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At least 1,567 records · Page 87Linked to original sources
PubMed1995

Poisson regression analysis in clinical research.

Generalized linear models (GLM) are now widely used in analyzing data from clinical trials and in epidemiological studies. In Poisson regression, which fits in the framework of a GLM, the response variable is a count that follows the Poisson distribution. This article describes the basic methodology of Poisson regression analysis and its application to clinical research. Overdispersion, model diagnostics, and sample size issues are discussed. The methodology is illustrated on a data set from a clinical trial for the treatment of bladder cancer, using a new procedure (PROC GENMOD) in the statistical package SAS.

Epilepsy↗
PubMed2002

Adherence to antiretroviral therapy by human immunodeficiency virus-infected patients.

Poor adherence to antiretroviral treatment regimens has serious consequences for human immunodeficiency virus-infected patients, including failure to prevent viral replication and an increased risk of developing viral resistance. Recent data suggest that the level of medication adherence required for optimal treatment effectiveness is extremely high. Treatment adherence can be measured by use of a variety of methods, including patients' self-reports, pharmacy-based approaches, pill counts, and electronic monitoring. However, these measures of adherence have different strengths and weaknesses in regard to practical application and identifying deficient adherence. All patients receiving antiretroviral therapy require support to insure a high level of treatment adherence, but the evidence about effective interventions is limited. Emerging evidence suggests adherence interventions should employ a multidisciplinary effort involving health care providers, social support networks, family, and friends. Although such programs will require a substantial investment in terms of time and energy, the rewards associated with optimal treatment adherence are worth the effort.

Anti-HIV Agents↗
PubMed2004

Development and application of a spiral plating method for the enumeration of Escherichia coli O157 in bovine faeces.

AIM: To develop and validate a direct plating method applicable to epidemiological studies for enumerating Escherichia coli O157 in cattle faeces. METHODS AND RESULTS: The spiral plate count method was used to enumerate E. coli O157 in faecal samples. The accuracy and variation of counts was then assessed using faecal samples inoculated with E. coli O157. There was good agreement between inoculated levels of E. coli O157 and those recovered from faeces, particularly when counts were > 10(2) CFU g(-1) of faeces. The method was applied to a small study assessing short-term survival of E. coli O157 in naturally infected cattle faeces. E. coli O157 was found to survive in faeces for over 10 days at concentrations above 10(3) CFU g(-1) of faeces. Populations of E. coli O157 were also found to increase 100-fold in the first few hours after defecation. CONCLUSIONS: The enumeration method is easy to implement and enables a quick throughput of large numbers of samples. The method is accurate and reliable and enables the inherent variation in count data to be explored but needs to be used in combination with a more sensitive method for samples containing < 10(2) CFU g(-1) of faeces. SIGNIFICANCE AND IMPACT OF THE STUDY: The method described is appropriate for enumeration of E. coli O157 in cattle faeces in large-scale epidemiological studies.

Animals↗
PubMed1997

Long-term efficacy and safety of Jessner's solution and 35% trichloroacetic acid vs 5% fluorouracil in the treatment of widespread facial actinic keratoses.

BACKGROUND: Few studies have examined the long-term efficacy of fluorouracil (FU) or chemical peels for the treatment of actinic keratoses (AK). Our earlier work examined the efficacy and safety of a medium-depth chemical peel compared with the standard regimen of topical FU in the treatment of widespread facial AK through 12 months. OBJECTIVES: To determine long-term efficacy of both treatments by extending our observations through 32 months. METHODS: Fifteen patients with severe facial actinic damage were treated on the left side with a single application of Jessner's solution and 35% trichloroacetic acid and on the right side with twice daily applications of 5% FU cream for 3 weeks. Parameters evaluated at 1, 6, 12, and 32 months included counts of visible AK, random skin biopsies from both treatment areas, development of intercurrent neoplasms, and surveys assessing sun exposure. RESULTS: Eight patients were available for reevaluation at 32 months. Both treatment sides showed a reduction in mean number of AK at 12 months followed by an increase in mean AK number between 12 and 32 months. Improvements in biopsies of clinically actinically damaged skin were seen in keratinocytic atypia, hyperkeratosis, parakeratosis, and inflammation at all treatment times during the study with both treatments. Three squamous cell carcinomas developed in the patients after initial treatment; one developed on the side treated with the peel, and two developed on the side treated with fluorouracil. Surveys failed to demonstrate an association between sun exposure and clinical response. CONCLUSION: Based on these findings, patient with widespread actinic keratoses treated with medium-depth chemical peel or with 5% FU should be reevaluated yearly or every 1.5 years for reappearance of AK and retreatment.

Administration, Topical↗
PubMed1993

Flow cytometric reticulocyte analysis and the reticulocyte maturity index.

Reticulocyte analysis has evolved to one of the accepted and routinely practiced clinical applications of flow cytometry technology. Similar to CD4 measurements, FCM technology has contributed to documented improvements in reticulocyte counting precision over previous microscope-based techniques. The ability to FCM instruments to quantitate fluorescence intensity has been utilized to derive a parameter of reticulocyte maturity, which we have termed the reticulocyte maturity index. The FCM-derived RMI parameter offers an additional perspective to assess the erythropoietic response in anemic patients over reticulocyte counting alone and provides further insight into the differential diagnosis of anemia. Clinical utility of the RMI has been reported in monitoring expensive, new-technology therapies, such as bone marrow transplantation and erythropoietin therapy. FCM reticulocyte analysis is still not fully mature, but is in a state of continued evolution. Needs exist for (i) improved software for data analysis, (ii) newer automation techniques to improve interlaboratory correlations, and (iii) further validation and refinement of the reticulocyte maturity index parameter.

Anemia↗
PubMed1998

The tetrameric structure of a glutamate receptor channel.

The subunit stoichiometry of several ligand-gated ion channel receptors is still unknown. A counting method was developed to determine the number of subunits in one family of brain glutamate receptors. Successful application of this method in an HEK cell line provides evidence that ionotropic glutamate receptors share a tetrameric structure with the voltage-gated potassium channels. The average conductance of these channels depends on how many subunits are occupied by an agonist.

Binding Sites↗
PubMed2004

Size and UV germicidal irradiation susceptibility of Serratia marcescens when aerosolized from different suspending media.

Experimental systems have been built in laboratories worldwide to investigate the influence of various environmental parameters on the efficacy of UV germicidal irradiation (UVGI) for deactivating airborne microorganisms. It is generally recognized that data from different laboratories might vary significantly due to differences in systems and experimental conditions. In this study we looked at the effect of the composition of the suspending medium on the size and UVGI susceptibility of Serratia marcescens in an experimental system built in our laboratory. S. marcescens was suspended in (i) distilled water, (ii) phosphate buffer, (iii) 10% fetal calf serum, (iv) phosphate-buffered saline (saline, 0.8% sodium chloride), and (v) synthetic saliva (phosphate-buffered saline with 10% fetal calf serum). At low humidity (36%), S. marcescens suspended in water-only medium was the most susceptible to UVGI, followed by those in serum-only medium. The count median diameters (CMDs) for culturable particles from water-only and serum-only media were 0.88 and 0.95 micro m, respectively, with the measurements based on their aerodynamic behavior. The bacteria suspended in phosphate buffer, synthetic saliva, and phosphate-buffered saline had similar UVGI susceptibility and CMD at 1.0, 1.4, and 1.5 micro m, respectively. At high humidity (68%) the CMD of the particles increased by 6 to 16%, and at the same time UVGI susceptibility decreased, with the magnitude of decrease related to the type of suspending medium. In conclusion, the choice of suspending medium influenced both size and UVGI susceptibility of S. marcescens. These data are valuable for making comparisons and deciding on the use of an appropriate medium for various applications.

Aerosols↗
PubMed1974

Inactivation of dried bacteria and bacterial spores by means of gamma irradiation at high temperatures.

Dried preparations with Streptococcus faecium, strain A(2)1, and spores of Bacillus sphaericus, strain C(I)A, normally used for control of the microbiological efficiency of radiation sterilization plants and preparations with spores of Bacillus subtilis, normally used for control of sterilization by dry heat, formalin, and ethylene oxide, as well as similar preparations with Micrococcus radiodurans, strain R(1), and spores of Bacillus globigii (B. subtilis, var. niger) were gamma irradiated with dose rates from 16 to 70 krad/h at temperatures from 60 to 100 C. At 80 C the radiation response of the spore preparations was the same as at room temperature, whereas the radiation resistance of the preparations with the two vegetative strains was reduced. At 100 C the radiation response of preparations with spores of B. subtilis was unaffected by the high temperature, whereas at 16 and and 25 krad/h the radiation resistance of the radiation-resistant sporeformer B. sphaericus, strain C(I)A, was reduced to the level of radiation resistance of preparations with spores of B. subtilis. It is concluded that combinations of heat and gamma irradiation at the temperatures and dose rates tested may have very few practical applications in sterilization of medical equipment.

Bacillus↗
PubMed2004

A prospective study of pregnant patients with rheumatoid arthritis and ankylosing spondylitis using validated clinical instruments.

OBJECTIVE: : To analyse the disease course of patients with rheumatoid arthritis (RA) and ankylosing spondylitis (AS) during and after pregnancy by validated clinical instruments for measurement of disease activity, and assess their usefulness in pregnant patients. METHODS: Included were 10 patients with RA and 9 with AS (10 pregnancies). Clinical examination and blood/urine sampling was performed before conception, at each trimester, and weeks 6, 12, and 24 post partum. Assessment of RA was by the RA Disease Activity Index (RADAI), the 44 joint count, and the Health Assessment Questionnaire; assessment of AS by the Bath Ankylosing Spondylitis Activity Index (BASDAI), the Dougados Functional and Articular Index, and a night pain index. Common for all patients were the patient's and physician's global assessment. RESULTS: : Most patients with RA showed sustained or increased improvement of disease activity during pregnancy. Higher disease activity scores were found in the patients with AS with a frequent increase of disease activity in the second trimester and mitigation of symptoms in the third trimester. Analysis specifically for the patient's assessment of pain showed continuously higher pain scores in the patients with AS than in those with RA. Rank correlation showed good to moderate correlation between most clinical measurements and RADAI or BASDAI, respectively. Functional indices were confounded by physiological changes of late pregnancy. CONCLUSION: RA can be monitored during and after pregnancy by the swollen joint count and RADAI without interference from pregnancy related symptoms, whereas usual measures of disease activity are not always applicable in pregnant patients with AS.

Adult↗
PubMed1986

Clinical assessment of corneal endothelial cell density: an original system of grading using a slit-lamp biomicroscope.

An original system of grading of the corneal endothelial specular reflection, as assessed with a Haag-Streit 900 slit-lamp biomicroscope, has been shown to have a very highly significant relation to the endothelial cell density measured by contact specular photomicroscopy. The grading, though subjective and therefore not a substitute for the detailed record of photomicroscopy, is readily applicable to clinical practice and is a useful method of comparing and recording endothelial cell densities when assessed by the same observer. The intraobserver, but not the interobserver, variability has been examined, and the theoretical aspects of the grading system and a clinically applicable interpretation of the grading are presented.

Aged↗
PubMed1991

A monoclonal antibody against the platelet glycoprotein IIb/IIIa receptor complex prevents platelet aggregation and thrombosis in a canine model of coronary angioplasty.

BACKGROUND: The comparative effects of aspirin and F(ab')2 fragments of monoclonal antibody 7E3 against the platelet glycoprotein IIb/IIIa receptor on ex vivo platelet aggregation and in vivo thrombosis were studied in a canine coronary balloon angioplasty model. METHODS AND RESULTS: Three groups were studied. Group 1 (n = 8) was pretreated with saline placebo, group 2 (n = 8) was pretreated with 325 mg aspirin, and group 3 (n = 8) was pretreated with 0.8 mg/kg 7E3 F(ab')2. Coronary angioplasty was performed in the left anterior descending coronary artery of open-chest dogs under fluoroscopic control; serial measurements of basal and hyperemic coronary blood flows were then made for 2 hours after application of an external stenosis that decreased hyperemic flow by 50%. There were no significant differences in platelet counts or hemodynamic measurements during the experiments. Platelet aggregation was decreased by treatment: group 1, 64 +/- 13% versus 50 +/- 13% (p = NS); group 2, 57 +/- 4% versus 25 +/- 4% (p less than 0.001); and group 3, 77 +/- 5% versus 10 +/- 6% (p less than 0.0002). Compared with initial measurements, the 7E3 antibody was superior to aspirin in maintaining hyperemic coronary blood flow after release of the external stenosis: group 1, 177 +/- 14 versus 21 +/- 14 ml/min (p less than 0.0003); group 2, 189 +/- 9 versus 110 +/- 28 ml/min (p less than 0.008); and group 3, 194 +/- 12 versus 181 +/- 15 ml/min (p less than 0.02). In group 1, arterial occlusion developed in five dogs, and nonocclusive thrombus was seen in three dogs. In group 2, arterial occlusion developed in one dog, and nonocclusive thrombus was seen in five dogs. No thrombotic material was visualized in group 3 dogs treated with 7E3 F(ab')2. CONCLUSIONS: In this animal model, the 7E3 antiplatelet antibody is superior to aspirin in inhibiting platelet aggregation, thrombosis, and acute closure after deep arterial injury caused by coronary balloon angioplasty.

Angioplasty, Balloon, Coronary↗
PubMed2000

Prevalence and pattern of retinal diseases at the Guinness Eye Hospital, Onitsha, Nigeria.

OBJECTIVES: To determine the prevalence and pattern of retinal diseases at the Guinness Eye Hospital, Onitsha, Nigeria. MATERIALS AND METHODS: This was a prospective study. All new patients seen by the author at the outpatients clinic of the Guinness Eye Hospital, Onitsha, Nigeria were examined for evidence of retinal diseases, using the Snellen chart, tonometry, indirect ophthalmoscopy after full mydriasis, slit-lamp examination with a 78D non-contact fundus lens, fundus contact lens examination, and slit-lamp examination of the anterior segment. Ancillary tests performed, as applicable, included Mantoux, skin-snip, hemoglobin genotype, urinalysis, fasting blood sugar, oral glucose tolerance test, full blood count, platelet count, ESR, VDRL, and HIV tests. RESULTS: 8.1% of the patients had retinal diseases. The leading retinal diseases were age-related macular degeneration (ARMD), diabetic retinopathy, retinal vein occlusion, retinal tears/detachment, retinitis pigmentosa and retinochoroiditis with epiretinal membrane. ARMD, diabetic retinopathy, and retinitis pigmentosa often caused bilateral lesions. Bilateral blindness was present in 14% and bilateral visual impairment in 16%, with macular degeneration, retinitis pigmentosa and retinal vascular diseases as major causes. CONCLUSIONS: Retinal diseases may be a significant cause of blindness and visual impairment in this part of Nigeria. Since most of the diseases are treatable with laser and vitrectomy techniques, it is recommended that these facilities be provided in all major eye hospitals in the area.

Adolescent↗
PubMed2002

Real-time quantitative PCR in parasitology.

Standard techniques for counting parasites are often time-consuming, difficult and inaccurate, and occasionally unpleasant. Real-time quantitative polymerase chain reaction has recently been applied to parasitology, specifically Plasmodium, Toxoplasma, Leishmania and Neospora. These techniques are truly quantitative, give results over a range of 6-7 orders of magnitude, are quick to perform and require no manipulations post-amplification. They can be used to count genome numbers and to study levels of gene expression. The advantages and limitations of existing thermocyclers and applicable detection systems are discussed here, and promising new developments are highlighted.

Journal Article↗
PubMed2002

Real-time quantitative PCR in parasitology.

Standard techniques for counting parasites are often time-consuming, difficult and inaccurate, and occasionally unpleasant. Real-time quantitative polymerase chain reaction has recently been applied to parasitology, specifically Plasmodium, Toxoplasma, Leishmania and Neospora. These techniques are truly quantitative, give results over a range of 6-7 orders of magnitude, are quick to perform and require no manipulations post-amplification. They can be used to count genome numbers and to study levels of gene expression. The advantages and limitations of existing thermocyclers and applicable detection systems are discussed here, and promising new developments are highlighted.

Animals↗
PubMed1990

Continuous-slice PENN-PET: a positron tomograph with volume imaging capability.

The PENN-PET scanner consists of six hexagonally arranged position-sensitive Nal(TI) detectors. This design offers high spatial resolution in all three dimensions, high sampling density along all three axes without scanner motion, a large axial acceptance angle, good energy resolution, and good timing resolution. This results in three-dimensional imaging capability with high sensitivity and low scatter and random backgrounds. The spatial resolution is 5.5 mm (FWHM) in all directions near the center. The true sensitivity, for a brain-sized object, is a maximum of 85 kcps/microCi/ml and the scatter fraction is a minimum of 10%, both depending on the lower level energy threshold. The scanner can handle up to 5 mCi in the field of view, at which point the randoms equal the true coincidences and the detectors reach their count rate limit. We have so far acquired [18F]FDG brain studies and cardiac studies, which show the applicability of our scanner for both brain and whole-body imaging. With the results to date, we feel that this design results in a simple yet high performance scanner which is applicable to many types of static and dynamic clinical studies.

Equipment Design↗