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Additional Evaluation (additional + evaluation)
Selected AbstractsThe Organic Brain Syndrome (OBS) scale: a systematic reviewINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 3 2006Karin Björkman Björkelund Abstract Background/Objective The Organic Brain Syndrome (OBS) Scale was developed to determine elderly patients' disturbances of awareness and orientation as to time, place and own identity, and assessment of various emotional and behavioural symptoms appearing in delirium, dementia and other organic mental diseases. The aim of the study was to examine the OBS Scale, using the eight criteria and guidelines formulated by the Scientific Advisory Committee of the Medical Outcomes Trust (SAC), and to investigate its relevance and suitability for use in various clinical settings. Method Systematic search and analysis of papers (30) on the OBS Scale were carried out using the criteria suggested by the SAC. Results The OBS Scale in many aspects satisfies the requirements suggested by the SAC: conceptual and measurement model, reliability, validity, responsiveness, interpretability, respondent and administrative burden, alternative forms of administration, and cultural and language adaptations, but there is a need for additional evaluation, especially with regard to different forms of reliability, and the translation and adaptation to other languages. Conclusions The OBS Scale is a sensitive scale which is clinically useful for the description and long-term follow-up of patients showing symptoms of acute confusional state and dementia. Although the OBS Scale has been used in several clinical studies there is need for further evaluation. Copyright © 2006 John Wiley & Sons, Ltd. [source] Black and white , does melanin change the bulk carbon and nitrogen isotope values of feathers?RAPID COMMUNICATIONS IN MASS SPECTROMETRY, Issue 7 2010Andreas Michalik Bird feathers are employed in a wide range of carbon and nitrogen isotope studies relating to diet and migration. Feathers are chemically inert with respect to carbon and nitrogen, after synthesis. It has always been assumed that feathers show isotope values characteristic of keratin, a fibrous structural protein from which they are formed. Little attention has been paid to other components of feathers such as melanin or carotenoids. Melanin is synthesized from tyrosine, which is depleted in both 13C and 15N. We compared isotope values of coeval black and white feathers in four different species. Black feather parts were in all cases significantly depleted in 13C relative to white feather parts but in most species no clear trend was discernable for 15N. We suggest that additional evaluation may be required to characterize the carbon and nitrogen isotope contribution of feather pigments like carotenoids. Care should be taken in future stable isotope studies when comparing differently coloured feathers. Copyright © 2010 John Wiley & Sons, Ltd. [source] Electrocardiographic Transmural Dispersion of Repolarization in Patients with Inherited Short QT SyndromeANNALS OF NONINVASIVE ELECTROCARDIOLOGY, Issue 3 2008Olli Anttonen M.D. Background: Short QT syndrome (SQTS) carries an increased risk for sudden cardiac death. However, only a short QT interval does not express the risk of ventricular arrhythmias. Thus, additional evaluation of the repolarization abnormality in SQTS patients is essential. In experimental models of SQTS, increased transmural dispersion of repolarization (TDR) and its electrocardiographic counterpart T-wave peak to T-wave end interval (TPE) appeared critical for induction of polymorphic ventricular tachycardia (PMVT). In a clinical study with acquired long QT syndrome patients, TPE/QT ratio > 0.28 indicated arrhythmia risk. We hypothesized that the TPE/QT ratio would be greater in SQTS patients than in control subjects. Methods and Results: We compared the behavior of the electrocardiographic TDR in three seriously symptomatic SQTS patients of unknown genotype presenting baseline QTc values <320 ms and in nine healthy age-matched control subjects. We determined QT and TPE intervals as well as TPE/QT ratio from 24-hour ECG recordings using a computer-assisted program. Diurnal average of TPE/QT ratio was 0.28 ± 0.03 in SQTS patients and 0.21 ± 0.02 in control subjects (P = 0.01). SQTS patients had also lesser capacity to change TPE intervals from steady-state conditions to abrupt maximal values than control subjects. Conclusion: SQTS patients have increased and autonomically uncontrolled electrocardiographic TDR. According to experimental SQTS models, the present results may in part explain increased vulnerability of SQTS patients to ventricular arrhythmias. [source] C-reactive protein in the diagnosis of deep vein thrombosisBRITISH JOURNAL OF HAEMATOLOGY, Issue 2 2002Robert A. Bucek Summary. The role of C-reactive protein (CRP) in the diagnosis of suspected deep vein thrombosis (DVT) and a possible advantage of its additional evaluation with D-dimer has not been clearly evaluated. We therefore studied plasma CRP and D-dimer levels in 233 consecutive patients with suspected DVT; the final diagnosis was based on the results of colour duplex ultrasound or venography. DVT was diagnosed in 31·3%. CRP and D-dimer correlated significantly (r = 0·64, P < 0·01); both were increased significantly in patients suffering from DVT (P < 0·001). Multivariate analysis revealed a significant influence of the presence of DVT (P < 0·001), the presence of malignancy (P < 0·001) and the presence of inflammatory diseases (P = 0·009) on plasma CRP, while there was no significant influence of the duration of symptoms (P = 0·30). The sensitivity (75%vs 93%) to specificity (69%vs 55%) relationship showed inferior results for CRP compared with D-dimer; its additional evaluation did not improve the diagnostic value of D-dimer. We conclude that CRP can provide additional information neither for the diagnostic process in patients with suspected DVT nor for the differential diagnosis of DVT and inflammatory diseases. [source] Pediatric primary care to help prevent child maltreatment: the Safe Environment for Every Kid (SEEK) modelCHILD: CARE, HEALTH AND DEVELOPMENT, Issue 4 2009Richard Reading Pediatric primary care to help prevent child maltreatment: the Safe Environment for Every Kid (SEEK) model . DubowitzH., FeigelmanS., LaneW. & KimJ. ( 2009 ) Pediatrics , 123 , 858 , 864 . DOI: 10.1542/peds.2008-1376 . Context Effective strategies for preventing child maltreatment are needed. Few primary care-based programmes have been developed, and most have not been well evaluated. Objective Our goal was to evaluate the efficacy of the Safe Environment for Every Kid (SEEK) model of pediatric primary care in reducing the occurrence of child maltreatment. Methods A randomized trial was conducted from June 2002 to November 2005 in a university-based resident continuity clinic in Baltimore, Maryland. The study population consisted of English-speaking parents of children (0,5 years) brought in for child health supervision. Of the 1118 participants approached, 729 agreed to participate, and 558 of them completed the study protocol. Resident continuity clinics were cluster randomized by day of the week to the model (intervention) or standard care (control) groups. Model care consisted of (1) residents who received special training; (2) the Parent Screening Questionnaire; and (3) a social worker. Risk factors for child maltreatment were identified and addressed by the resident physician and/or social worker. Standard care involved routine pediatric primary care. A subset of the clinic population was sampled for the evaluation. Child maltreatment was measured in three ways: (1) child protective services reports using state agency data; (2) medical chart documentation of possible abuse or neglect; and (3) parental report of harsh punishment via the Parent-Child Conflict Tactics scale. Results Model care resulted in significantly lower rates of child maltreatment in all the outcome measures: fewer child protective services reports, fewer instances of possible medical neglect documented as treatment non-adherence, fewer children with delayed immunizations and less harsh punishment reported by parents. One-tailed testing was conducted in accordance with the study hypothesis. Conclusions The SEEK model of pediatric primary care seems promising as a practical strategy for helping prevent child maltreatment. Replication and additional evaluation of the model are recommended. [source] Feasibility of commercial interferon-,-based methods for the diagnosis of latent Mycobacterium tuberculosis infection in Finland, a country of low incidence and high bacille Calmette,Guérin vaccination coverageCLINICAL MICROBIOLOGY AND INFECTION, Issue 8 2007T. Tuuminen Abstract The performances of the QuantiFERON-TB Gold in Tubes (QFGT), T SPOT-TB (ELISPOT) and the Mantoux test were compared for the diagnosis of latent tuberculosis infection in Finland, a country of low tuberculosis incidence. In Cohort A (16 students), freshly isolated peripheral blood mononuclear cells (PBMCs), and in Cohort B (21 school children), cryopreserved PBMCs, were used for the ELISPOT assay. Cryopreservation of cells in fetal calf serum, but not in serum-free medium, produced false-positive results. Discrepancies between the results of the assays were observed. It was concluded that the accuracy of these ex-vivo methods needs additional evaluation. [source] The Brief Pain Inventory and Its "Pain At Its Worst in the Last 24 Hours" Item: Clinical Trial Endpoint ConsiderationsPAIN MEDICINE, Issue 3 2010Thomas M. Atkinson PhD Abstract Context., In 2006, the United States Food and Drug Administration (FDA) released a draft Guidance for Industry on the use of patient-reported outcomes (PRO) Measures in Medical Product Development to Support Labeling Claims. This draft guidance outlines psychometric aspects that should be considered when designing a PRO measure, including conceptual framework, content validity, construct validity, reliability, and the ability to detect clinically meaningful score changes. When finalized, it may provide a blueprint for evaluations of PRO measures that can be considered by sponsors and investigators involved in PRO research and drug registration trials. Objective., In this review we examine the short form of the Brief Pain Inventory (BPI) and particularly the "pain at its worst in the last 24 hours" item in the context of the FDA draft guidance, to assess its utility in clinical trials that include pain as a PRO endpoint. Results and Conclusions., After a systematic evaluation of the psychometric aspects of the BPI, we conclude that the BPI and its "pain at its worst in the last 24 hours" item generically satisfy most key recommendations outlined in the draft guidance for assessing a pain-reduction treatment effect. Nonetheless, when the BPI is being considered for assessment of pain endpoints in a registration trial, sponsors and investigators should consult with the appropriate FDA division early during research design to discuss whether there is sufficient precedent to use the instrument in the population of interest or whether additional evaluations of measurement properties are advisable. [source] | ||||||||||