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At least 253 records · Page 14Linked to original sources
PubMed2003

Reliability of classifications derived from Cyriax's resisted testing in subjects with painful shoulders and knees.

STUDY DESIGN: Intrarater and interrater reliability. OBJECTIVES: Examine intrarater and interrater reliability of the resisted-testing component of Cyriax's selective tension testing for patients with painful shoulders and knees. BACKGROUND: Clinicians make diagnostic and intervention decisions about lesions in contractile tissues based on resisted testing. Diagnostic and intervention decisions require reliable data gathering, especially when more than 1 physical therapist manages a patient. No studies have examined agreement of the results of the resisted tests used in selective tension testing, either within or between physical therapists, in subjects having pathology. METHODS AND MEASURES: Subjects with pain in 1 knee (18 male, 22 female; mean age +/- SD = 31.8 +/- 9.5 years) or shoulder (21 male, 25 female; mean age +/- SD = 34.3 +/- 12.9 years) were examined twice. Referring diagnoses included ligament injuries, overuse syndromes, joint instability, and postsurgical symptoms, with some subjects seeking initial diagnosis. Two physical therapists used standardized positions to evaluate 2 knee motions or 6 shoulder and elbow motions. Evaluators applied maximal isometric manual resistance and rated the contraction as strong or weak while subjects identified the presence or absence of pain during the contraction. Evaluators did not interview the subjects and were masked to previous test results. Analyses included percentage of agreement, kappa coefficients, confidence intervals, and maximum kappa coefficients. RESULTS: Intrarater kappa coefficients ranged from 0.44 to 0.82 and interrater coefficients ranged from 0.00 to 0.46. The small number of subjects who were classified as weak affected the kappa coefficients. In the intrarater condition, evaluators averaged 91% of maximum kappa for the knee and 66.5% for the shoulder. In the interrater condition, they averaged 60.4% of the maximum kappa for both the knee and the shoulder. CONCLUSIONS: Based on 2 physical therapist evaluators with previous education in the selective tension system and an additional 6 hours of formal training on the methods, intrarater reliability of resisted tests was generally acceptable for the knee but not for the shoulder. Interrater reliability of these tests, however, was generally not acceptable. Results were limited by subjects who were younger and had mostly chronic conditions that were mildly to moderately severe and by the small subject samples in the analyses. Reliability might be improved by more intensive training of the evaluators and by standardizing the magnitude of the applied resistance and stabilization of the subjects.

Adult↗
PubMedDate not supplied

Anthropometric studies on students of the Nepal Medical College: elbow breadth.

BACKGROUND: Body mass index is a valuable tool to assess the nutritional status of an individual. It can be used to identify subjects who are underweight and obese. The present study was conducted with a view to identify the prevalence of underweight and obesity among Nepalese medical students. The study also detects the body frame size of these medical students by elbow breadth measurements. AIM OF STUDY: To measure Body mass index and body frame size based on elbow breadth measurements. MATERIALS AND METHODS: A total of 191 (males, 106) students participated in the study. The ratio of male to female was 1.24:1. The elbow breadth was measured by a vernier caliper (Tajima, Japan) to the nearest 0.1 mm. The body mass index (kg/m2) (BMI) was calculated using the height and weight measurements taken previously. Body frame size was obtained using a table based on elbow width. Data were analyzed using Microsoft excel for Windows 98. RESULTS: The study reveals that the prevalence of underweight and overweight in males of Nepal Medical college Vth batch were 30% and 1% and of IVth batch were 23.2% and 12.15% respectively. Of the females 38.6% and 2.2% of the IVth batch and 36.6% and 4.9% of the Vth batch were underweight and overweight respectively. The body frame size results indicted that 70% of the males and 61% of the females had small body frame. The study revealed a significant degree of under nutrition in male (26.4%) and female (20%) of Nepalese medical students. CONCLUSION: The present study observed that majority of the medical students of the Nepal Medical College were of small body frame size.

Adolescent↗
PubMed1990

Factors associated with short- versus long-term skilled nursing facility placement among community-living hip fracture patients.

Characteristics associated with long-term placement among community-living patients admitted to a skilled nursing facility (SNF) after a hip fracture were identified. Subjects were 151 consecutive, elderly, community-living persons discharged from two acute hospitals to SNFs after surgery for a hip fracture. Medical, functional, psychological, social, and outcome data were collected from hospital and nursing home charts. Ninety-seven subjects (64%) were discharged home within 6 months; 50 (33%) became permanent SNF residents; and four died. Multiple logistic regression identified orientation, younger age, ability to bathe independently, family involvement, ability to ambulate or transfer independently, and greater number of available physical therapy hours as factors contributing independently to returning home. Likelihood of returning home increased from 7% among subjects with fewer than two of the patient characteristics to 82% among subjects with four or more characteristics (P less than .0005). These results suggest that hip fracture patients at high risk of permanent SNF placement can be identified at time of hospital discharge. Investigations are needed to determine whether more intensive rehabilitation and discharge planning may improve the chance of returning home for a large percent of hip fracture patients.

Activities of Daily Living↗
PubMed2005

An evaluation of photographic screening for neovascular age-related macular degeneration.

BACKGROUND: Photographic screening for neovascular age-related macular degeneration (AMD) is not commonly employed because the prevalence of treatable disease is low and fluorescein angiography is considered necessary for the diagnosis of this form of AMD. However, there may be a role for colour retinal imaging in assisting with the diagnosis and triage of subjects with neovascular AMD. The purpose of this study was to evaluate the utility of colour fundus photographs for identifying subjects with potentially treatable neovascular AMD. METHODS: A total of 74 stereo pairs of Kodachrome colour slides of subjects with AMD were evaluated (i) nonstereoscopically, (ii) stereoscopically, and (iii) stereoscopically with visual acuity and visual symptom data. Two retina specialists read the images to identify active exudative lesions. RESULTS: The kappa statistic comparing the retinal specialists diagnosis of treatable neovascular AMD from color slides was excellent. The sensitivity and specificity of nonstereo images for the appropriate categorization of lesions was 0.95 and 0.90 respectively. The evaluation of stereo pairs was more sensitive, but less specific, 0.98, 0.83, as was the evaluation of stereo-pairs with clinical histories and visual acuities, 1.00, 0.77. CONCLUSIONS: The evaluation of colour images for subjects with suspected exudative macular degeneration can be diagnostic for neovascular AMD and may expedite the appropriate referral of patients for more timely angiography and treatment. Incorporating more clinical information for the image evaluators ((i) stereo image pairs and/or (ii) presenting symptomatology and visual acuity data) led to a decrease in the false-negative rate, but also decreased the screening specificity.

Aged↗
PubMed2005

Impact of statins in microalbuminuric subjects with the metabolic syndrome: a substudy of the PREVEND Intervention Trial.

AIMS: Microalbuminuria frequently clusters with the metabolic syndrome and may identify subjects at increased coronary risk. Statin treatment may reduce the incidence of major adverse cardiac events in subjects with the metabolic syndrome, but evidence is limited. We evaluated the impact of pravastatin treatment on the incidence of major adverse cardiac events in microalbuminuric subjects with the metabolic syndrome. METHODS AND RESULTS: This substudy of the PREVEND Intervention Trial (a randomized, placebo-controlled trial with a 2x2 factorial design) included 864 microalbuminuric subjects, who were randomized to fosinopril 20 mg or matching placebo and pravastatin 40 mg or matching placebo (mean follow-up 46 months). The metabolic syndrome was defined according to the NCEP ATPIII-report. Subjects with or without the metabolic syndrome were characterized by a higher age, male sex, and increased albuminuria. The incidence of major adverse cardiac events in subjects with the metabolic syndrome [9.1%; 95% confidence interval (CI) 6.0-13.0%] was increased vs. those without [3.6%; 95% CI 2.3-5.5%; P=0.007). Pravastatin treatment lowered the incidence of major adverse cardiac events in subjects with the metabolic syndrome after adjustment for age and sex (hazard ratio=0.39; 95% CI 0.17-0.89; P=0.025). CONCLUSION: This study supports the use of statins in microalbuminuric subjects with the metabolic syndrome to reduce the incidence of major adverse cardiac events.

Albuminuria↗
PubMed2001

How covert are covertly manipulated diets?

OBJECTIVE: To quantitatively assess subjects' ability to detect hedonic (palatability), sensory and nutritional differences between covertly manipulated high-fat (HF) and low-fat (LF) diets. SUBJECTS AND DIETS: This study examined the response of 16 subjects (eight men, eight women) to 20 LF and 20 HF versions of manipulated foods. Average percentage protein:fat:carbohydrate (by energy) and energy density (ED) of the two diets were 13:25:62, 371 kJ/100 g and 13:50:37, 672 kJ/100 g, respectively. PROTOCOL: Subjects were asked to simultaneously assess the HF and LF versions of each food in terms of (i) subjective pleasantness of each food, (ii) perceived differences in appearance, smell, taste and texture of the foods, and (iii) for each sample to assess whether it was high or low in energy, protein, carbohydrate, fat, fibre, sugar and salt. ANALYSIS: Perceived pleasantness of HF and LF versions of the foods was compared by analysis of variance. Comparisons used chi-squared tests of independence to assess departure from the null hypothesis of no perceived difference in remaining parameters (ii-iii). RESULTS: On average, subjects exhibited no significant preference for LF or HF versions of the foods (no difference 15 foods, three HF foods more pleasant, two LF foods more pleasant (P<0.03)). On average there were no general differences in comparison of sensory attributes that were consistently ascribable to the LF or HF foods, although there were numerous significant differences for individual foods. Subjects appeared unable to distinguish the HF foods as being HF (66% of estimates) and guessed correctly 33% of the time. They were better able to categorize the LF foods correctly (53% correct). On aggregate 43% of HF and LF foods were correctly identified. Subjects appeared able to detect sensory differences between foods but not to relate them to energy or nutrient content of these foods. CONCLUSIONS: These data suggest that subjects are on average not able to perceive large differences in the fat content of diets manipulated in this manner. In general the assumption that the manipulation of such foods is covert appears to hold, but subjects were far better at correctly identifying certain food types (dairy-based) over others.

Adult↗
PubMed2006

Variability of CYP2J2 expression in human fetal tissues.

CYP2J2 metabolizes arachidonic acid to 20-hydroxyeicosatetraenoic acid and epoxyeicosatrienoic acids (EETs), which play a critical role in the regulation of renal, pulmonary, cardiac, and vascular function. However, the contribution of CYP2J2 to EET formation in the liver remains poorly characterized. Likewise, information is sparse regarding the extent and variability of CYP2J2 expression during human development. This investigation was undertaken to characterize the variability of CYP2J2 expression in fetal liver, heart, kidney, lung, intestine, and brain and in postnatal liver samples. CYP2J2 mRNA expression was measured using quantitative polymerase chain reaction, and immunoreactive CYP2J2 was examined using two anti-CYP2J2 antibodies. CYP2J2 mRNA was ubiquitously expressed in pre- and postnatal samples. Fetal hepatic mRNA expression varied 127-fold (1351 +/- 717 transcripts/ng total RNA), but this variation was reduced to 8-fold after exclusion of four samples with extremely low levels of mRNA. Amounts of immunoreactive protein also varied substantially among samples without an apparent relationship with transcript number or genotype. Western blot analysis revealed a different protein pattern between prenatal and postnatal liver samples. DNA resequencing of selected subjects identified a single novel single-nucleotide polymorphism (CYP2J2*10), which was found in only one subject and therefore did not explain the large variability in CYP2J2 protein content. In vitro expression suggests that the protein product of CYP2J2*10 confers reduced enzymatic activity. Aberrant splicing produces three minor transcripts, which were present in all samples tested. Due to premature termination codons, none encodes functional protein. The mechanisms leading to variable amounts of immunoreactive protein and distinct pre- and postnatal CYP2J2 protein patterns warrant further investigation.

Alleles↗
PubMed1990

Combined single day 14C-triolein breath test and PABA test in the diagnosis of malabsorption.

The 14C-triolein breath test, a recognised index of fat absorption, and the p-aminobenzoic acid (PABA) test, a 'tubeless' test of exocrine pancreatic function, have both been widely used in the diagnosis of malabsorption and exocrine pancreatic insufficiency. This study evaluates the potential of a combination of both tests in the investigation of fat absorption and exocrine pancreatic function. Combination of the tests has become technically feasible because of the introduction of high pressure liquid chromatography as the preferred method of analysis for PABA, and use of p-aminosalicylic acid (PAS) as the marker for PABA absorption and metabolism. We studied 25 healthy subjects, 11 patients with exocrine pancreatic disease and 12 patients with gastrointestinal disease. The combined test identified subjects with reduced fat absorption and distinguished subjects with exocrine pancreatic insufficiency from those with an intestinal cause of fat malabsorption. The test could be completed in 7 h and had high patient acceptability. These findings suggest that the combined 14C-triolein breath test and PABA test can be used as a non-invasive, 1-day investigation of fat absorption and exocrine pancreatic function.

4-Aminobenzoic Acid↗
PubMed1990

[Dental awareness among young adults].

Awareness of own dental appearance was studied in 150 18-year old individuals by assessing their ability to identify a photograph of own teeth among 17 alternative photographs. More than two thirds of the subjects identified their picture on first trial, which reflects a high level of dental awareness in the group. Consciousness about dental arrangement was high as 56% reported deviating tooth position as a primary cause for recognition. Other features, such as tooth morphology, discolouration and fractures were stated as reasons for identification by 26% of the individuals. The findings indicate that young adults are able to recognize a good orthodontic treatment result. Therefore, a high standard of the treatment delivered seems to be justified by the level of dental awareness in young adults.

Adolescent↗
PubMed1998

The influence of nationality on the accuracy of face and voice recognition.

Sixty English and U.S. citizens were tested to determine the effect of nationality on accuracy in recognizing previously witnessed faces and voices. Subjects viewed a frontal facial photograph and were then asked to select that face from a set of 10 oblique facial photographs. Subjects listened to a recorded voice and were then asked to select the same voice from a set of 10 voice recordings. This process was repeated 7 more times, such that subjects identified a male and female face and voice from England, France, Belize, and the United States. Subjects demonstrated better accuracy recognizing the faces and voices of their own nationality. Subgoups analysis further supported the other-nationality effect as well as the previously documented other-race effect.

Adult↗
PubMed1997

Laryngopharyngeal sensory testing with modified barium swallow as predictors of aspiration pneumonia after stroke.

Improved diagnostic tests that can accurately identify subjects at high risk for aspiration pneumonia (AP) are needed. One measure of this accuracy is the false-negative rate (FNR), which determines the failure of a test to identify a group at high risk. This study compares FNRs for AP among dysphagic stroke patients for two prognostic techniques: modified barium swallow (MBS) alone and MBS combined with laryngopharyngeal sensory discrimination testing (MBS + LPSDT). MBS and LPSDT were performed within 4 weeks of stroke in 20 subjects who were prospectively followed for at least 2 years to identify the frequency of AP. MBS identified 10 patients as not at risk based on the finding of no aspiration on initial MBS; four of these patients developed AP (FNR = 40%). MBS + LPSDT identified five patients as not at risk based on the findings of neither aspiration nor bilateral sensory deficits; none of these patients developed AP (FNR = 0%). The combination of MBS criterion (aspiration) with the LPSDT criterion (bilateral sensory deficits) improves prognostication of outcome in dysphagic stroke patients by identifying a subgroup at high risk for developing AP (nonaspirators with bilateral deficits).

Adult↗
PubMed1996

The relevance of continuous blood pressure monitoring in examining the relationship of memory efficiency with blood pressure characteristics.

The study of the relationship between hypertension and cognitive decline is characterized by various difficulties of realization and, as a consequence, by incongruent results. One of the reasons for these difficulties may be explained by the occasional method of measurement of blood pressure (once a day). This study presents the results obtained in 27 normotensive and mild hypertensive subjects of both sexes (ages between 20 and 77 years) with a continuous blood pressure monitoring for 24 h. A noninvasive sphygmomanometric technique was used employing a portable recorder programmed to take a measure every 30 min. Both objective and subjective measures of memory, measures of attention efficiency, and IQ were correlated to the blood pressure measures. Continuous monitoring data of blood pressure were analyzed according to a model that included a macroscopic descriptive analysis, a microscopic rhythmometric analysis, and a microscopic integrative analyses where the effects of the interaction between level and duration of excess and the time of the day when the excess eventually appeared were considered. Results evidenced no differences in cognitive efficiency between those subjects identified with the traditional occasional measurement of blood pressure as hypertensives of mild severity and the normal subjects. Cognitive efficiency of our subjects was found correlated, independently from the clinical diagnosis, with the time of peak and with the duration of excess of their blood pressure when the results of the analyses on the continuous monitoring of blood pressure were considered.

Adult↗
PubMed1989

Preclinical detection of nephrotoxicity: description of the tests and appraisal of their health significance.

The prevention of renal diseases induced by chemicals requires the use of tests with which adverse renal effects can be detected at a stage when removal from exposure to the offending agent(s) may lead to complete recovery or may at least prevent an accelerated decline in renal function. The screening tests used in clinical medicine for assessing the functional integrity of the kidney are not sufficiently sensitive to attain this objective. In this review, we describe the tests currently available for detecting incipient renal damage and attempt to assess their health significance. A minimal battery of tests is recommended for the detection of groups in industry or in the general population who are at risk. If an increased prevalence of abnormal values for these parameters is found repeatedly in a population, efforts should be made to identify the causal agent(s) and, if possible, to reduce the exposure. Follow-up examinations of subjects identified in this way are also indicated, in order to define the predictive value of the detected changes better.

Drug-Related Side Effects and Adverse Reactions↗
PubMedDate not supplied

Infant feeding choice and the adolescent mother.

A descriptive study of 25 pregnant adolescents was conducted to determine where information about feeding is obtained and when the information has the most impact. Family and social environment was a source of information for all of the subjects; the next most frequently cited source of information on infant feeding was magazines. Only two of the subjects identified clinical nurses as a source of infant feeding information. Data indicate that the majority of the subjects had made their feeding decisions in early pregnancy. Results of this study indicate that nurses need to improve their image as a source of information for the adolescent who is trying to make the important feeding decision.

Adolescent↗
PubMed2005

Components of the metabolic syndrome and carotid atherosclerosis: role of elevated blood pressure.

Elevated blood pressure is among the factors that contribute to the metabolic syndrome (MetS). It is not known whether subjects with MetS and elevated blood pressure are at the same cardiovascular risk as subjects with MetS but without elevated blood pressure. To clarify this point, we have evaluated the prevalence of carotid atherosclerosis in subjects with MetS with or without elevated blood pressure. A large population was examined (842 women and 1011 men). Blood pressure, lipids, glucose, and waist were measured by routine methods. Carotid atherosclerosis was evaluated by echo Doppler examination. The prevalence of MetS was 24.4% in women and 28.7% in men. The prevalence of carotid atherosclerosis was 35.1% in women and 37.3% in men (p=NS), and increased with increasing number of MetS components. Age, smoking, and systolic blood pressure (SBP) were associated with the presence of carotid atherosclerosis (logistic model), whereas age, high-density lipoprotein cholesterol, and SBP were associated with the extent of atherosclerosis (linear model). When comparing subjects with an equal number of MetS components, the prevalence of carotid atherosclerosis was significantly higher in subjects with elevated blood pressure than in those without. No difference in carotid atherosclerosis prevalence was found in subjects bearing or not bearing components of the syndrome other than elevated blood pressure. The present findings demonstrate that subjects with MetS and elevated blood pressure have increased carotid atherosclerosis compared with subjects with MetS but without elevated blood pressure. The diagnosis of MetS per se might not adequately identify subjects at elevated cardiovascular risk.

Adult↗
PubMed1992

Targeted colon cancer screening: a concept whose time has almost come.

Screening of large populations for colon malignancy has been advocated in several countries to detect cancers at earlier, curable stages and/or prevent cancer by detecting and removing premalignant polyps. Ideal screening would identify subjects with the highest risk of cancer and target sensitive screening tests at this population. Recent data suggesting that environmental factors and genetic alterations contribute to increased cell proliferation in colonic mucosa provide several avenues for identification of high-risk subjects. This review examines the current literature regarding colon cancer risk factors, focusing on new ways to identify individuals who may benefit from targeted screening.

Biomarkers, Tumor↗
PubMed1990

Nutrition care planning: comparison of the skills of dietitians, interns, and students.

A written case study--or patient management problem--was used to examine how the nutrition care planning process is influenced by increasing clinical experience. The sample consisted of 45 students in diet therapy courses, 46 dietetic interns, and 44 experienced clinical or generalist dietitians. The patient management problem tested data gathering, with sections containing information needed to assess nutritional status, and nutrition care planning, in which subjects identified and evaluated problems and selected short- and long-term goals. Performance was scored by comparing subjects' answers with those of five dietetic experts. Dietitians scored highest and students scored lowest on efficiency of data gathering. Dietitians and interns scored higher than students on proficiency of data gathering and nutrition care planning. Overall, dietitians and interns performed better than students. Only in tasks requiring the highest levels of information processing and/or confidence in clinical judgment were differences between dietitians and interns consistently found. These findings demonstrate that basic nutrition care planning skills are acquired during dietetic internships, but advanced skills are added with clinical experience.

Dietary Services↗
PubMed1980

Eustachian tube function in selection of airmen.

A comprehensive study of Eustachian tube function in 84 aspirants accepted for flight training was made. Using a pressure chamber, both static and dynamic pressure changes, as in ascent and descent, were applied to test the tubal pressure equilibrating capacity in the sitting position. While all 84 were otologically healthy, a wide range in the pressure equilibrating capacity was found--20% could not equilibrate static over- and underpressures of 10 cm H2O completely, 8% could not equilibrate at all during simulated descent, 3 subjects reported acute vertigo during simulated ascent in combination with high unilateral middle ear pressure. Asymmetry between ears of single subjects in pressure equilibrating capacity was also found to a large extent. It was not possible to identify subjects with poor equilibrating capacity by simple tests like Valsalva's or Toynbee's manoeuvres. The results may indicate that today's criteria for Eustachian tube function in the selection of airmen can be made more efficient.

Adolescent↗