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PubMed1994

Use of sleep questionnaires in assessing the effect of moclobemide on the sleep profiles of depressive patients.

The sleep profiles of healthy adult volunteers (group 1) were compared with the sleep profiles of depressive patients (group 2), using the method suggested by Görtelmeyer. This method uses a questionnaire to evaluate the various aspects of sleep profiles that may be different in depressive patients compared with healthy subjects. Thirty patients in group 2 were tested before and during exposure to moclobemide (450 mg/day) for 8 weeks. The group of healthy adults did not receive moclobemide and showed stable sleep profiles throughout the study period. After approximately 2 weeks of administration of moclobemide, the sleep profiles of depressive patients that had been aberrant at baseline became more normal. Around this same time, the antidepressant effects of moclobemide became apparent. The sleep questionnaire used in this study appears to be a valuable and practical method for evaluating sleep architecture.

Adult↗
PubMed1996

Profiling primary care physician resource use: examining the application of case mix adjustment.

Growing emphasis on managed care has led to increased interest in physician practice profiling. Standardized techniques for conducting profiling are not yet well established. One particularly challenging methodologic issue, case mix adjustment, is explored here using actual cost profiles derived from primary care physicians at two independent practice association (IPA)-model health maintenance organizations (HMOs). Specifically, this article examines how the ambulatory care group case mix methodology can be applied to profiling and illustrates that it provides more depth of information with which to assess performance than does standard demographic adjustment alone. This analysis suggests both the potential and methodologic limitations of profiling at the individual physician level.

Ambulatory Care↗
PubMed2002

Childhood behavioral profiles leading to adolescent conduct disorder: risk trajectories for boys and girls.

OBJECTIVE: To examine the link between childhood behavioral dimensions and adolescent conduct disorder (CD) among a large sample of boys and girls monitored longitudinally. METHOD: Teachers rated the behaviors of 1,569 children every year between kindergarten and grade 6. On the basis of these seven yearly ratings, groups of children who followed distinct trajectories on three behavioral dimensions--hyperactivity, fearfulness, and helpfulness--were identified with a semiparametric statistical analysis. Children were then categorized into one of eight behavioral profiles, representing different combinations of the trajectories. Logistic regressions were used to estimate the relation between the profiles and CD in adolescence (mean = 15.7 years). RESULTS: Boys had a significant risk for CD if they were hyperactive (odds ratio [OR] = 4.27; 95% confidence interval [CI], 1.8-10.16); hyperactive and unhelpful (OR = 2.83; CI, 1.07-7.46); or hyperactive, fearless, and unhelpful (OR = 3.93; CI, 1.27-12.17). Girls had a significant risk for CD only if they were both hyperactive and unhelpful (OR = 4.61; CI, 1.31-16.24). More boys than girls exhibited profiles of risk and met criteria for CD in adolescence. CONCLUSIONS: Sex-specific childhood behavioral profiles that represented risk for CD in adolescence were identified. There were sex differences in the prevalence of the childhood profiles representing risk for CD.

Adolescent↗
PubMed1988

Empirically derived MMPI profiles. Coronary bypass surgery.

A cluster analysis of eight clinical scales of the MMPI-168 was performed on data from 129 subjects awaiting coronary bypass surgery. Four abnormal profiles were derived and these profiles were consistent with clinical expectancy. The five empirically derived profiles were labeled as a) normal--that is, no elevated scales; b) marginal distress--elevated Hs; c) conversion V--elevated Hs and Hy; d) neurotic--elevated Hs, D, Hy, and Pt; and e) generalized distress--elevated D, Hy, Pd, Pa, Pt, and Sc. Subsequent postsurgical follow-ups were done at 3-, 12-, and 24-month intervals. These data suggest that the profiles retained their characteristic shape and were still statistically different from each other, but the overall elevation decreased significantly after successful surgical intervention. To externally validate these profiles, the five derived groups were compared in terms of Beck Depression scores and the State/Trait Anxiety Inventory. These results were consistent with the MMPI. These data are discussed in terms of developing models for assessing the interaction of personality and specific stressors.

Adult↗
PubMed1990

Serum lipoprotein profile in children with celiac disease.

Jejunal mucosa is responsible for the absorption of triglycerides and the production of lipoproteins [chylomicrons, very-low-density lipoprotein (VLDL), high-density lipoprotein (HDL)] and apolipoproteins (B-48, A-I, A-II, A-IV, C-II). Mucosal damage is known to cause fat malabsorption and probably also affects the serum lipid profile. To determine lipoprotein production in states of enterocyte dysfunction, we compared the serum lipid profiles in a group of 12 children with untreated celiac disease (flat jejunal mucosa) with the profiles in a control group of 10 children suffering from other intestinal diseases. Statistically significant differences were found in the following parameters (celiac versus control): plasma levels of triglycerides (70 versus 119 mg/dl), cholesterol content in LDL (107 versus 67.7 mg/dl), protein content in VLDL (6 versus 10 mg/dl), and level of apoprotein A-I (112 versus 140 mg/dl). No significant differences were found between the two groups in the serum levels of total cholesterol, the cholesterol content in VLDL and HDL, the protein content in LDL and HDL, and the level of apoprotein B. Following institution of a gluten-free diet, the lipoprotein profile reverted to normal. These data suggest that the changes in the serum lipoprotein profile in celiac disease are secondary to alterations in enterocyte function and not only a reflection of fat malabsorption.

Celiac Disease↗
PubMed1976

Studying the impact of patient drug profiles in an HMO.

The objectives of the study were to determine if a drug profile quantitatively and qualitatively influenced various aspects of drug utilization. A group of 1,632 medically indigent persons enrolled in the Kaiser Health Plan constituted the study population. This population received completely prepaid medical care including drug services from the Kaiser Medical Care Program. A computer-based chronological and monthly updated listing of drugs ordered and prescriptions received was provided as the front page of the centralized outpatient medical chart for a randomly selected half of the study population for a full year. Duplicate and bound copies of these patient drug profiles were also provided each outpatient pharmacy. The findings indicated the presence of the drug profile did not quantitatively or qualitatively affect prescription receipt of the group with the profile. Although the findings must be viewed in the contexts of the population served and the medical care setting, the findings strongly indicate the need for additional research to assess additional forms of drug profiles and under conditions not addressed by this study.

Adult↗
PubMed1983

The Seattle evaluation of computerized drug profiles: effect on provider activities.

We studied whether furnishing care providers with computer-generated summaries of patients' current and past medications would reduce the time they spent on various drug-related tasks during patient visits. An observer used time-sampling methods to measure the amount of provider time spent on each of 10 activities during 166 clinic visits, some with profiles and some without them. Additional data were taken from the medical record on factors that might affect the time spent on various tasks. The results suggest that record reading time was reduced for first encounters between patients and providers in the medical clinics, where prescribing volume was highest; in other situations, no effect of profiles on record reading time was evident. Providers continued to document drug data in their progress notes, whether or not a profile was available, saving no time. Prescription writing required about one third less time when a profile was used than when a traditional prescription blank was used. Both uses of profiles for prescribing and the time saved per prescription also increased sharply with the number of drugs prescribed per visit.

Computers↗
PubMed2000

Aerobic exercise and the lipid profile in type 1 diabetic men: a randomized controlled trial.

PURPOSE: Despite the potential importance of favorable changes in the lipid profile produced by aerobic exercise, training-induced lipid profile changes in atherosclerosis-prone type 1 diabetes mellitus (DM) have not heretofore been adequately addressed. METHODS: We assessed the effect of a 12- to 16-wk aerobic exercise program on cardiorespiratory fitness and the lipid profile in young men with type 1 DM. Generally active men aged 20-40 yr with type 1 DM (N = 56) were randomized into training (N = 28) and control (untrained, N = 28) groups after baseline measurements. Training consisted of 30-60 min moderate-intensity running 3-5 times a week for 12-16 wk. RESULTS: For the 42 men finishing the study, peak oxygen consumption (VO2 peak) increased significantly only in the trained group. Total and low-density lipoprotein (LDL) cholesterol and apolipoprotein (apo) B decreased and the high-density lipoprotein (HDL)/apo A-I ratio increased in the trained group. HDL and apo A-I increased in both groups. The exercise program brought about improvements in the HDL/LDL and apo A-I/apo B ratios and apo B and triglyceride levels when comparing the relative (%) changes in the trained versus control group. In the trained group, men with HDL/LDL ratios below the group median at baseline showed even more favorable changes in their lipid profile than those with higher initial HDL/LDL ratios. Body mass index, percent body fat and hemoglobin A1c did not change during the training period in either group. CONCLUSIONS: Endurance training improved the lipid profile in already physically active type 1 diabetic men, independently of effects on body composition or glycemic control. The most favorable changes were in patients with low baseline HDL/LDL ratios, likely the group with the greatest benefit to be gained by such changes.

Adult↗
PubMed1988

Biophysical profile scoring in the management of the diabetic pregnancy.

Biophysical profile scoring was the principal technique of antepartum fetal surveillance in 238 well-controlled diabetic pregnancies. Fifty insulin-dependent diabetics had twice-weekly testing, and 188 gestational diabetics had weekly testing. Intervention was not pursued unless there were maternal or fetal complications. There were no stillbirths and three neonatal deaths, all resulting from congenital anomalies, giving a corrected perinatal mortality rate of 0. The incidence of abnormal biophysical profile scores, eight of 238 (3.3%) overall, was low, with no significant difference between types of diabetics. In those with an abnormal score, intervention was mandated; the cesarean section rate was 50% and the rate of intensive care nursery admissions was high. Of the 230 fetuses with a normal biophysical profile score, 200 (87%) were delivered at term with minimal maternal or neonatal morbidity. Amniocentesis for phospholipid profile was performed in only 33 cases (13.9%). Hyaline membrane disease was confined to five premature neonates (incidence 2.1%). We conclude that antepartum fetal surveillance using the biophysical profile score permits safe expectant management in the diabetic pregnancy, yielding significant clinical advantages to both mother and fetus.

Amniotic Fluid↗
PubMedDate not supplied

Coping profile differences in the biopsychosocial functioning of patients with temporomandibular disorder.

OBJECTIVE: The objective of this study was to evaluate whether biopsychosocial functioning differences exist between samples of patients with temporomandibular disorder (TMD) who differ in coping profiles as assessed by the Multidimensional Pain Inventory. METHODS: A total of 322 patients who presented with TMD were administered a comprehensive biopsychosocial assessment battery, and the acute or chronic status of their disorder was determined. A follow-up evaluation was conducted 6 months later to determine the status of their pain. RESULTS: TMD patients with dysfunctional and interpersonally distressed coping profiles demonstrated more acute and chronic psychosocial difficulties than patients with adaptive coper profiles. The data also suggest that having a dysfunctional/distressed coping profile on the Multidimensional Pain Inventory has some predictive value in determining the likelihood of developing chronicity in the absence of treatment. CONCLUSIONS: The presence of a dysfunctional/distressed coping profile in patients with TMD is likely to provide clinicians with important information about the biopsychosocial functioning of those patients, which, in turn, will help to determine the most effective treatment modalities to use with TMD patients.

Acute Disease↗
PubMed1994

Digital assessment of MRI for lumbar disc desiccation. A comparison of digital versus subjective assessments and digital intensity profiles versus discogram and macroanatomic findings.

During magnetic resonance imaging, a vast amount of digital data on anatomic structures is translated into images, which are then assessed subjectively. The development of an objective, sensitive method to directly assess the digital data would have clear benefits, particularly for clinical research on disc degeneration. The study goals were to develop a method of digital assessment of disc desiccation and to compare digital signal intensity profiles with discographic patterns and macroanatomic findings. Proton density-weighted MRIs were obtained from 45 males (9-77 years) and digital analysis was done with a freely selectable region of interest facility. The adjacent cerebrospinal fluid (CSF) was used as a reference for disc signal-intensity scores, and the disc to CSF-intensity ratio provided "adjusted digital scores." The CSF-adjusted digital method yielded reproducible scores that correlated with the subjective assessments. However, the CSF-adjusted digital scores were more sensitive than the subjective assessments, identifying findings that otherwise were undetected in younger subjects. Additionally, 10 cadaveric spines were evaluated using MRI with T2 and proton density-weighted sequences, discography, and macroanatomic dissection. MRI disc-intensity profiles were determined along a midsagittal line drawn through the disc. The profile of the digital scores along this line was then compared with discograms and macroanatomic sections. In all cases of disc degeneration on discograms, changes were present in the intensity profile. Based on both the living subjects and the cadaveric specimens, the digital assessments and disc intensity profiles appear to demonstrate disc degeneration, particularly in early stages.

Adolescent↗
PubMedDate not supplied

Profiles of communication disorder in children with velocardiofacial syndrome: comparison to children with Down syndrome.

PURPOSE: To describe communication profiles in children with velocardiofacial syndrome (VCFS) compared with children with Down syndrome. METHODS: Four children with VCFS and four children with Down syndrome underwent cognitive and speech and language assessment. RESULTS: Communication profiles of children with Down syndrome showed a flat profile, indicating all measures were similar and delayed relative to chronological age. Children with VCFS showed vocabulary, pattern of sound types, and Mean Babbling Length below cognitive and other language ages. CONCLUSION: Communication profiles of children with VCFS differed qualitatively and quantitatively from children with Down syndrome and support the hypothesis that some children with VCFS present with a profile of communication impairment that may be distinctive to the syndrome.

Abnormalities, Multiple↗
PubMed2003

A cluster-analytic investigation of MMPI profiles of serious male and female juvenile offenders.

OBJECTIVE: To use cluster analysis to identify psychological profiles and related mental health symptoms among male and female juvenile offenders. METHOD: Juvenile offenders (N = 141) incarcerated in the California Youth Authority completed the Minnesota Multiphasic Personality Inventory (MMPI) and the Massachusetts Youth Screening Instrument-Version 2 (MAYSI-2). RESULTS: MMPI cluster analysis revealed four distinct profiles: two for male and two for female juvenile offenders. Among males, we identified one Normative cluster with no clinically elevated scores. A second male cluster, labeled Disorganized, exhibited clinical elevations on scales 8 (Schizophrenia), 6 (Paranoia), 4 (Psychopathic Deviate), and 7 (Psychasthenia). Among females, two clinically elevated profiles emerged. One Impulsive-Antisocial cluster consisted of clinical elevations on scale 4 (Psychopathic Deviate), which has been consistently associated with delinquent and antisocial behavior. The second cluster, labeled Irritable-Isolated, produced elevations on MMPI scales 4 (Psychopathic Deviate), 8 (Schizophrenia), 6 (Paranoia), and 7 (Psychasthenia). There were no significant sex, ethnicity, or offense differences across clusters, but the clusters exhibit distinct psychiatric profiles (MMPI) and mental health symptoms (MAYSI-2). CONCLUSIONS: The findings indicate that not only do female offenders have more acute mental health symptoms and psychological disturbances than male offenders, they exhibit qualitatively distinct psychiatric profiles. Results reinforce the need for assessment of mental health symptoms for male and female juvenile offenders as well as sex-appropriate treatments.

Adolescent↗
PubMedDate not supplied

An in vitro study of changing profile heights in mitral bioprostheses and their influence on flow.

In vitro assessment of different profiles for prosthetic mitral valves can result in better understanding of the physics of transmitral flow for each design. It has been postulated that decreasing the profile height of the mitral bioprosthetic valve has potential clinical benefit. In the present study, we compared the atrial and ventricular flow characteristics in different conditions using Carpentier-Edwards Perimount mitral valves with various profile heights. Each valve was placed at the intersection of the left ventricle, made of transparent silicone rubber, and the left atrium in Caltech's left heart pulsed flow simulator system. Digital particle image velocimetry has been used as the quantitative flow visualization technique. With the intention of studying the blood wash out around each valve, circulation and particle residence time were computed based on the vorticity and velocity fields around each valve, respectively. Results show that by increasing the profile's height at the atrial side of the valve, the magnitude of circulation near the atrial side of the valve decreases while particle residence time increases. However, extreme reduction of profile height in the ventricular side may increase the magnitude of circulation around the valve and decrease the particle residence time.

Bioprosthesis↗
PubMed2004

Regulation of the profile of iron-management proteins in brain microvasculature.

The distribution of brain iron is heterogeneous, but the mechanism by which these regional differences are achieved and maintained is unknown. In this study, the authors test two hypotheses related to brain iron transport. The first is that there is regional variability in the profile of proteins associated with iron transport and storage in the brain microvasculature. The second hypothesis is that the iron status of the brain will dictate the response of the protein profile in the microvasculature to changes in systemic iron status. The profile analysis consists of transferrin (iron transport), ferritin (iron storage), transferrin receptor (iron uptake), and divalent metal transporter 1 (release of iron from endosomes). An additional protein involved in cellular iron efflux, ferroportin, was not detected in brain microvasculature. The results show that there are significantly higher levels of these proteins in the microvasculature from each area of the brain compared to a whole brain homogenate, but no regional differences within the microvasculature. The levels of ferritin observed in the microvasculature indicate that the microvascular endothelial cells have significant iron storage capacity. There are no significant changes in the regional protein profiles in response to systemic iron manipulation when brain iron status was normal. In contrast, in Belgrade rats, whose brain is iron deficient, the expression of both divalent metal transporter 1 and transferrin receptor was increased compared with control in almost all brain regions examined, but not transferrin or ferritin. These findings indicate that regional brain iron heterogeneity is not maintained by differences in microvascular iron-management protein levels. The results also indicate that brain iron status dictates the response of the microvascular protein profile to systemic iron manipulation.

Animals↗
PubMed2006

Efficacy and tolerance profile of agomelatine and practical use in depressed patients.

Agomelatine is a new agent with a unique pharmacological profile, as the first melatonergic antidepressant. Its antidepressant efficacy has been demonstrated in the treatment of major depressive disorder (MDD) at a dose of 25 mg/day. Expectations from antidepressant therapies now go beyond efficacy alone, to include advantages in tolerability and safety. Due to its pharmacological profile, agomelatine does not induce the side-effects typical of other therapies, such as selective serotonin reuptake inhibitors (i.e. gastrointestinal disorders, weight gain, serotonergic syndrome and insomnia). Moreover, a placebo-controlled trial in MDD comparing the effects of agomelatine and venlafaxine on sexual dysfunction (another significant side-effect with current antidepressant medications) indicated the very favourable profile of agomelatine; in the same study, there was similar antidepressant efficacy in the same two groups. A double-blind, placebo-controlled trial investigating the effect of abrupt cessation of treatment demonstrated the absence of discontinuation symptoms with agomelatine, which was in contrast with the results observed with paroxetine. The ability of an antidepressant to relieve sleep complaints with no sedative effects is a key advantage because sleep complaints are a major presenting feature of depression. Again due to its unique pharmacological profile, agomelatine has been shown to positively influence disturbed circadian rhythms in depressed patients by significantly improving all phases of disturbed sleep and the overall quality of sleep, with a favourable impact on daytime alertness. In conclusion, experience with agomelatine across a range of clinical studies suggests that this compound offers a novel approach to the treatment of depression combining efficacy, even in severe depression, with an extremely favourable side-effect profile and sleep regulation. These properties give agomelatine a definite clinical advantage in the treatment of depression.

Acetamides↗
PubMed1997

Profiles of cognitive functioning in subjects with neurological disorders.

This report completes a four-year funded project designed to develop a data bank of Neurobehavioral Cognitive Status Examinations (NCSE) profiles of patients with neurological based disorders. Seven facilities participated in the study. Twenty categories of neurological/ psychological disorders were obtained from the NCSE profiles of 804 patients. Four categories had a sample large enough to permit inferences about the cognitive deficits related to the specific neurologic diagnosis. Including all diagnoses, the major areas of cognitive decline were auditory memory, visual memory and construction. Subjects with dementia had similar profiles but the severity varied depending upon the diagnoses of multi-infarct dementia, dementia of unknown origin or Alzheimer's disease. Profiles of cognitive functioning appear to differ among patients with different neurological/psychological disorders. The study also illustrated unique cognitive deficits that occur with different neurologic disorders, and how NCSE profiles were able to identify specific areas of cognitive deficits in population of patients with similar neurologic insults.

Central Nervous System Diseases↗
PubMed2000

Staircase electrophoresis profiles of stable low-molecular-weight RNA--a new technique for yeast fingerprinting.

Staircase electrophoresis (SCE) in polyacrylamide gels was used to analyse the stable low-molecular-weight (LMW) RNA profiles of several yeast species and genera. As in prokaryotes, this new electrophoretic technique results in good separation of molecules forming LMW RNA profiles in yeasts. In this study it is reported that, while LMW RNA profiles in prokaryotes include only 5S rRNA, and class 2 and class 1 tRNA, these profiles in eukaryotes also include 5.8S rRNA. Differences in the number and distribution of RNA bands in these profiles allowed identification of differences among the yeast species and genera assayed. LMW RNAs, analysed by SCE, provide a yeast fingerprint that allows them to be clearly differentiated and will in the future enable the rapid assignment of yeast isolates to already described species and the detection of new ones.

Electrophoresis, Polyacrylamide Gel↗