[Value of the systolic delay time index and height-width index in comparison with pulsatility index].
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Arterial Occlusive Diseases↗
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Dysfunction of the masticatory system and the mutilated dental arch: anamnestic index, dysfunction index and occlusal index before restorative and prosthetic treatment.
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Adult↗
Benign prostatic hyperplasia specific health status measures in clinical research: how much change in the American Urological Association symptom index and the benign prostatic hyperplasia impact index is perceptible to patients?
PURPOSE: We assessed the relationship between changes in scores for the American Urological Association (AUA) symptom index and benign prostatic hyperplasia (BPH) impact index with patient global ratings of improvement in a large Veterans Affairs trial comparing different pharmacological therapies for BPH. MATERIALS AND METHODS: The primary analyses compared absolute score changes from baseline with global ratings of improvement at 13 weeks for 1,218 men. RESULTS: Subjects who rated themselves as being slightly improved had a mean decrease in AUA symptom index and BPH impact index scores of 3.1 and 0.4 points, respectively. However, the baseline scores strongly influenced this relationship. CONCLUSIONS: These data provide guidance for investigators using the AUA symptom index and BPH impact index as outcome measures.
Health Status↗
Prognostic significance of DNA ploidy and proliferative index (MIB-1 index) in gastrointestinal stromal tumors.
The DNA content and proliferative index of 61 gastrointestinal stromal tumors (GIST) were measured by image analysis and correlated with the lesion's clinicopathological features and patient's survival. DNA analysis was performed on cytospin single-cell preparations obtained from the paraffin-embedded tissue blocks. MIB-1 was the proliferation marker used on paraffin sections. DNA aneuploidy was detected in 12 tumors (18%), and high MIB-1 index (>22%) in 12 lesions (18%). DNA aneuploidy and high MIB-1 index statistically correlated with high mitotic rate (> or = 5 x 10 high-power field [HPF]) (P < .001) and with the presence of necrosis (P < .05). The patient's survival was significantly correlated with DNA ploidy (P < .01), MIB-1 index (P < .00001), mitotic rate (P < .00001), presence of necrosis (P < .0001), and size of the tumor (P < .01). Multivariate regression analysis showed that only MIB-1 index was an independent parameter in predicting the clinical outcome for patients with GIST. The mitotic rate was the only other independent prognostic factor when MIB-1 index was not allowed to enter the model.
Adult↗
EEG-based indices of anaesthesia: correlation between bispectral index and patient state index?
BACKGROUND AND OBJECTIVE: Both the bispectral and the patient state indices are derived from the electroencephalogram and have been proposed as a measure of the same clinical target, the hypnotic component of anaesthesia. The present study evaluated whether there is concordance between the bispectral and the patient state indices with regard to end-points measured simultaneously in patients undergoing surgery under general anaesthesia. METHODS: Fifty-seven patients scheduled for elective abdominal, orthopaedic (Groups 1 and 2) or cardiac surgery (Group 3) under general anaesthesia were enrolled in the study. Anaesthesia was performed using remifentanil/ sevoflurane (Group 1, 19 patients), remifentanil/propofol (Group 2, 19 patients) or sufentanil/propofol/isoflurane (Group 3, 19 patients). The bispectral and the patient state indices were simultaneously recorded. Pearson's correlation between these two indices was calculated for the complete data and each group. The percentage of bispectral index values in the recommended range for general anaesthesia (45-60) that were confirmed by levels of patient state index (25-50) was calculated and vice versa. RESULTS: Overall correlation between the bispectral and the patient state indices was 0.667, 0.671 in Group 1, 0.650 in Group 2 and 0.675 in Group 3 (P < 0.01). For values of the bispectral index between 45 and 60, only 40% of corresponding patient state index values were between 25 and 50. For patient state index values of 25-50, only 50% of the corresponding bispectral index values were in the range of 45-60. CONCLUSIONS: Concordance between the bispectral and patient state indices is relatively weak, whereas both are thought to reflect the same clinical target, the hypnotic component of anaesthesia. As a consequence, further studies are required to compare reliability of both indices as indicators of different levels of hypnosis.
Adolescent↗
Structural interpretation of a topological index. 1. External factor variable connectivity index (EFVCI).
The external factor variable connectivity index (EFVCI) is interpreted by mining out the structural features hidden in the space spanned by the EFVCI indices through projection pursuit combining with number-theory net (NT-net) on the unit sphere U(Us). Projection pursuit is concerned with "interesting" projections of high-dimensional data sets to machine-pick "interesting" low-dimensional projections of a high-dimensional point cloud by numerically maximizing a certain objective function or projection index. At first, the optimal EFVCI index reaches to -0.80 in the correlation with a retention index of 207 hydrocarbons produced by insects. The EFVCI indices, with regression results of R = 0.99998, s = 3.49, RMSECV = 3.90, and F = 7.9560e+005, obtain high regression quality. The model is proven valid by leave-one-out cross validation. Second, the EFVCI index is interpreted by the structure information, that is, size, branch number, graph center, and branching position of topological structures, which is searched out on the unit sphere U(Us) by projection pursuit. Finally, the interpretation information is used to discover some chemical knowledge concerning the variation of the retention index with the change in chemical structures.
Journal Article↗
The population RDH index: a novel vector index and graphical method for statistical assessment of antihypertensive treatment reduction, duration, and homogeneity.
Current indices used in the evaluation of antihypertensive treatment duration and homogeneity such as the trough-peak, smoothness index, and normalized smoothness index were designed to be applied to ambulatory blood pressure monitoring recordings from individual participants. Evaluation of antihypertensive treatment in populations is often carried out by calculating these individual indices for each of the participants and providing summarizing statistics about the population, such as the mean and median. We describe a new population vector index and graphical method for the statistical assessment of antihypertensive treatment reduction, duration, and homogeneity (RDH) from ambulatory blood pressure monitoring. The population (RDH) was specifically designed as a tool to evaluate and compare blood pressure coverage offered by antihypertensive drugs over 24 h in populations. The population RDH is a three-component vector index that incorporates information about the reduction, duration, and homogeneity of antihypertensive treatment, as well as their statistical significance over the 24 h period. In addition to defining the RDH index, in this paper we also demonstrate its usefulness and advantages as an index and graphical method for antihypertensive treatment duration and homogeneity assessment by using it to analyze two data sets.
Adult↗
Assessment of long-term physical function in acute respiratory distress syndrome (ARDS) patients: comparison of the Charlson Comorbidity Index and the Functional Comorbidity Index.
OBJECTIVE: It is often important to adjust for the effect of comorbid diseases on patient outcomes. This study compares the association between physical function in acute respiratory distress syndrome patients with scores on two comorbidity indices, the Charlson Comorbidity Index, designed to predict mortality, and the Functional Comorbidity Index (FCI), which was designed to predict physical function. DESIGN: This is a prospective, longitudinal, observational study. A total of 73 survivors of acute respiratory distress syndrome were contacted at 3, 6, and 12 mos. Patient comorbidity was evaluated with the Charlson Comorbidity Index and the FCI. Physical function was measured using the Medical Outcomes Study 36-Item Short Form Health Survey Physical Function Subscale and the Physical Component Subscale scores. RESULT: Mean FCI and Charlson Comorbidity Index scores correlated fairly strongly (Spearman rho = 0.62, P < 0.001). FCI, but not the Charlson Comorbidity Index, scores correlated with the Physical Function Subscale and Physical Component Subscale scores. After controlling for other potentially confounding variables such as age and severity of illness through regression analysis, the FCI score was still significantly associated with both Physical Function Subscale and Physical Component Subscale scores. CONCLUSIONS: The FCI is a better method of measuring comorbidity with physical function as the outcome. This study illustrates the importance of choosing the most appropriate comorbidity index for the outcome of interest.
Activities of Daily Living↗
Index profiling of anisotropic graded-index planar waveguides from effective indices.
We present a method for recovering the refractive-index profile of an anisotropic graded-index waveguide from the effective indices by using a cubic spline interpolation function. The first and second derivatives of cubic splines are continuous to ensure a smooth index profile, which is consistent with practical graded-index distributions. A straightforward iteration with an exact dispersion equation to verify the interpolated profile makes this method easy and reliable for application. This approach is proved by numerical analysis of several typical index distributions and experimental examples showing that the refractive-index profiles in anisotropy can be reconstructed close to the exact profile. Waveguides with both more modes (more than four guiding modes) and fewer modes (two to four) can be universally profiled with good accuracy.
Journal Article↗
[Significance of MIB-1 labeling index and TUNEL labeling index in papillary carcinoma].
Papillary carcinomas, which comprise more than 80% of all thyroid gland cancers, are generally regarded as slow-growing tumors with relatively good prognosis. Histologically and pathologically, there is a close relationship in papillary carcinoma between differentiation and the clinical picture, particularly progress and prognosis, However, tumors with the same degree of differentiation may have very different growth rates. Therefore, it is important that we have some clinical indicator, in addition to differentiation, for projecting clinical prognosis, including the likelihood of postoperative recurrence, and for planning follow-up care. In this study, we used paraffin embedded specimens obtained from 40 cases of papillary carcinoma and assessed the proliferative ability of the tumor with MIB-1 staining. Moreover, in 28 of the 40 cases we used TUNEL staining to study apoptosis in cancer cells, then correlated these two indicators with known information about the clinical pathology and prognosis. The degree of differentiation and intensity of the MIB-1 labeling index correlated almost exactly. Some well-differentiated papillary carcinomas stained heavily with MIB-1. In fact, in all cases of postoperative recurrence the carcinomas were well differentiated, and over half of those showed strong MIB-1 staining. The difference between the MIB-1 labeling index for recurring cancers and non-recurring cancers was statistically significant. In contrast, there was no correlation between the TUNEL labeling index and clinical pathology or postoperative recurrence. However, in cases of well-differentiated papillary carcinoma with anaplastic reversion in the recurrence, the TUNEL labeling index was particularly low at the time of the first operation. This indicates that for the purpose of patient follow-up, an extremely low TUNEL labeling index may be an important piece of information. We also believe that the MIB-1 labeling index is another indicator of potential postoperative recurrence.
Adult↗
The performance of electroencephalogram bispectral index and auditory evoked potential index to predict loss of consciousness during propofol infusion.
UNLABELLED: The bispectral index (BIS) of the electroencephalogram and middle latency auditory evoked potentials are likely candidates to measure the level of unconsciousness and, thus, may improve the early recovery profile. We prospectively investigated the predictive performance of both measures to distinguish between the conscious and unconscious state. Twelve patients undergoing lower limb orthopedic surgery during regional anesthesia additionally received propofol by target-controlled infusion for sedation. The electroencephalogram BIS and the auditory evoked potential index (AEPi), a mathematical derivative of the morphology of the auditory evoked potential waveform, were recorded simultaneously in all patients during repeated transitions from consciousness to unconsciousness. Logistic regression procedures, receiver operating characteristic analysis, and sensitivity and specificity were used to compare predictive ability of both indices. In the logistic regression models, both the BIS and AEPi were significant predictors of unconsciousness (P < 0.0001). The area under the receiver operating characteristic curve for discrete descending index threshold values was apparently, but not significantly (P > 0.05), larger for the AEPi (0.968) than for the BIS (0.922), indicating a trend of better discriminatory performance. We conclude that both the BIS and AEPi are reliable means for monitoring the level of unconsciousness during propofol infusion. However, AEPi proved to offer more discriminatory power in the individual patient. IMPLICATIONS: Both the bispectral index of the electroencephalogram and the auditory evoked potentials index are good predictors of the level of sedation and unconsciousness during propofol infusion. However, the auditory evoked potentials index offers better discriminatory power in describing the transition from the conscious to the unconscious state in the individual patient.
Aged↗
[Nocturnal hypoxia index: a new pulse oxymetry index of nocturnal hypoventilation in neuromuscular disorders].
Respiratory insufficiency due to progressive muscle wasting is a major cause of death in various neuromuscular disorders. Morning headache and anorexia leading to slowly progressive body weight loss are frequently observed as initial symptoms of insufficient ventilation. From our experience nocturnal pulse oxymetry is a valuable study to detect early respiratory insufficiency and helpful to evaluate the effectiveness of ventilatory assistance, since ventilation is more impaired during sleep in early stage of respiratory insufficiency. Percent desaturation time (total desaturation time (SaO2 < or = 90%)/total sleep time) has been used as the most reasonable index of nocturnal hypoventilation. The criteria for introduction of nocturnal mechanical ventilation is 20% or more in Duchenne muscular dystrophy. Unfortunately, the earliest stage of hypoventilation cannot be detected by this index and it is of no use in advanced respiratory failure, because this index never exceeds 100% by definition. Here we propose a new index for nocturnal hypoventilation, which is defined as follows: nocturnal hypoxia index (NHI) = (% time of 95% > or = SaO2 > 90%) + (% time of 90% > or = SaO2 > 85%) x 2 + (% time of 85% > or = SaO2 > 80%) x 3 + (% time of 80% > or = SaO2 > 75%) x 4 + (% time of 75% > or = SaO2 > 70%) x 5.... This index is good for any stage of respiratory failure, and applicable to nocturnal hypoxia of other causes. The criteria for initiating mechanical ventilation in DMD can be substituted by "NHI is above 130."
Adult↗
The body-mass index, airflow obstruction, dyspnea, and exercise capacity index in chronic obstructive pulmonary disease.
BACKGROUND: Chronic obstructive pulmonary disease (COPD) is characterized by an incompletely reversible limitation in airflow. A physiological variable--the forced expiratory volume in one second (FEV1)--is often used to grade the severity of COPD. However, patients with COPD have systemic manifestations that are not reflected by the FEV1. We hypothesized that a multidimensional grading system that assessed the respiratory and systemic expressions of COPD would better categorize and predict outcome in these patients. METHODS: We first evaluated 207 patients and found that four factors predicted the risk of death in this cohort: the body-mass index (B), the degree of airflow obstruction (O) and dyspnea (D), and exercise capacity (E), measured by the six-minute-walk test. We used these variables to construct the BODE index, a multidimensional 10-point scale in which higher scores indicate a higher risk of death. We then prospectively validated the index in a cohort of 625 patients, with death from any cause and from respiratory causes as the outcome variables. RESULTS: There were 25 deaths among the first 207 patients and 162 deaths (26 percent) in the validation cohort. Sixty-one percent of the deaths in the validation cohort were due to respiratory insufficiency, 14 percent to myocardial infarction, 12 percent to lung cancer, and 13 percent to other causes. Patients with higher BODE scores were at higher risk for death; the hazard ratio for death from any cause per one-point increase in the BODE score was 1.34 (95 percent confidence interval, 1.26 to 1.42; P<0.001), and the hazard ratio for death from respiratory causes was 1.62 (95 percent confidence interval, 1.48 to 1.77; P<0.001). The C statistic for the ability of the BODE index to predict the risk of death was larger than that for the FEV1 (0.74 vs. 0.65). CONCLUSIONS: The BODE index, a simple multidimensional grading system, is better than the FEV1 at predicting the risk of death from any cause and from respiratory causes among patients with COPD.
Aged↗
Geriatric Nutritional Risk Index: a new index for evaluating at-risk elderly medical patients.
BACKGROUND: Patients at risk of malnutrition and related morbidity and mortality can be identified with the Nutritional Risk Index (NRI). However, this index remains limited for elderly patients because of difficulties in establishing their normal weight. OBJECTIVE: Therefore, we replaced the usual weight in this formula by ideal weight according to the Lorentz formula (WLo), creating a new index called the Geriatric Nutritional Risk Index (GNRI). DESIGN: First, a prospective study enrolled 181 hospitalized elderly patients. Nutritional status [albumin, prealbumin, and body mass index (BMI)] and GNRI were assessed. GNRI correlated with a severity score taking into account complications (bedsores or infections) and 6-mo mortality. Second, the GNRI was measured prospectively in 2474 patients admitted to a geriatric rehabilitation care unit over a 3-y period. RESULTS: The severity score correlated with albumin and GNRI but not with BMI or weight:WLo. Risk of mortality (odds ratio) and risk of complications were, respectively, 29 (95% CI: 5.2, 161.4) and 4.4 (95% CI: 1.3, 14.9) for major nutrition-related risk (GNRI: <82), 6.6 (95% CI: 1.3, 33.0), 4.9 (95% CI: 1.9, 12.5) for moderate nutrition-related risk (GNRI: 82 to <92), and 5.6 (95% CI: 1.2, 26.6) and 3.3 (95% CI: 1.4, 8.0) for a low nutrition-related risk (GNRI: 92 to < or =98). Accordingly, 12.2%, 31.4%, 29.4%, and 27.0% of the 2474 patients had major, moderate, low, and no nutrition-related risk, respectively. CONCLUSION: GNRI is a simple and accurate tool for predicting the risk of morbidity and mortality in hospitalized elderly patients and should be recorded systematically on admission.
Aged↗
Superior responsiveness of the pain and function sections of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) as compared to the Lequesne-Algofunctional Index in patients with osteoarthritis of the lower extremities.
OBJECTIVE: To compare the responsiveness of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and a questionnaire format of the Lequesne-Algofunctional Index in patients with OA of the lower extremities. METHODS: Longitudinal analysis of the instruments' responsiveness [standardized response mean (SRM), effect size (ES)] in ambulatory patients undergoing hip or knee arthroplasty. RESULTS: At six months 36, and at one year 40 out of 43 patients undergoing hip (N=30) or knee arthroplasty (N=13) could be examined. Both responsiveness statistics revealed the same order of responsiveness. For both indices and for both locations, the pain sections were more responsive than the function sections. However, the WOMAC scales and the WOMAC global index (hip at 12 months: SRM=2.4; knee at 12 months: SRM=2.0 ) were more responsive than the comparable Lequesne sections and Lequesne index (hip at 12 months: SRM=2.1; knee at 12 months: SRM=1.5). CONCLUSIONS: Although our results are based on a German version using a self-report format, the WOMAC scales appear to be more responsive than the Lequesne index in patients with OA of the lower extremities.
Adult↗
Discriminating ability of composite indices for measuring disease activity in rheumatoid arthritis: a comparison of the Chronic Arthritis Systemic Index, Disease Activity Score and Thompson's articular index.
OBJECTIVE: To compare the discriminating ability of the chronic arthritis systemic index (CASI), an index that uses the Health Assessment Questionnaire (HAQ) as the main variable, with the disease activity score (DAS) and Thompson's articular index (TAI) to detect high and low disease activity in rheumatoid arthritis (RA). METHODS: Two hundred and two RA patients were examined. According to criteria proposed previously, they were divided into two subgroups: those with active disease and those with low activity. The areas under receiver operating characteristic (ROC) curves were employed to assess the diagnostic accuracy of the CASI in comparison with the DAS and TAI for the discrimination of disease activity. RESULTS: The difference between areas under the ROC curves of the CASI and TAI (0. 897+/-0.023 vs 0.780+/-0.032) and between the DAS and TAI (0.933+/-0. 018 vs 0.780+/-0.032) was highly significant (P=0.0001), thus reflecting the accuracy of the diagnostic assessment. No difference arose between areas under the ROC curves of the CASI and the DAS (difference between areas=0.036+/-0.022; P=0.103). CONCLUSION: The CASI discriminates just as well between high and low disease activity as does the DAS. Either index consisting of more than one variable performs better than TAI. We conclude that even including the HAQ, a severity parameter in the long term, it is possible to construct an index that, at any time point, evaluates disease activity as well.
Adolescent↗
Homeostasis model assessment of insulin resistance, quantitative insulin sensitivity check index, and oral glucose insulin sensitivity index in nonobese, nondiabetic subjects with high-normal blood pressure.
To investigate the relationships between high-normal blood pressure (BP) and insulin resistance, we examined insulin sensitivity in 306 nonobese and nondiabetic Japanese subjects with various BP categories (optimal BP, normal BP, high-normal BP, and hypertension). Insulin sensitivity was measured from fasting plasma glucose and insulin values and those during a 75-g oral glucose tolerance test by five formulas: the homeostasis model assessment of insulin resistance (HOMA-R), the quantitative insulin sensitivity check index (QUICKI), the oral glucose insulin sensitivity (OGIS) index, and two insulin sensitivity indexes (ISI-composite and ISI-stumvoll). The HOMA-R was significantly higher, and the QUICKI was significantly lower in subjects with hypertension than in subjects with optimal BP. Both HOMA-R and QUICKI values showed that high-normal BP patients had a higher (but not significant) degree of insulin resistance than optimal BP patients. The OGIS index was significantly lower in subjects with high-normal BP or hypertension than in subjects with optimal BP. The ISI-composite was significantly lower in subjects with high-normal BP or hypertension than in subjects with optimal BP, and it was also significantly lower in subjects with hypertension than in subjects with normal BP. The ISI-stumvoll was significantly lower in subjects with high-normal BP or hypertension than in subjects with optimal BP. The OGIS index, ISI-composite, and ISI-stumvoll significantly decreased with increasing severity of BP status among the normotensive groups (optimal BP, normal BP, and high-normal BP). These findings indicate that insulin resistance is present even in the high-normal BP categories of nonobese and nondiabetic Japanese individuals.
Aged↗
[Effect of an obesity management program on body weight, body mass index and physiological index of high school girl students].
PURPOSE: This study was to examine the effect of an obesity management program on the body weight, body-mass index, and physiological index of obese female high school students. METHOD: Students from one school were selected as the experimental group, and students from another school as a control group so the latter group wasn't exposed to the experiment. The experimental group and the control group were each organized with 20 students. The experimental group received 60 minutes of behavior modification once a week, for eight weeks. RESULT: The Body weight, and Body mass-Index of the experimental group significantly decreased after the obesity management program. Total-cholesterol, T-G, and LDL-C significantly decreased and HDL-C increased in the experimental group. Total-cholesterol, T-G, LDL-C and HDL-C between the experimental group and control group showed significant differences. CONCLUSION: These results indicate that the obesity management program had a great effect on decreasing the body weight and body-mass index of the female obese high school students, normalizing their physiological index. In conclusion, this program turned out to be one of the safest and most effective obesity-management methods that could be applied to female high school students.
Adolescent↗