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PubMed2003

Correlates of youth suicide attempters in Australian community and clinical samples.

OBJECTIVE: This study (i) explores differences between a clinical sample of deliberate self-poisoning (DSP) patients and a community sample who reported previous attempted suicide (AS); and (ii) examines correlates of suicidal behaviour in these groups compared with a community control group (CC) with no suicidal behaviour. METHOD: The study design was: case-case, case-control and cross-sectional population studies. A clinical sample of DSP (n = 51), a community sample of AS (n = 31) and a community sample with no suicidal behaviour (n = 842) were used, all aged 18-24 years. The DSP and AS groups were compared on several variables and two logistic regression models were developed for risk of (i) DSP and (ii) AS compared to community controls. RESULTS: The adjusted odds ratios for DSP were: female gender (OR = 5.7, CI = 1.7-19.4), anxiety (OR = 7.4, CI = 2.2-25.1), affective (OR = 23.0, CI = 6.9-76.5), or substance-use disorder (OR = 19.2, CI = 5.6-65.4) and greater mental health related disability (OR = 0.5, CI = 0.3-0.7 for 1 SD decrease). For AS the results were: anxiety (OR = 9.4, CI = 1.7-52.8) or substance-use disorder (OR = 3.0, CI = 1.1-8.7) and greater mental health disability (OR = 0.5, CI = 0.4-0.7). Affective disorder was close to significant for the AS group (OR = 4.0, CI = 0.9-17.1). CONCLUSIONS: Correlates of DSP/AS were usually more powerful in the clinical group, but showed a similar pattern of psychiatric disorder and disability factors in both groups, supporting a continuum of risk factors across these groups. Interventions based on modifiable risk factors could target the same factors for public health, primary care or hospital populations: anxiety, depression and substance use disorders and mental health related disability.

Adolescent↗
PubMedDate not supplied

Selection bias in the study of spouse similarity for psychiatric morbidity in clinical samples.

The existing literature on spouse similarity for health variables can be divided into two fields of application, high blood pressure and other coronary risk factors and psychiatric morbidity. In the former field, almost all studies have been conducted on general-population samples, whereas in the psychiatric field, most of the investigations studied clinical samples, i.e., where one or both members of the couple were under psychiatric treatment. In this report, we demonstrate that studies of spouse similarity for psychiatric morbidity are subject to selection bias whenever they are conducted on clinical samples. This selection bias has a double origin. First, some bias arises from the fact that the probability of a couple being drawn for a clinical sample is dependent on whether one or both spouses are afflicted with the illness in question. A second source of bias lies in the likelihood that each spouse's help-seeking behavior is not independent of the other's. It would appear then that, owing to this selection bias, it is preferable to restrict the study of spouse similarity for psychiatric morbidity to general-population samples.

Female↗
PubMed2006

Quality of life in a clinical sample of obese children.

OBJECTIVES: To measure health-related quality of life (HRQoL) in a clinical sample of obese children by child self-report and parent-proxy report; to compare quality of life assessments provided by obese children and their parents; to assess differences in quality of life between the obese clinical sample and healthy control children. DESIGN: Pairwise comparison of obese children matched for age, gender and socio-economic status with non-obese controls. SUBJECTS: One hundred and twenty-six obese children (body mass index (BMI) >/=98th centile) and 71 lean control children (BMI <85th centile). Controls were matched with 71 children from the obese clinical group (mean age 8.6, standard deviation (s.d.) 1.9 years; 33 M/38 F). MEASUREMENT: The Paediatric Quality of Life Inventory (UK) version 4 was self-administered to parents and to children aged 8-12 years and interview was administered to children aged 5-7 years. This questionnaire assessed physical, social, emotional and school functioning from which total, physical and psychosocial health summary scores were derived. RESULTS: In the obese clinical group (n=126), parent proxy-reported quality of life was low for all domains. In the obese clinical group, parent-reported scores were significantly lower than child self-reported scores in all domains except physical health and school functioning. Parent-proxy reports were significantly higher for healthy controls than obese children in all domains (median total score 85.2 vs 64.7; 95% confidence interval (CI) 15.6, 24.1). For child self-reports, only physical health was significantly higher for healthy controls than obese children (median score 81.3 vs 75.0; 95% CI 3.1, 12.5). CONCLUSIONS: HRQoL is impaired in clinical samples of obese children compared to lean children, but the degree of impairment is likely to be greatest when assessed using the parent perspective rather than the child perspective.

Body Mass Index↗
PubMed2003

Health-related quality of life in children assessed by their parents: evaluation of the psychometric properties of the CHQ-PF50 in two German clinical samples.

The aim of the study was to evaluate the psychometric properties of the German translation of the Child Health Questionnaire (CHQ). Parents of two clinical samples were asked to rate the quality of life of their children using the German version of the CHQ. Item internal consistency (item-scale correlation) and internal consistency of scales were tested; quartiles and factor analysis were conducted. The results of the German clinical samples were compared with US clinical samples (t-test). The two clinical German sub-groups were compared using multivariate analysis (MANOVA). The psychometric testing of the CHQ showed good results. Internal consistency of the hypothesized scales were all higher than 0.70. The results of the factor analysis confirmed the results of the US norm sample: As expected, the subscales loaded on two factors explaining 57.4% of the total variance. The group comparison supported the discriminative properties of the CHQ. Preliminary psychometric findings support use of the German version of the CHQ. The next step will be the testing of healthy German samples and development of norm scores.

Activities of Daily Living↗
PubMed1994

Detection of Salmonella serovars from clinical samples by enrichment broth cultivation-PCR procedure.

To overcome problems associated with application of PCR to clinical samples, we have combined a short cultivation procedure with a Salmonella-specific PCR-hybridization assay to specifically identify Salmonella serovars from clinical samples of various animal species. The technique was investigated by using fecal samples seeded with known numbers of Salmonella organisms and cultivated for different lengths of time in assorted selective and nonselective enrichment media. The ability of PCR to amplify a Salmonella-specific DNA product (457-bp sequence covering the Salmonella invE and invA genes) was examined in Southern hybridizations with an internal oligonucleotide probe. Forty-seven Salmonella isolates representing 32 serovars were evaluated, and all Salmonella isolates resulted in a 457-bp product that hybridized with the oligonucleotide probe, whereas no hybridizations were evident with 53 non-Salmonella organisms. The assay detected as few as 9 CFU of Salmonella organisms in pure culture and as little as 300 fg of purified chromosomal DNA. Rappaport-Vassiliadis and tetrathionate broths were inhibitory to PCR, whereas brain heart infusion and selenite-cystine broths were not. The PCR-hybridization assay coupled with a brain heart infusion enrichment culture incubated for 2 h detected as few as 80 CFU of Salmonella organisms in seeded feces. We have successfully identified Salmonella serovars in clinical samples from swine, horses, and cattle more rapidly than with conventional culture techniques. The sensitivity and specificity of this assay were both 100% compared with culture results. These results indicate that a combined cultivation-PCR-hybridization assay could be applicable and advantageous in the rapid identification of Salmonella serovars in routine diagnostic situations.

Animals↗
PubMed2005

Men's and women's use of intimate partner violence in clinical samples: toward a gender-sensitive analysis.

Early research with nationally representative samples suggested that women reported initiating violence as often as men. Such research has been criticized as focusing only on participation rates, and not assessing gender differences in impact, context, and motivation for using partner violence. Furthermore, research with nationally representative samples has been largely a-theoretical and may lack relevance to those working with clinical samples. Research with clinical populations has begun to address gender similarity and differences in the commission and experience of partner violence. The present article reviews research on men's and women's partner violence using a model for examining such gender differences that incorporates key elements of partner violence, including initiation of the overall pattern of partner violence, proportional initiation rates of violent episodes, physical and mental health impacts of partner violence, behavioral and emotional responses to partner-initiated violence, motivations for using partner violence, and fearfulness of partner-initiated violence. The review concludes that, within and across clinical samples, women are disproportionately victimized by partner violence compared to men. Implications for research, clinical programs, and policy development are discussed.

Fear↗
PubMed1998

Rapid detection, culture-amplification and typing of herpes simplex viruses by enzyme immunoassay in clinical samples.

BACKGROUND: The laboratory diagnosis of herpes simplex infection may require rapid (direct) tests, as well as cell cultures, for detection of the virus in clinical samples. The quantity of virus present in clinical samples is variable and this may depend on the period from onset of rash. In addition, not all patients may show obvious symptoms with this infection. The successful culture of herpes simplex virus requires prompt transportation after collection of the specimen as the virus is easily inactivated. Hence, rapid and culture tests would enable detection of non-viable and viable viruses. STUDY DESIGN: We describe the rapid detection of HSV by EIA directly in various clinical samples using commercially available polyclonal sera. In addition specimens were inoculated in microwell cell cultures and 4 days post inoculation the culture fluids were tested for HSV and subtyped by a similar EIA (culture amplified EIA). RESULTS: The direct EIA showed an endpoint detection of 100 TCID50/ml, sensitivity of 92% (all specimen types) and specificity of 100%. The direct EIA sensitivity was 97% in non-genital specimens and 88% in genital specimens. The culture amplified EIA showed a sensitivity of 95% compared to all confirmed HSV positive samples. CONCLUSIONS: The results of the HSV rapid tests were available within 24 h from receipt of specimens. Specimens which were culture negative/direct EIA positive were confirmed by blocking antisera. Culture positive specimens which were direct EIA negative were confirmed by subtyping of the virus.

Animals↗
PubMed2000

Reverse cross blot hybridization assay for rapid detection of PCR-amplified DNA from candida species, Cryptococcus neoformans, and Saccharomyces cerevisiae in clinical samples.

A PCR-based assay was developed to detect and identify medically important yeasts in clinical samples. Using a previously described set of primers (G. Morace et al., J. Clin. Microbiol. 35:667-672, 1997), we amplified a fragment of the ERG11 gene for cytochrome P-450 lanosterol 14alpha-demethylase, a crucial enzyme in the biosynthesis of ergosterol. The PCR product was analyzed in a reverse cross blot hybridization assay with species-specific probes directed to a target region of the ERG11 gene of Candida albicans (pCal), C. guilliermondii (pGui), C. (Torulopsis) glabrata (pGla), C. kefyr (pKef), C. krusei (pKru), C. parapsilosis (pPar), C. tropicalis (pTro), the newly described species C. dubliniensis (pDub), Saccharomyces cerevisiae (pSce), and Cryptococcus neoformans (pCry). The PCR-reverse cross blot hybridization assay correctly identified multiple isolates of each species tested. No cross-hybridization was detected with any other fungal, bacteria, or human DNAs tested. The method was tested against conventional identification on 140 different clinical samples, including blood and cerebrospinal fluid, from patients with suspected fungal infections. The results agreed with those of culture and phenotyping for all but six specimens (two of which grew yeasts not included in the PCR panel of probes and four in which PCR positivity-culture negativity was justified by clinical findings). Species identification time was reduced from a mean of 4 days with conventional identification to 7 h with the molecular method. The PCR-reverse cross blot hybridization assay is a rapid method for the direct detection and identification of yeasts in clinical samples.

Candida↗
PubMed2001

A confirmatory factor analysis of the WISC-III in a clinical sample with cross-validation in the standardization sample.

Maximum likelihood confirmatory factor analysis was applied to the Wechsler Intelligence Scale for Children-Third Edition (WISC-III; Wechsler, 1991) data of a mixed clinical sample of 318 children. Analyses were designed to determine which of nine hypothesized oblique factor solutions could best explain intelligence as measured by the WISC-III in the clinical sample. Competing latent variable models were identified in previous studies, and results in the clinical sample were cross-validated by testing all models in the WISC-III standardization sample (n = 2200). Findings in both the clinical and standardization samples supported a five-factor model including Verbal Comprehension, Constructional Praxis, Visual Reasoning, Freedom from Distractibility, and Processing Speed factors. The Visual Reasoning factor was defined primarily by Picture Arrangement, whereas Mazes did not appear to improve model fit. Potential opportunities and pitfalls with regard to the interpretation of the proposed Visual Reasoning factor are discussed.

Adolescent↗
PubMed1997

Use of reverse-transcription polymerase chain reaction for detection of rubella virus RNA in cell cultures inoculated with clinical samples.

A recently developed reverse transcription-nested polymerase chain reaction (RT-nPCR) method for rubella virus (RV) RNA detection was assessed in a series of African green monkey kidney (AGMK) cell cultures inoculated with clinical samples from patients with suspected RV infection. Results were compared with those of conventional virus isolation/identification. The assay included an internal control of amplification consisting of a synthetic RNA molecule mimicking the RV E1 target sequence. A semiquantitation of RV RNA was achieved by comparing the relative band intensity of internal control and RV E1 fragment. RT-nPCR was positive in 15/16 (94%) RV isolation-positive cultures and in 12/60 (20%) RV isolation-negative cultures. All 27 cell cultures positive by RT-nPCR had been inoculated with clinical samples taken from patients with ascertained RV infection or given RV vaccination and consisted of cells harvested 1-10 days after primary inoculation of clinical samples. No RV RNA was found in any of the cell cultures inoculated with 14 clinical samples from 6 patients in whom RV infection was excluded. When considering the time-course of RV infection, it was found that RV RNA could be detected as early as 4 days p.i. in 10/21 (48%), and by 7-10 days p.i. in 27/28 (96%) cell cultures, whereas by the same time RV was isolated in only 7/16 (44%) cell cultures. Semiquantitation showed that: i) viral RNA amount progressively increased with time; ii) cell cultures containing very low levels of viral RNA one week p.i. either required a few blind passages for virus recovery or remained negative for RV isolation. Finally, PCR inhibitors were found in 10/164 (6%) cell cultures examined. In conclusion, RT-nPCR proved to be very sensitive and very specific and greatly reduced RV detection time in inoculated cell cultures.

Adult↗
PubMed2001

Performance of a commercial immunoassay for detection and differentiation of periodontal marker bacteria: analysis of immunochemical performance with clinical samples.

BACKGROUND: We employed a commercial immunoassay for simultaneous detection and differentiation of marker bacteria Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, and Prevotella intermedia and reassessed the immunochemical performance of the assay. METHODS: We compared the analytical performance of the immunoassay in our study of clinical samples from 249 periodontal patients in 2 private periodontal practices with the previously reported analytical performance of the same immunoassay. We also compared immunoassay measurements of the marker bacteria in clinical samples with values obtained in other studies by direct culture of the same organisms. RESULTS: The assay produced 3 times more high-end readings than reported previously. We also reassessed and revised previously published calibration curves for the immunoassay. The immunoassay provided measurements of the marker bacteria in clinical samples from our patients that were comparable to and consistent with measurements of the same bacteria by direct culture in other studies. CONCLUSIONS: We ascribe the increased sensitivity of the immunoassay in our study to: 1) a more standardized and vigorous sample dispersion that improves release of particulate and soluble antigens from dental plaque biofilm, and 2) better visualization of the reaction product of the enzyme-linked immunoassay. High-technology assays, such as diagnostic immunoassays, have a significant potential for future development in dental diagnosis, because they simplify detection and measurement of biologically important markers such as specific bacteria in clinical samples. Commercial assays also have an important potential for standardization of clinical measurements of biological markers.

Aggregatibacter actinomycetemcomitans↗
PubMed1995

[Rapid detection of Mycoplasma pneumoniae in clinical samples by the polymerase chain reaction technique].

The polymerase chain reaction (PCR) technique was used to detect Mycoplasma pneumoniae in clinical samples (bronchoalveolar lavage fluids and throat swabs). A specific DNA sequence for M. pneumoniae was selected from a genomic library. The amplification target region was partial DNA sequence of the 500- bp fragment. The oligonucleotide sequence of two primers (MP5-1 and MP5-2) were complementary with the oligonucleotide sequence in two ends of the amplification target region. PCR with purified DNA fragment as templates yielded an expected 144-bp fragment from M. pneumoniae but not from any of the other Mycoplasma spp. assayed. With this method, the 144-bp product specific for M. pneumoniae could be obtained from a minimum of 10 pg of M. pneumoniae DNA. Subsequently this PCR technique was used for the detection of M. pneumoniae in bronchoalveolar lavage fluids or in throat swab samples. Thirty of 140 samples from the patients with non-bacterial pneumonia gave positive results in the test. Twenty-one indirect hemoagglutination test-negative clinical samples from the same patients of 140 cases gave positive results in the same PCR test. When the amplified products were hybridized with a complementary probe (MP5-4 oligonucleotide probe), thirty PCR-positive samples all gave positive hybridization signals. It suggests that PCR method can be used for the direct detection of M. pneumoniae in clinical samples.

Base Sequence↗
PubMed2001

Susceptibility genes for a trait measure of attention deficit hyperactivity disorder: a pilot study in a non-clinical sample of twins.

Attention deficit hyperactivity disorder (ADHD) is a highly heritable disorder, and molecular genetic studies are underway, with most researchers focusing on identifying susceptibility genes in clinical samples with ADHD. An alternative approach is to search for quantitative trait loci underlying the trait measure of ADHD in non-clinical samples. Positive findings of association of the dopamine transporter DAT1 480 bp allele (allele 10) and the DRD4 7 repeat allele with clinical ADHD have been previously reported. In this pilot study, we examined these polymorphisms in a selected population-based sample of twins (50 high scoring pairs, 42 low scoring pairs). There was a trend for an increase in the frequency of the dopamine receptor DRD4 7 repeat allele in the high-scoring concordant monozygotic twins (odds ratio=1.4). Although this result was not statistically significant, the frequency of the 7 repeat allele was similar to that reported for our clinic sample of ADHD patients drawn from the same geographical area. There was a non-significant trend for an increased frequency of the DAT1 allele 10 (odds ratio=1.3). These results suggest that a molecular genetic study based on a questionnaire-derived measure of ADHD in a non-clinical sample is feasible and the results appear to be comparable with those from studies of clinical cases. However, sample size and power are key issues to consider when using this approach.

Adolescent↗
PubMed1997

The MAACL-R6 with an adult clinical sample.

To determine the usefulness of the MAACL-R6 (sixth grade reading level version of the Multiple Affect Adjective Check List-Revised), its characteristics were studied in an adult clinical sample. As with the rescored samples, acceptable reliability and validity with this clinical sample was found. Also, the MAACL-R rescored on the sixth grade adjectives was equivalent in reliability and validity to the MAACL-R6 in this clinical sample, indicating that there was no context effect produced by being imbedded in the larger list of adjectives.

Adult↗
PubMed2002

A confirmatory factor analysis of the WAIS-III in a clinical sample with crossvalidation in the standardization sample.

A maximum likelihood confirmatory factor analysis of the Wechsler Adult Intelligence Scale-III (WAIS-III) was performed by applying LISREL 8 to a clinical sample (n=328). Analyses were designed to determine which of the nine hypothesized oblique factor solutions could best explain intelligence as measured by the WAIS-III in the general clinical sample. Competing latent variable models were identified in previous studies and a priori model modifications were made to test derivations of the nine base models. Results in the clinical sample were crossvalidated by testing all models in the normative sample used in the standardization of the scale. Findings in both the clinical and standardization samples supported a six-factor model including Semantic Memory, Verbal Reasoning, Constructional Praxis, Visual Reasoning, Working Memory, and Processing Speed factors. Our analysis differed from that presented in the WAIS-III manual as we tested more complex models of intelligence in addition to the ones evaluated by the test publishers. As a result, a six-factor model that corresponded to an expanded version of a model based on Horn's Gf-Gc theory was empirically supported as having the best fit to the data. More complex derivations of this model failed to achieve sufficient goodness of fit.

Journal Article↗
PubMed1989

Amplification of rhinovirus specific nucleic acids from clinical samples using the polymerase chain reaction.

We describe a novel method for the detection of human rhinoviruses in clinical samples, using the polymerase chain reaction. Two synthetic oligonucleotide primers were produced that bind in the 5' noncoding region of all rhinovirus serotypes tested, about 350 nucleotides apart, and were used to prime polymerase chain reaction amplification of the intervening stretch of DNA. The product of this reaction, which can be clearly visualized by gel electrophoresis, is a discrete 380 bp band, the occurrence of which is diagnostic of the presence of a rhinovirus in the clinical sample analysed. The technique, which is rapid, sensitive, and reliable, has been used successfully for all the different rhinovirus serotypes tested to date in our laboratory. However, the sensitivity of detection is greatly dependent on the inclusion of both tRNA and vanadyl complexes during the viral RNA extraction process. Using this technique, under optimal conditions, we were able to detect virus in clinical samples with titres as low as TCID50 10(2.5).

Base Sequence↗
PubMed1995

[Tuberculosis presenting as diffuse pulmonary infiltrates in AIDS patients: diagnostic performance of clinical samples].

BACKGROUND: In patients with human immunodeficiency virus (HIV) infection, tuberculosis is frequently presented with diffuse pulmonary infiltrates which are indistinguishable from those caused by other respiratory pathogens. It is therefore useful to know the diagnostic performance of different clinical samples. METHODS: We have retrospectively analyzed the clinical histories of 56 patients seen over a 3-year period. All the patients had HIV infection, Mycobacterium tuberculosis isolated in at least one clinical sample and presented with diffuse bilateral infiltrates in thorax radiography. The results of all the clinical samples submitted to the microbiology laboratory. RESULTS: The highest performance in both stainings and cultures were obtained from the biopsy (or aspirate) of adenopathies (93 and 100%, respectively), sputum (57 and 88%) and urine (31 and 64%). A lower than expected sensitivity was obtained in the fibrobronchoscopy samples (bronchoalveolar lavage and transbronchial biopsy). The staining had low sensitivity for predicting positive cultures in all the samples except in the adenopathies. Visualization of granulomas in transbronchial biopsies and bone marrow was more sensitive for diagnosis than the demonstration of resistant acid-alcohol bacilli in the same samples. Globally, rapid diagnosis was obtained in 43 patients (76%). The remaining 13 (24%) patients were not diagnosed until the culture results had been received despite the adequate use of diagnostic procedures. CONCLUSIONS: These findings support the use of empiric treatment when tuberculosis is suspected despite initial negativity of the microbiologic and pathologic examinations following the discarding of other potential causes.

AIDS-Related Opportunistic Infections↗
PubMed1997

Depression, self-esteem, sex, and age in a child and adolescent clinical sample.

Examines the relation between depression, self-esteem, sex, and age to determine if the previously reported associations between these variables in nonreferred samples remain consistent in a sample of clinically referred patients. Two hundred thirty-six participants between the ages of 6 and 17 years were included. All were consecutive referrals to an outpatient child and adolescent mood disorders program. Eighty-four percent met the criteria for at least 1 depressive disorder from the third and revised edition of the Diagnostic and Statistical Manual of Mental Disorders (major depressive disorder, dysthymia, both, depression NOS, or adjustment disorder with depressive mood). In keeping with previous reports, the data indicate an inverse relation between age and self-esteem and an even stronger inverse relation between depression and self-esteem. However, there was no evidence for a sex difference for self-esteem, alone or interactively with age. The implications of these findings in relation to the importance of self-esteem in depressed youth are discussed.

Adjustment Disorders↗