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PubMed1988

Are there tests predictive for prolonged apnoea and SIDS? A review of epidemiological and functional studies.

Sudden infant death syndrome (SIDS) remains the predominant cause of postneonatal mortality. Epidemiological studies have led to the definition of populations with an increased risk for SIDS: subsequent siblings of SIDS victims, infants with near miss for SID episodes, prematurely born infants with perinatal risk factors, and infants of drug dependent mothers. Furthermore, a variety of additional although rarely independent factors regarding both mothers and infants have been found to be associated with an increased risk for SIDS. Despite of this, the majority of infants still dying from SIDS do not belong to one or more of these risk groups and even within a group considered to be at increased risk it is impossible so far to identify individual infants at highest risk on the basis of an infant's history and clinical data. Therefore, different methods have been applied during the last several years in order to detect functional abnormalities of cardiorespiratory control during sleep with the aim of obtaining more specific and sensitive predictors of subsequent severe apnoea and SIDS. In an attempt to evaluate the predictive power of these various methods the present article reviews their results in relation to the follow up data of the infants under study. The results of the meanwhile innumerous studies were found to be at variance and often controversial. At the present time, none of these tests may be looked at as virtually improving our ability to predict the risk for prolonged apnoea and SIDS. One of the reasons for this may be the lack of standardisation of the particular methods with respect to both definition of study groups and conditions of testing infants. Since all of these tests have mainly been performed in infants of epidemiological risk groups, the definition of which is an indispensable prerequisite for the evaluation of both the indication and the results of such tests, an updated survey of the more recent epidemiological studies is given as an introduction.

Apnea↗
PubMed1985

[Allergy to chymopapain: value of predictive tests before chemonucleolysis].

It is possible to treat vertebral disc hernias by chemonucleolysis because of the enzymatic properties of chymopapain extracted from Carica papaya. But, 1% of the general population would seem to have a latent sensitivity to this protein, and would thus be at risk of presenting life-threatening anaphylactic shock. Recent clinical studies have identified different risk factors: atopy, previous food and drug allergies. A case is here reported of a 35 year old woman with a history of urticaria following anti-tetanus serum and penicillin injections, who frequently ate exotic fruit, and who was intolerant to alcohol. HBDT and prick tests confirmed both drug allergies. A prick test to chymopapain 1 mg X ml-1 gave a borderline result; the HBDT was positive, with 45% degranulation. Both these tests had been previously assessed by a study of 20 volunteers in good general health: negative prick tests in all 20, and negative HBDT in 19 out of the 20, with chymopapain concentrations ranging from 10 micrograms X ml-1 to 1 micrograms X ml-1. The one volunteer with a positive HBDT probably had latent sensitivity to the enzyme. The great sensitivity of both prick tests and HBDT in detecting IgE specific for food proteins is recalled. It is suggested that a routine predictive immuno-allergological assessment be carried out, with prick tests to the standard airbone allergens (to find a possible atopy), and a prick-test with 1 mg X ml-1 chymopapain, and a HBDT to the enzyme. A sample of serum should be kept for possible RAST and FAST carried out later.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1985

Predictive testing in cancer chemotherapy. I. In vivo.

Several in vivo methods have been assessed for their capacity to predict sensitivity for anticancer agents in humans. Standard strategies have been developed for screening purposes. Adjustments of these strategies are frequently suggested in reports in which the correlation between assay results and clinical therapeutic efficacy is analysed. Low predictivity and high costs of these assays are important reasons for changing the screening strategy. In vivo methods which predict the clinical response in the individual patient, are under investigation. Only the results of the subrenal capsule assay (in normal mice) have been correlated with the clinical response in a larger study. The criticism of the method and the low predictivity for sensitivity in a prospective study provide no reason for optimism. Methods which study changes predicting the clinical response in patients are still in a developmental phase.

Animals↗
PubMed1995

Treadmill roller ski test predicts biathlon roller ski race results of elite U.S. biathlon women.

This study evaluated ski-specific laboratory testing and the relationship of test parameters to biathlon race performance. Since the ski skating technique used exclusively during biathlon racing requires a large upper body contribution, treadmill roller ski test parameters may provide relevant information for ski-specific training and ski performance. Seven top U.S. female biathlon skiers performed lactate threshold and VO2 peak tests running (TR) and roller skiing (skating technique, RS) on a motor driven treadmill. In addition, a constant workload (14 km.h(-1), 6% grade) roller ski test to exhaustion at race pace (ET) on a motor driven treadmill, and a short-term double pole power test (DP) were also performed. Results indicate that lactate threshold VO2 and HR were significantly lower during RS than TR, DP power (w.kg(-1)) was related to RS VO2 peak (r = 0.90), but not to TR parameters. ET time to exhaustion was related to gross efficiency during ET (r = -0.86), RS VO2 peak (r = 0.80) and DP HR (% peak HR, r = 0.80). These results suggest that ski-specific laboratory testing provides better insight to ski performance than treadmill run testing.

Adult↗
PubMed1996

Predictive testing for respiratory sensitisation.

A rat bioassay has been developed to provide an objective approach for the identification and classification of upper and lower respiratory tract irritants, with particular emphasis on the concentration-dependent induction and regression of lesions characteristic of asthma, such as persisting non-specific airway hyperreactivity, inflammation and ensuing mismatch of the ventilation-perfusion relationship. For the identification of respiratory allergy, the established guinea-pig bioassay has been further refined. Refinement focused on procedures making this animal model more robust to changes in study design. Attempts were made to allow differentiation of non-specific and specific bronchial hyperresponsiveness and to minimise the use of hapten-protein conjugates for elicitation of respiratory allergy. It appears that the combined assessment of specific pathologic features such as airway eosinophilia and the evaluation of several breathing parameters during hapten and acetylcholine bronchoprovocation challenge make it easier to distinguish effects caused by irritation and respiratory hypersensitivity. Findings support the conclusion that current guinea-pig models require specific optimisation of sensitisation and challenge procedures for each chemical class tested.

Acetylcholine↗
PubMed2005

Antipyrine test predicts pharmacodynamics in docetaxel and cisplatin combination chemotherapy.

To clarify the role of cytochrome P450 in docetaxel and cisplatin combination chemotherapy, cytochrome P450 activity was measured by simple antipyrine test, and its correlation with the drugs' pharmacodynamics was assessed. Twenty-five patients with advanced non-small cell lung cancer received an antipyrine test and were treated with docetaxel and cisplatin. Plasma antipyrine concentration (C) was measured 4 and 24h after oral administration of 500 mg antipyrine. Antipyrine disappearance rate (ADR) was calculated by: [(C(4h)-C(24h))/C(4h)]x100. ADR correlated significantly with neutropenia nadir. ADR and alpha(1)-acid glycoprotein were selected for independent predictors of neutropenia by multiple regression analysis. In addition, 25 patients were separated into "low ADR" (<40%) and "high ADR" groups (>40%). Grade 3--4 neutropenia was observed in 7/9 "low ADR" patients (77%), whereas grade 3--4 neutropenia was observed in 5/16 "high ADR" patients (31%). We concluded that antipyrine test and cytochrome P450 play an important role in predicting toxicities of docetaxel and cisplatin combination chemotherapy.

Adenocarcinoma↗
PubMed1998

Octreotide suppression test predicts beneficial outcome from antrectomy in a patient with gastric carcinoid tumor.

Multiple gastric carcinoids are a well-recognized complication of hypergastrinemia associated with chronic atrophic gastritis. However, the management of large tumors (>2 cm in diameter) remains uncertain, with the decision between antrectomy or total gastrectomy being empirical. This report describes the investigation of a patient with chronic atrophic gastritis and multiple large gastric carcinoid tumors. Before surgery, octreotide was infused for 72 hours to suppress enterochromaffin-like (ECL) cell and gastrin cell function. The infusion decreased plasma gastrin and gastrin synthesis; moreover, there were marked reductions in markers of ECL cell function, e.g., histidine decarboxylase and chromogranin A messenger RNA abundance, in carcinoid tumor tissue and macroscopically normal corpus mucosa. An antrectomy was performed, after which the patient made an uneventful recovery. Six months after surgery, a single residual polyp, enriched with smooth muscle cells but not ECL cells, was removed. One year after antrectomy, the remaining stomach was normal. The response of ECL cell markers in carcinoid tissue to octreotide suggested that these cells were under neuroendocrine control and, therefore, predicted a beneficial outcome for antrectomy. It is suggested that an octreotide supression test coupled with assay of histidine decarboxylase or chromogranin A gene expression is useful in the assessment of gastric carcinoid tumors.

Adult↗