[The correlation of factors concerning dental plaque control. The cumulative analysis of variance of multiple-way classification].
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The postural defects of cerebral palsy children arising at heel contact during ambulation result, in many cases, in considerable initial vertical loads. These, in turn, lead to unfavorable motor patterns, a high degree of joint load, and undesirable spinal movements. An acoustic feedback system aimed at improving the motor process was developed; this turns vertical loads arising during ambulation into sounds, enabling thus to control a motor learning process. A KISTLER measuring platform was used as measuring instrument; this instrument translates vertical forces into a sequence of tones via a tone generator. In a series of experiments, the children with motor disorders learned to perform consciously a heel contact and toe off pattern which is checked and controlled through the use of tones and acoustic feedback. The aim is to achieve a slow increase in power at heel contact, a graduated power peak, and a well defined floor contact phase. The computation of the test using a 2 x 3 x 3 factor variance analysis showed a highly significant reduction in load increase not only in children with hemiplegia but also in those with diplegia. The most important findings was the fact that all the children were capable of practising a complex motor process controlled by an external feedback system and to compensate accordingly. In addition, at the end of the test, the children were in a position to reproduce alternatively the various motor patterns, and were thus able to distinguish between joint-loading and joint-relieving heel contact and toe off pattern. Moreover, the children's considerable motivation to practise on the 'sound plate' represented a substantial therapeutic aid.
Alterations in cross-sectional shape at midlength of the femur, tibia, and humerus of 16 male Beagle dogs exposed for 6 months to either 2.1 g or 2.6 g by centrifugation were analysed by the area moment correlation coefficient, as defined by AMTMANN and POTULSKI (1981). As shown by variance analysis the cross-sectional shape differences between bones are highly significant, while the treatment effects are only significant at a 5% level. While the femur and the tibia are almost alike in the shape of their whole sectional area and cortical surface, they differ in the shape of their marrow cavity. The most oval cross sections were found in the humerus. In femur and humerus the shape of the whole sectional area, the marrow cavity and the cortical surface tend to be more oval in the centrifuged animals than in the controls. In the tibial cross sections the opposite is the case. A significant interaction "Gravity X Bone" was found for the shape of the marrow cavity.
Part II presents a statistical model devised by the authors for evaluating toxicological analyses results. The model includes: 1. Establishment of a reference value, basing on our own measurements taken by two independent analytical methods. 2. Selection of laboratories -- basing on the deviation of the obtained values from reference ones. 3. On consideration of variance analysis, t-student's test and differences test, subsequent quality controls and particular laboratories have been evaluated.
Frequently adolescents use oral contraceptives (OP). Measures of some biological and metabolical patterns were performed in a sample of 339 young girls under going periodic health examination at Pasteur Institute in Lille. A case control study showed lower glucose level, and lower quantity of red blood cells and hemoglobin in OP users. Variance analysis showed lower GGT and TGO with "Gestodene", "Desogestrel" and "Norgestimate" than with the older progestatives (but cigarette smoking seems to influence these datas). Conclusion claims that new progestatives have the best biological tolerance.
To assess the efficacy of recombinant alfa 2b-interferon treatment "Heberon alfa R" in children with chronic active hepatitis (CAH) B virus, we conducted a long-term study (three years) in 22 children infected with hepatitis B virus (17 males and 5 females), age range 3 to 15 years. Diagnostic criteria included the clinical picture, laboratory tests, virus markers (HBeAg, HBsAg), laparoscopy and liver biopsy. Children under 12 years received 3 million IU of interferon per day whereas those older than 12 years received 6 million IU of interferon per day by intramuscular injection, three times per week for four months. Alanine aminotransferase (ALT) levels had been elevated for six months in all patients and hepatitis B viral infection was replicative. A variance analysis was made to evaluate ALT response to interferon administration and the Mc Nemar test was used to analyze HBeAg/anti-HBe behavior. Seventeen (77%) out of 22 patients responded to treatment (clearance of HBeAg and ALT levels returned to normal. HBeAg seroconversion (anti-HBe) occurred in 36% of patients during the first year (p < 0.01) and it increased to 50% by the third year follow-up. ALAT levels also decreased and the difference was statistically significant (p < 0.01). This occurred during and after treatment with a steady and increasing tendency to return to normal levels within the first and third year. Side effects were scarce, transient and tolerable and they only appeared during the initial phase of treatment; symptoms were mainly influenza-like and they disappeared very soon. There were no late side effects such as medullar depression, renal toxicity and glycemia alterations.(ABSTRACT TRUNCATED AT 250 WORDS)
BACKGROUND: Neonatal intensive care units show one of the highest frequencies of nosocomial infections (NI), specially in teaching hospitals. METHODS: The cumulative incidence and distribution of NI in a neonatal intensive care unit of a teaching hospital during three years and three months (536 children) is studied, evaluating the relation between NI and its risk factors with X2 and variance analysis and, finally, estimating the excess stays with a multiple linear regression. RESULTS: The global cumulative incidence of NI was 11% (or an incidence density of 30.7 per 100 children/month); the prevailing etiological agents were negative coagulase Staphylococcus and fungi of Candida Sp. When analyzing, according to the kind of infection, sepsis associated to catheter, stands out. The relation between the different intrinsic or extrinsic risk factors and the NI was studied as well, and it stood out that infected children suffer manipulations as: Central catheter, assisted respiration, parenteral feeding et cetera, with a greater frequency (twice as much) that of non infected children. CONCLUSIONS: The cumulative incidence of NI is moderate-low; but is is necessary to continue insisting and increasing the current control measures and on the other hand, is is necessary to calculate the excess stays, due to NI, with multivariate methods because the direct estimation produces an overestimation of that one.
Fifteen males with stable angina pectoris were screened for efficacy of antianginal drugs in single doses (isosorbide dinitrate, 10 mg; nifedipine, 20 mg; propranolol, 40 mg) and in combinations (ID+Pr, ID+Nf, Nf+Pr, Nf+Pr+ID). The findings at paired bicycle ergometries indicated that ID was most beneficial in monotherapy. Only two combinations (Nf+Pr and Nf+Pr+ID) were superior when compared to single drugs. Combinations ID+Pr and ID+Nf had the same efficacy as ID. Interaction of the drugs assessed with two-dimensional variance analysis was insignificant in all the combinations. Nf+Pr+ID combination had no advantages over two-drug combinations and induced worse tolerance.
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In order to know the usefulness of a combined treatment with gliburide and NPH insulin 25 patients with well controlled type II diabetes mellitus were studied. The patients were randomly divided in to three groups: Group I just received gliburide, Group II only insulin and Group III gliburide and insulin. Glucose in fast, glycosylated haemoglobin and C peptide levels were determined over five months. For the statistical data processing variance analysis was performed. The initial and final glucose determinations were: Group I, 169.3 mg% and 139.0 mg% respectively (p > 0.05); Group II, 202.1 mg% and 177 mg% (p > 0.05); Group III, 157.8 mg% and 158.8 mg% (p > 0.1) for the glycosylated haemoglobin the determinations were: Group I, 7.2% and 5.1% (p > 0.05); Group II, 6.2% and 5.1% (p > 0.05) and Group III, 5.7% and 4.7% (p > 0.05). For the C peptide were 2.5 and 4.5 for Group I (p > 0.05), 2 and 4.1 for Group II (p > 0.05) and 3.2 and 5.3 for Group III (p > 0.05) with no significant statistical differences. It is concluded that the combined treatment showed to be effective, but not superior, in order to control diabetic patients and it can be a useful therapeutic alternative in well selected patients.
Nursing case management has been documented as one solution to the balance of cost and quality issues in healthcare. A current focus in healthcare is continuous quality improvement (CQI). CQI methods are focused on outcome measurements. Outcome research is a recent development in case management. Tracking variance, evaluating cost reduction and patient effectiveness, and determining types of patients at risk for negative variance are current case management research demands. Tracking patient comorbidities would allow for additional subset "tailoring" of existing critical pathways for specific comorbidities. Little research has been done on these issues. Few systems exist that track both variance and comorbidities. This article presents a graphic, simple, multidisciplinary tracking system that includes comorbidities and allows for individual and group patient variance analysis.
BACKGROUND: There is currently no doubt concerning the detrimental effects of the intake of high doses of alcohol during pregnancy. Nonetheless, there has been some controversy regarding the effects of intake of low or moderate quantities of alcohol. The aim of the present study, carried out within the framework of a more extensive European study (EUROMAC), was to specifically analyze the relation between moderate intake of alcohol in pregnant women and the weight of the newborns. METHODS: A prospective cohort study including 1,005 women who attended prenatal consultation in the Hospital La Fe of Valencia between 12 and 18 weeks of pregnancy during 1989 was performed. All the subjects were asked on alcohol intake during the week prior to the interview with data on other sociodemographic and biologic variables being collected. Variance analysis was carried out to evaluate the association of the weight of the newborn with alcohol intake as well as with each of the control variables. Multiple lineal regression analysis was performed by the minimum squares method to evaluate possible effects of confusion and interaction. RESULTS: Following adjustment for parity, weight of the mother prior to pregnancy, sex of the newborn, age at pregnancy and tobacco consumption, only a slight reduction in the weight of the newborns was observed in the category of intake greater than 90 g/week, however this difference was not statistically significant. CONCLUSIONS: The low or moderate intake of alcohol during the first months of pregnancy has no detectable effect on fetal growth.
Various studies performed in chronic alcoholic patients have demonstrated immunologic alterations, which have been described more often in patients with alcoholic hepatitis or liver cirrhosis. We have observed that the serum of some patients with alcoholic liver cirrhosis produces the inhibition of E rosette formation by T lymphocytes. This observation induced us to study E rosette formation and its probable inhibition by the serum of chronic alcoholic patients. Subjects were split into three groups: Group 1: n = 21. Normal individuals. Group 2: n = 15. Chronic alcoholic patients without cirrhosis. Group 3: n = 26. Chronic alcoholic patients with histologically demonstrated liver cirrhosis. E rosette and E rosette inhibition (TIRE) sera tests were performed utilizing subject's sera tested against lymphocytes of normal individuals not related to group 1. The results found are listed in detail in Table 1 (mean = -SD) and Figure 1 (median), for each of the test groups. We applied unifactorial variance analysis and observed highly significant differences between the groups studied in all tests performed. It was found that tests that utilized I.E. discriminate most efficiently among the three groups of patients and that those which utilize unabsorbed assay serum (S/A) yield the best differentiation. Using this last assay it was observed that 20/21 control individuals showed less than 15% inhibition. On this basis, we decided to separate the results into 15% regular intervals (Table 3). Inhibition above 30% was found only in cirrhotic patients with the exception of one individual of the control group and one non-cirrhotic alcoholic patient with no alcoholic liver disease.(ABSTRACT TRUNCATED AT 250 WORDS)
An in vitro system has been set up to study the possible genetic effects of diagnostic ultrasound (US) on the developing fetus. Amniotic cells were cultured by the in situ technique. Well established clones were exposed to US for various lengths of time using a linear array transducer within a sound transparent apparatus. Cells were then grown in the presence of 5-bromo-2'-deoxyuridine and processed for scoring the number of sister chromatid exchanges (SCE) as the cytogenetic endpoint. There was no linear relationship between the SCE frequency and the duration of US exposure. Variance analysis showed that only interindividual variability was a significant component of total variation. Neither the main effect of treatment nor the interaction effect were statistically significant. The data suggest that US delivered from a diagnostic unit to actively growing cultured fetal cells in a system closely mimicking the conditions of US exposure during amniocentesis does not induce SCE.
Vertebral crush fracture associated with glucocorticoid therapy causes major morbidity in juvenile chronic arthritis (JCA). Deflazacort (DFZ) may have an advantage over prednisone (PRED) because of its alleged bone sparing properties. Of 34 children with JCA receiving more than 5 mg PRED/day, 31 completed a 1-year, double blind, randomized, comparative trial of DFZ and PRED. Patient characteristics at trial entry were well matched. DFZ and PRED were prescribed in equivalent amounts. DFZ achieved similar disease control to PRED, and was not associated with untoward effects. Joint counts, hematological indices and biochemical values did not differ between treatment groups initially or during the trial. Bone density trends (velocities) in the lumbar spine were measured using dual photon absorptiometry at 3-monthly intervals and trends in bone and soft tissue growth calculated. Lumbar spine bone growth correlated with indices of somatic growth, with wide ranges in each group. Co-variance analysis showed a significant advantage (p < 0.007) of DFZ over PRED when spinal bone density was compared to body surface area and weight. Children taking DFZ showed less weight gain but similar height gain to children taking PRED. Children with poor or no somatic growth showed significant lumbar bone loss only in the PRED group. Of the children originally treated with PRED; 11 were switched to DFZ after completing the double blind study. Data for 26 children treated with DFZ for 1 year were thus available and confirmed a significantly greater rate of spinal bone growth relative to somatic growth, p < 0.002.(ABSTRACT TRUNCATED AT 250 WORDS)
The selection of a group of patients based on a high value of a clinical or biological parameter leads to the finding of a tendency to a reduction of this value when remeasured, known as "regression towards the mean". The amplitude of this phenomenon is greater when the selected subjects are far from normal values and the intra-individual variability of the parameter under consideration is very high. Measurement of left ventricular mass is very affected by this statistical phenomenon. The authors undertook a prospective study to analyse the components of variability of repeated echocardiographic measurements of left ventricular mass and to quantify the expected effect of regression towards the mean in the follow-up of patients with left ventricular hypertrophy. Twenty-five randomly chosen subjects underwent 2 echocardiographic examinations at 2 week intervals: at each visit, the patient had two recordings and each recording was measured twice by the same "blinded" operator. Variance analysis showed intra-individual variability represented 30% of total variability, comprising only 2% for the measurements and 28% for the recordings and the visits. The importance of regression towards the mean was calculated with respect to the initial value of the left ventricular mass index: for example, when the left ventricular mass index was 150 g/m2, a spontaneous regression of 18 g/m2 can be expected at the next measurement. This phenomenon should be taken into consideration in the interpretation of longitudinal echocardiographic studies.
The aim of study was to assess the value of signal averaged ecg for detection of patients (pts) at risk for paroxysmal atrial fibrillation (paf). We examined three groups of pts: group I-41 pts with nonvalvular paf, group II-20 pts with hypertension and/or ischemic heart disease without paf and group 3-26 health persons, without organic heart disease. In all pts the signal-averaged electrocardiogram triggered by P waves was recorded. Seven parameters of the spatial magnitude of filtered P wave were measured. Significant difference between group I and group II or III was found in most parameters. Using the method of multidimensional variance analysis we constructed "the diagnostic vector" in multidimensional parameters space, which was used to determine patients belonging to group. Total percent of right decision was 85%. These findings suggest that pts at risk for paf could be detected while in sinus rhythm by using the P wave-triggered signal-averaged ecg.
PURPOSE: To determine whether children and adolescents, whose fathers have established coronary artery disease (CAD), have increased prevalence of coronary risk factors (RF). METHODS: The frequencies of abnormal values of lipid variables, glucose, blood pressure, obesity index (calculated through Newen-Goldstein index), smoking and electrocardiographic alterations (ECG), were assessed in 280 descendents of young revascularized patients (< 55 years). The study population was divided in two groups according to age, respectively GA (2 to 12 years) and GB (12 to 19 years). Eventual influences of age, gender, obesity and smoking on lipid variable were evaluated through variance analysis. RESULTS: Of the study population, 48.2% and 44.6% had total cholesterol (TC) and LDL-C respectively above the desirable values; 21.7% and 26.1% had values similar to adults under increased risk. Triglyceridemia (TG) > 200mg/dl was found in 1.4% of the sample and lower values of HDL-C in 16.8%. Overweight and obesity were observed in 13.1% and 20.0% of the patients and influenced TG levels in GB. Smoking occurred in 10.4%; hypertension in 3 cases and none had abnormal glucose levels or ECG. CONCLUSION: Healthy children of fathers with established CAD, exhibit a high frequency of altered lipid profile and increased body weight. The results suggest the need for early identification of RF in offspring of young CAD patients, thus emphasizing changes in risk profile and improving lifestyle.