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At least 307 records · Page 17Linked to original sources
PubMed2005

Relationships between hematological recovery and overall survival in older adults undergoing allogeneic bone marrow transplantation.

OBJECTIVE: The advancement of hematopoietic stem cell transplantation techniques and the increase in frequency of hematological malignancy in older patients are expected to expand the indications to include more elderly patients. We investigated the problem of allogeneic bone marrow transplantation (allo-BMT) in patients over 40 years old. PATIENTS AND METHODS: We retrospectively analyzed 21 consecutive patients (13 males and 8 females) over 40 years old who underwent allo-BMT at our center during the past 12 years. RESULTS: The patients had a median age of 46 years, and 5 patients were over 50 years old. There were 8 cases of acute myelogenous leukemia (AML), 5 cases of acute lymphocytic leukemia (ALL), 6 cases of chronic myelogenous leukemia (CML) and 2 cases of myelodysplastic syndrome (MDS). The 3-year overall survival rate was 43.0%. Overall survival was associated with recovery of platelets in less than 30 days and recovery of neutrophil counts in less than 15 days. We did not observe any severe graft-versus-host disease (GVHD) or regimen-related toxicities. Twelve patients died of transplantation-related diseases. CONCLUSION: A faster recovery of the neutrophil and platelet counts was significantly associated with overall survival. Decreasing transplantation-related death, particularly by infection control, in allo-BMT in patients over age 40 is an important problem.

Adult↗
PubMed2003

Contributions of fasting and postprandial plasma glucose increments to the overall diurnal hyperglycemia of type 2 diabetic patients: variations with increasing levels of HbA(1c).

OBJECTIVE: The exact contributions of postprandial and fasting glucose increments to overall hyperglycemia remain controversial. The discrepancies between the data published previously might be caused by the interference of several factors. To test the effect of overall glycemic control itself, we analyzed the diurnal glycemic profiles of type 2 diabetic patients investigated at different levels of HbA(1c). RESEARCH DESIGN AND METHODS: In 290 non-insulin- and non-acarbose-using patients with type 2 diabetes, plasma glucose (PG) concentrations were determined at fasting (8:00 A.M.) and during postprandial and postabsorptive periods (at 11:00 A.M., 2:00 P.M., and 5:00 P.M.). The areas under the curve above fasting PG concentrations (AUC(1)) and >6.1 mmol/l (AUC(2)) were calculated for further evaluation of the relative contributions of postprandial (AUC(1)/AUC(2), %) and fasting [(AUC(2) - AUC(1))/AUC(2), %] PG increments to the overall diurnal hyperglycemia. The data were compared over quintiles of HbA(1c). RESULTS: The relative contribution of postprandial glucose decreased progressively from the lowest (69.7%) to the highest quintile of HbA(1c) (30.5%, P < 0.001), whereas the relative contribution of fasting glucose increased gradually with increasing levels of HbA(1c): 30.3% in the lowest vs. 69.5% in the highest quintile (P < 0.001). CONCLUSIONS: The relative contribution of postprandial glucose excursions is predominant in fairly controlled patients, whereas the contribution of fasting hyperglycemia increases gradually with diabetes worsening. These results could therefore provide a unifying explanation for the discrepancies as observed in previous studies.

Blood Glucose↗
PubMed2000

Overall self-confidence, self-confidence in mathematics, and sex-role stereotyping in relation to salivary free testosterone in university women.

This study investigated in 40 young university women the possible relationships between levels of testosterone and specific measures of overall self-confidence and self-confidence in approaching mathematics. Correlations of -.43 and -.49 with each measure of self-confidence, respectively, and level of testosterone were found in the portion of the sample displaying normal ovulatory function. There was no correlation (r=.02) between the measures of mathematics and overall self-confidence. 19 women did not display normal ovulatory function. The only significant result for the full sample was a significant correlation of -.73 between scores on the Bem Sex Role Inventory Masculinity and overall self-confidence. The reasons for the high anovulatory percentage are not clear, nor are the associations which anovulation might have with either hormonal levels or the personality characteristics in question.

Adolescent↗
PubMed1981

Ectopic pregnancy during 1961-78 in Uppsala county, Sweden. Impact of demographic factors on overall incidence.

From 1961-66 to 1973-78 in Uppsala county, Sweden the overall incidence rate of ectopic pregnancy rose from 0.31 per 100 notified pregnancies or 0.28 per 1 000 women 15-44 years of age, to 1.00 and 0.96, respectively. The impact of demographic changes on the increase in the overall incidence was studied. By using indirect age standardization it was found that 13% of the increase in the overall rate of ectopics per 1 000 women was attributable to a change in the age distribution of women in the fertile age-span.

Abortion, Induced↗
PubMed1992

Total overall management and surgical outcome after aneurysmal subarachnoid haemorrhage in a defined population.

It was possible from a geographically well-defined region to detect all patients sustaining an aneurysmal subarachnoid haemorrhage. Different outcomes were measured and compared with other published series. Twenty-one per cent of all our patients at risk were never seen by a neurosurgeon. By adding further 20% of dead patients to the management series a total overall outcome, i.e. from all 'patients at risk', could be calculated, making comparison between different series easier. Favourable outcomes in the three groups (total overall, total management and surgical) as measured with the Glasgow Outcome Scale at 12 months were 46, 58 and 69%, respectively, in this series. In a super selected group such as good-grade patients (Hunt and Hess I-II) at surgery favourable results were seen in 87% of the patients at 6 months follow-up. The favourable outcome in the total overall, total management and surgical groups increased between 6 and 12 months follow-up by 1, 1 and 2%, respectively, as compared to 4, 5 and 6%, respectively, between discharge and 6 months follow-up. The time of follow-up to measure outcome should not be shorter than 6 months in aneurysm cases. It is emphasized that all patients drop-outs from the initial 'patient at risk' should be identified.

Adult↗
PubMed1990

A comparison of overall health between patients with rheumatoid arthritis and a population with and without rheumatoid arthritis.

Women with rheumatoid arthritis (RA) at a rheumatology outpatient clinic (PAT) were compared with women with RA in representative samples of the Gothenburg population (POP), and with non-arthritic women in this population (REF). Clinical routine measures disclosed substantial dysfunction in both RA groups. Their physical, psychosocial, and overall function, assessed by means of the Sickness Impact Profile (SIP), was more impaired than that of the REF. The PAT had a higher disease activity and worse overall health status than the POP. In definite and classical RA, a poorer SIP physical and overall function was noted in the PAT than in the POP group, despite similar mean age and mean disease duration. Women with probable RA in the POP group had worse SIP dysfunction than the REF, particularly regarding ambulation and personal care. The SIP was sensitive to variations in disease activity and comprehensively disclosed dysfunction better than routine clinical measures.

Activities of Daily Living↗
PubMed1990

Contribution of gluconeogenesis to overall glucose output in diabetic and nondiabetic men.

Increased hepatic glucose output is the main cause of fasting hyperglycemia in non-insulin dependent diabetes mellitus. Due to difficulties in obtaining a quantitative estimate of gluconeogenesis in vivo, the relative contribution of gluconeogenesis and glycogenolysis to this increased hepatic glucose output was unknown. The application in vivo of a new isotopic approach based on a mathematical model of the Krebs cycle enabled us to obtain a quantitative estimate of gluconeogenesis in vivo. Using this approach, gluconeogenesis was found to account for approximately 28% and approximately 97% of overall hepatic glucose output in healthy volunteers in the postabsorptive and in the fasted state respectively. When this technique was used to compare gluconeogenesis rates in non-insulin dependent diabetes mellitus and nondiabetic patients, gluconeogenesis was found to be increased threefold in the patients with non-insulin dependent diabetes mellitus (12.7 +/- 1.6 mu vs 3.6 +/- 0.6 mumol/Kg/min) and to be significantly correlated with fasting plasma glucose. Furthermore, the increase in gluconeogenesis could explain more than 80% of the increase in overall hepatic glucose output in patients with non-insulin dependent diabetes mellitus. In conclusion, in non-insulin dependent diabetes mellitus, gluconeogenesis, as measured by a new isotopic technique, is increased and this increase represents the main cause for increased overall hepatic glucose output and fasting hyperglycemia.

Carbon Radioisotopes↗
PubMed2006

Overall outpatient satisfaction and its components: perceived changes at the Huntington VA Medical Center over five years.

The number of veterans obtaining healthcare services at Huntington Veteran's Administration Medical Center (HVAMC) had significantly increased over the five-year span from fiscal year 2000 through fiscal year 2004. The authors' purpose in this study was to determine changes in outpatient satisfaction levels at HVAMC over that five-year period. The authors assessed the following specific measures of patient satisfaction: courtesy, access, patient preferences, coordination of care, education and information, emotional support, overall quality, pharmacy services, and overall satisfaction. Of the 17,000 patients meeting the criteria, 630 were randomly selected; 195 patients completed surveys, resulting in a 31% response rate. Results demonstrated an overall significantly higher level of patient satisfaction than five years previously. On the basis of these results, the medical center administration can probably conclude that any process he improvements made over the five-year period have been successful.

Ambulatory Care↗
PubMed2001

The systematic discrepancy between A' for overall recognition and remembering: a dual-process account.

Signal detection accounts of recognition assume that all item endorsements arise from the assessment of a single continuous indication of memory strength, even when subjects claim to categorically separate items accompanied by contextual recollection from those that are not (viz., remembering vs. knowing). Dissociations of these response types are held to occur because the former require a higher response criterion for item strength than does the latter. Meta-analytic and individual subject data suggest that when the A' metric is used, accuracy for remembering can systematically deviate from that of overall responding for individual subjects. This occurs because, unlike the symmetric and rigid receiver-operating characteristic (ROC) implied under A', empirical ROCs are asymmetric and plastic. A dual-process model predicted that the magnitude of the deviation would vary as a systematic function of the proportion of overall recognition accompanied by subjective remember reports for individual subjects. The predictions were confirmed using multiple regression on Monte Carlo and experimental data sets and were also shown to generalize to the double equal-threshold, single high-threshold [i.e., H - FA; (H - FA)/(1 - FA)], and the equal variance signal detection d' corrections. The unequal variance signal detection model was also shown to mirror the data, but only under the post hoc assumption that every subject adopts a very similar remember criterion placement rule. The results demonstrate that the systematic failure of tightly constrained models of recognition constitutes valuable regression data for more complex models and simultaneously highlights why single-point measures of accuracy are unsuitable as summaries across conditions or groups. Furthermore, the results show that remember rates carry unique information regarding the underlying processes governing individual subject performance that cannot be gleaned from the overall hit and false alarm rates in isolation.

Data Interpretation, Statistical↗
PubMed1999

Children with acute lymphoblastic leukemia who receive T-cell-depleted HLA mismatched marrow allografts from unrelated donors have an increased incidence of primary graft failure but a similar overall transplant outcome.

Disparity for HLA in unrelated donor bone marrow transplantation (BMT) increases the risk of graft rejection and graft-versus-host disease (GVHD) and may compromise transplant outcome. We have compared the outcome of matched and mismatched transplants from unrelated donors in 137 children with acute lymphoblastic leukemia (ALL). Their disease status was complete remission (CR)-1, 24 patients; CR-2, 88 patients; CR-3, 18 patients; CR-4, 2 patients; and relapse, 5 patients. CAMPATH monoclonal antibodies were used for T-cell depletion and cyclosporin A was given to 134 children together with short-course methotrexate in 43, mainly when there was HLA disparity. Fifty-two donor/recipient pairs were HLA-mismatched, 41 at HLA-A and -B and 11 at HLA-DR and -DQ loci. Overall graft failure was increased in recipients of marrow mismatched at either HLA-A, -B, -DR, or -DQ (15.7% v 4.8%; P =.057) mainly because there was a higher proportion of children with primary graft failure (11. 8% v 1.2%; P =.012). The presence of an HLA-C locus mismatch did not independently increase the likelihood of graft failure. There was no significant difference in the incidence of acute GVHD >/= grade 2 between the matched and mismatched groups (P =.849). For patients in CR-2, the risk of relapse post-BMT was significantly lower if leukemic relapse occurred off-treatment (P =.005). The Kaplan-Meier overall and leukemia-free survival (LFS) estimates for recipients of matched and mismatched BMT, respectively, at 36 months were 49% versus 42% (P =.380) and 45% versus 40% (P =.654). Although HLA mismatching results in an increased occurrence of primary graft failure with T-cell-depleted allografts, it allows more donors to be identified rapidly for children with ALL without compromising overall transplant outcome.

Adolescent↗
PubMed2000

The D' measure of overall gametic disequilibrium between pairs of multiallelic loci.

The D' coefficient is one of the most commonly used measures of the extent of gametic disequilibrium between multiallelic loci. It has been suggested that the range of the D' measure of overall disequilibrium between pairs of multiallelic loci depends on allele frequencies, except under some very restricted conditions. Nevertheless, the problem of dependence of the range of D' has not been characterized under a wide set of possible polymorphisms. Evaluation of the utility of D' as a measure of the strength of overall disequilibrium between all possible pairs of alleles at two multiallelic loci requires better knowledge of its range than is currently available. In this work, the conditions of polymorphism under which the range of D' is frequency independent are given. It is found that the range of D' is more often independent of allelic frequencies than is commonly thought. Furthermore, the range of D' undergoes only small fluctuations as a function of the polymorphisms at the loci. Numerical cases and microsatellite data from humans are used for illustration. These observations indicate that the D' coefficient is a useful tool for the estimation and comparison of the extent of overall disequilibrium across pairs of multiallelic loci.

Alleles↗
PubMed2001

Factors affecting the overall survival after salvage surgery in patients with recurrent nasopharyngeal carcinoma at the primary site: experience with 60 cases.

OBJECTIVE: To analyze the factors affecting overall survival after salvage surgery in patients with recurrent nasopharyngeal carcinoma at the primary site after a full course of radiotherapy. DESIGN: Retrospective analysis of 60 consecutive patients treated by surgical resection of the recurrent tumors, with a mean follow-up of 43.1 months (range, 19-96 months). SETTING: Academic tertiary referral center. RESULTS: The overall survival and locoregional relapse-free survival were 56% and 60% at 2 years, respectively, and 30% and 40% at 5 years. Twenty-nine (81%) of 36 patients died with uncontrolled local disease. The T stage of the recurrent tumors appeared to be an important prognostic factor. Age, sex, pathologic findings, and disease-free interval (time between previous radiotherapy and local recurrence) were not significant prognosis-affecting factors by the log-rank test. Multivariate analysis showed that patients with recurrent tumors of undifferentiated carcinoma, sarcoma, or small cell carcinoma had unfavorable prognoses. Uncontrolled local disease and the emergence of distant metastasis predicted grave results as well. Postoperative irradiation showed some benefit to patients, but the difference was not statistically significant. CONCLUSIONS: The T stage of the recurrence was the prominent prognosis-affecting factor in patients with recurrent nasopharyngeal carcinoma who received salvage surgery. Patients with local recurrence should be carefully selected for the salvage surgery. We recommend this surgery for patients with rT1, rT2, or limited rT3 lesions. The results of surgical resection in terms of local control and overall survival were slightly better than those of high-dose reirradiation, with fewer late complications.

Adult↗
PubMed2001

Managed care and primary care physicians' overall career satisfaction.

Salaried employment among primary care physicians (PCPs) is becoming the rule rather than the exception. Because of this trend, the consequences of employment, types of practice revenues and overall career satisfaction will have the greatest impact on this group, their employers, and the populations they serve. This article examines the relationship between managed care contracts, managed care revenues and salaried PCP overall career satisfaction. Proportion of practice revenues from managed care and types of managed care contracts were associated with PCP overall career satisfaction. The implications of these findings and their importance to PCP turnover are discussed.

Attitude of Health Personnel↗
PubMed2002

[Relation between overall treatment time and local control of early glottic laryngeal cancer: comparison of six versus five times per week].

PURPOSE: Local control probabilities of early glottic cancer were evaluated in relation to overall treatment time. MATERIALS AND METHODS: From 1971 to 1996, 162 patients with T1 or T2 glottic cancer were treated with radiation therapy. Fifty-nine patients received irradiation six times per week from 1971 to 1987, and 103 patients received irradiation five times per week from 1987 to 1996. Local control rates were calculated by the Kaplan-Meier method, and the log-rank test was used for statistical analysis. The Cox proportional hazards model was used to evaluate the significance of prognostic variables on local control. RESULTS: The 5-year local control rates were 91.8% for T1 tumors and 78.1% for T2 tumors. There was a statistically significant difference in local control rates between the two groups (p = 0.009). The overall local control rate was 86.4% for both groups, showing no statistically significant difference. Multivariate analysis showed that T stage and overall treatment time were important parameters in relation to local control. CONCLUSIONS: In early glottic cancer, there is no significant difference in local control probabilities between irradiation six times per week and five times per week.

Carcinoma, Squamous Cell↗
PubMed2002

Pragmatic validity of the combined model of expert system for assessment and analysis of the actual quality overall structure of basketball players.

The authors presumed that it was possible to replace certain criteria of the expert system aimed at evaluating actual quality of basketball players, proposed by Trninić et al., with the corresponding indicators of situation-related efficiency (official statistics of the game). Hence, the aim of this study is to verify the potential of establishing such a combined model of expert system that would consist of both the evaluation criteria and certain number of objectively measurable aspects of actual quality (player's partial performance or playing efficiency) and to determine its pragmatic validity. To achieve the aim the sample comprised of 60 basketball players that were competing in the Croatian First Division League in the 1998/99 season was tested. The sample and their quality of play was described by the two different types of data: 1) the 13 situation-related efficiency data (FIBA statistics of the game) utilized to objectively assess performance or playing effectiveness of players, collected at 132 games played by 12 teams, and 2) the evaluation data, subjectively assessing actual quality of players, i.e. their perceived overall performance, collected at the end of the season from the 10 basketball trainers. On the basis of relatively high correlations within the 7 pairs of mutually equivalent variables (from 0.63 to 0.84) and the extremely high correlation (0.97) obtained between the perceived overall performance (actual quality), subjectively assessed with respect to the 19 criteria of the original expert evaluation system, and the overall performance (actual quality) assessed by the combined model (where the 8 evaluation criteria had been replaced by the 7 corresponding indicators ofplaying efficiency), it is feasible to consider the combined model of expert system as an acceptable tool for more objective and economical assessment of actual quality of basketball players.

Basketball↗
PubMed2003

The effect of obesity on overall, circulatory disease- and diabetes-specific mortality.

This paper explores the relationship between body mass and risk of death among US adults. The National Health Interview Survey-Multiple Cause of Death linked data set is used for the years 1987-1997, and Cox proportional hazard models are employed to estimate the association between obesity, as measured by the body mass index (BMI), and overall, circulatory disease-specific and diabetes-specific mortality. A U-shaped relationship is found between BMI and overall mortality. Compared with normal weight individuals, mortality during the follow-up period is 34% higher among obese class II individuals and 77% higher among obese class III individuals, controlling for age and sex. A J-shaped relationship exists between circulatory disease mortality and obesity, with a slightly higher risk of death for all categories of BMI. The relationship between BMI and diabetes mortality is striking. Compared with normal weight individuals, obese class I individuals are 2.8 times as likely to die, obese class II individuals are 4.7 times as likely to die, and obese class III individuals are 9.0 times as likely to die of diabetes during the follow-up period, controlling for age and sex. These results demonstrate that obesity heightens the risk of overall and circulatory disease mortality, and even more substantially increases the risk of diabetes mortality. These mortality findings, together with the substantial recent increases in obesity, lend urgency to public health programmes aimed at reducing the prevalence and consequences of obesity.

Adult↗
PubMedDate not supplied

Hormone replacement therapy in prevention of morbidity and mortality in the older woman. Part IV: HRT and the aging brain, overall mortality, and individual decision-making.

OBJECTIVES: The objective of this four part series is to review for the practicing clinician the extensive and sometimes contradictory literature on the effects of estrogen replacement therapy and hormone replacement therapy (HRT) in the postmenopausal woman. This final article reviews the role of long-term HRT in stroke, Alzheimer's disease (AD), and overall mortality as well as strategies to guide decision-making for the individual patient. DESIGN: Studies reviewed were obtained through Medline searches, examination of citations in the articles reviewed from those searches, interviews with local experts in geriatrics, cardiology, and women's health. CONCLUSIONS: Evidence for benefit from HRT in delaying onset of and preventing AD in aging women is inconclusive. No consistent trend for beneficial or harmful effect of HRT on stroke risk has been demonstrated. HRT does seem to be beneficial in decreasing overall mortality risk, especially in women with coronary heart disease risk factors. The overall health and functioning of the geriatric patient and the presence of co-morbid conditions must be factored into clinical decisions. The decision to initiate HRT is complex, requires thoughtful assessment of net benefit and risk for the individual patient, and should accommodate the individual's personal preferences. Forthcoming results from the Women's Health Initiative HRT trial and observational study will help resolve some of the ambiguities in this decision-making process.

Journal Article↗
PubMed1992

A simple and practical method for evaluating overall measurement error of joint moments obtained by a force plate and a position sensing device.

Joint moments are now widely used in the field of gait analysis and sports biomechanics. They are usually calculated from the data obtained by a force plate and a position sensing device. Although separate assessment of the measurement error of a force plate and a position sensing device is possible, it can give only the worst case estimate of the joint moments. A simple and practical method is presented here which can give an estimate of the overall error of the combined system. The basic principle of this method is that if a lumped load is applied to a point where the joint center is supposed to be located and the moment is calculated about this point, then the moment should be zero. Thus, the deviation of the calculated moment from zero will give an estimate of the overall error. Examples of experimental data of a joint moment measuring system are given to validate this method. Various factors which contribute to the overall error are discussed and a method of reducing it by software compensation is presented.

Ankle Joint↗