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At least 1,063 records · Page 59Linked to original sources
PubMed1996

Serum neuron-specific enolase, carnosinase, and their ratio in acute stroke. An enzymatic test for predicting outcome?

BACKGROUND AND PURPOSE: Few admission variables adequately predict neuronal damage and prognosis in individual patients after stroke. Therefore, there is a need for a reliable non-invasive surrogate measure of clinical outcome. METHODS: We have developed a surrogate measure of stroke outcome using the ratio of serum neuron-specific enolase (NSE) to human serum carnosinase (HSC) in 124 patients with acute ischemic or hemorrhagic stroke and 61 matched control subjects. Serum NSE is known to rise and HSC to fall after neuronal injury such as cerebral ischemia. RESULTS: Serum NSE levels were significantly higher and HSC levels lower in the patient group. The NSE/HSC ratio was elevated in patients with stroke: median (semiquartile) hemorrhages, 0.072 (0.033); infarcts, 0.039 (0.026); and control subjects, 0.019 (0.014), P = .0001. Patients with a primary intracerebral hemorrhage had nonsignificantly higher ratios than those with an infarct (P = .082). The NSE/HSC ratio was significantly associated with 90-day outcome measured in two out of three disability and handicap scales: modified Barthel Index (rs = -.34, P = .001), modified Rankin Scale (rs = .30, P = .002), and Lindley Score (rs = .19, P = .057). Patients who died or were institutionalized had higher ratios than those who were discharged home: 0.069 (0.043) versus 0.038 (0.024), P = .011. Correlations between the NSE/HSC ratio and outcome were comparable to those between patient age or consciousness level on admission and clinical outcome. CONCLUSIONS: We believe that measurement of NSE, HSC, or their ratio may be useful in the assessment of patients with acute stroke with respect to diagnosis and prediction of clinical outcome.

Acute Disease↗
PubMed1986

Thyrotropin-releasing hormone and gonadotropin-releasing hormone test to predict effectiveness of bromocriptine therapy in infertile women.

Sixty-four infertile women presenting with luteal phase defect, anovulatory cycle, and secondary amenorrhea were compared with 15 normal cycling women with bolus injections of thyrotropin-releasing hormone (TRH) and gonadotropin-releasing hormone (GnRH) before bromocriptine (BCPT) therapy. All of the women had normal baseline prolactin (PRL), luteinizing hormone (LH), and follicle-stimulating hormone (FSH) concentrations. Responses of PRL, LH, and FSH levels were measured. PRL responses in BCPT responders were markedly greater than in controls and nonresponders. A better responder rate to BCPT therapy was observed in patients with apparent (88.9%) or borderline (69.2%) exaggerated responses of PRL to TRH than in normal patients (41.7%). Further, in patients with normal PRL responses, the inappropriately enhanced LH responses were seen in BCPT responders but not in nonresponders. These findings suggest that TRH and GnRH tests are worthwhile in predicting the outcome of BCPT therapy in infertile patients.

Adult↗
PubMed2004

Ketamine-induced changes in rat behaviour: a possible animal model of schizophrenia. Test of predictive validity.

Previously, it was shown that subchronic application of the NMDA receptor antagonist ketamine (Ket) induces schizophrenia-related alterations, e.g. decreased non-aggressive behaviour in the social interaction test, which might be a useful animal model in the study of negative symptoms of this disease. In order to further evaluate the predictive validity of this model, the anxioloytic diazepam, the classic neuroleptic haloperidol and the atypical neuroleptics clozapine and risperidone were tested after acute and subchronic treatment. The experiments demonstrated that haloperidol did not normalise the behavioural effects of Ket. After acute administration, diazepam was ineffective in control animals but increased non-aggressive behaviour in Ket-treated animals. Similar effects were found in animals injected with either clozapine or risperidone. Twenty-four hours after discontinuation of subchronic treatment with both substances, there was an increase in the percentage of non-aggressive behaviour in the ketamine group and a decrease in the control animals. This decrease was explained in terms of withdrawal. Different effects in the control groups and the Ket groups were found when the test was performed 1 h after subchronic clozapine or risperidone treatment. The data suggest that atypical antipsychotic drugs (APD) effectively counteract Ket-induced alterations in social behaviour. Regarding false-positive effects by anxiolytic drugs without antipsychotic efficacy, this model may have some predictive validity for identifying anxiolytic effects of novel antipsychotic compounds.

Analysis of Variance↗
PubMed1995

What is the best test to predict outcome after prolonged cardiac arrest?

Multimodality evoked potentials (EPs), linear electroencephalograms and Glasgow Coma Scale (GCS) scores were recorded within 24 h of cardiac arrest in 62 patients who were comatose following cardiopulmonary resuscitation. The cardiac arrest had a cardiac cause in 35 patients and a non-cardiac cause in 27 patients. The Glasgow Outcome Scale (GOS) scores were established 6 months after resuscitation. The prognostic value of all the recorded variables was calculated in terms of sensitivity, specificity and accuracy. Spearman's rank test was also used for the determination of the correlation coefficients with GOS. EP recordings furnished no falsely pessimistic predictions, with a specificity of 100%. In other words, when EPs were altered, the prognosis was always poor. However, while all patients who regained consciousness had normal EPs, not all patients in whom EPs were recordable survived. The GCS score showed a higher sensitivity and correlation with GOS score than EPs, but it was associated with a high percentage of false positive results, and its specificity was only 67%. The combination of the GCS score with EPs may be a promising strategy to counterbalance the respective limits of these methods and to reduce the loss of information due to sedation and myorelaxation, which impede clinical examination but not EP results.

Adolescent↗
PubMed1986

Value of physical and pharmacological tests in predicting intrinsic and extrinsic sick sinus syndrome.

We studied 13 patients with sick sinus syndrome using various physical (postural reflex testing. Valsalva manoeuvre, carotid sinus massage), pharmacological (intravenous isoprenaline, atropine, neostigmine and total autonomic blockade) and electrophysiological tests in order to identify simple non-invasive markers of intrinsic sick sinus syndrome. Following autonomic blockade, 6 patients had normal and the remaining 7 had an abnormal intrinsic heart rate. Electrophysiological testing revealed abnormal sinus node parameters in 8 (62%) subjects in the basal state and 11 (85%) after autonomic blockade. Carotid sinus massage was abnormal in all patients (100%) with an abnormal intrinsic heart rate, and in only 2 of the 6 (33%) with normal intrinsic heart rate (P less than 0.05). The heart rate response to isoprenaline was abnormal in 5 of the 6 (83%) patients with normal as compared to only 1 of the 7 with abnormal intrinsic heart rate. With isoprenaline there was a significantly (P less than 0.05) higher increase in heart rate in patients with abnormal as compared to those with normal intrinsic heart rate. The other physical and drug tests were not helpful to differentiate between intrinsic and extrinsic mechanisms. Thus, carotid sinus massage and, to some extent, isoprenaline administration appear simple bedside tests which may be helpful in identifying the underlying mechanism of sick sinus syndrome.

Adult↗
PubMed2005

Combined use of field and laboratory testing to predict preferred flow paths in an heterogeneous aquifer.

Elevated nitrate concentrations within a municipal water supply aquifer led to pilot testing of a field-scale, in situ denitrification technology based on carbon substrate injections. In advance of the pilot test, detailed characterization of the site was undertaken. The aquifer consisted of complex, discontinuous and interstratified silt, sand and gravel units, similar to other well studied aquifers of glaciofluvial origin, 15-40 m deep. Laboratory and field tests, including a conservative tracer test, a pumping test, a borehole flowmeter test, grain-size analysis of drill cuttings and core material, and permeameter testing performed on core samples, were performed on the most productive depth range (27-40 m), and the results were compared. The velocity profiles derived from the tracer tests served as the basis for comparison with other methods. The spatial variation in K, based on grain-size analysis, using the Hazen method, were poorly correlated with the breakthrough data. Trends in relative hydraulic conductivity (K/K(avg)) from permeameter testing compared somewhat better. However, the trends in transient drawdown with depth, measured in multilevel sampling points, corresponded particularly well with those of solute mass flux. Estimates of absolute K, based on standard pumping test analysis of the multilevel drawdown data, were inversely correlated with the tracer test data. The inverse nature of the correlation was attributed to assumptions in the transient drawdown packages that were inconsistent with the variable diffusivities encountered at the scale of the measurements. Collectively, the data showed that despite a relatively low variability in K within the aquifer under study (within a factor of 3), water and solute mass fluxes were concentrated in discrete intervals that could be targeted for later bioremediation.

Cities↗
PubMed1997

Familial neuroendocrine tumors as a model of hereditary cancer.

Familial neuroendocrine tumors are reviewed. The most dramatic advances have been in the application of molecular genetic techniques to define the affected genes and to develop predictive testing for patients with multiple endocrine neoplasia syndromes. Germline mutations at specific loci of the RET proto-oncogene have been demonstrated in patients with multiple endocrine neoplasia types IIA, IIB, and familial medullary thyroid carcinoma not associated with multiple endocrine neoplasia. This has led to direct DNA testing for these mutations in patients at risk for these syndromes. The approach to predictive testing, diagnosis, and early treatment of these patients is discussed as a model for the approach to hereditary cancers. Linkage testing with DNA markers is still required for patients with multiple endocrine neoplasia type I because the responsible gene has not yet been isolated. Efforts to clarify the etiologies of other familial neuroendocrine tumors not associated with multiple endocrine neoplasia continue. Familial pheochromocytoma, neuroblastoma, and carcinoid also are reviewed. The use of molecular genetic techniques as a powerful tool for the early identification and treatment of susceptible individuals is emphasized.

Algorithms↗
PubMed1982

"Outcome-counting'-Significance tests from incomplete predictions of order.

Experiments testing models usually predict that some treatment effects will be greater than others, but they do not as a rule feel able to predict the exact ordering of treatment effects. A useful significance test for such incomplete order predictions can be obtained by comparing the number of possible outcomes (orderings) with the number that satisfy the predictions. The difficulty is to count the outcomes satisfying the predictions, which can be a lengthy task if there are many treatments. A straightforward method of outcome-counting is derived from simple algebra and examples of its use are given.

Humans↗
PubMed1999

Noninvasive diagnosis in patients with undocumented tachycardias: value of the adenosine test to predict AV nodal reentrant tachycardia.

INTRODUCTION: Patients with symptoms suggestive of paroxysmal supraventricular tachycardia (PSVT) but no tachycardia documentation often undergo diagnostic electrophysiologic study. In dual AV node physiology with AV node reentrant tachycardia (AVNRT), the anterograde fast pathway is more sensitive than the slow pathway to the effects of adenosine. The purpose of the study was to test the hypothesis that adenosine can be used as a bedside test for the diagnosis of dual AV node physiology and hence for AVNRT. METHODS AND RESULTS: During electrophysiologic study, 37 patients without prior documentation but symptoms indicative for PSVT received incremental dosages of adenosine during sinus rhythm until second-degree or greater AV block was observed. Suggestive signs of dual AV node physiology on the surface ECG (sudden jump of PQ interval > or = 50 msec) were found in 13 (76%) of 17 patients with inducible AVNRT but in only 1 (5%) of the remaining patients (P < 0.01). In the AVNRT group, the maximal increase of the PQ interval between two beats was greater (88+/-45 msec) than in the remaining 20 patients (17+/-11 msec) (P < 0.01). CONCLUSION: Careful evaluation of surface ECG during administration of adenosine helps to identify patients prone to AVNRT. The adenosine test is a valuable noninvasive adjunct in patients with undocumented palpitations suggestive of PSVT.

Adenosine↗
PubMed1996

The role of functional respiratory tests in predicting pneumothorax during lung needle biopsy.

In 243 of 945 patients having lung percutaneous needle biopsy, we retrospectively evaluated 10 independent variables that potentially influence the incidence of pneumothorax (PNX): age, sex, lesion size, number of needle passes, needle intrapulmonary route, distance of the lesion from the chest wall, FEV1, FVC, residual volume, and total lung capacity percent predicted. The subjects considered (mean age, 61 years; 192 men and 51 women) performed respiratory function tests within 1 year of the procedure. The sample was also subdivided into four functional groups: restricted patients, obstructed ones, obstructed with alveolar hyperinflation patients, and normal subjects. The variables significantly correlated to PNX were the length of the needle intraparenchymal route (p<0.05) and the distance of the lesion from chest wall greater than 0 cm (p<0.01). None of the functional parameters was determinant in predicting PNX occurrence. Bronchial obstruction was not significantly associated with a higher risk of PNX. Nevertheless, when alveolar hyperinflation was associated with bronchial obstruction, the risk increased significantly (odds ratio, 2.38).

Aged↗
PubMed1995

[Emergency assessment in the hospital: the ability of early diagnostic tests to predict short-term prognosis, progression of infarct, hemorrhagic conversion and cerebral edema].

Acute stroke should be assessed by a specialist on an emergency basis. This article reviews the ability of clinical data and the results of diagnostic tests performed within 6 hours of onset to predict short-term prognosis, neurological deterioration, hemorrhagic transformation of the infarct and cerebral edema. Scores on neurological deficit scales, early signs of infarct on cranial computerized tomography, biochemical parameters such as glycemia, and the characteristics of vascular occlusion on Doppler ultrasonography or angiography are good predictors of acute phase complications and can be used to help identify patients that might benefit from new stroke therapies.

Brain Edema↗
PubMed1996

Sonographic endometrial thickness: a useful test to predict atrophy in patients with postmenopausal bleeding. An Italian multicenter study.

Eighteen centers took part in this prospective study into which 930 eligible patients were recruited. The selection criteria for admission were atypical bleeding after at least 6 months of postmenopausal amenorrhea, and absence of hormonal therapies for at least 6 months. The sonographic measurement of the maximum bi-endometrial thickness was made in a longitudinal plane. Sonographic measurements were always performed within 3 days prior to histological evaluation. In these patients the mean number of years from menopause (25-75th centile) was 6 (range 2-16). The prevalence of endometrial carcinoma was 11.5% and the prevalence of atrophy was 49.2%. The area under the receiver operator characteristic curves generated by sonographic thickness measurements reached the level of 85%, both for cancer and atrophy. The likelihood ratio for cancer, yielded by an endometrial thickness of < or = 4.0 mm, was 0.05, and for atrophy it was 7.1. This cut-off of > 4.0 mm yielded a sensitivity for the detection of cancer of 98% and a negative predictive value of 99%. The overall sensitivity and positive predictive value for atrophy achieved by this cut-off were 57.2% and 87.3%, respectively. A multivariate logistic model showed that age and body mass index were independent variables associated with a significantly higher risk of endometrial cancer. The post-test probabilities for cancer and atrophy were recalculated on the basis of the integration of age, body mass index and endometrial thickness. The estimated reduction of invasive procedures on the basis of this integration was 31%. Transvaginal sonographic measurement of endometrial thickness, integrated with individual risk factors, can help in the management of postmenopausal patients with atypical bleeding, with regard to either the need for histological evaluation in high risk cases, or the choice of possible expectant management. We have shown that an endometrial thickness of < or = 4.0 mm safely predicts endometrial atrophy and justifies expectant management when the patient understands the need for proper follow up. This could be achieved with a reduction in the use of invasive procedures without unwanted delay in cancer diagnosis.

Aged↗
PubMed2004

Use of sorption and extraction tests to predict the dynamics of the interaction of trace elements in agricultural soils contaminated by a mine tailing accident.

Over 2000 ha of agricultural soils were contaminated by a pyritic sludge and acidic waste waters coming from a spill from a mining exploitation. The affected soils were acidic with sandy-loam texture (SL), loamy with neutral pH (L), and calcareous, saline, with clay texture (Cs). The Cs soils were contaminated only with acidic waste waters. Sorption and extraction tests were applied to examine the medium-term dynamics of the interaction of trace elements (As, Cd, Cu, Pb and Zn) in the soils. The solid-soil solution distribution coefficient (KD) was determined in soil samples taken 3 months (initial stage, 3M samples) and then nearly 2 years (final stage, 21M samples) after the accident. Distribution coefficient values ranged from the lowest values in the SL samples (from 0.2 l kg(-1) for Cd and Zn to 25 l kg(-1) for As) to higher values in the L and Cs soils. Lead and As had the highest KD in all soils (over 10(5) l kg(-1) in the L soils). No clear dynamics pattern could be derived from these data because of the low heavy metal concentrations in the soil solution. As a complementary approach, four single extractions (0.01 and 1 mol l(-1) CaCl2; 0.05 mol l(-1) EDTA; 0.43 mol l(-1) CH3COOH) were applied to soil and sludge samples. Samples derived from submitting field 3M samples to drying-wetting (DW) cycles were included to define a complete laboratory approach to predict field dynamics. Results from extraction tests indicated that changes of the trace element interaction over time depended on the soil pH and on the source of contamination. For those soils affected only by the acidic waste waters, where an increase in fixation occurred, natural processes such as diffusion controlled dynamics. For those soils contaminated by a mixed source, the dynamics of the interaction was the resultant process of the combination of the natural attenuation and the oxidation of the pyritic sludge. This latter process led to an increase in the remobilization for those elements associated with soluble secondary minerals (Cd and Zn) and to an increase in the fixation for those elements coprecipitating with insoluble secondary minerals (Pb and As). Drying-wetting cycles were useful to predict the dynamics in the field at month-year scale. The CH3COOH was recommended as the best test among those studied here to derive conclusions about dynamics pattern because it provided significant desorption yields in most scenarios. Acidic soils with sludge contamination represented the scenarios with the highest risk, while calcareous soils better attenuated contamination. In a longer time scale, the depletion of calcareous components needs to be controlled.

Journal Article↗
PubMed2003

A new stressed test to predict the foreign matter formation of minodronic acid in solution.

A formulation containing 0.5 mg/ml minodronic acid, 40 mM citrate, pH 4.5, and sodium chloride, stored in regular flint glass ampoules, was stable without particulate increase under high temperature conditions, such as 40 degrees C for 6 months, or 50 or 60 degrees C for 3 months. However, when stored at 25 degrees C, there was an increase in >or=2 microm particles at the 5-month timepoint. This demonstrated that long-term stability cannot simply be predicted by the evaluation of samples just stored at higher temperatures. Therefore, a new stressed test was designed which is useful in the rapid selection of formulations that are stable and without particulate increase. Since the particulate matter is apparently a complex of minodronic acid and aluminum ions leaching from ampoules, samples were placed at 80 degrees C for up to 4 weeks to accelerate aluminum leaching. Although no particulate increase was observed directly after storage at 80 degrees C, 4 freeze-thaw cycles following the storage caused a drastic particulate increase. The evaluation of samples subjected to the freeze-thaw cycles indicated that the following formulation modifications have inhibitory effects on particulate generation: (1). addition of meglumine, diethanolamine, mannitol, or glycerol to the formulation; (2). increase of citric acid concentration; (3). decrease of minodronic acid concentration. These modifications also worked well for samples stored at 25 degrees C for 6 months, and particulate increase did not occur. This method is a powerful tool for predicting the stability of minodronic acid in solution.

Diphosphonates↗
PubMed1981

Using a battery of tests to predict suicide in a long-term hospital: a quantitative analysis.

Examined the Wechsler-Bellevue, Rorschach, TAT and Word Association Tests of 40 Patients for quantitative indications of suicide potential. Ten of these patients had completed suicide, 10 "serious" attempts, 10 "mild" attempts and 10 had never made a suicide attempt. In addition to a study of the quantification of major aspects of the tests, various published hypotheses also were examined. No quantitative aspect of the data differentiated all four groups. When the "completed" and "serious" attempters were compared to the "mild" and "no" attempters, the more lethal patients were found to give more movement responses and more total responses. Those who completed suicide also had a larger difference than others between their Verbal and Performance IQs. Of the published hypotheses, only the Roth & Blatt and Sapolsky hypotheses received significant support.

Hospitals, Psychiatric↗
PubMed1985

Dexamethasone suppression test in predicting response to tricyclic antidepressants in depressed outpatients.

75 outpatients who presented to an affective disorder clinic received the dexamethasone suppression test (DST). Following 1 week observation, and following 1 week on low-dose imipramine HCl, all patients who remained depressed (Hamilton score 16 or greater) were given a full clinical trial of imipramine HCl (150-300 mg/day) over a minimum 3- to 5-week period. Of the 45 patients who required this trial and who received imipramine HCl for at least 3 weeks, there was no relationship between DST suppression or nonsuppression vs. clinical response to imipramine HCl. There was a statistically significant trend for suppressors (negative DST) to respond either spontaneously or to low-dose imipramine HCl as opposed to nonsuppressors (positive DST).

Depressive Disorder↗