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PubMed1990

Quantitative genetic analysis of longitudinal trends in height: preliminary results from the Louisville Twin Study.

A preliminary series of quantitative genetic models was applied to a subset of longitudinal height data, spanning birth to maturity, gathered from twin families in the Louisville Twin Study. Descriptive Cholesky factor parameterization was found to give more satisfactory results than did a system of constraints based on a model of developmental transmission of a time-constant and time-specific factors. The results from application of two autosomal sex-limitation models are contrasted with those from a model specifying both autosomal and sex-chromosomal patterns of inheritance. The latter model was more conducive to parameter reduction. Although these models do not constitute conclusive tests of autosomal sex-limitation versus sex-linkage, the more parsimonious model is consistent with previous research suggesting a stature locus on the long arm of the Y chromosome. Heritability of height is estimated at about 90% or greater from 6 years of age on. Substantial and fairly constant longitudinal genetic correlations are found from 3 years of age on. Shared environmental effects unrelated to parental height were seen for birth length, corrected for gestational age, to height at 3 years of age, but these are not satisfactorily differentiated from possible twin effects in the present sample. The genetic consequences of assortative mating are emphasized since failure to take assortment into account can lead to overestimation of shared environmental effects and under-estimation of genetic effects. The results indicate that about 20% of within-gender variability for mature height can be attributed to the genetic consequences of assortment, even though the phenotypic marital correlation of 0.22 is quite modest. The importance of testing the assumption of multivariate normality underlying the application of the method of maximum-likelihood is also highlighted.

Body Height↗

PubMed2006

A unified single-event microkinetic model for alkane hydroconversion in different aggregation states on Pt/H-USY-zeolites.

A single-event microkinetic model for the catalytic hydroconversion of hydrocarbons on Pt/H-US-Y bifunctional zeolite catalysts developed for low-pressure vapor phase conditions was extended to cover high-pressure vapor phase and liquid phase conditions. The effect of the density of the bulk hydrocarbon phase on the physisorption as well as on the protonation steps of the reaction network was accounted for explicitly and can be interpreted in terms of "compression" of the hydrocarbon sorbate inside the zeolite pores and "solvation" of the catalyst framework by the dense bulk hydrocarbon phase. The bulk phase density effect on the physisorbed state is described via a single excess free enthalpy of physisorption. A dense bulk hydrocarbon phase destabilizes the sorbate molecules inside the catalyst pores. An expression of the excess free enthalpy of physisorption involving the fugacity coefficient and a zeolite dependent factor allows description of physisorption data. Typical excess free enthalpy values are in the range 1.5-5.1 kJ mol(-1) increasing with carbon number in the series of C5-C16 alkanes. At high-pressure vapor phase and liquid phase conditions, the excess standard protonation enthalpy is estimated at -7.8 kJ mol(-1) leading to relatively more stable carbenium ions at dense bulk phase conditions. As a result of the excess physisorption and protonation properties, the lightest hydrocarbons in mixtures are more competitive at dense phase conditions and their conversion is enhanced compared to low-density conditions.

Journal Article↗

PubMed1997

Predictors of response to subsequent chemotherapy in platinum pretreated ovarian cancer: a multivariate analysis of 704 patients [seecomments].

BACKGROUND: The probability of response to chemotherapy following platinum based treatment in ovarian cancer has usually been related to the 'platinum-free interval'. However, in a recent European-Canadian trial of paclitaxel, serous histology, tumor bulk, and hemoglobin, but not treatment free interval, were predictors of response. To determine if these observations were unique to this study (or this drug), data from other active agents given as second- or third-line treatment in ovarian cancer were obtained and analyzed. METHODS: In the first part of the study, results of trials in 1185 platinum pretreated ovarian cancer patients were obtained on six agents: paclitaxel, epirubicin, docetaxel, carboplatin, irinotecan, and gemcitabine. Response results according to histology, baseline hemoglobin, tumor size and time from last chemotherapy were determined for each agent and the Cochran-Mantel-Haenszel procedure was used to obtain an overall assessment of significance for each factor. In the second part of the study, individual data from 704 patients in four studies (three agents: paclitaxel, docetaxel and epirubicin) were pooled for univariate and multivariate analysis of factors predictive of response. RESULTS: In the analysis of results of individual agents all factors examined were significant predictors of response: serous histology (P = 0.001), tumor size < or = 5 cm (P = 0.02), normal baseline hemoglobin (P = 0.003), and > or = 6 mo since last treatment (P = 0.001). While these results were interesting, they did not supply definitive answers regarding independent response predictors. Therefore a multifactor analysis was undertaken on the 704 patients for whom individual data were available. Of the 11 factors examined in a univariate analysis, 10 met the criteria for inclusion in a stepwise logistic regression. In the final model only 3 factors remained as significant independent predictors of response: serous histology (P = 0.009), no. disease sites (P = 0.003), and tumor size (P = 0.001). Time from last treatment, when evaluated as a continuous variable, was not in the final model and was highly correlated with tumor size (P = 0.0005). CONCLUSIONS: On the basis of this analysis, we conclude that tumor burden (as assessed by size of the largest lesion and number of disease sites) and histology are factors of importance in response to subsequent chemotherapy in relapsed ovarian cancer. Time from last treatment was correlated with tumor size in this data set and its effect on response was dependent on whether it was examined as a categorical or continuous variable, so we conclude it is not the sole critical factor of biologic importance. We recommend description of these factors in reports of phase II studies, confirmation of these findings in other data sets and further investigation of the mechanism of sensitivity of serous tumors.

Female↗

PubMed2001

Perceptions of body image, happiness and satisfaction in adolescents wearing a Boston brace for scoliosis treatment.

AIMS: To explore the impact of bracing on the perceptions of body image, happiness and satisfaction of adolescents with scoliosis. DESIGN: The study was designed as compare of 134 girls and 16 boys who wore a Boston type brace for scoliosis treatment and a control group of 99 healthy girls and 51 healthy boys. All them were secondary school pupils living in Athens Greece and were interviewed. A semi-structured schedule included general questions, and the Piers-Harris scale was used. Data were analysed using the SPSS/PC+ software, and descriptive statistics, factor analysis and the non-parametric Mann-Whitney U-test. Statistical significance was set at P=0.05 or less. RESULTS: The scoliosis group had a poorer perception of body image in comparison to the control group (P=0.048), while boys with scoliosis (P=0.030) had a better perception of body image than girls with scoliosis. Girls with scoliosis had a statistically significant difference (P=0.0388) in perception of happiness and satisfaction, in comparison with girls in the control group. Cohabitation with the mother seemed to be negatively correlated with body image, happiness and satisfaction perceptions because adolescents with scoliosis who were not living with their mother had a better body image perception (P=0.027) as well as better perceptions of happiness and satisfaction (P=0.047). Nevertheless, only 5% of those with scoliosis declared that they had opportunities to discuss their feelings and problems with health professionals, while 90% of them declared that they wanted to have more opportunities to do this. CONCLUSION: Adolescents with scoliosis face problems during bracing and they need to be supported by health care professionals.

Adolescent↗

PubMed1998

Perineal outcomes in a home birth setting.

BACKGROUND: Perineal lacerations are a source of significant discomfort to many women. This descriptive study examined perineal outcomes in a home birth population, and provides a preliminary description of factors associated with perineal laceration and episiotomy. METHODS: Data were drawn from a prospective cohort study of 1404 intended home births in nurse-midwifery practices. Analyses focused on a subgroup of 1068 women in 28 midwifery practices who delivered at home with a midwife in attendance. Perineal trauma included both episiotomy and lacerations. Minor abrasions and superficial lacerations that did not require suturing were included with the intact perineum group. Associations between perineal trauma and study variables were examined in the pooled dataset and for multiparous and nulliparous women separately. RESULTS: In this sample 69.6 percent of the women had an intact perineum, 15 (1.4%) had an episiotomy, 28.9 percent had first- or second-degree lacerations, and 7 women (0.7%) had third- or fourth-degree lacerations. Logistic regression analyses showed that in multiparas, low socioeconomic status and higher parity were associated with intact perineum, whereas older age (>/= 40 yr), previous episiotomy, weight gain of over 40 pounds, prolonged second stage, and the use of oils or lubricants were associated with perineal trauma. Among nulliparas, low socioeconomic status, kneeling or hands-and-knees position at delivery, and manual support of the perineum at delivery were associated with intact perineum, whereas perineal massage during delivery was associated with perineal trauma. CONCLUSIONS: The results of this study suggest that it is possible for midwives to achieve a high rate of intact perineums and a low rate of episiotomy in a select setting and with a select population.

Adult↗

PubMed2003

Prognostic factors in Waldenstrom's macroglobulinemia: description of the complications during the evolution-preliminary results on 101 patients.

Data on clinical features observed in patients with Waldenstrom's macroglobulinemia (WM) during follow-up remain limited. Therefore, we evaluated 860 follow-up procedures in 101 patients. Median age was 66 years and 5-year overall survival 72%, with a median follow-up of 36 months in surviving patients. Sixteen patients presented at diagnosis with two or three cytopenias lasting for at least 3 months (multiple cytopenias [MC]), and MC improved after treatment in eight patients, 4 to 18 months later. MC was observed during at least 6 consecutive months in 23 other patients, 2 to 73 months (median, 24) after diagnosis. MC occurred off-therapy in 12 patients, and on-therapy in 11. Regression occurred in three of the former patients, and in seven of the latter (6 to 24 months after completion of treatment; median, 7). Finally, the 4-year estimated cause-specific cumulative incidence was 40% in the 101 patients. A second malignancy was observed in 11 patients, histological transformation in three, and rapid rise of M-component in only six patients. In conclusion, the present analysis pointed out a high incidence of long lasting MC during the evolution of WM, and a low frequency of rapid rise of M component.

Adult↗

PubMed1990

New narcissism scales for the California Psychological Inventory and MMPI.

New Narcissism scales for the California Psychological Inventory (CPI) and the Minnesota Multiphasic Personality Inventory (MMPI) were developed on the basis of DSM-III criteria and the writings of Akhtar and Thomson (1982), Kernberg (1975) and Kohut (1971, 1977). Self-report protocols from 152 adults and 198 college students were utilized. Rationally selected preliminary items were retained or discarded according to their alignment with the total score on these items. The resulting 49-item CPI and 39-item MMPI scales correlated .81 with each other, and significantly so at p less than .01 with ratings of narcissism, the Raskin-Hall Narcissistic Personality Inventory (NPI) and the MMPI Narcissism scale of Morey, Waugh, and Blashfield. Personological implications of the two new scales were examined in relation to other measures and to observers' adjectival and Q-sort descriptions. Intrascale factor analyses identified five common themes: Cathexis of Power, Risk-Seeking Propensity, Need for Attention, Disesteem for Others, and Impatient Willfulness.

Adult↗

PubMed1999

Outbreak of post-parturient haemoglobinuria in an autumn calving dairy herd.

AIM: Description of factors relating to an outbreak of post-parturient haemoglobinuria in a dairy herd in New Zealand. HISTORY: Fifty cows out of 300 newly autumn calved cows, at about 3 weeks post partum, developed signs of anorexia, jaundice, anaemia, red urine, and 14 died. Many cows were severely inappetant. Others were subclinically affected, as indicated by partial inappetance. Routine haematological examinations carried out at this time revealed a profound regenerative anaemia, and serum phosphorus concentrations were markedly decreased, giving a diagnosis of post-parturient haemoglobinuria. The cows had been through a severe drought, but were in good condition. They were being fed a combination of grass, barley and a mix of fruit, vegetable cannery waste and silage. Analysis of the grass, milker mix and silage, which formed a component of the milker mix, revealed a marginally low phosphorus concentration in the silage. TREATMENT: The cows were treated by phosphorus supplementation and supportive treatment, and most eventually recovered.

Journal Article↗

PubMed1998

Evaluation of a Swedish version of the Hearing Disabilities and Handicaps Scale, based on a clinical sample of 101 men with noise-induced hearing loss.

The aim of this study was to evaluate, in terms of descriptive statistics, factor analysis, corrected item-total correlations, and internal consistency reliability, a Swedish translation of the Hearing Disabilities and Handicaps Scale (HDHS). The HDHS is shortened and modified version of the Hearing Measurement Scale. Data from 101 men having noise-induced hearing loss, with the pure-tone audiometric data showing a median value of 53.3 dBHL (R = 81.6; Q = 12.5) over the frequencies 3, 4, and 6 kHz better ear, were assessed at the Department of Audiology, Sahlgrenska University Hospital, Göteborg. A principal component analysis followed by a varimax rotation was conducted giving four emerging factors, accounting for 64.6% of the variance. Two of the factors, "speech perception" (alpha = 0.89) and "non-speech sounds" (alpha = 0.85), appear to measure perceived disability, whereas two factors, "interpersonal distress" (alpha = 0.79) and "threat to self-image" (alpha = 0.84), appear to measure dimensions related to the process of creating a handicap. The four-factor HDHS needs to be further tested in order to find out its usefulness for clinical assessment of perceived disability and handicap.

Adolescent↗

PubMed1995

Dietary correlates of fat intake.

Dietary fat intake has been associated with the development of chronic diseases, including heart disease and cancer, in human populations; however, associations demonstrated between disease and fat intake may be confounded by related dietary factors. Therefore, description of the correlates of fat intake in free-living adults may help identify important confounders independent of disease status. In a population of 863 women and 538 men between the ages of 50 and 85 randomly selected from two counties in western New York, we found that most nutrients were correlated with grams of total fat intake including protein, carbohydrates, cholesterol, dietary fiber, retinol, iron, and calcium. Carbohydrates and dietary fiber were not related to the concentration of fat in the diet (% of energy from fat). Alcohol intake was negatively associated with fat concentration for men but not for women. Particularly important for the study of cancers, the antioxidants carotene and ascorbic acid were negatively associated with fat concentration in the diet.

Aged↗

PubMedDate not supplied

Self-reported outcomes of aural rehabilitation in a developing country.

The aim of this study was to evaluate self-reported outcomes among hearing aid users (age 16-89 years; mean 45.8 years) to determine the effectiveness of aural rehabilitation in Nigeria based on the International Outcome Inventory for Hearing Aids (IOI-HA). The responses were evaluated with descriptive statistics, factor analysis of the principal components and multiple regressions. Most respondents reported favorable outcomes in all domains of the inventory, comprising: daily use (mean 4.1; SD 1.2), benefits (mean 3.5; SD 1.1), residual activity limitation (mean 3.4; SD 1.2), satisfaction (mean 3.7; SD 1.2), residual participation restriction (mean 3.5; SD 1.3), impact on others (mean 3.4; SD 1.3) and changes in quality of life (mean 3.8; SD 1.0). The mean score distribution compared favorably with those reported in the developed world. There were significant intercorrelations among all items, and two factors (eigenvalue>1) accounted for 68% of the underlying variance. Impact on others was the only domain associated with demographic/audiologic variables. The study showed that aural rehabilitation is feasible and effective in enhancing activity and participation for the hearing impaired in a developing country.

Adolescent↗

PubMed1997

Brief description of the Multiple Risk Factor Intervention Trial.

The Multiple Risk Factor Intervention Trial (MRFIT) was one of the coronary heart disease prevention trials recommended to the National Heart and Lung Institute in 1971 as an alternative to a national single-factor dietary trial, which was judged to be infeasible. MRFIT was a randomized, primary prevention trial, conducted at 22 US clinical centers from 1973 to 1982 to test whether lowering elevated serum cholesterol and diastolic blood pressure and ceasing cigarette smoking would reduce coronary heart disease mortality. Men 35-57 y of age (n = 12,866) with one or more of these risk factors were randomly assigned to the special intervention (SI) or usual care (UC) group and followed for 6-8 y. UC men were given information on risk factors, referred to their usual sources of care, and reexamined annually. SI participants received group and individual counseling on a fat-modified diet, a stepped-care drug treatment program for diastolic hypertension (after an initial attempt at blood pressure control by weight reduction, if indicated), and, for cigarette smokers, counseling aimed at cessation. SI men had risk factor assessments every 4 mo and annual examinations that were generally identical to those given to UC men and that always included measurement of blood cholesterol concentration. A listing of variables measured at each visit along with the design and major mortality results of MRFIT are included in this chapter.

Adult↗

PubMed2006

Malignant melanoma in Turkey: a single institution's experience on 475 cases.

BACKGROUND: This study was performed to determine the characteristics and the clinical outcomes of patients with cutaneous melanoma in Turkey. METHODS: The medical records of patients between 1991 and 2003 at Institute of Oncology were retrieved from the cancer registry. RESULTS: Of the 475 adult cases with complete staging procedure, the incidence of localized (stages I-II) disease was 301 (63.4%), and followed by node involved (stage III) and metastatic (stage IV) disease with the incidence of 117 (24.6%) and 57 (12.0%), respectively. The median age of patients was 50 years (17-104 years) and male/female ratio was 1.1. Of 206 patients (43.4%) the diseases were located on extremities, 150 (31.6%) on the trunk, and 102 (21.5%) on the head and neck region. In cases with early/node negative stage, stage distribution was identical. The superficial spreading type was the commonest histology (52.2%). The Breslow thickness distributed equally, whereas tumor invasion aggregated mainly at Clark level III and IV. Half of the lesions were ulcerated and with low mitotic potential. In cases with the node involved stage, the majority of patients had only one lymph node involved. In metastatic patients, two thirds had distant metastases including lung metastases and half of them had single metastatic region. With the median follow-up of all patients of 5.2 years, the median overall survival of all patients was 62.2 months and the 5-year overall survival was 50.5%. Overall survival was significantly negatively correlated with male (P<0.001), advanced stages (P<0.001) and old ages (P=0.005). The five-year survival rates of patients with stages I-II and III disease were 63.6% and 36.6%, respectively. Nodular histology subtype, deeper Breslow tumor depth, extensive invasion, presence of ulceration, advanced stage, presence of relapse, being male and elderly patient, presence of visceral recurrence, and high mitotic activity were found to be associated with poor prognosis for overall survival in localized disease. The median survival of metastatic patients was 9.9 months and 1-year overall survival rate was 32.7%. Unresponsiveness to chemotherapy, visceral metastasis, multiple metastases and not given chemotherapy were the poor prognostic factors for overall survival. CONCLUSION: The descriptive and prognostic factors in Turkey are similar to those in Western countries.

Adolescent↗

PubMed1989

Leisure time physical activity in the Framingham Offspring Study. Description, seasonal variation, and risk factor correlates.

Self-reported leisure time physical activity was analyzed for 1,598 men and 1,762 women aged 20-69 years in the Framingham Offspring Cycle 2 exam in 1979-1983. Walking for pleasure was generally the most common physical activity for both sexes throughout the year. Substantial seasonal variation was noted for the most common activities: gardening, carpentry, lawn mowing, golf, and running for men; and gardening, swimming, health club exercise, dancing, and bicycling for women. Both sexes expended more kilocalories in physical activities in summer than in winter (p less than 0.001). Frequency of participation in activities sufficient to induce perspiration was associated with frequency of participation in at least one hour of conditioning (greater than or equal to 7.5 kilocal/minute) activities per week (p less than 0.001). Based on age-adjusted mean levels, higher high density lipoprotein cholesterol, lower heart rate, lower body mass index and fewer cigarettes smoked per day were consistently observed across four quartiles of increasing physical activity levels (p less than 0.01). Men who participated in at least one hour of conditioning activities per week had significantly different mean levels for these four risk factors than men who reported less than one hour of such activities per week (p less than 0.001). Results substantiate previous reports of an inverse relation between physical activity levels and cardiovascular risk, and suggest seasonal variation in activity levels should be considered in future studies which explore the relation between physical activity and cardiovascular disease.

Adolescent↗

PubMed1978

Benign fatty tumors of the peripheral nerves.

Fatty tumors of the peripheral nerves, although rare, occur with sufficient frequency to pose problems in diagnosis and treatment. Moreover, the nomenclature of these tumors has suffered from controversy over their morpological description. These factors have contributed to a misunderstanding about the treatment of these localized nerve abnormalities leading, in the past, to unnecessary radical nerve excisions with resultant total motor and sensory deficit. This paper reviews the various types of fatty tumors, describes the morphology and pathophysiology of one such lesion, and provides a basis for a rational surgical approach.

Adolescent↗

PubMed2002

An item analysis of the COMFORT scale in a pediatric intensive care unit.

OBJECTIVE: The objective of this study was to conduct an item analysis of the COMFORT scale within a sample of critically ill children. The COMFORT scale is a tool that measures eight clinical parameters at the bedside to determine a critically ill child's level of distress. However, documentation of the reliability and validity of specific components of this instrument has been limited to date. DESIGN: This was an observational study. SETTING: A tertiary care pediatric intensive care unit. PATIENTS: A sample of 18 intubated, mechanically ventilated patients. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: An item analysis of the COMFORT scale was conducted. The scale was used for variable intervals with each child, providing a total of 514 individual completed ratings. These ratings were then submitted to descriptive, correlational, factor, and regression analyses using the Statistical Package for the Social Sciences. The principal finding of this item analysis was that 97% of the total score variance was explained by six of the eight items. In particular, it was remarkable that heart rate and blood pressure demonstrated very limited reliability and validity as determinants of the total COMFORT score. As well, the clinical experience of the investigators with this scale has demonstrated that these two items can be cumbersome to use, given that these parameters are often affected by hemodynamic factors. CONCLUSIONS: On the basis of these findings, we propose a modified COMFORT scale based on a six-item scoring system. This modified scale would provide a more reliable and valid measure for research as well as clinical purposes, by eliminating two parameters that can be affected by factors other than the child's level of distress.

Journal Article↗

PubMed2006

The prognosis of major and minor depression in older medical inpatients.

BACKGROUND: Major and minor depression is frequent in older medical inpatients, but the prognosis of these two disorders is not clear. The current study proposed to determine the prognosis of major and minor depression in this population. METHOD: This prospective, observational cohort study, conducted in Montreal, Quebec, Canada, involved assessment of 380 elderly medical inpatients with major, minor, or no depression at three, six, and 12 months after enrollment using the Diagnostic Interview Schedule and Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria. Information on suicide attempts, completed suicides, and potential prognostic factors was also collected. Analysis of outcomes and potential prognostic factors involved descriptive statistics and multiple logistic regression. RESULTS: Among patients with major depression at enrollment, 13% were recovered, 14% were partially recovered, and 73% remained depressed with a protracted stable or protracted fluctuating course. Among patients with minor depression, 28% were recovered and 72% had a protracted course. Patients diagnosed with major depression at enrollment often had minor depression at follow up and vice versa. CONCLUSION: The prognosis of both major and minor depression in older medical inpatients is poor and worse than previously thought.

Activities of Daily Living↗

PubMed1985

Factors affecting intracranial pressure: a descriptive study.

This study examined the effects of 365 occurrences on the intracranial pressure (ICP) of four patients with severe head injuries and a Glasgow Coma Score below five. The occurrences were in: 1) health care activities, 2) patient-initiated activities, and 3) environmental stimuli. The health care activities that increased intracranial pressure were suctioning, turning, and flexion of the head; decreases were realized by elevating the head of the bed and repositioning the patient. The patient-initiated activities that increased intracranial pressure were flexion of extremities, rotation of the neck, and coughing. In contrast to previous reports, environmental stimuli did not affect intracranial pressure and bathing increased it. Recommendations for nursing care include: turning patients more slowly to less acute angles; proper head/neck positioning; and more direct psychosocial interactions with families of patients who have low Glasgow Coma Scores.

Adult↗