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PubMed1998

[Plasmid profile typing of Salmonella typhimurium and its distribution in some provinces and cities of China].

OBJECTIVE: To study the relationship between the infection and prevalence of Salmonella typhimurium. METHODS: From 1980 to 1995, when Salmonella typhimurium infection was prevalent in north and south China, a total of 2,655 isolates of Salmonella typhimurium were collected from 19 provinces, municipalities, and autonomous regions and Hong Kong Special Administrative Region for plasmid profile analysis. The profiles consisting of some small plamids were recorded with capital letters A to J, and the profile which was free from small plasmid was recorded with capital letter O. Large plasmid in molecular weights of 140-20 Mdal showing in profiles was recorded with Arabic numerals 9 to 0 respectively. Having two or more than two large plasmids, the profile was recorded with two or more Arabic numerals. RESULTS: The 2,655 strains were divided into 11 plasmid profile groups and 168 plasmid profile types. Of 52 plasmid profile types frequently isolated, plasmid profile type O 4 was distributed extensively in 16 provinces, municipalities, and autonomous rehions and Hong Kong. Plasmid profile type O 5 was isolated in 5 provinces and Hong Kong, mostly in Jiangxi and Hubei. Plasmid profile type J 4 was isolated in 7 provinces, municipalities and autonomous regions, mostly in Jiangxi. Five plasmid profile types of Group A caused a big prevalence of nosocomial infection in Henan. Type A 6 was also isolated in Xinjiang and Anhui. Six plasmid profile types of Group E were prevalent in Xinjiang predominantely, three types caused nosocomial infection in Shanghai, type E 82 caused nosocomial infection and food poisoning in Liaoning. Type F 4 was isolated in 4 provinces, mostly in jiangxi and Fujian. Many plasmid profile types were prevalent local. Types B 5, BCEG 60, BE 6, B' 0 G 6, G 5 and EG 6 were prevalent in Jiangxi, Types IF'4, IF'H40 and F 9864 were prevalent in Sandong, Type IF'4 was also isolated in Jiangsu and Hubei, Type IF 40 in Anhui, Type BH 6 in Huibei, and Type EH 5 in Fujian. CONCLUSION: Plasmid profile analysis showed the same types in the prevance but different plasmid profiles in different provinces.

China↗
PubMed1992

Inaccuracies in manufacturer-reported deflated PTCA balloon profiles.

Deflated balloon profile is an important consideration in the selection of PTCA catheters. In order to test the accuracy of manufacturer-reported balloon profiles, we measured deflated shoulder and mid-balloon profile in 107 unused catheters (2.0, 2.5, and 3.0 mm) from 6 manufacturers using a precision hole gauge with a resolution of .001 inches. A significant difference was defined as a discrepancy greater than or equal to 0.003 inches from the manufacturer's reported profile. During Phase I, measurements were obtained at room temperature on catheters directly out of the package. Of the 36 models tested, 21/36 (56%) had measured shoulder profiles that were larger than their reported profile, and 29/36 (81%) had mid-balloon profiles that were larger than their reported profile. During Phase II, measurements were made at body temperature following a 60 second inflation at 120 psi (8.16 atm). Of 33 models tested, 18/33 (55%) had measured shoulder profiles that were larger than their reported profile; 26/33 (79%) had mid-balloon profiles that were larger than their reported profile. The term "profile" is imprecisely defined. Manufacturer-reported deflated PTCA balloon profiles are not always accurate. Independent and uniform testing of balloon profiles is necessary for valid comparisons between balloons and manufacturers.

Angioplasty, Balloon, Coronary↗
PubMed1984

Soft-tissue profile preference.

The relative influence on profile preference of the anteroposterior maxillomandibular relation, the lower facial height, and the form of the dorsum of the nose is a source of interesting controversy. In order to obtain more information on this subject, twenty-seven shadow profile photographs were artificially constructed to represent the main characteristics of the nine profile types proposed by Sassouni combined with three different kinds of nose dorsum. Each series of nine profiles was ranked according to the personal esthetic preference of 249 adults (mean age, 23 years). One group of test persons (40 females and 91 males) had no orthodontic background, while another group (49 females and 69 males) had received some orthodontic teaching. Chi-square tests of significance showed no significant difference between male and female participants in esthetic preference for the sex of a profile. Also, the difference in orthodontic knowledge had no significant effect on esthetic preference. Nose dorsum changes induced significant differences only in Class II normal profiles; convex noses were less appreciated. Calculation of average preference values revealed that Class I normal profile types were clearly the favored ones, followed by Class I deep profiles. Open profile types, on the contrary, were obviously the least appreciated. This sequence indicates that, in profile evaluations, vertical profile characteristics could be more important than anteroposterior features and that a lengthening of the soft-tissue profile is not desirable in most cases. Seven weeks after the first ranking of male profiles, 193 persons were retested. The rank correlation values according to Kendall showed that one out of four persons ranked profiles significantly different in the retest.

Adult↗
PubMed2000

Variation of relative transit dose profiles with patient-detector distance.

BACKGROUND AND PURPOSE: In view of using portal images for exit dosimetry, an experimental study is performed of relative transit dose profiles at different distances behind patients (and phantoms) and of their relation to the exit dose profile. MATERIALS AND METHODS: Irregular, homogeneous polystyrene phantoms with a variable thickness to simulate head and neck (H&N) treatments (6-MV photon beam) are investigated by ionization chamber measurements performed close to the exit surface and at various distances behind the phantom (10, 20 and 30 cm). Similar measurements are performed for a rectangular phantom with large inhomogeneities (A1 and air). For one irregular homogeneous phantom and an irregular phantom containing an A1 inhomogeneity, ionization chamber measurements are performed at the exit surface, and a portal film image is taken at 30 cm behind the phantom. Portal films of a patient treated for a head and neck malignancy are evaluated for different air gaps behind the patient. RESULTS: For the irregular phantoms, deviations up to 15% and more are observed between the exit dose profile (along the shaped surface of the phantom) and the transit profile close to the phantom (perpendicular to the beam axis). There is, however, a good agreement--within 3%--between the exit profile and the transit profile at 30 cm. For the rectangular, inhomogeneous phantom, the deviation between the exit profile and the transit dose profile at 30 cm does not exceed 5%; transit dose profiles overestimate the exit dose for the air cavity and underestimate the dose for the A1 inhomogeneity. Measurements on portal films of a H&N patient for different air gaps confirm the order of magnitude of the difference observed between transit dose profiles close to the patient and transit dose profiles at some distance behind the patient. CONCLUSIONS: For 6-MV photon beam treatments with significant thickness variations (H&N), large variations (> 10%) are observed in transit dose profiles as a function of the air gap between the patient and the portal film. For this energy, a good agreement is found between the exit profile and the transit profile at about 30 cm behind the patient.

Head and Neck Neoplasms↗
PubMed2003

Clinical assessment identifies hemodynamic profiles that predict outcomes in patients admitted with heart failure.

OBJECTIVES: This study was designed to determine the relevance of a proposed classification for advanced heart failure (HF). Profiles based on clinical assessment of congestion and perfusion at the time of hospitalization were compared with subsequent outcomes. BACKGROUND: Optimal design of therapy and trials for advanced HF remains limited by the lack of simple clinical profiles to characterize patients. METHODS: Prospective analysis was performed for 452 patients admitted to the cardiomyopathy service at the Brigham and Women's Hospital with a diagnosis of HF. Patients were classified by clinical assessment into four profiles: profile A, patients with no evidence of congestion or hypoperfusion (dry-warm, n = 123); profile B, congestion with adequate perfusion (wet-warm, n = 222); profile C, congestion and hypoperfusion (wet-cold, n = 91); and profile L, hypoperfusion without congestion (dry-cold, n = 16). Other standard predictors of outcome were included and patients were followed for the end points of death (n = 117) and death or urgent transplantation (n = 137) at one year. RESULTS: Survival analysis showed that clinical profiles predict outcomes in HF. Profiles B and C increase the risk of death plus urgent transplantation by univariate (hazard ratio [HR] 1.83, p = 0.02) and multivariate analyses (HR 2.48, p = 0.003). Moreover, clinical profiles add prognostic information even when limited to patients with New York Heart Association (NYHA) class III/IV symptoms (profile B: HR 2.23, p = 0.026; profile C: HR 2.73, p = 0.009). CONCLUSIONS: Simple clinical assessment can be used to define profiles in patients admitted with HF. These profiles predict outcomes and may be used to guide therapy and identify populations for future investigation.

Blood Pressure↗
PubMed1991

Association of the renin-sodium profile with the risk of myocardial infarction in patients with hypertension.

BACKGROUND: To test the prognostic value of plasma renin activity prospectively, we determined the pretreatment renin-sodium profile of 1717 subjects with mild-to-moderate hypertension (mean age, 53 years; 36 percent white; 67 percent men) in a systematic work-site treatment program. METHODS: Renin profiles, obtained by plotting plasma renin activity against the urinary excretion of sodium, were classified as high (12 percent of the subjects), normal (56 percent), and low (32 percent), and there were expected variations according to age, sex, and race. Modified stepped-care treatment for hypertension, prescribed without reference to the renin profile, was similar in the three renin groups. RESULTS: Mean (+/- SD) blood pressure at entry was 151 +/- 19/100 +/- 10 mm Hg in the subjects with a high renin profile, 151 +/- 19/97 +/- 10 mm Hg in those with a normal profile, and 151 +/- 20/96 +/- 11 mm Hg in those with a low profile. During 8.3 years of follow-up, there were 27 myocardial infarctions. As adjusted for age, sex, and race, the incidence of myocardial infarction per 1000 person-years was 14.7 among the subjects with a high renin profile, 5.6 among those with a normal profile, and 2.8 among those with a low profile (rate ratio for high vs. low, 5.3; 95 percent confidence interval, 3.4 to 8.3). The rate of mortality from all causes was 9.3 in the high-profile group, 5.3 in the normal-profile group, and 3.9 in the low-profile group. The independent association of a high renin profile with myocardial infarction (but not with stroke or noncardiovascular events) was affirmed by Cox analyses (rate ratio for high vs. normal plus low, 3.2; 95 percent confidence interval, 1.2 to 8.4) after adjustment for race, sex, age at entry, serum cholesterol level, smoking status, electrocardiographic evidence of left ventricular hypertrophy, blood glucose level, body-mass index, history of cardiovascular disease or treatment, blood pressure, and use of beta-blockers. CONCLUSIONS: In the study population, whose blood pressure before and during treatment was in a narrow range, and after other cardiovascular risk factors had been considered, the renin profile before treatment remained independently associated with the subsequent risk of myocardial infarction.

Blood Pressure↗
PubMed2000

Opinions on provider profiling: telephone survey of stakeholders.

The views of producers, purchasers, and users of provider profiling concerning this practice were studied. A snowball sample of individuals representing seven groups with a stake in retrospective provider profiling were interviewed by telephone over a 12-week period in 1997. Participants were asked what they believed were the most important uses for profiles, who should receive copies of profiles, and what the limitations of profiles are. A semi-structured format was used to ensure that each interview was comparable and complete. The responses were aggregated, and qualitative research approaches were used to analyze them. A total of 40 people were interviewed. A majority of the respondents cited physician education, changing physician behavior, and monitoring and improving the quality of care as valid uses of provider profiles. A majority believed that the recipients of profile data should include the individual providers being profiled, medical administrative staff, people directly involved in the profiling program, pharmacists, and health plan administrators. The respondents acknowledged many limitations of profiles, with the top concern being inherent problems in the use of billing and administrative databases for profiling. Interviews with stakeholders in provider profiling yielded insights into the strengths and weaknesses of profiling, as well as echoing findings reported elsewhere. Health system administrators and health care professionals need to be aware of these issues as they use and modify profiling.

Drug Utilization Review↗
PubMed2002

Antimitochondrial antibody profiles: are they valid prognostic indicators in primary biliary cirrhosis?

OBJECTIVE: Retrospective studies have reported that subtypes of antimitochondrial antibodies (AMAs) discriminate between a benign and a progressive course in patients with primary biliary cirrhosis (PBC). Four AMA profiles (A-D) were defined: profiles A and B associated with a benign course and C and D with a progressive course. We aimed to confirm whether AMA profiles predict prognosis in a large sample of North American patients with PBC. METHODS: Stored pretreatment sera from patients with PBC from two centers were tested for AMA profiles using standard techniques. Proportions of patients in each profile group reaching the endpoints of liver transplantation or death from liver disease were compared. Kaplan-Meier curves were constructed comparing AMA profiles. RESULTS: All 472 patients studied had AMA positive, biopsy-confirmed PBC. Mean age at diagnosis was 53 yr, 90% were female, mean follow-up was 7.6 yr (range = 0.5-23), and 51% received ursodeoxycholic acid for >6 months. Profile A was not detected; 16.7% had profile B; 51.1%, profile C; and 32.2%, profile D. Duration of follow-up was comparable among the different profile groups. The proportions of patients reaching endpoints of death from liver disease or transplantation did not differ among the AMA profiles. No difference in the Kaplan-Meier curves between the different profile groups was observed (p > 0.05). CONCLUSION: AMA profiles do not predict prognosis in patients with PBC.

Autoantibodies↗
PubMed1993

The clinical significance of autoantibody profiles in patients with systemic lupus erythematosus.

We have evaluated the autoantibody profiles in the sera of 117 patients with systemic lupus erythematosus (SLE) and compared and contrasted the clinical and laboratory features of the disease of patients segregated according to an autoantibody profile. Using this approach we are able to demonstrate that autoantibody profiles identified subsets of patients with SLE. Patients with a negative autoantibody profile had fewer clinical and laboratory features of their disease when compared to the other subsets of patients. In contrast, patients with profile A (anti-nDNA and/or anti-Sm antibodies) had a statistically significant increase in malar rash, renal and hematologic involvement and hypocomplementemia when compared to patients with a negative profile. Patients with profile B (anti-nRNP antibodies) had a clinical pattern of disease different from that of patients with profile A and had a statistically significant increase in Raynaud's phenomenon when compared to patients with a negative profile. Patients with profile C (anti-SSA and/or anti-SSB antibodies) had a statistically significant increase in lupus-related rashes and photosensitivity. None of the lupus patients reviewed in this study has profile D (antibodies to centromere and/or Scl-70), this profile being seen largely in patients with scleroderma or one of its variants. Both patients with profile E (anti-histone antibodies) had drug-induced lupus. We conclude that the use of autoantibody profiles defines subsets of patients with lupus that may have clinical, therapeutic and prognostic implications.

Antibodies, Antinuclear↗
PubMed1999

The risk of thrombosis in patients with lupus anticoagulants is predicted by their specific coagulation profile.

Lupus anticoagulants belong to the family of antiphospholipid antibodies. They include two phospholipid-dependent inhibitors of coagulation that may be distinguished on the basis of specific coagulation profiles generated from the comparison of the ratios of the Kaolin Clotting Time (KCT) and the dilute Russell's Viper Venom Time (dRVVT): when the ratio of the KCT exceeds that of the dRVVT, the plasma is allocated to the "KCT" coagulation profile, when the opposite occurs, the plasma is defined to belong to the "dRVVT" coagulation profile group. We prospectively followed-up a historical cohort of 100 consecutive patients with lupus anticoagulants referred to our Institution between January 1988 and October 1997 to investigate the relationship between their coagulation profile at diagnosis and the development of thrombosis during a median follow-up time of 37.5 months (range 1-115 months). Fifty-six patients were allocated to the "dRVVT" coagulation profile, whereas the other 44 displayed the "KCT" profile. Lupus anticoagulants were transient in 17 patients, without differences between the two groups. None of these patients developed clinical events before disappearance of the phospholipid-dependent inhibitors of coagulation. The 83 cases with persistent lupus anticoagulants consistently displayed the same coagulation profile they had been allocated to at entry. Fourteen patients developed 18 thromboembolic events during the follow-up, with an overall rate of thrombosis of 4.2% patients-year. Twelve of them belonged to the "dRVVT" coagulation profile, whereas the other 2 to the "KCT" profile (p = 0.03). The "dRVVT" coagulation profile gave an odds ratio of thrombosis of 5.25 (95% confidence interval [C.I]: 1.17-23.50). Ten of the 14 patients who developed thrombosis during follow-up had already experienced thrombosis: a previous thrombotic event caused an odds ratio of recurrency of 2.72 (95% C.I.: 0.85-8.73) (p = 0.09). By multivariate analysis, the "dRVVT" coagulation profile was still associated with a trend to a higher risk of thrombosis, but the difference did not reach statistical significance. Increased levels of anticardiolipin antibodies (> 40 GPL and/or MPL units) were found in all the 14 patients (p = 0.0064). The "KCT" coagulation profile was significantly associated (p = 0.005) with moderate thrombocytopenia (platelets 50-150 X 10(9)/l). Neither profile was found to represent a risk factor for the development of recurrent miscarriages, neoplastic diseases and death. In conclusion, the "dRVVT" profile appears to have predictive value with respect to the thrombotic complications suffered by patients with antiphospholipid antibodies.

Adult↗
PubMed1985

Growth-plate-chondrocyte profiles and their orientation.

We studied the proximal tibial physes of mice, seven, fifteen, twenty-two, and twenty-eight days old, to define in mathematical terms the changes in cell profile and profile orientation among growth-plate zones and to determine if cell profile and profile orientation change with changes in the rate of growth. Using electron microscopy, we identified five growth-plate zones: the reserve zone, the upper proliferative zone, the lower proliferative zone, the upper hypertrophic zone, and the lower hypertrophic zone. In transverse sections, cell profiles did not change among growth-plate zones and the degree of cell-profile orientation approached zero in all zones. In longitudinal sections, cell profiles and profile orientations differed significantly among zones. Cell profiles in the upper and lower proliferative zones were eccentric and highly oriented. They became more rounded and the degree of cell orientation decreased between the proliferative and hypertrophic zones. As the rate of longitudinal bone growth decreased, cell profiles and cell-profile orientation changed. The cell profiles in the reserve zone became flatter and in the other zones the cell profiles became more rounded. The degree of cell-profile orientation decreased quadratically in the upper and lower proliferative zones, decreased linearly in the reserve and upper hypertrophic zones, and remained unchanged in the lower hypertrophic zone.

Aging↗
PubMed2002

Predicting adolescent profiles of risk: looking beyond demographics.

PURPOSE: To identify vulnerability and protective factors related to profiles of risk encapsulating the co-occurrence of health risk behaviors. METHODS: The current sample includes 12,578 high school students from the National Longitudinal Study of Adolescent Health, a nationally representative sample. Four profiles of risk behaviors (sexual activity, general alcohol use, binge-drinking, cigarette use, marijuana use, other illicit drug use, fighting, and suicide) were compared separately by gender for factors in four domains: psychosocial adjustment, daily activities, school, and family. Data were analyzed using ordinary least-squares regression with follow-up contrast statements and multinomial logit regression. RESULTS: Results indicate that profiles are related to factors in the psychosocial adjustment, school, and family domains. Students in the lowest risk profiles reported consistently higher levels of protective factors and lower levels of vulnerability factors than students in any other profiles. Likewise, students in the highest risk profiles reported consistently lower levels of protective factors and higher levels of vulnerability factors than those in any other profiles. Students in profiles of risk distinguished by higher levels of suicidal thoughts and behaviors reported similar levels of vulnerability and protection as the highest risk profiles. Students in profiles consisting of sexually active, substance-using teens reported higher levels of protective factors and lower levels of vulnerability factors than both the highest risk profiles and the profiles distinguished by suicidal thoughts and behaviors. CONCLUSION: Program staff and policymakers should recognize that different profiles of risk behaviors are related to varying levels of vulnerability and protective factors which have potential implications for preventive interventions.

Adaptation, Psychological↗
PubMed1997

Antimitochondrial antibody profiles in primary biliary cirrhosis distinguish at early stages between a benign and a progressive course: a prospective study on 200 patients followed for 10 years.

In recent retrospective studies, it was shown that subtypes of antimitochondrial antibodies (AMA) can help to discriminate between a benign [only anti-M9 and/or anti-M2 positive by enzyme-linked immunosorbent assay (ELISA)] and a rather progressive course (anti-M2, -M4 and/or -M8 positive). According to different constellations of these AMA subspecificities in ELISA and complement fixation test (CFT), four AMA profiles (A-D) were defined. In 1984 we started a prospective study based on 200 PBC patients with known AMA profiles in order to correlate the antibody pattern with the clinical outcome. Progression was defined primarily as the necessity of liver transplantation and death due to hepatic failure or variceal bleeding. At entry, 18 (9%) of the 200 patients had AMA profile A (only anti-M9), 57 (29%) profile B (only anti-M2 with or without anti-M9), 74 (37%) profile C (anti-M2 in association with anti-M4/-M8 by ELISA), and 51 (26%) profile D (anti-M2/-M4/-M8 by ELISA and CFT). At the beginning of the study, 177 patients had PBC stage I/II. During the observation period of ten years, ten patients died and in 18 orthotopic liver transplantation (OLT) was performed; all these patients belonged to profile C/D. Furthermore, 44% of the patients with profile C and 31% of the patients with profile D progressed to late stages, as defined by histology and clinical manifestations such as portal hypertension and increase of bilirubin, while only one of the patients with profile B and none of the profile A-patients developed late stage PBC. A significant increase of bilirubin was observed only in C/D-patients. AMA profiles did not change during the follow-up. In conclusion, AMA profiles discriminate between a benign and a progressive course of PBC already at early stages.

Adult↗
PubMed1999

Gender differences in the responsiveness of the sex-dependent isoforms of hepatic P450 to the feminine plasma growth hormone profile.

Most of the constitutive hepatic P450 isoforms expressed in the rat exhibit dramatic gender differences. Whereas only male hepatocytes contain CYP2A2, 2C11, and 3A2, only female hepatocytes express CYP2C12 and 3- to 4-fold greater levels of CYP2C7. This sexually dimorphic expression of hepatic P450 isoforms is regulated by the gender-dependent secretory GH profiles, i.e. episodic in males and continuous in females. In the case of the feminine GH profile, the continuous presence of the hormone in the circulation completely suppresses male-specific CYP2A2, 2C11, and 3A2, while stimulating full expression of female-dependent CYP2A1, 2C7, 2C12, and non-P450 testosterone 5alpha-reductase (type 1). The gender-dependent expression of the P450s can be reversed by exposing male rats to the continuous feminine plasma GH profile and females to the episodic masculine GH profile. Under these conditions, females will now express the male-specific isoforms and suppress the female-dependent forms, whereas the opposite will occur in the males. Nevertheless, it is not clear whether the levels of expression or suppression are comparable in male and female rats exposed to the same sex-dependent GH profiles. In the present study, we have renaturalized the circulating feminine GH profile in euthyroid-maintained, hypophysectomized female and male rats at six concentrations ranging from 3-100% of normal. Continuous monitoring of GH levels revealed indistinguishable plasma profiles in females and males at each dosage administered. In the case of females, restoration of the feminine-like plasma GH profile at a concentration that was 3% of the normal level restored expression levels (i.e. mRNA, protein, and/or catalytic activity) of female-dependent CYP2C12, 2A1, and 5alpha-reductase to 50% or greater of normal and fully suppressed expression of male-specific CYP2A2, 2C11, and 3A2. Twice the dosage of the hormone (6% of normal) was required to restore female-predominant CYP2C7 to 50% of normal in hypophysectomized female rats. In contrast, we found that all of the measured isoforms were significantly less responsive to the inductive and suppressive effects of the feminine-like GH profile when administered to male rats. While suppression of the male-specific isoforms (i.e. CYP2A2, 2C11, and 3A2) in male rats required concentrations of GH in the feminine profile 2-3 times greater than were effective in female rats, no dosage of the hormone was as effective in inducing female-dependent P450s (i.e. CYP2A1, 2C7, and 2C12) in males as in females. Clearly, the continuous feminine GH profile was more effective at inducing and suppressing gender-dependent isoforms of hepatic P450 when restored to female rats, where it is normally secreted, than in males. As GH profiles appear to be the sole factor responsible for regulating the sexually dimorphic expression of hepatic P450 isoforms in adult rats, the differential responsiveness of male and female rats to the feminine GH profile are likely to be inherently induced by irreversible imprinting during a critical developmental period.

3-Oxo-5-alpha-Steroid 4-Dehydrogenase↗
PubMed1992

[Analysis of circadian blood pressure profiles using Fourier analysis].

Blood pressure is subject to considerable circadian and situational fluctuation. In 24-h blood-pressure monitoring the severity of arterial hypertension is generally classified on the basis of the arithmetic mean of the diastolic blood pressure between 07.00 and 22.00 hours. In the present study Fourier analysis was used to generate continuous functions from the discrete blood-pressure values measured during 24-h blood-pressure monitoring in a sample of 50 normotensive persons aged from 25 to 80 years. A common reference profile was then constructed from these 50 profiles. This reference profile is characterized by the fact that the sum of the integrals over the squares of the distances between the individual profiles and the reference profile is the smallest possible. The reference profile is thus the best approximation of all normotensive profiles and practically ignores individual blood pressure fluctuations. The individual 24-h profiles of 80 patients with untreated arterial hypertension were classified on the basis of the daytime mean as mild, moderate or severe arterial hypertension and also each is described by a Fourier series. The pathological profiles were then compared with the normotensive reference profile. The comparison was made, not only with respect to the absolute pressure over 24 h, but also with respect to the circadian fluctuations in blood pressure. Comparison of the profiles shows that the Fourier analysis of 24-h blood-pressure profiles presented here permits reliable analysis and classification of arterial hypertension and can thus be used for more precise evaluation of the influence of antihypertensives on 24-h blood-pressure profiles.

Adult↗
PubMed1997

[The autoantibody profile and disease activity in patients with systemic lupus erythematosus].

Antinuclear antibodies are a group of autoantibodies which are typical for collagenous diseases. By means of the autoantibody profile different sub-groups of systemic lupus erythematosus (SLE) can be identified. This can serve as a certain prognostic factor of the affection. Patients with a negative antibody profile have fewer clinical and laboratory manifestations of SLE. Profile A (anti-dsDNA and/or anti-Sm has, as compared with patients with a negative antibody profile, more frequent organ manifestations. Patients with profile B (anti-RNP) have a higher frequency of Raynaud's phenomenon. Profile C (anti-Ro, anti-La) is characterized in particular by photosensitivity of the skin and secondary Sjögren's syndrome. Profile D (antibodies against centromeres and/or Scl-70) are found in subjects with SLE with traits of scleroderma. Finally profile E (antibodies against histones) are found in SLE induced by drugs. In the submitted study in 28 patients with SLE autoantibodies anti-dsDNA, anti-DNP, extracted nuclear antibodies (ENA-Sm,Ro,La, histones, Sm/RNP, Scl-70) were evaluated and different subgroups of SLE were assessed. Attention was paid to their common characteristics and the activity of the disease. Associations of clinical activity of the disease expressed by the ECLAM index (European Consensus Lupus Activity Measurement) were tested as well as anti-dsDNA levels and also the association of the disease activity with C3 and C4 constituents of complement, CRP and circulating immunocomplexes in serum. Positivity of the antinuclear factor (ANF) was found in 21 patients, while in 7 subjects who were in clinical and laboratory remission, ANF was negative. A negative antibody profile was recorded in 9 patients, profile A was found in 13, 1 patient had profile B, and 4 patients had profile C. Antibody profile D was not found in the group. When using regression analysis and Pearson s correlation coefficient, correlations were found between anti-dsDNA values and the system ECLAM (r = 0.72, p < 0.01), anti-dsDNA and C3 levels (r = -0.59, p < 0.01), C4 (r = -0.50,, p < 0.01), and between the ECLAM system and C3 (r = -0.60, p 0.01) and C4 (r = -0.52, p < 0.01) and also between C3 and C4 mutually (r = 0.72, p < 0.01). From the submitted investigation ensues that investigation of antinuclear antibody levels in SLE is important not only for assessment of the diagnosis of the disease and its activity but also for assessment of the subgroups of the disease and for prediction of its development. As to other indicators of activity, assessment of the C3 and C4 constituents of complement is still important.

Adolescent↗
PubMed1999

The future of physician profiling.

Although enthusiasm for physician profiling dates back to the origins of scientific medicine, the track record of profiling as an intervention is not strong. Profiling appears to be most valuable for simple interventions and processes, but its acceptance, usefulness, and impact will be influenced by future trends. Health care organizations will continue to be complex, and multiple overlapping profiles will be the norm. Technology will advance, but concerns over privacy and confidentiality will influence the social, political, and regulatory approaches to profiling. Public sector purchasers and consumers will increasingly demand profiling, but data will continue to lack the ability to interpret complex profiling data. Medical practice will increasingly accept profiling as part of ongoing quality improvement efforts, but profiling may become focused on key processes, not outcomes. Statistical, cognitive, and epistemological challenges to profiling will remain, and profiling may simultaneously become more complex and more simplified with the rise of information brokers. Greater attention to the human side of profiling will enhance its effectiveness.

Data Collection↗
PubMed2002

Impact of obesity on glucose and lipid profiles in adolescents at different age groups in relation to adulthood.

BACKGROUND: As obesity is rapidly becoming a major medical and public health problem, the aim of our study was to determine: 1) if obesity in Caucasian adolescents at 5 different Tanner stages are associated with obesity in adulthood and its obesity-associated abnormal glucose and lipid profiles, 2) the type of fat distribution is associated with glucose and lipid profile abnormalities, and 3) the risk level and the age of appearance of these abnormalities. METHODS: For the first study, data analyses were from a case-control study of adolescents classified according to their BMI; a BMI >or= 85th percentile for age and sex as overweight, and those with a BMI >or= 95th percentile as obese. Subjects with a BMI < 85th percentile were classified as controls. WC:AC ratio of waist circumference to arm circumference was used as an indicator of a central pattern of adiposity. Two other indices of central adiposity were calculated from skinfolds: Central-peripheral (CPR) as subscapular skinfold + suprailliac skinfold)/ (triceps skinfold + thigh skinfold) and ratio of subscapular to triceps skinfold (STR). The sum of the four skinfolds (SUM) was calculated from triceps, subscapular, suprailliac and thigh skinfolds. SUM provides a single measure of subcutaneous adiposity. Representative adult subjects were used for comparison. Glucose and lipid profiles were also determined in these subjects. Abnormal glucose and lipid profiles were determined as being those with fasting glucose >or= 6.1 mmol/l and lipid values >or= 85th percentile adjusted for age and sex, respectively. Prevalence and odds ratio analysis were used to determine the impact of obesity on glucose and lipid profiles at each Tanner stages for both sexes. Correlation coefficient analyses were used to determine the association between glucose and lipid profiles and anthropometric measurements for both sexes. The second study evaluated in a retrospective-prospective longitudinal way if: 1) obesity in adolescence is associated with obesity in adulthood and 2) the nature of obesity-associated risk factors. Incidence and odds ratio analysis were used to determine the impact of obesity on glucose and lipid profiles at 7 different age groups from 9 to 38 years old in both sexes between 1974 to 2000. RESULTS: Overall, glucose and lipid profiles were significantly (P < 0.01) associated with all anthropometric measurements either in male and female adolescents. WC:AC, CPR, STR and SUM are stronger predictors of both glucose and lipid profiles than BMI. Obese and overweight adolescents of Tanner stages III and higher are at increased risk of having an impaired glucose and lipid profiles than normal subjects with odds ratios of 5.9 and higher. Obesity in adolescents of 13-15 years old group is significantly (P < 0.01) associated with obesity in adulthood (with odds ratios of at least 12 for both men and women) and abnormal glucose (odds ratio of >or= 8.6) and lipid profiles (odds ratio of >or= 11.4). CONCLUSIONS: This study confirmed that adolescents aged between 13 and 15 years old of both sexes with a BMI >or= 85th percentile are at increased risk of becoming overweight or obese adults and presenting abnormal glucose and lipid profiles as adults. This emphasizes the importance of early detection and intervention directed at treatment of obesity to avert the long-term consequences of obesity on the development of cardiovascular diseases.

Adolescent↗