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The proliferating cell nuclear antigen index in breast carcinomas does not correlate with mitotic index and estrogen receptor immunoreactivity.

To investigate the expression of a marker of cell proliferation (PCNA/Cyclin) and its putative relationship with histological grading, mitotic index and estrogen receptor immunoreactivity, we studied twenty-seven cases of invasive breast carcinoma in formalin-fixed, paraffin-embedded tissue sections. The PCNA and estrogen receptor were detected by the PC 10 and H 222 monoclonal antibodies respectively, using an avidin-biotin-peroxidase method. The median value of PCNA index was 20.9% with a range from 1.4 to 84.2%. We did not find any significant relationship between PCNA index and the histological grading, mitotic index and estrogen receptor immunoreactivity. We conclude that PCNA detected by the monoclonal antibody PC 10 in formalin-fixed material looks at present unreliable as a proliferation marker in breast carcinoma.

Adult↗

Fat-free mass index and fat mass index percentiles in Caucasians aged 18-98 y.

OBJECTIVE: To determine reference values for fat-free mass index (FFMI) and fat mass index (FMI) in a large Caucasian group of apparently healthy subjects, as a function of age and gender and to develop percentile distribution for these two parameters. DESIGN: Cross-sectional study in which bioelectrical impedance analysis (50 kHz) was measured (using tetrapolar electrodes and cross-validated formulae by dual-energy X-ray absorptiometry in order to calculate FFMI (fat-free mass/height squared) and FMI (fat mass/height squared). SUBJECTS: A total of 5635 apparently healthy adults from a mixed non-randomly selected Caucasian population in Switzerland (2986 men and 2649 women), varying in age from 24 to 98 y. RESULTS: The median FFMI (18-34 y) were 18.9 kg/m(2) in young males and 15.4 kg/m(2) in young females. No difference with age in males and a modest increase in females were observed. The median FMI was 4.0 kg/m(2) in males and 5.5 kg/m(2) in females. From young to elderly age categories, FMI progressively rose by an average of 55% in males and 62% in females, compared to an increase in body mass index (BMI) of 9 and 19% respectively. CONCLUSIONS: Reference intervals for FFMI and FMI could be of practical value for the clinical evaluation of a deficit in fat-free mass with or without excess fat mass (sarcopenic obesity) for a given age category, complementing the classical concept of body mass index (BMI) in a more qualitative manner. In contrast to BMI, similar reference ranges seems to be utilizable for FFMI with advancing age, in particular in men.

Adipose Tissue↗

Comparison of body mass index values proposed by Cole et al. (2000) and Must et al. (1991) for identifying obese children with weight-for-height index recommended by the World Health Organization.

OBJECTIVES: To calculate the sensitivity, specificity and agreement of body mass index (BMI) values proposed by Cole et al. (Br. Med. J. 2000; 320: 1) and Must et al. (Am. J. Clin. Nutr. 1991; 53: 839 & 54: 773) with weight-for-height index in the nutritional evaluation of children. DESIGN: Criterion standards for diagnostic tests. SETTING: : North-east and south-east Brazil. SUBJECTS: Two thousand nine hundred and twenty children studied in Life Pattern Research performed by the Brazilian Institute of Geography and Statistics in 1997. Main outcome measures are the sensitivity, specificity and agreement of BMI values proposed by Must et al. (1991) and Cole et al. (2000). RESULTS: Sensitivity of values proposed by both authors was around 90%. Specificity was almost 100% considering weight-for-height index as the gold standard. The agreement of both values with weight-for-height index, based on kappa results, was good and in pre-school children it was excellent. CONCLUSIONS: Values proposed by Cole et al. (2000) and Must et al. (1991) should be used carefully to screen obesity in childhood but can be used to "diagnose" overweight children with a very low chance of having false-positive results. Although the values proposed by both authors performed similarly, use of Cole et al.'s values should be encouraged. The latter cover children from 2 to 6 years old; their values are presented for six-month age intervals; they are based on a larger sample from six different countries; and they are related to the definition of adult obesity.

Body Height↗

Validity of body mass index compared with other body-composition screening indexes for the assessment of body fatness in children and adolescents.

BACKGROUND: Validation studies of height- and weight-based indexes of body fatness in children and adolescents have examined only small samples of school-age children. OBJECTIVE: The objective was to validate the performance of age- and sex-specific body mass index (BMI) compared with the Rohrer index (RI) and weight-for-height in screening for both underweight and overweight in children aged 2-19 y. DESIGN: Data from the third National Health and Nutrition Examination Survey (n = 11096) and a pooled data set from 3 studies that used dual-energy X-ray absorptiometry (n = 920) were examined. The receiver operating characteristic curve was used to characterize the sensitivity and specificity of these 3 indexes in classifying both underweight and overweight. Percentage body fat and total fat mass were determined by dual-energy X-ray absorptiometry. Subcutaneous fat was assessed on the basis of the average of triceps and subscapular skinfold thicknesses. RESULTS: For children aged 2-19 y, BMI-for-age was significantly better than were weight-for-height and RI-for-age in detecting overweight when average skinfold thicknesses were used as the standard, but no differences were found in detecting underweight. When percentage body fat or total fat mass was used as the standard, BMI-for-age was significantly better than was RI-for-age in detecting overweight in children aged 3-19 y. No differences were found between BMI-for-age and weight-for-height in detecting overweight or underweight. CONCLUSION: For children and adolescents aged 2-19 y, the performance of BMI-for-age is better than that of RI-for-age in predicting underweight and overweight but is similar to that of weight-for-height.

Absorptiometry, Photon↗

Metacarpal bone mineral density, body mass index and lifestyle among postmenopausal Japanese women: relationship of body mass index, physical activity, calcium intake, alcohol and smoking to bone mineral density: the Hizen-Oshima study.

The present study was designed to investigate the influence of modifiable risk factors (body weight and lifestyle) for bone loss on bone mineral density (BMD). We examined age-specific changes in metacarpal BMD, and its associations with body mass index and lifestyle among 532 community-dwelling postmenopausal Japanese women. Measurements of the second metacarpal BMD were obtained from the hand radiographs using computer-assisted radiographic absorptiometry. Body height and weight were measured, and body mass index (BMI) was calculated. Physical activity index was calculated using validated questionnaire. Daily calcium intake and amount of ingested alcohol were estimated by semiquantitative food frequency questionnaire. Current smoking status was obtained by questionnaire. Metacarpal BMD decreased significantly with increasing age. Simple correlation analysis indicated that metacarpal BMD correlated significantly with BMI and physical activity index. On the other hand, metacarpal BMD did not correlate with calcium intake and alcohol drinking. Metacarpal BMD in current smokers was not different from that in nonsmokers. Multiple regression analysis showed that increasing age was associated with decreased metacarpal BMD and greater BMI increased metacarpal BMD. However, physical activity, calcium intake, alcohol drinking and current smoking were not significant determinants of metacarpal BMD. Our findings suggest that maintenance of adequate body mass (prevention for leanness) is important for prevention of postmenopausal bone loss.

Adult↗

The patellotrochlear index: a new index for assessing patellar height.

The radiological methods to determine patellar height described in the literature are variable, not reliable and depend on the chosen ratio. The purpose of this paper is to describe another method of measuring patellar height on sagittal MRI using the true articular cartilage patellotrochlear relationship. An analysis of magnetic resonance (MR) examinations of 66 consecutive patients was performed. The most common diagnoses were meniscal or anterior cruciate ligament pathologies. No patient suffered from patellofemoral complaints. Measurements on sagittal MR images included different parameters using the articular cartilage of the patella and the trochlea. The ratio patella : trochlea of the cartilage baselines was measured in percentages and described as patellotrochlear index. The measurements were assessed at two different times by three raters under blinded conditions. The mean patellotrochlear index was 31.7% (CI: 12.5-50.0; range -5.0 to 61.1%; SD +/-11.6). The intraobserver variability showed only in the "second observer" a difference of the mean values of the two different measurements (t=2.189; P=0.032). The interobserver correlation was high and significant (0.663-0.893; P=0.000). Our results indicate that the patellotrochlear index is a reliable and precise method to determine the exact articular correlation of the patellofemoral joint and the patellar height. The results represent the average patellotrochlear index in the normal population without patellofemoral complaints. Measurements of the articular cartilage congruence can be helpful to define an underlying pathology of patellar height, such as patella alta or infera.

Adolescent↗

Constructing an Index for the Subjective Well-being Under Neuroleptics scale (SWN), short form: applying structural equation modeling for testing reliability and validity of the index.

Structural equation modeling (SEM) has been widely used in psychology and sociology for testing validity of measurement instruments. However, this statistical technique has so far played minor role in quality-of-life research. The main objective of this paper is to demonstrate the potential of SEM for constructing and testing the validity of a Subjective Well-being under Neuroleptics (SWN) index for patients with schizophrenia. For these purposes, data from the GEO study (Gesundheitsökonomische Evaluation von Olanzapin in Deutschland; Health economics study of olanzapine in the treatment of schizophrenia in Germany) were used. The GEO is a prospective, comparative, noninterventional, observational study. A total of 646 participants treated with either olanzapine (n = 416) or haloperidol (n = 230) were enrolled in the study; 360 patients were available for factor analyses. The short (20-item) form of the SWN scale was administered to assess patients' perspectives on their quality of life. The structural equation models (SEMs) were then applied to construct 5- and 10-item indexes based on SWN. The data indicate that the 5-item index is the most time-saving approach for evaluating perceptions of well-being (and thus, quality of life) among patients with schizophrenia. The application of SEM showed no appreciable loss of validity of this index.

Adult↗

The role of location indexes in spatial perception: a sketch of the FINST spatial-index model.

This paper hypothesizes a resource-limited mechanism, called a FINST, for individuating or indexing visual features, as distinct from encoding their type or location. FINSTs have the property that they index features in a way that is transparent to their retinal location, and hence under certain conditions succeed in "pointing to" scene locations. The basic assumption is that no operation upon sets of features can occur unless all the features to which the operation applies are first FINSTed. A number of applications of this hypothesis are explored in this paper, including applications to phenomena such as the spatial stability of visual percepts, the ability to track several independently moving targets in parallel, the ability to detect a class of spatial relations requiring the use of "visual routines", various mental imagery phenomena, and the ability to encode complex shapes for recognition. In addition, the possibility is examined that such indexes might be used to bind perceived locations to arguments in motor commands, thereby allowing some forms of perceptual-motor coordination. Several additional assumptions are introduced for this purpose, including the postulation of other indexes (called ANCHORS) for non-visually sensed locations. It is assumed that ANCHORS can be bound to FINSTs, thus allowing cross-referencing of visually detected locations to locations given within a proprioceptive or motor-command frame of reference.

Attention↗

The relative gonadal index: an alternative index for quantification of reproductive condition.

Gonadal indices (i.e. GSI = gonadal wt/body wt X 100) commonly are used to quantify reproductive condition in fishes. These indices may be inappropriate with specimens of different sizes, however, for gonadal growth often is allometric. A new gonadal index (relative gonadal index, RGI) was developed to quantify the reproductive condition of animals independent of body size. The RGI is based on the underlying model W = alpha i X S beta i, where W is gonadal weight, S is body size (less gonadal weight if body weight is used), and alpha i and beta i are parameters to be estimated for gonadal developmental stage i. Assuming that a multiplicative lognormal error is appropriate, parameter estimates for alpha i and beta i were obtained by linear least squares regression for the log-transformed model ln(W) = beta i X ln(S) + ln(alpha i), where, in this form, beta i is the slope and ln(alpha i) is the intercept. Only if estimates of beta i do not differ significantly among ovarian developmental stages, as in our case, can a pooled estimate of beta be used to obtain the relative gonadal index, RGI = alpha i = W/S beta. Applicability of the RGI was tested using ovaries of three ecologically distinct fish species. The RGI was found to be more appropriate than the gonosomatic index for all three species.

Animals↗

Myocardial performance index, a Doppler-derived index of global left ventricular function, predicts congestive heart failure in elderly men.

AIMS: There is limited data on echocardiographic and Doppler indices of cardiac function as predictors for congestive heart failure (CHF) in the general population. Myocardial performance index (MPI, also denoted TEI-Doppler index) reflects both left ventricular (LV) systolic and diastolic function. METHODS AND RESULTS: We compared eight different echocardiographic and Doppler indices of cardiac function as predictors of CHF using a population-based cohort of 552 seventy-year-old men without CHF and significant valve disease at baseline (median follow-up time 8.2 years). In a stepwise multivariable Cox proportional-hazard analysis including the different indices of cardiac function, high MPI (above the 90th percentile of MPI [> or =0.91]), abnormal LV wall motion score index and a pseudo-normalized/restrictive E/A-ratio pattern independently predicted future CHF morbidity. After adding traditional CHF risk factors (age, previous myocardial infarction, hypertension, diabetes mellitus, hyperlipidaemia, smoking, LV hypertrophy and body mass index) to the above model, only a high MPI remained a significant predictor (hazard ratio 4.72, 95% CI 1.75-12.76, p=0.002). CONCLUSION: MPI provides important prognostic information for the risk of future CHF, beyond other measurements of cardiac function and traditional heart failure risk factors in elderly men. MPI seems to be a clinically relevant indicator of cardiac function and may prove to be a valuable tool in assessing the risk of future CHF.

Aged↗

Structure-activity study on antiulcer agents using Wiener's topological index and molecular connectivity index.

The relationship of Wiener's topological index and molecular connectivity index with antiulcer activity of a series of 4-substituted-2-guanidino thiazole analogs has been investigated. The values of Wiener's topological index and molecular connectivity index of 128 compounds were computed and active ranges were identified. The activity assigned to each analog using these topological descriptors was subsequently compared with the reported in vitro and in vivo activities against gastric hydrogen-potassium stimulated adenosine triphosphatase (H+K(+)-ATPase) enzyme. Predictions with an accuracy of the order of approximately 89% were observed with regard to in vivo activity using these topological indices.

Animals↗

Harvard report on cancer prevention volume 4: Harvard Cancer Risk Index. Risk Index Working Group, Harvard Center for Cancer Prevention.

OBJECTIVE: Prediction of cancer risk is a minor component of current health risk appraisals. Perception of individual cancer risk is poor. A Cancer Risk Index was developed to predict individual cancer risk for cancers accounting for 80% of the cancer burden in the United States. METHODS: We used group consensus among researchers at the Harvard Medical School and Harvard School of Public Health to identify risk factors as definite, probable and possible causes of cancer. Risk points were allocated according to the strength of the causal association and summed. Population average risk of cancer and cumulative 10-year risk was obtained from SEER data. Individual ranking relative to the population average was determined. The risk index was evaluated for validity using colon cancer incidence in prospective cohort data. RESULTS: The Harvard Cancer Risk Index provides a broad classification of cancer risk. Validation against cohort data shows good agreement for colon cancer. CONCLUSION: The Harvard Cancer Risk Index offers a simple estimation of personal risk of cancer. It may help inform users of the major risk factors for cancer and identify changes in lifestyle that will reduce their risk. It offers the potential for tailored health-promotion messages.

Adult↗

Myocardial performance index (Tei index) does not reflect long-term changes in left ventricular function after acute myocardial infarction.

AIMS: To evaluate whether changes in myocardial performance index (MPI or Tei index) were related to changes in other Doppler echocardiographic parameters after acute myocardial infarction, or had any independent prognostic impact in a 2-year observational study. METHODS AND RESULTS: Seventy-one patients with acute myocardial infarction without heart failure were examined at baseline, 3 months, and 2 years. MPI was significantly related to end-diastolic and end-systolic volume indexes, ejection fraction, maximal velocity, and time velocity integral of early mitral filling wave at 3 months and 2 years. MPI did not contribute significantly to the prediction of any changes in the measures of diastolic or systolic function at 3 months or 2 years. Baseline MPI was significantly higher in patients who later developed heart failure(0.55 +/- 0.16)than in other patients(0.43 +/- 0.13, P = 0.006), but had no independent predictive power for the development of heart failure or death relative to end-systolic volume index and deceleration time of early mitral filling wave. CONCLUSION: MPI did not accurately reflect changes in Doppler and two-dimensional echocardiographic measures of diastolic or systolic function during a 2-year follow-up after acute myocardial infarction, and did not have any independent prognostic impact.

Echocardiography, Doppler↗

Evaluation of the peer assessment rating (PAR) index as an index of orthodontic treatment need.

The need for orthodontic treatment has an objective component based on occlusal traits and a subjective component based on the esthetic impact of the occlusion. An occlusal index that measures the objective deviation from normal or ideal occlusion might be sufficient to mirror the subjective opinion of orthodontists about treatment need. The objective of this study was to determine whether the American (US) and United Kingdom (UK) weightings of the peer assessment rating (PAR) index are valid instruments with which to determine treatment need. Fifteen orthodontists rated the need for orthodontic treatment of 170 casts. Their collective decision was compared with the PAR value for the cast determined by a calibrated examiner. A range of suggested treatment cutoff points from the literature was used to generate receiver operating characteristic (ROC) curves and optimized cutoff points. The cutoff points were 17 for both the US PAR and the UK PAR, and sensitivity, specificity, and kappa were 92%, 86%, and 0.77 for the US PAR and 92%, 89%, and 0.80 for the UK PAR. The area under the ROC curve was 97% for the US PAR and the UK PAR. Both the US PAR and the UK PAR scores were excellent predictors of orthodontic treatment need as determined by a panel of orthodontists. An occlusal index used to measure deviation from normal or ideal occlusion might perform as well as indexes of treatment need in predicting orthodontists' evaluations of treatment need.

Dental Occlusion↗

Index Lists provided by the VAMPP computer programme for dairy herd health and production control. I. Interpretation and analysis of data on Index List 1.

In a series of 4 papers the Index Lists as provided by the VAMPP computer programme are presented. The information on Index List 1, covering milk production, milk quality and udder health, is suitable to monitor actual herd performance, especially when used in connection with the other index lists. With computer programmes becoming available to veterinary control programmes, proper interpretation and prompt analysis of data is more critical. This paper outlines how deviations of index figures from reference values are detected, how analysis may be performed and how advice is built-up.

Animals↗

Index Lists provided by the VAMPP computer programme for dairy herd health and production control. II. Interpretation and analysis of data on Index List 2.

In a series of four papers computerized herd reports on various aspects of dairy farming, the Index Lists, are presented for herd health and production control purposes. This second paper presents Index List 2, on calving, breeding efficiency and lameness. The information from this list is suitable to monitor herd performance, especially when used in combination with information from other index lists. Methods for interpretation and evaluation of the data listed are provided. Evaluations should take those aspects related to reproduction and lameness into account. The use of current information and prompt computerized analysis in detecting deviations in index figures and providing advice to farm management is discussed.

Animals↗

Index Lists provided by the VAMPP computer programme for dairy herd health and production control. III. Interpretation and analysis of data on Index List 3.

In a series of four papers computerized herd reports for dairy herd health and production control purposes, the Index Lists, are presented. This third paper deals with Index List 3 on youngstock rearing and cow culling. The information from this list is suitable for monitoring rearing efficiency and culling policy in a veterinary herd health and production control programme, especially when used in combination with information from the other index lists. Methods for interpretation and evaluation of the data are provided. It is demonstrated how prompt computerized analysis of current information is used to detect deviations in index figures and to advise the farmer.

Animals↗

Index Lists provided by the VAMPP computer programme for dairy herd health and production control. IV. Interpretation and analysis of data on Index List 4.

In a series of 4 papers computerized herd reports on various aspects of dairy farming, the Index Lists, are presented for herd health and production control purposes. This fourth paper regards Index List 4 on nutritional disorders, body condition and ration composition. The information from this list is suitable to monitor nutritional efficiency and feeding management, especially when used in combination with information from the other index lists. Methods for interpretation and evaluation of the data listed are provided. Evaluations should take into account the aspects related to nutrition. It is demonstrated how deviations of index figures are detected and how advice to farm management is built up by means of actual information and prompt computerized analysis.

Animal Feed↗