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PubMedDate not supplied

Validation of the Mental Alternation Test with the Mini-Mental State Examination in geriatric psychiatric inpatients and normal controls.

The Mental Alternation Test (MAT) is a bedside test of cognition that was used for the detection of human immunodeficiency virus (HIV)-related cognitive impairment. It has been shown to have good reproducibility and inter-rater reliability, and takes only 60 seconds to administer. To assess the utility of the MAT in the geriatric primary care and geriatric psychiatric settings, we used the Mini-Mental State Examination (MMSE) as a further validation of the test. This cohort study included 20 geriatric psychiatric inpatients, 15 normal geriatric controls, and four normal adult controls. The study was conducted within the inpatient psychiatric unit of a referral hospital. Scores on the MAT and the MMSE were compared using correlation calculations. Test score means and standard deviations were computed for each study population. Test score cutoffs derived from a previous study were used to determine the sensitivity and specificity of the MAT as compared with the MMSE. The MAT score was found to correlate significantly with the MMSE score (r =.84, P <.0001). Scores on the MAT were predictive of scores on the MMSE, with a sensitivity of 91% and a specificity of 100%. We conclude that MAT is a good test of cognition in both geriatric primary care and geriatric psychiatric populations. It has both good specificity and sensitivity, and its ease of administration and inter-rater reliability make it a useful diagnostic tool for identifying those patients who may need further cognitive evaluations.

Adult↗
PubMed1979

Benzimidazole resistance of equine stronygles--critical tests of six compounds against population B.

Critical tests were conducted on eight horses naturally infected with several species of large and small strongyles from population B. Tested were six benzimidazoles, including thiabendazole (2 lots) (44 mg/kg of body weight); mebendazole (8.8 mg/kg); cambendazole (two formulations) (20 mg/kg); fenbendazole (10 mg/kg); oxibendazole (10 mg/kg); and oxfendazole (10 mg/kg). All compounds were administered by stomach tube except one of the two cambendazole formulations which was an intraoral paste. Removal of large strongyles (when present), Strongylus vulgaris and Strongylus edentatus, was 100% by each drug. In general, five species of small strongyles (Cyathostomum catinatum, Cyathostomum coronatum, Cylicocyclus nassatus, Cylicostephanus goldi, and Cylicostephanus longibursatus) exhibited varying degrees of resistance (% removal) to all of the drugs except oxibendazole. A total of 19 other species of small strongyles from seven genera, including the three described earlier were about 100% removed by the six benzimidazoles. Poor removal of immature (fourth-stage larvae) forms was also characteristic of the six drugs.

Animals↗
PubMed1997

Studies of postnatal diabetes mellitus in women who had gestational diabetes. Part 1. Estimation of the prevalence of unrecognized prepregnancy diabetes mellitus.

This study investigated the prevalence of undiagnosed diabetes in women in the reproductive age group in a Victorian population by analysis of the results of glucose tolerance testing in 57,563 pregnancies. Gestational diabetes (GD) was diagnosed in 4,243 pregnancies and in 2,957 (69.7%) of these, postnatal glucose tolerance testing was performed. Diabetes mellitus was diagnosed within 26 weeks of delivery in 59 women, 55 of whom were diagnosed by the postnatal glucose tolerance test (GTT). There were 4 women with GD who developed diabetic ketosis during pregnancy (3) or within 12 weeks of delivery (1). By consideration of the results of the antenatal and postnatal GTTs, it was deduced that 53% (31 of 59) of the women with diabetes diagnosed after delivery may have had unrecognized prepregnancy diabetes. Consideration of the entire glucose-tolerance tested population led to the conclusion that approximately 1 in 1,031 women in the reproductive age group in our community have unrecognized prepregnancy diabetes mellitus.

Adult↗
PubMed2003

Diagnostic properties of nerve conduction tests in population-based carpal tunnel syndrome.

BACKGROUND: Numerous nerve conduction tests are used for the electrodiagnosis of carpal tunnel syndrome (CTS), with a wide range of sensitivity and specificity reported for each test in clinical studies. The tests have not been assessed in population-based studies. Such information would be important when using electrodiagnosis in epidemiologic research. The purpose of this study was to compare the diagnostic accuracy of various nerve conduction tests in population-based CTS and determine the properties of the most accurate test. METHODS: In a population-based study a questionnaire was mailed to a random sample of 3,000 persons. Of 2,466 responders, 262 symptomatic (numbness/tingling in the radial fingers) and 125 randomly selected asymptomatic responders underwent clinical and electrophysiologic examinations. A standardized hand diagram was administered to the symptomatic persons. At the clinical examination, the examining surgeon identified 94 symptomatic persons as having clinically certain CTS. Nerve conduction tests were then performed on the symptomatic and the asymptomatic persons by blinded examiners. Analysis with receiver operating characteristic (ROC) curves was used to compare the diagnostic accuracy of the nerve conduction tests in distinguishing the persons with clinically certain CTS from the asymptomatic persons. RESULTS: No difference was shown in the diagnostic accuracy of median nerve distal motor latency, digit-wrist sensory latency, wrist-palm sensory conduction velocity, and wrist-palm/forearm sensory conduction velocity ratio (area under curve, 0.75-0.76). Median-ulnar digit-wrist sensory latency difference had a significantly higher diagnostic accuracy (area under curve, 0.80). Using the optimal cutoff value of 0.8 ms for abnormal sensory latency difference shown on the ROC curve the sensitivity was 70%, specificity 82%, positive predictive value 19% and negative predictive value 98%. Based on the clinical diagnosis among the symptomatic persons, the hand diagram (classified as classic/probable or possible/unlikely CTS) had high sensitivity but poor specificity. CONCLUSIONS: Using the clinical diagnosis of CTS as the criterion standard, nerve conduction tests had moderate sensitivity and specificity and a low positive predictive value in population-based CTS. Measurement of median-ulnar sensory latency difference had the highest diagnostic accuracy. The performance of nerve conduction tests in population-based CTS does not necessarily apply to their performance in clinical settings.

Adult↗
PubMed1997

Pattern of immediate type hypersensitivity reactions in the Eastern Province, Saudi Arabia.

BACKGROUND: In the period between July, 1992, and July, 1994, 1,159 patients in our Allergy Clinic tested positive to one or more inhalants. The nationalities of the population tested included 806 Saudi Arabs and 241 Western expatriates (mainly North Americans). The others were of various different nationalities. OBJECTIVES: Our objective was to determine the pattern of immediate type hypersensitivity reactions among the atopic population in the Eastern Province of the Kingdom of Saudi Arabia. METHODS: A standard prick skin test was applied and the reaction was considered positive if there was a 3-mm wheal associated with 10 mm of erythema, greater than the negative control. RESULTS: The ten most common reactions in the Saudi Arab patients were as follows: Chenopodium album 53%, Kochia 51%, mesquite 46%, cottonwood 38%, alfalfa 36%, dust mite-farinae 36%, cockroach 35%, house dust 31%, Bermuda grass 29%, and acacia 29%. For North American expatriates living in the area, the ten most common reactions were: dust mite-farinae 43%, house dust 41%, Alternaria 36%, grass mix 34%, Bermuda grass 33%, mesquite 32%, cat 31%, Kochia 28%, alfalfa 24%, and Chenopodium album 24%. CONCLUSIONS: Hypersensitivity to pollens, house dust, dust mite and cockroach was common. Mold and cat allergies were only common among Western expatriates.

Adolescent↗
PubMed1982

Genetic survey of an isolated community in Bali, Indonesia. I. Blood groups, serum proteins and hepatitis B serology.

320 adults and children of an isolated community of Bali, Indonesia, have been tested for blood groups ABO, Rh, MNS, P, Lewis, Duffy, Kell, for haptoglobin and transferrin and for hepatitis B surface antigen and antibodies. Phenotype distribution and gene frequencies are given for the total population tested and for two subgroups representative of the inbred population of the isolate and of the non-inbred part of the population. Significant differences between the two subgroups show a clear genetic drift in the inbred population. The study brings biological support to the ethnological hypothesis of population migrations in this area. Tests for hepatitis B surface antigen reveal a lower prevalence of the disease than in most other south-east Asian populations.

Adolescent↗
PubMed2006

[Phoneme discrimination test material for preschool children: development and preliminary assessment].

BACKGROUND: Several tests have been developed to probe phoneme discrimination. However, little is known about the reliability and validity of discrimination abilities in preschool children as assessed by these tests. Based on previous results we now developed a test material based on minimal pair presentation. METHODS: Prospective study; 30 preschool children (5;1 to 6;3 years old, 17 boys, 13 girls); descriptive statistics and correlational analysis; items: 60 minimal pairs consisting of real words and nonsense words. RESULTS: Empirical testing confirmed prediction of normal distributed phoneme discrimination errors. No gender specific effects were found. Results correlated with the degree of phoneme opposition and with phonological loop capacity. DISCUSSION: These results indicate that the test material developed is suitable for testing phoneme discrimination in preschool children. However other normative assessments using larger test populations are warranted. Phoneme discrimination tasks appear to include testing of sensory as well as linguistic-cognitive functioning.

Age Factors↗
PubMed1992

Evaluation of a mechanical/chemical infectious waste disposal system.

OBJECTIVES: The mechanical/chemical infectious waste disposal system (IWDS), model Z-5000 HC, manufactured by Medical SafeTEC Inc. (Indianapolis, Indiana) was evaluated for its ability to disinfect biomedical waste. METHODS: The IWDS was operated with a sodium hypochlorite solution and tested with loads consisting of microbial cultures and blood. During and after processing, samples of liquid, milled solid waste, and leachate were collected to determine the efficacy of disinfection and the chemical by-products released. An inactivation factor was calculated. Aerosol emission was studied. All tests were done in triplicate. RESULTS: Our results showed the expected level of disinfection (inactivation factor greater than or equal to 5 log10) for all tests carried out with Bacillus subtilis, Enterococcus faecalis, Candida albicans, and Serratia marcescens, and for most of the tests with Mycobacterium fortuitum and bacteriophages OX174 and f2. Further tests performed in the absence of blood resulted in an inactivation factor greater than or equal to 5 log10 for all tests with M fortuitum, but not for those of the milled solids with bacteriophage f2. Aerosols were found to escape the apparatus when the IWDS was operated in the absence of chlorine. The liquid effluent contained an average of 17,600, and 15 mg/l of free chlorine, chloramines, and trihalomethanes (THM), respectively. The air effluent contained 1.1 mg/m3 of total chlorine and 1.4 micrograms/m3 of THM. CONCLUSIONS: Under our study conditions and except for certain tests with bacteriophage f2, the IWDS reduced the microbial populations tested by a factor of 5 log10. The aerosol dispersion problem remains to be solved, and the significance of the chemical by-products released will require further investigation.

Aerosols↗
PubMed1985

Respiratory illness in the construction trades. I. The significance of asbestos-associated pleural disease among sheet metal workers.

To assess the rate of roentgenographic and lung function abnormalities in asbestos-exposed construction workers, the authors studied 314 white male members of a local sheet metal workers union. Health outcomes were assessed by questionnaire, simple spirometry, and chest roentgenography; data were collected and interpreted following guidelines of the American Thoracic Society and the International Labor Office. Analyses of union records showed the tested population to be representative of all those eligible for testing. Pleural abnormalities were common, increasing to a prevalence of approximately 70% in workers with more than 30 years employment. Roentgenographic evidence of pleural disease was significantly correlated with decreased forced vital capacity (p = 0.027) after controlling for the potential confounding effects of age, height, cigarette consumption history, and employment duration. In contrast, forced expiratory volume in 1 s showed a stronger association with amount smoked (p = 0.022) than with pleural abnormality (p = 0.316). Logistic regression analyses showed that cigarettes act to increase the effect of asbestos in causing pleural disease among exposed workers. Cigarettes, in the absence of significant asbestos exposure, do not appear to cause pleural disease. The authors conclude that construction workers, such as those described herein, have a considerably increased rate of pleural disease, which has functional significance in view of the correlations noted with forced vital capacity measurements. Therefore, pleural disease in asbestos-exposed workers is not only an indicator of exposure but also an indicator of early impairment of pulmonary function.

Adult↗
PubMed1993

Chest radiographs as a screening test for diffuse idiopathic skeletal hyperostosis.

OBJECTIVE: To evaluate the sensitivity, specificity, predictive value, interrater reliability and intrarater reliability of using chest radiographs as a screening tool for the diagnosis of diffuse idiopathic skeletal hyperostosis (DISH). METHODS: After review of thoracic spine radiographs by 2 "gold standard" physicians, 45 patients with DISH meeting the criteria of Resnick and Niwayama were contrasted with 106 control patients consisting of 45 with thoracic spondylosis, 45 who lacked spondylosis and whose thoracic spine radiographs were otherwise normal for the age of the patient, and 16 with ankylosing spondylitis. The chest radiographs on the 151 subjects were placed in random order and read independently using an ordinal diagnostic certainty scale by 2 "test" radiologists, experienced in reading bone radiographs. Two months later the order of chest radiographs was rerandomized and the films reassessed by the same test radiologists. RESULTS: The averages for the diagnostic and population test characteristics were sensitivity = 77%; specificity = 97%; positive predictive value = 91%; and, negative predictive value = 91%. The area under the receiver operating characteristic curves was 0.975 and 0.976 for the radiologists, and kappa was 0.93, demonstrating that interrater reliability was high. On rereading the chest radiographs, intrarater reliability was exceptional (weighted kappa of 0.90 and 0.96 for the two test radiologists). DISH patients whose chest radiographs were read as not demonstrating DISH had significantly less extensive disease. CONCLUSIONS: We conclude that chest radiographs are a reliable and valid screening tool for the diagnosis of DISH.

Adult↗
PubMed1991

[The usefulness of vaccination in elderly persons].

The antitetanus, antipneumococcal and antiinfluenza immune status, as well as the efficacy of vaccination have been evaluated in the elderly. Ages of the studied populations ranged from 60 to 98 years. Before vaccination, only half of the tested population was found to be protected against tetanus. Immunization resulted in 80% coverage of this population. Prior to antipneumococcal vaccination, 32% of the tested sera did not contain a "potentially" protective antibody titre. Vaccination resulted in 100% seroconversion. It was verified that 100% of tested sera contained antibodies (greater than 10 U.H.A./ml) directed to the former Singapore antigen and 99.2% and 66.7%, respectively, to the newly immerged Shanghaï and Yamagata antigens (present in the administered vaccine). Following vaccination, 100% of the sera exhibited antibody titres higher than 10 U.H.A./ml to the Singapore and Shanghaï antigens, and 90.5% to the Yamagata antigen. It can be concluded from the reported results that antitetanus, antipneumococcal and antiinfluenza vaccinations should be systematically given to all individuals beyond 60 years of age, since these vaccinations are innocuous and confer extended vaccinal coverage.

Aged↗
PubMed1996

Patch testing in an aged population without dermatitis: high prevalence of patch test positivity.

BACKGROUND: Epidermal immune function has been observed to decline in the aged. OBJECTIVE: The purpose of this study was to determine the prevalence and relevance of patch test reactivity in an aged population without dermatitis and compare this with patch test reactivity in healthy younger volunteers. METHODS: Patch testing with the North American Contact Dermatitis Group standard tray was performed on 82 healthy volunteers ranging in age from 68 to 87 years (mean age, 75 years), and the results were compared with those of 41 healthy younger volunteers (mean age, 24 years). A questionnaire regarding cutaneous symptoms was administered to both groups. RESULTS: Thirty subjects in the older population (37%) had one or more positive patch test results compared with 6 members of the control group (15%) (P = .01). Common sensitizers in the older group included balsam of Peru (7[9%]), fragrance (8[10%]), neomycin (6[7%]), nickel (5[6%]), and methylchloroisothiazolinone/methylisothiazolinone (3[4%]). A history of severe pruritus (without dermatitis) was associated with positive patch test results to balsam of peru and nickel. CONCLUSION: A high prevalence of positive patch test results in an aged population without dermatitis was observed. Factors contributing to to the high prevalence of patch test reactivity in the aged population may include cumulative exposure to potential allergens over time, a preserved ability to develop contact allergy, and altered percutaneous absorption. Patch testing in the aged must be interpreted carefully because the results may relate to past rather than present relevance.

Adult↗
PubMed1997

Population genetics of a functional variant of the dopamine beta-hydroxylase gene (DBH).

Dopamine beta-hydroxylase (E.C. 1.14.17.1; protein abbreviation: DbetaH) catalyzes conversion of dopamine to norepinephrine. Previous work identified two expressed alleles of the gene encoding DbetaH (locus symbol DBH), containing either G or T at nucleotide position 910, resulting in specification by codon 304 of alanine (DBH*304A) or serine (DBH*304S), respectively. The current study employed denaturing gradient gel electrophoresis to identify these alleles, and after developing a PCR RFLP for rapid genotyping, estimated the frequencies of the alleles in African-Americans, European-Americans, and in several geographically dispersed populations (Mbuti, Danes, Adygei, Chinese, Japanese, Surui, Maya, and Nasioi). DBH*304A was the most common allele in all populations tested, with allele frequencies greater than 0.80 in each case. There was significant heterogeneity in allele frequency across population groups. The DBH*304S allele was most common in subjects of African descent, and least common in East Asians and individuals from indigenous populations of North and South America. The frequency of DBH*304S was significantly higher in African-Americans (0.16) than in European-Americans (0.06; P < 0.004). Of the four DBH*304S homozygotes observed, all were Europeans and three of the four were Danes. Based on empirical P-values generated by computer simulation, the observed proportions of DBH*304S homozygotes did not differ significantly from Hardy-Weinberg expectations in any of the populations after Bonferroni correction for multiple comparisons. The observation of significant heterogeneity in DBH*304S allele frequency across different population samples demonstrates the importance of controlling for population stratification in future studies testing for associations between DBH*304S and clinical phenotypes.

Alleles↗
PubMed2004

Quantitative trait locus mapping for age-related cataract severity and synechia prevalence using four-way cross mice.

PURPOSE: The goal of this study was to map mouse quantitative trait loci (QTL) that influence the development of murine age-related cataract and synechia, by using a genetically heterogeneous mouse population bred by a four-way cross. METHODS: The test population consisted initially of 510 mice bred as the progeny of (BALB/cJ x C57BL/6J)F1 females and (C3H/HeJ x DBA/2J)F1 males. Each mouse was examined by slit lamp at 18 and 24 months of age and scored for degree of lens opacity on a 0 to 4+ scale, and the presence or absence of additional anterior chamber disease was noted. The presence of synechia was confirmed by histology. Each mouse was genotyped at 96 maternal and 92 paternal loci, and the significance of association between genotype and eye lesions was tested by permutation analysis. RESULTS: Significant QTL with effects on lens opacity at 24 months were detected on mouse chromosomes 4, 11, and 12. The effects were additive, and severe cataracts were seen in 80% of the mice with all three high-risk alleles, but in only 28% of the mice with all three low-risk alleles. The risk of synechia was associated with paternal chromosome 1 and on both the maternal and paternally inherited chromosome 4. Mice with all three high-risk alleles had a 68% risk of synechia, compared with a 0% incidence in mice with all three counteralleles. CONCLUSIONS: A four-way cross population of mice can be used to map polymorphic loci that influence cataract severity and synechia prevalence in late life. The results provide a first step toward identification of the individual genes involved and may help to guide the search for homologous human genes.

Aging↗
PubMed2004

Canavan disease: carrier-frequency determination in the Ashkenazi Jewish population and development of a novel molecular diagnostic assay.

Canavan disease (CD) is an autosomal recessive progressive neurodegenerative disorder prevalent in the Ashkenazi Jewish (AJ) population. The carrier rate for the most common mutations that cause CD in the AJ population is often quoted as 1:37-1:40. This is not supported by our finding of only two diagnosed cases of CD in the last 20 years in the Toronto AJ population of 160,000 and an estimated birth rate of 1,500-2,000 per year. Therefore, we embarked on a prevalence cross-sectional screening study to determine the carrier rate of CD in this population. In order to perform low-cost, high-throughput population testing for CD using molecular techniques, we first developed a novel molecular assay using multiplex fluorescent allele specific polymerase chain reaction (PCR) to test for the three most common mutations causing CD in the AJ population (A854C, C693A, C914A) and a neutral polymorphism at the site of the C693A mutation. During testing it was noted that individuals who were carriers of the A854C mutation also had a T polymorphism at the site of the C693A mutation (Y231X). We confirmed that in all A854C carriers the 854C mutation was in disequilibrium with the 693T polymorphism, indicating a founder chromosome for the A854C mutation in the AJ population. Twenty-five carriers were found from 1,423 samples yielding a carrier rate of 1:57, differing from the widely quoted frequency of 1:40 and supporting our observed frequency of disease.

Alleles↗
PubMed1984

Factors affecting sensitivity and specificity of exercise electrocardiography. Multivariable analysis.

Unlike the predictive value of a diagnostic test, which depends on the prevalence of disease in the population tested, its sensitivity and specificity have been assumed to be constants. This assumption was examined in patients who had both exercise electrocardiography and cardiac catheterization. The effects on sensitivity of factors from clinical history, catheterization, and exercise performance were defined by multivariable logistic regression analysis in 1,401 patients with coronary disease; effects on specificity were defined by a similar analysis in 868 patients without coronary disease. Five factors had significant, independent effects on exercise electrocardiographic sensitivity: maximal exercise heart rate, number of diseased coronary arteries, type of angina, and the patient's age and sex. Only maximal exercise heart rate had a significant, independent effect on exercise electrocardiographic specificity. Thus, the sensitivity and specificity of exercise electrocardiography vary with clinical history, extent of disease, and treadmill performance; the sensitivity and specificity of other diagnostic tests may also vary.

Adult↗
PubMed1982

Development of a new biochemical mutation test in mice based upon measurement of enzyme activities. II. Test results with ethyl methanesulfonate (EMS).

An experiment with ethyl methanesulfonate (EMS) was conducted to determine the feasibility of detecting chemically induced mutations in mice by quantitative analysis of metabolic characters using the test procedure of Feuers et al. (1982). A test population of 518 F1 mice from matings of untreated C57BL/6J females to C57BL/6J males treated with 0, 100, 175 or 200 mg/kg EMS was evaluated according to a set of multi-level biochemical and genetic screening criteria. The goal of the assay was identification of F1 individuals heterozygous at an unspecified locus for an induced mutant allele which altered the activity of one or more of 19 enzymes in brain and liver tissues of their F2 and F3 progeny, 8 individuals among a population of 345 F1's from the EMS-dosed groups were classified as confirmed mutants having at least 2 of their F2 progeny exhibiting the same enzyme aberrancy and transmitting this aberrancy to the F3 generation. No confirmed mutants were detected in the control population of 173 F1 individuals. These results indicate that this test method can be used to detect chemically induced mutations expressed as quantitative alterations in enzyme activity.

Animals↗
PubMed2004

Human herpesvirus 8 seroconversion in Kenyan women by enzyme-linked immunosorbent assay and immunofluorescence assay.

BACKGROUND: Human herpesvirus 8 (HHV-8) antibody tests vary in reported sensitivity and specificity, depending on the population tested and the assay. OBJECTIVE: The purpose of this study was to compare the ability to detect seroconversion to HHV-8 in a cohort of HHV-8 seronegative female commercial sex workers in Kenya using three tests: HHV-8 viral lysate-based enzyme-linked immunosorbent assay (ELISA), an immunofluorescence assay for HHV-8 lytic antigens (IFA-lytic) and IFA for latent nuclear antigens (IFA-LANA). STUDY DESIGN: By ELISA, 16 women from a prospective cohort of commercial sex workers were identified as seroconverting to HHV-8. A total of 124 post-enrollment samples from these 16 women as well as the enrollment samples were tested for HHV-8 antibodies by all three assays to monitor seroconversion. RESULTS: Of 16 women with apparent seroconversion by ELISA, 8 had a rise in IFA-lytic titers either concomitant with or prior to the first positive ELISA sample and no initial LANA by IFA. Five of the 16 women were IFA-LANA positive at entry, indicating prior infection with HHV-8. Three women had no evidence of seroconversion by either IFA-lytic or IFA-LANA and two of these three had increased ELISA reactivity concomitant with HIV-1 infection. CONCLUSIONS: Conversion from a negative to a positive ELISA result for HHV-8 antibody indicated seroconversion in only half of the study cohort of 16 women when IFA-lytic and IFA-LANA results were considered. The IFA-lytic assay was more sensitive than ELISA for early antibody responses. The IFA-LANA was positive in some women who had neither IFA-lytic nor ELISA antibodies suggesting it may be a marker for latent infections. Presumptive identification of incident HHV-8 infection by ELISA screening followed by IFA-lytic testing to confirm the positive test and IFA-LANA to rule out prior infection provides the most accurate documentation of HHV-8 seroconversion.

Antibodies, Viral↗