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PubMed1996

Proliferation indexes--a comparison between cutaneous basal and squamous cell carcinomas.

AIMS: To compare differences in cell proliferation indexes and apoptotic indexes between cutaneous basal and squamous cell carcinomas, in an attempt to suggest an explanation for the differences in their biological behaviour. METHODS: Forty cases of cutaneous basal cell carcinoma (BCC) and 40 cases of moderately and well differentiated squamous cell carcinoma (SCC) were retrieved from the archives. Sections, 4 microns thick, were cut from formalin fixed, paraffin wax embedded tissue in each case and stained with haematoxylin and eosin. These were then examined for mitotic and apoptotic figures per 1000 cells. Sections from the same cases were also immunostained with the mouse monoclonal antibody Ki67 (MIB1); positive nuclear staining was counted per 1000 cells. RESULTS: No significant differences were found between the mitotic indexes and apoptotic indexes in these tumours. There was, however, a significant difference in Ki67 (MIB1) staining, with greater staining in the squamous cell carcinomas. CONCLUSION: Estimation of the mitotic and apoptotic indexes did not reveal any differences between these two tumour types. The proliferation indexes, assessed by Ki67 immunostaining, did differ. This may be one of the factors underlying the more aggressive behaviour of SCC.

Apoptosis↗
PubMed2006

[Relationship between lipid profile and body mass index. Five-year follow-up in children aged 6-11 years old. The Rivas-Vaciamadrid study].

BACKGROUND: To study the relationship between lipid profile and body mass index (BMI) in children after a 5-year follow-up. METHOD: A total of 281 children were evaluated at the ages of 6 and 11 years. Total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), and apoproteins A1 (Apo A) and B100 (Apo B) were measured. Low-density lipoprotein cholesterol (LDL-C) was determined and the Apo B/Apo A, TC/HDL-C, LDL-C/HDL-C indexes, and the atherogenic index were calculated. BMI was also calculated (BMI 5 kg/m2). Evolution parameters were calculated (EVO 5 value 11 years - value 6 years). Associations between BMI and lipid profile were studied. RESULTS: The prevalence of obesity (according to the criteria of the International Obesity Task Force) was 4.98 % (6 years) and 16,72 % (11 years). In children who were in the fourth BMI quartile at the age of 11 years, LDL-C/HDL-C and TC/HDL-C levels were significantly higher and than those in children in the first quartile but HDL-C and Apo A levels were lower. A significant positive correlation was found between the evolution of BMI and the four indexes studied and TG, but this correlation was negative for HDL-C and Apo A. The evolution of the indexes was positive in 11-year-old obese children and negative in nonobese children. CONCLUSIONS: Lipid profile was worse in 11-year-old children in the fourth BMI quartile than in the remaining children. Obese children had higher values of the indexes studied, supporting the importance of obesity as a cardiovascular risk factor.

Apoproteins↗
PubMed1993

Predictive value of a morphometric prognostic index in female breast cancer.

Survival data of the patients were correlated to tumour size, axillary lymph node (pN) status, mitotic frequency and morphometric prognostic index (MPI) in a series of 611 women with a primary breast carcinoma treated and followed-up for over 12 years in Kuopio University Hospital. The pN status, tumour size, mitotic activity index (MAI), volume-corrected mitotic index (M/V index) and MPI all predicted recurrence-free survival and cancer survival (p < 0.001). In pN(-) patients, the MPI was the most important predictor of recurrence-free survival and cancer survival (p < 0.001) followed by the mitotic frequency. In pN(+) patients, tumour diameter and MPI were equal predictors (p < 0.001) of survival followed by M/V index. In Cox's analysis, MPI, pN status and mitotic frequency independently predicted survival in the whole series. In the separate analysis of pN(-) and in pN(+) tumours, the MPI and MAI independently predicted survival. The M/V index was independently related to recurrence-free survival in pN(+) tumours. In multivariate analysis, MPI was an independent predictor although it does not include all the prognostic information. The results suggest that the decisions on adjuvant therapy in breast cancer can be based on the MPI, particularly in pN(-) patients.

Breast Neoplasms↗
PubMed2000

Assessment of aortic valve stenosis severity: A new index based on the energy loss concept.

BACKGROUND: Fluid energy loss across stenotic aortic valves is influenced by factors other than the valve effective orifice area (EOA). We propose a new index that will provide a more accurate estimate of this energy loss. METHODS AND RESULTS: An experimental model was designed to measure EOA and energy loss in 2 fixed stenoses and 7 bioprosthetic valves for different flow rates and 2 different aortic sizes (25 and 38 mm). The results showed that the relationship between EOA and energy loss is influenced by both flow rate and aortic cross-sectional area (A(A)) and that the energy loss is systematically higher (15+/-2%) in the large aorta. The coefficient (EOAxA(A))/(A(A)-EOA) accurately predicted the energy loss in all situations (r(2)=0.98). This coefficient is more closely related to the increase in left ventricular workload than EOA. To account for varying flow rates, the coefficient was indexed for body surface area in a retrospective study of 138 patients with moderate or severe aortic stenosis. The energy loss index measured by Doppler echocardiography was superior to the EOA in predicting the end points, which were defined as death or aortic valve replacement. An energy loss index </=0.52 cm(2)/m(2) was the best predictor of adverse outcomes (positive predictive value of 67%). CONCLUSIONS: This new energy loss index has the potential to reflect the severity of aortic stenosis better than EOA. Further prospective studies are necessary to establish the relevance of this index in terms of clinical outcomes.

Adult↗
PubMed1997

Relative influence of menopausal status, age, and body mass index on blood pressure.

The objective of this study was to assess the influence of menopausal status on blood pressure levels in a cross-sectional population study in the setting of a preventive health care program clinically conducted in Ferrara, Italy. The patients were 2397 healthy women 35 to 65 years old (489 in premenopause, 847 in perimenopause, 887 in spontaneous menopause, and 174 in surgical menopause); subgroups were also obtained with increasing duration of menopause (1 to > 5 years) matched with premenopausal and perimenopausal women by chronological age at onset of menopause. Measurements of sphygmomanometric blood pressure, age, age at menopause, duration of menopause, and body mass index were made. Postmenopausal women had higher blood pressure than premenopausal and perimenopausal subjects. After adjustment for body mass index, the blood pressure changes with menopausal status were still significant, but not after correction by age. The increased risk of hypertension of postmenopausal women also lost statistical significance after adjustment for age and body mass index. At multivariate analysis, blood pressure showed no significant relation with the duration of menopause, whereas age was a significant covariant for systolic blood pressure, and body mass index for systolic and diastolic blood pressure. A transient initial rise in blood pressure and body mass index was detected in surgical but not in spontaneous menopause. Blood pressure rises after menopause appear to be due more to increased body mass index and aging than ovarian failure per se.

Adult↗
PubMed2004

Sex differences in the relation between body mass index and asthma and atopy in a birth cohort.

RATIONALE: Several studies have identified an association between asthma and obesity in women. It remains unclear if this association is due to genuine asthma or to symptoms caused by overweight, at what age the association develops, and whether it is confined to females. OBJECTIVE: To explore the relations between body mass index, asthma, and atopy in a birth cohort of approximately 1,000 individuals. METHODS: Information on asthma and measurements of lung function, airway responsiveness, and atopy were obtained on multiple occasions between ages 9 and 26. Associations between these outcomes and body mass index were analyzed using generalized mixed linear regression models. Further analyses adjusted for potential covariates including breastfeeding, birth order, parental asthma, and personal and family smoking history. MAIN RESULTS: Body mass index was positively associated with asthma, wheeze, asthma treatment, atopy, immunoglobulin E, and inversely with the FEV(1)/FVC ratio in females. There was no significant association with airway responsiveness to methacholine or salbutamol. There was little evidence of an association between body mass index and asthma or atopy in males. Analyses adjusting for potential covariates showed similar findings. Asthma was not associated with a raised body mass index in childhood and childhood asthma did not lead to being overweight as an adult. CONCLUSIONS: A raised body mass index is associated with asthma and atopy in women but not men. Population attributable fraction calculations estimate that 28% (95% confidence interval 7-45) of asthma developing in women after age 9 is due to overweight.

Adolescent↗
PubMed2006

Acute effect of meal glycemic index and glycemic load on blood glucose and insulin responses in humans.

OBJECTIVE: Foods with contrasting glycemic index when incorporated into a meal, are able to differentially modify glycemia and insulinemia. However, little is known about whether this is dependent on the size of the meal. The purposes of this study were: i) to determine if the differential impact on blood glucose and insulin responses induced by contrasting GI foods is similar when provided in meals of different sizes, and; ii) to determine the relationship between the total meal glycemic load and the observed serum glucose and insulin responses. METHODS: Twelve obese women (BMI 33.7 +/- 2.4 kg/m2) were recruited. Subjects received 4 different meals in random order. Two meals had a low glycemic index (40-43%) and two had a high-glycemic index (86-91%). Both meal types were given as two meal sizes with energy supply corresponding to 23% and 49% of predicted basal metabolic rate. Thus, meals with three different glycemic loads (95, 45-48 and 22 g) were administered. Blood samples were taken before and after each meal to determine glucose, free-fatty acids, insulin and glucagon concentrations over a 5-h period. RESULTS: An almost 2-fold higher serum glucose and insulin incremental area under the curve (AUC) over 2 h for the high- versus low-glycemic index same sized meals was observed (p < 0.05), however, for the serum glucose response in small meals this was not significant (p = 0.38). Calculated meal glycemic load was associated with 2 and 5 h serum glucose (r = 0.58, p < 0.01) and insulin (r = 0.54, p < 0.01) incremental and total AUC. In fact, when comparing the two meals with similar glycemic load but differing carbohydrate amount and type, very similar serum glucose and insulin responses were found. No differences were observed for serum free-fatty acids and glucagon profile in response to meal glycemic index. CONCLUSION: This study showed that foods of contrasting glycemic index induced a proportionally comparable difference in serum insulin response when provided in both small and large meals. The same was true for the serum glucose response but only in large meals. Glycemic load was useful in predicting the acute impact on blood glucose and insulin responses within the context of mixed meals.

Adult↗
PubMed2006

Validation of the severity index by cardiac catheterization and Doppler echocardiography in patients with aortic sclerosis and stenosis.

The severity index is a new echocardiographic measure that is thought to be an accurate indicator of aortic leaflet pathology in patients with AS. However, it has not been validated against cardiac catheterization or Doppler echocardiographic measures of AS severity nor has it been applied to patients with aortic sclerosis. The purposes of this study were to compare the severity index to invasive hemodynamics and Doppler echocardiography across the spectrum of calcific aortic valve disease, including aortic sclerosis and AS. 48 patients with aortic sclerosis and AS undergoing echocardiography and cardiac catheterization comprised the study population. The aortic valve leaflets were assessed for mobility (scale 1 to 6) and calcification (scale 1 to 4) and the severity index was calculated as the sum of the mobility and calcification scores according to the methods of Bahler et al. The severity index increased with increasing severity of aortic valve disease; the severity indices for patients with aortic sclerosis, mild to moderate AS and severe AS were 3.38 +/- 1.06, 6.45 +/- 2.16 and 8.38 +/- 1.41, respectively. The aortic jet velocity by echocardiography and the square root of the maximum aortic valve gradient by cardiac catheterization correlated well with the severity index (r = 0.84, p < 0.0001; r = 0.84, p < 0.0001, respectively). These results confirm that the severity index correlates with hemodynamic severity of aortic valve disease and may prove to be a useful measure in patients with aortic sclerosis and AS.

Aortic Valve Insufficiency↗
PubMed2006

Effect of changes in contractility on the index of myocardial performance in the dysfunctional left ventricle.

BACKGROUND: The index of myocardial performance has prognostic power in patients with cardiomyopathy and following myocardial infarction. As the index of myocardial performance has been shown to be preload and afterload dependent, the effect of altering contractility on IMP and its components with left ventricular dysfunction has been incompletely delineated. METHODS: Chronic left ventricular dysfunction was induced in 10 canines using coronary microsphere embolization. Each dog was instrumented and imaged with 2D echo and Doppler. At the same atrially paced rate, contractility was increased with a dobutamine infusion and then following 4 weeks of oral digoxin. RESULTS: With chronic left ventricular dysfunction, a reduced left ventricular ejection fraction (42 +/- 3%, p < 0.001) and increased index of myocardial performance (0.58 +/- 0.17, p < 0.01) due to isovolumic contraction time lengthening and shortened left ventricular ejection time were noted. Dobutamine increased ejection fraction (p < 0.001), reduced left ventricular end diastolic pressure (p < 0.01), and reduced the index of myocardial performance (0.33 +/- 0.17, p < 0.001) due to isovolumic contraction time, isovolumic relaxation time, and left ventricular ejection time shortening. Digoxin increased ejection fraction (p < 0.05), reduced left ventricular end diastolic pressure (p < 0.05), and reduced the index of myocardial performance (0.42 +/- 0.13, p < 0.01) due to isovolumic contraction time shortening (p < 0.001). Both dobutamine and digoxin lengthened the diastolic filling period (p < 0.01). CONCLUSION: Increased inotropy with digoxin and dobutamine reduced the index of myocardial performance in dogs with left ventricular dysfunction. Shortened isovolumic contraction time, increased diastolic filling period, and reduced left ventricular end diastolic pressure with digoxin may provide insight into its efficacy in heart failure.

Animals↗
PubMed2001

Early damage as measured by the SLICC/ACR damage index is a predictor of mortality in systemic lupus erythematosus.

The aim of this study was to determine whether early damage accrued in SLE as measured by the SLICC/ACR Damage Index predicts mortality in an inception cohort of lupus patients that have been followed prospectively in a single centre. SLE patients from the University of Toronto Lupus Clinic presenting within 1 y of their diagnosis prior to 1988 were included. This enabled all patients to be potentially followed for at least 10 y. Yearly SLICC/ACR Damage Index scores were determined for each patient. Early damage was defined as a score > or = 1 and no damage as a score of 0 at the initial assessment. Log rank test was used to compare the survival experience between those with and without damage, with all patients being censored at 10 y. Two-hundred and sixty-three patients were identified in this inception cohort who were followed for 10 y. One-hundred and ninety patients (72%) had a SLICC/ACR Damage Index score of 0 (no damage) while 73 patients (28%) had at least one SLICC/ACR Damage Index item scored (early damage). Twenty-five percent of lupus patients who exhibited damage at their first SLICC/ACR Damage Index assessment died within 10 y of their illness as compared to only 7.3% who had no early damage (log rank P-value = 0.0002). SLE patients who died within 10 y were more likely to have renal damage (P = 0.013), and a trend toward more cardiovascular disease (P = 0.056), compared to patients who were alive. Early damage as reflected by the initial SLICC/ACR Damage Index is associated with a higher rate of mortality.

Adolescent↗
PubMed2005

[Body mass index and measures of adiposity among elderly adults].

OBJECTIVE: To evaluate the nutritional status of elderly persons and to compare the correlation between the body mass index (BMI=kg/m2) with measures of adiposity and fat distribution among elderly and middle-aged adults. METHODS: Elderly persons (N=699; 60 years or older) and middle-aged adults (N=1,306; 40-59.9 years) participating in a population-based survey conducted in 1996 in the municipality of Rio de Janeiro were evaluated as to body mass index, arm, waist, and hip circumferences, skinfolds, and arm fat and muscle areas using standardized procedures. The cutoff points proposed by the World Health Organization for waist circumference, waist-to-hip ratio, and body mass index were used. Analyses were performed using the Spearman correlation coefficient and linear regression adjusted for age. RESULTS: About 50% of elderly subjects were classified as overweight and more than 50% of women in all age groups had waist circumference and waist-to-hip ratio outside the normal range. Among men, these percentages were about 40% for waist circumference and 20% for waist-to-hip ratio. Among elderly subjects, the partial correlation (adjusted for age) between body mass index and measures of adiposity (waist circumference, skinfolds, and arm fat area) ranged from 0.45 to 0.85 for men and 0.55 to 0.86 for women. Weight and waist circumference were the variables more strongly correlated with body mass index among both elderly persons and adults. CONCLUSIONS: The prevalence of overweight among elderly persons was high for both men and women. Body mass index shows a similar relationship with adiposity regardless of ageing.

Adipose Tissue↗
PubMed1999

Genetic sonogram scoring index: accuracy and clinical utility.

We sought to evaluate the accuracy of the genetic sonogram scoring index in detecting Down syndrome fetuses in a high-risk population. Women referred for genetic sonogram scoring index based on increased risk for aneuploidy were prospectively evaluated. Each fetus was assigned a score based on our previously published genetic sonogram scoring index. A score of 1 or greater was an indication for karyotype determination. Of 1076 patients (1118 fetuses) in the study group, follow-up data were available for 1030 (92%), eight of whom had Down syndrome (prevalence 0.8%). Three fetuses with Down syndrome had a genetic sonogram scoring index of 0, and for one of these the mother was 42 years old. One affected fetus had a score of 1 and the other four had scores of 2 or greater. Using a genetic sonogram scoring index of 1 or greater (age not considered), five of eight fetuses with Down syndrome (62.5%) were identified, as well as 150 of 1030 (14.6%) of normals. Down syndrome was undetected in three fetuses of 1030 (1 in 343) or 0.29%. In addition, when all women 40 years old or older underwent karyotype testing regardless of their sonographic findings, six of eight Down syndrome fetuses were identified (75%), as well as 271 of 1030 (26.3%) of normals. The number of cases of Down syndrome not detected was two in 1030 (1 in 515) or 0.19%. In conclusion, the genetic sonogram scoring index was used to identify approximately 75% of fetuses with Down syndrome, with amniocentesis being recommended in 26.7% of a high-risk population.

Adult↗
PubMed1999

[Atención Primaria journal in MEDLINE: an analysis of the first 7 years of indexing (1989-1995)].

OBJECTIVES: To evaluate the validity of the information of bibliometric interest retrieved from MEDLINE and referred to the articles published by Atención Primaria journal from 1989 to 1995. To describe the presence of this journal and its evolution among the journals of its own thematic group (Family Practice) during the same period. DESIGN: Retrospective descriptive study. MATERIAL: MEDLINE database on SilverPlatter, 1997 edition. MEASUREMENTS: In a first step, all the documents published by the spanish journal during this period have been revised. Secondly, with a sample of 385 documents that comes from 24 issues selected at random, it has been analysed the indexing of the following fields: title in english (TI), original title (TO), authors (AU), bibliographic citation (SO), year of publication (PY), country of publication (CP) and type of publication (PT). The field institutional address of primary author (AD) will be studied exhaustively. The number of articles indexed coming from the different journals of the Family Practice group, and their evolution during the studied period were analysed, as the countries and languages of publication of these journals. The spanish journal has been compared with the rest of its thematic group in type of publications and type of studies (PT field). MAIN RESULTS: MEDLINE hasn't indexed 158 out of 1865 (8.47%) of the documents published by the journal from 1985 to 1995. This percentage becomes 4.04% when reply letters, that MEDLINE doesn't indexed, are not considered. MEDLINE offers the field AD for the papers published by the Spanish journal from 1990. From this moment on the field AD appears in 95% of the indexed documents. The 30% of the registers without the AD field, don't have institutional address in the original document. The institution or centre that MEDLINE cites firstly in the AD field, coincide with the one of the first author, in 99% of the cases. The number of authors is correct in all cases, even if in 3.37 +/- 1.8% there are typographical mistakes. TO, SO, PY and CP fields are always corrected. Nevertheless MEDLINE modifies in 66.7 +/- 4.7% of the documents the english title (TI field). The presence of the spanish journal in the Family Practice group has continuously increased in global terms from its inclusion in MEDLINE database, even if its relative contribution has stayed the same, around a 14%, in the course of the period analysed. There are differences between the spanish journal and the rest of the journals of its thematic group in type of publications and type of studies. CONCLUSIONS: The analysis of the 7 first years of the Atención Primaria indexing bring us to affirm that MEDLINE can be used to obtain valid information to describe some bibliometric aspects interesting for the scientific production, mainly coming from primary care spanish professionals, and published in this journal. Translations into english of the titles that appears in the english summary had to be improved. Institutional address had to be always and more clearly provided. The presence of the spanish journal among the journals of its thematic group is important (14%), even if its profile in type of publications and type of studies is significantly different.

Abstracting and Indexing↗
PubMedDate not supplied

[The correlation of arterial pressure with weight and body mass index].

OBJECTIVES: To analyze the influence of weight and different body mass indexes on blood pressure (BP) values. The study was carried out in 823 volunteers (345 males, 478 females), aged 25/80 years. A standardized protocol, based on the recommendations provided by the V Joint National Committee was set up. The means of three consecutive readings taken at 2-min. intervals on three occasions were used. Weight and height were determined and the indexes were calculated. Correlations between weight and the selected indexes, with SBP and DBP, respectively, by sex and age interval were performed. The most representative indexes were body mass index (BMI) followed by lean BMI and weight. Analysis of BP values are BMI, for a period starting at 25 years and ending at 74 year, for both SPB and DBP, in comparison with the Humboldt Study data was performed, showing a strikingly similar pattern of behavior with our data. Additionally, weight and BMI are more closely associated with DBP in males than in females. Conversely, this association is closer in women with SBP. The importance of the ethnic factor is emphasized in order to establish body mass index cut-off values regarding the population under study, because the values proposed by the American Heart Association are probably rather high for our population.

Adult↗
PubMed1999

Waist circumference and body mass index as predictors of elevated alanine transaminase in Danes aged 30 to 50 years.

INTRODUCTION: We examined whether waist circumference and waist-to-hip circumference ratio were a better predictor for elevated alanine transaminase level than body mass index. METHODOLOGY: In a cross-sectional survey we examined body mass index, waist circumference, waist-to-hip ratio, alcohol consumption, and alanine transaminase level in a random sample of 903 men and women aged 30 to 50 years from The Ebeltoft Health Promotion Project in Denmark. RESULTS: Body mass index, waist circumference and waist-to-hip ratio explained an approximate 12% variation in alanine transaminase in men and 4% in women, whereas waist-to-hip circumference ratio explained a 2% variation in women. The risk of elevated alanine transaminase level in men, calculated as odds ratio, with a body mass index (kg/m2) above 30, or a waist circumference above 102 cm, or a waist-to-hip circumference ratio above 0.9 was 9.3 (95% confidence interval [CI], 3.6-24.1), 5.6 (95% CI, 2.5-12.5) and 2.7 (95% CI, 1.3-5.3) respectively, but there was no elevated risk among women. CONCLUSIONS: Waist circumference and body mass index were both predictors in men. Waist-to-hip ratio was also a predictor in men, but not as strong a predictor as waist circumference and body mass index. No association was found in women. This difference is probably explained by differences in the accumulation of intra-abdominal adipose tissue among men and women with the same degree of obesity.

Adult↗
PubMed1999

Analysis of three dental fluorosis indexes used in epidemiologic trials.

The objective of this paper was to compare the DEAN, T-F and TSIF dental fluorosis indexes in relation to prevalence of surfaces, teeth and locality, and to verify the statistical correlation among them. The sample consisted of 461 schoolchildren, ages 12-14 years, born and reared in 3 cities in the State of São Paulo from 2 years of age. A total of 153 were from Cesário Lange with a fluoride concentration in the water supply of 1.4 ppm F, 142 from Piracicaba (0.7 ppm F) and 166 from Iracemápolis (< 0.3 ppm F). The clinical examination was conducted after tooth brushing, using a plane mirror, artificial light and air drying of the teeth for 1 min. Premolars, second molars, and occlusal surfaces were the most severely affected. The three indexes showed similar percentages of children affected in the 3 three cities: 32.7%, 16.9% and 4.2% for the DEAN index, 33.3%, 17.6% and 4.2% for the T-F index and 32.7%, 16.9% and 4.2% for the TSIF index. There were no difficulties in using the three indexes in the field trials; thus the use of any one may be recommended in regions with similar fluoride concentrations to those of this study.

Adolescent↗
PubMed2000

Measuring the epidemiology of distress: the rheumatology distress index.

OBJECTIVES: (1) To examine clinical and psychological variables to determine which are associated with psychologic and psychosocial severity or "distress"; (2) to investigate whether patients with the 2 major rheumatic disorders, rheumatoid arthritis (RA) and osteoarthritis (OA), differ in distress variables and distress; and (3) to develop and validate a simple, clinically acceptable index of distress suitable for routine care and research purposes. METHODS: A total of 2,403 patients were evaluated in 2 data sets (N = 1,399 and N = 1,490). The first data set was evaluated in the clinic by a routine clinical examination and administration of the Clinical Health Assessment Questionnaire (CLINHAQ). This instrument includes measures of pain, global severity, functional disability, anxiety, depression, sleep disturbance, fatigue, health satisfaction, and health status. The second data set was evaluated by a mailed questionnaire that included the CLINHAQ, but also coping scales, the Beliefs in Pain Control Questionnaire, the Self Performance Scale, and the Arthritis Helplessness Index. RESULTS: RA and OA groups had similar scores for the variables associated with distress: pain, global severity, functional disability, anxiety, depression, sleep disturbance, fatigue, health satisfaction, and health status. Patients with fibromyalgia (FM) had more abnormal scores for every variable, reflecting overall distress. Using patients with FM as a "gold standard" of distress, we developed an index in data set 2. the Rheumatology Distress Index (RDI), made up of 5 variables, anxiety, depression, global severity, fatigue, and sleep disturbance, that best identified patients with FM compared to other patients. We then validated the instrument on the distress severity clusters formed in data set 1. The correlation between RDI and distress severity cluster was 0.874 with all patients considered and 0.867 with FM patients excluded. In addition, RDI predicted 1,174 of 1,399 (83.9%) cluster memberships correctly. Compared with a battery of psychological and clinical tests that classified 74% of FM and non-FM patients correctly, the RDI and is only slightly less effective, classifying 70.3% correctly. CONCLUSION: Distress is a patient rather than a disease phenomenon. A simple, easy to administer self-report questionnaire can be used to classify patients according to their level of distress. The resulting index, the RDI. accurately identifies distressed and non-distressed patients. Such an index should be useful for patient care and research.

Aged↗
PubMed2003

Singaporean Chinese adolescents have more subcutaneous adipose tissue than Dutch Caucasians of the same age and body mass index.

Data on weight, height and skinfold thickness (biceps, triceps, subscapular and suprailiac) of 101 Singaporean Chinese adolescents (49 girls and 52 boys), aged 16-18 years, were compared with data of Dutch Caucasians (52 girls, 37 boys) of the same age. Age did not differ between the sexes in each ethnic group or between the ethnic groups within each sex group. The Chinese females were shorter, lighter and had a lower BMI, but the sum (mean +/- SD) of four skinfolds was much higher (69.1+/-15.4 mm) than in Caucasian girls (52.4 +/- 17.8 mm). Also, the Chinese boys were shorter and lighter, but their body mass index was not lower compared to Caucasian boys. Their skinfold thickness was, as in girls, much higher compared to Caucasians (48.8 +/- 17.0 mm versus 31.1 +/- 10.2 mm). After correcting for (non significant) differences in age and skinfold thickness the Chinese adolescent girls had a 3.3 +/- 0.4 kg/m2 (mean +/- SE) lower body mass index than their Caucasian counterparts. Singapore Chinese boys had a 2.7 +/- 0.4 kg/m2 lower body mass index mean+/-SE) than their Caucasian counterparts. Similarly, predicted body fat percent was 5.8+/-0.6 percent points higher (mean +/-SE) in Singapore Chinese girls compared to their Caucasian counterparts of the same age and body mass index. Singapore Chinese boys had 6.0+/-0.6 percent more body fat percent (mean+/-SE) than Caucasians of the same age and body mass index. The data confirm the high body fat percent/low body mass index relationship in Singaporean Chinese as is reported earlier in the literature for adults and children.

Adipose Tissue↗