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Biomedical subjects

A Funkhouser

Publications and source records attributed to A Funkhouser.

13 recordsLinked to original sources
PubMed2000

Total body calcium in obese women. Validation of dual-energy X-ray absorptiometry against in vivo neutron activation analysis.

In vivo neutron activation analysis (IVNA) allows in vivo measurement of total body calcium and is considered the gold standard technique. Dual-energy X-ray absorbtiometry (DXA) estimates total body calcium. Although there are a few comparisons of the two techniques, there are none with obese women. The present study compared the estimation of total body calcium by DXA with the measurement of Ca by IVNA in 69 obese women. Sixty-nine obese women (age 44 +/- 10 years, body weight [BW] 93 +/- 10.4 kg, body mass index [BMI] 35 +/- 4, fat mass 42 +/- 7 kg, 48 pre- and 21 postmenopausal, 30 Caucasian and 39 African-American) were recruited for a six-month body composition study without weight loss intervention. Total body (TB) Ca was measured by IVNA (CaIVNA) and by DXA (CaDXA) at baseline (n = 69) and again at six months (n = 40). At baseline, CaDXA was significantly higher than CaIVNA (1018 +/- 130 g vs. 706 +/- 92 g, p = 0.0001). The difference remained after six months (1028 +/- 153 g vs. 715 +/- 96 g). There was a small but significant increase in TBCa at six months by both DXA (16.5 +/- 40, p < 0.02) and IVNA (8 +/- 22 g, p < 0.03). However, this change was not significantly different between the two methods (p = 0.2365). The correlation between the two methods was very high (r = 0.937) and was independent of either race or menopausal status (p = 0.5163). We generated a regression equation: CaIVNA = 0.659 x CaDXA + 34.77; SEE = 32.2, R = 0.937. We present a model integrating the effect of weight and height on the relationship between CaIVNA and CaDXA. The higher the BMI, the bigger the difference between CaIVNA and CaDXA. In our population with a mean BMI of 35.3, CaIVNA = 69% CaDXA.

Absorptiometry, Photon↗
PubMed1993

Antibodies to recombinant gp160 in mucosal secretions and sera of persons infected with HIV-1 and seronegative vaccine recipients.

An enzyme immunoassay (EIA) was developed to detect secretory IgA (sIgA) antibodies to HIV-1 envelope glycoprotein, using a mouse monoclonal antibody and a highly purified, baculovirus-expressed recombinant gp160 (rgp160) as antigen. Detection of sIgA was enhanced by prior immunoprecipitation of IgG. IgG and sIgA rgp160 antibodies were measured in parotid saliva and nasal wash samples of 18 HIV-1-seropositive volunteers and 14 HIV-1-seronegative adult volunteers immunized 3 times with HIV-1 IIIB rgp160 vaccine at 1 of 4 dosage levels: 40 micrograms (N = 3), 80 micrograms (N = 3), 160 micrograms (N = 4), and 640 micrograms (N = 4). We detected rgp160-specific IgG antibody in the nasal wash samples of all HIV-1-seropositive volunteers and 4/8 vaccinees (50%) immunized with the two highest doses of rgp160 vaccine. All infected volunteers tested had rgp160-specific sIgA in their nasal wash samples. None of the vaccinees and very few of infected volunteer specimens had detectable antibody in the parotid saliva samples (5/8 had IgG and 1/8 had sIgA). We also detected IgG antibody to rgp160 in the sera of all infected volunteers and 13/14 vaccinees (93%). With this EIA, sIgA antibody can be measured in mucosal secretions of recipients of appropriate candidate HIV-1 vaccines.

AIDS Vaccines↗
PubMed1993

Infant health care utilization predicted by pattern of prenatal care.

STUDY OBJECTIVE: The objective of this study was to examine the relationship between patterns of prenatal care and subsequent infant health care use in a sample of inner-city women and their infants. In testing this relationship we controlled for several sociodemographic, economic, and psychological factors. DESIGN: This case-control study examined medical records of 148 infants born to mothers previously enrolled in a 9-month study of prenatal care and use or nonuse of illicit drugs. Cases (N = 62) were defined as infants born to women who first registered for prenatal care after 28 weeks' gestation or completed fewer than four prenatal visits. Controls (N = 86) were all other infants matched by date of birth. Data on maternal health and sociodemographic factors were obtained from a maternal interview and medical record review. Maternal drug use was defined as the use of illicit drugs at any time during the pregnancy based on maternal interview and/or a positive maternal or neonatal urine toxicology screen obtained within 48 hours of delivery. RESULTS: Infants of case mothers had significantly lower birth weight and gestational age, increased number of protective service referrals, and lower completion rate of three or more health supervision visits by 9 months of age. Multiple logistic regression analysis revealed that adequate prenatal care was significantly associated with adequate use of infant health care independent of maternal drug use, educational level, marital status, and number of previous living children. CONCLUSIONS: Patterns of infant health care use can be predicted before birth based on the mother's pattern of prenatal care use.

Adult↗
PubMed1992

A comparison of five methods for estimating general glaucomatous visual field depression.

The separation of local and diffuse visual field loss is important for evaluating the nature and extent of glaucomatous visual field damage. Here, five automated methods for estimating diffuse loss in glaucomatous visual fields (as measured with the Octopus G1 program) are compared. Four are taken from the published literature, and one is introduced in this investigation. It is shown that the new index (here called diffuse loss) provides the best agreement with a value determined using a more empirical approach.

Glaucoma↗
PubMed1991

The effects of weighting the "mean defect" visual field index according to threshold variability in the central and midperipheral visual field.

Two visual field indices, the mean defect (MD) of Flammer and the mean deviation (MD) of Heijl, have found wide acceptance among perimetrists. We compared these indices in 169 visual fields from normal- and high-tension glaucomatous eyes. Visual field damage in these eyes varied from slight to severe. In computations of the mean deviation index, the threshold values are weighted by the threshold deviations obtained from normal eyes as a function of eccentricity. However, the present study shows that the differences between the two indices in the population studied are negligible. Thus, subsequent interpretation is not affected by the choice of index, and the two MD indices may be considered to be interchangeable for the types of visual fields used in this study and for program-G1 examinations carried out using Octopus automated perimeters. Since we found smaller increases in local intersubjective fluctuations as a function of eccentricity in 274 normal visual fields as compared with results published by others, caution is indicated for interpretation of the visual field using probability weighting.

Humans↗
PubMed1990

Evaluating a perimetric expert system: experience with Octosmart.

When evaluating expert systems to be used in clinical perimetry, various aspects of their performance as compared with that of human interpreters must be considered. In this investigation, the results produced by the new Octosmart diagnostic program have been compared with the performance of three interpreters with various amounts of experience in visual field analysis. The evaluations were based on 27 visual fields with glaucomatous damage, which had been examined with the Octopus program G1. It is shown that in borderline cases (i.e., neither clearly normal nor clearly pathological) where strict statistical criteria must be employed in order to distinguish between possible pathology and artifacts, the "personal styles" of human interpreters, more than standardized decision criteria, implicitly guide the decision process, resulting in unpredictable, non-standardized interindividual differences. A standardized expert system, based on constant, explicit, and logical criteria is therefore considered to be superior to unaided human interpretation. It is pointed out that the influence of the implicit decision criteria of human interpreters must be controlled carefully if expert systems are to be evaluated with reference to human interpreters.

Analysis of Variance↗
PubMed1989

A comparison of three methods for abbreviating G1 examinations.

The G1 glaucoma program is now widely employed in Octopus automated perimetry in order to detect early visual field damage and as an aid in regular follow up. For some patients, however, the examination duration, about 20 minutes, can be excessive. Three methods which could be used for an abbreviated initial screening phase were studied: 1) examining 30 test locations with full 2 dB minimum step size bracketing; 2) using all 59 test locations, but with 4 dB minimum step size bracketing; and 3) using 30 test locations and 4 dB minimum step size. Two indices derived from these abbreviated examination procedures were compared to those obtained from the first phase of the G1 program. The study was based on data of 1008 visual fields of both normal and pathological eyes. It was found that the 30 test location full bracketing method yielded the best agreement with the results obtained with the first phase of the G1 program. Recommendations concerning the optimal utilization of these methods in possible future versions of the G1 program are included.

Adolescent↗
PubMed1989

A comparison of eight test location configurations for estimating G1 mean defect values.

Examinations performed with the Octopus G1 glaucoma program can last up to 20 minutes or more and this may be too long for some patients who are easily fatigued. It may also be that the examiner wishes to have a first look at examination results and then decide whether to continue examining or be satisfied with preliminary values. Eight different test location configurations consisting of 4, 8, 12, 16, 20, 24, 28 and 32 test locations for obtaining a first look at a visual field were investigated based on 764 examinations of normal and pathological visual fields. The mean errors in estimating the mean defect expected for each configuration were calculated. The results indicate that using configurations with 24 or 28 test locations for an advance estimate of the mean defect produces the least amount of error.

Adolescent↗
PubMed1986

Advantages and limitations of the spatially adaptive program SAPRO in clinical perimetry.

The SAPRO program devised for the OCTOPUS 201 automated perimeter, consists of a number of program components. It is designed to be used on the Octopus 201 computer. In its measurement mode, it employs an algorithm which achieves high speed and efficiency. This is made possible by a threshold bracketing strategy which is simpler than the normal OCTOPUS bracketing. Moreover, three grids with test location distributions of increasing resolution are superimposed in succession on the whole or on part of the visual field to be analyzed. Out of the distribution of test locations, only those which fulfill a number of criteria are actually utilized. These criteria must be given and are adaptable to any given clinical problem. As a result, despite the high spatial resolution achieved, only a fraction of the test locations are utilized using SAPRO as compared with a program using a fixed pattern of test locations. The algorithm is thus able to imitate human intelligence, which tends to concentrate stimuli at places which appear to be relevant for the solution of a problem. The results of program SAPRO are disturbed by short- and long-term fluctuations. Their validity is limited, in a manner similar to that encountered in any other threshold determination procedure. A number of printout modes is available which are oriented towards an optimal understanding of the information contained in various examinations. These principles will be illustrated by one case of inactive disseminated chorioretinitis.

Computers↗
PubMed1986

Evaluating the applications of the spatially adaptive program (SAPRO) in clinical perimetry: Part I.

Some clinical application possibilities of a spatially adaptive program (SAPRO) are presented and analyzed. Due to the ability of the program to adapt operationally to the visual field situation that is encountered, useful clinical findings can be obtained, even in patients with complicated visual field disturbances. The spatially adaptive detection mechanism, as well as a simplified bracketing strategy, make it possible to keep the cost/benefit ratio down. Short- and long-term fluctuations, especially when these are large, may compromise the validity of the examination results or place them in doubt. Their effects can be diminished using data reduction methods (averaging). In cases where averaging cannot be applied, one can nevertheless achieve useful results by the appropriate selection of the perimetric visual fields (or portions thereof) that are measured.

Adult↗
PubMed1985

Quantification of glaucomatous visual field defects with automated perimetry.

A method to quantify different glaucomatous visual field defects is presented. Three visual field indices are calculated: the short-term fluctuation, the mean defect, and the corrected loss variation. The method was applied to visual fields tested with program JO on the Octopus automated perimeter. The indices of 130 glaucoma suspects and 50 glaucoma patients were compared with 100 normal controls. The indices provide good detectability of visual field defects and easy follow-up.

Adult↗
PubMedDate not supplied

Haemophilus influenzae disease and immunization in developing countries.

Haemophilus influenzae is one of the leading causes of severe bacterial infection in children of developing regions, causing 30% of the cases of culture-positive pneumonia and 20%-60% of the cases of bacterial meningitis. In infants and children, the majority of isolates from cerebrospinal fluid and blood and 16%-38% of pulmonary isolates are H. influenzae type b. The availability of several new polysaccharide-protein conjugate vaccines for the prevention of invasive disease due to H. influenzae type b prompts this review of the epidemiology of H. influenzae disease in the developing world and of the characteristics of current H. influenzae type b vaccines. To develop a strategy for use of H. influenzae type b vaccines in developing countries, the following data are needed: the age-specific attack rates of H. influenzae type b disease and the immunogenicity and efficacy of these vaccines in young infants in developing countries. Should H. influenzae type b vaccines prove to be inadequate for the prevention of H. influenzae pneumonia, the use of non-type b H. influenzae vaccines may be necessary.

Bacterial Capsules↗