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PubMed2002

Cerebrospinal fluid corticotropin-releasing factor (CRF) and vasopressin concentrations predict pituitary response in the CRF stimulation test: a multiple regression analysis.

There is considerable evidence that stress-related psychiatric disorders, including depression and post-traumatic stress disorder (PTSD), are associated with hypersecretion of corticotropin-releasing factor (CRF) within the central nervous system (CNS). One line of evidence that is consistent with central CRF hypersecretion in these disorders is the blunted adrenocorticotropin hormone (ACTH) response to intravenous CRF administration, likely a consequence, at least in part, of downregulation of anterior pituitary CRF receptors. The present study tests the hypothesis that elevated cerebrospinal fluid (CSF) concentrations of CRF and a secondary ACTH secretagogue, arginine vasopressin (AVP), are associated with diminished adenohypophyseal responses in a standard CRF stimulation test. CSF concentrations of CRF and AVP, and plasma ACTH responses to the administration of 1 microg/kg ovine CRF (oCRF) were measured in healthy adult women with and without current major depression and/or a history of significant childhood abuse. The primary outcome measure was ACTH area under the curve (AUC) in the CRF stimulation test. Multiple linear regression was performed to identify the impact of CSF CRF and AVP concentrations upon the pituitary response to CRF stimulation. The regression model explained 56.5% of the variation in the ACTH response to CRF stimulation. The relationship of CSF concentrations of CRF to ACTH responses to CRF were best described by a third-order function that was inversely correlated over most of the range of studied values. The association of ACTH response with CSF concentration of AVP and the dose of oCRF followed second-order kinetics. These findings support the hypothesis that central CRF hypersecretion is associated with a blunted ACTH response to exogenously administered CRF, explaining almost 60% of the variation in the ACTH response to CRF.

Adrenocorticotropic Hormone↗

PubMed1998

[Factors associated with an atherogenic lipid profile in premenopausal women without clinical cardiovascular disease].

BACKGROUND: To investigate different factors associated to a non desirable lipid profile in premenopausal women without cardiovascular disease. To determine the independent factors of lipid profile as a whole of the sample, for planning preventive studies. PATIENTS AND METHODS: We study (March 1994 to June 1996) premenopausal women with alcohol consumption less than 14 g/day and normal serum level of glucose. Group I: women with a non desirable lipid profile (total cholesterol [TCH, mg/dl]/high density lipoprotein cholesterol [HDL-C, mg/dl] > or = 5). Group II: with a desirable lipid profile (TCH/HDL-C < 5). The following factors were analyzed: age, body mass index (BMI), waist/hip ratio (W/H), systolic blood pressure (SBP, mmHg), fasting plasma insulin (fpI, microU/ml), cigarette smoke (CS) and presence of parents with history of non insulin dependent diabetes mellitus (NIDDM) or hypertension. STATISTICAL METHODS: Mann-Whitney and Student statistics. Contingency-table analysis (chi 2 statistic). Pearson correlation and multiple linear regression. RESULTS: We analyzed 126 women (age = 30 +/- 8.2; 95% CI, 29-32; TCH = 197 +/- 36; 95% CI, 190-203 mg/dl), with 20 women (group I) and 106 (group II). Women from group I had higher values of W/H (0.83 +/- 0.04 vs 0.78 +/- 0.06; p < 0.001), BMI (29.9 +/- 9 vs 24.6 +/- 4.9; p < 0.03), fpI (12.9 +/- 10.4 vs 7.8 +/- 3.5; p < 0.05), SBP (125.9 vs 117; p < 0.02), as well as higher percentage of smokers (75 vs 40%; p < 0.01) and parents with NIDDM (60 vs 26%; p < 0.01) or hypertension (60 vs 49%; NS). No differences of age were detected (32 +/- 7.3 vs 30 +/- 8.3; NS). BMI (0.32; p < 0.01), W/H (0.50; p < 0.01), SBP (0.27; p < 0.01) and fpI (0.33; p < 0.01) were positively correlated with TCH/HDL-C ratio (n = 126). In multiple regression analysis (n = 126), W/H (regression coefficient = 6.1; 95% CI, 3.1-9.1), fpI (regression coefficient = 0.045; 95% CI, 0.018-0.072) and CS (regression coefficient = 0.5; 95% CI, 0.336-0.667) were the only independent predictors (p < 0.01) of the TCH/HDL-C ratio, controlling a 46% of the variance (R2 = 0.46). CONCLUSIONS: Our data indicates that central obesity, hyperinsulinemia and cigarette smoke are independently associated to a high risk cardiovascular lipid profile in premenopausal women without cardiovascular disease. This study suggests the importance of these factors in the management of early lipid control in these women.

Adult↗

PubMed2006

Patient and health care system delays in the start of tuberculosis treatment in Norway.

BACKGROUND: Delay in start of tuberculosis (TB) treatment has an impact at both the individual level, by increasing the risk of morbidity and mortality, and at the community level, by increasing the risk of transmission. The aims of this study were to assess the delays in the start of treatment for TB patients in Oslo/Akershus region, Norway and to analyze risk factors for the delays. METHODS: This study was based on information from the National TB Registry, clinical case notes from hospitals and referral case notes from primary health care providers. Delays were divided into patient, health care system and total delays. The association with sex, birthplace, site of the disease and age group was analyzed by multiple linear regression. RESULTS: Among the 83 TB patients included in this study, 71 (86%) were born abroad. The median patient, health care system and total delays were 28, 33 and 63 days respectively, with a range of 1-434 days. In unadjusted analysis, patient delay and health care system delay did not vary significantly between men and women, according to birthplace or age group. Patients with extra-pulmonary TB had a significantly longer patient, health care system and total delay compared to patients with pulmonary TB. Median total delay was 81 and 56 days in the two groups of TB patients respectively. The health care system delay exceeded the patient delay for those born in Norway. The age group 60+ years had significantly shorter patient delay than the reference group aged 15-29 years when adjusted for multiple covariates. Also, in the multivariate analysis patients born in Norway had significantly longer health care system delay than patients born abroad. CONCLUSION: A high proportion of patients had total delays in start of TB treatment exceeding two months. This study emphasizes the need of awareness of TB in the general population and among health personnel. Extra-pulmonary TB should be considered as a differential diagnosis in unresolved cases, especially for immigrants from high TB prevalence countries.

Adolescent↗

PubMed1996

Relationship to blood pressure of combinations of dietary macronutrients. Findings of the Multiple Risk Factor Intervention Trial (MRFIT).

BACKGROUND: Elevated blood pressure remains a widespread major impediment to health. Obesity and specific dietary factors such as high salt and alcohol intake and low potassium intake adversely affect blood pressure. It is a reasonable hypothesis that additional dietary constituents, particularly macronutrients, may also influence blood pressure. METHODS AND RESULTS: Participants were 11,342 middle-aged men from the Multiple Risk Factor Intervention Trial (MRFIT). Data from repeat 24-hour dietary recalls (four to five per person) and blood pressure measurements at six annual visits were used to assess relationships, singly and in combination, of dietary macronutrients to blood pressure, adjusted for multiple possible confounders (demographic, dietary, and biomedical). Multiple linear regression was used to assess diet-blood pressure relations in two MRFIT treatment groups (special intervention and usual care), with adjustment for confounders, pooling of coefficients from the two groups (weighted by inverse of variance), and correction of coefficients for regression-dilution bias. In multivariate regression models, dietary cholesterol (milligrams per 1000 kilocalories), saturated fatty acids (percent of kilocalories), and starch (percent of kilocalories) were positively related to blood pressure; protein and the ratio of dietary polyunsaturated to saturated fatty acids were inversely related to blood pressure. These macronutrient-blood pressure findings were obtained in analyses that controlled for body mass, dietary sodium and ratio of sodium to potassium, and alcohol intake, each positively related to blood pressure, and intake of potassium and caffeine, both inversely related to blood pressure. CONCLUSIONS: These data support the concept that multiple dietary factors influence blood pressure; hence, broad improvements in nutrition can be important in preventing and controlling high-normal and high blood pressure.

Adult↗

PubMed1999

Determinants of cognitive change after coronary artery bypass surgery: a multifactorial problem.

BACKGROUND: Several studies have investigated predictors of cognitive decline after coronary artery bypass grafting (CABG), but there is little consensus as to which specific factors are predictive of poor cognitive outcomes. METHODS: We evaluated 127 patients undergoing CABG with standardized neuropsychological tests preoperatively, at 1 month and at 1 year. The outcome measure was a continuous variable reflecting change in z-scores for eight cognitive domains over time for individual patients. Univariate analyses were performed to evaluate the association between the demographic, operative, and postoperative factors and the cognitive outcome variables. Factors that were significant were included in a multiple linear regression analysis. RESULTS: Among the medical history variables, diabetes was associated with change in executive functions and psychomotor speed. Some of the operative variables were associated with short-term changes, but none with the 1-year outcomes. For example, the surgeon's rating of degree of difficulty in selecting a cross-clamp site was associated with change in attention. Higher mean pump rate during the procedure was associated with improved performance on tests of language. The cognitive domains associated with medical variables were different from those associated with surgical variables, and the associations observed at 1-year were different from those seen at 1-month. CONCLUSIONS: Change in cognition after CABG is associated with both medical and surgical variables. The specifics of these associations depend on the choice of time points after surgery. This suggests that there are multiple etiologies for these changes, with nonspecific effects of anesthesia and prolonged surgery interacting with the more specific effects of the surgical procedure itself.

Aged↗

PubMed2001

The relationship between intramuscular temperature, skin temperature, and adipose thickness during cryotherapy and rewarming.

OBJECTIVE: To describe the relationships among muscle temperature, skin temperature, room temperature, body core temperature, time, and subcutaneous adipose thickness during cryotherapy and rewarming. DESIGN: A multiple linear regression with 5 independent variables (skin temperature, body core temperature, subcutaneous adipose thickness, room temperature, time) predicting intramuscular (IM) temperature. SETTING: A sports injury research laboratory. PARTICIPANTS: Fifteen volunteers with thigh skinfold measurements smaller than 40 mm. INTERVENTIONS: Thirty-minute cryotherapy treatment (ice bag) followed by a 120-minute rewarming period. MAIN OUTCOME MEASURES: The relationship between skin and IM temperature was described, and an equation predicting IM temperature by using room temperature, skin temperature, body core temperature, time, and adipose thickness was developed. RESULTS: Pearson's correlations between each predictor variable of IM temperature during cryotherapy were skin temperature, r = .46; skinfold, r = .37; time, r = -.59; core temperature, r =.21; and room temperature, r = -.47. During rewarming, the correlations were skin temperature, r = .71; skinfold, r = .27; time, r = .76; core temperature, r = - .05; and room temperature, r = - .21. A multiple regression equation (R(2) = .76) was developed to predict IM temperature during cryotherapy. A separate equation (R(2) =.81) was developed to predict muscle temperatures during rewarming. CONCLUSIONS: During and after ice application, no single predictor adequately explained the change in IM temperature. Skin surface temperature was a weak predictor of IM temperature during cryotherapy and should not be used as the sole dependent measure in cryotherapy efficacy studies.

Adult↗

PubMed2006

B-type natriuretic peptide testing is associated with reduced cost in patients with secondary diagnosis of heart failure.

BACKGROUND: This study was designed to examine the effect of BNP use on resource utilization and clinical outcome in hospitalized patients with heart failure (HF). METHODS: Details of all (1788) hospital discharges over 12 months with ICD-9 code 428.x diagnosis were matched to the laboratory and echocardiography databases. Multiple linear regression and logistic regression analysis were performed using use of BNP testing, number of secondary diagnoses, sex, age, financial status, cardiology care, performance of echocardiography as dependent variables to predict length of stay, payable amount and discharge status in separate HF as primary and HF as secondary diagnosis groups. RESULTS: Use of BNP measurement was associated with an average $ Singapore 1305 (p=0.007) decrease in payable amount in patients with secondary diagnosis of HF when controlled for other variables. Its use was associated with reduced use of echocardiography in both primary (odds ratio: 0.04) and secondary (OR: 0.08) diagnosis groups. CONCLUSIONS: Use of BNP measurement was associated with reduced cost of hospitalization in patients with a secondary diagnosis of HF and with reduced use of echocardiography in heart failure patients. This suggests the potential of BNP measurement to reduce costs for the many patients whose multiple problems include HF.

Aged↗

PubMed2004

Prognostic aspects of 18F-FDG PET kinetics in patients with metastatic colorectal carcinoma receiving FOLFOX chemotherapy.

UNLABELLED: We evaluated quantitative measurement series (MS) with 18F-FDG and PET and compared different quantification methods for prediction of individual survival in patients with metastatic colorectal cancer receiving chemotherapy with 5-fluorouracil, folinic acid, and oxaliplatin (FOLFOX). METHODS: The study comprised 25 patients. All patients were examined before the onset of FOLFOX therapy and after completion of the first and fourth cycles. SUV, fractal dimension (FD), a 2-compartment model with computation of k1, k2, k3, and k4, and vascular fraction (VB) were used for data evaluation. Survival data served as a reference for the PET data. Discriminant analysis (DA), regression, and best-subset analysis were applied to the data. RESULTS: Twenty of 25 patients died up to 801 d after the first PET study. A cutoff of 1 y (364 d) was used to classify the patients into 2 a priori groups, namely the short- and long-term survival groups. DA was used to predict the 2 categories using SUV and kinetic parameters of 18F-FDG metabolism as predictor variables. SUV provided a correct classification rate (CCR) ranging from 62% to 69%. SUV of the third MS resulted in a CCR of 69% as a single parameter. The best results were yielded by the use of kinetic parameters (k1, k3, VB, and FD) as predictor variables. CCR was 78% using kinetic 18F-FDG parameters of the first and third MS, in comparison with 69% for the corresponding SUVs. A multiple linear regression model was applied to the data to assess the relationship between individual survival and the PET data. The best-subset method revealed a correlation coefficient of 0.850 for the kinetic parameters of the first (k3, k4, VB, and FD) and third (k1, k2, k4, and VB) MS. CONCLUSION: The combination of kinetic parameters of the first and the third MS is acceptable for classification into a short or long survival class. Furthermore, even an individual prognosis of survival can be achieved using kinetic 18F-FDG parameters of the first and third MS.

Algorithms↗

PubMed1999

Analysis of temporal wear patterns of porous-coated acetabular components: distinguishing between true wear and so-called bedding-in.

BACKGROUND: Standard radiographic assessment of penetration by the femoral head into a polyethylene liner does not enable clinicians to distinguish between the two processes that cause movement of the head: true wear (the removal of polyethylene particles) and so-called bedding-in (other factors, such as creep and settling-in of the liner). By analyzing radiographs made over time, researchers can distinguish true wear from the bedding-in process. The purpose of the current study was to compare the wear performance of the initial modular acetabular cup design (so-called first-generation components) of three different manufacturers with that of a so-called second-generation component made by one of the manufacturers. METHODS: A two-dimensional computerized radiographic method was used to analyze 1300 radiographs of 315 hips that were followed for 3.0 to 10.5 years. Temporal penetration by the head in the three groups of first-generation cups was compared with penetration in the group of second-generation cups. Multiple linear regression analysis was used to model penetration-versus-time data as a line for each group. The slope of each regression line indicated the true rate of wear, and the intercept of the regression line indicated the amount of bedding-in. RESULTS: Modifications in the design of the second-generation components, including thicker polyethylene and an improved locking mechanism, led to a decrease in the mean penetration by the head; however, the second-generation component did not have a lower true rate of wear than two of the first-generation components. Rather, the decreased penetration by the head into the second-generation component resulted from decreased bedding-in of the liner. CONCLUSIONS: These findings and this technique of analysis are clinically relevant to surgeons who evaluate polyethylene wear radiographically. First, penetration by the head in the early postoperative years might not be due entirely to abrasive wear of the polyethylene liner but, rather, to a change in the position of the head resulting from the bedding-in process. The inclusion of bedding-in in calculations of wear artificially inflates the rate of wear and may result in a misrepresentation of the potential risk of wear-related complications. This is especially true with regard to comparisons of different designs of modular cups, in which conformity and tolerances between the polyethylene liner and the metal shell can vary greatly. Second, analysis of penetration by the head at multiple time-intervals can be used to distinguish true polyethylene wear from the bedding-in process. Such an analysis allows more accurate determination of the true rates of wear of different designs of modular cups and, therefore, of potential wear-related complications.

Acetabulum↗

PubMedDate not supplied

QSAR/QSPR studies using probabilistic neural networks and generalized regression neural networks.

The Probabilistic Neural Network (PNN) and its close relative, the Generalized Regression Neural Network (GRNN), are presented as simple yet powerful neural network techniques for use in Quantitative Structure-Activity Relationship (QSAR) and Quantitative Structure-Property Relationship (QSPR) studies. The PNN methodology is applicable to classification problems, and the GRNN is applicable to continuous function mapping problems. The basic underlying theory behind these probability-based methods is presented along with two applications of the PNN/GRNN methodology. The PNN model presented identifies molecules as potential soluble epoxide hydrolase inhibitors using a binary classification scheme. The GRNN model presented predicts the aqueous solubility of nitrogen- and oxygen-containing small organic molecules. For each application, the network inputs consist of a small set of descriptors that encode structural features at the molecular level. Each of these studies has also been previously addressed in this research group using more traditional techniques such as k-nearest neighbor classification, multiple linear regression, and multilayer feed-forward neural networks. In each case, the predictive power of the PNN and GRNN models was found to be comparable to that of the more traditional techniques but requiring significantly fewer input descriptors.

Bayes Theorem↗

PubMed1999

Validation of Italian multiple sclerosis quality of life 54 questionnaire.

OBJECTIVES: Health related quality of life (HRQOL) inventories are multi-dimensional measures of patient-centred health status developed for clinical research. The MS quality of life 54 (MSQOL-54) is an MS-specific HRQOL inventory originally devised for English speaking patients. It consists of a core measure, the 36-item short form health survey (SF-36) previously adapted into Italian, and 18 additional items exploring domains relevant to patients with MS (MS-18 module). The authors translated and culturally adapted into Italian the MS-18 module of the MSQOL-54 questionnaire, and clinically validated the whole questionnaire. METHODS: The MS-18 module was translated following the methodology of the International Quality of Life Assessment (IQOLA) project. The MSQOL-54 was validated in 204 consecutive patients with MS seen between April and September 1997 at three participating centres. The questionnaire was explained by the physician who also administered the expanded disability status scale (EDSS) and mini mental status scale examination, and the patient filled in the MSQOL-54 and Beck depression inventory questionnaires (BDI), with assistance if required. The contribution of impairments and disabilities to MSQOL-54 scores were assessed, and mean scores were compared with normative data for the general Italian population, and with the original sample of United States MS patients. RESULTS: The mean age of the 204 patients was 42 years; mean EDSS score was 4.5 (range 0-8. 5). Patients' participation in the assessment was satisfactory, and all scales satisfied the usual psychometric standards. The characteristics of the United States sample matched those of our patients in all but gender (72% United States patients v 52% Italian patients were women), and education (90% United States patients and 44% Italian patients completed high school); MSQOL-54 profiles were also similar. The EDSS was significantly associated with the physical health composite but not with the mental health composite score. Multiple linear regression modelling showed that age and BDI independently predicted physical health composite (p < 0.001), and mental health composite (p < 0.001). Clinical worsening in the previous year had an independent effect on the physical health composite (p < 0.001). CONCLUSIONS: The Italian version of MSQOL-54 is easy to administer and is well accepted by patients. Neurological impairment has a limited influence on perceived quality of life, while age and depressive symptoms has a major influence.

Adult↗

PubMed2004

Association between some educational indicators and dental caries experience of 12-year-old children in developing countries: an ecological approach.

OBJECTIVE: The aim of this study was to investigate the association between some educational indicators and dental caries experience of 12-year-old children in developing countries. BASIC RESEARCH DESIGN: The ecological association between DMFT levels amongst 12 year olds (DMFT-12 index) with six educational indicators (adult literacy rate, mean years of schooling, pupil-teacher ratio for primary level, educational expenditure as a percentage of gross national product, primary enrollment ratio and percent completing primary level) has been studied using developing countries as the unit of analysis. Pearson's correlation analysis and stepwise linear multiple regression technique were used to identify the significantly associated educational indicators with the DMFT-12 index. RESULTS: A negative association between DMFT-12 index and percent completing primary education level has been observed (r = -0.509; p < 0.01). Also, stepwise regression analysis results have shown that only percent completing primary level education is significantly associated with DMFT-12 index scores (partial regression coefficient = -0.042; 95% confidence intervals: -0.064, -0.021). CONCLUSION: Dental caries experience of 12-year-old children appears to be highest in countries with low percent of primary level completion. Percent completing primary level education may be considered a good predictor of DMFT-12 index in developing countries.

Child↗

PubMed2006

Prediction of carbon-13 NMR chemical shift of alkanes with rooted path vector.

Systematic studies were further made on graph theory in quantitative structure-spectrum relationships (QSSR) for various areas of spectroscopies. Chemical shifts (CS) in alkanes for carbon-13 nuclear magnetic resonance (13C NMR) were well correlated with a set of novel molecular graph indices, called the rooted path vector of various lengths, as several multivariate regression equations as following:CS=3.022+5.336P1+7.356P2-1.648P3+0.83859P4+0.210P5-0.138P6-0.506P7+2.486P8-1.669P9; n=402, m=9, R=0.944, RCV=0.9413, S.D.=3.333, F=358.343, U=35833.211, Q=4355.422 for all types (primary, secondly, tertiary, quaternary as well as methane) of carbon atoms CS=0.983+6.811P1+7.584P2-2.029P3+0.809P4+0.106P5+0.043P6-0.124P7+1.715P8-1.101P9; n=374, m=9, R=0.975, RCV=0.9737, S.D.=2.303, F=773.372, U=36912.109, Q=1930.363 for primary, secondly, tertiary (including methane) carbon atoms; and CS=27.819+2.351P2+0.549P3-0.440P4+0.170P5-0.050P6; n=27, m=5, R=0.992, RCV=0.9674, S.D.=0.324, F=265.418, U=138.891, Q=2.198 for quaternary carbon atoms, respectively. Quite good estimation and prediction results were obtained from the quantitative molecular modeling and the performance of multiple linear regression (MLR) equations were tested to work well through cross-validation (CV) with the leave-one-out (LOO) procedure.

Alkanes↗

PubMed2000

Abdominal adiposity and clustering of multiple metabolic syndrome in White, Black and Hispanic americans.

PURPOSE: The aim of this study was to evaluate the association of abdominal adiposity assessed by waist circumference (WC) with clustering of multiple metabolic syndromes (MMS) in White, Black and Hispanic Americans. MMS was defined as the occurrence of two or more of either hypertension, type 2 diabetes mellitus, dyslipidemia, hypertriglyceridemia or hyperinsulinemia. METHODS: The number of MMS and fasting insulin (a surrogate measure of MMS) were each used as dependent variables in gender-specific multiple linear regression models, adjusting for age, smoking and alcohol intake. The contribution of WC to interethnic differences in clustering of MMS and fasting insulin concentration was assessed in gender-specific linear regression models. The risk of MMS due to large waist was estimated by comparing odds ratio for men with WC >/= 102 cm with those with WC < 102, and women with WC >/= 88 cm with women with WC < 88 cm in the logistic regression model adjusting for age, smoking and alcohol intake. RESULTS: WC was positively and independently associated with clustering of MMS and increased fasting insulin concentration adjusting for age, smoking and alcohol intake in the three ethnic groups (p < 0.01). Black ethnicity was associated with clustering of MMS and fasting insulin concentration (p < 0.01). Hispanic ethnicity was also associated with clustering of MMS in men and associated with fasting insulin concentration in both men and women (p < 0.01). In both men and women, the risk of MMS clustering was strongly associated with increased WC in all ethnic groups independent of BMI. CONCLUSION: WC appears to be a marker for multiple metabolic syndromes in these ethnic groups. The results of this investigation lend support to the view that waist measurement should be considered as a clinical variable for assessing the risk of cardiovascular diseases.

Abdomen↗

PubMed2003

Effect of DRD2, 5-HT2A, and COMT genes on antipsychotic response to risperidone.

Risperidone is a widely used atypical antipsychotic with certain advantages over typical antipsychotics. Although variations in the efficacy of treatment with risperidone have been observed, no specific predictable marker has been identified as of yet. In all, 73 Japanese patients with schizophrenia were given risperidone for 8 weeks, and clinical symptoms were evaluated using the Positive and Negative Syndrome Scale (PANSS). Six candidate polymorphisms (HTR2A -1438G>A, 102T>C, H452Y; DRD2 -141delC, Taq I A; COMT V158M) were genotyped. The diplotype configuration for each individual was estimated by the maximum-likelihood method. Multiple linear regressions were used to analyze the effects of these haplotypes/genotype and other prognostic factors on PANSS scale performance. After adjustment for the effects of patient-related variables, HTR2A diplotype and COMT genotype, as well as other potential prognostic factors, did not significantly influence the clinical performance. A DRD2 haplotype tended to correlate with better clinical performance. Compared with patients who had Ins-A2/Ins-A2 diplotype (n=25), PANSS total scores of patients with Ins-A2/Del-A1 diplotype (n=10) showed 40% greater improvement (P=0.03). The PANSS total scores of patients with HTR2A A-T/A-T diplotype (n=22) tended to show 15% worse improvement compared with A-T/G-C diplotype (n=33) (P=0.06). These results should be treated with caution because of limitations due to small sample size, heterogeneity of patients with respect to past antipsychotic use history, and no correction for multiple corrections. However, the present findings generate important hypotheses in a sample of Japanese schizophrenia patients that may lay the foundation for future pharmacogenomics investigations in other populations.

Adult↗

PubMed1996

Factors influencing the response to growth hormone in children with renal disease.

The effects of age, height velocity over the preceding year, glomerular filtration rate (GFR) and prednisolone dose on growth response have been assessed by single and multiple linear regression analysis in 23 prepubertal children [age, mean (SD), 8.2 (2.5) years] with chronic renal failure (CRF) and 16 prepubertal children [12.1 (2.3) years] with renal transplants treated for 1 year with recombinant human growth hormone (rhGH), 30 U/m2 per week. Height velocity [mean (SD), cm/year] increased from 4.7 (1.3) to 9.7 (2.1) (P < 0.0001) in the CRF group and 3.1 (1.6) to 7.3 (2.8) (P < 0.0001) in the transplant group. In the CRF group, there was a correlation between age and height velocity, both in the pretreatment year (r = -0.755, P < 0.0001) and during treatment (r = -0.421, P = 0.045). There was no correlation between pretreatment height velocity or GFR and response to rhGH. In the transplanted children height velocity during the treatment year correlated with age (r = -0.647, P = 0.007), prednisolone dose (r = -0.689, P = 0.003), GFR (r = 0.542, P = 0.030) and pretreatment height velocity (r = 0.655, P = 0.006). Multiple regression analysis showed prednisolone dose and age to be the most important predictors of response.

Anti-Inflammatory Agents↗

PubMed2003

Proton magnetic resonance spectroscopic imaging can predict length of survival in patients with supratentorial gliomas.

OBJECTIVE: We compared the ability of proton magnetic resonance spectroscopic imaging ((1)H-MRSI) measures with that of standard clinicopathological measures to predict length of survival in patients with supratentorial gliomas. METHODS: We developed two sets of leave-one-out logistic regression models based on either 1) intratumoral (1)H-MRSI features, including maximum values of a) choline and b) lactate-lipid, c) number of (1)H-MRSI voxels with low N-acetyl group values, and d) number of (1)H-MRSI voxels with high lactate-lipid values, all (a-d) of which were normalized to creatine in normal-appearing brain, or 2) standard clinicopathological features, including a) tumor histopathological grade, b) patient age, c) performance of surgical debulking, and d) tumor diagnosis (i.e., oligodendroglioma, astrocytoma). We assessed the accuracy of these two models in predicting patient survival for 6, 12, 24, and 48 months by performing receiver operating characteristic curve analysis. Cox proportional hazards analysis was performed to assess the extent to which patient survival could be explained by the above predictors. We then performed a series of leave-one-out linear multiple regression analyses to determine how well patient survival could be predicted in a continuous fashion. RESULTS: The results of using the models based on (1)H-MRSI and clinicopathological features were equally good, accounting for 81 and 64% of the variability (r(2)) in patients' actual survival durations. All features except number of (1)H-MRSI voxels with lactate-lipid/creatine values of at least 1 were significant predictors of survival in the (1)H-MRSI model. Two features (tumor grade and debulking) were found to be significant predictors in the clinicopathological model. Survival as a continuous variable was predicted accurately on the basis of the (1)H-MRSI data (r = 0.77, P < 0.001; median prediction error, 1.7 mo). CONCLUSION: Our results suggest that appropriate analysis of (1)H-MRSI data can predict survival in patients with supratentorial gliomas at least as accurately as data derived from more invasive clinicopathological features.

Adult↗

PubMed2006

Acute-phase protein levels, diarrhoea, Trichuris trichiura and maternal education are predictors of serum retinol: a cross-sectional study of children in a Dhaka slum, Bangladesh.

The objectives of the present study were to identify predictors of serum retinol concentration as well as to assess the prevalence of low serum retinol concentration, in both the whole population after correcting for the effect of serum C-reactive protein (CRP) (using multiple categories), and the healthy subgroup. A cross-sectional study of 579 apparently healthy children, aged 3-7 years from a Dhaka slum, Bangladesh, was conducted. The effects of age, gender, serum CRP and alpha1-antichymotrypsin, reported morbidity (during the previous 2 weeks), Ascaris lumbricoides and Trichuris trichiura infections, parental education, wasting, stunting and underweight on serum retinol were estimated using multiple linear regression. The mean serum retinol concentration was 0.84 (sd 0.27) micromol/l. Elevated serum CRP levels, reported diarrhoea, reported nasal discharge and T. trichiura infection were negative predictors of serum retinol, whereas maternal education was a positive predictor. Compared with a serum CRP level of < 1 mg/l, CRP levels of 2 to < 5, 5 to < 10 and > or = 10 mg/l were associated with 0.12, 0.16 and 0.32 micromol/l lower serum retinol, respectively. The prevalence of low serum retinol (< 0.70 micromol/l) fell from 31.2 % to 15.6 % in the whole population, after correcting for the effect of CRP, and was 20.1 % in the healthy subgroup (CRP < 2 mg/l). The prevalence of low serum retinol was high but overestimated due to the effect of CRP. Interventions are needed to address low serum retinol in Bangladesh. Controlling diarrhoea, nasal discharge and T. trichiura infection and improving maternal education may be important interventions. The use of multiple categories of acute-phase proteins and cut-off values that indicate elevated levels need further research.

Acute-Phase Proteins↗