Home About us Contact
|
Home About us Contact | ||
|
|
||
Main Analyses (main + analysis)
Selected AbstractsVariations on the CAGE Alcohol Screening Questionnaire: Strengths and Limitations in VA General Medical PatientsALCOHOLISM, Issue 10 2001Katharine A. Bradley Background: Several variations on the CAGE alcohol screening questionnaire have been recommended. This report evaluates modifications and additions to the CAGE. Methods: Alcohol screening questionnaires were evaluated in male VA general medicine patients (n= 227; mean age, 65.8). Mailed questionnaires included two scoring options for the CAGE (standard and last-year time frames), questions about quantity and frequency of drinking, two questions about episodic heavy drinking, and the question "Have you ever had a drinking problem?" Main analyses compared alcohol screening questions, at various cut-points, to a gold standard of hazardous drinking during the past year (,14 drinks/week or ,5 drinks on an occasion) and/or DSM-III-R alcohol abuse or dependence, based on standardized interviews. Results: The CAGE questionnaire with a past-year time frame was much less sensitive (0.57 vs. 0.77) but more specific (0.82 vs. 0.59) than the standard CAGE for detecting hazardous drinking during the past year and/or DSM-III-R alcohol abuse or dependence. An eight-item questionnaire that included the standard CAGE was most sensitive (0.92) but had low specificity (0.50). A single question about the frequency of drinking ,6 drinks on an occasion, included in the eight-item questionnaire, was both relatively sensitive (0.77) and specific (0.83). Conclusion: The CAGE questionnaire with a past-year time frame was an insensitive alcohol-screening test. An eight-item augmented version of the standard CAGE was the most sensitive. A question about the frequency of drinking ,6 drinks on an occasion performed better than the standard CAGE, which made it the optimal brief screening test for at-risk drinking. [source] Body size and human energy requirements: Reduced mass-specific total energy expenditure in tall adults,AMERICAN JOURNAL OF HUMAN BIOLOGY, Issue 3 2010Steven B. Heymsfield Mammalian resting energy expenditure (REE) increases as ,weight0.75 while mass-specific REE scales as ,weight,0.25. Energy needs for replacing resting losses are thus less relative to weight (W) in large compared with small mammals, a classic observation with biological implications. Human weight scales as ,height2 and tall adults thus have a greater weight than their short counterparts. However, it remains unknown if mass-specific energy requirements are less in tall adults; allometric models linking total energy expenditure (TEE) and weight with height (H) are lacking. We tested the hypothesis that mass-specific energy requirements scale inversely to height in adults by evaluating TEE (doubly labeled water) data collected by the National Academy of Sciences. Activity energy expenditure (AEE) was calculated from TEE, REE (indirect calorimetry), and estimated diet-induced energy expenditure. Main analyses focused on nonmorbidly obese subjects ,50 yrs of age with non-negative AEE values (n = 404), although results were directionally similar for all samples. Allometric models, including age as a covariate, revealed significantly (P < 0.05) greater REE, AEE, and TEE as a function of height (range H1.5,1.7) in both men and women. TEE/W scaled negatively to height (,H,0.7, P < 0.01) with predicted mass-specific TEE (kcal/kg/d) at ±2 SD for US height lower in tall compared with short men (40.3 vs. 46.5) and women (37.7 vs. 42.7). REE/W also scaled negatively to height in men (P < 0.001) and women (P < 0.01). Results were generally robust across several different analytic strategies. These observations reveal previously unforeseen associations between human stature and energy requirements that have implications for modeling efforts and provide new links to mammalian biology as a whole. Am. J. Hum. Biol. 2010. © 2009 Wiley-Liss, Inc. [source] Quantitative EEG in Patients With Alcohol-Related SeizuresALCOHOLISM, Issue 10 2010Trond Sand Background:, To investigate whether quantitative electroencephalography (QEEG) recorded within a few days after a generalized seizure can improve the discrimination between alcohol-related seizures (ARSs), seizures in epilepsy and other seizures. In addition, we wanted to evaluate the influence of various external factors on QEEG, e.g., drug use, time from seizure occurrence, and alcohol intake. Methods:, An ARS was defined by (i) scores ,8 in the Alcohol Use Disorders Identification Test (AUDIT) and (ii) no history of epilepsy. Twenty-two ARS patients, 21 epileptic patients with seizures (ES), 30 AUDIT-negative patients with seizures (OS), and 37 well-controlled epileptic outpatients (EPO) were included. EEG from 79 sciatica patients (SC) served as an additional control group. EEG was recorded in relaxed wakefulness with eyes closed. Spectral analysis of ongoing resting EEG activity was performed. For the main analysis, spectral band amplitudes were averaged across 14 electrodes. Results:, Major quantitative EEG abnormalities were mainly seen in the ES group. AUDIT score correlated negatively with QEEG band amplitudes in patients with seizures unrelated to alcohol, but not in the ARS group. Recent alcohol intake correlated negatively with delta and theta amplitude. We could not confirm that beta activity is increased in ARS subjects. Conclusions:, A QEEG with slightly reduced alpha amplitude supports a clinical diagnosis of ARS. An abnormally slow QEEG profile and asymmetry in the temporal regions indicates ES. QEEG predicted the clinical diagnosis better than standard EEG. [source] Linezolid versus vancomycin for MRSA skin and soft tissue infections (systematic review and meta-analysis)ANZ JOURNAL OF SURGERY, Issue 9 2009Tristan John Dodds Abstract Background:, This review aims to compare the effectiveness of linezolid to vancomycin for the treatment of Methicillin Resistant Staphylococcus Aureus (MRSA) skin and soft tissue infections (SSTIs) in inpatients. Methods:, MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials and reference lists were searched in March 2007. We included randomized controlled trials that looked at inpatients treated with linezolid versus vancomycin for the treatment of hospital-acquired MRSA SSTIs. Outcome measures were clinical cure (resolution of symptoms and signs) and microbiological cure (eradication of MRSA on wound culture). The validity of the included trials was assessed. The results were combined in meta-analyses, the robustness of which was tested in sensitivity analyses. Results:, Four trials were included in this review: three for clinical outcomes (174 participants) and three for microbiological outcomes (439 participants). For clinical outcomes there were non-significant trends in favour of linezolid (RR 0.34; 95% CI 0.04, 2.89; P = 0.32). For microbiological outcomes there was weak evidence of linezolid outperforming vancomycin (RR 0.55; 95% CI 0.30, 1.01; P = 0.05). Sensitivity analyses did not change the conclusions taken from the main analysis. Conclusion:, With the current available data no difference could be detected between the two treatments, but a trend towards higher effectiveness of linezolid was observed. More data will be required to determine if linezolid is superior to vancomycin for the treatment of MRSA SSTIs. Further systematic reviews are needed to look at other outcomes (length of hospital stay, safety and tolerability, cost-effectiveness) and at MRSA infections at other sites. [source] | ||||||||||