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PubMed1991

Aspirin injection test to predict angioplasty outcome in unilateral renovascular hypertension: preliminary report.

We examined the usefulness of aspirin DL-lysine for prediction of the outcome of renal artery angioplasty in renovascular hypertension. The study was carried out in eight hypertensive patients with unilateral renal artery stenosis: six were free from azotemia and two had slight azotemia. Before and 30 min after an intravenous injection of aspirin DL-lysine (18 mg/kg), renal venous and abdominal aortic plasma was sampled and assayed for prostaglandin E2 and plasma renin activity. Blood pressure and heart rate were serially measured at this time. Renal angioplasty was later performed and was technically successful in all patients. In the six patients without azotemia, aspirin inhibited renal prostaglandin E2 synthesis and suppressed renin release from the ischemic kidney, resulting in lowered blood pressure. Renal angioplasty caused plasma renin activity to become normal and lowered high blood pressure. The reduction in blood pressure by angioplasty was correlated with the responses of blood pressure and renin release to aspirin. However, in the two patients with azotemia, aspirin neither suppressed renin release nor lowered blood pressure. Their hypertension was not reduced by the angioplasty. These results indicate that an aspirin injection test could be useful for prediction of the outcome of angioplasty in unilateral renovascular hypertension.

Adult↗
PubMed1988

Huntington's disease: prediction and prevention.

The identification of a DNA restriction fragment length polymorphism closely linked to Huntington's disease on the short arm of chromosome 4 has for the first time allowed presymptomatic prediction to be undertaken in first-degree relatives at risk. The late and variable onset of this dominantly inherited disorder makes such prediction a powerful and potentially valuable aid in genetic counselling, but in the absence of effective therapy there are serious ethical reservations concerning such a predictive test. The new developments have stimulated an active and informative debate among professionals and family members on whether and how predictive tests should be used. Guidelines have emerged which should be useful not only for Huntington's disease, but for other serious late-onset neurogenetic disorders. Meanwhile, studies in Wales and elsewhere have not only confirmed the original linkage but have excluded multi-locus heterogeneity as a significant problem. Genetic prediction for the individual at risk remains critically dependent on a suitable family structure, present in only a minority of families in Wales. A more feasible alternative for most families is prenatal exclusion, which can allow risk prediction for a pregnancy without altering the situation for the person at risk. This approach has already been applied in Wales; the experience gained will be useful in full prediction, which is currently being introduced.

Female↗
PubMedDate not supplied

Simple blood tests can predict compensated liver cirrhosis in patients with chronic hepatitis C.

BACKGROUND/AIMS: Twenty to fifty percent of patients with chronic hepatitis C virus infection will insidiously progress to cirrhosis after 10-20 years' follow-up. The aim of this study is to retrospectively evaluate the role of simple non-invasive blood tests in detecting the presence of compensated liver cirrhosis in Chinese patients with chronic hepatitis C. METHODOLOGY: One hundred and eleven biopsy-proven chronic hepatitis C patients were enrolled, 23 (20.7%) patients showed cirrhosis with class A in Child-Pugh's classification and were all asymptomatic. Liver biochemistry, complete blood count, and serum N-terminal propeptide of type III procollagen were determined and then compared between chronic hepatitis C patients with compensated cirrhosis and without cirrhosis. Multivariate logistic regression analysis was used to predict factors associated with compensated cirrhosis. RESULTS: Multivariate logistic regression analysis showed platelet count < or = 140,000/mm3 (odds ratio: 23.44, P < 0.001), globulin/albumin ratio > or = 1 (odds ratio: 31.47, P = 0.008), and AST/ALT ratio > or = (odds ratio: 6.58, P = 0.035) were significant predictors associated with hepatitis C virus-related compensated cirrhosis. Platelet count < or = 140,000/mm3 had 83% sensitivity and 85% specificity in detecting liver cirrhosis. Globulin/albumin ratio > or = 1 had 43% sensitivity, 98% specificity and AST/ALT ratio > or = 1 had 39% sensitivity, 92% specificity in detecting liver cirrhosis. Combined tests with AST/ALT > or = 1 and globulin/albumin > or = 1, platelet count < or = 140,000/mm3 and globulin/albumin > or = 1 had 100% specificity, 100% positive predictive value but lower sensitivity (22% and 39% respectively), lower negative predictive value (83% and 86%, respectively) in detecting hepatitis C virus-related compensated liver cirrhosis. CONCLUSIONS: Simple blood tests with platelet count < or = 140,000/mm3, globulin/albumin ratio > or = 1, and AST/ALT ratio > or = 1 can indicate liver cirrhosis in follow-up patients with chronic hepatitis C.

Adult↗
PubMed1999

Uptake of genetic testing and pre-test levels of mental distress in Norwegian families with known BRCA1 mutations.

232 family members from 27 Norwegian families with BRCA1 mutations were offered genetic testing. 180/232 (78%) chose to be tested, 14/232 (6%) have not yet decided and 38/232 (16%) declined. All 232 persons were invited to fill in the following questionnaires when offered testing: Impact of Event Scale (IES), Hospital Anxiety and Depression Scale (HADS), General Health Questionnaire (GHQ-28) and Beck Hopelessness Scale (BHS). 207/232 (89%) responded to the questionnaires. Of those declining to be tested 23/38 (61%) answered the questionnaires compared to 170/180 (94%) of those wanting the test (p < 0.0001). A higher proportion of females with a history of cancer than females without such a history had abnormal scores on the IES-intrusion and GHQ questionnaires (p < 0.001). Healthy females who were deciding on predictive testing had the same or lower prevalence of mental distress compared to the general population, between 4.3% and 18.0% as measured by the different questionnaires. Males did not differ from healthy females on any of the measures. According to their HADS scores, women without a history of cancer deciding on predictive testing for breast-ovarian cancer had lower or equal levels of mental distress compared to the general population. The high uptake of genetic testing combined with the lower than normal prevalence of mental distress indicates that the activity may continue as practised, awaiting longitudinal data concerning the levels of mental distress after genetic testing.

Anxiety↗
PubMed2000

Can we use in vitro fertilization tests to predict semen fertility?

This presentation deals with assays based on in vitro fertilization (IVF) and related techniques such as zona pellucida (ZP) binding assays and oocyte penetration tests. These types of assays have been developed for several species of domestic animals. A description of the assays and how they have been performed in domestic animals, as well as data on the correlation between the results of assays and actual in vivo fertility are presented. Used either as single tests or in combination with other tests, this type of assay can provide valuable information about a semen donor, an insemination dose or a method of semen preservation.

Animals↗
PubMedDate not supplied

Preembolization functional evaluation in brain arteriovenous malformations: the ability of superselective Amytal test to predict neurologic dysfunction before embolization.

PURPOSE: To describe the incidence of neurologic dysfunction following embolization of supratentorial AVMs, and to correlate findings with results of preembolization Amytal tests. MATERIALS AND METHODS: Data from 147 embolizations of supratentorial AVMs following Amytal tests in 30 awake patients were analyzed retrospectively. RESULTS: Of five embolizations done after a positive Amytal test, two were followed by neurologic complications. Eighty-two embolizations done as single embolizations immediately after a negative Amytal test were associated with no neurologic complications. The remaining embolizations were parts of multiple series of embolizations, each beginning with an Amytal test and followed by a number of embolizations without catheter movement or repeat Amytal testing. Since any prior embolization in the series might reduce the sump effect of the AVM, embolic agent delivered later in the series could potentially reach functional brain tissue not fully tested by the Amytal test. Therefore, repeat embolizations (not immediately preceded by an Amytal test) were considered separately. In 60 repeat embolizations, six (10%) were associated with some neurologic complication. CONCLUSIONS: Repeat Amytal testing might detect the loss of sump effect as the AVM is embolized. We conclude that use of data from superselective Amytal tests adds to the safety of AVM embolizations and that repeat Amytal testing potentially could be valuable when serial embolization of a vessel is planned.

Adolescent↗
PubMed1995

Antidepressant-like actions of the polyamine site NMDA antagonist, eliprodil (SL-82.0715).

Functional N-methyl-D-aspartate (NMDA) antagonists including competitive antagonists, glycine partial agonists, and use-dependent channel blockers exhibit antidepressant-like actions in preclinical models. The present study examined the effects of eliprodil (SL-82.0715), an NMDA antagonist acting at polyamine sites, in behavioral and neurochemical tests predictive of antidepressant activity. In mice, eliprodil produced a dose-dependent reduction in immobility in the forced swim test, but was inactive in the tail suspension test. Chronic treatment with eliprodil produced both a significant downregulation of beta-adrenoceptors and a reduction in the potency of glycine to inhibit [3H]5,7-dichlorokynurenic acid binding to strychnine-insensitive glycine receptors in neocortical membranes. In toto, these data indicate that like other NMDA antagonists, eliprodil possesses antidepressant-like actions in preclinical tests predictive of clinical efficacy.

Adrenergic Uptake Inhibitors↗
PubMed2003

Application of the PKCYP test to predict caffeine clearance mediated by CYP1A2 in a rat acute liver injury model.

We previously established a method for assessing in vivo drug-metabolizing capacity by pharmacokinetic estimation of the quantity of cytochrome P450 (CYP) in vivo (PKCYP test), in which an apparent liver-to-blood free concentration gradient in vivo (qg) is introduced (Matsunaga et al., Jpn. J. Hosp. Pharm., 26: 492-504 (2000)). This method was applied to estimate the amount of CYP2C11 in rats treated with carbon tetrachloride (CCl(4)-treated rats). In this study, we estimated the amount of CYP1A2 in CCl(4)-treated rats by using acetanilide and caffeine as a probe and a model drug, respectively. In CCl(4)-treated rats, the total body clearance (CL(tot)) of acetanilide and caffeine was about one-fifth and one-eighth of that in control rats, respectively. In CCl(4)-treated rats, the amount of CYP1A2 was predicted as 0.60+/-0.06 nmol/kg from the clearance of acetanilide mediated by CYP1A2. Moreover, the clearance of caffeine mediated by CYP1A2 in CCl(4)-treated rats was estimated as 0.47+/-0.05 mL/min/kg by using the predicted amount of CYP1A2. The observed value was 0.44+/-0.03 mL/min/kg, and the predicted value was within the 95% confidence interval of the observed value. In conclusion, we have demonstrated that the PKCYP test can also be applied for estimating the amount of CYP1A2 in CCl(4)-treated rats.

Journal Article↗
PubMed2005

Cancer screening among Latino subgroups in the United States.

BACKGROUND: Relying upon the Health Belief Model and a behavioral model of health care utilization, the purpose of this study was to examine current adherence to cancer screening among Latino subgroups. METHODS: Using data from the 2000 National Health Interview Survey, 5377 Latinos were surveyed for their use of Pap smear, mammogram, breast self-examination and the clinical breast exam among women, prostate specific antigen test among men, and the fecal occult blood test, sigmoidoscopy, colonoscopy, and proctoscopy among both men and women. Using sampling weights, multivariate logistic regression models were used to assess screening use. RESULTS: Dominican women had 2.4 times greater likelihood of having had mammography than other Latinos. In addition, Latinas aged 50-69, who had more years of education, a personal history of cancer, who were not current smokers, had health insurance, had visited a primary care provider over the past 12 months, and had at least one other screening test had greater use of mammography. Younger age, marriage, greater acculturation, visits to a primary care provider, health insurance, and the use of other cancer screening tests predicted the uptake of the Pap smear. Latinas were more likely to use a CBE if they were younger, had a Bachelor's degree, a personal history of cancer, were more acculturated, had visits to a primary care provider over the past 12 months, and used other cancer screening tests. Puerto Ricans, Central or South Americans had half the likelihood of having colorectal cancer screening than other groups. Ages between 50 and 69, male sex, marriage, history of visiting a health care provider, and use of other screening tests predicted use of the FOBT. Older age, greater education, male sex, history of visiting a health care provider in the previous year, use of other screening tests, and better health status influenced the uptake of endoscopy for colorectal cancer screening. Cuban males had fivefold greater utilization of PSA testing. Additionally, PSA use among Latinos was predicted by older age, history of visiting a primary care provider in the past 12 months, and use of other screening tests. CONCLUSIONS: Cancer screening programs must take into account differences among Latinos in age, gender, educational levels, marital status, cancer history, risk behaviors, insurance, health status and health services utilization.

Adult↗
PubMed2003

Ability of exercise testing to predict cardiovascular and all-cause death in asymptomatic women: a 20-year follow-up of the lipid research clinics prevalence study.

CONTEXT: The value of exercise testing in women has been questioned. OBJECTIVE: To determine the prognostic value of exercise testing in a population-based cohort of asymptomatic women followed up for 20 years. DESIGN AND SETTING: Near-maximal Bruce-protocol treadmill test data from the Lipid Research Clinics Prevalence Study (1972-1976) with follow-up through 1995. PARTICIPANTS: A total of 2994 asymptomatic North American women, aged 30 to 80 years, without known cardiovascular disease. MAIN OUTCOME MEASURES: Cardiovascular and all-cause mortality. RESULTS: There were 427 (14%) deaths during 20 years of follow-up, of which 147 were due to cardiovascular causes. Low exercise capacity, low heart rate recovery (HRR), and not achieving target heart rate were independently associated with increased all-cause and cardiovascular mortality. There was no increased cardiovascular death risk for exercise-induced ST-segment depression (age-adjusted hazard ratio, 1.02; 95% confidence interval [CI], 0.57-1.80; P =.96). The age-adjusted hazard ratio for cardiovascular death for every metabolic equivalent (MET) decrement in exercise capacity was 1.20 (95% CI, 1.18-1.30; P<.001); for every 10 beats per minute decrement in HRR, the hazard ratio was 1.36 (95% CI, 1.19-1.55; P<.001). After adjusting for multiple other risk factors, women who were below the median for both exercise capacity and HRR had a 3.5-fold increased risk of cardiovascular death (95% CI, 1.57-7.86; P =.002) compared with those above the median for both variables. Among women with low risk Framingham scores, those with below median levels of both exercise capacity and HRR had significantly increased risk compared with women who had above median levels of these 2 exercise variables, 44.5 and 3.5 cardiovascular deaths per 10 000 person-years, respectively (hazard ratio for cardiovascular death, 12.93; 95% CI, 5.62-29.73; P<.001). CONCLUSION: The prognostic value of exercise testing in asymptomatic women derives not from electrocardiographic ischemia but from fitness-related variables.

Adult↗
PubMed1990

Serological markers and celiac disease: a new diagnostic approach?

We analyze the diagnostic efficacy of two celiac disease serological markers: anti-gliadin (IgA and IgG class) and anti-endomysium IgA-class (EmA-IgA) antibodies applied to 336 serum samples from celiac patients on both gluten-challenge and gluten-free diets, and a control group. The anti-gliadin and anti-endomysium antibodies levels were significantly higher among the gluten-consuming celiac patients than in the other groups. The greatest efficacy in diagnosing celiac disease was achieved in the Ema-IgA class test. The IgA-class anti-gliadin antibodies proved to be more specific, with a higher positive test predictive value than the IgG-class anti-gliadin antibodies, whereas the latter proved to be more sensitive, with a higher negative test predictive value than those of the IgA-class anti-gliadin antibodies. Our results also demonstrate that the simultaneous assessment of anti-gliadin IgA- and IgG-class antibodies constitutes a valid test in selecting patients suspected of having celiac disease. In turn the EmA-IgA antibodies constitute a confirmative test for indication of an intestinal biopsy.

Adolescent↗