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PubMed1991

The effects of uncertainty on the physician-patient relationship in predictive genetic testing.

In this commentary, I wish to focus on the physician as teacher and communicator. How will physicians deal candidly with their patients in the face of multiple sources of uncertainty? Will physicians recognize the extent of uncertainty? Are they prepared to? Disposed to? Failure to take advantage of a test that may significantly affect the health of an individual or the health of future offspring is a source of one possible disservice to patients. Failure to appreciate the magnitude of uncertainty in clinical testing may lead to other harms. Physicians are also called on to convey information and to aid understanding; individuals are at a disadvantage when this process is flawed by physicians' failure to appreciate uncertainty.

Biomedical Technology↗
PubMed2003

Study on lung function tests and prediction equations in Indian male children.

OBJECTIVE: The present study was carried out to evaluate lung functions and develop prediction equations in Indian boys. SUBJECTS: 1555 normal healthy schoolboys from Hyderabad city who were in the age group of 5 to 15 years were selected for the present study. DESIGN: The anthropometric parameters such as height, sitting height, weight, and chest circumference were measured and body surface area (BSA) and percent body fat (% Fat) were derived. The lung functions studied were FEV1, FVC, FEV1% and PEFR. RESULTS: The height, sitting height, weight, BSA, chest circumference, body fat as well as FEV1, FVC, FEV1 % and PEFR were comparable with Indian boys. The height for age, weight for age and weight for height were found to be lower than 50th percentile of NCHS standards in the subjects studied. Similarly the lung function values of the study population were found to be lower than the values of corresponding western population. CONCLUSION: Regression equations were derived to predict FEV1, FVC and PEFR using physical characteristics. Height, chest circumference and fat free mass were the best predictors for FEV1, FVC, and PEFR. Age, height, sitting height, weight, chest circumference and fat free mass showed significant association with lung functions.

Adolescent↗
PubMedDate not supplied

Temporary balloon occlusion of the carotid artery combined with brain blood flow imaging as a test to predict tolerance prior to permanent carotid sacrifice.

PURPOSE: To describe the technique of using SPECT brain blood flow imaging to identify patients at risk for having strokes after balloon or surgical ligation of an internal carotid artery. PATIENTS AND METHODS: 29 patients underwent temporary balloon occlusion of the internal carotid artery and blood flow imaging studies were obtained prior to sacrifice of the vessel; 11 internal carotid arteries were indeed sacrificed and form the basis of our study. Follow-up of these patients ranged from 3 to 65 days. RESULTS: Three groups emerged: group I, patients with symptoms during occlusion and an abnormal blood flow study (one patient); group II, patients with no symptoms during the occlusion but with an unequivocally abnormal blood flow study (two patients); group III, patients without symptoms during occlusion and a normal or slightly abnormal blood flow study (eight patients). CONCLUSION: Carotid sacrifice without initial and temporary balloon occlusion is unnecessarily risky. Imaging of blood flow in the brains of these patients can further improve the safety of occlusion procedures in the internal carotid artery.

Adolescent↗
PubMed1991

Quantification of alphafetoprotein (AFP) endocytosis by PHA-activated peripheral blood mononuclear cells (PBMC) from HIV-infected individuals. A useful test of predictive value for the progression of AIDS.

Serum alphafetoprotein (AFP) is actively taken up, through receptor-mediated endocytosis, by many embryo-fetal cells during ontogenic development but also by neoplastic cells, as well as by normal peripheral T lymphocytes after mitogenic activation. We have previously shown that the ability to internalize AFP is impaired in mitogen-activated T cells from several groups of (HIV+)-seropositive individuals and that this expression roughly correlates with the progression of the disease. It is not clear whether this impaired AFP-endocytosis results from an HIV-mediated inhibition of AFP-receptor expression or if it is the consequence of a target signal transduction impairment due to HIV-infection. In the present work we have explored both possibilities by studying AFP-endocytosis in peripheral blood mononuclear cells (PBMC) from seropositive (HIV+)-asymptomatic heterosexual individuals and in in vitro HIV-infected PBMC from healthy donors, either quiescent or stimulated with phytohemagglutin (PHA). Our results suggest that this novel abnormality of T-cells associated with HIV-infection reflects an unusual proliferative response of PBMC to mitogenic stimuli.

Acquired Immunodeficiency Syndrome↗