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At least 973 records · Page 54Linked to original sources
PubMed2005

Performance of the Roche AMPLICOR human papillomavirus (HPV) test in prediction of cervical intraepithelial neoplasia (CIN) in women with abnormal PAP smear.

OBJECTIVES: To assess the performance of a novel PCR-based assay (Roche AMPLICOR HPV test) in detection of cervical pathology as a part of management for abnormal PAP smear (MAPS) and in women participating in cervical cancer screening. STUDY DESIGN: Altogether, 504 women comprising 270 patients referred for colposcopy due to an abnormal Pap smear and another 234 women participating in cervical cancer screening (tested for comparison) were analyzed for oncogenic (HR) Human papillomavirus (HPV) types 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, and 68 using the Roche AMPLICOR HPV test in cervical samples collected in PreservCyt liquid media. Colposcopic biopsy and/or LEEP cone biopsy was used as the gold standard in the triage group, while liquid-based cytology (LBC) was the reference test in the screening group. RESULTS: The prevalence of HPV was significantly higher in the MAPS group (65.9%) than in the screening group (31.2%) (P = 0.0001). There was a poor concordance between the referral PAP and the current LBC, being only moderate in the screening series, ICC (weighted kappa) = 0.291 (95%CI 0.070-0.459) (P = 0.007), and almost poor in the MAPS Series, with ICC = 0.217 (95%CI 0.04-0.384) (P = 0.023). AMPLICOR HPV positivity increased linearly with the increasing grade of cervical lesions. In detecting high-grade (CIN2-3), colposcopy was the most sensitive test (96.5%), very similar to AMPLICOR (95.2%) (P = 0.731), while LBC with HSIL cutoff was by far the most specific test (99.5%) and showed the highest PPV (96.1%). NPV of colposcopy (97.2%) and AMPLICOR (96.7%) were similar (P = 0.839). Together with abnormal colposcopy and HSIL cytology, the AMPLICOR HPV test is a powerful independent predictor of high-grade CIN2-3, and as such suitable to replace cervical cytology in management of women with abnormal PAP test (MAPS). CONCLUSIONS: The Roche AMPLICOR HPV test is comparable to other HPV tests (HCII, PCR) in detecting CIN in MAPS. However, more data are clearly needed on the performance of AMPLICOR test in management of abnormal PAP and particularly as a screening tool.

Adolescent↗
PubMed2003

Noninvasive tests to predict fetal anemia: a study comparing Doppler and ultrasound parameters.

OBJECTIVE: This study was undertaken to compare test characteristics of ultrasound and Doppler parameters in the prediction of fetal anemia in alloimmunized pregnancies. STUDY DESIGN: In a prospective cohort study, 16 nonhydropic fetuses with red blood cell alloimmunization were evaluated with ultrasound and Doppler imaging. Middle cerebral artery (MCA) peak systolic velocity, intrahepatic umbilical venous (IHUV) maximum velocity, liver length, and spleen perimeter were measured. Results before first fetal blood sampling (FBS) or delivery were analyzed. Fetal anemia was defined as hemoglobin deficit 5 SD or greater. Sensitivity and specificity were calculated. RESULTS: Six fetuses were anemic and required intrauterine transfusion, and 10 were not severely anemic at birth. MCA Doppler imaging was the best predictor of fetal anemia (100%), followed by IHUV (83%). Sensitivity was low for spleen perimeter (66%) and liver length (33%). CONCLUSION: Doppler evaluation of MCA peak systolic velocity is better than IHUV maximum velocity, liver, or spleen size in the prediction of fetal anemia in red blood cell alloimmunization.

Blood Transfusion, Intrauterine↗
PubMed2006

The association between endothelial dysfunction and cardiovascular outcomes in a population-based multi-ethnic cohort.

BACKGROUND: Brachial artery flow-mediated dilation (FMD) may predict cardiovascular events in selected high-risk patients. Whether FMD testing predicts cardiovascular events in asymptomatic, lower risk individuals from the general population is unknown. METHODS AND RESULTS: As a part of a multi-ethnic, prospective cohort study, the Northern Manhattan Study, we examined FMD by high-resolution ultrasonography in 842 community participants who were free of stroke or myocardial infarction. Lower FMD levels predicted cardiovascular events (myocardial infarction, stroke and vascular death) at 36 months of follow-up (hazard ratio (HR)=1.12 for every 1% decrease in FMD, 95% CI 1.01-1.25, p=0.03). The risk of events in patients with FMD in the lower two tertiles (FMD<7.5%) was significantly higher than those in the highest tertile (HR=3.28, 95% CI 1.07-10.06, p=0.04 for lowest versus highest tertile, and HR=3.05, 95% CI 1.03-9.66, p=0.04 for middle versus highest tertile). In a multivariate analysis including cardiovascular risk factors, the increase in risk associated with FMD was no longer statistically significant. CONCLUSIONS: Non-invasive FMD testing predicts incident cardiovascular events in this multi-ethnic, population-based sample, but its predictive value is not independent of cardiovascular risk factors.

Aged↗
PubMed1991

The ability of short-term tests to predict carcinogenicity can be summarized in a single index.

This paper presents a new procedure aimed at quantifying the ability of short-term tests (STT) to discriminate between carcinogens and noncarcinogens. While the sensitivity, specificity, and accuracy indices provide an estimate that is not biased by the relative proportion of carcinogens and noncarcinogens of the different databases, the new index, called Relative Operating Characteristics (ROC), goes a step further, and overcomes the problem of the decision criterion bias. In fact, if the threshold--that is, minimum increase over the control above which an STT result is positive--is varied, sensitivity and other factors are also consequently affected. A similar problem occurs when the STTs are assembled in batteries: the performance of the battery in discriminating between carcinogens and noncarcinogens depends on the preliminary decision of how many and which assays should be positive for considering a chemical as positive in the battery. The ROC analysis produces a single value, which places the performance of different systems on a common, easily interpreted scale (instead of using several different indices such as sensitivity, etc.). Most importantly, this index is independent of the decision criterion bias; consequently it is the best measure of the true ability of STTs to discriminate between carcinogens and noncarcinogens. To illustrate the approach, the ROC analysis is applied to a battery composed of the four in vitro assays studied by the U.S. National Toxicology Program: the analysis confirmed the previous results, pointing to the limited ability of this battery to discriminate between carcinogens and noncarcinogens.

Animals↗
PubMed2003

The value of routine non-invasive tests to predict clinical outcome in stable angina.

BACKGROUND: Chronic stable angina is a common condition, but considerable differences exist in the likelihood of acute coronary events such as CHD death, non-fatal myocardial infarction (MI) and unstable angina between individual patients. Effective risk prediction is necessary for optimum management. The aim of this study was to identify clinical features and non-invasive test parameters associated with high risk of these coronary events in stable angina and compose a clinically useful model to predict adverse outcomes in this population. METHODS: Six hundred and eighty-two patients with stable angina and a positive exercise test (1mm ST depression) from the Total Ischaemic Burden European Trial (TIBET) study, were studied. Resting ECG, exercise tolerance testing and echocardiography were performed at baseline, off anti-anginal therapy. The patients were then randomised to treatment with atenolol, nifedipine or a combination of both. Clinical follow up continued for an average of 2 years (range 1-3 years). RESULTS AND CONCLUSIONS: Prior MI or prior CABG were the clinical parameters associated with adverse outcome in patients with stable angina and a positive exercise test. On the ECG, left ventricular hypertrophy was predictive, and on echocardiogram, increased left ventricular dimensions were predictive of adverse events. When combined with time to ischaemia on exercise testing in a simple clinically applicable table these factors could be used to predict of 2 year probability of events for an individual patient.

Adult↗
PubMed1990

The clinical utility of the roll-over test in predicting pregnancy-induced hypertension in a high-risk Andean population.

The utility of the roll-over test (ROT) as a prognostic tool for predicting pregnancy-induced hypertension (PIH) was examined in primiparas in Quito, Ecuador. In Study I, 14 of 16 subjects with a +ROT developed PIH (positive predictive value (PPV) = 88%); only 2 of 27 subjects with a -ROT developed PIH (negative predictive value (NPV) = 92.5%). In Study II (n = 66), the PPV and NPV were 71.4% and 78.6%, respectively. Data from these and previous studies indicate that although the ROT is not a perfect predictor, its advantages recommend usage in populations with high PIH-associated maternal and perinatal mortality.

Adolescent↗
PubMed2002

New rapid bed-side test to predict preterm delivery: phosphorylated insulin-like growth factor binding protein-1 in cervical secretions.

BACKGROUND: Phosphorylated insulin-like growth factor binding protein-1 (phIGFBP-1) is secreted by decidual cells and leaks into cervical secretions when fetal membranes detach from decidua. Our aim was to assess whether detection of phIGFBP-1 in cervical secretions by a rapid bed-side test could be used to predict preterm delivery in patients with regular uterine contractions. STUDY DESIGN: In our prospective study, 36 women between 20 and 36 weeks of gestation with regular, persistent contractions (> 10/h) and 18 women between 20 and 36 weeks gestation without symptoms of preterm labor were assessed for the presence of cervical phIGFBP-1. Dacron swabs were applied to the cervix and assayed in 5 min by using immunochromotography, a new rapid bed-side test (actim partus test, Medix Biochemica, Kauniainen, Finland). Data analysis included one-way variance analysis (ANOVA), Student's t-test, chi-square and Fisher's exact test. RESULTS: Of the 36 patients with regular uterine contractions, 18 had a positive actim partus test and 18 had a negative test. Among the 18 patients with a positive test, only one delivered term and the other 17 patients delivered preterm (< 37 weeks). Among the 18 women with a negative test, only two delivered preterm (p < 0.05). Mean gestational age at delivery for patients with a positive and a negative test was 34.4 +/- 3.0 and 37.9 +/- 2.3 weeks, respectively (p < 0.05). Sensitivity, specificity, positive and negative predictive values of the rapid phIGFBP-1 test for preterm delivery was 89.5, 94.1, 94.4 and 88.9%, respectively. For delivery < 37 weeks, positive likelihood ratio was 15.2 (+/- 95% CI; range 2.6-102.5). When cervical phIGBP-1 assay was used to predict delivery within 7 days, sensitivity, specificity, positive and negative predictive values were 93.8, 85%, 83.3 and 94.1%, respectively. Positive likelihood ratio with +/- 95% CI was 6.25 (range 2.2-17.8). When patients were categorized according to cervical dilatation, the positive likelihood ratio of the test when the cervix was closed at 2 cm were 8.3 (1.3-55.3), 13.6 (2-91.4), 15.8 (2.3-106.3) and 1.5 (0.2-11.5), respectively, CONCLUSION: The presence of cervical phIGFBP-1 is predictive of preterm delivery < 37 weeks of gestation. Our study shows that cervical detection of phIGFBP-1 by immunochromotography is a rapid and easily applicable test that highly anticipates preterm delivery in patients at risk.

Adult↗
PubMed1993

[Exercise test to predict postoperative complications in patients with impairment of pulmonary function].

We studied the prediction of postoperative complications in patients whose predicted postoperative FEV1.0% and/or %VC were below fifty. Preoperative exercise tests were performed in 88 cases mainly old patients of age or with impaired pulmonary function; 57 were lobectomies, 10 were bilobectomies and 21 were pneumonectomies. Predicted postoperative FEV1.0% and/or %VC were below fifty in 29 cases consisting of 12 lobectomies, one bilobectomy and 16 pneumonectomies. Among these 29 patients, thirteen suffered postoperative complications (A group) and sixteen did not (B group). All five cases of operative death (death within 30 days after operation) were included in the A group. The prediction of postoperative complications in cases of which pred. postope, FEV1.0% and %VC were fifty or over (C group) was also studied. The results were as follows; (1) The percentage of complications among A and B groups was higher than that among C group but no statistical difference could be found. (2) In the A group, the number of pred. postope. FEV1.0% and/or %VC had little correlation to complications. (3) Statistical differences between A and B group were found in submax VO2 (p < 0.05), VO2/VE at AT (p < 0.001) and VCO2/VE at submaximal exercise (p < 0.001). (4) Cardiac output ratio of maximal exercise to rest had marked correlation to complications (p < 0.001) in C group but had no correlation in the A and B groups. (5) The three items of A and B groups, submax VO2 < 500 ml/min/m2, VO2/VE at AT < 40 ml/l and submax VCO2/VE < 25 ml/l, showed high correlation to operative death (p < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1997

Uptake of genetic testing for cancer predisposition.

Although there has been much debate about the uptake and effects of predictive testing for common cancers, such as breast and colon cancer, little has been published on the more classical tumour predisposing conditions, such as von Hippel-Lindau disease and familial adenomatous polyposis. Since 1990 the genetics departments in Manchester and Cambridge have had a genetic register for cancer predisposing syndromes and presymptomatic testing for these conditions has been offered once this has become possible. To investigate the factors that might influence uptake of genetic testing in familial cancer syndromes we have reviewed our experience. Demand for predictive testing has generally been high, but men had a lower uptake (77%) than a comparable group of women (93%) (p < 0.01).

Adenomatous Polyposis Coli↗
PubMed1987

Usefulness of isoproterenol facilitation of ventricular tachycardia induction during extrastimulus testing in predicting effective chronic therapy with beta-adrenergic blockade.

Previous studies indicate that programmed extrastimulus testing (PES) during isoproterenol infusion facilitates induction of clinical ventricular tachycardia (VT) in some patients. This study attempts to determine if VT inducible only during isoproterenol infusion predicts suppression of VT with chronic oral beta-adrenergic blockade. Nine patients, aged 23 to 77 years, with symptomatic VT or syncope not necessarily provoked by exercise or stress were evaluated. Extrastimuli did not induce VT in any patient. However, during isoproterenol infusion (1 to 4 micrograms/min), all patients had reproducibly inducible VT corresponding to their spontaneously occurring VT (recordings available in 7 patients). Coupling intervals inducing tachycardia during isoproterenol were similar to intervals that did not induce VT without isoproterenol. No patient had VT with isoproterenol infusion alone (without extrastimuli). In only 4 of 8 patients who underwent exercise tests while not taking medications was VT provoked. With propranolol therapy (160 mg/day) or its equivalent, only 1 patient had recurrent symptoms during a mean follow-up of 39 months (range 23 to 52). VT inducible with extrastimuli only during isoproterenol infusion predicts that oral beta-adrenergic blockade will prevent spontaneous VT or syncope long term. These data suggest that occurrence of VT in some patients depends on premature depolarizations in the setting of beta-adrenergic influence.

Adrenergic beta-Antagonists↗
PubMedDate not supplied

Stable microbubble test for predicting the occurrence of respiratory distress syndrome.

To predict the development of respiratory distress syndrome (RDS) in premature neonates who might benefit from early administration of surfactant, the clinical applicability of stable microbubble (SM) test was prospectively evaluated. Fifty-nine preterm neonates with the gestational ages of less than 37 weeks were studied. SM test was performed on gastric aspirates obtained within 30 minutes after birth. The number of microbubbles was correlated with later development of RDS. With a cut-off value of less than 10 microbubbles/mm2, the SM test showed a positive predictive value of 76.0% (19/25) and a negative predictive value of 97.1% (33/34), while sensitivity and specificity were 95.0% (19/20) and 84.6% (33/39), respectively. The overall accuracy was 88.1% (52/59). It was concluded that use of the SM test on gastric aspirates immediately after birth is a rapid, simple and reliable procedure for identifying those neonates with surfactant deficiency who may benefit from prophylactic surfactant therapy.

Gastric Juice↗
PubMed2005

Utility of the Boston naming test in predicting ultimate side of surgery in patients with medically intractable temporal lobe epilepsy.

PURPOSE: Confrontation naming tasks have long been presumed to be sensitive to left temporal dysfunction and, consequently, are frequently used in the evaluation of surgical epilepsy patients. Despite wide and frequent use, few studies have examined the utility of confrontation naming tasks in individuals with temporal lobe epilepsy (TLE). METHODS: The current study examined the presurgical Boston Naming Test (BNT) performance of 217 right-handed adult patients with intractable TLE (left, 108; right, 109) to determine the utility of this measure in predicting ultimate side of surgery. RESULTS: The results support the clinical utility of the BNT in determining ultimate side of surgery and suggest that the BNT has incremental validity over and above presurgical delayed memory and intelligence scores. This relation was found to be moderated by Full Scale IQ (FSIQ), age at seizure onset, and duration of epilepsy. The use of a logistic regression equation to predict side of surgery revealed that prediction of left temporal surgery was best among patients with low BNT scores, high FSIQs, and late age at seizure onset. In contrast, right temporal surgery was best predicted among patients with high BNT scores, low FSIQs, and short duration of epilepsy. CONCLUSIONS: This study supports the clinical utility of the BNT in the preoperative evaluation of candidates for TLE surgery and highlights the importance of examining potential moderating variables when making predictions about side of surgery. This study further provides clinicians with a regression equation that can be used to predict side of surgery in patients with temporal lobe epilepsy.

Adolescent↗
PubMed1985

Usefulness of exercise stress testing for prediction of blood pressure trends.

The purpose of this study was to determine whether values of blood pressure during exercise help predict which adolescents are prone to maintain high blood pressure. Dynamic and isometric exercise stress tests were performed on 131 adolescents who had had systolic or diastolic pressures greater than the 95th percentile on three examinations the previous year. Follow-up blood pressures were measured 1 year after the stress testing, and outcomes were classified on the basis of the blood pressure status that year. Stepwise regression analysis was used to examine the association between earlier blood pressures and exercise pressures with outcome pressures. In both male and female adolescents, the average resting systolic pressure on the earlier survey was the best predictor of systolic pressure 2 years later. Blood pressures and heart rates during dynamic and isometric exercise did not significantly contribute to the models' prediction of future systolic or diastolic pressures. The data suggest that exercise stress testing is not a valid method for predicting youths whose blood pressures will remain elevated over the next 1 to 2 years.

Adolescent↗
PubMed2000

Usefulness of the QTc interval in predicting myocardial ischemia in patients undergoing exercise stress testing.

Prolongation of the QTc interval during stress testing predicts myocardial ischemia with a sensitivity of 88% and a specificity of 93%. Measurement of the QTc segment should be considered as an adjunctive electrocardiographic variable in the interpretation of stress tests and is even useful in patients who are not able to achieve the age-predicted target heart rate level.

Case-Control Studies↗
PubMed1982

Evaluation of a maximal predictive cycle ergometer test of aerobic power.

A maximal predictive cycle ergometer (CE) test for estimating maximal oxygen uptake (VO2 max) was evaluated in 15 male and 12 female subjects. The test consisted of pedalling a cycle ergometer (Monark) at 75 rev X min-1, beginning at an intensity of 37.5 watts and increasing by this amount each min until the subject could no longer maintain pedal rate. The highest work rate achieved was recorded as the endpoint of the test and used to construct regression equations to predict VO2 max. This was compared with two direct measures of VO2 max [an interrupted treadmill (TM) run and an interrupted CE procedure at 60 rev X min-1] and with the submaximal predictive test of Astrand-Rhyming. When compared to TM VO2 max, VO2 measured during the final 30 s of the maximal predictive CE test was 16.0% and 16.2% lower for males and females respectively; compared to VO2 max determined by the direct CE test, it was lower by 2.9% for males and 5.2% for females. Correlation coefficients for VO2 max predicted from the maximal predictive CE test and VO2 max measured directly by CE and TM were 0.89 and 0.87 for males and 0.88 and 0.83 for females (p less than 0.01), respectively. The VO2 max predicted from the Astrand-Rhyming test correlated significantly with VO2 max measured by CE and TM only in the male group. Test-retest reliability coefficients for intensity (watts) on the maximal predictive CE test were 0.95 and 0.81 for males and females respectively (p less than 0.01). The data suggest that this CE test gives a reliable and valid estimate of VO2 max.

Adult↗
PubMed1989

Failure of clinical tests to predict cerebral ischemia before neck manipulation.

A case report is presented of a patient with vertebral artery occlusion, demonstrated by digital subtraction angiography, in whom clinical tests designed to test for potential vertebrobasilar insufficiency were negative. The clinical tests used to examine our patient included the vertebrobasilar artery functional maneuver, the Smith and Estridge, Maigne's, Hautand's and Underberge's tests. This case report highlights the limited diagnostic value of these tests.

Adult↗