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PubMed2006

Weight gain in cachectic COPD patients receiving noninvasive positive-pressure ventilation.

BACKGROUND: In chronic obstructive pulmonary disease (COPD), body mass index (BMI) is an important predictor of survival. Little is known about the prevalence of malnutrition or longitudinal changes of BMI in patients undergoing noninvasive positive-pressure ventilation (NPPV). METHODS: In a cohort study of 141 patients with COPD and severe chronic respiratory failure (mean forced expiratory volume in the first second [FEV1] 0.80 +/- 0.27 L, mean P(aCO2) 55.6 +/- 8.8 mm Hg), we investigated nutritional status in relation to respiratory impairment. Changes in BMI were evaluated at 6 and 12 months after initiation of NPPV. RESULTS: Malnutrition, indicated by a BMI of < 20 kg/m2, was found in 20.6% of the patients. BMI was significantly correlated with the severity of respiratory impairment, especially with hyperinflation (residual volume divided by total lung capacity, r = -0.55, p < 0.001). In malnourished patients (BMI < 20 kg/m2) there was a significant increase in body weight after 6 months (6.2 +/- 12.5%, p < 0.05) and 12 months (12.8 +/- 16.0%, p < 0.01), whereas there were no significant changes in the overall study population. Furthermore, there was no correlation between changes in BMI and changes in blood-gas values, lung function, or inspiratory muscle function, either in the entire patient group or in the subgroup of malnourished patients. CONCLUSIONS: In COPD with chronic respiratory failure, malnutrition is common and strongly related to hyperinflation. After initiation of NPPV, a significant weight gain is observed in malnourished COPD patients.

Adult↗
PubMed1990

Urinary zinc excretion in infancy.

In view of the conflicting data on urinary Zn excretion in infancy we investigated the possible influence of contamination, collecting methods, nutrition (human milk versus formula) and longitudinal changes during the first 16 weeks of life. Methodical investigation showed that special attention is necessary to avoid contamination due to the use of Zn-containing baby creams in the genital region. The sampling device for collection should include the smallest area of skin possible and the use of Zn-containing baby creams has to be avoided both during the collection and at least 24 hours prior to urine collection. Previous fractional urine sampling of the collecting method to be evaluated proves that erroneously high values are not obtained at the beginning of collection. Midstream urinary samples reduce the possibility of contamination. Increased urinary excretion was shown in pre-term infants under theophylline or coffeine medication. The median daily urinary Zn excretion in healthy breast-fed term infants declined significantly from 0.063 (0.027-0.111) mg per kg body weight at the age of 2 weeks to 0.018 (0.004-0.059) mg per kg body weight at the age of 16 weeks. Comparable values for formula-fed term infants were 0.029 (0.025-0.063) mg per kg body weight initially and 0.025 (0.007-0.059) mg per kg body weight at the end of the study. These values can be used as reference values for the urinary Zn excretion of healthy infants.

Aging↗
PubMed1989

[Study of the structural compensation of the mandible during treatment with cervical headgear].

This study was performed on two cephalometric films of each fourteen subjects with skeletal class 1 facial structure and Angle Class II molar relation treated with cervical headgear for a period 0.777 +/- 0.06 years; and of each thirteen control subjects with skeletal class 1 facial structures and normal occlusion observed for a period of 0.807 +/- 0.03 years. The correlation coefficients for the longitudinal changes of angular and linear measurements during control and treatment periods in both groups were evaluated. The correlation coefficients belonging to each group were compared; and the compensational regions during cervical traction were investigated. It was concluded that; the structural compensations occurred in the mandible according to the inhibition of the mesial migration of lower permanent first molars because of the interdigitation with the upper ones were the increase in the ramus inclination, change in the growth pattern of the mandibular condyle, increases in the gonial angle, lower anterior facial height and the mandibular plane angle.

Cephalometry↗
PubMed1989

[Discriminant analysis concerning the background factors of dental caries prevalence in young child-patients visiting the pedodontic clinic of Ohu University Dental Hospital].

In order to get the appropriate clinical information for dental caries prevention, 38 boys and 30 girls who visited the pedodontic clinic of Ohu University Dental Hospital were surveyed for 3 years, they ranged from 2 to 5 years of age. They had all deciduous teeth and were classified into 4 groups, desirable, light, moderate and severe, on the basis of the longitudinal changes of the dental caries attack patterns, after 1 year and 3 years, which is used at the dental health examination of 3-year old children in Japan. The relationships between the groups and the investigations from documents of their past history, health and usual condition of living at their first visit to the hospital were analysed by means of discriminant analysis of the first class of Hayashi's quantifying theory. The results were as follows: 1. O caries attack patterns at 2 years of age transmitted to all caries attack patterns except B patterns at 3 years, and O caries attack patterns at 3 and 4 years never transmitted to C patterns at 5 years. 2. The desirable group having no change in the caries attack patterns was 64.7%, at 2 to 3 years, but was 25.1% and decreased markedly at 2 to 5 years. The severe group transmitting to C caries attack patterns was 17.7% at 2 to 3 years, but was 42.6% and increased remarkably at 2 to 5 years.(ABSTRACT TRUNCATED AT 250 WORDS)

Child, Preschool↗
PubMed1989

Decline of height with age in adults in a general population sample: estimating maximum height and distinguishing birth cohort effects from actual loss of stature with aging.

The decline in stature with age among adults is well documented. Although part of this represents a birth cohort effect, actual height declines among older individuals are known to contribute to the effect. In this study we used longitudinal changes in the heights of adults in a general population sample to determine the rate of decline in height over time in individuals of different ages. This allowed an estimation of the age at which decline in height begins, a value close to age 40 in both sexes. It also allowed derivation of equations from which the maximum height of subjects can be estimated on the basis of their sex, current height, and age. These equations should prove useful when examining the effect of aging per se on physiological measurements that are height dependent. The data also allow one to compare the magnitude of the effect of year of birth with that of the actual decline in height seen among the elderly. We estimate that approximately 60% of the smaller stature of older male subjects and 45% of the smaller stature of older female subjects is a birth cohort effect deriving from the secular trend toward greater stature; the remainder is a result of an actual decrement in height after the age of 40.

Adult↗
PubMed1988

Demonstration of the presence of digoxin-like immunoreactive substance (DLIS) in the serum and urine in children with nephrotic syndrome.

Longitudinal changes of digoxin-like immunoreactive substance (DLIS) in serum and urine from nephrotic children have been studied. The magnitude of DLIS in samples was measured by digoxin RIA kit. The binding activity to the ouabain receptor was measured by radioreceptor assay using crude rat brain synaptosomal fraction. In five cases of nephrosis, the mean value of DLIS in diuresis was significantly higher than during other stages (p less than 0.05). It was also higher than the levels recorded for six patients with nephritis (p less than 0.05). The presence of DLIS in the urine followed a similar pattern. The positive correlation between urine DLIS and ouabain-like substance (OLS) corrected by creatinine was observed for one month after the onset of nephrosis. The present study indicates the presence of DLIS in the serum and urine from patients with nephrosis which have the binding activity to the ouabain receptor. DLIS may be involved in natriuresis and may regulate active sodium transport in nephrotic children.

Blood Proteins↗
PubMed1988

Metabolic state does not influence lymphocyte subsets in type 1 diabetic patients.

In most studies the distribution of peripheral lymphocyte subsets at diagnosis of type 1 diabetes has been found to be altered. Lymphocyte subpopulations were therefore studied during longitudinal changes in the glycaemic control of 11 type 1 diabetics to investigate whether poor metabolic status affects these results. To avoid any influence of the etiopathogenetic mechanisms, the patients studied had a disease duration of 10 +/- 2 (SEM) years and all but one had no residual beta-cell function. The patients were selected randomly amongst those with a long record of poor glycaemic control and at the first examination they had a mean fasting blood glucose of 15 +/- 1 mmol/l and a mean glucosuria of 67 +/- 11 g/24 h. They were then hospitalized and strictly regulated using pump treatment, resulting in a massive reduction in glucosuria (0 +/- 0 g/24 h) and fasting blood glucose (6 +/- 1 mmol/l) at a second examination a week later. Five of the patients were tested for a third time 35 +/- 4 days later and were still in very good glycaemic control. Peripheral lymphocytes were labelled with monoclonal antibodies and examined by flow cytometry (FACS). Neither CD3+ (pan) T-lymphocytes, CD4+ (helper) T-cells, CD8+ (suppressor/cytotoxic) T-cells, the relation between CD4+ and CD8+ T-cells, nor the total amount of lymphocytes, changed significantly between the first, second, and third examination. None of the results were significantly different from those of healthy controls. There was no correlation between any of the immunological and metabolic parameters. It is concluded that metabolic influence on the distribution of lymphocyte subsets is unlikely.

Adult↗
PubMed1988

Predictive value of insulin autoantibodies for further progression of beta cell dysfunction in non-insulin-dependent diabetics.

The predictive value of insulin autoantibodies (IAA) was examined prospectively in 58 non-insulin-dependent diabetics (NIDDs) with and without IAA. The longitudinal changes in serum C-peptide (CPR) responses to 100 g oral glucose tolerance tests (OGTTs) as well as IAA and islet cell antibodies (ICA) in these subjects were followed up to 84 mo (mean 38 mo). Based on the positivity for IAA and ICA during the study, the subjects were subdivided into the following four groups; (a) persistently IAA- and ICA-positive subjects (Group 1, n = 7), (b) persistently IAA-negative and ICA-positive subjects (Group 2, n = 18), (c) persistently IAA-positive and ICA-negative subjects (Group 3, n = 3), (d) persistently IAA- and ICA-negative subjects (Group 4, n = 30). In Group 1 subjects serum CPR response to OGTT decreased significantly during the follow-up study (p less than 0.01), while in the remaining three groups, the response did not show any significant change. Blood glucose level during OGTT in Group 1 increased (p less than 0.01), while the values in remaining groups had no significant change. Four out of seven in Group 1 and 3 out of 18 in Group 2 progressed slowly to insulin-dependent state (p less than 0.07 Group 1 vs. Group 2). None of the subjects in Group 3 and Group 4 progressed to insulin-dependent state (p = 0.01 Group 1 vs. Group 4). The percent binding of labeled insulin and titer of ICA did not show any significant change among their positive groups during the study.(ABSTRACT TRUNCATED AT 250 WORDS)

Autoantibodies↗
PubMed1988

Lung function in patients with tracheobronchopathia osteochondroplastica.

We have analysed the ventilatory function of seven patients with tracheobronchopathia osteochondroplastica. One patient showed reversible airflow obstruction meeting the criteria of bronchial asthma. Another two patients yielded reduced percentage forced expiratory volume (FEV%) and features of small airways obstruction. The patients' previous spirometric measurements also made the rough estimation of longitudinal changes in lung function possible during a follow-up period of 1-8 yrs (mean 4.2 yrs). Although most patients had suffered severe chest infections, no deterioration in spirometric parameters was found during the follow-up. These findings suggest that tracheobronchopathia osteochondroplastica usually has a benign course.

Adult↗
PubMed1988

Liquid-chromatographic profiling of solutes in serum of uremic patients undergoing hemodialysis and chronic ambulatory peritoneal dialysis (CAPD); high concentrations of pseudouridine in CAPD patients.

Using "high performance" liquid chromatography, we studied non-protein-bound fractions and total concentrations of 18 solutes accumulating in sera from a group of 12 patients who were undergoing chronic ambulatory peritoneal dialysis (CAPD) and in predialysis sera from a group of 15 hemodialysis (HD) patients. We monitored longitudinal changes in solute concentrations for two patients with respect to change of therapy between HD and CAPD. The concentrations of pseudouridine (P less than 0.001), uric acid (P less than 0.001), and an unknown fluorescent solute, "UKF3" (P less than 0.01), differed in sera of HD and CAPD patients. When standardized with respect to serum creatinine concentrations, the concentration of the transfer-RNA catabolite, pseudouridine, was significantly (P less than 0.0001) higher in sera of CAPD patients than in HD patients, suggesting an increase in turnover of transfer RNA. In stepwise linear discriminant analysis, the combination of pseudouridine and the probably biochemically related fluorescent unknown, UKF3, contributed most to the differentiation between sera from CAPD and HD patients.

Adult↗
PubMed1988

Mamre Community Health Project--rationale and methods.

The overall aim of the Mamre Community Health Project is to improve the health status of the people of Mamre and to develop an approach to health promotion which may be applicable to other similar areas. Integral to this is the establishment of a surveillance system to monitor changes longitudinally with particular reference to the effects of interventive programmes and the rural-urban transition that the community is experiencing. A multidisciplinary approach that also involves both postgraduate and undergraduate students will be utilised. This article outlines the methodology employed in the first phase of the project, which was concerned with the collection of the baseline data to determine priorities, plan interventions and establish a suitable surveillance system. Approximately 1,000 households were visited and 5,000 residents interviewed by 10 trained interviewers who were selected from the community. Sampling was not used. Methodological issues addressed include the methods used to gain the co-operation and participation of the community, development of an appropriate questionnaire, selection and training of interviewers, supervision of field-work, coding of data and steps taken to ensure the reliability and validity of information collected. Thorough planning with meticulous attention to detail ensured that the Mamre Community Health Project was completed on target with fairly smooth implementation of the data collection phase. Future research will focus on refining epidemiological methods, especially aspects of study design, case definition and exposure status.

Data Collection↗
PubMedDate not supplied

Mineral homeostasis in very low birth weight infants fed either own mother's milk or pooled pasteurized preterm milk.

As part of a randomised controlled study to assess the effect of pasteurization of breast milk on the growth of very-low-birth-weight infants, the longitudinal changes in serum calcium, phosphorus, alkaline phosphatase, 25-hydroxyvitamin D, and bone-gla-protein concentrations were investigated. Infants fed untreated own mother's milk grew more rapidly than those fed pasteurized pooled preterm milk and had higher serum alkaline phosphatase and lower phosphorus values. Serum calcium and 25-hydroxyvitamin D (25-OHD) concentrations were similar in the two groups. Despite the provision of 750 IU vitamin D daily from the 2nd week of life, serum 25-OHD values remained low in a number of infants in both groups, suggesting that either malabsorption of vitamin D or hepatic immaturity might be responsible for the persistently low values. Bone-gla-protein rose significantly after birth and was correlated with alkaline phosphatase values, but not with 25-OHD or phosphorus values. The study supports previous work that indicates that the low phosphorus content of breast milk is probably responsible for biochemical evidence of inadequate bone mineralization and that despite vitamin D supplementation, 25-OHD values do not rise adequately. Thirty-six infants were reexamined between 4 and 11 months after birth. The 25-OHD values had risen significantly in all infants except one who had vitamin D deficiency rickets.

Alkaline Phosphatase↗
PubMed1979

Speed of response characteristics of goalkeepers: a descriptive and developmental report.

Photoelectric cells and accelerometers enabled the measurement of reaction, movement and total response times of the limbs of representative goalkeepers (N = 12) from five levels of organized hockey, under simple and choice test conditions. Speed of response characteristics fundamental to success at these levels of competition and the developmental improvement, which must occur annually to permit progress through the goalkeeping hierarchy, were suggested. The point at which the beginner's "reaction-type" pattern of goaltending must be augmented with "anticipation-type" behavior was explored. The concept that the ability to react and move is specific to the direction of the response was upheld at all levels of investigation. Standard deviation of the RT/MT/TRT's of each group reflected the degree of variability of performance that is tolerable at each level. This variability generally decreased with each ascending level within both testing conditions, with the exception of the CRT measures. Data collected over a two year period, for four subjects, revealed that the most evident longitudinal changes occurred in MT and that the youngest player experienced the greatest degree of overall improvement.

Adolescent↗
PubMed1983

The prognosis of tardive dyskinesia.

Reexamination of the prognosis of tardive dyskinesia indicates that the concept of irreversibility should be replaced by a focus on longitudinal changes. Factors involved in the etiology and point prevalence of TD (e.g., neuroleptic exposure) are not necessarily the determinants of outcome. The presence of affective disorder and poor response to treatment in chronic psychotic patients appear to be related to poor prognosis. Severe dyskinesia with functional impairment is rare. Such severe cases are more likely to show a rapidly developing malignant course than to be the end result of slowly progressing TD after many years of neuroleptic treatment.

Acute Disease↗
PubMed1984

A longitudinal assessment of anaerobic threshold and distance-running performance.

Longitudinal changes in the anaerobic threshold (AT) and distance-running performances (DRP) were assessed with a 4.5-month interval between the pre-, mid-, and post-tests in a relatively homogeneous (in terms of both maximal aerobic power and DRP) sample of 21 male, trained, endurance runners (means age = 18.5 yr) than had been employed previously. ANOVA with repeated measures followed by the Newman- Keuls post-hoc comparison revealed that there were significant alterations in both DRP and AT. Even in this improved state, higher relationships (r greater than or equal to 0.75) between the DRP and AT-related attributes held up consistently over the 9-month training period. Anaerobic threshold (expressed as ml O2 X min-1 X kg-1) showed a correlation higher than 0.80 with 10,000-m race time in every set of tests. When the relationships between the absolute amount of change in the Vo2@AT and the absolute amount of change in DRP were evaluated, significant correlations (r = -0.56 to -0.83) were found in several different time periods. Running velocity at AT (V@AT) also improved significantly, and was closely related to DRP changes. It is speculated that DRP changes are more directly accounted for by the Vo2@AT and/or V@AT changes rather than changes in other physiological attributes.

Adolescent↗
PubMed1981

The developmental course of behavioral states in preterm infants: a descriptive study.

This study describes longitudinal changes in observable states of 58 preterm infants, 29-40 weeks conceptional age, after various forms of stimulation were given during a standardized neurologic examination. The states used in this investigation were considered only in terms of observable behavior. The data indicate that regardless of conceptional age, the level of arousal increased as the examination progressed. Both the rapidity of change from lower to higher states and the predominant highest state reached were clearly dependent upon conceptional age. No relationship between length of extrauterine life with states at 40 weeks was found.

Child Behavior↗
PubMed1995

Multichannel cochlear implantation with inner ear malformation: case report of performance and management.

A small percentage of children who have received the Nucleus multichannel cochlear implant have cochlear malformations of the inner ear and consequent partial electrode insertions. This case describes one child with a cochlear "common cavity" who received an implant at a young age. The case has been further complicated by a gradual malfunction of the electrode array, although the device has not failed completely. Despite the increase in the number of nonfunctional electrodes over time, the subject has continued to improve in auditory, speech production, and language development over a 30-month period. Methods are discussed for clinical monitoring of both performance and the stability of electrodes over time. The circumstances of this case reinforce the importance of postimplant collaboration with families and school staff and highlight the need for objective measures to evaluate both longitudinal changes in performance and device integrity.

Audiometry, Speech↗
PubMed1995

A taxonomy of health status instruments.

Clinicians and policymakers are recognizing the importance of measuring health related quality of life (HRQL) to inform patient management and policy decisions. Self or interviewer administered questionnaires can be used to measure cross sectional differences in quality of life between patients at a point in time (discriminative instruments) or longitudinal changes in HRQL within patients over time (evaluative instruments). Both discriminative and evaluative instruments must be valid (really measuring what they are supposed to measure) and have a high ratio of signal to noise (reliability and responsiveness, respectively). Reliable discriminative instruments are able to reproducibly differentiate between persons. Responsive evaluative measures are able to detect important changes in HRQL over time, even if those changes are small. HRQL should be interpretable--that is, clinicians and policymakers must be able to identify differences in scores that correspond to trivial, small, moderate, and large differences. Two basic approaches to quality of life measurement are available: generic instruments that attempt to provide a summary of health related quality of life; and specific instruments that focus on problems associated with individual disease states, patient groups, or areas of function. Generic instruments include health profiles and instruments that generate health utilities. The approaches are not mutually exclusive. Each approach has its strengths and weaknesses and may be suitable under different circumstances. Investigations in HRQL have led to instruments suitable for detecting minimally important effects in clinical trials, measuring the health of populations, and for providing information for policy decisions.

Classification↗