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PubMedDate not supplied

Michigan's fisheater cohorts: a prospective history of exposure.

Interest in environmental contaminants and their effect on human health emerged as a primary focus in the 1970s following the discovery of significant levels of mercury, dichloro diphenyl trichloroethane (DDT), and polychlorinated bihpenyls (PCBs) in recreationally caught Great Lakes fish. In response to these findings, the Michigan Department of Public Health, in 1971, initiated a series of "fisheater" cohort studies. These studies continue to be conducted today. The evolution of human exposure assessment by serum PCB determination parallels the evolution of more precise and sensitive analytical laboratory procedures over the past 25 years. Early work quantitated PCB with Aroclor 1254 standards. By 1980, the Webb and McCall packed-column method (Webb and McCall, 1972, 1973), which quantitates total PCB with Aroclor 1016 and 1260 standards, had gained the Association of Official Analytical Chemists (AOAC) approval and became the accepted method. This method was used in the 1978-1980 Michigan Great Lakes Fisheater Study, the first sizable study of this kind in the nation. The study confirmed that fisheaters had significantly more exposure (median 21.4 ppb vs 6.6 ppb) than controls. Toxicology studies have indicated the need to quantitate individual PCB congeners, in order to correlate exposure with possible toxicological and health outcomes. Today, capillary column gas chromatography and gas chromatography/mass spectrometry are used to search for trace components of the total PCB dose (Mullen et al., 1984). Because of the legacy of the earlier analytical data, Michigan also continues to conduct packed-column analysis for longitudinal comparisons. The Michigan fisheater study database and registry provide a significantly exposed and historic foundation for research testing health outcome hypotheses.

Cohort Studies↗

PubMed1997

Predicting survival in heart failure case and control subjects by use of fully automated methods for deriving nonlinear and conventional indices of heart rate dynamics.

BACKGROUND: Despite much recent interest in quantification of heart rate variability (HRV), the prognostic value of conventional measures of HRV and of newer indices based on nonlinear dynamics is not universally accepted. METHODS AND RESULTS: We have designed algorithms for analyzing ambulatory ECG recordings and measuring HRV without human intervention, using robust methods for obtaining time-domain measures (mean and SD of heart rate), frequency-domain measures (power in the bands of 0.001 to 0.01 Hz [VLF], 0.01 to 0.15 Hz [LF], and 0.15 to 0.5 Hz [HF] and total spectral power [TP] over all three of these bands), and measures based on nonlinear dynamics (approximate entropy [ApEn], a measure of complexity, and detrended fluctuation analysis [DFA], a measure of long-term correlations). The study population consisted of chronic congestive heart failure (CHF) case patients and sex- and age-matched control subjects in the Framingham Heart Study. After exclusion of technically inadequate studies and those with atrial fibrillation, we used these algorithms to study HRV in 2-hour ambulatory ECG recordings of 69 participants (mean age, 71.7+/-8.1 years). By use of separate Cox proportional-hazards models, the conventional measures SD (P<.01), LF (P<.01), VLF (P<.05), and TP (P<.01) and the nonlinear measure DFA (P<.05) were predictors of survival over a mean follow-up period of 1.9 years; other measures, including ApEn (P>.3), were not. In multivariable models, DFA was of borderline predictive significance (P=.06) after adjustment for the diagnosis of CHF and SD. CONCLUSIONS: These results demonstrate that HRV analysis of ambulatory ECG recordings based on fully automated methods can have prognostic value in a population-based study and that nonlinear HRV indices may contribute prognostic value to complement traditional HRV measures.

Aged↗

PubMedDate not supplied

Bioelectrical impedance analysis in dialysis patients.

Identification of malnutrition is imperative in chronic dialysis patients. Bioelectrical impedance (BIA) is a noninvasive method to measure body composition and estimate total body water (TBW), lean body mass (LBM) and body cell mass (BCM). Studies suggest BIA has good reliability as compared to other accepted methods of body composition analysis. Preliminary data also suggest that BIA-derived parameters (reactance and phase angle) predict clinical outcome in chronic hemodialysis patients. Overall, BIA is a promising nutritional assessment tool to monitor health status, long-term follow-up, tailor nutrition support, and detect early subtle losses of LBM in chronic dialysis patients.

Body Composition↗

PubMedDate not supplied

Comparison of Chemstrip uG, Clinitest, and Diastix urine test methods in diabetic children.

The new urine test, Chemstrip uG, was compared with Clinitest and Diastix methods by pediatric diabetic patients and by health care professionals. With the children testing all urine samples (N = 108), accuracy for Chemstrip uG and Clinitest was similar and superior to that of Diastix. When the children tested specimens containing up to only 2.2% glucose (N = 75), all test methods were shown to have generally similar accuracies. The diabetic children, however, preferred Chemstrip uG (P less than 0.02). It is concluded that Chemstrip uG is a clinically useful and acceptable method for self-monitoring of urine glucose in diabetic children.

Adolescent↗

PubMed1981

Assay of delta-aminolaevulinate dehydratase in 10 microL of blood.

A method is presented for the assay of delta-aminolaevulinate dehydratase (EC 4.2.1.24) to be performed on 10 microL of whole blood. Results compare favorably with those obtained with an accepted method (J. Clin. Chem. Clin. Bio-chem. 12: 389-390, 1974) that involves use of 200 microL of blood.

Blood Chemical Analysis↗

PubMed1996

Method for determination of free intracellular and extracellular methylglyoxal in animal cells grown in culture.

Methylglyoxal is present at low levels in most cells as a by-product of glycolysis and a product of lipid and amino acid catabolism. The most widely accepted method for measurement of methylglyoxal involves the derivatization of methylglyoxal with 1,2-diaminobenzene derivatives, such as o-phenylenediamine, followed by quantification of the resulting quinoxaline with high-performance liquid chromatography (HPLC). Here we describe the modification of this procedure for the measurement of free intra- and extracellular methylglyoxal in animal cells grown in culture. Cell harvest and sample volume measurement techniques were developed. Solid-phase extraction prior to methylglyoxal derivatization reduced interferences unique to cell culture, such as the phenol red indicator dye used in most cell culture media, and extended the useful life of the HPLC column. In addition, this extraction step significantly lessened the interference represented by oxidative degradation of nucleic acids to methylglyoxal by perchloric acid under assay conditions. The concentration of free intracellular methylglyoxal in Chinese hamster ovary (CHO) cells grown in culture ranged from 0.7 +/- 0.3 microM (mean +/- 2 standard deviations; n = 4) to 1.2 +/- 0.3 microM (mean +/- 2 standard deviations; n = 7). The concentration of free extracellular methylglyoxal in the growth medium was 0.07 +/- 0.02 microM (mean +/- 2 standard deviations; n = 4), severalfold less than that found inside the cell. A possible explanation for the difference between measured free intracellular and extracellular methylglyoxal levels is that the assay for free intracellular methylglyoxal also measures some reversibly bound methylglyoxal.

Animals↗

PubMed1997

Teenagers' use of emergency contraception in a general practice.

British teenagers who become pregnant commonly express ignorance about emergency contraception. A case-note survey was conducted in a general practice serving about 14,200 people in a Devon market town. Of the 373 registered girls aged 15-19 years, 59 (16%) had consulted for emergency contraception, 19 of them more than once. The oral method (Yuzpe regimen) was prescribed eighty times and 2 girls became pregnant. 4 of the 59 girls who used emergency contraception had subsequent unwanted pregnancies. A consultation for emergency contraception presents an opportunity to discuss more reliable and acceptable methods of contraception.

Adolescent↗

PubMed1981

Size and number of adipocytes and measures of body fat in boys and girls 10 to 18 years of age.

In 111 boys and girls, 10 to 18 yr of age, body density was measured by underwater weighing, and the size of adipocytes in adipose tissue from the buttocks was measured by the osmium tetroxide method. From these two measures, estimates of percentage body fat, total body fat, and adipocyte number were computed for most of the children. Their skeletal age was also calculated by an acceptable method. Across chronological age, the girls have significantly larger mean values of total and percentage body fat and larger and more numerous adipocytes than the boys. The mean number of adipocytes in each sex is within adult levels, as is the mean size of the adipocytes in the girls. The boys' mean adipocyte size is below the adult level. There are negative, significant correlations between percentage body fat and chronological or skeletal age in the boys, and positive significant correlations between total body fat and chronological or skeletal age in the girls. Also, adipocyte size is positively correlated with percentage body fat but only in the boys. With the effects of chronological age removed, percentage body fat was significantly and negatively correlated with skeletal age in boys only. All other correlations among the variables were not statistically significant.

Adipose Tissue↗

PubMed1990

Use of homology domains in sequence similarity detection.

We have found the detection of homology domains using a nonlinear similarity score and the DD algorithm to be a useful approach for identifying similarity between sequences and evaluating potential homology. There are several reasons for the success of the method. (i) Homology domains are identified by a rigorous method that guarantees they will be locally optimal. (ii) The relative significance of different homology domains can be directly compared using the nonlinear similarity score. (iii) Different cost matrices can be used in the calculation of the similarity score. (iv) Relatively long sequences can be compared in a single pass as storage requirements are proportional to the shorter of the two sequences being compared. (v) The method has proved to be very sensitive in practice. (vi) The boundaries of authentic regions of homology are accurately identified. (vii) The information required to define a homology domain (its location, size, similarity score, etc.) can be stored in a compact data structure, facilitating the sharing of homology domain data among different software tools. (viii) The method can be applied to similarity searches of the nucleotide and protein sequence data banks. These properties make the identification of homology domains for studying sequence similarity a useful companion to other accepted methods, such as dynamic programming based analyses.

Animals↗

PubMed1983

The telescoping plugged catheter in suspected anaerobic infections. A controlled series.

The results of bacterial cultures from transtracheal aspiration and from aspirations obtained by a new telescoping plugged catheter were compared in specimens taken from 13 patients with suspected anaerobic infections of the lower respiratory tract. When all bacterial isolates (potential aerobic pathogens, aerobic nonpathogens, and anaerobes) were counted with transtracheal aspiration as the standard method for comparison, cultures of material obtained by the telescoping plugged catheter technique yielded 22 false negatives and 14 false positives. The results of the 2 methods were in complete agreement in only 3 paired specimens cultured aerobically and in only 6 paired specimens cultured anaerobically. When only potential aerobic pathogens and anaerobes were considered with transtracheal aspiration as the standard method for comparison, cultures of material obtained by the telescoping plugged catheter technique yielded 11 false negatives and 7 false positives, and the results of the 2 methods were in complete agreement in 9 paired specimens cultured aerobically and 6 paired specimens cultured anaerobically. Our results suggest that fiberoptic bronchoscopy using the telescoping plugged catheter technique may be an acceptable method for collecting specimens from the lower respiratory tract, but further studies comparing this method with transtracheal aspiration are needed.

Adult↗

PubMed1982

[In vitro determination of the biological activity of choleragen by the anaerobic dehydrogenase inhibition test in a surviving blastoma cell culture].

A rapid method for the detection and titration of choleragen in vitro in the test allowing one to evaluate dehydrogenase activity in the surviving blastoma culture has been developed. In comparison with the commonly accepted method of using the ligated loop in adult rabbits, the above method is simple, highly sensitive and economical.

Anaerobiosis↗

PubMed1992

Comparison of three methods for detection of group A streptococci in throat swabs.

Group A streptococci are generally detected in throat swabs by (i) rapid antigen tests, (ii) conventional culture, or (iii) combinations of both. Direct fluorescent-antibody testing of a 2-h enrichment broth (FA/EN) was an accepted method for same-day results before the advent of rapid antigen tests. We compared FA/EN in Todd-Hewitt Broth (THB) with conventional culture and a rapid antigen test, TestPack Strep A (TPS). Nine hundred seventy specimens were evaluated in this study. Cultures were performed for 48 h on sheep blood agar (SBA) incubated aerobically and on a selective agar for group A streptococci (SSA) incubated in 5 to 10% CO2. Following a 2-h incubation, the fluorescent-antibody test was performed. A subculture of the centrifuged sediment from the THB enrichment was also done. In comparison with a positive culture on SBA or SSA or subculture of the THB pellet, the sensitivities and specificities of the different methods were as follows: SBA, 92 and 100%; SSA, 92 and 100%; TPS, 68 and 99%; FA/EN, 88 and 98%. The FA/EN method offers the potential for definitive finalized reports on the same day as specimen collection with greater sensitivity than TPS. This study included sequential plating and rapid antigen testing of a single swab. In a separate set of experiments to validate this study design, it was shown that recovery of streptococci from swabs plated sequentially on five plates did not vary with the order of plating and the actual proportion of organisms recovered from a swab on a single plate was only 1%.

Antigens, Bacterial↗

PubMedDate not supplied

Gastrointestinal foreign bodies and strictures: radiologic interventions.

Food impaction and foreign body ingestion are significant and sometimes life-threatening medical problems. As described in part 1 of this monograph, a variety of techniques and instruments are available to diagnose and treat these conditions. The radiologist interested in interventional procedures can find ample opportunities to participate in the management of esophageal obstructions by applying radiographic and fluoroscopic techniques to the diagnosis and removal of foreign bodies and food impactions. The recommended radiologic procedures are relatively safe, cost-effective, and efficient methods of addressing these serious situations. Stricture formation in the gastrointestinal tract is another significant medical problem that can often be managed nonoperatively by the radiologist. Fluoroscopically guided balloon dilatation has become an accepted method of effectively treating a large variety of strictures. As described in part 2 of this article, the technique is easy to perform, usually with very little inconvenience to the patient, and the risks of complications are very low. The procedure is relatively inexpensive and does not require the acquisition of any specialized or high-technology equipment. Also, the technique can be performed easily by any radiologist with interest in interventional procedures on the gut. A wide use of the fluoroscopic methods for treatment of impacted foreign bodies and strictures of the gastrointestinal tract is recommended.

Adolescent↗

PubMed1975

[Motivation and education].

It was thought for many years that successful motivation in oral health should be based on the knowledge of epidemiology of caries and periodontal diseases and the methods of prevention. One should learn from mistakes: 95 per cent of the Swiss population "suffers" from caries and periodontal disease but apparently this had little impact on prevention. Simple, world-wide accepted methods of prevention are not used by the majority although they provide a pronounced reduction of caries and gingivitis. The number of Swiss communities which offer adequate preventive programs to schoolchildren ranges between 5 to 10 per cent. Although the budgets of school dental services could be lowered by 75%. Reasons for such failures may be inadequate information of dentists, authorities and the population. Not enough information is spread regarding sugarless sweets, or prevention by fluoride. Unsuccessful motivation probably also lies in the inadequate assignment of the roles ofthe patient, his dentist and the social security. So far only the dentist has formulated oral health duties to the patient, e.g. a better oral hygiene, a reasonable healthy nutrition. In the future the patient should have the right to ask the dentist some questions. Is his dentition at the end of a treatment, healthy and ready to render hygienic efforts effective? Patient, doctor and insurances should know that disease still exists if gingival papillae bleed upon using a toothpick. Absence or presence of gingival bleeding are the criteria for health or disease. A check list of the state of oral health and a signed questionnaire concerning the patient's knowledge of oral health are used to improve motivation of both patient and dentist.

Dental Hygienists↗

PubMedDate not supplied

Pseudoephedrine absorption from controlled release formulations: absorption rate constant estimation methods.

Five methods of absorption rate (Ka) estimation were compared using data from a previously reported bioavailability study: Wagner-Nelson (WN), asymptotic WN (AWN), the Hendeles-Weinberger modification of the WN (HW), nonlinear regression performed on plasma concentration vs time data with fixed elimination rates (NL), and nonlinear regression performed on the cumulative sum of AUCs obtained during WN analysis (AUCNL). The maximum plasma concentration (Cmax) and the time at which Cmax occurred (Tmax) were predicted with each method's respective Ka's, and these were compared to observed values. The WN and HW were consistently biased in their predictions of Cmax and Tmax, providing slower Ka's than any of the other methods. AWN could only be used for the reference treatment. Both NL and AUCNL provided unbiased estimations, but AUCNL had a high level of imprecision. With this set of data, only NL was an acceptable method for accurately estimating Ka.

Adult↗

PubMed1999

Minimally invasive vascular surgery: review of current modalities.

The concept of a minimally invasive approach to the treatment of vascular pathology was realized nearly 30 years ago when Charles Dotter described dilatation of atherosclerotic stenoses. Since that time biotechnology and therapeutic innovation have progressed to the point where entire medical subspecialties are based on the endoluminal treatment of diseases of the blood vessels. The most rapid progress has been made in the area of endoluminal treatment of vascular lesions, with angioplasty, stent, and stent graft deployment becoming an increasingly common method of treating various vascular lesions. Extraluminal endoscopic treatment of vascular disease has been gaining popularity, particularly for management of perforator vein incompetence associated with venous stasis disorders. Endoscopic saphenous vein harvest has become an accepted method for minimizing the length of incision required for saphenectomy. Vascular imaging has followed similar trends, with more detailed information being derived from tiny intravascular ultrasonic catheters. This article summarizes the current state of minimally invasive vascular surgery to provide the reader with an understanding of the efficacy of the various modalities. It also discusses future directions in the field.

Angiography↗

PubMed1998

Assessing strength of preference for abortion method using 'willingness to pay': a useful research technique for measuring values.

Policy makers and practitioners need to differentiate between patient preferences which are strongly held, and those which are not. This study measured not only women's preferences for medical abortion versus surgical vacuum aspiration, but also the strength of these preferences, using a 'willingness to pay' (WTP) technique. Fifty women were recruited and interviewed prior to and following termination of early pregnancy. Due to the sensitivity of the situation, the WTP approach was administered by interview. Results revealed that 34 (64%) preferred to have the medical method. The amounts offered for each method were similar; however, a minority gave higher values for the medical method, thus for those women their strength of preference for that method was more intense. Validity of the technique was supported by the finding of a positive association with social class and the importance women attached to having choice. It is argued that WTP is an acceptable method for the elicitation of strength of treatment preferences. Its further use by nurses and midwives to assess health care preferences should be explored, particularly when considering aspects of care which are traditionally difficult to identify and measure.

Abortion, Induced↗

PubMed1979

Determination of vitamin D in foods: a review.

Determining vitamin D content in foods is difficult because in natural foods of highest vitamin D activity, and even in vitamin D-fortified foods, only small quantities are present, and many other compounds are extracted along with vitamin D that cause difficulties in purifying the extract or in the spectrophotometry or colorimetry that follows. Several physicochemical methods--such as spectrophotometric, colorimetric, thin-layer chromatographic, adsorption, partition, gas-liquid, and high-performance column chromatographic--have been tried for assay foods for vitamin D, but none of them have been accepted for official or routine use; they are time consuming and expensive, or lack the required sensitivity, precision, or accuracy. Curative biological assays, based on degree of healing of a leg bone of rats previously made rachitic, is the generally accepted method to determine vitamin D content of foods. However, that method also requires too much time and is expensive. The recently developed high-performance liquid chromatographic method may offer the most for establishing a satisfactory physicochemical method for determining vitamin D in foods. Many of the difficulties and problems in assaying foods for vitamin D are discussed.

Animals↗