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Clinical Screening (clinical + screening)
Selected AbstractsCNS response to a thermal stressor in human volunteers and rats may predict the clinical utility of analgesicsDRUG DEVELOPMENT RESEARCH, Issue 1 2007David Borsook Abstract fMRI was used to test the hypothesis that global brain activation following a stressor (a thermal stimulus) that activates multiple brain circuits in healthy subjects can predict which drugs have higher potential for clinical utility for neuropathic pain. The rationale is that a drug will modulate multiple neural circuits that are activated by the system-specific stressor (e.g., pain). In neuropathic pain, some brain circuits have altered function, but most brain systems are "normal." Thus, the manner in which a drug effect on neural circuits is modulated by the stressor may provide insight into the clinical utility based on the readout of brain activation in response to the stimulus. Six drugs with known clinical efficacy (or lack thereof) in treating neuropathic pain were selected and the CNS response to each drug in the presence or absence of a pain stimulus was examined. The present results suggest that it is possible to identify potentially effective drugs based on patterns of brain activation in healthy human subjects and indicate that CNS activity is a more sensitive measure of drug action than standard psychophysical measures of pain intensity. This approach was repeated in rats and showed that a similar fMRI paradigm segregates these drugs in a similar manner suggesting a potential "translational tool" in evaluating drug efficacy for neuropathic pain. The sensitivity of this paradigm using fMRI allows clinical screening in small groups of healthy subjects, suggesting it could become a useful tool for drug development as well as for elucidating the mechanisms of neuropathic disease and therapy. Drug Dev. Res. 68:23,41, 2007. © 2007 Wiley-Liss, Inc. [source] Universal multiplex PCR and CE for quantification of SMN1/SMN2 genes in spinal muscular atrophyELECTROPHORESIS, Issue 7 2009Chun-Chi Wang Abstract We established a universal multiplex PCR and CE to calculate the copy number of survival motor neuron (SMN1 and SMN2) genes for clinical screening of spinal muscular atrophy (SMA). In this study, one universal fluorescent primer was designed and applied for multiplex PCR of SMN1, SMN2 and two internal standards (CYBB and KRIT1). These amplicons were separated by conformation sensitive CE. Mixture of hydroxyethyl cellulose and hydroxypropyl cellulose were used in this CE system. Our method provided the potential to separate two 390-bp PCR products that differ in a single nucleotide. Differentiation and quantification of SMN1 and SMN2 are essential for clinical screening of SMA patients and carriers. The DNA samples included 22 SMA patients, 45 parents of SMA patients (obligatory carriers) and 217 controls. For evaluating accuracy, those 284 samples were blind-analyzed by this method and denaturing high pressure liquid chromatography (DHPLC). Eight of the total samples showed different results. Among them, two samples were diagnosed as having only SMN2 gene by DHPLC, however, they contained both SMN1 and SMN2 by our method. They were further confirmed by DNA sequencing. Our method showed good agreement with the DNA sequencing. The multiplex ligation-dependent probe amplification (MLPA) was used for confirming the other five samples, and showed the same results with our CE method. For only one sample, our CE showed different results with MLPA and DNA sequencing. One out of 284 samples (0.35%) belonged to mismatching. Our method provided a better accurate method and convenient method for clinical genotyping of SMA disease. [source] Reliability and Validity of a Steadiness ScoreJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 9 2005Daniel O. Clark PhD Objectives: To determine the internal consistency and construct and predictive validity of three survey questions regarding steadiness in a sample of community-dwelling lower-income older adults. Design: A 6-month prospective cohort study. Setting: Community-based. Participants: Three hundred fifty-seven older adults who completed a baseline and 6-month follow-up interviewer-administered survey. These older adults received care at a single, public health system and were judged by insurance status to be of low income. Measurements: Self-report measures of steadiness while walking and transferring; difficulty in mobility, activities of daily living (ADLs), and instrumental activities of daily living (IADLs); chronic illness; falls; hospitalization; and sociodemographic characteristics. Results: The three steadiness questions showed good internal consistency (0.88); construct validity in Pearson correlations with mobility (0.57), ADL (0.53), and IADL scores (0.41); and predictive validity. With regard to predictive validity, steadiness was predictive of falls, hospitalization, and decline in ADL and IADL function over a subsequent 6-month period. Conclusion: Steadiness questions are a potentially valuable addition to survey research and clinical screening to identify persons with current impairment status and falls and disability risk. [source] Automatic analysis of normal bone marrow blood cells using the XE-2100 automated hematology analyzerJOURNAL OF CLINICAL LABORATORY ANALYSIS, Issue 1 2003Hisako Shibata Abstract The bone marrow aspiration test conventionally has been performed by visual methods, using a light microscope, because automatic blood cell analyzers cannot adequately capture erythroblasts and immature granulocytes (IGs) (Tatsumi et al.: Osaka City Med J 1988;34:135,146; Tatsumi et al.: Am J Clin Pathol 1986;86:50,54). With the development of the XE-2100 automatic blood cell analyzer (Sysmex Corporation, Kobe, Japan) in 1999, the classification of erythroblasts and IGs by means of flow cytometry (Zini et al.: Infus Ther Transfus Med 2001;28:277,279; Briggs et al.: Sysmex J Int 1999;9:113,119) became possible. In the present study we classified cells in 65 bone marrow aspiration specimens by the microscopic method and with the XE2100, and compared the results. A good correlation was found in the nucleated red blood cell (NRBC), white blood cell (WBC), and total nucleated cell (TNC) counts; the myeloid/erythroid ratio (M/E ratio); neutrophils, lymphocytes, eosinophils, and IGs in the immature myeloid information (IMI) channel; and the total cell count. These items can all be analyzed in about 54 sec with the XE2100, which is faster than with the microscopic method. Therefore, analysis of bone marrow aspiration specimens with this apparatus appears to be very useful for clinical screening as well as laboratory testing. J. Clin. Lab. Anal. 17:12,17, 2003. © 2003 Wiley-Liss, Inc. [source] Possible automatic cell classification of bone marrow aspirate using the CELL-DYN 4000® automatic blood cell analyzerJOURNAL OF CLINICAL LABORATORY ANALYSIS, Issue 2 2002Ryousuke Yamamura Abstract In clinical hematology, the demand for bone marrow aspiration testing is increasing. However, conventional automatic blood cell analyzers cannot completely analyze erythroblasts, and evaluation has mainly been performed by visual examination (the microscopic method). Using the CELL-DYN 4000® automatic blood cell analyzer (CD4000) (Abbott Laboratories, North Chicago, IL), specific recognition and classification of erythroblasts by DNA staining is possible. In the present study, using bone marrow blood collected from normal subjects and patients with hematological malignancy, we classified cells by the microscopic method and with the CD4000, and compared the results. Good correlations were found for total nucleated cell count (TNCC), neutrophils, lymphocytes, erythroblasts, and the myeloid series to erythroid series (M/E) ratio. It is possible to detect blasts that emerge in patients with hematological malignancy using the blast flag system installed on the CD4000. Since all of the items can be analyzed in about 80 sec with the CD4000, cells in bone marrow aspirates can be classified faster with this apparatus than by the microscopic method. Therefore, analysis of bone marrow aspirates with this apparatus appears to be very useful not only for laboratory testing but also for clinical screening. J. Clin. Lab. Anal. 16:86,90, 2002. © 2002 Wiley-Liss, Inc. [source] Psychometric properties of the Chinese version of the Bipolar Spectrum Diagnostic ScaleJOURNAL OF CLINICAL NURSING, Issue 19-20 2010Hsin Chu Aim and objectives., The aim of this study was to test the psychometric properties of the Chinese version of the Bipolar Spectrum Diagnostic Scale (C-BSDS) in a Chinese population to serve as an aid to clinical diagnosis of bipolar disorders. Background., Bipolar spectrum disorders are often misdiagnosed because of the wide range of symptoms seen in patients. The consequences of delayed diagnoses or misdiagnoses can be devastating. Design., A cross-sectional research design. Method., Two hundred patients with affective disorders from a psychiatric outpatient clinic in Taiwan were enrolled. Internal consistency reliability and two-week test,retest reliability were performed to evaluate the reliability of the C-BSDS. Expert content validity and factor analysis were used for testing construct validity. To evaluate sensitivity and specificity, the Chinese version of the Mini International Neuropsychiatric Interview (MINI) was used as the gold standard for diagnosis. Results., The internal consistency coefficient measured by intra-class correlation (ICC) was 0·81, the test,retest reliability coefficient was 0·85 and the expert validity was 0·85. For construct validity, ,irritable and hyper-energetic factors' and ,depressed and lack of energy factors' were extracted by factor analysis. These two factors reflected the structure of the original scale and accounted for 33·27% of the variance. The optimal cut-off was 12, which yielded a sensitivity of 74 and a specificity of 0·97 for detecting bipolar disorder and for bipolar II disorder these were 0·79 and 0·68, respectively. Conclusions., The C-BSDS showed good reliability and validity, and the results were consistent with the English version of the BSDS. Therefore, the C-BSDS is an effective tool for evaluation of a Chinese population. Relevance to clinical practice., The BSDS can further increase the detection rate of bipolar disorders, especially bipolar II disorder, with satisfactory sensitivity and specificity. It can effectively assist with clinical screening of patients for bipolar spectrum disorders. [source] Psychometric research and clinical screening: do we really want one without the other?PSYCHO-ONCOLOGY, Issue 7 2009Christopher J. Recklitis No abstract is available for this article. [source] | ||||||||||