires UCL Mont-Godinne, Yvoir (Belgium)); Delaunois, L. (Services de Radiologie, de Pneumologie, Cliniques Universitaires UCL Mont-Godinne, Yvoir (Belgium)); Jamart, J. (Services de Radiologie, de Pneumologie, Cliniques Universitaires UCL Mont-Godinne, Yvoir (Belgium))

    1994-05-01

    The diagnosis of saber-sheath trachea is easy at CT due to its cross-sectional imaging, but the significance of this CT sign has not been evaluated in the diagnosis of chronic obstructive pulmonary disease (COPD). Various signs of COPD were compared between a series of 20 patients with a saber-sheath trachea at CT (tracheal index [<=]66%) and a group of 20 pneumologic control patients without saber-sheath trachea (tracheal index [>=]70%). These signs include clinical and standard radiographic indices of COPD, sternum-spine distance and 3 functional tests of COPD: forced expiratory volume in one second, carbon monoxide diffusing lung capacity, and funtional residual capacity (FRC). A significant difference was found between the 2 groups, concerning the values of FRC and of sternum-spine distance (p<10[sup -2]). The tracheal index was significantly correlated with the FRC values and with the sternum-spine distance. No other significant difference was observed. It is concluded that saber-sheath trachea is basically a sign of hyperinflation. (orig./MG).

  5. A pharmacokinetic study and correlation with clinical response of rufinamide in infants with epileptic encephalopathies.

    Science.gov (United States)

    la Marca, Giancarlo; Rosati, Anna; Falchi, Melania; Malvagia, Sabrina; Della Bona, Maria Luisa; Pellacani, Simona; Guerrini, Renzo

    2013-01-01

    To evaluate the relationship between the pharmacokinetic (PK) parameters and therapeutic and adverse effects of rufinamide (RUF) in children with epileptic encephalopathies (EE) aged 50% decrease of seizures. Tolerability was evaluated by analysis of a parental report of adverse effects, a clinical examination and laboratory tests. Maximum plasma concentration (47.40 ± 35.36 mg/l), average plasma concentration (39.94 ± 24.53 mg/l) and half-life (13.66 ± 4.43 h) were extremely variable and considerably higher than those reported in older children treated with the same dose regimen. At the last evaluation, 9 patients (60%) were responders. RUF is efficacious and is well tolerated in children with EE. Nonetheless, a correlation between dose, serum concentration and efficacy could not be demonstrated. The variability in measured concentrations may be related to polytherapy that is necessary for controlling seizures in this very severe form of epilepsy, in which the off-label use of RUF is justified. Copyright © 2013 S. Karger AG, Basel.

  6. STUDY OF THYROID DYSFUNCTION IN GERIATRIC AGES AND ITS CLINICAL CORRELATION

    Directory of Open Access Journals (Sweden)

    Rajendra Prasad Suram

    2016-07-01

    Full Text Available AIMS AND OBJECTIVES This study was performed to study the thyroid dysfunction in elderly patients and its clinical correlation. MATERIALS AND METHODS This is a prospective study, which consists of 150 patients aged more than 60 years and were admitted to Government General Hospital, Nizamabad. They were under suspicion that they were suffering from thyroid disorders and were subjected to detailed clinical examination as per proforma. Thyroid antibody test was done for those who were found to have altered thyroid functions. From these patients, demographic details, anthropometric measurements, and clinical information was collected. Serum T3, T4, and TSH levels were evaluated in the laboratory by chemiluminescence assay method. Other tests like USG/FNAC neck, CBC, RBS, Lipid profile, PS, ESR, ECG, Echo were done. INCLUSION CRITERIA 150 patients with age of above 60 years were selected who were suspected to have thyroid disorders. EXCLUSION CRITERIA Patients who were sick, who were with established thyroid disorders, who were using drugs, which alter thyroid functions, who were using thyroid supplements, who have undergone thyroid surgery, who have been on radioactive iodine therapy, who were using iodine-containing vitamins and minerals, who have undergone radiological tests. RESULTS In the present study, out of 150 patients, 82 males and 68 were females. It was found that the thyroid dysfunction is more among females (21% than in males (14%. This was seen in both hypothyroidism and hyperthyroidism as females have increased autoimmune diseases. Out of 150 patients, only 35% had total thyroid abnormalities. Out of 150 patients, 15% had hypothyroidism, 10% had subclinical hypothyroidism, 4% had hyperthyroidism, and 6% had subclinical hyperthyroidism. TFT always is helpful in diagnosing the disease. Hypothyroidism is more common than hyperthyroidism in elderly patients. In elderly patients, thyroid dysfunction is not uncommon. Quarter of the

  7. Correlation of MRI findings with clinical findings of trochanteric pain syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Blankenbaker, Donna G.; Ullrick, Steven R.; Davis, Kirkland W.; De Smet, Arthur A. [University of Wisconsin School of Medicine and Public Health, Department of Radiology, Madison, WI (United States); Haaland, Ben; Fine, Jason P. [University of Wisconsin School of Medicine and Public Health, Departments of Biostatistics and Medical Informatics and Statistics, Madison, WI (United States)

    2008-10-15

    Greater trochanter pain syndrome due to tendinopathy or bursitis is a common cause of hip pain. The previously reported magnetic resonance (MR) findings of trochanteric tendinopathy and bursitis are peritrochanteric fluid and abductor tendon abnormality. We have often noted peritrochanteric high T2 signal in patients without trochanteric symptoms. The purpose of this study was to determine whether the MR findings of peritrochanteric fluid or hip abductor tendon pathology correlate with trochanteric pain. We retrospectively reviewed 131 consecutive MR examinations of the pelvis (256 hips) for T2 peritrochanteric signal and abductor tendon abnormalities without knowledge of the clinical symptoms. Any T2 peritrochanteric abnormality was characterized by size as tiny, small, medium, or large; by morphology as feathery, crescentic, or round; and by location as bursal or intratendinous. The clinical symptoms of hip pain and trochanteric pain were compared to the MR findings on coronal, sagittal, and axial T2 sequences using chi-square or Fisher's exact test with significance assigned as p<0.05. Clinical symptoms of trochanteric pain syndrome were present in only 16 of the 256 hips. All 16 hips with trochanteric pain and 212 (88%) of 240 without trochanteric pain had peritrochanteric abnormalities (p=0.15). Eighty-eight percent of hips with trochanteric symptoms had gluteus tendinopathy while 50% of those without symptoms had such findings (p=0.004). Other than tendinopathy, there was no statistically significant difference between hips with or without trochanteric symptoms and the presence of peritrochanteric T2 abnormality, its size or shape, and the presence of gluteus medius or minimus partial thickness tears. Patients with trochanteric pain syndrome always have peritrochanteric T2 abnormalities and are significantly more likely to have abductor tendinopathy on magnetic resonance imaging (MRI). However, although the absence of peritrochanteric T2 MR abnormalities

  8. An autopsy study of combined pulmonary fibrosis and emphysema: correlations among clinical, radiological, and pathological features

    Science.gov (United States)

    2014-01-01

    Background Clinical evaluation to differentiate the characteristic features of pulmonary fibrosis and emphysema is often difficult in patients with combined pulmonary fibrosis and emphysema (CPFE), but diagnosis of pulmonary fibrosis is important for evaluating treatment options and the risk of acute exacerbation of interstitial pneumonia of such patients. As far as we know, it is the first report describing a correlation among clinical, radiological, and whole-lung pathological features in an autopsy cases of CPFE patients. Methods Experts retrospectively reviewed the clinical charts and examined chest computed tomography (CT) images and pathological findings of an autopsy series of 22 CPFE patients, and compared these with findings from 8 idiopathic pulmonary fibrosis (IPF) patients and 17 emphysema-alone patients. Results All patients had a history of heavy smoking. Forced expiratory volume in 1 s/forced vital capacity (FEV1/FVC%) was significantly lower in the emphysema-alone group than the CPFE and IPF-alone groups. The percent predicted diffusing capacity of the lung for carbon monoxide (DLCO%) was significantly lower in the CPFE group than the IPF- and emphysema-alone groups. Usual interstitial pneumonia (UIP) pattern was observed radiologically in 15 (68.2%) CPFE and 8 (100%) IPF-alone patients and was pathologically observed in all patients from both groups. Pathologically thick-cystic lesions involving one or more acini with dense wall fibrosis and occasional fibroblastic foci surrounded by honeycombing and normal alveoli were confirmed by post-mortem observation as thick-walled cystic lesions (TWCLs). Emphysematous destruction and enlargement of membranous and respiratory bronchioles with fibrosis were observed in the TWCLs. The cystic lesions were always larger than the cysts of honeycombing. The prevalence of both radiological and pathological TWCLs was 72.7% among CPFE patients, but no such lesions were observed in patients with IPF or emphysema

  9. Clinical and psychological correlates of health-related quality of life in obese patients

    Directory of Open Access Journals (Sweden)

    Mannucci Edoardo

    2010-08-01

    Full Text Available Abstract Background Health-related quality of life (HRQL is poor in obese subjects and is a relevant outcome in intervention studies. We aimed to determine factors associated with poor HRQL in obese patients seeking weight loss in medical units, outside specific research projects. Methods HRQL, together with a number of demographic and clinical parameters, was studied with generic (SF-36, PGWB and disease-specific (ORWELL-97 questionnaires in an unselected sample of 1,886 (1,494 women; 392 men obese (BMI > 30 kg/m2 patients aged 20-65 years attending 25 medical units scattered throughout Italy. The clinics provide weight loss treatment using different programs. General psychopathology (SCL-90 questionnaire, the presence of binge eating (Binge Eating scale, previous weight cycling and somatic comorbidity (Charlson's index were also determined. Scores on SF-36 and PGWB were compared with Italian population norms, and their association with putative determinants of HRQL after adjustment for confounders was assessed through logistic regression analysis. Results HRQL scores were significantly lower in women than in men. A greater impairment of quality of life was observed in relation to increasing BMI class, concurrent psychopathology, associated somatic diseases, binge eating, and weight cycling. In multivariate analysis, psychopathology (presence of previously-diagnosed mental disorders and/or elevated scores on SCL-90 was associated with lower HRQL scores on both psychosocial and somatic domains; somatic diseases and higher BMI, after adjustment for confounders, were associated with impairment of physical domains, while binge eating and weight cycling appeared to affect psychosocial domains only. Conclusions Psychopathological disturbances are the most relevant factors associated with poor HRQL in obese patients, affecting not only psychosocial, but also physical domains, largely independent of the severity of obesity. Psychological

  10. Open-heart Surgery Complications Following Programmed Education and Nurses' Clinical Competence

    Directory of Open Access Journals (Sweden)

    Mahnaz Rakhshan

    2017-01-01

    Full Text Available Heart surgery can lead to certain complications that, if not diagnosed and treated on time, can be fatal. In view of the fact that nurses' clinical competence affects the quality of clinical judgment, the present study aimed to explore the effect of programmed education and nurses' clinical competence on complications following open-heart surgeries. The results of the present study showed that a closer attention to regular and programmed education and informing of open-heart surgery patients, especially before surgery and at the time of discharge, along with the clinical competence of nurses in ICUs, can reduce the incidence of post-surgery complications. Since the nurses' clinical competence greatly affects their clinical judgments and quality of care, paying greater attention to the nurses' education through systematic programs and increasing the clinical competence can lead to fewer post-heart-surgery complications; this, in turn, reduces the length of stay and the ensuing costs.

  11. The Effect of Peer-Mentoring Program on Nursing Students’ Clinical Environment Stressors

    Directory of Open Access Journals (Sweden)

    F Sardari Kashkooli

    2014-01-01

    Results: There was a significant difference between stress scores before and after of the intervention in both groups (p=0.00. Mean difference of clinical environment stress factors in two groups were not statistically significant (p=0.99. Conclusions: Peer-mentoring program is not significant effective on clinical environment stress reduction. Key Words: Nursing Education, Peer Mentoring, Clinical Environment Stressors

  12. Osteitis pubis in professional football players: MRI findings and correlation with clinical outcome.

    Science.gov (United States)

    Gaudino, Francesco; Spira, Daniel; Bangert, Yannic; Ott, Henning; Beomonte Zobel, Bruno; Kauczor, Hans-Ulrich; Weber, Marc-André

    2017-09-01

    Osteitis pubis (OP), a common pathology in elite athletes, is an aseptic inflammatory process of the pubic symphysis bone, and may involve surrounding soft tissues, tendons and muscles. OP is typically characterized by (often recurring) groin pain and is an important cause of time-off from sports activity in athletes. Aim of this retrospective study was to analyze magnetic resonance imaging (MRI) findings in professional football players with clinical diagnosis of OP and to correlate MRI findings with clinical outcome. All professional football players (23 males, 1 female; mean age: 21±3.7years; range: 16-30 years) with groin pain and clinical diagnosis of OP, who underwent pelvic MRI in our institution were retrospectively analyzed. The MR images were analyzed regarding the presence of bone marrow edema and its extension, whether fluid in the symphysis pubis or periarticular soft tissue edema with a rim-like periosteal distribution or edema in the muscles located around the symphyseal joint were present, whether degenerative changes of the symphysis pubis and of signs of symphyseal instability were encountered. A quantitative measurement of the signal intensity in bone marrow edema on 3T STIR sequences was performed, normalizing these values to the mean signal intensity values in the ipsilateral iliopsoas muscle. All patients were classified according to a 3-point grading scale. For each patient, both the symptoms 18 months after the initial MRI examination, the duration of time off from playing football and the kind of treatment applied were evaluated. Among all professional athletes, in 20/24 (83.3%) MRI showed signs of OP with bone marrow edema at the pubic bone. 12 of these patients showed complete clinical recovery without any symptoms after 18 months, while in 8 patients partial recovery with persistence of groin pain during higher sports activity was observed. Patients with edema in periarticular soft tissues or in the muscles around the symphyseal joint

  13. Clinical Investigation Program Report, RCS MED-300 (R1).

    Science.gov (United States)

    1986-10-31

    cells and the effect of pluronic F-68. Comparison with dog and rat cells. Chapter in: Swine in Biomedical Research, M. Tumblesome, (ed). (In Press...endoscopy on laboratory animals ( dogs ) in order to develop clinical skills in endoscopy. Also, creation of clinical gastrointestinal entities (pathology...birth, as additional information gained from prenatal ultrasonography , were compared with patents who did not have this prior knowledge. The purposes of

  14. Military sexual assault and homeless women veterans: clinical correlates and treatment preferences.

    Science.gov (United States)

    Decker, Suzanne E; Rosenheck, Robert A; Tsai, Jack; Hoff, Rani; Harpaz-Rotem, Ilan

    2013-01-01

    Both homeless women and women who have experienced military sexual assault (MSA) are at high risk of serious psychological sequelae. However, little is known about the combined impact of MSA and current homelessness on psychological distress, or about distinctive treatment preferences among homeless female veterans affected by MSA. This observational study compared clinical symptoms, pre-military experiences, and treatment preferences among 509 female veterans with and without MSA who enrolled in 11 VA Homeless Women Veterans Programs. Over one third of participants (41.1%) reported MSA. In multivariate analyses, homeless female veterans who reported MSA endorsed greater severity of PTSD and other psychiatric symptoms. Those who had experienced MSA were more likely to report interest in treatment, and treatment focused on safety was reported as especially attractive. Among homeless female veterans, MSA is associated with greater mental health symptoms and greater interest in safety-focused treatment. Services targeting the needs of homeless MSA survivors should be encouraged. Published by Elsevier Inc.

  15. Limitations of Significance Testing in Clinical Research: A Review of Multiple Comparison Corrections and Effect Size Calculations with Correlated Measures.

    Science.gov (United States)

    Vasilopoulos, Terrie; Morey, Timothy E; Dhatariya, Ketan; Rice, Mark J

    2016-03-01

    Modern clinical research commonly uses complex designs with multiple related outcomes, including repeated-measures designs. While multiple comparison corrections and effect size calculations are needed to more accurately assess an intervention's significance and impact, understanding the limitations of these methods in the case of dependency and correlation is important. In this review, we outline methods for multiple comparison corrections and effect size calculations and considerations in cases of correlation and summarize relevant simulation studies to illustrate these concepts.

  16. Baseline OCT measurements in the idiopathic intracranial hypertension treatment trial, part II: correlations and relationship to clinical features.

    Science.gov (United States)

    Auinger, Peggy; Durbin, Mary; Feldon, Steven; Garvin, Mona; Kardon, Randy; Keltner, John; Kupersmith, Mark J; Sibony, Patrick; Plumb, Kim; Wang, Jui-Kai; Werner, John S

    2014-11-04

    The accepted method to evaluate and monitor papilledema, Frisén grading, uses an ordinal approach based on descriptive features. Part I showed that spectral-domain optical coherence tomography (SD-OCT) in a clinical trial setting provides reliable measurement of the effects of papilledema on the optic nerve head (ONH) and peripapillary retina, particularly if a 3-D segmentation method is used for analysis.(1) We evaluated how OCT parameters are interrelated and how they correlate with vision and other clinical features in idiopathic intracranial hypertension (IIH) patients. A total of 126 subjects in the IIH Treatment Trial (IIHTT) OCT substudy had Cirrus SD-OCT optic disc and macula scans analyzed by using a 3-D segmentation algorithm to derive retinal nerve fiber layer (RNFL) thickness, total retinal thickness (TRT), retinal ganglion cell layer plus inner plexiform layer (GCL+IPL) thickness, and ONH volume. The SD-OCT parameter values were correlated with high- and low-contrast acuity, perimetric mean deviation, Frisén grading, and IIH features. At study entry, the average RNFL thickness, TRT, and ONH volume showed significant strong correlations (r ≥ 0.90) with each other. The same OCT parameters showed a strong (r > 0.76) correlation with Frisén grade and a mild (r > 0.24), but significant, correlation with lumbar puncture opening pressure. For all eyes at baseline, neither visual acuity (high or low contrast) nor mean deviation correlated with any OCT measure of swelling or GCL+IPL thickness. In newly diagnosed IIH, OCT demonstrated alterations of the peripapillary retina and ONH correlate with Frisén grading of papilledema. At presentation, OCT measures of papilledema, in patients with newly diagnosed IIH and mild vision loss, do not correlate with clinical features or visual dysfunction. (ClinicalTrials.gov number, NCT01003639.). Copyright 2014 The Association for Research in Vision and Ophthalmology, Inc.

  17. Summary of the Nevada Applied Ecology Group and correlative programs. Version 1

    Energy Technology Data Exchange (ETDEWEB)

    Friesen, H.N. [Raytheon Services Nevada, Las Vegas, NV (United States)

    1992-10-01

    This summary document presents results in a broad context; it is not limited to findings of the Nevada Applied Ecology Group. This book is organized to present the findings of the Nevada Applied Ecology Group and correlative programs in accordance with the originally stated objectives of the Nevada Applied Ecology Group. This plan, in essence, traces plutonium from its injection into the environment to movement in the ecosystem to development of cleanup techniques. Information on other radionuclides was also obtained and will be presented briefly. Chapter 1 presents a brief description of the ecological setting of the Test Range Complex. The results of investigations for plutonium distribution are presented in Chapter 2 for the area surrounding the Test Range Complex and in Chapter 3 for on-site locations. Chapters 4 and 5 present the results of investigations concerned with concentrations and movement, respectively, of plutonium in the ecosystem of the Test Range Complex, and Chapter 6 summarizes the potential hazard from this plutonium. Development of techniques for cleanup and treatment is presented in Chapter 7, and the inventory of radionuclides other than plutonium is presented briefly in Chapter 8.

  18. Nurse turnover in substance abuse treatment programs affiliated with the National Drug Abuse Treatment Clinical Trials Network.

    Science.gov (United States)

    Knudsen, Hannah K; Abraham, Amanda J; Roman, Paul M; Studts, Jamie L

    2011-04-01

    Voluntary nurse turnover, which is costly and disrupts patient care, has not been studied as an organizational phenomenon within substance abuse treatment organizations. In this exploratory study, we examined the frequency and correlates of nurse turnover within treatment programs affiliated with the National Drug Abuse Treatment Clinical Trials Network. During face-to-face interviews conducted in 2005-2006, 215 program administrators reported the number of nurses currently employed. Leaders of programs with nursing staff then described the number of nurses who had voluntarily quit in the past year, the degree to which filling vacant nursing positions was difficult, and the average number of days to fill a vacant position. About two thirds of these programs had at least one nurse on staff. In programs with nurses, the average rate of voluntary turnover was 15.0%. Turnover was significantly lower in hospital-based programs and programs offering adolescent treatment but higher in facilities offering residential treatment. Most of the administrators indicated that filling vacant nurse positions was difficult and took more than 2 months to complete. These findings suggest that nurse turnover is a significant issue facing many substance abuse treatment facilities. Efforts to improve retention of the addiction treatment workforce should be expanded to include nursing professionals. Copyright © 2011 Elsevier Inc. All rights reserved.

  19. Clinical capabilities of graduates of an outcomes-based integrated medical program

    Directory of Open Access Journals (Sweden)

    Scicluna Helen A

    2012-06-01

    Full Text Available Abstract Background The University of New South Wales (UNSW Faculty of Medicine replaced its old content-based curriculum with an innovative new 6-year undergraduate entry outcomes-based integrated program in 2004. This paper is an initial evaluation of the perceived and assessed clinical capabilities of recent graduates of the new outcomes-based integrated medical program compared to benchmarks from traditional content-based or process-based programs. Method Self-perceived capability in a range of clinical tasks and assessment of medical education as preparation for hospital practice were evaluated in recent graduates after 3 months working as junior doctors. Responses of the 2009 graduates of the UNSW’s new outcomes-based integrated medical education program were compared to those of the 2007 graduates of UNSW’s previous content-based program, to published data from other Australian medical schools, and to hospital-based supervisor evaluations of their clinical competence. Results Three months into internship, graduates from UNSW’s new outcomes-based integrated program rated themselves to have good clinical and procedural skills, with ratings that indicated significantly greater capability than graduates of the previous UNSW content-based program. New program graduates rated themselves significantly more prepared for hospital practice in the confidence (reflective practice, prevention (social aspects of health, interpersonal skills (communication, and collaboration (teamwork subscales than old program students, and significantly better or equivalent to published benchmarks of graduates from other Australian medical schools. Clinical supervisors rated new program graduates highly capable for teamwork, reflective practice and communication. Conclusions Medical students from an outcomes-based integrated program graduate with excellent self-rated and supervisor-evaluated capabilities in a range of clinically-relevant outcomes. The program

  20. Implementation of new clinical programs in the VHA healthcare system: the importance of early collaboration between clinical leadership and research.

    Science.gov (United States)

    Wu, R Ryanne; Kinsinger, Linda S; Provenzale, Dawn; King, Heather A; Akerly, Patricia; Barnes, Lottie K; Datta, Santanu K; Grubber, Janet M; Katich, Nicholas; McNeil, Rebecca B; Monte, Robert; Sperber, Nina R; Atkins, David; Jackson, George L

    2014-12-01

    Collaboration between policy, research, and clinical partners is crucial to achieving proven quality care. The Veterans Health Administration has expended great efforts towards fostering such collaborations. Through this, we have learned that an ideal collaboration involves partnership from the very beginning of a new clinical program, so that the program is designed in a way that ensures quality, validity, and puts into place the infrastructure necessary for a reliable evaluation. This paper will give an example of one such project, the Lung Cancer Screening Demonstration Project (LCSDP). We will outline the ways that clinical, policy, and research partners collaborated in design, planning, and implementation in order to create a sustainable model that could be rigorously evaluated for efficacy and fidelity. We will describe the use of the Donabedian quality matrix to determine the necessary characteristics of a quality program and the importance of the linkage with engineering, information technology, and clinical paradigms to connect the development of an on-the-ground clinical program with the evaluation goal of a learning healthcare organization. While the LCSDP is the example given here, these partnerships and suggestions are salient to any healthcare organization seeking to implement new scientifically proven care in a useful and reliable way.