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PubMed1995

New methods for transcervical cannulation of the fallopian tube.

Technological advances have led to major improvements in the design and application of Fallopian tube cannulation devices using the transcervical approach. Presently such cannulation systems are being used to overcome infertility disorders. These transcervical access systems are now able to displace debris that may block the tube, break down intraluminal adhesions or place egg, sperm or embryos in the tube to facilitate conception. Conversely, these same or modified devices could be used to place sclerosing agents or occlusive devices within the Fallopian tubes using similar transcervical access technology. Transcervical delivery systems incorporating a very fine endoscopic fiber have also been developed to visibly assess the inside lumen of the Fallopian tube using a transcervical approach. Such a system could be used to accurately identify specific sites in the tube for placement of such devices. The potential for placing permanent or temporary devices in the tube and the option of reversible sterilization may become a possibility in the future. One of the biggest obstacles against a wide distribution of these devices, particularly in third world countries, will be cost and the relative technical complexity in using them. These factors will need to be addressed more carefully in assessing the overall strategy of population control. The pressure on governments and international agencies to place more resources into population control may facilitate the accelerated development, application and cost containment of these new devices and delivery systems.

Cervix Uteri↗
PubMed2006

Comparing patients' predicted test scores from a regression equation with their obtained scores: a significance test and point estimate of abnormality with accompanying confidence limits.

In contrast to the standard use of regression, in which an individual's score on the dependent variable is unknown, neuropsychologists are often interested in comparing a predicted score with a known obtained score. Existing inferential methods use the standard error for a new case (s-subN+1) to provide confidence limits on a predicted score and hence are tailored to the standard usage. However, s-subN+1 can be used to test whether the discrepancy between a patient's predicted and obtained scores was drawn from the distribution of discrepancies in a control population. This method simultaneously provides a point estimate of the percentage of the control population that would exhibit a larger discrepancy. A method for obtaining confidence limits on this percentage is also developed. These methods can be used with existing regression equations and are particularly useful when the sample used to generate a regression equation is modest in size. Monte Carlo simulations confirm the validity of the methods, and computer programs that implement them are described and made available.

Confidence Intervals↗
PubMed2004

Analysis of heavy neurofilament subunit gene polymorphism in Russian patients with sporadic motor neuron disease (MND).

Motor neuron disease (MND) results in the selective degeneration of motor neurons in the cerebral cortex, brain stem and spinal cord. The most common form of MND is amyotrophic lateral sclerosis (ALS). MND is complex and many genetic systems may be involved in the pathogenesis of this disease. Pathological and animal studies implicate neurofilament involvement in MND. The heavy subunit (NEFH) tail domain contains a repeated motif. In humans, there are two common variants: the 45 motif repeats long allele (L) and 44 motif repeats short allele (S). Previous studies have shown that the NEFH tail may be involved in the pathogenesis of MND. To investigate whether the L/S genotypes of the NEFH gene are associated with MND, we studied the frequency of L and S alleles in sporadic MND patients and a control population from Moscow. We observed a difference in SS genotype frequency between the control population and sporadic MND patients from Moscow. It was established that the SS genotype is sufficiently higher in sporadic MND patients. Moreover, we determined that patients with the SS genotype have the highest value of loss of the total clinical score. In summary, we conclude that the NEFH gene is involved in the pathogenesis of sporadic MND. The SS genotype represents a risk factor for the development and progression of sporadic MND in the Moscow population.

Alleles↗
PubMed1999

Meniere's disease: the incidence of hydrops in the contralateral asymptomatic ear.

OBJECTIVE: This study analyzes the incidence of endolymphatic hydrops in the asymptomatic contralateral ear of patients with classic Meniere's disease. STUDY DESIGN: A retrospective study of 3000 subjects who underwent electrocochleography (ECOG) from 1988 to 1998. METHODS: The presence of endolymphatic hydrops was determined by use of ECOG recordings, which were made through a transtympanic recording needle situated in the round window niche. Analysis was made of the 1-kHz toneburst summation potential (SP), and comparison was made between asymptomatic contralateral "Meniere's ears" (n = 144) and asymptomatic normal "control ears" (n = 114). RESULTS: Results demonstrated that more than 10% of the contralateral asymptomatic Meniere's ears have an ECOG recording that is highly suggestive of the presence of endolymphatic hydrops. In contrast, less than 2% of the control population demonstrate abnormal ECOG recordings. Furthermore, 15% of the population of contralateral Meniere's ears lie above the 95th percentile of the control population for 1-kHz tone-burst (100 dB) SP negativity. CONCLUSIONS: This study suggests that a high percentage of patients who have what appears to be unilateral Meniere's disease have evidence of endolymphatic hydrops in the contralateral asymptomatic ear. This finding has important clinical relevance for the management of patients in whom destructive surgery is planned and further highlights the importance of electrocochleography in the diagnosis and management of this disease process.

Audiometry, Evoked Response↗
PubMed1980

Increase in the amount of fetal lymphocytes in maternal blood during pregnancy.

The presence of male fetal lymphocytes in the maternal blood of 18 pregnant women (15 primigravidae and three who had had previous pregnancies) was analysed by counting quinacrine positive Y bodies in interphases of Y chromosomes in metaphases. Counts were also performed on a control population of ten young women who had never been pregnant and on another control population of seven men to test the efficiency of the staining technique used. After completion of the calculations, comparison of the results with the sex of the newborn babies showed a correct sex prediction of 83% by interphase scoring and of 89% by metaphase scoring. The lymphocyte transfer from fetus to mother has already started by the tenth week of pregnancy, and the percentage of fetal cell present in the bloodstream of a pregnant woman increases with the duration of the pregnancy.

Cells, Cultured↗
PubMed1994

[Positive serology for Borrelia burgdorferi in patients with symptoms compatible with Lyme's disease].

UNLABELLED: The existence of Lyme's disease (LD) in Spain has been demonstrated for several years, but the impact that LD may have on the presence of symptomatology associated to this entity has not been evaluated so far in our region. Given the existence of serological false positives and negatives, the usefulness of positive serology as indicative of LD is discussed. In this work, we try to demonstrate the presence of a greater serological positivity for anti-Bb antibodies in patients with clinical signs compatible with Lyme's disease, in order to assess in our environment if positivity of the serological tests used is indicative of infection by Bb. METHOD: In the Health Center of Pino Montano, we studied a total of 100 patients which could have been in contact with ticks or which presented symptomatology compatible with Lyme's Borreliosis, no other explantation being plausible. Determinations were made using indirect immunofluorescence (IIF) at different dilutions and three commercial ELISA methods in each serum. RESULTS: Seropositivity for IIF at a dilution 1/128 was of 24%, similar to the one obtained with 3 different ELISA methods. This results were confirmed for each of the risk factors considered. Fever from unknown etiology was present in 33% of the cases and was associated to a higher risk of positive serology. When two systems were affected (probable LD), seropositivity was more frequent than when just one system was affected (possible LD). Advanced age in the study population was not associated to a greater risk of positive serology, the opposite of what happened in the control population. CONCLUSIONS: The presence of anti-Bb antibodies in a risk population (probable or possible LD) is 24%, much greater than in the control population. Techniques for anti-Bb antibodies detection using ELISA methods show a significant correlation between each other and with IIF at a dilution of 1/128.

Adolescent↗
PubMed1979

[Population growth rate noted in Guizhou figures].

In compliance with Chairman Mao's instruction that it is necessary to control population, party committees at all levels in Tongren [Tunjen] Prefecture have strengthened leadership over planned parenthood work. They have lowered the prefecture's population growth rate from 28.2/1000 in 1974 to 12/1000 in 1977, reaching the average level for the whole country. Tongren and Yinjiang [Yinchaing] counties, 21 districts, 4 counties, and 171 communes have fulfilled 3 years ahead of schedule the population plan target for the 5th 5-year plan. Planned parenthood work has shown further development this year. By the end of September, the whole prefecture had overfulfilled by 10% the sterilization operation quota allocated by the province 3 months ahead of schedule and laid a better foundation for continuously lowering the population growth rate. It is estimated that the natural rate of population growth will fall to 10/1000 this year. The vigorous grasping of planned parenthood has gradually benefitted the planned development of the national economy, the health of mothers and children and production, work and study.

Asia↗
PubMed2004

Parental employment status and neural-tube defects and folic acid/multivitamin supplementation in Hungary.

OBJECTIVE: To study the role of parental employment status as indicator of socio-economic status (SES) in the origin of neural-tube defect (NTD) and in the use of periconceptional folic acid/multivitamin supplementation. MATERIALS AND METHODS: One thousand two hundred and two cases with neural-tube defects, 38,151 population controls without any defects and 22,475 patient controls with other defects were compared in the population-based data set of the Hungarian case-control surveillance of congenital abnormalities, 1980-1996. RESULTS: The proportion of professionals was lower, while the proportion of semi- and unskilled workers was higher in the neural-tube defect group compared with the population control group. However, the comparison of neural-tube defect and patient control groups showed a lower socio-economic status in the patient control group. In addition, the socio-economic status of fathers in the neural-tube defect group seemed to be better than in the population and patient control groups. The higher periconceptional folic acid supplementation and the higher use of multivitamins during pregnancy occurred in the professional and managerial categories in all the three study groups. CONCLUSION: The occurrence of neural-tube defect shows a slight socio-economic dependence in the mothers at the comparison with population control group, however, patient control group had the lowest socio-economic status. The higher maternal education goes together with a higher proportion of periconceptional folic acid supplementation.

Adult↗
PubMed1982

Endemic filariasis on a Pacific Island. II. Immunologic aspects: immunoglobulin, complement, and specific antifilarial IgG, IgM, and IgE antibodies.

Sixty-eight individuals from a Pacific island hyperendemic for subperiodic bancroftian filariasis were selected from a larger study population to include the entire clinical spectrum of filarial infection in that region and also an "endemic control" group without clinical or parasitologic evidence of filarial infection. Analysis of their blood leukocyte and humoral immune responses yielded the following major findings: 1) levels of specific antifilarial antibodies of three different immunoglobulin class (IgG and IgM measured by ELISA and IgE determined by radioimmunoassay) were significantly greater in the "endemic control" population than in the patients with filariasis, an observation true for both children and adults; 2) the endemic controls also had significantly higher levels of serum IgM and C3 than did the filariasis patients 3) while individuals with "filarial fevers" and "chronic (lymphatic) pathology" did have significantly lower IgG antibody responses to filarial antigen than the controls, the lowest antibody levels were found in the patients with microfilaremia; 4) symptomatic patients (i.e., those with filarial fevers or lymphatic obstruction) regularly showed higher specific antibody responses to filarial antigens than asymptomatic, infected individuals, although the difference did not reach statistical significance. These findings are in concert with our previously reported, intriguing observation that lymphocyte proliferative responsiveness to filarial antigens was much greater in individuals of the "non-infected" endemic control population than in patients with filariasis; furthermore, they indicate the important issues that must be approached and resolved to define the immunologic determinants leading both to the various filarial clinical syndromes and to protective immunity.

Adolescent↗
PubMed1996

Relation between activated clotting time during angioplasty and abrupt closure.

BACKGROUND: The purpose of this study was to determine whether the degree of heparin anticoagulation during coronary angioplasty, as measured by the activated clotting time, is related to the risk of abrupt vessel closure. METHODS AND RESULTS: Sixty-two cases of in- and out-of-laboratory abrupt closure in patients in whom intraprocedure activated clotting times were measured were identified from a population of 1290 consecutive patients who underwent non-emergency coronary angioplasty. This group was compared with a matched control population of 124 patients who did not experience abrupt closure. Relative to the control population, patients who experienced abrupt closure had significantly lower initial (median, 350 seconds [25th to 75th percentile, 309 to 401 seconds] versus 380 seconds [335 to 423 seconds], P = .004) and minimum (345 seconds [287 to 387 seconds] versus 370 seconds [321 to 417 seconds], P = .014) activated clotting times. Higher activated clotting times were not associated with an increased likelihood of major bleeding complications. Within this population, a strong inverse linear relation existed between the activated clotting time and the probability of abrupt closure. CONCLUSIONS: This study demonstrates a significant inverse relation between the degree of anticoagulation during angioplasty and the risk of abrupt closure. A minimum target activated clotting time could not be identified; rather, the higher the intensity of anticoagulation, the lower the risk of abrupt closure.

Aged↗
PubMed2002

Desquamative inflammatory vaginitis: an exploratory case-control study.

PURPOSE: To investigate potential risk factors for desquamative inflammatory vaginitis (DIV), a rare but severe form of vaginitis. We are aware of no other controlled studies of DIV. METHODS: We conducted a case control study comparing DIV cases (n = 47), identified from the Wayne State University Vaginitis Clinic, to friend controls. For some variables, cases were also compared to 1432 women participating in a random digit dialing survey. RESULTS: Most cases reported that their last episode of DIV caused at least some pain (76.9%) and worry (73.1%). Cases were more likely than either friend or population controls to report (ORs from population controls) a history of vulvovaginal candidiasis (OR = 4.40, 95% CI 2.24, 8.65), bacterial vaginosis (OR = 25.58, 95% CI 15.91, 41.15), or pelvic inflammatory disease (OR = 16.90, 95% CI 8.26, 34.55); use of oral contraceptives (OR = 4.91, 95% CI 2.11, 11.43); use of hormone replacement therapy (OR = 4.74, 95% CI 2.69, 8.37); and laparoscopic procedures (OR = 22.24, 95% CI 11.46, 42.69). CONCLUSIONS: Future studies should be conducted to explain the association with fertility surgeries, hormone usage, and other urogenital conditions; to clarify the timing of these associations; and to identify other factors related to DIV.

Adult↗
PubMed2001

Quantitative electroencephalography in Alzheimer's disease: comparison with a control group, population norms and mental status.

OBJECTIVE: Given that quantitative electroencephalography (EEG) has repeatedly shown excessive slow wave activity in dementia of the Alzheimer type (DAT) that increases with disease progression, we assessed the clinical utility of this tool by comparing various approaches used to assess slowing. DESIGN: Cross-sectional study comparing quantitative EEG data from patients with DAT with normative data from an elderly control group and from EEG norms derived from a large population. PARTICIPANTS: 35 subjects diagnosed with probable DAT and 30 elderly controls. OUTCOME MEASURE: EEG recorded from 21 scalp sites of each patient and elderly control during vigilance-controlled, eyes-closed, resting conditions was spectrally analyzed to yield measures of absolute and relative power in delta, theta, alpha and beta bands and indices of mean alpha band and total band frequency. RESULTS: Group comparisons of raw or age-regressed z-score population normative values yielded different profiles with respect to direction of frequency band changes, regional topography and clinical rating correlations, but both procedures evidenced overall patterns of EEG slowing in DAT. However, both methodologies yielded only modest (75%) classification rates. CONCLUSION: Quantitative EEG remains a valuable research tool but, as yet, an unproven diagnostic tool, for DAT.

Aged↗
PubMed1993

Penile vascular evaluation of men with Peyronie's disease.

A penile vascular evaluation was performed upon 95 consecutive men with Peyronie's disease (19 potent and 76 impotent) and 100 consecutive impotent men without Peyronie's disease to gain further understanding of the pathophysiology of erectile dysfunction in patients with Peyronie's disease. Only 1 of the 19 potent patients with Peyronie's disease had abnormal arterial blood flow by duplex ultrasonography and none had evidence of veno-occlusive dysfunction by either duplex ultrasonography or dynamic infusion cavernosometry/cavernosography. In contrast, 36% of the impotent men with Peyronie's disease had abnormal arterial blood flow and 59% had evidence of veno-occlusive dysfunction. There was no significant difference in historical risk factors for impotence between the impotent patients with Peyronie's disease and the control population of impotent patients. However, the presence of veno-occlusive dysfunction in the control population (16%) was significantly less than that of the impotent Peyronie's disease patients (p < 0.001). Although patients with Peyronie's disease may suffer impotence due to arterial occlusive disease, our results indicate that the principal cause of impotence in this patient population is veno-occlusive dysfunction.

Adult↗
PubMed2001

Association analysis of NOTCH4 loci in schizophrenia using family and population-based controls.

A genetic association between NOTCH4 and schizophrenia has previously been proposed. Unsing all markers previously shown to be associated, we found no evidence for such in three independent family-based samples (n=519 parent-offspring trios), and a case-control sample derived from the same ethnic background as the original observation. These data strongly suggest that NOTCH4 is not a significant susceptibility allele for schizophrenia.

Case-Control Studies↗
PubMedDate not supplied

[Cost-of-illness in systemic sclerosis: a retrospective study of an Italian cohort of 106 patients].

AIMS: It is increasingly important to determine the economic consequences of diseases considering the policy of limited health-care budgets. In this study we evaluated the annual direct and indirect costs of Systemic Sclerosis (SSc) and we tried also to identify any cost predictors. METHODS: We studied 106 patients (103 female, 3 male), 57 affected by Limited Systemic Sclerosis (LSSc) and 49 affected by Diffuse Systemic Sclerosis (DSSc). Mean age was 57 years (SD +/- 13.8) and mean disease duration was 8,9 years (SD +/- 7.2). Direct Costs: data were calculated referring to DRG (Disease Related Group) expenses for the in-patients. We referred to national pharmacopoeia to calculate the pharmaceutical cost for the out-patients. Indirect costs: we estimated the expense comparing our cases to literature data. Intangible costs: these are attributable to pain and psychological suffering. It is very difficult to express the intangible costs in monetary terms and they are often conveyed as disability and poorer quality-of-life. We used the Health Assessment Questionnaire "HAQ" and the Short Form-36 "SF-36" to evaluate this issues. RESULTS: Our study confirms, the extremely high costs caused by Systemic Sclerosis (total cost's 2001 year is 1,173,842.93 Euro, and average yearly patient cost is 11,073.99 Euro). Considering an estimated prevalence of 375 cases/106, the total yearly economic impact of SSc in Italy should be 249 million euro. Intangible costs were calculated as modifications of the health status. Average value of the HAQ was significantly higher than the control population (0.94 +/- 0.72), average values in the SF-36 were significantly lower than the control population (49.99 +/- 19.16 for physical dimension and 58.42 +/- 27.71 for mental dimension). The diffuse form of SSc, anti-Scl 70 antibodies, high skin score and a poor health status (HAQ and SF-36) were found to be cost predictors. CONCLUSIONS: As reported in the literature, our study confirms, the extremely high costs for total and single patients caused by Systemic Sclerosis. The DSSc are more expensive than the LSSc approximately 11% (p=0.0067). The direct costs are 30% higher in the DSSc than the LSSc (p < 0.001). The indirect and intangible costs are not significantly different. Moreover, our study shows also the possibility of identifying different cost predictors.

Aged↗
PubMed2005

[Late effects following curative radiotherapy for prostate cancer].

In this study we report late bladder, gastrointestinal and sexual dysfunctions in 23 patients following radical radiotherapy (66Gy-70Gy/33-35fx, 5 fx/week) for prostate cancer. We interviewed the subjects by telephone and compared the results with those of 45 healthy population controls. In general, the patients' bladder function was well preserved. However, compared with the population controls, significantly more patients reported dysuria and hematuria. Twenty-six percent of the patients reported moderate distress from the gastrointestinal tract. Fecal urgency, incontinence and the use of sanitary pads, as well as diarrhoea, and blood and mucous were significantly more common among the patients. Thirty-nine percent of the patients reported moderate or worse distress upon sexual activity, and significantly more patients suffered from erectile impotence.

Aged↗
PubMed1977

Elevated expression of T-antigen in simian papovavirus 40-infected skin fibroblasts from individuals with cytogenetic defects.

A number of cytogenetic conditions were examined for expression of simian papovavirus 40 T-antigen in vitro. Skin fibroblasts from patients with Turner's syndrome and trisomy 18 syndrome and most cell lines from Klinefelter's syndrome, trisomy 13 syndrome, chromosomal translocations, chromosome 21 deletions, and single cases of 18q- and 4p- exhibited elevated T-antigen expression, compared to a clinically and cytogenetically normal control population. Thus, T-antigen expression was generally elevated in cells with increased, decreased, or rearranged genetic material involving many different chromosomes. Variation in T-antigen expression among cell lines may reflect two factors. Individual cell line factors may account for differences within homogeneous clinical groups, whereas population factors appear to account for differences between the various clinical groups and the control population. The observation of elevated T-antigen expression in diverse cytogenetic conditions suggests that this phenomenon may be a manifestation of chromosomal aberration unrelated to cancer susceptibility.

Antigens, Neoplasm↗
PubMed2004

Mortality in patients with diabetic neuropathic osteoarthropathy (Charcot foot).

OBJECTIVE: To determine the mortality of a population of patients diagnosed with Charcot neuropathic osteoarthropathy managed by a single specialist unit and to compare the results with a control population. METHODS: We have undertaken a retrospective analysis of all cases of Charcot foot on the comprehensive database which has been maintained at the specialist diabetic foot clinic at the City Hospital, Nottingham since 1982. Survival and the incidence of amputation (major and minor) was compared with a control population referred with uncomplicated neuropathic ulceration. Controls were individually matched for gender, age (+/-2 years), disease type, disease duration (+/-2 years) and year of referral (+/-3 years). RESULTS: Forty-seven cases (21 female, 26 male) of Charcot foot were identified, of whom 18 (38.3%) had Type 1 diabetes. Mean age and disease duration at presentation were 59.2 +/- 13.4 (sd) and 16.2 +/- 11.2 years, compared with 59.7 +/- 12.6 and 16.3 +/- 11.2 years, respectively, in the controls. Twenty-one (44.7%) of those with Charcot had died, after a mean interval of 3.7 +/- 2.8 years. This compared with 16 (34.0%) after a mean 3.1 +/- 2.7 years in the control group. Mean duration of follow-up in the survivors was 4.7 +/- 4.9 years (Charcot) and 5.3 +/- 3.9 years (controls). A total of 11 (23.4%) Charcot patients had had a major amputation on the side of the index lesion, compared with five (10.6%) controls. There was no difference between the two groups (P > 0.05, Chi-square). CONCLUSIONS: The mortality in this group of patients with Charcot foot was higher than expected. Nevertheless, there was no difference between those with Charcot and those with uncomplicated neuropathic ulceration. It is possible that it is neuropathy, rather than Charcot osteoarthropathy, which is independently associated with increased mortality in diabetes. The mechanism underlying any such association is not known. There is a need for a formal, prospective, multicentre study to investigate the life expectancy and cardiovascular risk of those with Charcot osteoarthropathy.

Adult↗