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Results for “physiologic variables”

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PubMed1996

Variability of clinical and pressure-flow study variables after 6 months of watchful waiting in patients with lower urinary tract symptoms and benign prostatic enlargement.

PURPOSE: We quantified the physiological variability of clinical and pressure-flow study variables in patients with symptomatic benign prostatic enlargement. MATERIALS AND METHODS: Symptom scores were measured, and advanced urodynamic studies with pressure-flow analysis were performed in 178 patients before and 6 months after a period a watchful waiting. RESULTS: Patients without bladder outlet obstruction experienced significant symptomatic improvement. Symptoms in patients with obvious bladder outlet obstruction did not improve significantly. The reproducibility of mean pressure-flow variables was evident. However, there was an important intra-individual variability. Patients with obvious bladder outlet obstruction showed a significant decreases in detrusor pressure at maximal flow of 14cm. water, a significant decrease in the urethral resistance factor of 7 cm. water and a significant decrease of 1 obstruction class on the linear passive urethral resistance relation nomogram, indicating less severe bladder outlet obstruction. CONCLUSIONS: Mean differences among therapy groups must be regarded critically, especially when the difference are slight and possibly within physiological variability.

Aged↗

PubMed2001

Modelling and simulation of variability and uncertainty in toxicokinetics and pharmacokinetics.

Two important methodological issues within the framework of the variability and uncertainty analysis of toxicokinetic and pharmacokinetic systems are discussed: (i) modelling and simulation of the existing physiologic variability in a population; and (ii) modelling and simulation of variability and uncertainty when there is insufficient or not well defined (e.g. small sample, semiquantitative, qualitative and vague) information available. Physiologically based pharmacokinetic models are especially suited for separating and characterising the physiologic variability from the overall variability and uncertainty in the system. Monte Carlo sampling should draw from multivariate distributions, which reflect all levels of existing dependencies in the intact organism. The population characteristics should be taken into account. A fuzzy simulation approach is proposed to model variability and uncertainty when there is semiquantitative, qualitative and vague information about the model parameters and their statistical distributions cannot be defined reliably.

Animals↗

PubMed1977

A critical appraisal of two common "neonatal" experiment subjects.

A comparative study of 11 physiologic variables in 200 piglets and puppies during the first 7 days of life was done. Seven of 11 physiologic variables significantly changed in the 1st wk of the piglets' life. Five of 11 variables significantly changed in the first week of the puppies' life. Six of 11 variables were significantly different when the newborn piglet was compared to the newborn puppy. The rate and/or direction of 7 of 11 physiologic changes during the first day of life were significantly different when the piglet was compared to the puppy. It was concluded that there are marked physiologic differences between: the newborn piglets and the 7 day old piglet; the newborn puppy and the 7 day old puppy; the newborn piglet and the newborn puppy and the "maturation" rate of the piglet and the puppy.

Animals↗

PubMedDate not supplied

[Physical workload and maximum acceptable work time among supermarket workers in Cali, Colombia].

OBJECTIVES: In order to guarantee safety and health conditions in labor the maximum physical workload that can be supported by a worker during a labor day, without causing fatigue, must be determined. The objective of this study was to determine the relationship between the physical load, expressed as relative heart rate (RHR), and the maximum acceptable work time (MAWT) in a Colombian working population (n = 30) from a tropical environment. METHODS: An observational study was carried out during a typical labor day in the warehouses of a supermarket. Physiological, demographic, health and labor conditions data were collected. The resting heart rate level and the average heart rate during work were measured, and the RHR was estimated according to with the model described by Wu & Wang. RESULTS: Significant correlations between MAWT and RHR and other physiological variables were observed. 43% of workers didn't fulfill the MAWT. The only single variable that was associated with fulfillment was a body mass index under 18.5 Kg/m2; the other associated variables were some specific conditions of the occupational environment. Results showed a negative correlation between physiological variables and MAWT. The RHR showed its potential usefulness in the enterprise's occupational health practice. CONCLUSIONS: It is important for companies to diminish extended schedules and implement physical conditioning programs.

Adult↗

PubMed1980

Prediction of the parameters of whole body cholesterol metabolism in humans.

Total body turnover of cholesterol was studied in 54 subjects by fitting a three-pool mathematical model to plasma decay curves of 32--49 weeks duration following [14C]cholesterol injection. Fifteen subjects were normal, 10 hypercholesterolemic, 21 hypertriglyceridemic, and 8 had both hypercholesterolemia and hypertriglyceridemia; 21 had a familial form of hyperlipidemia. In every subject in this heterogeneous population, the three-pool model gave the best fit for the data. An extensive search was conducted for relationships between model parameters and physiological variables (body size, serum lipid levels, age, and sex). Both linear and nonlinear relationships, and those involving interactions between pairs of variables, were explored. Fifty different forms of the model parameters and 53 forms of the physiological variables were examined. To guard against declaring statistical significance when none was present, subjects were first randomly divided into two matched groups. In the first (hypothesis-generating) group of 36 subjects, more than 100,000 regression equations were considered for each form of the model parameters. Twenty-one highly significant equations were found that were then tested in the second group (hypothesis-testing, 18 subjects). Eighteen of the 21 equations were found to be significant; of these, 6 were selected that accounted for a large part of the observed variation in the four model parameters for which equations were found (production rate (PR), and the sizes of pool 1, pool 3, and total exchangeable body cholesterol). The major determinant of cholesterol PR was body weight alone (r = 0.80). No function of serum lipid levels significantly influenced PR. Both body weight and serum cholesterol level entered into the equations for cholesterol mass. Age influenced the size of pool 3. Serum triglyceride level only had an effect on the size of pool 1. Since these equations were generated in one group of subjects and tested in another, they can be considered a confirmed set of predictive equations.

Adult↗

PubMed1991

[Effect of the depth of anesthesia on the postoperative course].

An assessment of the influence of several variables during the perioperative period revealed a cause-determining correlation between the explanatory variables age, body size, weight, duration of operation, loss of blood, and pain level and the physiologic variables adrenaline, total protein, blood glucose level, transferrin, cholinesterase and immunoglobulin G that could be statistically be proven. An evaluation of the influence of the depth of anesthesia on this cause-determining correlation demonstrated significant advantages for a deep level of anesthesia. The depth of anesthesia should be seen as an influential factor during the perioperative period. Anesthesia should therefore not be regarded simply as analgesia and loss of consciousness; rather, one should stress the psychophysiological attenuation and its negative influence on the sensorimotor functions that are accompanied by changes in physiology. The central organ of regulation controls the physiological levels of the organism, and changes in brain function result in changes in physiology. During the perioperative period, rapid and programmed functional mechanisms that are controlled by more primitive parts of the brain and thus are not influenced by individual inappropriate decisions of the "higher" brain centers are needed for the patient's convalescence. This would explain the advantage of a deep level of anesthesia. The usual grading of stages of anesthesia according to Güdel provides little help in this respect; therefore, an assessment of the depth of anesthesia using EEGs and evoked potentials should be combined with an evaluation of physiological variables at several other levels of the organism such that further information can be obtained on the conditions existing at the onset of the postoperative course.

Adolescent↗

PubMed2002

Predicting recovery in patients suffering from traumatic brain injury by using admission variables and physiological data: a comparison between decision tree analysis and logistic regression.

OBJECT: Decision tree analysis highlights patient subgroups and critical values in variables assessed. Importantly, the results are visually informative and often present clear clinical interpretation about risk factors faced by patients in these subgroups. The aim of this prospective study was to compare results of logistic regression with those of decision tree analysis of an observational, head-injury data set, including a wide range of secondary insults and 12-month outcomes. METHODS: One hundred twenty-four adult head-injured patients were studied during their stay in an intensive care unit by using a computerized data collection system. Verified values falling outside threshold limits were analyzed according to insult grade and duration with the aid of logistic regression. A decision tree was automatically produced from root node to target classes (Glasgow Outcome Scale [GOS] score). Among 69 patients, in whom eight insult categories could be assessed, outcome at 12 months was analyzed using logistic regression to determine the relative influence of patient age, admission Glasgow Coma Scale score, Injury Severity Score (ISS), pupillary response on admission, and insult duration. The most significant predictors of mortality in this patient set were duration of hypotensive, pyrexic, and hypoxemic insults. When good and poor outcomes were compared, hypotensive insults and pupillary response on admission were significant. Using decision tree analysis, the authors found that hypotension and low cerebral perfusion pressure (CPP) are the best predictors of death, with a 9.2% improvement in predictive accuracy (PA) over that obtained by simply predicting the largest outcome category as the outcome for each patient. Hypotension was a significant predictor of poor outcome (GOS Score 1-3). Low CPP, patient age, hypocarbia, and pupillary response were also good predictors of outcome (good/poor), with a 5.1% improvement in PA. In certain subgroups of patients pyrexia was a predictor of good outcome. CONCLUSIONS: Decision tree analysis confirmed some of the results of logistic regression and challenged others. This investigation shows that there is knowledge to be gained from analyzing observational data with the aid of decision tree analysis.

Adult↗

PubMed1998

Low-dose flunarizine does not affect short-term fetal circulatory responses to acute asphyxia in sheep near term.

Asphyxia is one of the major causes of perinatal brain damage and neuronal cell loss, which may result in psychomotor deficits during later development. It has been shown previously that the immature brain can be protected from ischemic injury by flunarizine, a class IV calcium antagonist. However, cardiovascular side-effects of flunarizine, when applied at the dosages used in those studies, have been reported. Recently, the present authors were able to demonstrate that even by injecting flunarizine at a far lower dosage (1 mg kg-1 estimated bodyweight) neuronal cell damage, caused by occlusion of both carotid arteries for 30 min, can be reduced in fetal sheep near term. The aim of the present study was, therefore, to examine whether low-dose flunarizine affects fetal cardiovascular responses to acute asphyxia in sheep near term. Ten fetal sheep were chronically instrumented at a mean gestational age of 132 +/- 1 days (term is at 147 days). Fetuses from the study group received a bolus injection of flunarizine (1 mg kg-1 estimated fetal weight) 60 min before asphyxia, whereas the solvent was administered to the fetuses from the control group. Organ blood flows, physiological variables and plasma concentrations of catecholamines were measured before, during and after a single occlusion of uterine blood flow for 2 min (i.e. at 0, 1, 2, 3, 4, and 30 min). Before asphyxia, the distribution of combined ventricular output and physiological variables, as well as concentrations of catecholamines, in fetuses from the control group were in the normal range for chronically prepared fetal sheep near term. During acute asphyxia there was a redistribution of cardiac output towards the central organs accompanied by a pronounced bradycardia and a rapid increase in arterial blood pressure. After asphyxia circulatory centralization did not resolve quite as rapidly as it developed, but was almost completely recovered at 30 min after the insult. There were nearly no differences in the time course of physiological and cardiovascular variables measured before, during and after acute intrauterine asphyxia between the control and study groups. From the present study it was concluded that low-dose flunarizine does not affect short-term fetal circulatory responses to acute asphyxia in sheep near term.

Adrenal Glands↗

PubMed1984

Respiration as a reliable physiological sensor for controlling cardiac pacing rate.

A study was carried out to determine whether variations in the respiration rate during physical exercise could be used as a physiological variable in controlling the rate of an implanted pacemaker. The relation between respiration rate and heart rate was significantly correlated in 73 patients (19 with normal lung function, four with restrictive pulmonary disease, and 50 with obstructive airways disease) during repeated calibrated ergometric tests; no significant differences were found between the subgroups. An external computerised programmable system with algorithm control activated by a radio frequency system was used to vary the cardiac stimulation rate in relation to respiration rate in 11 patients implanted with ventricular inhibited pacemakers. In addition, a prototype programmable pacemaker dependent on respiration rate was implanted in two patients. Maximum values of oxygen uptake, minute ventilation, and work time were increased during the exercise stress tests when the variable cardiac pacing rate was used. Thus respiration rate appears to be a valid and stable physiological variable for controlling the cardiac stimulation rate in order to improve cardiac output in patients dependent on pacemakers.

Aged↗

PubMed2006

Artificial neural network versus subjective scoring in predicting mortality in trauma patients.

OBJECTIVE: Current methods of trauma outcome prediction rely on clinical knowledge and experience. This makes the system a subjective score, because of intra-rater variability. This project aims to develop a neural network for predicting survival of trauma patients using standard, measured, physiological variables, and compare its predictive power with that obtained from current trauma scores. METHODS: The project uses 7688 patients admitted to the Swedish Medical Center, Colorado, U.S.A. between the years 2000-2003 inclusive. Neural Network software was used for data analysis to determine the best network design on which to base the model to be tested. The model is created using a minimum number of variables to produce an effective outcome predicting score. Initial variables were based on the current variables used in calculating the Revised Trauma Score, replacing the Glasgow Coma Scale (GCS) with a modified motor component of the GCS. Additional variables are added to the model until a suitable model is achieved. RESULTS: The best model used Multi-Layer Perceptrons, with 8 input variables, 5 hidden neurons and 1 output. It was trained on 5881 cases and tested independently on 1807 cases. The model was able to accurately predict 91% patient mortality. CONCLUSIONS: An ANN developed using pre-hospital physiological variables without using subjective scores resulted in good mortality prediction when applied to a test set. Its performance was too sensitive and requires refinement.

Adolescent↗

PubMed2002

[Analysis of variability of physiologic parameters using the Poincare plot].

The noninvasive assessment of spontaneous temporal physiological parameters variations can provide valuable information about control systems involved in their complex regulations. Recently, in addition to conventional measures describing variability in time and frequency domains, methods based on nonlinear dynamics are increasingly used in physiology. The graphical analysis using Poincaré plot analysis with subsequent qualitative and quantitative analysis is one of them. The aim of this paper is to provide basic information about this method and its application in physiological research and clinical praxis.

Electrocardiography, Ambulatory↗

PubMed1998

Incremental prognostic value of adenosine myocardial perfusion single-photon emission computed tomography in women with suspected coronary artery disease.

Adenosine myocardial perfusion single-photon emission computed tomography (SPECT) is now increasingly used for risk stratification of patients with known or suspected coronary artery disease. However, the incremental prognostic value of this test over clinical and historical information in a large series of women has not been examined. Thus, we studied 923 consecutive women who underwent adenosine technetium (Tc)-99m sestamibi myocardial perfusion SPECT and were followed-up for a mean period of 26+/-8 months. During the follow-up period, 77 hard events (46 cardiac deaths and 31 nonfatal myocardial infarctions) occurred. The results of the perfusion scan significantly risk stratified the population; patients with normal scans had a low rate of nonfatal myocardial infarction and cardiac death (< 1%/year of follow up). Patients with mildly abnormal scans had low cardiac death rates (0.9%/year of follow up); these rates increased as a function of scan abnormality (4.1% and 7.5% mortality per year of follow up in moderate and severely abnormal scans). Cox proportional hazards analysis demonstrated that after adjusting for prior myocardial infarction and diabetes mellitus (the most predictive individual clinical variables [global chi-square=22.5, p <0.001]), as well as heart rate at rest (the most predictive physiologic variable [chi-square=3.8; p=0.05]), the most predictive nuclear variable (summed stress score [chi-square=48.5; p <0.0001]) added significant incremental prognostic information (global chi-square increased from 22.5 to 56.2 [p <0.0001]). In conclusion, adenosine myocardial perfusion SPECT added significant incremental prognostic information to clinical and physiologic variables in women. Normal scans were associated with an excellent prognosis. In contrast, patients with moderately to severely abnormal scans were at a higher risk for future cardiac events.

Adenosine↗

PubMed1994

Ratings of perceived thigh and back exertion in forest workers during repetitive lifting using squat and stoop techniques.

STUDY DESIGN: Local thigh and low back perceived exertion (RPE), sagittal peak load moments, and leg and trunk muscular activity during repetitive submaximal lifting, with squat and stoop technique, were investigated. OBJECTIVES: This study analyzed changes in kinetic variables caused by changes in body movements during the lifting bouts, and the contribution of the biomechanical and physiologic variables to the variability in the local RPE responses. SUMMARY OF BACKGROUND DATA: Despite instructions that emphasize the "correct" lifting technique as the squat technique, the stoop technique is reported as more commonly used in practice. Few studies have investigated the effect of lifting technique on differentiated perceptual responses in repetitive lifting. METHODS: Ten experienced forest workers performed submaximal repetitive lifting bouts until steady-state VO2 was reached, using five different weight and frequency combinations with both squat and stoop techniques. Borg's scale was used for RPE measurements. Muscular activity in lumbar, hip, knee extensors, and knee flexors was recorded with surface electrodes. Kinematic data was obtained from electronic liquid-level sensors, and vertical ground reaction forces from a two-dimensional force plate. RESULTS: Low back RPE was higher for stoop than for squat, whereas the opposite was true for thigh RPE. The total accountable variance (R2) for the biomechanical and physiologic variables to the RPE responses ranged from 0.25 (low back RPE in squat lifting) to 0.61-0.76 for the other assessments. During the time course in squat lifting at the highest frequency, the knee load moment decreased and the vertical ground reaction forces increased. CONCLUSIONS: The study indicates that "movement strategies" to reduce the demand on the knee-extensor muscles were used during the squat lifting bouts at the highest frequencies, which combined with the relatively high assessed thigh exertions, leads to the hypothesis that quadriceps muscle exertion is the "weak link" for the squat technique. The study also indicates a discrepancy between the measured and perceived low back stress in squat repetitive lifting.

Adult↗

PubMed2006

Intrapulmonary percussive ventilation improves the outcome of patients with acute exacerbation of chronic obstructive pulmonary disease using a helmet.

OBJECTIVE: To evaluate the effect of intrapulmonary percussive ventilation (IPV) by mouthpiece during noninvasive positive-pressure ventilation with helmet in patients with exacerbation of chronic obstructive pulmonary disease (COPD). DESIGN: Randomized clinical trial. SETTING: General intensive care unit, university hospital. PATIENTS: Forty patients with exacerbation of COPD ventilated with noninvasive positive-pressure ventilation by helmet were randomized to two different mucus clearance strategies: IPV (IPV group) vs. respiratory physiotherapy (Phys group). As historical control group, 40 patients receiving noninvasive positive pressure and ventilated by face mask treated with respiratory physiotherapy were studied. INTERVENTIONS: Two daily sessions of IPV (IPV group) or conventional respiratory physiotherapy (Phys group). MEASUREMENTS AND MAIN RESULTS: Physiologic variables were measured at entry in the intensive care unit, before and after the first session of IPV, and at discharge from the intensive care unit. Outcome variables (need for intubation, ventilatory assistance, length of intensive care unit stay, and complications) were also measured. All physiologic variables improved after IPV. At discharge from the intensive care unit, Paco2 was lower in the IPV group compared with the Phys and control groups (mean +/- sd, 58 +/- 5.4 vs. 64 +/- 5.2 mm Hg, 67.4 +/- 4.2 mm Hg, p < .01). Pao2/Fio2 was higher in IPV (274 +/- 15) than the other groups (Phys, 218 +/- 34; control, 237 +/- 20; p < .01). In the IPV group, time of noninvasive ventilation (hrs) (median, 25th-75th percentile: 61, 60-71) and length of stay in the intensive care unit (days) (7, 6-8) were lower than other groups (Phys, 89, 82-96; control, 87, 75-91; p < .01; and Phys, 9, 8-9; control, 10, 9-11; p < .01). CONCLUSIONS: IPV treatment was feasible for all patients. Noninvasive positive-pressure ventilation by helmet associated with IPV reduces the duration of ventilatory treatment and intensive care unit stay and improves gas exchange at discharge from intensive care unit in patients with severe exacerbation of COPD.

Acute Disease↗

PubMed1989

[The variability of physiological parameters as an index of the activity of the system of cerebral circulatory regulation].

Chronic experiments of rabbits revealed the regularities of alterations in the variability of parameters characterizing cerebral blood supply under orthostatic and hypercapnic effects. Their connexion with the degree of activation of the systems controlling the cerebral circulation, is determined. A technique of coupled loads was suggested for a more precise prognostication of the system responses to the action of factors with increasing strength.

Animals↗

PubMed2002

Aged men display blunted biorhythmic variation of muscle performance and physiological responses.

Aging is known to disrupt the "biological clock" that governs physiological variables at rest. This study sought to determine whether aged men demonstrated biorhythmic variation in muscle performance during resistance exercise and physiological responses to that stimulus. Ten aged (75.6 +/- 1.6 yr; mean +/- SE) men completed an isokinetic testing protocol of knee extensors and flexors at 0800, 1200, 1600, and 2000 h. Although time of day variation in peak torque was detectable, significant (P < or = 0.05) oscillation was established only in the knee flexors at 3.14 rad/s. Heart rate, blood pressure, and rectal temperature displayed no significant variation, but trends (P < 0.10) in oscillation of postexercise blood pressure and rectal temperature were noted. Temporal patterns in biorhythmic variation of muscle performance, as well as thermal and cardiovascular measures, emulated those observed in a previous study involving young men where the magnitude of variation was sufficient to achieve statistical significance. Similar to our earlier findings in young men, however, pre- and postexercise testosterone and cortisol concentrations demonstrated significant variation among aged men. These data confirm the blunting of biorhythmic variation in muscle performance and physiological variables, except for circulating hormones, in aged men.

Aged↗

PubMed1996

Plasma clearance rate of 51Cr-EDTA provides a precise and convenient technique for measurement of glomerular filtration rate in diabetic humans.

It has not yet been fully clarified whether the plasma or renal clearance approach is the most reliable to investigate GFR in humans. The study presented here aimed to compare plasma decay with renal clearance of 51Cr-EDTA in 27 diabetic patients with patterns of renal function broadly dispersed in a wide range of values. Moreover, the comparison was also performed with renal clearance of nonlabeled iothalamate in a subgroup of 17 patients. A biexponential function was found to fulfill statistical and heuristic criteria for the modeling analysis of plasma 51Cr-EDTA decay with 19 samples after bolus intravenous 51Cr-EDTA injection. Individual GFR values from 51Cr-EDTA plasma clearance highly correlated with those from renal clearance (r2 = 0.977, P < 0.0001), but resulted on average about 2.5 mL.min-1.1.73 m-2 higher (66.8 +/- 6.5 mL.min-1.1.73 m-2 (mean +/- SE) versus 64.3 +/- 6.4, P < 0.02). This difference remained relatively constant from patients with normal renal function to those with impaired renal function, suggesting that the plasma clearance is slightly less accurate than renal clearance approach because of a constant extrarenal clearance rate. In the subgroup studied, a similar difference was found between GFR values from 51Cr-EDTA plasma clearance (84.7 +/- 7.3) and renal clearance of iothalamate (82.8 +/- 7.3), although not statistically significant (P = 0.4). Individual GFR values well correlated (r2 = 0.913, P < 0.0001). The precision and reproducibility of the experimental approaches were assessed by comparing three coefficients of variation: (1) CVb of the bolus injection, because of measurement errors; (2) CVc of the continuous infusion, which additionally includes errors of urine volume measurement and physiological variability in the same day; and (3) CVr of repeated measurements by using bolus injection, which also accounts for physiological variability in different days. CVc of iothalamate and 51Cr-EDTA infusions were 7.5 +/- 1.9% and 7.4 +/- 1.2% respectively. CVb and CVr of bolus injection of 51Cr-EDTA were 2.6 +/- 0.3% and 3.5 +/- 0.8% respectively. CVb and CVr of bolus injection of 51Cr-EDTA, but not CVc of iothalamate and 51Cr-EDTA infusions were twofold to tenfold lower than the percent yearly change reported in IDDM and NIDDM patients. More particularly, CVr was significantly less than CVc. In order to make the test less cumbersome, a reduced sampling schedule with seven samples was designed and validated. GFR measured with seven samples was 66.1 +/- 6.4 (P = 0.1 when compared with the full 19-sample schedule) with a CVb of 3.5 +/- 0.5%. This seven-sample protocol was not different from that obtained with the previously described simplified method of Brøchner-Mortensen (63.9 +/- 6.8, P = 0.16), yet yielding a statistically more accurate estimate (coefficient of variation for Brøchner-Mortensen method = 12.1 +/- 2.9, P = 0.004). Moreover, only bolus injection, along with modeling analysis of plasma clearance rate, allows the accurate measurement of the extracellular fluid volume, an important parameter in diabetic patients. It was concluded that the reduced seven-plasma sample protocol is able to detect as small as 4 to 5% changes per year in a single patient. Moreover, it provides precise and accurate estimate of GFR in diabetic patients with hyperfiltration, who are postulated to be at higher risk to develop renal damage.

Chromium Radioisotopes↗

PubMed1981

Serum gastrin and the family environment in duodenal ulcer disease.

The study investigated the relationships between specific demographic, psychosocial, and physiological variables and the severity of duodenal ulcer disease in a population of patients with proved duodenal ulcer. Intercorrelations between psychosocial and physiological variables were also studied. The study design was cross sectional and retrospectively assessed life change units and DUD severity during the previous 6 months in 39 male ulcer clinic outpatients. Anxiety, depression, life change units, the family environment, ABO blood type, secretor status, serum pepsinogen, and serum fasting gastrin were evaluated. A DUD severity score was calculated from self-reported ulcer pain symptoms and ulcer complications. Gastrin levels correlated significantly with three Family Environment Scale (FES) subscales, including: (a) independence, (b) achievement orientation, and (c) expressiveness. Duodenal ulcer disease severity scores correlated with Zung SDS scores, but not with state or trait anxiety, life change units, or the FES.

Achievement↗