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Clinical Tests (clinical + test)

Distribution by Scientific Domains

Medical Sciences	88%
Life Sciences	8%

Selected Abstracts

Nonmetallic Prefabricated Dowels: A Review of Compositions, Properties, Laboratory, and Clinical Test Results

JOURNAL OF PROSTHODONTICS, Issue 6 2009
Nadim Z. Baba DMD
Abstract Purpose: Prefabricated dowels have become popular, and a wide variety of systems are available. Recently, in response to a need for tooth-colored dowels, several nonmetallic dowels such as carbon-fiber epoxy resin, zirconia, glass fiber-reinforced epoxy resin, and ultra-high polyethelene fiber-reinforced dowels are available. With a plethora of different materials and systems currently available for use, an overview of the scientific literature on nonmetallic dowels is indicated. This article reviews the current literature dealing with the compositions, properties, and laboratory and clinical test results of nonmetallic prefabricated dowels. Methods: A comprehensive review of the literature was completed seeking evidence for the treatment of teeth with nonmetallic prefabricated dowels. A search of English language peer-reviewed literature was undertaken using MEDLINE and PubMed with a focus on clinical research articles published between 1996 and 2007. A hand search of relevant dental journals was also completed. Results: The literature demonstrates that in vitro investigations demonstrated favorable physical and mechanical properties of these dowels; however, clinically, there has been a wide range of reported failure percentages. Conclusion: Since there is considerable variation in reported failure percentages, longer-term studies are needed that present data regarding all types of complications that have been identified in the literature. [source]

Clinical tests in distinguishing between persons with or without craniomandibular or cervical spinal pain complaints

EUROPEAN JOURNAL OF ORAL SCIENCES, Issue 6 2000
Corine M. Visscher
The recognition of a craniomandibular or cervical spinal pain is usually based upon the pain complaint of the patient, reported during an oral history, and the pain responses provoked in a clinical examination. Often used clinical tests are palpation, and function tests like dynamic/static tests or active movements. The relative importance of these tests for the recognition of the musculoskeletal pain is important. Therefore, it was the aim of the present study to determine which test, or combination of tests, best discriminates between persons with or without craniomandibular and/or cervical spinal pain complaints. Two hundred and fifty persons participated. From each person, a standardized oral history was taken. Then, in a randomized order and using a blind design, physical examinations of the craniomandibular system and of the neck were performed. Forward stepwise logistic regression analyses showed that the dynamic/static tests discriminated better between persons with and without pain complaints than the other tests did. In conclusion, in studies to the coexistence of craniomandibular and cervical spinal pain, it may be a good choice to base the recognition of these disorders on the pain complaints reported in the oral history which are verified by the pain response of the dynamic/static tests. [source]

Practical tests for clinical diagnosis of kidney allograft dysfunction

CLINICAL TRANSPLANTATION, Issue 2008
Masayoshi Miura
Abstract:, Graft dysfunction after renal transplant occurs due to a variety of causes. Graft biopsy is a mainstay in the diagnosis of graft dysfunction, including rejection, infection, glomerulonephritis and drug toxicity. Clinical tests including regular laboratory tests, antibody tests and imaging studies, however, are also important in the process of diagnosis. The possible causes of graft dysfunction are different depending on the period after transplantation. Pre-transplant donor factors may also affect the early graft function. Perioperative graft dysfunction is mainly related to hemodynamic factors and surgical complications. Early acute rejection may occur in immunologically high-risk cases. Later graft dysfunction may be related to infection, acute and chronic rejection or drug toxicity. Clinical tests to differentiate these factors are discussed in this paper. [source]

Impairment due to cannabis and ethanol: clinical signs and additive effects

ADDICTION, Issue 6 2010
Jørgen G. Bramness
ABSTRACT Aims Studies have shown that the impairing effects of ,-9-tetrahydrocannabinol (THC) are dose-related. Cannabis intake increases the risk of traffic accidents. The purpose of this study was to see how different clinical tests and observations were related to blood THC concentrations and to determine whether the combined influence of THC and ethanol was different from either drug alone. Design A retrospective cross-sectional forensic database study. Setting Drivers apprehended by the police suspected of driving under the influence of alcohol other drugs. Participants We investigated 589 cases positive for THC only. In addition, 894 cases with THC and ethanol were included. A comparison was made with 3480 drivers with only ethanol in their blood and 79 drivers who tested negative. Measurements Data were analytical results of blood samples and the 27 clinical tests and observations included in the Norwegian clinical test for impairment (CTI). Findings No relationship was found between blood THC concentration and most of the CTI tests. Blood THC concentration was, however, related to conjunctival injection, pupil dilation and reaction to light and to the overall risk of being judged impaired. When THC and ethanol were detected together the risk of being judged impaired was increased markedly. Conclusions This study demonstrates that cannabis impairs driving ability in a concentration-related manner. The effect is smaller than for ethanol. The effect of ethanol and cannabis taken simultaneously is additive. Conjunctival injection, dilated pupils and slow pupil reaction are among the few signs to reveal THC influence. [source]

Methadone and impairment in apprehended drivers

ADDICTION, Issue 3 2009
Jean-Paul Bernard
ABSTRACT Aims According to Norwegian guidelines, patients who are in opioid-assisted rehabilitation programmes are permitted to drive a motor vehicle provided that certain requirements are met. The purpose of this study was to investigate apprehended drivers who had methadone in their blood at the time of apprehension and, further, the relationship between blood methadone concentration and impairment as measured by the clinical test of impairment (CTI). Methods The division of Forensic Toxicology and Drug Abuse (DFTDA) at the Norwegian Institute of Public Heath analyses blood samples from all drivers suspected of driving under the influence of drugs nation-wide. Cases with positive results for methadone in blood were collected over the period 2001,2006. Results A total of 635 drivers with methadone found in their blood samples were identified. The majority of drivers were men (>80%), aged between 30 and 40 years. Methadone was the only psychoactive drug detected in blood in only 10 cases. Benzodiazepines were a frequent finding (in approximately 90% of cases). A significant difference in blood methadone concentration was found between cases where only methadone was detected [median 0.46 mg/l (range 0.19,0.65)] and cases where methadone was detected in combination with other psychoactive drugs [median 0.28 mg/l (range 0.06,1.24)]. A CTI had been carried out, in conjunction with blood sampling, in 577 of the cases. A concentration,impairment relationship was not seen for methadone in these cases. Conclusions Cases of driving impairment involving methadone alone were very rare, with combination use most frequent. No correlation between methadone concentration and impairment as judged by the CTI was seen either for these cases or for the material as a whole. [source]

Development and evaluation of a one-step loop-mediated isothermal amplification for detection of spring viraemia of carp virus

JOURNAL OF APPLIED MICROBIOLOGY, Issue 4 2008
Z. Liu
Abstract Aim:, Spring viraemia of carp virus (SVCV) is the causative agent of SVC disease. The main aim of our study was to develop a one-step reverse transcription loop-mediated isothermal amplification (RT-LAMP) assay for rapid, sensitive and effective detection of SVCV. Methods and Results:, A set of four specific primers, two outer and two inner primers were designed based on the SVCV M gene for RT-LAMP assay. The sensitivity and specificity of RT-LAMP were determined and clinical test was performed under optimized amplification conditions (64°C, 60 min). The results showed that the assay has a high specificity and the detection limit was 80 copies using 10-fold series dilutions of SVCV RNA, 10 times more sensitive than nest reverse transcription-polymerase chain reaction. In the detection of 472 fish samples, this assay showed excellent agreement with the standard virus isolation method (, = 0·807). Conclusions:, A sensitive and specific RT-LAMP assay was successfully developed to monitor and detect SVCV. Significance and Impact of the Study:, This work provides a robust method for evaluating the risk of SVCV. Given the advantages of LAMP in the detection of SVCV, this method can be applied to diagnose other viruses, which pose serious threats to the aquaculture industry. [source]

Nonmetallic Prefabricated Dowels: A Review of Compositions, Properties, Laboratory, and Clinical Test Results

Recovery from neuromuscular blockade: a survey of practice,

ANAESTHESIA, Issue 8 2007
M. Grayling
Summary At present in the UK there is no consensus regarding the parameters anaesthetists use to indicate adequacy of reversal from neuromuscular blockade. In an attempt to determine current practice, we carried out a survey covering 12 anaesthetic departments throughout the UK. Individuals were asked to give details regarding their usage of available monitors or, alternatively, to list those clinical parameters which they felt offered the best guidance as to the adequacy of recovery from neuromuscular blockade. There was no consensus among anaesthetists as to the most reliable clinical signs of recovery from neuromuscular blockade. There was an apparent lack of understanding of the limitations of some clinical signs used to determine recovery, as well as inappropriate application of others. In all departments where monitors (quantitative or qualitative) were available, there was limited knowledge regarding the current minimum recommended train-of-four ratio which should be observed prior to extubation. There is an apparent overall confusion among clinicians as to the best method to confirm recovery from neuromuscular blockade. This is probably due to the lack of a single reliable clinical test which can be applied in the immediate postoperative period. Insufficient reliance is placed upon the use of quantitative monitors. There is a lack of clarity in national anaesthetic guidelines with respect to monitoring of neuromuscular function. Current standards need to be re-assessed in the light of recent improvements in nerve stimulators. [source]

Impairment due to cannabis and ethanol: clinical signs and additive effects

Clinical tests in distinguishing between persons with or without craniomandibular or cervical spinal pain complaints

Global and systematic demonstration for the practical usage of a direct in vivo measurement system to evaluate wrinkles

INTERNATIONAL JOURNAL OF COSMETIC SCIENCE, Issue 6 2007
T. Fujimura
Synopsis The global and systematic demonstration for the practical usage of a direct three-dimensional in vivo measurement system (PRIMOS) to evaluate wrinkles was investigated. Ten repetitive measurements of the corner of the eye of a subject showed that the coefficient of variation (CV)% value was 7.0% in a typical line-length roughness parameter Ra (the arithmetic mean of roughness), and that the CV% value in a typical surface area roughness parameter Sa was 2.4%. The relationships between the roughness values obtained from the corners of the eye and the age or wrinkle scores of Japanese women aged 10,70 years was examined. The values of several roughness parameters within the evaluation line length or surface area increased with age and showed a good correlation coefficient (r > 0.743). Similar relationships between the wrinkle scores and the values of roughness parameters were observed (r > 0.699). The roughness values were widely distributed even in the same wrinkle score because the measurement areas were limited and the values of skin roughness, including the microreliefs and/or small warts, were included in the calculation. However, changes in roughness values are considerable following treatment with potent active ingredients such as retinoic acid, so that this in vivo evaluation method is sufficient to objectively evaluate wrinkles. We conclude that the direct three-dimensional analysis of wrinkles in vivo should become a popular method to objectively evaluate wrinkles in clinical tests of wrinkle-smoothing ingredients or following cosmetic surgery to provide evidence of quantitative results. Résumé Une démonstration globale et systématique pour l'utilisation pratique d'un système de mesurage in vivo tridimensionnel direct (PRIMOS) pour évaluer les rides àétéétudiée. Dix mesurages répétitifs de la cornée de l',il d'un sujet ont montrées que la valeur du % du coefficient de variation était de 7,0% pour un paramètre de rugosité de mesure typique Ra (moyen arithmétique de rugosité), et que la valeur du % du coefficient de dérivation pour un paramètre de rugosité d'une surface typique Saétait de 2,4%. Les relations entre les valeurs de rugosité obtenues des cornées de l',il et l'âge ou les indices de rides de femmes japonaises âgées de 10 à 70 ans furent examinées. Les valeurs de plusieurs paramètres de rugosité en-deçà de la mesure d'évaluation ou de la surface ont augmenté avec l'âge et ont présenté un bon coefficient de corrélation (r > 0,743). Des relations similaires entre des indices de rides et les valeurs de paramètres de rugosité furent observées (r > 0,699). Les valeurs de rugosité furent largement réparties même avec un indice de rugosité semblable, du fait que les zones de mesurages furent limitées et que les valeurs de rugosité de la peau, comprenant des microreliefs et/ou de petites verrues, furent inclues dans les calculs. Cependant, des changements dans les valeurs de rugosité ont été considérables selon le traitement avec des ingrédients actifs potentiels, tel que l'acide rétinoïque, de telle sorte que cette méthode d'évaluation in vivo est suffisante pour une évaluation objective des rides. Nous en concluons qu'une analyse tridimensionnelle directe des rides in vivo est une méthode pratique pour évaluer objectivement des rides dans des essais cliniques d'ingrédients d'adoucissage des rides ou en suivant une chirurgie esthétique pour mettre en évidence des résultats quantitatifs. [source]

Knowledge of residual curarization: an Italian survey

ACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 3 2010
P. DI MARCO
Background: The use of neuromuscular blocking agents (NMBAs) is widespread in anesthetic practice; little is known about the current use of these drugs in Italy. This survey was conducted to obtain information about the most commonly used clinical tests and the train-of-four (TOF) ratios that are considered as being reliable for assessing recovery from neuromuscular blockade at the end of anesthesia and the estimated occurrence rates of post-operative paralysis in Italian hospitals. Methods: The questionnaire was given to Italian anesthesiologists attending the 62nd National Congress of the Italian Society of Anesthesia, Analgesia and Intensive Therapy. Collected data were stratified by age and the total number of surgical procedures performed in the hospitals concerned. Results: Seven hundred and fifty-four correctly compiled questionnaires were collected (response rate 88.7%). Seventy three percent of the respondents only used clinical tests for monitoring the level of neuromuscular blockade. The main clinical tests cited for the evaluation of residual paralysis were keeping the head lifted up for 5 s, protruding the tongue and opening the eyes. TOF was used by 35% of the respondents on a routine basis. Only 24% of the interviewed anesthesiologists reported that before extubation, a TOF ratio of at least 0.9 should be reached. Conclusions: Most Italian anesthetists assess the recovery from neuromuscular blockade only by clinical signs. There is poor awareness about the inability of such techniques to indicate even a significant amount of residual neuromuscular block. A more extensive use of quantitative instrumental monitoring is required for the more rational use of NMBAs. [source]

Normal Values of Balance Tests in Women Aged 20,80

JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 8 2004
Rosemary C. Isles B Phty
Objectives: To determine normal values for four commonly used clinical functional balance tests from community-dwelling women aged 20 to 80 and to identify any significant decline due to aging. Design: A cross-sectional study was undertaken to provide normative values for four clinical balance tests across 6 decade cohorts. Setting: The Betty Byrne-Henderson Center for Women and Aging, Royal Womens' Hospital, Brisbane, Australia. Participants: Four hundred fifty-six community-dwelling, independently ambulant women with no obvious neurological or musculoskeletal-related disability, aged 20 to 80, were randomly recruited from a large metropolitan region. Measurements: The clinical balance measures/tests were the Timed Up and Go test, step test, Functional Reach test, and lateral reach test. Multivariate analysis was used to test the effect for age, height, and activity level. Results: Normal data were produced for each test across each decade cohort. Gradual decline in balance performance was confirmed, with significant effect for age demonstrated. Conclusion: New normative data across the adult age decades are available for these clinical tests. Use of clinical balance tests could complement other balance tests and be used to screen women aged 40 to 60 whose performance is outside the normal values for age and to decrease later falls risk. [source]

Low Skeletal Muscle Mass Is Associated With Poor Structural Parameters of Bone and Impaired Balance in Elderly Men,The MINOS Study,

JOURNAL OF BONE AND MINERAL RESEARCH, Issue 5 2005
Pawel Szulc MD
Abstract In 796 men, 50-85 years of age, decreased relative skeletal muscle mass index was associated with narrower bones, thinner cortices, and a consequent decreased bending strength (lower section modulus), as well as with impaired balance and an increased risk of falls. Introduction: In men, appendicular skeletal muscle mass (ASM) is correlated positively with BMC and areal BMD (aBMD). In elderly men, low muscle mass and strength (sarcopenia) is associated with difficulties in daily living activities. The aim of this study was to evaluate if ASM is correlated with bone size, mechanical properties of bones, balance, and risk of falls in elderly men. Materials and Methods: This study used 796 men, 50-85 years of age, belonging to the MINOS cohort. Lifestyle factors were evaluated by standardized questionnaires. Estimates of mechanical bone properties were derived from aBMD measured by DXA. ASM was estimated by DXA. The relative skeletal muscle mass index (RASM) was calculated as ASM/(body height)2.3. Results: After adjustment for age, body size, tobacco smoking, professional physical activity, and 17,-estradiol concentration, RASM was correlated positively with BMC, aBMD, external diameter, and cortical thickness (r = 0.17-0.34, p < 0.0001) but not with volumetric BMD. Consequently, RASM was correlated with section modulus (r = 0.29-0.39, p < 0.0001). Men in the lowest quartile of RASM had section modulus of femoral neck and distal radius lower by 12-18% in comparison with men in the highest quartile of RASM. In contrast, bone width was not correlated with fat mass, reflecting the load of body weight (except for L3), which suggests that the muscular strain may exert a direct stimulatory effect on periosteal apposition. After adjustment for confounding variables, a decrease in RASM was associated with increased risk of falls and of inability to accomplish clinical tests of muscle strength, static balance, and dynamic balance (odds ratio per 1 SD decrease in RASM, 1.31-2.23; p < 0.05-0.001). Conclusions: In elderly men, decreased RASM is associated with narrower bones and thinner cortices, which results in a lower bending strength. Low RASM is associated with impaired balance and with an increased risk of falls in elderly men. It remains to be studied whether low RASM is associated with decreased periosteal apposition and with increased fracture risk in elderly men, and whether the difference in skeletal muscle mass between men and women contributes to the between-sex difference in fracture incidence. [source]

Malnutrition and hypermetabolism are not risk factors for the presence of hepatic encephalopathy: A cross-sectional study

JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 4 2008
Peter Sörös
Abstract Background and Aim:, Hepatic encephalopathy is a frequent complication of cirrhosis. The present retrospective investigation was conducted to characterize metabolic alterations in cirrhotic patients with and without hepatic encephalopathy. We tested the hypothesis that reduced nutritional status or the degree of tissue catabolism are associated with the presence of hepatic encephalopathy. Methods:, We investigated 223 patients with histologically confirmed nonalcoholic cirrhosis without hepatic encephalopathy and with hepatic encephalopathy (grades 1,3). To assess liver function, nutritional status, and energy metabolism, a variety of biochemical and clinical tests were performed including anthropometric measurements, bioelectrical impedance analysis, and indirect calorimetry. Results:, Nutritional status and tissue catabolism were not significantly different between patients with and without hepatic encephalopathy. Conclusions:, Our data do not support the hypothesis that malnutrition or tissue catabolism are independent risk factors for the presence of hepatic encephalopathy in patients with nonalcoholic cirrhosis. [source]

Effect of whole body vibration in Parkinson's disease: A controlled study,

MOVEMENT DISORDERS, Issue 6 2009
Pablo Arias PhD
Abstract In the search of new strategies to improve the quality of life of Parkinson's disease patients, recent work has reported an amelioration of Parkinsonian symptoms using Whole Body Vibration (WBV). A double-blinded, placebo controlled design was used to evaluate the effect of a 12 WBV sessions-programme on a number of motor and clinical tests in 23 Parkinson's disease patients. Patients were assigned to one of two groups, one receiving WBV and the other a placebo group. At the end of the programme as well as during intra-session evaluation, there was no difference between the experimental (vibration) and placebo groups in any outcomes. These results suggest that reported benefits of vibration are due to a placebo response. © 2009 Movement Disorder Society [source]

The relation between tear film tests in patients with dry eye disease

OPHTHALMIC AND PHYSIOLOGICAL OPTICS, Issue 6 2003
Kelly K. Nichols
Abstract Purpose:, The purpose of this report was to investigate the relation between dry eye diagnostic tests. Methods:, Dry eye patients were enrolled to complete a clinical examination, including the following dry eye tests: a meibomian gland evaluation, tear meniscus height, fluorescein tear breakup time, fluorescein staining of the cornea, the Schirmer 1 test, the phenol red thread test, and rose bengal staining of the conjunctiva. Statistical analyses, including correlation coefficients, the Wilcoxon sign rank test, chi-square test, and logistic regression were used to address the relation between these clinical tests of dry eye. Results:, There was a strong relation between the Schirmer test and fluorescein staining in all four statistical analyses. Similarly, there was also a strong relation between the phenol red thread test and both fluorescein and rose bengal staining. Finally, the results of the Schirmer test were associated with the tear breakup time test in three of four analyses. Conclusions:, The results indicate that tests of aqueous deficiency (volume or production) are associated with ocular surface desiccation. This important relation should be recognized when choosing dry eye tests as outcomes in clinical trials and epidemiological studies. [source]

Reliability and concurrent validity of the Expanded Timed Up-and-Go test in older people with impaired mobility

PHYSIOTHERAPY RESEARCH INTERNATIONAL, Issue 2 2008
Pernille Botolfsen
Abstract Background and Purpose.,,Expanded Timed Up-and-Go' (ETUG) was developed to assess each of the subtasks of the ,Timed Up-and-Go' (TUG). The aim of the study was to test the intrarater, interrater, test,retest reliability and internal consistency of the ETUG, and the concurrent validity with the TUG.,Methods.,The present study is a reliability and a validity study. Twenty-eight subjects (80 ± 4.1 years) with balance and gait problems were included. Three raters timed the ETUG subtasks from a video, using a computer-based scoring programme, and the total ETUG time was calculated. TUG was registered by a regular stopwatch.,Results.,The intrarater and interrater reliability (intraclass correlation [ICC][1,1]) ranged from 0.55 to 0.97. The test,retest reliability (ICC[1,1]) ranged from 0.54 to 0.85. The absolute measurement error of the total time (1.96 Sw) was 2.8 seconds. The internal consistency (Cronbach's alpha) was 0.74. The correlation (Pearson's r) between ETUG total time and TUG after correcting for attenuation caused by restricted reliability in each of the measures was 0.85.,Conclusion.,The ETUG scored from a video shows a good reliability for experienced raters and acceptable internal consistency. The ETUG showed a higher reliability than TUG when tested on the same sample of older subjects with impaired mobility, and the high concurrent validity between ETUG and TUG suggests that the two tests may have similar properties. Since ETUG also adds new information compared with TUG, we suggest that ETUG is an interesting alternative to existing clinical tests of mobility. Copyright © 2008 John Wiley & Sons, Ltd. [source]

Performance after surgical treatment of patients with ankle fractures , 14-month follow-up

PHYSIOTHERAPY RESEARCH INTERNATIONAL, Issue 2 2003
Gertrud Nilsson RPT
Abstract Background and Purpose Few studies have been published that extensively evaluate physical outcome after ankle fractures. In addition, there is a lack of knowledge of how physical outcome correlates with subjective assessments of symptoms and function after ankle fracture. The purpose of the present study was to investigate outcome after surgical treatment of patients with ankle fracture and to study how well the experience of symptoms and function correlated with the results of clinical physical tests. Method The study used a retrospective cross-sectional study design. Fifty-four patients, aged 17,64 years, were evaluated 14 months post-operatively. Evaluation included a questionnaire containing the Olerud,Molander Ankle Score (OMAS) (Olerud and Molander, 1984) and some additional questions. Patients were also called for a physical and radiographic examination. Results The median OMAS obtained was 75 (range 10,100). Only 10 (19%) of the patients reported complete recovery and 16 (30%) scored ,90, indicating good function. The results of the following clinical tests were correlated with OMAS: loaded dorsal extension; ankle circumference; number of toe and heel rises; and single-limb stance. Those who showed poorer results in physical outcome on the affected side had lower OMAS. No ankles with clear mechanical instability were found, although almost half the patients experienced functional instability that, in turn, was associated with decreased total OMAS. Conclusions Both subjectively scored function and physical performance after surgically treated ankle fractures indicated poor results. One reason for this might be insufficient rehabilitation. Copyright © 2003 Whurr Publishers Ltd. [source]

Perceived pain and self-estimated activity limitations in women with back pain post-partum

PHYSIOTHERAPY RESEARCH INTERNATIONAL, Issue 1 2003
Lena Nilsson-Wikmar RPT
Abstract Background and Purpose In the general population many daily activities have an impact on low back pain. The aim of the present study was to describe pain intensity, localization, type of sensation and perceived activity limitation in women with different back pain patterns post-partum. Method In this cross-sectional survey 119 women with back pain persisting for two months after having given birth were interviewed and examined on average 7.2 months (range 6,10 months) post-partum. Based on pain provocation tests, four different back pain pattern groups were identified. Pain could be provoked in the area of the posterior pelvic/sacroiliac joints, in the lumbar spine, both in the posterior pelvic/sacroiliac joints and in the lumbar spine, and in none of the above areas. All women rated pain intensity on a visual analogue scale (VAS, 0,100 mm), and the pain localization and type of sensation were indicated on a pain drawing. They scored their activity limitations by use of the Disability Rating Index (DRI), which covers 12 daily activity items (VAS, 0,100 mm). Results There was no significant difference (p = 0.12) in pain intensity (range of medians 19.5,10 mm) between the four groups. However, on average, most areas in the lower back (median 5 mm (range 2,14 mm)), were marked in the group with pain in both the posterior pelvic/sacroiliac joints and in the lumbar spine. The women in the three groups where pain was provoked in the lower area of the back had significantly (p < 0.01) more difficulties with movement-related daily activities than the group where no pain could be provoked. Conclusions The findings of this descriptive study suggest that back pain post-partum provoked by clinical tests considerably hampers movement-related activities. It seems important to pay special attention to the women where pain could be provoked in the lower back areas. The women should be identified early in the post-partum period to initiate adequate treatment. Copyright © 2003 Whurr Publishers Ltd. [source]

Cervicocephalic kinaesthesia: reliability of a new test approach

PHYSIOTHERAPY RESEARCH INTERNATIONAL, Issue 4 2001
Eythor Kristjansson Faculty of Medicine
Abstract Background and Purpose Relocating either the natural head posture (NHP) or predetermined points in range are clinical tests of impaired neck proprioception but memory might influence these tests. Three new tests, reasoned to be more challenging for the proprioceptive system, were developed. The objectives were to assess the reliability of all tests and whether the three new tests were more challenging for the proprioceptive system. Method A test,retest design was used to assess the reproducibility and errors of all five tests. Twenty asymptomatic volunteers were assessed a week apart, using an electromagnetic movement sensor system, the 3-Space Fastrak. A measure of error magnitude was used to detect kinaesthetic sensibility. Comparison of the means and their corresponding dispersion were analysed descriptively. The between-day intraclass correlation coefficients (ICCs) were calculated and plots of mean differences between days 1 and 2 were conducted to estimate test reliability. Multivariate analysis of variance (MANOVA) and least significant difference (LSD) pairwise comparisons were performed to compare the test accuracy between different target positions. Results ICCs were between 0.35 and 0.9, but plotting the data modified the interpretation in some tests. Relocating a NHP was easier when the trunk was in a neutral position than when pre-rotated (error 2.46° (±0.2°) versus 5.95° (±0.7°). Relocating a 30° rotation position (error 5.8° (±0.6°) and repeatedly moving through a target (error 4.82° (±0.7°) was also difficult. Conclusions The new tests were more challenging than relocating the NHP but the reliability of tests relocating uncommon positions was questionable. Copyright © 2001 Whurr Publishers Ltd. [source]

Estimation methods for time-dependent AUC models with survival data

THE CANADIAN JOURNAL OF STATISTICS, Issue 1 2010
Hung Hung
Abstract The performance of clinical tests for disease screening is often evaluated using the area under the receiver-operating characteristic (ROC) curve (AUC). Recent developments have extended the traditional setting to the AUC with binary time-varying failure status. Without considering covariates, our first theme is to propose a simple and easily computed nonparametric estimator for the time-dependent AUC. Moreover, we use generalized linear models with time-varying coefficients to characterize the time-dependent AUC as a function of covariate values. The corresponding estimation procedures are proposed to estimate the parameter functions of interest. The derived limiting Gaussian processes and the estimated asymptotic variances enable us to construct the approximated confidence regions for the AUCs. The finite sample properties of our proposed estimators and inference procedures are examined through extensive simulations. An analysis of the AIDS Clinical Trials Group (ACTG) 175 data is further presented to show the applicability of the proposed methods. The Canadian Journal of Statistics 38:8,26; 2010 © 2009 Statistical Society of Canada La performance des tests cliniques pour le dépistage de maladie est souvent évaluée en utilisant l'aire sous la courbe caractéristique de fonctionnements du récepteur (, ROC , ), notée , AUC , . Des développements récents ont généralisé le cadre traditionnel à l'AUC avec un statut de panne binaire variant dans le temps. Sans considérer les covariables, nous commençons par proposer un estimateur non paramétrique pour l'AUC simple et facile à calculer. De plus, nous utilisons des modèles linéaires généralisés avec des coefficients dépendant du temps pour caractériser les AUC, dépendant du temps, comme fonction des covariables. Les procédures d'estimation asociées correspondantes sont proposées afin d'estimer les fonctions paramètres d'intérêt. Les processus gaussiens limites sont obtenus ainsi que les variances asymptotiques estimées afin de construire des régions de confiance approximatives pour les AUC. À l'aide de nombreuses simulations, les propriétés pour de petits échantillons des estimateurs proposés et des procédures d'inférence sont étudiées. Une analyse du groupe d'essais cliniques sur le sida 175 (ACTG 175) est aussi présentée afin de montrer l'applicabilité des méthodes proposées. La revue canadienne de statistique 38: 8,26; 2010 © 2009 Société statistique du Canada [source]

The frequency of absence of palmaris longus in a South African population of mixed race

CLINICAL ANATOMY, Issue 4 2010
Robert Ndou
Abstract The palmaris longus (PL) is a weak flexor of the wrist that may be harvested as a tendon graft and used in surgical procedures for reconstructive purposes. The PL is congenitally absent in 15% of the worldwide population. However, the frequency of absence varies considerably among different population groups, being as high as 63.9% in the Turkish population and as low as 3% in the black population in the Republic of Congo. In this study, South African persons of mixed race (n = 201) were assessed by two anatomists for the presence of the PL tendon using three clinical tests, namely the Traditional Test, Mishra's Test II, and the Gangata Test. The most reliable of the three tests used was determined using Kendall's coefficient of concordance. Of the total number of subjects used, 11.5% had absence (either bilaterally or unilaterally) of the PL tendon. There was a 5.5% bilateral absence of the PL. The study revealed that the PL tendon may present in six different patterns according to the clinical assessment tests applied, the presence or absence of the PL alongside the flexor capi radialis, and the degree of prominence of PL, if present. Using the Kendall's coefficient of concordance, the Mishra's Test II, and the Gangata Test, both involving abduction of the thumb, were found to be most effective in revealing the PL. The frequency of absence of the PL in South Africans of mixed race has been determined. Clin. Anat. 23:437,442, 2010. © 2010 Wiley-Liss, Inc. [source]

Understanding diagnostic tests 3: receiver operating characteristic curves

ACTA PAEDIATRICA, Issue 5 2007
Anthony K Akobeng
Abstract The results of many clinical tests are quantitative and are provided on a continuous scale. To help decide the presence or absence of disease, a cut-off point for ,normal' or ,abnormal' is chosen. The sensitivity and specificity of a test vary according to the level that is chosen as the cut-off point. The receiver operating characteristic (ROC) curve, a graphical technique for describing and comparing the accuracy of diagnostic tests, is obtained by plotting the sensitivity of a test on the y axis against 1-specificity on the x axis. Two methods commonly used to establish the optimal cut-off point include the point on the ROC curve closest to (0, 1) and the Youden index. The area under the ROC curve provides a measure of the overall performance of a diagnostic test. In this paper, the author explains how the ROC curve can be used to select optimal cut-off points for a test result, to assess the diagnostic accuracy of a test, and to compare the usefulness of tests. Conclusion: The ROC curve is obtained by calculating the sensitivity and specificity of a test at every possible cut-off point, and plotting sensitivity against 1-specificity. The curve may be used to select optimal cut-off values for a test result, to assess the diagnostic accuracy of a test, and to compare the usefulness of different tests. [source]