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Objective Markers (objective + marker)
Selected AbstractsAgNOR count as objective marker for dysplastic features in oral leukoplakiaJOURNAL OF ORAL PATHOLOGY & MEDICINE, Issue 9 2002Amit Chattopadhyay Abstract Background:,, Dysplasia is an important feature of leukoplakia. Because agreement among oral pathologists is poor regarding lesional diagnosis, silver stainable nucleolar organizer regions (AgNORs) as replicatory markers may have a place in objectively characterizing dysplasia in tissue specimens. Methods:,, We studied 41 normal oral epithelia, 51 oral leukoplakia (26 dysplastic, 25 non-dysplastic), and 51 cases of squamous cell carcinoma specimens for their mean AgNOR counts. Results:,, Mean AgNOR counts increased gradually from normal epithelium to non-dysplastic to dysplastic leukoplakia to squamous cell carcinoma. Using ROC analysis, we determined a mean AgNOR count cut-point (2.37) that can be used to distinguish between dysplastic and non-dysplastic leukoplakia. The test had a sensitivity of 75% and specificity of 83% with area under the curve being 88%. Conclusions:, Mean AgNOR count could be a valuable criterion for defining objective parameters for diagnosis/determination of dysplasia distinguishing between dysplastic and non-dysplastic leukoplakia. [source] Reliability of the anaerobic threshold in cardiopulmonary exercise testing of patients with abdominal aortic aneurysms,ANAESTHESIA, Issue 1 2009E. Kothmann Summary Anaerobic threshold (AT), determined by cardiopulmonary exercise testing (CPET), is a well-documented measure of pre-operative fitness, although its reliability in patient populations is uncertain. Our aim was to assess the reliability of AT measurement in patients with abdominal aortic aneurysms. Eighteen patients were recruited. CPET was performed four times over a 6-week period. We examined shifts in the mean AT to evaluate systematic bias with random measurement error assessed using typical within-patient error and intraclass correlation coefficient (ICC, 3,1) statistics. There was no significant or clinically substantial change in mean AT across the tests (p = 0.68). The typical within-patient error expressed as a percentage coefficient of variation was 10% (95% CI, 8,13%), with an ICC of 0.74 (95% CI, 0.55,0.89). We consider the reliability of the AT to be acceptable, supporting its clinical validity and utility as an objective marker of pre-operative fitness in this population. [source] Cognitive-behavioral treatment for chronic nightmares in trauma-exposed persons: assessing physiological reactions to nightmare-related fearJOURNAL OF CLINICAL PSYCHOLOGY, Issue 4 2010Jamie L. Rhudy Abstract Cognitive-behavioral treatments (CBTs) that target nightmares are efficacious for ameliorating self-reported sleep problems and psychological distress. However, it is important to determine whether these treatments influence objective markers of nightmare-related fear, because fear and concomitant physiological responses could promote nightmare chronicity and sleep disturbance. This randomized, controlled study (N=40) assessed physiological (skin conductance, heart rate, facial electromyogram) and subjective (displeasure, fear, anger, sadness, arousal) reactions to personally relevant nightmare imagery intended to evoke nightmare-related fear. Physiological assessments were conducted at pretreatment as well as 1-week, 3-months, and 6-months posttreatment. Results of mixed effects analysis of variance models suggested treatment reduced physiological and subjective reactions to nightmare imagery, gains that were generally maintained at the 6-month follow-up. Potential implications are discussed. © 2010 Wiley Periodicals, Inc. J Clin Psychol 66: 1,18, 2010. [source] Phosphatidylethanol and Alcohol Consumption in Reproductive Age WomenALCOHOLISM, Issue 3 2010Scott H. Stewart Background:, Fetal alcohol disorders are preventable, but self-reported alcohol consumption can be misleading and impede effective treatment. Biomarkers represent an alternative method for assessing alcohol use, and this study evaluated the relationship between blood phosphatidylethanol (PEth) and alcohol use in a sample of reproductive age women. Methods:, Alcohol use was estimated by validated self-report methods in 80 nonpregnant women ages 18 to 35. PEth was measured by a contracted laboratory using a liquid chromatography-tandem mass spectrometry assay. Regression methods appropriate for the distribution of PEth were used to define its relationship to alcohol consumption during the prior 2 weeks and explore the effects of drinking patterns on this association. Receiver operating characteristic analysis was used to estimate the sensitivity of PEth for various drinking levels at 95% specific cutoffs. Results:, PEth had a positive linear association with grams of alcohol consumed (p < 0.001), and was detectable in 93% of subjects consuming an average of 2 or more drinks per day. The relationship between total alcohol consumption and PEth may be stronger in women with recent heavy drinking days. The relationship between drinking and PEth varied considerably between individuals, and sensitivity for a certain amount of drinking was low at a highly specific cutoff concentration. Conclusions:, PEth is a highly sensitive indicator of moderate and heavy alcohol consumption in reproductive age women and may complement the use of self-report alcohol screens when additional objective markers of alcohol use are desirable. However, choosing a highly valid cutoff concentration for PEth to differentiate various levels of alcohol consumption may not be feasible. [source] Validation of sternal skin conductance for detection of hot flashes in prostate cancer survivorsPSYCHOPHYSIOLOGY, Issue 2 2007Laura J. Hanisch Abstract The gold standard for objectively measuring hot flashes in women is an increased sternal skin conductance level (SCL), but validation studies in prostate cancer patients are lacking. In the laboratory, an SCL increase of ,1.78 micro-mho in 45 s had a sensitivity of 68% and a positive predictive value of 100% in detecting self-reported hot flashes among prostate cancer patients. Outside the laboratory, 71% of the objective markers of hot flashes were accompanied by a subjective report of a hot flash, and 65% of subjective reports occurred in the absence of an objective criterion. This study demonstrates that sternal skin conductance can be used to detect hot flashes in men in a manner analogous to its utilization among women. Such use would improve outcome analysis of treatment studies. [source] Performance of Phonoelectrocardiographic Left Ventricular Systolic Time Intervals and B-Type Natriuretic Peptide Levels in the Diagnosis of Left Ventricular DysfunctionANNALS OF NONINVASIVE ELECTROCARDIOLOGY, Issue 2 2007Brian Moyers M.D. Background: Systolic time intervals measured by echocardiography and carotid artery tracings are validated methods of assessing left ventricular function. However, the clinical utility of phonoelectrocardiographic systolic time intervals for predicting heart failure using newer technology has not been evaluated. Methods: We enrolled 100 adult patients undergoing left heart catheterization. Participants underwent computerized phonoelectrocardiographic analysis, left ventricular end-diastolic pressure (LVEDP) measurement, transthoracic echocardiographic measurement of left ventricular ejection fraction (LVEF), and B-type natriuretic peptide (BNP) testing. The heart rate-adjusted systolic time intervals included the time from the Q wave onset to peak S1 (electromechanical activation time, EMAT), Q wave onset to peak S2 (electromechanical systole, Q-S2), and peak S1 to peak S2 (left ventricular systolic time, LVST). Left ventricular dysfunction was defined as the presence of both LVEDP >15 mmHg and LVEF <50%. Results: EMAT (r =,0.51; P < 0.0001), EMAT/LVST (r =,0.41; P = 0.0001), and Q-S2 (r =,0.39; P = 0.0003) correlated with LVEF, but not with LVEDP. An abnormal EMAT ,15 (odds ratio 1.38, P < 0.0001) and EMAT/LVST ,0.40 (OR 1.13, P = 0.002) were associated with left ventricular dysfunction. EMAT ,15 had 44% sensitivity, 94% specificity, and a 7.0 likelihood ratio for left ventricular dysfunction, while EMAT/LVST ,0.40 had 55% sensitivity, 95% specificity, and a 11.7 likelihood ratio. In patients with an intermediate BNP (100,500 pg/mL), the likelihood ratio increased from 1.1 using the BNP result alone to 11.0 when adding a positive EMAT test for predicting left ventricular dysfunction. Conclusions: Phonoelectrocardiographic measures of systolic time intervals are insensitive but highly specific tests for detecting abnormalities in objective markers of left ventricular function. EMAT and EMAT/LVST provide diagnostic information independent of BNP for detecting patients with left ventricular dysfunction. [source] 3164: Post-concussive syndromeACTA OPHTHALMOLOGICA, Issue 2010V PURVIN Purpose Over 85% of traumatic brain injuries (TBI) are considered "mild", also referred to as "concussion". Mild TBI is increasingly recognized as an important public health problem. Despite their designation as "mild", adverse outcomes from such injuries are significant, with 25% of patients still impaired at one year. Visual difficulties are common, reported by two-thirds of patients in a Veterans Administration study. Methods Visual symptoms of mild TBI typically include blurring, light sensitivity, eyestrain, difficulty with near focus, trouble tracking, seeing haloes around lights, and diplopia (monocular and binocular). Results Despite the high incidence of visual symptoms, results of standard eye examination and neuro-ophthalmic testing are typically normal. Conventional neuro-imaging also fails to demonstrate objective evidence of neurologic dysfunction in most cases. Recent developments in neuroimaging (particularly diffusion tensor imaging) and serologic testing (S-100B) have provided some correlates of such injury. Conclusion New information from neuroimaging and serologic testing has helped to provide some objective markers for post-concussive syndromes. The diagnosis of such post-traumatic syndromes remains largely clinical. [source] | |||||||||||||