PubMed Health⌕ Search

Biomedical subjects

S M Debanne

Publications and source records attributed to S M Debanne.

13 recordsLinked to original sources
PubMed1992

Abnormal labor and infant brain damage.

OBJECTIVE: To determine whether arrest disorders result in increased neurologic abnormalities in infancy or childhood. METHODS: Four hundred thirteen infants with arrest disorders as defined by Friedman criteria were matched to a similar population without arrest disorders. The median length of follow-up was 6 years for the study infants and 5.07 years for the controls. The numbers of children with abnormalities in the groups with and without arrest disorders, as well as the specific abnormalities encountered, were stratified by method of delivery. RESULTS: Thirty neurologic abnormalities were found in the arrest group and 37 in the control group; thus, the null hypotheses could not be rejected. In addition, although the control group was not followed as long as the study population, the diagnosis of abnormalities was more frequent in the later years in the controls. This suggests that had the follow-ups been equal, there would have been stronger proof that arrest by itself was not associated with infant brain damage. CONCLUSION: Our study confirms that labor diagnoses of prolonged active phase, protractions or arrests, and failure to descend are not associated with increased neurologic abnormalities. Delivery by cesarean or vaginal birth and use of oxytocin are not factors in the etiology of major brain damage.

Brain Damage, Chronic↗
PubMed1989

Arrest disorders and infant brain damage.

In the past, difficult labors have been associated with maternal and infant damage. Today, changing patient management is associated with less trauma and more frequent use of cesarean births to avoid potential fetal neurologic damage. In this report, arrests of dilatation and descent and prolongation of the decelerative phase of labor were reviewed with respect to the later appearance of brain damage in infants after 2 years of age, in association with obstetric interventions including cesarean birth, forceps, and oxytocin. Charts of 413 infants born after abnormal labors were studied. Log-linear analysis was performed to determine the contribution of method of delivery and oxytocin use to the presence of neurologic abnormalities. Statistical testing ruled out the presence in the model of a three-way interaction, and excluded the two-way interactions of neurologic abnormalities-oxytocin use and neurologic abnormalities-method of delivery. Chi-square tests of partial association and marginal association for the delivery-oxytocin interaction yielded values of 33.54 (P less than .0001) and 33.78 (P less than .00001). This model asserted that method of delivery and use of oxytocin were unrelated to the presence of neurologic abnormalities, but were related to each other.

Birth Weight↗
PubMed1987

Male reproductive assessment of the rubber accelerator N-oxydiethylene thiocarbamyl-N-oxydiethylene sulfenamide in rats.

The rubber accelerator N-oxydiethylene thiocarbamyl-N-oxydiethylene sulfenamide (OTOS) was evaluated to determine its potential to cause reproductive effects. No evidence of a compound-related effect on mating, fertility, gestation length, number of implants or live births, pup growth, and survival was observed using Sprague-Dawley rats. Furthermore, light and electron microscopy of the testes from the high-dose males failed to reveal any morphological changes compared to the controls. Groups of 12 male Sprague-Dawley rats were continuously administered diets containing 0, 60, 200, or 600 ppm OTOS for 12 weeks. Following 56 days of exposure, the males were subsequently cohoused nightly with two females for a maximum of 21 days. During this mating period, males continued to receive control and OTOS-containing diets; however, feeders were removed for nightly cohabitation. Although a 4 to 8% reduction in body weight was observed in the 600 ppm animals, statistical significance was reached only at the end of the first week of treatment. In the 60 and 200 ppm males body weights generally were slightly elevated compared to the control, with the 60 ppm body weights showing statistically significant differences during Weeks 5 to 7 of exposure.

Animals↗
PubMed1986

Prognostic factors in vitrectomy for epiretinal membranes of the macula.

A retrospective multivariate analysis of 264 consecutive cases of vitrectomy for removal of epiretinal membranes of the macula was performed. Two main preoperative prognostic factors were identified that were associated with the visual outcome of surgery: (1) the preoperative visual acuity, and (2) the duration of blurred vision before surgery. Discriminant functions constructed using these two factors allowed correct classification of eyes into an outcome group with good visual acuity with a 69% accuracy, and an 80% accuracy in classifying eyes into a group showing significant improvement in the level of visual acuity. Eyes that began with vision better than 20/100 tended to have slightly better postoperative visions than eyes with poorer preoperative visual acuity. However, eyes with worse preoperative vision tended to improve the greatest amount after surgery. Eyes with a longer history of blurred vision had poorer visual acuity after surgery and also less improvement in vision. Other statistically significant prognostic factors were identified; however, they did not appreciably improve the accuracy of the discriminant function in predicting visual outcome.

Adolescent↗
PubMed1986

Adjusting for confounding with statistical software packages.

Much computer use in support of clinical research involves the execution of standard statistical packages. Prenatal risks, such as maternal substance use, may be related to outcomes, such as lowered birthweight for gestational age, using multiple regression. In standard stepwise multiple regression, variance shared by two risks is attributed to the first variable entered in the equation, potentially underestimating the effect size of subsequently entered variables. A novel solution to this problem, adapted from the epidemiologic technique of calculating attributable risk, is applied in the multivariate setting and produces more appropriate estimates of the effect sizes of independent risks. An example of this method, using a standard statistical package, is presented.

Alcohol Drinking↗
PubMed1986

Field evaluation of enzyme-linked immunosorbent assay for the serodiagnosis of tuberculosis.

An enzyme-linked immunosorbent assay (ELISA) was evaluated as a serodiagnostic test for active tuberculosis in La Paz, Bolivia. ELISA was compared with sputum smear in 277 persons presenting to the Instituto de Torax and was used for screening in 1,458 military personnel. The test was performed under field conditions on 4-microliter samples of capillary blood obtained by finger prick. ELISA was found to have a sensitivity of 69% and a specificity of 88%. Sputum smear had a sensitivity of 79% and a specificity of 100%. ELISA was found to have undiminished sensitivity and specificity in patients who were sputum-negative, and the two tests could be combined to achieve a sensitivity of 92% and specificity of 88%. Positive and negative predictive values were highest for populations with tuberculosis prevalences in the range of that seen among patients presenting to the Instituto de Torax in Bolivia, but ELISA also led to the diagnosis of tuberculosis in 5 of 1,458 soldiers tested in the screening program.

Adolescent↗
PubMed1985

Evaluation of statistical methodologies for estimation of median effective dose.

A comparison is made of statistical techniques currently in use for analysis of quantal assay data. The discussion focuses on the choice of the functional model to use in the description of the tolerance distribution for the estimation of the median effective dose and in the contrast between exact and graphical methods of estimation for a given choice of model. The data used to illustrate these focal points are derived from test data from biological assays performed at the University of Pittsburgh. A criterion for making a choice among functional models based on the significance of the dose-response relationship and the length of the fiducial limits for the median effective dose is proposed. It is also shown that graphical methods can lead to results similar to those arrived at through exact calculations where the data fit model assumptions but can lead to erroneous conclusions where this is not the case.

Animals↗
PubMed1985

Enzyme-linked immunosorbent assay using Mycobacterium tuberculosis antigen 5 and PPD for the serodiagnosis of tuberculosis.

Enzyme-linked immunosorbent assays (ELISA) of immunoglobulin G antibody to Mycobacterium tuberculosis antigen 5 and tuberculin purified protein derivative (PPD) were assessed for the serodiagnosis of tuberculosis in 41 patients with active tuberculosis, 19 patients with inactive tuberculosis, and 59 healthy control subjects. Patients with active tuberculosis were studied serially at monthly intervals following the initiation of therapy. When contrasted with our earlier studies of sera from patients in Bolivia and Argentina, serum titers in Cleveland patients with active tuberculosis were somewhat lower. Geometric mean titer in patients with active tuberculosis was 1:68 with antigen 5 and 1:46 with PPD. Titer was correlated with patient age, male sex, extent of tuberculosis, and history of prior tuberculosis. However, these associations were not statistically significant. During monthly follow-up for 16 months after the initiation of therapy, ELISA titers remained essentially stable. Thus, no convincing evidence was acquired to support the hypothesis that higher titers in sera from South American patients related to more chronic or more extensive disease. Receiver operating characteristics of ELISA with antigen 5 were better than those obtained using PPD and were similar to those reported by others for sputum smear. In a situation where tuberculosis screening is warranted, ELISA with antigen 5 might have a place if it recognizes a different population than does sputum smear.

Adult↗
PubMed1985

Long-term follow-up after recovery from acute myocardial infarction. Observations on survival, ventricular arrhythmias, and sudden death.

A long-term 12-year follow-up of 248 patients surviving acute myocardial infarction indicated a cumulative survival of 89%, 68%, 53%, and 45% for 1, 5, 10, and 12 years, respectively. When patients were assessed with five routinely obtained clinical factors, significant prognostic stratification of high- and low-risk survival groups extended throughout the follow-up period. Sudden cardiac death was found to be twice as frequent as nonsudden cardiac death, but a significant relationship between sudden death and complex ventricular ectopic beats could not be defined. The extent of complex features of ventricular ectopic beats such as pairs, multiform, repetitive, and R-on-T was inversely related to survival. During the first year after acute myocardial infarction, frequency of ventricular ectopic beats was also inversely related to survival. A long-term effect of frequency on survival, however, could not be demonstrated.

Actuarial Analysis↗
PubMed1984

Evaluation of mycobacterial antigens in an enzyme-linked immunosorbent assay (ELISA) for the serodiagnosis of tuberculosis.

Five mycobacterial antigens were compared in an enzyme-linked immunosorbent assay (ELISA) for the serodiagnosis of tuberculosis. The antigens studied were an unheated sterile culture filtrate of Mycobacterium tuberculosis, tuberculin purified protein derivative (PPD) from M. tuberculosis (PPDa), purified cytoplasmic protein antigens 5 and 6 from M. tuberculosis, and a PPD prepared from M. kansasi (PPDk). Multivariate analysis of variance showed that geometric mean titres obtained with each of the antigens in ELISA were significantly different in tuberculosis patients and in control groups. The covariation of the ELISA results with the five antigens was highly interdependent. Analysis of receiver operating characteristics revealed that the most accurate test was obtained with antigen 5. M. tuberculosis PPD, M. tuberculosis antigen 6, and M. tuberculosis culture filtrate were, in descending order, less accurate.

Antibodies, Bacterial↗
PubMed1982

The tuberculin specificity in humans of Mycobacterium tuberculosis antigen 5.

Mycobacterium tuberculosis antigen 5 is a protein antigen limited in distribution to M. tuberculosis and M. bovis and capable of eliciting typical delayed tuberculin skin test reactions in humans. A single large batch of this antigen was purified by immunoabsorbent affinity chromatography and used to skin test patients with tuberculosis and other mycobacterial infections and healthy persons in general populations in geographic areas where nonspecific tuberculin reactivity is frequently encountered. Antigen 5 was found to be no more specific as a tuberculin antigen than PPD. If the available data are accepted, then either a disparity in antigen recognition by antibody and T lymphocytes may exist or the widely accepted hypothesis attributing nonspecific tuberculin reactivity to antigenic cross reactivity with other mycobacteria may be incorrect.

Adult↗