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PubMed2006

Accuracy of physical examination, ultrasonography, and mammography in predicting residual pathologic tumor size in patients treated with neoadjuvant chemotherapy.

OBJECTIVE: To assess the accuracy of physical examination, ultrasonography, and mammography in predicting residual size of breast tumors following neoadjuvant chemotherapy. BACKGROUND: Neoadjuvant chemotherapy is an accepted part of the management of stage II and III breast cancer. Accurate prediction of residual pathologic tumor size after neoadjuvant chemotherapy is critical in guiding surgical therapy. Although physical examination, ultrasonography, and mammography have all been used to predict residual tumor size, there have been conflicting reports about the accuracy of these methods in the neoadjuvant setting. METHODS: We reviewed the records of 189 patients who participated in 1 of 2 protocols using doxorubicin-containing neoadjuvant chemotherapy, and who had assessment by physical examination, ultrasonography, and/or mammography no more than 60 days before their surgical resection. Size correlations were performed using Spearman rho analysis. Clinical and pathologic measurements were also compared categorically using the weighted kappa statistic. RESULTS: Size estimates by physical examination, ultrasonography, and mammography were only moderately correlated with residual pathologic tumor size after neoadjuvant chemotherapy (correlation coefficients: 0.42, 0.42, and 0.41, respectively), with an accuracy of +/-1 cm in 66% of patients by physical examination, 75% by ultrasonography, and 70% by mammography. Kappa values (0.24-0.35) indicated poor agreement between clinical and pathologic measurements. CONCLUSION: Physical examination, ultrasonography, and mammography were only moderately useful for predicting residual pathologic tumor size after neoadjuvant chemotherapy.

Adult↗
PubMed1999

2-D and 3-D reconstructions of spiral computed tomography in localization of the inferior alveolar canal for dental implants.

OBJECTIVE: The purpose of this study was to compare and validate the accuracy of measurements on 2-dimensional and 3-dimensional reconstructions from spiral computed tomography in localization of the inferior alveolar canal. STUDY DESIGN: Four edentulous human cadaver heads with intact mandibles were imaged in a spiral computed tomography scanner. The data were transferred to a networked computer workstation to generate 2-dimensional orthoradially reformatted and 3-dimensional volumetric images. Linear measurements of the images were made from the superior border of the inferior alveolar canal to the alveolar crest. The specimens were then dissected at corresponding locations, and physical measurements were made. RESULTS: There were no statistically significant differences between the 2-dimensional computed tomography measurements and the physical measurements or between the 3-dimensional computed tomography measurements and the physical measurements. However, we did find a statistically significant difference between the 2-dimensional and 3-dimensional computed tomography measurements. CONCLUSIONS: 2-dimensional and 3-dimensional computed tomography images allow accurate measurements for localization of the inferior alveolar canal.

Adult↗
PubMed1984

[A statistical approach to measure fitness by PWC170].

This paper discusses measurements of physical work capacity. When the sample size is small, its model selection problem is difficult in the multiple regression analysis. Although the development of model selection may be correct, it is not always useful for practical data. Since the number of the parameters is large compared with the sample size, we shall discretize continuous data into categorical data and shall use the CATDAP program.

Computers↗
PubMed1990

Biological age versus physical fitness age in women.

The purpose of this study was to determine whether adult women who are in a state of high physical fitness are in a good state biologically, in terms of biological and physical fitness ages as estimated by statistical means. The subjects were 65 healthy Japanese women (aged 20-64 years). Biological and physical fitness ages were estimated from the data for 18 physiological function tests and 5 physical fitness tests, respectively, by a principal component model. The correlation coefficient between biological and physical fitness ages was 0.70 (P less than 0.01), which was generally regarded as a high correlation. Therefore, those who were in a state of high physical fitness were considered to be in good biological condition. This result is in good agreement with the results (r = 0.72) from adult men, on whom we reported previously. A statistical analysis to ascertain the relative importance of each contributory variable associated with the variance in biological age suggested that routine clinical evaluation of blood pressure and lipid metabolism might play an important role in determining not only the presence and severity of vascular disease but also the rate of biological aging in women.

Adult↗
PubMed2004

Many-body theory of chemotactic cell-cell interactions.

We consider an individual-based stochastic model of cell movement mediated by chemical signaling fields. This model is formulated using Langevin dynamics, which allows an analytic study using methods from statistical and many-body physics. In particular we construct a diagrammatic framework within which to study cell-cell interactions. In the mean-field limit, where statistical correlations between cells are neglected, we recover the deterministic Keller-Segel equations. Within exact perturbation theory in the chemotactic coupling epsilon , statistical correlations are non-negligible at large times and lead to a renormalization of the cell diffusion coefficient D(R)--an effect that is absent at mean-field level. An alternative closure scheme, based on the necklace approximation, probes the strong coupling behavior of the system and predicts that D(R) is renormalized to zero at a critical value of epsilon, indicating self-localization of the cell. Stochastic simulations of the model give very satisfactory agreement with the perturbative result. At higher values of the coupling simulations indicate that D(R) approximately epsilon(-2) , a result at odds with the necklace approximation. We briefly discuss an extension of our model, which incorporates the effects of short-range interactions such as cell-cell adhesion.

Algorithms↗
PubMed1991

[Epidemiologic study on factors related to physical locomotion ability among the aged].

The present study was conducted in order to examine epidemiologic factors related to physical locomotion ability among the aged in an area with long life expectancy, a village in Okinawa Prefecture. Medical examinations and interviews were performed for 756 inhabitants aged 65 years and older, who were classified into 2 groups of physical locomotion ability, a high group and a low group. According to the results after multiple logistic regression analysis, the following factors showed positive relation to physical locomotion ability: age, working status, food intake frequencies (fish, eggs and green vegetables), skinfold thickness, grip strength and serum albumin. However, no statistical associations were observed between physical locomotion ability and other factors such as sex, smoking status, alcohol intake, hypertension, Quetelet's index, serum total cholesterol or and hemoglobin.

Aged↗
PubMed1979

Effects of repeated testing on the reliability of fitness scores of institutionalized mentally retarded individuals.

This study was designed to determine the effects of repeated trials on the reliability of physical fitness performance scores of 36, 12- to 20-year-old institutionalized mentally retarded children. They were tested 2 days a week for 5 consecutive weeks on the physical fitness criterion tests. The statistical analysis indicated no significant differences between trial scores on any variable over the 5 weeks. This lack of significance on all the physical fitness criterion tests suggests that administering all the trials on each item on one occasion is appropriate.

Adolescent↗
PubMed1998

The role of anxiety and depression in quality of life and symptom reporting in people with diabetes mellitus.

Although quality of life evaluations are widely used throughout medicine, relatively little is known about the psychological processes involved in making these judgements. What is known is that quality of life judgements are not straightforwardly associated with objective measures of health status or clinician ratings. In particular, patient affect appears to be associated with quality of life ratings but whether this relationship is secondary to physical health or not is controversial. The aim of this study was to determine the role of anxiety and depression in the reporting of quality of life in a group of patients with diabetes mellitus. One hundred consecutive patients with diabetes (insulin-dependent diabetes mellitus n = 36 and non-insulin-dependent diabetes n = 64) were assessed using a self-report measure of quality of life, a symptom checklist and a questionnaire measure of anxiety and depression. In addition, they were independently rated for their level of physical impairment. The results showed that depression and, to a lesser extent, anxiety were significantly related to self-reported quality of life even when the differences in physical health and age were controlled for statistically. This study shows that, independent of the level of physical illness, affect, particularly depressive affect, is an important factor in the determination of quality of life.

Activities of Daily Living↗
PubMed1994

[Budesonide in the treatment of mild asthma. A placebo-controlled multicenter study in general practice].

Fifty patients with mild asthma were randomized in a double-blind, parallel group design; 13 were protocol violators. Of the remaining 37, 20 patients were treated with budesonide, 17 with placebo. The Peak Expiratory Flow rate (PEF) was the main variable. In a diary, patients recorded PEF morning and evening, score of asthma symptoms and use of inhaled beta 2-agonist. Peak-flow and Goldberg's General Health Questionnaire were obtained at clinic visits. Parametric and non-parametric tests were used. All tests were two-tailed with a significance level of 0.05. The study proved that changes in the patients' PEF happened in the early phase of the treatment period. The increase in both morning and evening PEF and physical activity in the budesonide group were statistically significantly better than in the placebo group. There was no statistical difference between the two groups concerning the patients' general well-being as evaluated by Goldberg's General Health Questionnaire. No serious adverse events occurred. The conclusion is that patients with mild asthma had statistically significant effect on their morning and evening PEF and physical activity from treatment with a daily dose of 400 microgrammes budesonide given via Turbuhaler compared to treatment with placebo.

Administration, Inhalation↗
PubMed2002

Manual therapy, physical therapy, or continued care by a general practitioner for patients with neck pain. A randomized, controlled trial.

BACKGROUND: Neck pain is a common problem, but the effectiveness of frequently applied conservative therapies has never been directly compared. OBJECTIVE: To determine the effectiveness of manual therapy, physical therapy, and continued care by a general practitioner. DESIGN: Randomized, controlled trial. SETTING: Outpatient care setting in the Netherlands. PATIENTS: 183 patients, 18 to 70 years of age, who had had nonspecific neck pain for at least 2 weeks. INTERVENTION: 6 weeks of manual therapy (specific mobilization techniques) once per week, physical therapy (exercise therapy) twice per week, or continued care by a general practitioner (analgesics, counseling, and education). MEASUREMENTS: Treatment was considered successful if the patient reported being "completely recovered" or "much improved" on an ordinal six-point scale. Physical dysfunction, pain intensity, and disability were also measured. RESULTS: At 7 weeks, the success rates were 68.3% for manual therapy, 50.8% for physical therapy, and 35.9% for continued care. Statistically significant differences in pain intensity with manual therapy compared with continued care or physical therapy ranged from 0.9 to 1.5 on a scale of 0 to 10. Disability scores also favored manual therapy, but the differences among groups were small. Manual therapy scored consistently better than the other two interventions on most outcome measures. Physical therapy scored better than continued care on some outcome measures, but the differences were not statistically significant. CONCLUSION: In daily practice, manual therapy is a favorable treatment option for patients with neck pain compared with physical therapy or continued care by a general practitioner.

Adolescent↗
PubMed1982

Attitudes of physical therapists in Wisconsin toward disabled persons.

This article contains descriptive statistics on attitudes toward disabled persons of a population of physical therapist. The instrument used to measure attitudes was the Attitudes Toward Disabled Persons Scale-Form A. The population for this study was the 553 physical therapists listed in the 1976-77 Directory of the Wisconsin Chapter of the American Physical Therapy Association, and living in Wisconsin. From this population, a sample of 125 (22.5%) completed and returned the form. A table of normative data in the form of percentiles was developed, along with a table of descriptive statistics that include the median, the quartile deviation, and measures of skewness and kurtosis.

Attitude of Health Personnel↗
PubMed1990

Health risk behaviors and attempted suicide in adolescents who report prior maltreatment.

We hypothesized that high school students who experienced prior maltreatment would be more likely than their peers to report health risk behaviors and suicide attempts. Before the establishment of a high school-based clinic, an anonymous needs assessment survey was completed by 600 adolescents (grades 9 to 12). Sociodemographic information was obtained and questions were asked about physical and sexual abuse, health-related behaviors and habits, and suicide attempts. Thirteen percent of the adolescents had been maltreated: 5.2% reported prior physical abuse, 5.4% sexual abuse, and 2.7% both physical and sexual abuse. Multivariate statistical techniques were used to clarify how previous abuse was related to adolescent risk-taking behaviors and suicide. Students with a history of physical abuse were three times more likely than non-abused peers to drink alcohol and smoke cigarettes, almost twice as likely to use illicit drugs, six times more likely to self-induce vomiting, and five times more likely to attempt suicide. A student with a history of prior sexual abuse had a three and one-half times greater chance of being sexually active and was more than three times more likely to attempt suicide. These data on a nonclinical, nondeviant population of adolescents indicate that physical or sexual abuse in childhood may have a significant impact on adolescent health risk behaviors and suicide attempts.

Adolescent↗
PubMed1995

Physical activity trends among 26 states, 1986-1990.

Data to monitor physical activity from large, representative samples are rare. Therefore, we conducted standardized telephone surveys for 26 states participating in the Behavioral Risk Factor Surveillance System from 1986 through 1990. More than 34,800 adults aged 18 and older responded annually. We scored leisure time physical activity data into four patterns: 1) physically inactive, 2) irregularly active, 3) regularly active, not intensive, and 4) regularly active, intensive. Over time, roughly 6 in 10 persons were physically inactive or irregularly active. While almost 4 in 10 persons were regularly active, less than 1 in 10 were regularly active, intensive. There were statistically significant decreases (-2.3%) in physically inactive persons and significant increases (+2.1%) in persons classified as regularly active, intensive. The irregularly active pattern did not change, while only men of all ages and men less than age 30 increased the regularly active, not intensive pattern (+1.7% and +3.8, respectively). Improvements across the activity patterns varied by demographic group: women and older adults made the most beneficial changes, while races other than white and the least educated groups had unfavorable changes. Despite many improvements, most persons still did little or no physical activity, signaling the need for enhanced intervention efforts.

Adolescent↗
PubMed1997

[The effect of exercise on the pharmacokinetics of acetaminophen and acetylsalicylic acid].

The influence of exercise on the pharmacokinetics of drugs is not sufficiently apparent. Therefore the purpose of my study was to evaluate the influence of standardized exercise on pharmacokinetics of acetaminophen and acetylsalicylic acid (ASA) and also to establish whether moderate (submaximal) exercise demands modification involving the doses of these drugs. That was studied in 20 healthy young (ranging in age 22-42 years) male subjects receiving acetaminophen or ASA, 1 g orally. All subjects were non-smokers who abstained from using caffeine and alcohol 2 weeks before and in the period of study, which consisted of two parts: resting trials and exercise trials. Exercise trials: treadmill walking--3 mph (4.8 km/h), 20 minutes per half an hour for 3 hours (50% VO2max). On the rest day volunteers stayed in the supine or sitting position for the same period. Blood samples were collected from a forearm (antecubital) vein through an indwelling cannula. Acetaminophen and ASA plasma concentrations were determined by FPIA. The plasma level-time curves were fitted according to one compartment open pharmacokinetic model. Plasma concentrations measured (7 days) before and after the physical exercise, did not demonstrate statistically significant differences (Fig. 1, 2). The results of this study indicate that the pharmacokinetics of single doses of acetaminophen and ASA are independent of submaximal physical exercise. There were no significant differences between the rest and the exercise day in the pharmacokinetic parameters of acetaminophen and ASA (Fig. 3). Since both drugs belong to the group whose elimination is not due to the liver flow, it is not surprising that its total body clearance, and its half-life of elimination were unaffected by physical exercise. The minor changes in haematocrit, plasma protein, free fatty acids, levels which were reported are probably not sufficient to modify the disposition of these drugs. Therefore, there is no need for dose adjustment in patient who moderately exercises (50% VO2max). A little change in pharmacokinetics parameters of acetaminophen and ASA could arise due to some differences of its physical and chemical properties. Without further studies on this subject, the explanation of that finding remains very much speculative.

Acetaminophen↗