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PubMed2006

Discrimination of internal derangement of temporomandibular joint by lateral cephalometric analysis.

INTRODUCTION: The purposes of this study were to analyze the progress of internal derangement (ID) of the temporomandibular joint (TMJ) and to find critical yardsticks that can be used during lateral cephalometric analysis to identify subjects with potential ID. METHODS: The sample consisted of 134 women whose primary complaints were malocclusions. They were divided into 5 groups based on the results of magnetic resonance imaging of bilateral TMJs: bilateral normal disc position, unilateral disc displacement with reduction (DDR) and contralateral normal disc position, bilateral DDR, unilateral DDR and contralateral disc displacement without reduction (DDNR), and bilateral DDNR. Thirty-six cephalometric variables from their lateral cephalograms were analyzed with 1-way ANOVA and discriminant analysis to determine the key factors in identifying subjects with TMJ ID. RESULTS: Backward positioning of the mandible, clockwise rotation of the mandible, proclination of the mandibular incisors, and increase in overjet intensified gradually with the progression of TMJ ID, and the subjects with bilateral DDNR showed the greatest changes in dentofacial morphology. Stepwise variable selection in discriminant analysis identified the following 2 variables: mandibular incisor to Frankfort horizontal plane angle and overjet. Discriminant analysis resulted in the correct classification of 79.1% of the subjects and showed that those with smaller mandibular incisor to Frankfort horizontal plane angles and larger overjets had high possibilities of TMJ ID. CONCLUSIONS: This study suggests that some cephalometric variables can be used as an auxiliary diagnostic tool to help identify patients with potential TMJ ID.

Adolescent↗
PubMed2000

Misclassification of high-risk older subjects using waist action levels established for young and middle-aged adults--results from the Rotterdam Study.

OBJECTIVES: In the literature, cutoff points based on waist circumference (waist action levels) have been suggested to replace cutoff points based on body mass index (BMI) and waist-hip ratio (WHR) in identifying subjects who are overweight or obese and/or with central fat distribution. These cutoff points have been based on analysis in mainly middle-aged and younger adults. In this article, we examine the applicability of the suggested waist action levels in an older population. PARTICIPANTS: A total of 6,423 men and women aged 55 or over participating in the Rotterdam Study, a population-based cohort study. MEASUREMENTS: Sensitivities and specificities of the proposed waist action levels in relation to the cutoff points for BMI and WHR were calculated. Also, cardiovascular risk factor levels at baseline examination in the different categories defined by high/low waist circumference, BMI and WHR were investigated. RESULTS: At waist action level 1 (waist circumference > or =94 cm in men, > or =80 cm in women), sensitivity was 71% in men and 86% in women for detecting those with high BMI (> or =25 kg/m2) and/or WHR (> or =0.95 in men, > or =0.80 in women). At waist action level 2 (waist circumference > or =102 cm in men, > or =88 cm in women in comparison with BMI > or =30 kg/m2 and/or WHR > or =0.95 in men, > or =0.80 in women), sensitivity was considerably lower: 35% in men and 59% in women. This was mainly due to a large proportion of subjects with low waist and BMI but high WHR. Specificity was high (>90%) at both action levels. Cardiovascular disease risk factors, except smoking, tended to increase with increasing waist circumference, WHR, and BMI. CONCLUSIONS: The suggested cutoff points for waist circumference are only to a limited degree useful in identifying subjects with overweight and obesity and/or central fat distribution in an older population. This concerns especially the upper cutoff point (waist action level 2) and is mainly due to the increased central distribution of fat with advancing age.

Age Factors↗
PubMed2005

Electrophysiological correlates of threat processing in spider phobics.

The electrocortical correlates of the processing of feared/fear-relevant and neutral stimuli were investigated in a pictorial emotional Stroop paradigm with spider phobic, social phobic, and nonphobic subjects. Subjects identified either the color of red or blue pictures of spiders, birds, or flowers (emotional Stroop task) or the object itself (identification task) by pressing different buttons. No emotional Stroop interference was found for spider phobic subjects when identifying the color of spiders as opposed to neutral stimuli. However, in the object identification task, spider phobic subjects identified spiders significantly faster than birds or flowers. Parietal P300 and P400 amplitudes were enhanced independent of task in spider phobic but not in nonphobic subjects when viewing pictures of spiders, which is consistent with previous studies showing that highly unpleasant and arousing pictures affect parietal late positive potentials.

Adult↗
PubMed2006

Screening for hemochromatosis in asymptomatic subjects with or without a family history.

BACKGROUND: Hemochromatosis in white subjects is mostly due to homozygosity for the common C282Y substitution in HFE. Although clinical symptoms are preventable by early detection of the genetic predisposition and prophylactic treatment, population screening is not currently advocated because of the discrepancy between the common mutation prevalence and apparently lower frequency of clinical disease. This study compared screening for hemochromatosis in subjects with or without a family history. METHODS: We assessed disease expression by clinical evaluation and liver biopsy in 672 essentially asymptomatic C282Y homozygous subjects identified by either family screening or health checks. We also observed a subgroup of untreated homozygotes with normal serum ferritin levels for up to 24 years. RESULTS: Prevalence of hepatic iron overload and fibrosis were comparable between the 2 groups. Disease-related conditions were more common in male subjects identified by health checks, but they were older. Hepatic iron overload (grades 2-4) was present in 56% and 34.5% of male and female subjects, respectively; hepatic fibrosis (stages 2-4) in 18.4% and 5.4%; and cirrhosis in 5.6% and 1.9%. Hepatic fibrosis and cirrhosis correlated significantly with the hepatic iron concentration, and except in cases of cirrhosis, there was a 7.5-fold reduction in the mean fibrosis score after phlebotomy. All subjects with cirrhosis were asymptomatic. CONCLUSIONS: Screening for hemochromatosis in apparently healthy subjects homozygous for the C282Y mutation with or without a family history reveals comparable levels of hepatic iron overload and disease. Significant hepatic fibrosis is frequently found in asymptomatic subjects with hemochromatosis and, except when cirrhosis is present, is reversed by iron removal.

Adolescent↗
PubMed1980

A further parallel between selective adaptation and contrast.

It is generally believed that selective adaptation effects in speech perception are due to a reduction in sensitivity of auditory feature detectors. Recent evidence suggest that these effects may derive instead from contrast. In a further test of the contrast hypothesis, we conducted two experiments each involving both adaptation and contrast sessions with matching stimulus sets. During the adaptation sessions of Experiment 1, subjects identified two series of velar stimuli varying in voice onset time, [ga]-[kha] and [gi]-[khi], before and after adaptation with of the following stimuli: [ga], [kha], [gi], and [khi]. In the contrast session, subjects identified either of two ambiguous test items (drawn from near the phonetic boundaries of the [ga]-[kha] and the [gi]-[khi] series) following a single presentation of [ga], [kha], [gi], or [khi]. For both the adaptation and contrast sessions, (a) the [--a] test items were more greatly affected (in a contrast direction) by the [--a] than by the [--i] adaptor/context stimuli, and (b) the [--i] test items were not differentially affected by the [--1] and [--i] adaptor/context stimuli. An analogous design was used in Experiment 2, except that the stimulus sets varied in pitch rather than vowel quality. For both the adaptation and contrast sessions, the test items were not differentially affected by the pitch of the adaptor/context stimulus. These parallel results provide further evidence that adaptation effects are actually a form of contrast.

Habituation, Psychophysiologic↗
PubMed2004

Evolutionary expressed sequence tag analysis of Drosophila female reproductive tracts identifies genes subjected to positive selection.

Genes whose products are involved in reproduction include some of the fastest-evolving genes found within the genomes of several organisms. Drosophila has long been used to study the function and evolutionary dynamics of genes thought to be involved in sperm competition and sexual conflict, two processes that have been hypothesized to drive the adaptive evolution of reproductive molecules. Several seminal fluid proteins (Acps) made in the Drosophila male reproductive tract show evidence of rapid adaptive evolution. To identify candidate genes in the female reproductive tract that may be involved in female-male interactions and that may thus have been subjected to adaptive evolution, we used an evolutionary bioinformatics approach to analyze sequences from a cDNA library that we have generated from Drosophila female reproductive tracts. We further demonstrate that several of these genes have been subjected to positive selection. Their expression in female reproductive tracts, presence of signal sequences/transmembrane domains, and rapid adaptive evolution indicate that they are prime candidates to encode female reproductive molecules that interact with rapidly evolving male Acps.

Animals↗
PubMed2001

Reference values for ambulatory blood pressure and self-measured blood pressure based on prospective outcome data.

Although self-measured blood pressure and ambulatory blood pressure are widely used for research and clinical purposes, reference values are still scarcely supported by prospective outcome data. For self-measured blood pressure, values of 135 mmHg systolic and 85 mmHg diastolic (an average of two measurements in the morning and an additional two in the evening for at least 3 working days) have been suggested as the upper-normal reference limits. Unfortunately, these values have received limited support because only one study, the Ohasama study, examined the prognostic value of self-measured home blood pressure. For non-invasive 24 h ambulatory blood pressure, there are at least 11 reports of prospective outcome studies from independent centres that have examined the prognostic values of ambulatory blood pressure, but not all have attempted to define reference values. Currently, an average daytime blood pressure of less that 135 mmHg systolic and less than 85 mmHg diastolic is generally considered to be normal, and a level below 130/80 mmHg may be considered optimal. A reduction in blood pressure of less than 10% from day to night identifies subjects with an increased cardiovascular risk. There is some evidence that cardiovascular risk is further increased when night-time blood pressure is higher than daytime blood pressure. An average 24 h pulse pressure of over 53 mmHg identifies subjects with a raised cardiovascular risk.

Blood Pressure Determination↗
PubMed2005

[Severity of coronary artery disease in patients with acute coronary syndrome without ST segment elevation].

Risk stratification of patients presenting to the hospital with acute coronary syndrome (ACS) is usually based on ECG assessment, and several clinical and biochemical criteria, which are all intended to identify subjects with more severe disease, who might benefit from aggressive medical or interventional treatment. However, no one widely accepted jeopardy score is available. Our aim was to determine whether the initial ECG, biochemical data and past medical history correlate with the extent of coronary artery disease in patients with ACS thus identifying subjects with severe coronary artery disease (CAD) who may benefit from the early invasive strategy. Patients' data was prospectively collected and retrospectively analysed according to the result of angiography examination. Our cohort consisted of 220 consecutive patients hospitalised due to typical chest pain (> 5 min.) occurring at rest within the last 24 hours. Study group comprised of 115 patients, who were subsequently subjected to coronary angiography Blood for qualitative troponin I test (Cardiac STATus, Spectral Inc., NJ, USA), and other routine biochemistry tests was drawn and ECG was done on admission. Chi-square and Pearson correlation tests were used for statistical analysis, p < 0.05 being considered statistically significant. Stepwise forward regression analysis was used to identify variables predictive of significant coronary artery stenosis. We have identified 65 patients with significant and 5 patients with insignificant multivessel stenosis, 33 patients with significant and 7 patients with insignificant single vessel disease. Five patients had normal coronary arteries. Male sex was significantly more prevalent among patients with coronary artery disease than with normal arteries (71% vs. 40%, p = 0.02). No differences in biochemistry values were seen among the groups. There was a significant difference in the prevalence in ST segment depression (p = 0.03) among these patients and in the incidence of plasma fibrinogen levels of >380 mg% (p = 0.02), those findings being most frequently encountered in significant multi- and single-vessel disease subjects. Hypertension, myocardial infarction more than 10 days ago, history of smoking, hypercholesterolemia and diabetes were independent predictors of the presence of significant stenosis. Assessment of admitting ECG and troponin I together with patients medical history may allow for identification of ACS patients with significant CAD that may benefit from early invasive treatment.

Acute Disease↗
PubMed2004

The accuracy of self-reported high noise exposure level and hearing loss in a working population in Eastern Saudi Arabia.

OBJECTIVE: To determine the accuracy of questions in identifying subjects occupationally exposed to high noise level and those with hearing loss using noise dosimeter and pure-tone air conduction audiometry as the gold standards. DESIGN: A cross-sectional study involving 259 noise-exposed workers selected randomly from two factories in Eastern Saudi Arabia. Personal noise exposure was determined using a noise dosimeter. The hearing impairment for each subject was assessed using otoscopic examination and audiometry. Each subject completed a comprehensive questionnaire including questions about noise exposure and hearing loss. RESULTS: Eighty five percent of the total workers reported exposure to high noise level, compared to 76% found to be exposed to a high noise level defined as more than 85 dB (A) as determined by noise dosimeter. The prevalence of audiometric hearing loss (threshold average of 25 dB HL or more in any ear) was 32.4% for the low frequency average (0.5, 1 and 2 kHz), 47.9% for the all frequency average (0.5, 1, 2. 4 and 8 kHz) and 65.6% for the high frequency average (4 and 8 kHz). However, the percentage of the subjects who reported hearing loss ranged between 3.9% and 85.3% depending on the question used as indicator of hearing loss. The question "Do you consider the noise level where you are working now high?" was the most sensitive in correctly identifying subjects exposed to a noise level of more than 85 dB (A) (sensitivity = 93.4%) and subjects with hearing loss (sensitivity > 86%) compared with other questions evaluated. However, it overestimated the prevalence rate determined by audiometry. CONCLUSION: We conclude that in industries where facilities for an objective assessment of noise exposure and hearing loss are not available, questions addressing noise exposure and hearing loss might be a useful alternative means for screening subjects exposed to high noise level and those with hearing loss for the purpose of designing and implementing hearing conservation program.

Adult↗
PubMed1989

Assessment of AlbuSure and its usefulness in identifying IDDM subjects at increased risk for developing clinical diabetic nephropathy.

This study, which included 154 participants in a 10-yr follow-up study of diabetes complications, was conducted to evaluate AlbuSure (a qualitative test designed to detect urinary albumin concentrations greater than 0.03 g/L) for its ability to discriminate between albumin concentrations above and below the manufacturer's concentration threshold and to identify individuals at increased risk for developing diabetic nephropathy (i.e., those with albumin excretion rate [AER] greater than 0.0288 g/24 h). The reproducibility of AlbuSure results was also evaluated. The results of these evaluations were examined by three different types of urine collections (24 h, overnight, and timed postclinic) and overall. AlbuSure's validity was examined by comparing its results to immunonephelometrically measured concentrations and AER. When compared to albumin concentration, AlbuSure had an overall sensitivity of 81.8%, specificity of 94.8%, and positive predictive value of 90.6%. AlbuSure's sensitivity was lower (71.4%) when compared with AER; however, this was higher than the sensitivity achieved by dipsticks against AER (50.7%). On testing urine samples stored for 3 days at 4 degrees C, AlbuSure results were 100% reproducible after 1 day and had an overall reproducibility of 92% after 3 days. When urine was retested after 3 and 15 mo of storage at -70 degrees C, AlbuSure was greater than or equal to 90% reproducible, with some of the differing results attributable to corresponding changes in albumin concentration. The overnight sample appeared to be the sample of choice for testing with AlbuSure in that it showed excellent reproducibility and the highest sensitivity (compared to both albumin concentration and AER).

Agglutination Tests↗
PubMed2006

Bimodal distribution of vasodilator responsiveness to adenosine due to difference in nitric oxide contribution: implications for exercise hyperemia.

To gain insight into the role of adenosine (Ado) in exercise hyperemia, we compared forearm vasodilation induced by intra-arterial infusion of three doses of Ado with vasodilation during three workloads of forearm handgrip exercise in 27 human subjects. We measured forearm blood flow (FBF) using Doppler ultrasound and mean arterial pressure (MAP) via brachial artery catheters and calculated forearm vascular conductance (FVC = FBF/MAP) during each infusion dose or workload. We found that about half of the subjects demonstrated robust vasodilator responsiveness to both Ado infusion and exercise, and the other half demonstrated blunted vasodilator responsiveness to Ado infusion compared with exercise. In 15 subjects (identified as "Ado responders"), the change in FVC above baseline was 209 +/- 33, 419 +/- 57, and 603 +/- 75 ml.min(-1).100 mmHg(-1) for the low, medium, and high doses of Ado, respectively, and 221 +/- 35, 413 +/- 54, and 582 +/- 70 ml.min(-1).100 mmHg(-1) for the low, medium, and high exercise workloads, respectively. In the other 12 subjects (identified as "Ado nonresponders"), the change in FVC above baseline was 102 +/- 36, 113 +/- 42, and 151 +/- 54 ml.min(-1).100 mmHg(-1) for the low, medium, and high doses of Ado, respectively (P < 0.05 vs. Ado responders), whereas exercise hyperemia was not different from Ado responders (P > 0.05). Furthermore, infusion of NG-monomethyl-L-arginine (L-NMMA) blunted vasodilator responses to Ado infusion only in Ado responders (P < 0.01 vs. post-L-NMMA) and had no effect on exercise in either group. We also found differences in vasodilator responses to isoproterenol at all doses, but acetylcholine only at one dose, between Ado responders and nonresponders. We conclude that vasodilator responsiveness to Ado exhibits a bimodal distribution among human subjects involving differences in the contribution of nitric oxide to Ado-mediated vasodilation. Finally, our data support the concept that neither Ado nor nitric oxide is obligatory for exercise hyperemia.

Acetylcholine↗
PubMed1980

A study of perception of sentence intonation--evidence from Danish.

Ten subjects identified 15 Danish utterances by a human speaker, differing only in their fundamental frequency (F0) course, as being either declarative, nonfinal, or interrogative (forced choice). Responses are closely correlated with F0: the most steeply falling intonation contours are identified as being declarative, the least falling ones as being interrogative, and contours in the middle of the continuum as being nonfinal. Several mutually interdependent parameters in the F0 course may account for the results, the two most powerful one, however, being the levels of the last stressed and the succeeding unstressed syllable, respectively, in the utterance. In a subsequent experiment, seven subjects identified the same utterances as being either declarative or nondeclarative. The majority of the (formerly) nonfinal sentences were now labeled nondeclarative, rather than being equally distributed among the declarative and nondeclarative categories. When a subset of the same utterances were multilated, identification deteriorated almost progressively with the number of syllables being cut away from the end of the utterance, but only slightly so until nothing but the first stress group remained; whereas, syllables cut away from the beginning hardly affected identification at all.

Humans↗
PubMed2005

Unexpectedly high prevalence of alcohol use among pregnant Swedish women: failed detection by antenatal care and simple tools that improve detection.

OBJECTIVE: We examined the use of alcohol during early pregnancy in urban Swedish women, the ability of Swedish antenatal care to identify alcohol-related risk pregnancies and the utility of some potential tools for improving its performance. METHOD: Women attending regular antenatal care were randomized to regular assessment only (control, n = 156) or intensified screening (intervention, n = 147). In the intervention group, alcohol use was determined using the Timeline Followback (TLFB) interview, alcohol use habits with the Alcohol Use Disorder Inventory Test (AUDIT), and biomarkers for alcohol use were analyzed. Data were typically obtained in pregnancy week 12. RESULTS: In the intervention group as a whole, average absolute alcohol consumption during the first 6 weeks of pregnancy was low but highly variable (mean [SD] = 24.9 [50.5] g/week; 4.8 [6.0] episodes for the entire 6 week period); 22 women (15%) drank at levels exceeding 70 g/week during any 2 or more weeks and/or in a heavy episodic drinking pattern, 60 g/episode, on 2 or more episodes. The AUDIT had a moderate sensitivity (54%) to identify these subjects. Biomarkers identified subjects with somatic illness rather than high alcohol consumption. In the control group, only 4 (3%) were identified as using alcohol, indicating a probable underestimation of alcohol use by regular antenatal screening procedures (p = .0001). CONCLUSIONS: An unexpected proportion of pregnant women in urban Sweden consume alcohol at levels likely to produce adverse effects. Regular antenatal care did not identify most of these risk pregnancies. The TLFB identified pregnant women with risk use of alcohol during pregnancy who were only partly identified by analyzing prepregnancy alcohol use patterns with the AUDIT. Elevated laboratory markers likely indicated somatic illness rather than harmful drinking.

Adult↗
PubMed2005

Five-year risk of developing clinical diabetes after first myocardial infarction; the FINAMI study.

AIM: To investigate the incidence of clinical diabetes as determined by the incidence of diabetes drug reimbursements within a 5-year period after the first myocardial infarction (MI) in patients who were non-diabetic at the time of their first MI. RESEARCH DESIGN AND METHODS: A population-based MI register, FINMONICA/FINAMI, recorded all coronary events in persons of 35-64 years of age between 1988 and 2002 in four study areas in Finland. These records were used to identify subjects sustaining their first MI (n = 2632). Participants of the population-based risk factor survey FINRISK (surveys 1987, 1992, 1997 and 2002), who did not have diabetes or a history of MI, served as the control group (n = 7774). The FINMONICA/FINAMI study records were linked with the National Social Security Institute's drug reimbursement records, which include diabetes medications, using personal identification codes. The records were used to identify subjects who developed diabetes during the 5-year follow-up period (n = 98 in the MI group and n = 79 in the control group). RESULTS: Sixteen per cent of men and 20% of women sustaining their first MI were known to have diabetes and thus were excluded from this analysis. Non-diabetic men having a first MI were at more than twofold {hazard ratio (HR) 2.3 [95% confidence interval (CI) 1.6-3.4]}, and women fourfold [HR 4.3 (95% CI 2.4-7.5)], risk of developing diabetes mellitus during the next 5 years compared with the control population without MI. CONCLUSIONS: Many patients who do not have diabetes at the time of their first MI develop diabetes in the following 5 years.

Adult↗
PubMed2003

Severity of coronary artery disease in patients with acute coronary syndrome without ST segment elevation is related to baseline troponin I and ST-segment depression.

BACKGROUND: Risk assessment for patients admitted with acute coronary syndrome (ACS) is usually based on the past medical history, along with several clinical and biochemical criteria. We hypothesised that stratification of patients with ACS according to the presence of ST-segment depression and results of a qualitative troponin I test would identify subjects with more severe disease who may benefit from an earlier, more aggressive strategy. MATERIAL/METHODS: The study group consisted of 115 patients hospitalized for typical chest pain (>5 min) occurring within the last 24 hours, with coronary angiography. Blood was drawn for routine biochemistry and qualitative troponin I testing, and ECG was performed on admission. RESULTS: Patients were classified according to the presence of ST segment depression (ST) and the troponin I test results (T) into three categories: group A, consisting of 34 patients with ST+/T+; group B, consisting of 84 patients with either ST+/T- or ST-/T+; and group C, consisting of 7 subjects with ST-/T-. This stratification correlated significantly with the extent of coronary artery disease (p=0.0004). Significant coronary artery stenosis was significantly more prevalent in patients from groups A and B than in C (p<0.002). No difference in the patients' medical history, apart from more frequent AMI within the past 10 days in group A (p=0.009) was found between groups. CONCLUSIONS: Admission assessment of ECG and troponin I tests in patients with ACS may identify subjects with significant coronary artery disease, who are at high risk and could benefit from aggressive therapy.

Acute Disease↗
PubMed1976

Frequency dependence of total respiratory resistance in early airway disease.

Patients who develop frequency dependence of lung compliance will theoretically have frequency dependence of pulmonary resistance. We investigated the ability of the simpler, noninvasive measurement of frequency dependence of total respiratory resistance to identify subjects with frequency dependence of compliance. Ten healthy nonsmokers, 14 asymptomatic smokers, and 6 patients with obstructive airway disease were studied. Frequency dependence of total respiratory resistance was determined by the superimposed oscillating airflow technique at 3 to 9 cycles per sec, and frequency dependence of lung compliance was determined by measurements at 10 to 80 breaths per min. Spirometry, airway resistance, closing volume, and closing capacity were also measured. Frequency dependence of lung compliance and total respiratory resistance were closely correlated (P less than 0.001, r = 0.82), but closing volume, closing capacity, spirometry, and airway resistance could not be used to identify subjects with abnormal frequency dependence of lung compliance. Measurements of frequency dependence of total respiratory resistance and lung compliance, total respiratory resistance at 3 cycles per sec, and closing volume minus expiratory reserve volume were able to distinguish significantly between the smokers and the nonsmokers, but spirometry, closing volume, closing capacity, and airway resistance could not. These data indicate that in asymptomatic smokers and subjects with obstructive airway disease, frequency dependence of lung compliance can be predicted from measurements of frequency dependence of total respiratory resistance. These two tests appear to have equivalent sensitivity and selectivity in detecting the uneven time constants in the airways of asymptomatic smokers.

Adult↗
PubMed1999

[Identifying asbestos bodies in bronchoalveolar lavage fluid].

UNLABELLED: Asbestos bodies (AB) in respiratory secretions in bronchoalveolar lavage (BAL) identify subjects with lower airway AB content is a potential cause of pleural or pulmonary disease. The precision of this qualitative measure, however, has not been adequately analyzed. OBJECTIVE: To determine the sensitivity and specificity of finding AB in BAL fluid by conventional qualitative cytology in comparison with the quantification of AB in BAL fluid. METHOD: BAL samples from 40 subjects exposed to asbestos (mean age 59.2 years; men/women 36/4) were processed in the following ways: 1) qualitative cytology and 2) quantification of AB in BAL fluid expressed as AB/ml. The concentration of AB in BAL fluid was considered the gold standard (upper limit of normal 1 AB/ml) for determining the precision of qualitative cytology. RESULTS: In 9 of the 40 cases (22.5%) AB was found in BAL liquid cytology, but in only five of them were AB counts greater than 1 AB/ml. AB counts also showed concentrations greater than 1 AB/ml for four patients whose qualitative results were negative. The sensitivity of a qualitative AB-positive finding for identifying subjects with potentially disease-causing AB concentrations was 0.55, while specificity was 0.87. We conclude that a qualitative finding of AB in BAL fluid is adequately specific, but that sensitivity is very low, an indication that AB concentration in BAL should be determined to adequately screen for patients at high risk of developing disease.

Asbestos↗
PubMed1998

Serum transferrin receptor and transferrin receptor-ferritin index identify healthy subjects with subclinical iron deficits.

Despite the established utility of serum transferrin receptor (sTfR), serum ferritin, and the sTfR/log ferritin ratio (TfR-F Index) in the diagnosis of iron deficiency (ID) anemia, the numeric values of these parameters, which are indicative of subclinical ID, remain to be clearly defined. In this study, 65 apparently healthy nonanemic adults (22 men and 43 women) were treated with 3 months of oral iron supplementation to evaluate its effect on parameters reflecting iron status and to determine the prevalence of subclinical iron deficiency in apparently healthy adults. Significant supplementation-induced changes were observed in sTfR, ferritin, and TfR-F Index values in women, whereas in men, none of the studied parameters showed any significant change. Iron-deficient erythropoiesis (IDE) was not observed in men, but was found in 17 women (40%). Although individuals with a compromised iron status may be represented in substantial numbers in conventional reference populations, they can be readily identified using sTfR, ferritin, and TfR-F Index determinations.

Administration, Oral↗