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Cross-sectional Observational Study (cross-sectional + observational_study)
Selected AbstractsPrevalence of adrenal androgen excess in patients with the polycystic ovary syndrome (PCOS)CLINICAL ENDOCRINOLOGY, Issue 6 2005Ashim Kumar Summary Objective, To determine the prevalence of adrenal androgen (AA) excess in the polycystic ovary syndrome (PCOS) using age- and race-specific normative values. Design, Cross-sectional observational study. Patients, One hundred and eight-two (88 Black and 94 White) age-matched healthy eumenorrhoeic nonhirsute women (controls) and 213 (27 Black and 186 White) women with PCOS were recruited. Measurements, Total testosterone (T), free T, androstenedione (A4), dehydroepiandrosterone sulfate (DHEAS) and SHBG, as well as fasting insulin and glucose, were measured in plasma. Results, The mean total T, free T, A4, DHEAS and body mass index (BMI) were higher in women with PCOS than in control women. DHEAS levels were significantly lower in Black controls than White controls, whereas fasting insulin and BMI were higher in Black controls. In control and Black PCOS women, DHEAS levels did not correlate with BMI, waist-to-hip ratio (WHR) or fasting insulin. Among White women with PCOS, DHEAS levels correlated negatively with BMI and fasting insulin. DHEAS levels decreased similarly with age in control and PCOS women of either race. For each race and age group the upper 95% normative values for log DHEAS was calculated, and the number of PCOS subjects with log DHEAS values above this level were assessed. The prevalence of supranormal DHEAS levels was 33·3% and 19·9%, respectively, among Black and White women with PCOS. Conclusions, The prevalence of DHEAS excess is approximately 20% among White and 30% among Black PCOS patients, when using age- and race-adjusted normative values. This study also indicates that the age-associated decline in DHEAS levels is observable and similar in both control and PCOS women, regardless of race. While BMI and fasting insulin had little impact on circulating DHEAS levels in healthy women, among White PCOS patients these parameters were negatively associated with circulating DHEAS levels. [source] Sexual dysfunction and physicians' perception in medicated patients with major depression in TaiwanDEPRESSION AND ANXIETY, Issue 9 2008Kao Ching Chen M.D. Abstract Although prevalent during antidepressant treatment, sexual dysfunction (SD) is frequently ignored by both physicians and patients in Asia. In spite of impact of SD on medicated patients with major depression, sexual issues and illness remain a forbidden topic for most Asian people. The aims of this study were to: (1) estimate the prevalence of SD among stable outpatients taking different antidepressants in Taiwan; (2) investigate the factors related to SD; (3) compare physician-perceived with patient-reported prevalence rates of antidepressant-associated SD; and (4) study the differences of SD among antidepressant subgroups. In this cross-sectional observational study, 125 medicated patients with major depression were recruited. Patients were assessed using the Changes in Sexual Functioning Questionnaire (CSFQ), Taiwanese Depression Questionnaire (TDQ), Quality of Life Index (QOL), and neuroticism scores in the Maudsley Personality Inventory (MPI). Sixty-two physicians completed the Physician Antidepressant Experience Questionnaire. The estimated prevalence rate of SD was 53.6% (95% CI = 44.9,62.3%) in medicated patients with major depression. There were no significant differences in prevalence rate of SD among different antidepressants. The SD subgroup had poorer quality of life and lower moods than the non-dysfunction subgroup. An underestimation of the prevalence of SD by physicians was noted. Because antidepressant-associated SD is highly prevalent and seriously underestimated by physicians, greater physicians' recognition and better patients' education are imperative when prescribing antidepressants. Depression and Anxiety. © 2007 Wiley-Liss, Inc. [source] Carbonated Soft Drink Consumption and Bone Mineral Density in Adolescence: The Northern Ireland Young Hearts Project,JOURNAL OF BONE AND MINERAL RESEARCH, Issue 9 2003C McGartland Abstract In an observational study of 1335 boys and girls aged 12 and 15 years, higher intakes of carbonated soft drinks (CSDs) were significantly associated with lower bone mineral density at the heel, but only in girls. Owing to the upward trend in CSD intake in adolescence, this finding may be of concern. Introduction: High consumption of carbonated soft drinks (CSD) during adolescence may reduce bone mineral accrual and increase fracture risk. The aim of this study was to examine the relationship between CSD consumption and bone mineral density (BMD) in a representative sample of adolescents. Materials and Methods: This was a cross-sectional observational study in 36 postprimary schools in Northern Ireland. Participants included 591 boys and 744 girls either 12 or 15 years old. BMD was measured by DXA, and usual beverage consumption was assessed by the diet history method. Adjusted regression modeling was used to investigate the influence of CSD on BMD. Results: A significant inverse relationship between total CSD intake and BMD was observed in girls at the dominant heel (,, ,0.099; 95% CI, ,0.173 to ,0.025). Non-cola consumption was inversely associated with dominant heel BMD in girls (,, ,0.121; 95% CI, ,0.194 to ,0.048), and diet drinks were also inversely associated with heel BMD in girls (,, ,0.087; 95% CI, ,0.158 to ,0.016). However, no consistent relationships were observed between CSD intake and BMD in boys. Cola consumption and nondiet drinks were not significantly related to BMD in either sex. Conclusion: CSD consumption seems to be inversely related to BMD at the dominant heel in girls. It is possible that the apparent association results from the displacement of more nutritious beverages from the diet. Although the inverse association observed between CSD consumption and BMD is modest and confined to girls, this finding may have important public health implications given the widespread use and current upward trend in CSD consumption in Western populations. [source] Effect of maternal fasting on uterine arterial blood flowJOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH (ELECTRONIC), Issue 2 2007Hisham M. Mirghani Abstract Aim:, To determine the effect maternal diet pattern on the uterine artery Doppler flow velocimetry. Methods:, This is a cross-sectional observational study. The uterine artery Doppler flow velocimetry was measured between 20 and 24 weeks' gestation in healthy pregnant women observing Ramadan. For each fasting mother, a non-fasting healthy pregnant woman was recruited as a control. Maternal blood glucose level was measured. Results:, A total of 106 pregnant women were studied. The mean hours since last oral intake were significantly longer, and the maternal glucose level was significantly lower in the study group than in the control group. The Mean (95% CI) of the uterine artery pulsatility index, resistance index, peak systolic velocity, end diastolic velocity and systolic/diastolic ratio was similar in both groups. Conclusion:, Maternal fasting is not associated with significant changes in the uterine artery Doppler flow velocimetry. [source] Reproducibility of multiple breath washout indices in the unsedated preterm neonate,PEDIATRIC PULMONOLOGY, Issue 1 2010Sanjay Sinhal FRACP Abstract Multiple breath inert gas washout (MBW) is gaining popularity for measurements of resting lung volume and ventilation inhomogeneity. Test reproducibility is an important determinant of the clinical applicability of diagnostic tests. The between-test reproducibility of variables derived from MBW tests in newborn infants is unknown. We aimed to determine the within-test repeatability and short-term between-test reproducibility of MBW variables in unsedated preterm infants. We hypothesized that measurements obtained within a 3-day interval in clinically stable preterm infants would be reproducible and suitable for use as an objective clinical outcome measurement. In this cross-sectional observational study, clinically stable hospitalized preterm infants whose parents had given informed consent for MBW studies were tested twice within 72,hr during quiet, unsedated sleep. Functional residual capacity (FRC), lung clearance index (LCI), and the first and second to zeroeth moment ratios (M1:M0; M2:M0) were computed from MBW traces obtained using a mainstream ultrasonic flowmeter and 4% sulphur hexafluoride (MBWSF6). Within-test repeatability and between-test reproducibility were determined. Within-test repeatability (expressed as a coefficient of variability (Cv)) for differences between two and four replicate measurements on the same test occasion, were 9.3% (FRC), 9.0% (LCI), 7.6% (M1:M0), and 15.6% (M2:M0), respectively. The within-test Cv's were not statistically different to the between-tests Cv's, which were 7.7% (FRC), 10.3% (LCI), 6.1% (M1:M0), and 13.0% (M2:M0), respectively. Among unsedated preterm infants, between-test reproducibility over a 3-day interval was similar to within-test repeatability. The wide limits of agreement may limit the application of these measures to detect a clinically significant change in condition in small preterm infants. Pediatr Pulmonol. 2010; 45:62,70. © 2009 Wiley-Liss, Inc. [source] ORIGINAL RESEARCH,EPIDEMIOLOGY: Male Erectile Dysfunction: Its Prevalence in Western Australia and Associated Sociodemographic FactorsTHE JOURNAL OF SEXUAL MEDICINE, Issue 1 2008FRCPEdin, FRCPGlasg, Kew-Kim Chew MBBS ABSTRACT Introduction., This is a report of a population-based cross-sectional observational study in Western Australia (WA) on male erectile dysfunction (ED). Aim., To assess the prevalence of ED in WA and to examine its associated sociodemographic factors. Method., Postal questionnaires were sent to randomly selected age-stratified male population samples obtained from the WA Electoral Roll. Main Outcome Measures., In addition to items covering sociodemographic and clinical information, the Australian Standard Classification of Occupations (ASCO), the Socioeconomic Index for Area (SEIFA), and the 5-item International Index of Erectile Function (IIEF-5) were used. Results., One thousand seven hundred seventy (41.9%) of 4,228 questionnaires were returned. One thousand five hundred eighty (89.3%) were completed questionnaires from men aged 20.1 to 99.6 years (mean 57.9, median 59.1, standard deviation 18.5). The prevalences of any ED and of severe ED among adult males in WA, adjusted for age distribution, were 25.1 and 8.5%, respectively. Standardized to World Health Organization (WHO) World Standard Population, the corresponding prevalences were 23.4 and 7.4%. Prevalence, as well as severity, of ED increased with age. Thirty-eight percent of the participants who were married or had partners experienced ED (severe ED 19.1%). The prevalence of ED was not significantly different between "white-collar" and "blue-collar" workers. Despite the great majority of the affected participants having experienced ED for >1 year, only 14.1% reported having ever received any treatment for ED. Conclusions., The study has provided population-based epidemiological data on ED in Western Australian men covering a wide range of ages. The finding that ED is age related, highly prevalent, and grossly underdiagnosed and undertreated is pertinent to global population aging and a rapidly aging Australian population. To facilitate comparisons across populations with different age distributions, all future population-based studies on ED should be standardized to WHO World Standard Population. Chew K-K, Stuckey B, Bremner A, Earle C, and Jamrozik K. Male Erectile Dysfunction: Its Prevalence in Western Australia and Associated Sociodemographic Factors. J Sex Med 2008;5:60,69. [source] The Need for Emergency Medicine Resident Training in Informed Consent for ProceduresACADEMIC EMERGENCY MEDICINE, Issue 9 2007Theodore Gaeta DO Objectives: To determine emergency medicine (EM) residents' perceptions and reported practices of obtaining informed consent for emergency department procedures. Methods: The authors performed a cross-sectional observational study of EM residents. A brief, short-answer survey was distributed that covered the following topics related to informed consent: training, confidence and comfort levels, and current practices. Data were analyzed using basic frequency displays, and descriptive statistics are reported. Results: Of the 20 programs contacted, 16 responded and agreed to distribute the invitation to their residents. A total of 402 of 490 eligible residents (82%) in the participating programs responded. The majority of EM residents (56%) had never received formal training on obtaining informed consent, and those who had reported that their primary exposure to formal training occurred during their medical school years (79%). More than half of the residents (56%) have felt uncomfortable obtaining consent for a procedure. Few residents (32%) felt very confident that they provide comprehensive information to patients, while 9% were not very confident that they disclose all pertinent risks, benefits, and alternatives to their patients. Sixty-three percent of all EM residents believed formal training is necessary, and half (52%) reported interest in receiving training (i.e., listings of risks, benefits, and alternatives as well as standards for determining which procedures need consent). The residents' current perceptions of consent requirements for commonly performed emergency department procedures (emergent and nonemergent) are also reported. Conclusions: Few residents have had formal training in informed consent, and there is wide variability in the perception of which procedures require informed consent. Residents are not confident in their knowledge of all risks and benefits of common procedures, and comfort levels in obtaining informed consent are low. Residents can benefit from additional resources that provide standardized information and formal training on the issue. [source] | ||||||||||