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Screening Criteria (screening + criterion)
Selected AbstractsPrevalence and clinical characteristics of maternally inherited diabetes and deafness caused by the mt3243A > G mutation in young adult diabetic subjects in Sri LankaDIABETIC MEDICINE, Issue 3 2008P. Katulanda Abstract Aims The maternally inherited mt3243A > G mutation is associated with a variable clinical phenotype including diabetes and deafness (MIDD). We aimed to determine the prevalence and clinical characteristics of MIDD in a large South Asian cohort of young adult-onset diabetic patients from Sri Lanka. Methods DNA was available from 994 subjects (age of diagnosis 16,40 years, age at recruitment , 45 years). Mutation screening was performed using a QRT-PCR method on an ABI 7900HT system using sequence-specific probes. Samples with heteroplasmy , 5.0% were considered positive. Results Nine (four males) mutation-positive subjects were identified (prevalence 0.9%). They were diagnosed at a younger age (25.9 ± 4.8 years vs. 31.9 ± 5.6 years, P = 0.002) and were lean (body mass index [BMI] 18.7 ± 2.7 kg/m2 vs. 24.7 ± 4.0 kg/m2, P < 0.001) compared to NMCs. One mutation-positive subject (11.1%) had metabolic syndrome, compared to 633 (64.3%) of NMCs. Insulin therapy within 6 months of diagnosis was used in four (44.0%) carriers compared to 6.9% of NMCs (P = 0.002). Combined screening criteria of any two of maternal history of diabetes, personal history of hearing impairment and family history of hearing impairment only identified five (55%) of the carriers, with a positive predictive value of 7.4%. Conclusions The prevalence of mt3243A > G mutation among young adult-onset diabetic subjects from Sri Lanka was 0.9%. Our study demonstrates that a maternal family history of diabetes and either a personal and/or family history of deafness only distinguish half of patients with MIDD from Sri Lankan subjects with young-onset diabetes. [source] Spatial and temporal evaluation of metal concentrations in soils and sediments from new orleans, louisiana, USA, following hurricanes Katrina and RitaENVIRONMENTAL TOXICOLOGY & CHEMISTRY, Issue 10 2007Michael T. Abel Abstract During January 2006, soil and sediment samples from 75 sites in the New Orleans (LA, USA) area were collected and tested for 26 inorganic elements. The study design was intended to provide a spatial pattern of metal concentrations within the city following hurricanes Katrina and Rita. The sampling design included four transects that traversed the city in a north,south direction and three transects that traversed the city in an east,west direction. Contaminant concentrations were determined at multiple sites within each transect and compared to U.S. Environmental Protection Agency soil screening criteria pertaining to human health. Concentrations of Pb and As exceeded the criteria indiscriminately throughout the city. Of the 75 sites, 14 (19%) exceeded the soil screening criteria for Pb, and 73 (97%) exceeded the criteria for As. Forty-three of the 75 sites coincided with a previous sampling event in October 2005. Metal concentrations were evaluated for temporal comparisons using a pair sampled t test. Arsenic concentrations differed significantly over time, but Pb concentrations did not. [source] The Emergency Department Presentation of Patients with Active Pulmonary TuberculosisACADEMIC EMERGENCY MEDICINE, Issue 9 2000Peter E. Sokolove MD Abstract. Objective: To determine the clinical presentation of emergency department (ED) patients with active pulmonary tuberculosis (TB). Methods: This was a retrospective medical record review of adult patients, identified through infection control records, diagnosed as having active pulmonary TB by sputum culture over a 30-month period at an urban teaching hospital. The ED visits by these patients from one year before to one year after the initial positive sputum culture were categorized as contagious or noncontagious, using defined clinical and radiographic criteria. The medical records of patients with contagious visits to the ED were reviewed to determine chief complaint, presence of TB risk factors and symptoms, and physical examination and chest radiograph findings. Results: During the study period, 44 patients with active pulmonary TB made 66 contagious ED visits. Multiple contagious ED visits were made by 12 patients (27%; 95% CI = 15% to 43%). Chief complaints were pulmonary 33% (95% CI = 22% to 46%), medical but nonpulmonary 41% (95% CI = 29% to 54%), infectious but nonpulmonary 14% (95% CI = 6% to 24%), and traumatic/orthopedic 12% (95% CI = 5% to 22%). At least one TB risk factor was identified in 57 (86%; 95% CI%= 76 to 94%) patient visits and at least one TB symptom in 51 (77%; 95% CI = 65% to 87%) patient visits. Cough was present during only 64% (95% CI = 51% to 75%) of the patient visits and hemoptysis during 8% (95% CI = 3% to 17%). Risk factors and symptoms that, if present, were likely to be detected at triage were foreign birth, homelessness, HIV positivity, hemoptysis, and chest pain. Conclusions: Patients with active pulmonary TB may have multiple ED visits, and often have nonpulmonary complaints. Tuberculosis risk factors and symptoms are usually present in these patients but often missed at ED triage. The diversity of clinical presentations among ED patients with pulmonary TB will likely make it difficult to develop and implement high-yield triage screening criteria. [source] Relationship between Carbon Isotope Discrimination, Mineral Content and Gas Exchange Parameters in Vegetative Organs of Wheat Grown under Three Different Water RegimesJOURNAL OF AGRONOMY AND CROP SCIENCE, Issue 3 2010L. Zhu Abstract Carbon isotope discrimination (,) has been proposed as an indirect selection criterion for transpiration efficiency and grain yield in wheat. However, because of high cost for , analysis, attempts have been made to identify alternative screening criteria. Ash content (ma) has been proposed as an alternative criterion for , in wheat and barley. A pot experiment was conducted to analyse the relationship between ,, mineral content and gas exchange parameters in seedlings and leaves of bread wheat (Triticum aestivum L.). Plants of 10 genotypes were cultivated under three different water regimes corresponding to moderate (T3), intermediate (T2) and severe drought (T1) stress obtained by maintaining soil humidity at 75 %, 55 % and 45 % of the humidity at field capacity respectively. , and ma in seedlings and leaves showed significant differences among the three water treatments. Significant positive correlations were found between , and ma in seedlings and leaves at elongation and anthesis stages in severe drought stress (T1). , was negatively associated with potassium (K) content in intermediate drought stress (T2) and positively with magnesium (Mg) content in T2 and T3 (moderate drought stress) in flag leaf at anthesis. There were negative correlations between , and single-leaf intrinsic water-use efficiency (WT) in T2 and T3 at anthesis stage. Stronger positive associations were noted between , and stomatal conductance (gs) in T1 and T2 than in T3 at anthesis. These results suggested that , is a good trait as an indirect selection criterion for genotypic improvement in transpiration efficiency, while ma is a possible alternative criterion of , in wheat vegetative organs, especially in stressed environments. Significant association was found between , and K, Mg and Ca contents that would merit being better investigated. [source] Relationship between Carbon Isotope Discrimination and Mineral Content in Wheat Grown under Three Different Water RegimesJOURNAL OF AGRONOMY AND CROP SCIENCE, Issue 6 2008L. Zhu Abstract Carbon isotope discrimination (,) has been proposed as an indirect selection criterion for transpiration efficiency and grain yield in wheat. However, because of the high cost for , analysis, attempts have been carried out to identify alternative screening criteria. Ash content (ma) has been proposed as an alternative criterion for , in wheat and barley. A pot experiment was conducted to analyse the relationship between , and ma in flag leaf and grain. Plants of 10 genotypes were cultivated under three different water regimes corresponding to moderate, intermediate and severe drought stress obtained by maintaining soil humidity at 75 %, 55 % and 45 % of the humidity at field capacity, respectively. , and ma in flag leaf and grain showed significant differences between the moderate, intermediate and severe drought stress levels. Significant correlations were found among genotypes for , and ma in flag leaf under severe drought stress, and for , and ma in grain under intermediate and moderate drought stress. In flag leaf at anthesis, , was negatively associated to K content and positively to Mg content. At maturity, , in grain was negatively correlated with Mg and Ca contents in flag leaf and grain, respectively. These results suggested that these traits may be potentially useful traits, which could be surrogates for ,. [source] Assessing the Suitability of Various Physiological Traits to Screen Wheat Genotypes for Salt ToleranceJOURNAL OF INTEGRATIVE PLANT BIOLOGY, Issue 9 2007Salah E. El-Hendawy Abstract Success of improving the salt tolerance of genotypes requires effective and reliable screening traits in breeding programs. The objective was to assess the suitability of various physiological traits to screen wheat genotypes for salt tolerance. Thirteen wheat genotypes from Egypt, Germany, Australia and India were grown in soil with two salinity levels (control and 150 mmol/L NaCl) in a greenhouse. The physiological traits (ion contents in leaves and stems, i.e. Na+, Cl,, K+, Ca2+), the ratios of K+/Na+ and Ca+/Na+ in the leaves and stems, net photosynthesis rate, stomatal conductance, transpiration rate, chlorophyll content (SPAD value), and leaf water relations, were measured at different growth stages. The physiological traits except for Na+ and Cl, in stems and the leaf transpiration rate at 150 mmol/L NaCl showed a significant genotypic variation, indicating that the traits that have a significant genotypic variation may be possibly used as screening criteria. According to the analysis of linear regression of the scores of the physiological traits against those of grain yield, however, the physiological traits of Ca2+ and Ca2+/Na+ at 45 d and final harvest with the greatest genotypic variation were ranked at the top. From a practical and economic point of view, SPAD value should be considered to be used as screening criteria and/or there is a need to develop a quick and practical approach to determine Ca2+ in plant tissues. [source] Evaluating the efficacy of tele-cognitive rehabilitation for functional performance in three case studiesOCCUPATIONAL THERAPY INTERNATIONAL, Issue 1 2003Dr Sing-Fai Tam PhD Associate Professor Abstract Traumatic brain injury (TBI) is one of the main causes of long-term disability, and its rehabilitation is a challenge to the healthcare team. Tele-rehabilitation, through using advancements in networking and tailor-made software, has been developed and applied to the cognitive rehabilitation of persons with brain injury in the present study. Tele-cognitive rehabilitation uses customized online computer software as a treatment mode. The online treatment software is operated on an interactive tele-communication platform , for example, video conferencing with screen sharing. Through implementing the tele-cognitive rehabilitation activities, therapists can help clients to practise and thus improve their cognitive skills through using the treatment software successfully. Moreover, hypermedia programming techniques allow the therapist to adjust the software to meet the client's treatment needs, so that the treatment is appropriate to his/her functional levels and living environment. Also the software can customize immediate visual, auditory and personalized feedback to motivate the client and training can be set at the right pace for the client's needs. The present study aimed to evaluate the effectiveness and perceived efficacy of the newly developed customized tele-cognitive rehabilitation programme for three subjects with traumatic brain injury through using single-case and qualitative research design. The cognitive factors investigated in this pilot study were, respectively, Chinese word recognition, prospective memory and semantic memory. The subjects had undergone a recruitment process with stipulated screening criteria. A single case experimental design (ABA reversal/withdrawal design) consisted of a no-intervention baseline phase (A), an intervention phase (B) and a no-intervention withdrawal phase (A). There were six sessions in each phase, making a total of 18 sessions. Tele-cognitive rehabilitation software was tailor-made according to each subject's cognitive functional needs. To monitor the change in cognitive functions, variables were tapped by tailor-made assessment and qualitative questionnaires through interviews, and they were then used to explore subjects' opinions of the programme and to test the treatment efficacy of the tele-cognitive rehabilitation programme. Finally, the relationships among the three phases were analysed through visual analysis and trend line analysis by means of the split-middle method. The three persons with brain injury showed improving trends and levels of specific cognitive performance during the treatment phase. Qualitative findings were analysed and confirmed the efficacy of the treatment module. The tele-cognitive rehabilitation approach was well received by subjects. The authors suggest that further replication studies of this kind should be conducted in the future and that more subjects should be recruited to improve the generalizability of the results. Copyright © 2003 Whurr Publishers Ltd. [source] Radiofrequency Neurotomy for Low Back Pain: Evidence-Based Procedural GuidelinesPAIN MEDICINE, Issue 2 2005W. Michael Hooten MD ABSTRACT Objective., This review was undertaken to outline the procedural limitations of the randomized controlled trials (RCTs) of radiofrequency (RF) neurotomy for low back pain. Second, the literature related to patient selection, diagnostic testing, and the technique of performing lumbar spine, RF neurotomy will be critically reviewed and analyzed. Based on these analyses, diagnostic and procedural guidelines will be proposed. Design., A Medline and EMBASE search identified three RCTs and two systematic reviews of RF neurotomy for low back pain. A similar search identified pertinent literature related to the method of patient selection for a diagnostic block, the medial branch and L5 dorsal ramus comparative block, and the anatomical and technical parameters of lumbar spine RF neurotomy. Results., Substantial procedural shortcomings were identified in all three RCTs. In the systematic reviews, these procedural limitations were not accounted for by the quality assessment of study design which resulted in an inaccurate estimate of clinical effectiveness. Analysis using likelihood ratios showed that screening criteria could increase the probability of zygapophysial joint pain before performing diagnostic blocks. Similar analysis showed that comparative medial branch blocks, rather than single blocks, must be used before RF neurotomy. Anatomical studies demonstrated that the shorter distal compared with the circumferential radius of the RF lesion necessitates placement of the electrode parallel to the course of the nerve along the base of the superior articular process. Conclusions., The evidence-based procedural guidelines provide consistent criteria for multisite studies that could enroll a sufficiently large homogenous study cohort. [source] Reduction in the proportion of patients with colorectal cancer presenting as an emergency following the introduction of fast-track flexible sigmoidoscopy: a three-year prospective observational studyCOLORECTAL DISEASE, Issue 4 2004R. J. Davies Abstract Objective We established a fast-track flexible sigmoidoscopy service to meet the two-week target for colorectal cancer, and have performed a prospective observational study over three years to assess its impact on the proportion of patients with colorectal cancer presenting as an emergency. Methods The fast-track system was established on 1 November 1999 using six screening criteria to select high-risk patients. Data on all high-risk patients referred through the fast-track system and all patients diagnosed with colorectal cancer were recorded prospectively in two time periods: six months before fast-track (1 November 1998 to 30 April 1999, Period 1) and three years following fast-track (1 November 1999 to 31 October 2002, Period 2). Results In Period 2, 2294 fast-track referrals were received. A total of 635 cases (321 male, 314 female) of colorectal cancer were diagnosed in Period 2 vs. 84 cases (43 male, 41 female) in Period 1. In Period 1, 30 patients with colorectal cancer (35.7% of the total) presented as an emergency vs. 165 patients (25.9%) in Period 2 (P = 0.059, ,2test). Conclusion Introduction of a fast-track service to meet the two-week target has resulted in a trend towards fewer emergency presentations with colorectal cancer. [source] | |||||||||||||