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The biophysical profile in labor.

To determine whether the biophysical profile would be a valuable intrapartum addition to fetal heart rate monitoring in predicting umbilical arterial acid-base status at delivery, 95 patients at term had serial studies during labor and umbilical artery blood gas analysis. There was no significant association between biophysical profile score and cord blood pH, nor was there a difference in scores between the acidemic and nonacidemic groups. Of the five components of the initial biophysical profile, only a nonreactive nonstress test (NST) was associated with both pH 7.20 or less (P = .019) and metabolic acidemia (P = .016). None of the individual variables of the final examination correlated with a pH of 7.20 or less. However, a nonreactive NST was associated with metabolic acidemia (P = .03), as was the presence of breathing (P = .03). Of the ten infants with pH 7.20 or less, eight had an initial and five had a final biophysical profile score of 8 or higher. Of the five whose pH was less than 7.15, four had an initial and three a final score of 8 or more. Finally, of the five with metabolic acidemia, four had an initial and two a final score of 8 or higher. Half of the acidemic fetuses had final biophysical profile scores of 8 or higher, suggesting that this score in labor is not reliable to rule out acidemia at delivery.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

The cytokeratin profiles of ovarian common "epithelial" tumors.

An improved immunohistochemical determination of the cytokeratin profiles of epithelia and their neoplasms is possible using monoclonal antibodies that will either identify all 19 cytokeratins (AE1/3) or delineate specific subsets (35 beta H11, 34 beta E12, 34 beta B4 and Cam 5.2). Ovarian common "epithelial" tumors (CET) contain cytokeratin filaments. To determine the nature and differences in the cytokeratin profiles of ovarian CET, eight benign Brenner tumors, four serous cystadenofibromas, 28 mucinous tumors, 27 serous tumors and six endometrioid, five clear cell and five undifferentiated carcinomas, as well as nine normal ovaries were immunostained with the above five antibodies. AE1/3 staining was predominant, while Cam 5.2 and 35 beta H11 displayed the most frequent staining thereafter. Statistically significant staining differences were found between a number of tumor groups using the antibodies 35 beta H11, 34 beta E12 and Cam 5.2. In this study, all ovarian CET, except the benign Brenner tumors, displayed a predominantly low molecular weight cytokeratin profile. The same profile in the normal surface epithelium lends credence to the belief that these tumors are derived from this epithelium. A significant staining difference between some of the tumor types using some of the antibodies suggests a possible ancillary, diagnostic role of cytokeratin profiling in situations where exact tumor typing is difficult.

Adenocarcinoma↗

Antibiogram, biotyping and plasmid profile analysis of Acinetobacter calcoaceticus var. anitratus.

Antibiogram, biotyping, and plasmid profile analysis were studied on 115 isolates (40 nosocomial and 75 community strains) of Acinetobacter calcoaceticus var. anitratus isolated from clinical specimens. By disk diffusion method, we found 14 antimicrobial susceptibility patterns. Among them, the gentamicin-resistant patterns were recovered more frequently from nosocomial origin than from community-acquired origin. Fifteen patterns of biocodes were found by using GNI card of AutoMicrobic System (Vitek System). By using rapid alkaline extraction method and agarose gel electrophoresis, 102 isolates (88.7%) contained plasmids, and 72 distinct profiles were found. No particular plasmid profile correlates with specific antibiogram or biotype. However, multiple isolates with identical antibiogram and biotype recovered from the same patient were usually of identical plasmid profile. In view of the heterogeneity of the plasmid patterns that were found, the combined use of antibiogram, biotyping, and plasmid profile analysis could be satisfactory for epidemiological investigation.

Acinetobacter↗

Fetal biophysical profile and perinatal death.

Antepartum assessment of 5034 high-risk pregnancies to predict perinatal death included five biophysical variables (nonstress test, fetal breathing movements, fetal movements, fetal tone, and amniotic fluid volume) which combined to form a biophysical profile score. We assessed 4148 fetuses within seven days of delivery. The ability of each variable to predict perinatal death was expressed as the likelihood ratio, which incorporates sensitivity and specificity into one number. The predictive ability was most accurate with fetal movement (likelihood ratio 48.1) and the combined biophysical profile score (likelihood ratio 51.0). The biophysical profile score was more likely to predict perinatal death due to asphyxia (seven of eight) than lethal anomaly (six of 19). The overall perinatal mortality was 7.6 per 1000 total births. The perinatal mortality rate was 1.0 for a normal biophysical profile score, 31.3 for an equivocal score, and 200.0 for an abnormal score. The false-negative rate for the biophysical profile score was 0.7 per 1000.

Amniotic Fluid↗

EEG profile and behavioral changes after a single dose of clozapine in normals and schizophrenics.

Clozapine, a powerful neuroleptic with unique clinical efficacy (and without parkinsonic side effects), has been shown to have an unusual EEG profile. The EEG changes after clozapine, especially when instrumentally quantified, demonstrated the predictive value of EEG. The similarities of the EEG profile of clozapine with the profile of thymoleptic compounds indicated its possible thymoleptic effect. This later proved to be the case with therapeutic studies in depression. The EEG profile of clozapine in volunteers is similar to the EEG profile in schizophrenics (with appropriately higher doses). Instrumental quantification was performed with spectral and iterative interval analysis to show the advantages of each method and also the complementary value of both of them.

Adult↗

Morphometric distinction of granulomas in tuberculosis and sarcoidosis. Difference in nuclear profiles.

Morphometric measurements were carried out on epithelioid-cell nuclei of noncaseating granulomas in paraffin-embedded sections of lymph node biopsy specimens originating from 15 patients with sarcoidosis and from 18 patients with tuberculosis. The results, which were obtained with the help of a computer-assisted tracing device, established highly significant differences in shape and size of epithelioid-cell nuclear profiles in these two diseases. Direct measurements and computations on these results showed that epithelioid-cell nuclear profiles in sarcoidosis have a smaller mean and median perimeter (boundary length), area and long diameter (maximum length of the nuclear profile) and exhibit a more plump, elliptical-like shape than do those in tuberculous granulomas. Epithelioid-cell nuclear profiles of the latter, as a whole, show more irregular contours, resembling those, e.g., of the sole of a shoe or other elongated patterns. Differences in shape of nuclear profiles were best demonstrated by a size-independent form factor (4 pi *area/perimeter2).

Adolescent↗

Detailed faecal bile acid profile: a diagnostic test for colorectal cancer?

Detailed profiles of bile acids in faeces were evaluated as a diagnostic test for colorectal cancer in rats. Twenty-seven bile acid peaks were measured using improved methods of extraction and separation followed by the sensitive and specific techniques of capillary column gas liquid chromatography and mass spectrometry. Colorectal cancer was induced in experimental animals (female Sprague-Dawley rats, n = 20) by subcutaneous injection of dimethylhydrazine (DMH) and faecal unconjugated bile acids compared with those in the control group (n = 20). The amount of total faecal unconjugated bile acids was lower in the animals administered DMH (255 mg/day vs 334 mg/day: (P = 0.04), and the excretion of seven individual bile acids was reduced when compared with those in the control group (P less than 0.01). In order to use the faecal bile acid profiles as a diagnostic test, linear discriminant analysis was performed. A discriminant score was derived which was applied to each profile, to determine to which group (control or DMH) each animal belonged retrospectively. All analyses were performed blind, and 90% of the animals were correctly assigned. In man, as in rats, the bile acid profile of faces is equally complex and the bile acid profile may be useful as a diagnostic test.

Animals↗

Behavioral profiles of dog breeds.

Breed behavior profiles were obtained by a method that was quantitative and free of personal biases. The profiles concerned 13 traits, eg, excitability, snapping at children, watchdog barking, and affection demand, which are of interest to people wanting dogs as pets. Authorities for the development of the profiles were 48 small animal veterinarians and 48 obedience judges, randomly selected from directories so as to represent equally men and women, and eastern, central, and western geographic regions of the United States. Each authority was asked to rank on each of the behavioral traits a list of 7 breeds chosen randomly from a list of 56 breeds. The data were analyzed in a custom-designed computer program that pooled the data and then ranked all 56 breeds on the basis of the 13 traits. The results indicated that some behavioral traits discriminate between breeds better than others. An examination of sample profiles indicated the feasibility of developing a statistically meaningful behavioral profile that integrates comparative rankings of several authorities balanced as to representation of geographic location, sex, and type of experience with dogs.

Analysis of Variance↗

The application of visual cell profiles in the study of premalignant atypias in sputum.

Because the diagnosis of squamous-cell carcinoma of the lung by routine cytologic screening of sputum is often inconclusive, our laboratory is studying the use of cytomorphologic profiles as a reliable diagnostic aid. This study reports the analysis of the profiles of 75 subjects, both cigarette-smoking volunteers and hospitalized patients suspect for lung cancer. Twenty-five of the subjects had been classified as having squamous metaplasia, 25 as having atypias and 25 as having squamous-cell carcinoma. Four slides were made for each subject, with 100 random fields viewed on each slide. The frequency of free alveolar macrophages, metaplastic squamous cells, epithelial atypical cells and malignant squamous cells were noted for each field. The results indicated that, although there were large differences between individual profiles within each diagnostic category, there were significant differences between the average profiles for each diagnostic category. Furthermore, although there were differences in cell frequencies from slide to slide and within slides, the differences were constant across diagnostic categories. The results are supportive of the progressive-atypia hypothesis for squamous-cell carcinoma of the lung and provide a baseline for comparison with subsequent individual profiles.

Carcinoma↗

Numerical evaluation of cytologic data: II. Comparison of profiles.

Results of cytologic studies are often presented as profiles of some type. The numerical characterization of these profiles may be statistically compared using methods of multivariate analysis. This article describes the determination of the statistically significant differences between portions of profiles, the computation of the Mahalanobis distance measure between profiles and the use of the chi-square statistic as a measure of the typicality of a profile. Fully worked numerical examples suitable for execution on a pocket calculator are given.

Cytological Techniques↗

[The protein profile. Statistical treatment and use of the results, principles and applications].

The serum protein profile is a biological multi parametric analysis. Its validity will be tested by multidimensional statistical treatment to help the medical decisions and the practical exploitation of the results. The mean and the range are given by classical methods which also allow the correlations of some proteins. The factorial analysis of the tables of correlations by showing the proximities between the proteins and the pathological classes gives a first indication of the structure of the data. The multidimensional approach introduces the notion of distance between two profiles, gives an automatic classification of the profiles in distinct groups and an evaluation of these groups as real pathological entities. A table of distance between the profiles can also discriminate between the groups of patients. However the biological model implies some hypotheses: does any disease imply a specific profile and the reverse? Are the variations of each protein compatible and do they require some pondering? Therefore the best in the present time is to try a multidimensional approach as an help for medical decision rather than an automatic mean of diagnosis.

Blood Proteins↗

High resolution plasma lipoprotein cholesterol profiles by a rapid, high volume semi-automated method.

A new rapid and sensitive method, the single vertical spin autoprofiler (VAP), has been developed for quantitative profiling of the major plasma lipoproteins. The method involves a combination of single vertical spin separation of plasma and continuous on-line analysis of cholesterol. Plasma lipoproteins are first separated by a 45-min spin in a vertical rotor, after which the amount of cholesterol in the effluent of each tube is monitored continuously by a modification of the BMC automated enzymatic cholesterol method; simultaneously, 80% of the sample is diverted by stream-splitting to a fraction collector for further analysis, if desired. VAP not only resolves very low density lipoprotein (VLDL), low density lipoprotein (LDL), and high density lipoprotein (HDL) peaks quantitatively but also detects the presence of intermediate density lipoprotein (IDL) and other lipoprotein variants. VAP was highly reproducible; the inter-run coefficient of variation for cholesterol concentration in VLDL, LDL, and HDL was 4.8%, 2.9%, and 2.4%, respectively. Cholesterol recovery using VAP was 98.5 +/- 3.5%. Lipoprotein-cholesterol profiles of plasma from three major hyperlipoproteinemia phenotypes examined by VAP were qualitatively and quantitatively different from each other and from profiles of normolipidemic individuals. One significant finding was that IDL could be detected in the plasma of all type IV hyperlipoproteinemic subjects examined thus far. Several variant lipoprotein profiles which did not correspond to known phenotypes have also been detected by VAP using plasma from hyperlipidemic as well as from normolipidemic subjects. We submit that VAP is an accurate and rapid method for lipoprotein analysis, either for routine clinical screening or for detailed experimental studies. In addition, VAP provides a visual display of partially to completely resolved lipoprotein classes that is suitable for computer-assisted analysis.-Chung, B. H., J. P. Segrest, J. T. Cone, J. Pfau, J. C. Geer, and L. A. Duncan. High resolution plasma lipoprotein cholesterol profiles by a rapid, high volume semi-automated method.

Animals↗

Critical care profiling for informed treatment of severely ill patients.

An important advance in critical care medicine is the availability of key biochemical test results at the patient's bedside within the brief period when they can be used to guide resuscitation and cardiovascular stabilization effectively. Frequently the menu of key tests, called a "critical care profile (CCP)," must be available to the attending clinician within 5 minutes to guide therapy in real time. Recent developments that make it possible to deliver a CCP with these 5 minutes include the ability to measure all of the analytes of the critical care profile on a whole-blood sample, and point-of-care testing. Today the results of a critical care profile can be available to the attending clinician within 5 minutes of his or her request by sampling approximately 200 microL of whole blood with a critical care instrument at or near a patient's bedside. Tests frequently recommended for a critical care profile include glucose, pO2, pCO2, pH, lactate, ionized calcium, potassium, sodium, ionized magnesium, and either hemoglobin concentration or hematocrit. Hospital areas that need critical care profile support include the emergency department, the operating room, and the intensive care unit.

Critical Care↗

[Importance of the protein profile in internal medicine].

Until recent years, main biologic markers of inflammation used in current practice were limited to erythrocyte sedimentation rate, fibrinogen, and serum protein electrophoresis. A better understanding of inflammatory mechanisms and improvement of laboratories technologies helped in better understanding of the role and potential usefulness of inflammatory reaction proteins. Arrival of proteic profile and, more recently, the development of automation, still improved analysis of variations of different inflammatory reaction proteins. These proteins are then analyzed as an element of a "functional biological system", with known and so expected kinetics and ranges. The analyze of proteic profile combines the analyze of proteins variations, with elected but not exclusive associations, as Immunoglobulins and Complement, Orosomucoid and Haptoglobin, or Albumin and Transferrin. In Internal Medicine, proteic profile may help in solving daily problems. These problems may be so schematized: when the fundamental pathology is not yet known in an unraveling check-up, facing clinical symptoms, with a normal or fewly disrupted usual biologic panel, proteic profile may help to choose investigations necessary for the diagnosis; in the follow-up of patients treated for known inflammatory pathology facing new symptoms, part has to be done between complication of the disease and/or of the treatment, new pathology associated or unefficiency of the treatment. We report herein part of our experience of proteic profile in an Internal Medicine department, from some particularly demonstrative case reports: congenital or acquired abnormality of iron metabolism, with normal usual iron panel (iron deficiency, hemochromatosis); severe evolutive inflammatory or infectious disease with normal erythrocyte sedimentation rate (temporal arteritis, infectious endocarditis).

Acute-Phase Proteins↗

Lipid profiles in patients with systemic lupus erythematosus.

OBJECTIVE: To determine the prevalence of abnormal lipid profiles in 100 consecutive patients with systemic lupus erythematosus (SLE) and the role of potential risk factors. METHODS: Fasting lipid profiles were measured using an enzymatic method. Biodata noted for each patient included age, sex, race, presence of diabetes mellitus, thyroid disease, familial hyperlipidemia, smoking history, presence of nephritis or nephrotic syndrome, lupus activity as measured by the lupus activity criteria count (LACC), duration of SLE, use of antihypertensive agents and the current and cumulative dose of steroids. Statistical analysis was done using PC SAS software. RESULTS: Seventy-three patients had abnormal lipid profiles. Patients with normal and abnormal profiles were comparable in age, sex, race, history of diabetes mellitus, familial hyperlipidemia, and smoking. Abnormal values of total cholesterol (TC), low density lipoprotein (LDL), triglycerides (TG) and TC/high density lipoprotein (HDL) were associated with renal involvement and high dose corticosteroids (> 30 mg prednisolone/day). HDL levels were significantly lower in patients receiving high dose corticosteroids (p < 0.05). In patients with active lupus disease but without renal disease, lipid abnormalities were not observed. CONCLUSION: Abnormal lipid profiles are common in this group of patients with SLE. High dose steroids and the nephrotic syndrome are important contributing factors.

Adult↗

Validity and reliability of facial profile evaluation in vertical and horizontal dimensions from lateral cephalograms and lateral photographs.

Esthetic profile evaluation was performed by six judges on a random sample of 130 white women. Vertical and horizontal profile evaluations of the subjects' cephalograms were compared with vertical and horizontal profile evaluations of the same subjects' photographic slides. Statistically significant differences were found: Judges sometimes favored the photographic profile and sometimes favored the cephalographic profile. Esthetic treatment goals should be based on facial shortcomings as they are observed clinically or seen on a patient's photograph.

Adolescent↗

Raising the nursing profile: the case of the invisible nurse.

The reform of nursing and midwifery is a key concern of health services in the CCEE/NIS. This major change will be impossible without accurate and up-to-date information made readily available to nursing leaders and to people helping them with the reforms. At present, however, such information is hard to come by and nurses remain statistically neglected--the case of the Invisible Nurse. The WHO Regional Office for Europe has launched a project to tackle this through the development of nursing and midwifery profiles. Such profiles were created for each of these countries, and they have proved useful to nursing leaders, WHO staff and consultants and other agencies and researchers. Despite the problems arising from limited WHO resources, the quality of the data collected and differences in terminology, the success of the profiles has laid the foundation for future work: completing the profiles for the central and eastern countries and answering the demands for profiles for other Member States of the European Region. The data thus compiled would enable a comparative analysis of nursing in the Region to be made, with the tracking of trends and perhaps the design of indicators of nursing development in countries.

Delivery of Health Care↗

Comparison of stressed simultaneous urethral pressure profiles between anesthetized continent and incontinent bitches with urethral sphincter mechanism incompetence.

The popular urodynamic technique of stressed urethral pressure profilometry used for investigation of genuine stress incontinence in women was adapted and applied to bitches. The aim was to assess the suitability and reproducibility of the technique in the canine species, and to determine whether differences seen in continent and incontinent women were found in bitches. Resting and stressed simultaneous urethral pressure profiles were obtained for 25 continent and 25 incontinent bitches, the latter diagnosed as having urethral sphincter mechanism incompetence. The stressed urethral pressure profiles were produced by ballottement of the abdomen during catheter withdrawal. The degree of stress induced was consistent and had got short-term reproducibility. Highly significant (P < 0.001) differences in the percentage of negative spikes extending below the resting intravesical pressure were found between continent and incontinent bitches. Significant differences were not observed in the pressure transmission profiles between continent and incontinent bitches; both groups had a gradual decrease in pressure transmission from the bladder neck to the external urethral orifice. The distance from the start of the urethral pressure profile to the first negative peak (attributable to respiration or ballottement) on the subtracted profile was compared with the radiographic distance that the bladder neck was positioned with respect to the cranial pubic brim, taking body weight and continence status into account. Body weight and continence status did not have significant effect on the relation in either instance.(ABSTRACT TRUNCATED AT 250 WORDS)

Analysis of Variance↗