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Objective Parameters (objective + parameter)

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Medical Sciences	100%

Selected Abstracts

Application of post-surgical stimulated thyroglobulin for radioiodine remnant ablation selection in low-risk papillary thyroid carcinoma,,

HEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 6 2010
Alon Vaisman HBSc
Abstract Background We present our ongoing experience in the use of postsurgical stimulated serum thyroglobulin (Stim-Tg) to assist in radioiodine remnant ablation (RRA) decision-making. Methods Patients with low-risk well-differentiated thyroid carcinoma (WDTC) with undetectable anti-Tg antibodies were prospectively followed after total thyroidectomy and therapeutic central compartment neck dissection, when indicated.Stim-Tg was performed 3 months postoperatively and used to base RRA selection. Results Of 104 patients, 59 patients (56.7%) had an undetectable Stim-Tg after thyroidectomy, 35 (33.7%) had Stim-Tg values of 1,5 ,g/L, and 10 (9.6%) had Stim-Tg values >5 ,g/L. RRA was administered to 1 patient (1.7%) with undetectable Stim-Tg, 6 patients (17.1%) with Stim-Tg1,5 ,g/L, and 9 patients (90%) with Stim-Tg >5 ,g/L, for a total of 16 patients (15.4%) receiving RRA. When compared to current RRA selection guidelines, the proposed protocol achieved a significantly lower RRA administration rate. Conclusion Stim-Tg measurement performed several months after total thyroidectomy is a useful objective parameter in assisting RRA decision-making for patients with low-risk WDTC. © 2010 Wiley Periodicals, Inc. Head Neck, 2010 [source]

Monitoring myeloablative therapy-induced small bowel toxicity by serum citrulline concentration

CANCER, Issue 1 2005
A comparison with sugar permeability tests
Abstract BACKGROUND Intestinal mucositis is an important cause of cancer treatment-related morbidity and mortality, carrying a serious economic burden. Currently, objective parameters are lacking that would enable the monitoring of gut damage in routine clinical practice, thus hindering the development of clinical studies designed to investigate potential new strategies aimed at reducing or preventing this side effect. The authors investigated the characteristics of serum citrulline concentration compared with sugar permeability tests with respect to its use as a marker for cancer treatment-induced small bowel injury. METHODS In this prospective study, 10 patients with hematologic malignancies who were receiving myeloablative therapy had gut toxicity assessed with sugar permeability tests. Serum citrulline concentrations also were determined using archival serum samples. The association between both parameters and their respective characteristics were analyzed and compared with data from the literature. RESULTS Sensitivity and specificity were better for the citrulline assay compared with sugar permeability tests. Maximum gut damage assessed with the citrulline assay was observed 1,2 weeks earlier compared with the sugar permeability test. Similarly, citrulline indicated recovery of gut damage at 3 weeks after transplantation, whereas most sugar permeability tests remained abnormal. CONCLUSIONS The simplicity of the method, the low costs, and the lack of drawbacks to the method make the citrulline assay the first choice for measuring and monitoring treatment-related gut damage and provides an objective parameter for cancer treatment-related gut toxicity. Cancer 2005. © 2004 American Cancer Society. [source]

Resynchronization or Dyssynchronization,Successful Treatment with Biventricular Stimulation of a Child with Obstructive Hypertrophic Cardiomyopathy without Dyssynchrony

JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Issue 5 2007
LENARCZYK RADOSLAW M.D.
CRT in a Child with Hypertrophic Cardiomyopathy. We present a case of a 10-year-old boy with hypertrophic cardiomyopathy, intraventricular pressure gradient of 104 mmHg, and indications for prophylactic ICD implantation. Based on intraoperative pressure measurements, the child was implanted with biventricular ICD. During 2.5 months of observation, the patient's functional status improved significantly, as shown by subjective and objective parameters and, moreover, the pressure gradient fell to 12 mmHg. Significant electrical and mechanical cardiac dyssynchrony appeared parallel to clinical improvement. [source]

Assessment of a Novel Angiographic Image Stabilization System for Percutaneous Coronary Intervention

JOURNAL OF INTERVENTIONAL CARDIOLOGY, Issue 2 2007
ANDREW J. BOYLE M.B.B.S., Ph.D.
Background: Optimization of coronary images for percutaneous coronary intervention (PCI) remains difficult due to cardiac motion throughout the respiratory and cardiac cycles. We tested a novel system to stabilize angiographic images at the region of interest in order to assist during PCI. Methods: Patients undergoing PCI to the right coronary artery (RCA) (group 1, n = 22) or complex PCI (group 2, n = 16) were prospectively enrolled and the angiographic image sequences of patients who died suddenly of confirmed or presumed stent thrombosis following PCI (group 3, n = 16) were retrospectively reviewed. All image sequences were analyzed off-line by three cardiologists before and after image stabilization for accuracy of stent placement, presence of residual edge dissection, and adequacy of procedural outcome. Results: Image stabilization was successful in 100% of cases in a mean time of 95 ± 71 seconds and was considered to be helpful in 13.6% of group 1, in 18.3% of group 2, and in 10% of group 3 cases. There was good correlation between observers with a kappa statistic of 0.85 to 1.0 for all observations. However, there was no difference in the reviewers' opinions of stent placement, presence of edge dissection, or adequacy of procedural result when comparing the standard angiographic views and the stabilized images. In particular, no previously unrecognized edge dissections were apparent in group 3 with stabilized display. Conclusion: Image stabilization centered on the region of interest was considered helpful in a small subset of patients, particularly the complex PCI patients. However, no differences in objective parameters could be demonstrated. [source]

AgNOR count as objective marker for dysplastic features in oral leukoplakia

JOURNAL OF ORAL PATHOLOGY & MEDICINE, Issue 9 2002
Amit 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]

Efficacy of pollen immunotherapy in seasonal allergic rhinitis

PEDIATRICS INTERNATIONAL, Issue 1 2007
DEMET CAN
Abstract Background: The efficacy of subcutaneous pollen immunotherapy has been documented in published double-blind, placebo-controlled studies related to treatment of seasonal allergic rhinitis. In the present study, subjective (symptom scores) and objective (nasal peak inspiratory flow, nasal smear, nasal biopsy) parameters were used to study the efficacy of pollen immunotherapy. Methods: Forty-eight patients (32 male), mean ± SE age 13.6 ± 2.8 years allergic to grass-pollen participated in the present study. Patients were divided into three groups: group I, 24 patients who did not receive pollen immunotherapy; group II, 12 patients who received the build-up phase of pollen immunotherapy; and group III, 12 patients who had just finished pollen immunotherapy. With regard to objective and subjective parameters these three groups were compared. Results: When group I was compared to groups II and III, the patients who had not received any immunotherapy were found to have a high daytime nasal symptoms score (P < 0.01), high daytime eye symptoms score(P < 0.01) and high night-time symptoms score (P < 0.01). In objective parameters, it was found that group I had low nasal peak inspiratory flow (P < 0.05), and a high eosinophil count in nasal smears (P < 0.05) and peripheral blood (P < 0.05). It was also demonstrated that there was an increased eosinophil infiltration (P < 0.01) and mast cell infiltration (P < 0.05) in nasal biopsy in group I. There was no significant difference between group II and group III according to these results (P > 0.05). Conclusions: Immunotherapy leads to a better clinical and histopathological prognosis in children with seasonal allergic rhinitis. [source]

Is physical activity influenced by urinary incontinence?

BJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 5 2004
Beata Stach-Lempinen
Objective To evaluate physical activity among urinary incontinent women seeking treatment and to assess the change of physical activity after treatment. Design Part of a prospective observational intervention study to examine the factors influencing the severity of urinary incontinence. Setting Tampere University Hospital,referral unit. Population Eighty-two urinary incontinent women were evaluated in the baseline and 69 (84%) one year (mean 13 months, range 6,21) after treatment. Methods Physical activity was measured by self-report questionnaire and electronic motion sensor: Caltrac accelerometer worn by women for one week. The diagnosis and severity of urinary incontinence was estimated on the basis of urodynamics, pad test, diary and incontinence-specific quality of life measures. Treatment outcome was assessed according to objective parameters and patients satisfaction. Main outcome measures Physical activity at work, leisure and sport expressed in MET (metabolic unit) and kilocalories, change in physical activity after treatment. Results Twenty-one (25.6%) of all women reported exercise of more than three times per week. Incontinent women with the highest leisure time activity ,6 MET (n= 23, above 75th centile) were younger; they had less body mass index and greater urine leakage than others. One year after treatment, there was no change in any parameters of physical activities. Also exercise habits among women who were completely dry (n= 37) after treatment were not changed. Conclusion Urinary incontinent women who seek treatment are as physically active as the normal population. Even after successful incontinence treatment, exercise habits do not change. [source]

Monitoring myeloablative therapy-induced small bowel toxicity by serum citrulline concentration

Quality of life in allergic rhinitis

CLINICAL & EXPERIMENTAL ALLERGY REVIEWS, Issue 3 2006
G. Passalacqua
Summary Quality of life (QoL)or, better, health-related quality of life, is now recognized as a crucial aspect in assessing the impact of a given disease on the general well-being of patients. This fact was ascertained in the last 10 years also for respiratory allergy (asthma and rhinitis). In particular, it was shown that allergic rhinitis (AR), although not life threatening, profoundly affects many aspects of everyday life. In this regard, a number of specific questionnaires (instruments) have been developed and validated to assess the quality of life in adults, adolescents and children. Although the concept of QoL is easy to understand, the development and validation process of questionnaires is quite complex and time consuming. The literature provided strong evidence of the effects of AR and its treatments on QoL, but also evidenced some controversial points, including the weak correlation of QoL with objective parameters. It has therefore become clear that QoL questionnaires measure aspects of the disease that partially differ from the routinely evaluated parameters and that quality of life should integrate, not replace, the objective measurements. In the near future, ,sharper' instruments are expected to be developed for the evaluation of quality of life and of the effects of treatments in AR. [source]

Computerized corneal topography in a paediatric population with Down syndrome

CLINICAL & EXPERIMENTAL OPHTHALMOLOGY, Issue 1 2005
Clinical Science
Abstract Purpose:,To characterize abnormal corneal topographic changes using corneal computerized videokeratography (CVK) in a paediatric population with Down syndrome, and in their parents. Methods:,Prospective, non-randomized clinical trial. Twenty-one children with Down syndrome (mean age 6.9 years) recruited from The Hospital for Sick Children, 18 of their parents, and a paediatric control group of 60 otherwise well children (mean age 9 years), underwent complete ocular examination and CVK using the EyeSys system. Corneal topographic maps were assessed subjectively, and three objective parameters analysed: central corneal power (CP), difference in central corneal power between the two eyes (DCP), and inferior,superior steepening asymmetry (I-S). Results:,Corneal curvature in children with Down syndrome was significantly steeper than in the paediatric control population (CP 46.66 vs 42.60 D, P < 0.0001), but changes with age paralleled that of the control population. DCP and I-S values were also significantly different from the control population (P < 0.0001). 39% of the parents of children with Down syndrome had at least one abnormal parameter. Conclusions:,This study demonstrates that CVK is a useful tool in the ocular assessment of patients with Down syndrome. The findings suggest that this patient population have abnormalities of corneal shape even in the absence of clinical evidence of keratoconus. A greater than expected incidence of abnormal topographic changes was observed in the parents of these patients. [source]

Can objective parameters derived from videofluoroscopic assessment of post-laryngectomy valved speech replace current subjective measures?

CLINICAL OTOLARYNGOLOGY, Issue 6 2006
An e-tool-based analysis
Objectives:, The primary purpose of this study was to assess the pharyngoesophageal segment in total laryngectomy patients using a videofluoroscopy e-tool. Study design:, Cross-sectional study. Setting:,, Head and Neck Oncology Unit, Tertiary Referral Centre. Patients:, Forty-two patients following total laryngectomy. Intervention:, Videofluoroscopy using an e-tool (JRuler). Main outcome measures:, Subjective and objective videofluoroscopy parameters correlated with the GRBAS scale and treatment variables. Results:, Of 32 men and 10 women, mean age 63.5 years (10.8) the majority (64.3%) had a reasonable voice (good = 11 and poor = 4 patients). Comparing subjective and objective parameters, significant correlations were only seen with a smaller minimal neoglottic distance at phonation with no regurgitation of barium at phonation (P = 0.05) and a type 1 shape of neoglottis at phonation (P = 0.02). There were also significant correlations between smaller maximum sub-neoglottic distance at phonation and type 1 shape of neoglottis (P = 0.02), smaller maximum sub-neoglottic distance at rest and absence of stasis of barium at phonation (P = 0.05) and the length of neoglottis at phonation and type 1 shape of neoglottis (P = 0.01). For perceptual evaluation, significant correlation was seen only between G1 voice and a smaller minimal neoglottic distance at phonation (P = 0.03) amongst the subjective and objective parameters. There were no correlations between visual parameters and the clinical parameters. Conclusions:, Our observations suggest that this interesting concept has limitations. While objective and quantifiable data can be obtained using videofluoroscopy in laryngectomees, only a few correlate with each other and with voice quality. [source]