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PubMedDate not supplied

Femoral neck and lumbar spine bone mineral densities in a normal population 3-20 years of age.

Dual-photon absorptiometry (DPA) with a 153gadolinium radionuclide source was used to measure bone mineral in the lumbar spine of 109 subjects and the femoral neck of 100 subjects 3-20 years of age. From the scan data collected, multiple linear regression models were developed to predict the measured bone mineral density values as a function of age, height, and weight; male and female data were evaluated separately. From the table of predicted values, a particular subject's bone mineral measurements can be readily compared with that of normal subjects in the same way "growth charts" are commonly used to assess development.

Absorptiometry, Photon↗
PubMed2003

Osteoporosis in Canadian adult cystic fibrosis patients: a descriptive study.

BACKGROUND: Cystic fibrosis is the most common fatal autosomal recessive genetic disease in the Caucasian population. Osteoporosis is increasingly being recognised as an important complication in people with cystic fibrosis. METHODS: A descriptive study of adult cystic fibrosis patients receiving care at a Canadian tertiary care hospital was conducted to evaluate the prevalence of osteoporosis, the prevalence of non-vertebral fractures, and the change in bone mineral density during the course of a year. Data on bone mineral density were obtained for 40 adult cystic fibrosis patients by reviewing dual x-ray absorptiometry scans taken at baseline (when annual scans became standard clinical practice) and one year prior to baseline. Data on prevalent fractures were obtained by reviewing all available patient charts. Clinical and laboratory data were collected from an existing clinic database. RESULTS: Over half of the 40 patients had reduced T- and Z-scores at baseline. For the 27 patients who had data available one year prior to baseline, total hip and lumbar spine bone mineral density had decreased by 3.04% and 0.86% after one year while total body bone mineral density had not changed significantly. Four prior non-vertebral fractures were reported in three patients (1,146 patient-years). CONCLUSION: This study confirms that osteoporosis is a significant problem in adult cystic fibrosis patients, and constitutes the first published evidence of cystic fibrosis bone disease in Canadians.

Adult↗
PubMedDate not supplied

Information management for managed care.

A key concern for medical groups is how to manage information in a dual environment of capitation and fee for service. Information systems that work for one may not work for the other. Finding a system that works for both is critical. Some of the data that would be beneficial to collect for starting managing capitation contracts include: age/sex ratios of the practice patient population, average number of visits per patient per year, average number of visits by ICD-9 code for total population, average procedures per patient per year, and analysis of paverage payment per visit/procedure for commercial and Medicare patients. Some of the major concerns addressed include operational issues, financial viability and automated billing systems.

Capitation Fee↗
PubMed2004

Age- and BMD-related differences in biochemical markers of bone metabolism in rural and urban women from Lublin Region, Poland.

The utility of biochemical markers of bone metabolism has not been proven in the diagnosis of metabolic diseases of the bone tissue; however they are widely used as a tools for treatment monitoring. Their serum concentrations are influenced by a number of factors, like gender, health status, anthropometric and environmental factors. All the factors listed above should be taken into consideration during clinical use. The aim of the study was to determine the reference values and evaluate the influence of environmental and anthropometric variables on biochemical markers of bone turnover for women from Lublin Region (Poland). Subjects of the study were 188 normal women aged 30-79, all residents of Lublin Region. Analysed markers of bone turnover were: osteocalcin (OC) and C-terminal cross-linking telopeptide of type I collagen (CTX-I), both assessed using ELISA method. All blood samples were taken and analyzed at the Clinical Chem. Laboratory and Patho-morphology Department at the Institute of Agricultural Medicine in Lublin. The lumbar spine (L2-L4) of all subjects was examined in a-p position using the dual X-ray absorptiometry-DXA (DPX-A LUNAR Corp.) at the Department of Metabolic and Degenerative Diseases of Bone Tissue of Institute of Agricultural Medicine in Lublin. Data pertaining to factors affecting bone tissue were collected using a specially prepared questionnaire. Serum levels of OC and CTX-I in women in every age range were different, generally increasing with age. Serum levels of OC and CTX-I in the analysed population strongly depended of both menopausal status and bone mineral density. In conclusion, this study demonstrates that age and menopausal status variations need to be considered when interpreting laboratory measurements of biochemical markers of bone metabolism.

Adult↗
PubMed1983

[Detectability of stress-induced ischemic lesion in previous myocardial infarction using 201T1 myocardial single photon emission computed tomography].

The purpose of this study was to evaluate the detectability of stress-induced ischemic lesion in patients with previous myocardial infarction using single photon emission computed tomography (SPECT) producing thallium-201 (T1-201) myocardial perfusion imagings (MPI). Seventy patients underwent stress SPECT by symptom-limited graded bicycle ergometer exercise using a dual-headed rotating gamma camera (Toshiba GCA70A) equipped with a computer system (GMS90). After intravenous administration of 2.5 mCi of T1-201, stress SPECT data at 10 minutes and delayed SPECT data at 3 hours after the injection were collected in the 64 X 64 matrix form covering 360 degrees directions by camera sweep of 180 degrees in 6 minutes, which were immediately followed by conventional planar imagings (PL). Transaxial tomographic image reconstruction was performed by convolution method using a Shepp-Logan's filter. Thereafter, sagittal and coronal tomographic images were reconstructed for about 2 minutes. Image interpretation was assessed visually. The results were as follows: Sensitivity and specificity in detecting the affected vessel with more than 75% stenosis by segmental analysis of myocardial images were higher by SPECT than by PL (LAD 89% and 65%, LCX 68% and 56%, RCA 89% and 76% in sensitivity and LAD 94% and LCX 75%, 92% and 94%, RCA 81% and 59% in specificity, respectively). Sensitivity in detecting both single (82%) and multivessel disease (76%) was fairly high. Detectability of stress-induced ischemia (i.e. occurrence of a new defect in patients with previous myocardial infarction and ST-segment depression in ECG) was significantly higher in SPECT (67%) than in PL (39%, p less than 0.005) and in ECG (39%, p less than 0.005). A perfusion defect in the extensive anterior wall, marked left ventricular dilatation and the widening of the angle toward the apex composed of septal and anterolateral walls in transaxial images were the findings characteristic of anterior myocardial infarction with severe dyskinesis. We conclude that stress SPECT is a useful noninvasive technique for the documentation of the number of vessels affected and severe wall motion abnormality of the LV and for the detection of stress-induced ischemia in previous myocardial infarction.

Electrocardiography↗
PubMedDate not supplied

Comparison of single and dual platform methodologies for the estimation of CD34+ hematopoietic progenitor cells: correlation with colony assay.

In this study three assays for the enumeration of CD34+ progenitors were compared: 1) a modified version of the Milan protocol, used in the standard dual-platform format; 2) a dual-platform version of the ISHAGE protocol; 3) the ProCOUNT software version 2.0/ProCOUNT kit. The assays were compared to validate the accuracy of CD34+ cell counts in mobilized peripheral blood (PB), apheresis products (AP), and cord blood (CB). The ProCOUNT protocol uses reference beads for absolute CD34+ cell counting, whereas CD34 counts by other techniques are derived from a separate leukocyte count performed by a hematology analyzer. A good correlation between the ISHAGE and ProCOUNT methods was obtained for estimation of CD34+ counts in PB (n=42 samples analyzed) and AP (n=35)--except for samples having a leukocyte count >25 x 10(9)/L or a CD34 count <0.0025 x 10(9)/L)--while a suboptimal correlation between the methods was observed for CB (n=30). The ProCOUNT system proved to be effective in reducing the variability in CD34+ cell counting and appeared to be useful for intralaboratory methodology standardization. The main disadvantage of the ProCOUNT assay was its inability to calculate CD34 counts in leukopenic samples and in CB samples showing a high erythroblast count. As far as the correlation with hematopoietic colonies is concerned, data collected from apheresis samples showed a good correlation between the three flow cytometry methods and colony-forming unit granulocyte-macrophage (CFU-GM) counts, confirming the value of the flow cytometric test as a real-time, truly predictive test to measure the hematopoietic potential of the graft. In summary, all methods are suitable for enumeration of most PB samples, while the single-platform methodology should be preferred for the analysis of AP and CB. We also found the dual-platform format of the ISHAGE method precise and accurate for the estimation of CD34+ cells from CB samples. Based on these data it can be concluded that the single-platform flow cytometry assay format should be the preferred approach for CD34+ stem cell enumeration in different types of samples.

Adolescent↗
PubMed2004

Combined effect of vision and hearing impairment on depression in elderly Chinese.

BACKGROUND: Sensory impairment and depression are common in old age and the relation between depression and vision as well as hearing impairment have been established. However, few studies have directly compared their effects and examined the impact of dual sensory loss. The purpose of this study is to compare impacts of self-reported hearing and vision loss as well as the effect of double sensory impairment on depression. METHOD: This article analyzes cross-sectional data collected from a representative community sample of 2,003 Chinese elderly people aged 60 or above in Hong Kong. Respondents were interviewed in a face-to-face format and data including vision and hearing impairment, socio-demographic variables, health indicators, family support, and depression were obtained. RESULTS: Logistic regression analyses revealed that visual impairment was significantly related to depression even after age, gender, marital status, education, self-reported health status, the presence of 11 diseases, functional limitation and family support were controlled but hearing loss was not. Hearing impairment did not add to the likelihood of depression where visual impairment was already present. CONCLUSION: The impact of visual impairment on psychological well-being among elderly Chinese is more robust than hearing loss. Therefore, aged care service practitioners must take this risk factor into consideration in their preventive intervention and treatment for psychological well-being.

Age Distribution↗
PubMed2001

Bone density reduction in patients with Crohn disease and associations with demographic and disease variables: cross-sectional data from a population-based study.

BACKGROUND: The extent of bone density reduction in patients with Crohn disease is still being debated. The aim of this study was to examine bone mineral density (BMD) and factors associated with reduced BMD in a representative population of patients with Crohn disease aged between 20 and 70 years. METHODS: BMD (using dual energy X-ray absorptiometry) was measured in spine and hip in 55 patients with Crohn disease recruited from the entire Crohn population (n = 96) in a defined area of southern Norway. Demographic and clinical data were also collected. The patients were compared with 52 age- and gender-matched healthy controls. Potential demographic and disease-related factors associated with BMD reduction were statistically tested with bi- and multivariate analyses. RESULTS: The BMD reduction in patients with Crohn disease was 7.1% (P = 0.02) in spine L1-4, 6.1% (P = 0.08) in femoral neck and 8.4% (P = 0.02) in total hip as compared with the controls. In total hip and femoral neck, age, body weight and gender were independently associated with reduced BMD, but in the spine only body weight. Among the disease-related variables, only ever use of prednisolone was independently associated with reduction in BMD but this only in the femoral neck. CONCLUSIONS: The spine and hip BMD reduction of 6%-8% is similar to that found in a comparable population-based study performed in another area in Norway. Among the disease-related variables tested for, only the use of prednisolone was independently associated with BMD reduction. However, the BMD reduction measured in this study indicates that disease-related mechanisms are involved.

Absorptiometry, Photon↗
PubMed2002

A regional audit of the prevention and treatment of corticosteroid-induced osteoporosis in patients with rheumatic diseases in the West Midlands.

BACKGROUND: Audit is an important tool in clinical governance. Combining resources from across a region may facilitate data collection and allow variation in practice between individual units to be analysed. This audit is the first such regional audit to be carried out in rheumatology in the West Midlands and the organization and value of regional audit is discussed. This audit assessed the prevention and management of corticosteroid-induced osteoporosis (CIOP). METHODS: Adult patients attending rheumatology follow-up clinics in 10 units, during a 2-week period were assessed using the 1998 National Osteoporosis Society (NOS) guidance on the prevention and management of CIOP. The audit standard adopted was that 80% of eligible patients should be on appropriate therapy. RESULTS: Data was collected on 1766 (95.2%) of 1855 patients during the audit period. Two hundred and thirty-five (13.3%) were currently being prescribed or about to commence >or=7.5 mg daily of oral prednisolone for >or=6 months. Dual X-ray absorptiometry scans were performed in 102 patients (43.4%). Of these, 53 (52%) had a T score of -1.5 or below at the hip or spine. Of the 235 patients, 202 (86%) were receiving osteoporosis treatment. One hundred and forty-eight patients (63%) were receiving appropriate osteoporosis medication according to the NOS 1998 guidelines and 87 (37%) were inappropriately treated. Of these, 71 (81.6%) were under-treated and 16 (18.4%) were over-treated. CONCLUSIONS: Overall, the Region failed to meet the audit standard. The audit highlighted a number of differences and potential problems in the West Midlands with regard to CIOP which are currently being addressed by individual units and the West Midlands Rheumatology Services and Training Committee (WMRSTC). The Committee plan to re-audit in 2 yr.

Female↗
PubMedDate not supplied

Detection of interictal spikes and artifactual data through orthogonal transformations.

This study introduces an integrated algorithm based on the Walsh transform to detect interictal spikes and artifactual data in epileptic patients using recorded EEG data. The algorithm proposes a unique mathematical use of Walsh-transformed EEG signals to identify those criteria that best define the morphologic characteristics of interictal spikes. EEG recordings were accomplished using the 10-20 system interfaced with the Electrical Source Imaging System with 256 channels (ESI-256) for enhanced preprocessing and on-line monitoring and visualization. The merits of the algorithm are: (1) its computational simplicity; (2) its integrated design that identifies and localizes interictal spikes while automatically removing or discarding the presence of different artifacts such as electromyography, electrocardiography, and eye blinks; and (3) its potential implication to other types of EEG analysis, given the mathematical basis of this algorithm, which can be patterned or generalized to other brain dysfunctions. The mathematics that were applied here assumed a dual role, that of transforming EEG signals into mutually independent bases and in ascertaining quantitative measures for those morphologic characteristics deemed important in the identification process of interictal spikes. Clinical experiments involved 31 patients with focal epilepsy. EEG data collected from 10 of these patients were used initially in a training phase to ascertain the reliability of the observable and formulated features that were used in the spike detection process. Three EEG experts annotated spikes independently. On evaluation of the algorithm using the 21 remaining patients in the testing phase revealed a precision (positive predictive value) of 92% and a sensitivity of 82%. Based on the 20- to 30-minute epochs of continuous EEG recording per subject, the false detection rate is estimated at 1.8 per hour of continuous EEG. These are positive results that support further development of this algorithm for prolonged EEG recordings on ambulatory subjects and to serve as a support mechanism to the decisions made by EEG experts.

Action Potentials↗
PubMed2003

Crystallization of the effector-binding domains of BenM and CatM, LysR-type transcriptional regulators from Acinetobacter sp. ADP1.

BenM, a member of the LysR-type family of transcriptional regulators, controls genes for benzoate degradation in the Gram-negative bacterium Acinetobacter sp. strain ADP1. Recent studies show that BenM activates benABCDE expression synergistically in response to two effector ligands: cis,cis-muconate (CCM) and benzoate. As an initial step in investigating the structural basis of dual effector response, the effector-binding domain of BenM (BenM-EBD) was crystallized by the microbatch-under-oil technique with conditions optimized from high-throughput screens performed by the Hauptman-Woodward Institute. Data-collection quality crystals of BenM-EBD belonged to space group P2(1)2(1)2(1), diffracted to 2.3 A and had unit-cell parameters a = 65.64, b = 66.34, c = 117.46 A. The influence of effector ligands on crystal formation was also evaluated. The presence of benzoate or CCM impaired the formation of crystals. The presence of both effectors together resulted in a dramatic decrease in the production of crystals. The effector-binding domain of CatM, a homolog of BenM, was also crystallized.

Acinetobacter↗
PubMed1990

Breast-feeding and child-spacing: importance of information collection for public health policy.

The presence of lactational amenorrhoea cannot be fully relied upon to protect the individual mother against becoming pregnant. Nevertheless, the use of breast-feeding as a birth-spacing mechanism has important implications for global health policy. This article identifies the information that should be collected and examined as a basis for developing guidelines on how to reduce the dual protection afforded by postpartum lactational amenorrhoea and other family planning methods, and discusses when such methods should be introduced.

Birth Intervals↗
PubMed1998

Does child care involvement increase or decrease distress among dual-earner couples?

This study addressed how parents' relative involvement in child care is related to marital-role quality and psychological distress. These relationships were examined in a random sample of 133 mothers and fathers in dual-earner couples. Regression analyses employing hierarchical linear modeling techniques indicated that the more fathers participated in child care relative to their wives, the lower the father's distress. For mothers, the effect of child care involvement was complex: Although there were psychological benefits to spending proportionally more time involved in child care (lowered distress), these benefits were offset by a decrease in marital-role quality, which in turn increased distress. These findings indicate that the relation between child care involvement and the psychological health of both women and men in dual-earner couples is intertwined and complex.

Adult↗
PubMed2005

A longitudinal study of the effects of dual-earner couples' utilization of family-friendly workplace supports on work and family outcomes.

Little research exists on the effects of the utilization of workplace supports on work-family conflict and job satisfaction. With family systems theory as a framework, 2 waves of national survey data were collected from 234 couples (N = 468) caring for children and for aging parents. Data were analyzed with structural equation modeling techniques. Longitudinal results indicate that individuals' use of workplace supports was related to work-family conflict in the direction opposite to expectations and was related to job satisfaction in the direction consistent with expectations. Differential effects for wives versus husbands were found. In addition, couples' use of workplace supports was only minimally related to wives' outcomes. Results are discussed in terms of gender differences, family systems theory, and methodological and measurement issues related to the longitudinal study of utilization of workplace supports.

Adolescent↗
PubMed1998

New ICD-technologies: first clinical experience with dual-chamber sensing for differentiation of supraventricular tachyarrhythmias.

Inappropriate ICD therapy for supraventricular arrhythmias remains an unsolved problem and may lead to serious clinical situations. Current algorithms for differentiation of supraventricular and ventricular arrhythmias are based on ventricular sensing solely and, therefore, lack sensitivity and specificity. This preliminary analysis from a multicenter trial comprises data from the first 26 patients who received a Res-Q Micron active-can ICD (Sulzer Intermedics) with a ventricular defibrillation lead and an additional bipolar lead for atrial sensing. Digitized atrial and ventricular waveform storage as well as interval charts from 102 induced and 30 spontaneous arrhythmia episodes were prospectively collected and analyzed with regard to appropriateness of ICD therapy. From all 132 arrhythmia episodes, high-quality stored dual-chamber intracardiac electrograms (IEGM) could be retrieved for further analysis: in 40 (30%) episodes, atrial fibrillation (AF with rapid ventricular response 22, AF with VT 9, AF with VF 9) was identified as the underlying intrinsic rhythm, and inappropriate ICD therapy was delivered in 4/22 (18%) episodes of AF with rapid ventricular response. In the remaining 92 (70%) episodes, sinus rhythm was the underlying atrial rhythm (SR with VT 13, SR with VF 79), and no inappropriate therapy was observed. Three of 22 (15%) high-energy shocks delivered for ventricular arrhythmias (VT 9, VF 9, rapid AF 4) terminated AF at the same time. In total, there were 3 complications (2 atrial lead dislodgments, 1 revision for bleeding). Both atrial lead dislodgments occurred in the 2 patients with passive-fixation leads compared to none in the 24 patients with active-fixation leads (p = 0.003). In conclusion, dual-chamber sensing and waveform storage of the new Res-Q Micron offer very helpful diagnostic tools for the detection of inappropriate ICD-therapy. Placement of an additional atrial lead is safe and does not interfere with proper ICD function. However, for avoidance of atrial lead dislodgment, active fixation leads are recommended. With the tested active-can lead configuration, the efficacy of successful atrial cardioversion by high-energy shocks delivered for ventricular arrhythmias seems to be low.

Algorithms↗
PubMed1995

Risk factors for the development of recurrent atrial fibrillation: role of pacing and clinical variables.

Atrial fibrillation recurs in many patients treated with antiarrhythmic therapy to maintain sinus rhythm. From March 1985 to August 1991, 214 patients with recurrent symptomatic chronic or paroxysmal atrial fibrillation for which conventional antiarrhythmic agents had failed were treated with propafenone or sotalol. Baseline demographic data including the presence of pacing therapy were collected. Life-table estimates of the duration of freedom from atrial fibrillation were constructed on the basis of pacemaker status. Of 214 patients, 26 (12.1%) had pacing therapy. Patients with dual-chamber pacing were more likely to remain in sinus rhythm at 6 months (80%) than were patients with ventricular pacing (40%) or patients without pacing therapy (55%) (p = 0.002). A Cox univariate regression analysis demonstrated that dual-chamber pacing in contrast to ventricular pacing or no pacing was associated with a lower risk of recurrent atrial fibrillation. Clinical parameters such as age, gender, left atrial size, fibrillation pattern, drug assignment, ejection fraction, and underlying cardiac disease did not alter the risk of recurrent atrial fibrillation. Dual-chamber pacing was associated with a decreased likelihood of recurrent atrial fibrillation even after adjustment for other clinical covariates in a multivariate model (p = 0.04). In patients with recurrent atrial fibrillation treated with propafenone or sotalol, dual-chamber pacing improved maintenance of sinus rhythm.

Atrial Fibrillation↗
PubMed1984

A method for measurement of arterial concentration of cerebral blood flow tracer for autoradiographic experiments.

A new method for continuous monitoring of the concentration of 131I-labelled iodoantipyrine during an autoradiographic local cerebral blood flow (LCBF) experiment is described. During infusion of iodoantipyrine, radioactivity in an external femoral arteriovenous loop is monitored by a scintillation detector. Data is collected with a variable time base, and the arterial activity curve displayed visually in its entirety. The main advantage of this method is that there is no blood loss. It will therefore be of particular importance in dual-label autoradiography. This method can also be used for other gamma-emitting blood flow tracers, e.g. 123I-iodoantipyrine.

Animals↗
PubMed1984

A multidetector alpha spectroscopy analysis system.

This document describes the attributes of an alpha spectroscopy counting and analysis system called Low Level Pulse Height Analysis (LLPHA). It was developed for multi-sample alpha spectroscopy analysis. The LLPHA system is controlled by a MIK-11/2 microcomputer with 28K of memory and uses a double-density, dual floppy disk for data storage. Detectors are interfaced to the computer via CAMAC (Computer Automated Measurement and Control) equipment. The system simultaneously supports 32 active and independent surface-barrier alpha-particle detectors. It operates with the total collection rate of up to 300 counts/sec from all active detectors, using 128 channels per spectrum and a dynamic energy range of 1.4 MeV. The system is not limited, however, to these conditions. In addition to spectral acquisition, the system provides analysis functions which include peak identification, curve-smoothing, integration, linear and logarithmic scale graphics, and corrections for base-line shift, dead-time, and background counts. These functions can be implemented while other spectra are being collected. The LLPHA system represents a highly cost-effective means of acquiring alpha spectrometric data from a large number of samples simultaneously and with rapid data analysis capability.

Alpha Particles↗