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PubMed2026

Radiology considerations for the PREMIUM study: a multicenter randomized controlled trial of abbreviated MRI versus ultrasound for liver cancer screening in cirrhosis.

This paper describes the rationale and radiology considerations in the implementation of the Preventing Liver Cancer Mortality through Imaging with Ultrasound versus MRI (PREMIUM) study. PREMIUM is a multicenter, randomized controlled trial sponsored by the Department of Veterans Affairs comparing dynamic contrast-enhanced (DCE) abbreviated MRI (aMRI) plus serum AFP versus ultrasound (US) plus serum AFP for hepatocellular carcinoma (HCC) screening in patients with cirrhosis. PREMIUM aims to randomize 4,700 participants across over 47 Veterans Affairs Medical Centers to semiannual surveillance for up to eight years, with HCC-related mortality as the primary endpoint. To date, 35 sites have been activated with 1,085 patients randomized. To ensure uniform implementation and reporting of per-protocol screening, the PREMIUM Radiology Workgroup developed standardized imaging protocols, structured LI-RADS-based reporting templates, and a centralized training program for radiologists and technologists. They also perform ongoing quality control on both scans and reports. The aMRI protocols utilize multiphasic post-contrast imaging to allow LI-RADS scoring. A non-contrast-enhanced aMRI protocol is available for participants who develop renal impairment or contrast allergy during the study. US protocols conform to US LI-RADS standards. Structured reporting promotes consistency in documentation of findings, visualization scores, and follow-up recommendations. A centralized Image Repository was established, incorporating advanced de-identification methods to remove metadata and pixel-embedded protected health information from imaging files. More than 20,000 curated liver MRI and US exams are anticipated, supporting both trial outcomes and future radiomics and artificial intelligence research. PREMIUM aims to determine whether screening for HCC with a DCE aMRI protocol reduces HCC-related mortality and also facilitates ancillary studies utilizing the Image Repository.

Abbreviated MRI↗
PubMed1999

Analysis of Minnesota Multiphasic Personality Inventory-2 profiles of prospective anonymous oocyte donors in relation to the outcome of the donor selection process.

OBJECTIVE: To examine the scores of prospective anonymous oocyte donors on the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) in four outcome groups. DESIGN: Chart review. SETTING: Academic medical center. PATIENT(S): One hundred fifty prospective anonymous oocyte donors who underwent a preliminary screening and a 1-hour structured psychological interview and who completed the MMPI-2. INTERVENTION(S): Psychological evaluation prior to donation. MAIN OUTCOME MEASURE(S): Scores on the MMPI-2 and outcomes of the donor selection process. RESULT(S): Seventy (47%) women were accepted as donors and completed one donation cycle; 30 (20%) were accepted as donors but did not donate because of medical reasons or relocation; 18 (12%) were accepted as donors but were noncompliant; and 32 (21%) were rejected as donors because of psychological concerns. Statistically significant differences were found between outcome groups on scales F, K, 1, 2, 7, 8, and 0. Although these differences were statistically significant, all group subscale mean scores were in the average to low-average range and differences between group means were small. CONCLUSION(S): The MMPI-2 differentiates between prospective donor outcome groups, but psychologists need to interpret the results of the MMPI-2 carefully in the context of clinical interview information.

Female↗
PubMed1980

The relationship of dermatomyositis and polymyositis to internal malignancy.

The association of malignancy with dermatomyositis and polymyositis has been questioned. During the last 20 years (1956 to 1975), we have studied 58 cases of myositis that met predefined diagnostic criteria. These cases were analyzed for the frequency of malignancy, prognosis, and the value of a diagnostic test series for malignancy. A significantly greater frequency of malignancy was found with dermatomyositis than with polymyositis. The prognosis of dermatomyositis and polymyositis appears to be altered in the presence of malignancy. In the absence of malignancy, the prognosis is similar in the two forms of myositis. Lastly, the value of a screening laboratory and roentgenographic investigation for the presence of occult malignancy beyond a thorough history, physical examination, and the use of basic laboratory tests such as complete blood count, stool gualac test, urinalysis, multiphasic analysis, and chest roentgenogram was not documented by this study.

Adult↗
PubMedDate not supplied

Use of radiologic techniques to screen for hepatocellular carcinoma.

The role of imaging in screening and evaluation of cirrhotic patients is to assess the extent of cirrhosis and portal hypertension (liver morphology, varices, ascites, vessel patency) and to detect hepatocellular carcinoma (HCC). Ultrasonography, computed tomography (CT), and magnetic resonance imaging (MRI) have valuable roles, with catheter angiography usually reserved for specific problem solving. Ultrasonography is highly operator-dependent, and detection of focal masses is often difficult or impossible because of large patient body habitus and hepatic steatosis and fibrosis, which attenuate the ultrasound beam. For sonography, as well as CT and MRI, the use of intravenous contrast material with multiphasic imaging (arterial, portal venous, and delayed) is essential to accurately depict the morphology and hemodynamics of focal hepatic lesions. Computed tomography and MRI are highly accurate in diagnosis of large HCC but are much less accurate for lesions less than 2 cm in diameter. Many factors influence the choice and timing of imaging tests, including the etiology of the chronic liver disease, the elevation of serum tumor markers, and the availability and excellence of equipment and personnel. In our practice, helical multiphasic CT is obtained at least every 12 months, more frequently in patients judged to be at high risk for HCC.

Carcinoma, Hepatocellular↗
PubMed2000

Stress management: an exploratory study of chiropractic patients.

BACKGROUND: Stress is a recognized variable in the diagnosis, management, and prognosis of musculoskeletal conditions; chiropractic care is reputed to be successful in the management of stress-related visceral conditions. It may be useful for chiropractors to include stress management as a clinical care option. OBJECTIVE: To explore screening tools to aid stress self-assessment, investigate patients' perceptions of stress management as a chiropractic care option, and examine which stress-management strategies chiropractic patients perceive as most useful. DESIGN: A multiphase qualitative study with purposive sampling of chiropractic clinics to maximize the diversity of the patient population. Convenience sampling of patients was undertaken in a Western Australian case study, an inner city, and a national exploratory study. Data for the case study were collected by semistructured interview. Questionnaires and a self-assessed stress-management task were used to collect data from the inner city and national studies. Data was thematically analyzed, and results were triangulated. RESULTS: The sample size of chiropractic patients in the West Australian case study was 48, 15 in the Western Australia exploratory study and 36 in the national study. A number of chiropractic patients participating in this study perceive themselves to be stressed and were interested in having stress-management strategies included in their chiropractic care. Individual patients preferred different stress-management options. This qualitative study found little justification for routinely using a stress-assessment technique more complex than asking the patient to rate his or her stress level as absent, minimal, moderate, or severe. Exercise, particularly walking, was found to be a prevalent pasttime among participants in the case study. CONCLUSION: This study was too small to warrant statistical analysis; nonetheless, the results of this study are relevant because some patients believe they would benefit from chiropractic care that includes information about stress-management strategies.

Adolescent↗
PubMed1989

Concurrent validation of Hutt's Bender Gestalt screening method for schizophrenia, depression, and brain damage.

The effectiveness of Hutt's Bender Gestalt scoring system in screening for schizophrenia, depression, and brain damage was investigated in a sample of mixed, psychiatric inpatients. Fifteen patients represented each diagnostic category. After an examination of each patient's Bender Gestalt protocol according to Hutt's criteria, it was found that the true positive and true negative success rates of the screening procedures for depression and brain damage were significantly higher than corresponding base rates. The Lacks Bender Gestalt screening method for brain damage was no more successful than the Hutt method in identifying true positives and true negatives. With the brain-damaged patients excluded, Hutt's screening procedures for both depression and schizophrenia resulted in significantly high rates of successful identification of true positives and true negatives. Moreover, these rates did not significantly differ from those determined by patients' Minnesota Multiphasic Personality Inventory (MMPI) T scores on corresponding scales.

Adult↗
PubMed1993

Dispositional traits as risk in problem drinking.

A trait-dispositional paradigm for conceptualizing personality provided the framework for investigating the relationship between personality dispositions and drinking problems. This approach was compared directly with personality research based on the Minnesota Multiphasic Personality Inventory (MMPI). A total of 241 subjects (192 men and 49 women) were tested at a mandatory Driving While Intoxicated (DWI) first-offender education program. Information was gathered from the Michigan Alcoholism Screening Test (MAST), Blood Alcohol Concentration (BAC) at time of arrest, and two personality tests--the MacAndrew Alcoholism Scale (MAC) and the Problem Drinker Trait List (PDTL). The psychometric properties of the PDTL were analyzed and compared with those of the MAC. In comparing the two personality tests in terms of their capacity to predict drinking problems over a wide range of drinking severity, the PDTL performed as well or better than the MAC, particularly for drinkers with low arrest BAC. Comparative analysis between the best predictor items of the MAC and of the PDTL revealed little relationship between the item domains. The predictive trait clusters of the PDTL for men were Emotionality/Depressiveness, Impulsivity, and Low Self-Confidence, whereas predictive clusters for women included Depressiveness, Overcontrol, and Alienation.

Adult↗
PubMed1996

Gluten-sensitive enteropathy in patients with insulin-dependent diabetes mellitus.

OBJECTIVE: To determine the prevalence of celiac disease in a cohort of patients with insulin-dependent diabetes mellitus and to describe the clinical characteristics of patients with coexistent disease. DESIGN: Prospective cohort study. SETTING: U.S. Army medical center. PATIENTS: 47 patients with insulin-dependent diabetes mellitus. MEASUREMENTS: Antiendomysial antibody testing was used to screen for celiac disease. The diagnosis of celiac disease required histologic evidence of villous atrophy and crypt hyperplasia and a positive antiendomysial antibody test result. In patients identified as having coexistent disease, complete blood counts, multiphasic biochemical testing, D-xylose absorption testing, and bone mineral density estimates were done. RESULTS: 3 of 47 patients with insulin-dependent diabetes mellitus (6.4%; 95% CI, 1.4% to 17.5%) had positive antiendomysial antibody test results and small-bowel biopsy specimens consistent with celiac disease. The 95% CI lies entirely above the estimated prevalence of celiac disease expected in the general U.S. population, which ranges from 0.02% to 0.1%. Mean bone mineral densities were 0.8 and 1.1 SD below age-, ethnicity-, and sex-matched controls in each of the 2 antiendomysial antibody-positive patients tested. Small bowel absorption was abnormal in 1 of the 2 patients tested by D-xylose. Anemia and hypoalbuminemia were not detected in any of the patients with coexistent disease. Only 1 of the 3 patients had symptoms of diarrhea. All patients were at or above their ideal body weights. CONCLUSIONS: Celiac disease appears to be more common among patients with insulin-dependent diabetes mellitus than in the general U.S. population (p less than 0.001). Two of the three patients with coexistent disease in this study had subclinical or latent celiac disease.

Adult↗
PubMed1976

Psychologic evaluation of impotent men.

Psychologic evaluations have been performed as part of the screening process on men who were candidates for surgical implantation of the inflatable penile prosthesis. Goals and methods of evaluation are discussed, with special attention to the use of interview and psychologic test results. Minnesota Multiphasic Personality Inventory profiles that suggest a psychogenic basis for impotence are presented and discussed.

Adult↗
PubMed1993

Expression of a human homeobox-containing gene is regulated by 1,25(OH)2D3 in bone cells.

The murine msh-like homeobox-containing gene Msx-2 (Hox-8) has a multiphasic pattern of embryonic expression which includes the developing skull bones and teeth. In order to determine whether this gene might be expressed in adult mineralizing tissues, an adult human bone cell (osteoblastic) cDNA library was screened with a murine Msx-2 probe. One of the positive clones obtained was sequenced in full and shown to be highly homologous to the murine Msx-2 gene. Expression of this gene, MSX2, was studied in human bone-derived cells, where a low level of expression was detected which was greatly induced by stimulation with 1,25(OH)2D3. Little or no increase in expression was detected with retinoic acid or TPA stimulation. In cultures of skin fibroblasts no stimulation of expression with 1,25(OH)2D3 was detected. MSX2 is the first homeobox-containing gene to be shown to be regulated by 1,25(OH)2D3 and to be expressed in adult human bone cells. These results suggest a possible role for MSX2 in bone cell differentiation and/or calcium homeostasis.

Amino Acid Sequence↗
PubMed1993

Personality characteristics of men who physically abuse women.

OBJECTIVE: Studies have suggested that personality disorders may be common among men who habitually commit domestic violence. The study reported here attempted to characterize personality traits and psychological and cognitive characteristics of men who batter women in order to distinguish them from nonbattering men. METHODS: A group of 21 batterers were compared with a group of nonbatterers using the Minnesota Multiphasic Personality Inventory and its personality disorder scales (MMPIPDS) and the Hostility and Direction of Hostility Questionnaire. Comparability of the two groups was assessed on several demographic variables and on scores on the Revised Michigan Alcoholism Screening Test, three cognitive measures, and three measures of affective disturbance. RESULTS: Batterers scored higher on only the borderline and antisocial MMPIPDS and on the acting-out hostility and self-criticism scales of the hostility questionnaire. Problem-solving skills for both of the groups were considerably poorer than published norms. No significant differences were found between the groups in age, race, education, socioeconomic status, alcohol abuse, performance on cognitive measures, depression scale scores, or overall scores on the MMPI. As children, batterers were more likely to have experienced physical or emotional abuse. CONCLUSIONS: Men who commit domestic violence may be found among a larger pool of men with poor problem-solving skills, but in addition they appear to have borderline-antisocial personality traits, certain types of hostility, and histories of abuse as children that may predispose them to become violent with their female companions.

Adult↗
PubMed2005

Endophytic and ectophytic potato-associated bacterial communities differ in structure and antagonistic function against plant pathogenic fungi.

Differences between endophytic and ectophytic bacterial communities with stress on antagonistic bacteria, were studied by comparing the composition of communities isolated from the rhizosphere, phyllosphere, endorhiza and endosphere of field-grown potato plants using a multiphasic approach. Terminal restriction fragment length polymorphism analysis of 16S rDNA of the bacterial communities revealed discrete microenvironment-specific patterns. To measure the antagonistic potential of potato-associated bacteria, a total of 2648 bacteria were screened by dual testing of antagonism to the soilborne pathogens Verticillium dahliae and Rhizoctonia solani. Composition and diversity of bacterial antagonists were mainly specific for each microenvironment. The rhizosphere and endorhiza were the main reservoirs for antagonistic bacteria and showed the highest similarity in their colonisation by antagonists. The most prominent species of all microenvironments was Pseudomonas putida, and rep-PCR with BOX primers showed that these isolates showed microenvironment-specific DNA fingerprints. P. putida isolates from the rhizosphere and endorhiza gave nearly identical fingerprints confirming the high similarity of bacterial populations. The phlD gene, involved in the production of the antibiotic 2,4-diacetyl-phloroglucinol, was found only among Pseudomonas isolates from the rhizosphere and endorhiza. Evaluation of the bacterial isolates for biocontrol potential based on fungal antagonism and physiological characteristics resulted in the selection of five promising isolates from each microenvironment. The most effective isolate was Serratia plymuthica 3Re4-18 isolated from the endorhiza.

Bacteria↗
PubMed1990

The relationship of the Allen Cognitive Level Test to cognitive abilities and psychopathology.

The cognitive factors measured by the Allen Cognitive Level Test (ACL) (Allen, 1982) as well as the test's relationship to level of psychopathology were examined through a retrospective study of 71 patients from a general hospital psychiatry unit. Pearson correlations, computed for the ACL score with the Shipley Institute of Living Scale (Shipley, 1940), a general measure of intellectual functioning, were significant. A strong correlation was found between the ACL and the Symbol-Digit Modalities Test (Smith, 1982), a measure of motor speed and concentration often used as a neurological screening instrument. This suggests the potential usefulness of the ACL to screen for cognitive dysfunctions associated with organicity. Contrary to hypothesis, there was no significant correlation between the ACL and measures of psychopathology such as the Beck Depression Inventory (Beck, Ward, Mendelson, Mock, & Erbaugh, 1961) and the Minnesota Multiphasic Personality Inventory (Hathaway & McKinley, 1940). The relationship of the ACL to other recognized measures of cognitive functioning increases its usefulness as a valid measure of day-to-day limitations in the functioning of psychiatric patients. Effective communication of the implications of these cognitive levels to a multidisciplinary treatment team is enhanced by knowledge of the relationship of the ACL to measures of cognitive functioning and psychopathology used by other disciplines.

Adult↗
PubMed1990

Depression in homicidal adolescents.

The problem of adolescents who commit homicides is of increasing concern in its own right, as well as from the possibility of their facing execution. In this study, a psychiatric and psychological assessment was aimed at screening out a group of juveniles who were being considered for certification to adult court in terms of depressive symptomatology. Within a group of 213, 30 males and 14 females were assessed as depressed by clinical history, the Minnesota Multiphasic Personality Inventories (MMPI) and the Beck Depressive Inventory (BDI). Empirical and psychosocial data attempted to differentiate significant developmental components related to the homicides, as well as differences between the 30 males and 14 females. Although the problem of predicting such behavior from descriptive characteristics remains elusive, certain patterns were present among diverse homicidal behaviors. In conclusion, some psychodynamic hypotheses are offered.

Adolescent↗
PubMed1994

Subjective memory complaints and personality traits in normal elderly subjects.

OBJECTIVE: To evaluate the relationship between objectively measured memory functions and subjective complaints of memory disturbance and whether subjective complaints are affected by some personality traits or affective states. DESIGN: Cross-sectional two-group comparison. SETTING: The city of Kuopio in Eastern Finland, considered representative of the urban elderly population of Finland. PARTICIPANTS: Originally 403 subjects aged 67-78 years from the random sample and then two matched study groups initially including eighteen subjects but only ten in the final analysis. MEASUREMENTS: Screening and follow-up examinations of subjects with and without subjective memory complaints: (1) Memory functions: Benton's visual retention test and the paired-associated learning subtest of Wechsler Memory Scale. (2) Memory complaints: Memory Complaint Questionnaire. (3) Personality traits and affective state: Two subscales from Minnesota Multiphasic Personality Inventory and Geriatric Depression Scale. RESULTS: Complaints of memory loss did not correlate with the actual memory performance in the tests. However, those subjects who most emphatically complained of memory disturbance had greater tendencies toward somatic complaining, higher feelings of anxiety about their physical health, and more negative feelings of their own competence and capabilities than those who did not complain of memory deterioration associated with aging. CONCLUSIONS: The study suggests that subjective feelings of memory impairment are more closely associated with personality traits than with actual memory performance in normal elderly people.

Affect↗
PubMed1987

A redundancy analysis for the Inwald Personality Inventory and the MMPI.

A redundancy analysis between two psychological preemployment screening inventories was conducted with 2,438 male correction officer candidates. One canonical variate accounted for the majority of overlapping variance. When cross-validated, redundancy indices were. 17 for the Inwald Personality Inventory (IPI) and. 15 for the Minnesota Multiphasic Personality Inventory (MMPI). Three areas of overlap-control over actions, external control, and restlessness-were suggested. Less pathological behavioral patterns predictive of future job performance appeared measured only by the IPI. These results, combined with results from predictive validity studies, provide evidence that pathology is not sufficient for identifying "high risk" candidates.

Journal Article↗
PubMedDate not supplied

Evaluating psychosocial stress: preliminary report on a brief and convenient instrument for health professionals.

The Heimler Scale of Social Functioning (HSSF) is an effective instrument for evaluating psychosocial stress and dysfunction. When tested, the HSSF clearly differentiated between two different patient groups: those who had scheduled initial appointments for outpatient psychotherapy and those who were participating in a multiphasic health examination. Both groups were composed of members of the same prepaid health plan, utilizing the same medical center, and were comparable to each other in all respects except age. This scale has excellent potential for use as a screening instrument by primary care physicians in clinics and medical centers, psychotherapists in various clinical settings, and psychiatric professionals in outpatients services.

Adult↗
PubMed1995

The usefulness of the Minnesota Multiphasic Personality Inventory in the clinical management of patients with temporomandibular disorders.

The Minnesota Multiphasic Personality Inventory (MMPI) is a useful instrument in the process of evaluating certain patients with chronic orofacial pain. Since the MMPI is time-consuming and difficult for some patients, it is not likely to be useful as a general screening test for psychological factors involved in chronic orofacial pain. It provides valuable information about diagnostic issues such as the degree of emotional distress in patients and it can be helpful in identifying patients who may need additional attention to their psychological problems that are not addressed in the usual dental management. Cultural differences need to be considered in order to make appropriate use of the English language versions in countries outside the United States. In addition, translations of the MMPI are available but must be used with knowledge of the accuracy and applicability of the translated version.

Chronic Disease↗