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At least 19 recordsLinked to original sources

Homocysteine and cognitive function in institutionalised elderly A cross-sectional analysis.

BACKGROUND: Several cross-sectional, case-control and prospective studies revealed a relation between homocysteine and cognitive function or dementia. These studies included either patient populations or healthy, community- dwelling elderly people. AIM OF THE STUDY: In this study we tested the hypothesis that homocysteine was inversely associated with cognitive function in a population of institutionalised elderly (aged >/= 60 y; n = 157). METHODS: For testing this hypothesis baseline data of a recently conducted intervention study in institutionalised elderly (median age 83 years) were used. Cognitive function was evaluated by the cognitive subscale of the Alzheimer's disease Assessment Scale (ADAS-cog). The association between fasting plasma homocysteine level and cognitive function was investigated by multiple linear regression analysis. RESULTS: In the crude model homocysteine concentration was not significantly related to ADAS-cog score (beta = 0.061; p = 0.45). Age was found to be related to ADAS-cog score (beta = 0.161; p < 0.05). Adjusting for age did however not result in a relation between homocysteine and cognitive function. CONCLUSIONS: In our study no association was found between homocysteine and cognitive function in a population of very old institutionalised subjects.

Age Factors↗

Predictors of out-of-home placement of children with severe handicaps: a cross-sectional analysis.

In previous cross-sectional studies of out-of-home placement, wide ranges of age and levels of retardation were used. In contrast, we employed a sample restricted to severely and profoundly mentally retarded children under 18 years. Predictor variables examined included child age, maladaptive behavior, adaptive behavior, and presence of multiple handicaps. Different patterns of results were observed when groups of severely and profoundly retarded persons were analyzed separately and combined. Findings suggest that variables other than child characteristics should be included in analyses of the placement decision for children at high risk of placement.

Adaptation, Psychological↗

Incidence of compensatory enlargement and paradoxical shrinkage of coronary arteries in presence of atherosclerotic lesions: an intracoronary ultrasound study based on multiple cross-section analysis per artery.

BACKGROUND: The aim of the study was to evaluate with intravascular ultrasound (IVUS) the incidence of compensatory enlargement and paradoxical shrinkage in 50 de novo coronary lesions, using two different approaches: 1) a single cross-section analysis and 2) a multiple cross-section analysis per artery. A 3-D IVUS system based on contour detection of lumen and plaque was applied (image acquisition speed: 0.5 mm/s, digitization rate: 5 images/s). In each cross section, we determined: 1) the lumen area (LA), 2) the external elastic membrane area (EEMA), 3) the plaque+media complex (p+m), 4) the relative EEMA = cross section EEMA/reference EEMA, 5) the relative p+m area = cross-section p+m area/reference p+m area, 6) the lumen area stenosis: 1-(cross-section LA/reference LA). In the single cross-section analysis, compensatory vessel enlargement was defined as narrowest EEMA > reference EEMA, and paradoxical vessel constriction as narrowest EEMA < reference EEMA. In the multiple cross-section analysis, compensatory vessel enlargement was defined as the presence of a significant positive correlation between relative EEMA and relative p+m area and paradoxical vessel constriction as a significant negative correlation between relative EEMA and lumen area stenosis. RESULTS: In the single cross-section analysis, compensatory vessel enlargement and paradoxical constriction occurred in 58 and 42% of cases respectively. The multiple cross-section per artery analysis showed compensatory vessel enlargement in 80% of cases and paradoxical constriction in 36% of cases and revealed the combination of compensatory enlargement with paradoxical constriction in 22% of the analyzed segments. CONCLUSIONS: Compensatory enlargement of coronary arteries was underestimated by the single cross-section analysis and was observed in 80% of cases when a multiple cross-section per artery analysis was applied. Paradoxical shrinkage was less common and often occurred in combination with compensatory enlargement within the same analyzed segment.

Adult↗

The impact of pituitary adenoma on morbidity. Increased sick leave and disability retirement in a cross-sectional analysis of Swedish national data.

OBJECTIVE: To quantify sick leave and medical retirement for the year 1989 in adults with a history of nonsecreting pituitary adenoma. DESIGN AND SETTING: A cross-sectional analysis of official Swedish data from 1989 was performed. Sick leave and disability pension data for these patients were obtained from the Swedish National Social Insurance Board, which also supplied information on sick leave taken by an age- and gender-matched control population of 5121 individuals. Uptake of disability pensions and the reasons for drawing these pensions in the study group were compared with national statistics. STUDY POPULATION: A group of 809 eligible adults with nonsecreting pituitary adenoma was identified from the national cancer registry. MAIN OUTCOME MEASURES AND RESULTS: Almost a quarter of the patients with a history of pituitary adenoma had retired due to ill health (23.8%); this was twice the figure expected from national statistics (11.5%). Similar results were obtained when men and women were considered separately. Some patients (17%) had received disability pensions before the diagnosis of pituitary adenoma, but the majority (75%) retired on medical grounds at least 1 year after their diagnosis. The reasons for early retirement in the study group were largely related to the diagnosis of pituitary adenoma (e.g. neoplasm, endocrine disorders), but there was some evidence of an increase in the number of disability pensions awarded because of diseases of the nervous system and sensory organs. Patients with a history of pituitary adenoma took significantly more sick leave in 1989 than those in the control group (mean 40.2 vs 24.0 days), and this significant difference applied to both sexes. CONCLUSIONS: A cross-sectional analysis of Swedish national data from 1989 showed excess morbidity, relative to reference data, in patients with a history of nonsecreting pituitary adenoma. Suboptimal conventional hormone replacement therapy and untreated growth hormone deficiency might to some extent explain the increased morbidity found in the present study.

Adenoma↗

Cross-sectional analysis of guidelines on cardiovascular disease risk factors: going to meet the inconsistencies.

OBJECTIVE: To identify the possible inconsistency of statements among the practice guidelines of the Dutch College of General Practitioners (DCGP) with respect to the management of risk factors for cardiovascular disease (CVD). METHODS: Cross-sectional analysis of all electronically available DCGP practice guidelines dealing with CVD risk factor management for statement inconsistencies and reference inconsistencies. RESULTS: Six DCGP guidelines out of 74 electronically available guidelines had either CVD or CVD risk factors as the subject of the guideline. Eight statement inconsistencies-were found, and for each statement inconsistency, a reference inconsistency was present. CONCLUSIONS: Given that inconsistencies were found, the authors recommend that organizations that maintain a set of guidelines update the guidelines using a cross-sectional analysis of guidelines. Inconsistencies between guidelines might lead to physicians being unintentionally noncompliant with guideline recommendations.

Cardiovascular Diseases↗

Individual income, income distribution, and self rated health in Japan: cross sectional analysis of nationally representative sample.

OBJECTIVE: To assess the effects on self rated health of individual income and income distribution in Japan. DESIGN: Cross sectional analysis. Data collected on household income, self rated health, and other sociodemographic characteristics at the individual level from comprehensive survey of the living conditions of people on health and welfare in a nationally representative sample from each prefecture. SETTING: Prefectures in Japan. PARTICIPANTS: 80 899 people aged >15 years with full records in survey. MAIN OUTCOME MEASURES: Dichotomous variable for self rated health of each respondent (0 if excellent, very good or good; 1 if fair or poor). RESULTS: Inequality in income at the prefecture level measured by the Gini coefficient was comparable with that in other industrialised countries. Unadjusted odds ratios show a 14% increased risk (odds ratio 1.14, 95% confidence interval 1.02 to 1.27) in reporting poor or fair health for individuals living in prefectures with higher inequality in income. After adjustment, individual income was more strongly associated with self rated health than income inequality. Additional inclusion of regional effects showed that median income at the prefecture level was inversely related to self rated health. CONCLUSIONS: Individual income, probably relative to the median prefecture income, has a stronger association with self rated health than income inequality at the prefecture level.

Adolescent↗

Cross-sectional analysis of triplet birth weight.

Parameters of fetal growth in triplet gestations are poorly studied and controversial. A cross-sectional analysis of triplet birth weight was performed to elucidate fetal growth patterns. Birth weight and gestational age data were analyzed on 580 infants in 196 triplet sets (eight stillborn infants excluded) between 1985 and 1988. Ovulation induction was used in approximately one half the gestations and early obstetric and ultrasonographic dating was available in all pregnancies. The mean triplet set and individual triplet weights versus gestational age were calculated with distinctly linear growth displayed between 22 to 38 weeks' gestation. Mean intratriplet differences at all gestational ages were determined. A comparison of singleton and triplet growth curves was constructed to show the distinct growth characteristics of triplets.

Birth Weight↗

A cross-sectional analysis demonstrated the healthy volunteer effect in smokers.

OBJECTIVE: This cross-sectional descriptive analysis sought to determine if a healthy volunteer effect can be demonstrated among smokers selected to participate in a dietary intervention trial. STUDY DESIGN AND SETTING: Body mass index (BMI), body fat, physical activity, dietary intake, and plasma concentration of antioxidant nutrients and carotenoids were assessed cross-sectionally, at the time of enrollment into a dietary intervention trial, among 136 adult smokers. RESULTS: Mean BMI was below national age- and gender-specific averages as was prevalence of overweight and obesity. Physical activity was reported to average 15.4 h/wk. Compared with other sample populations of smokers, our smokers reported lower total fat and cholesterol intakes, higher vitamin C and beta-carotene intakes, and generally equal vitamin E intakes. Plasma ascorbic acid, alpha-tocopherol, alpha- and beta-carotene, and beta-cryptoxanthin concentrations were higher than those of smokers surveyed by NHANES III. CONCLUSION: These findings suggest that a "healthy volunteer effect" can be described among adult smokers. Future dietary intervention trials among smokers should cautiously estimate sample size because smokers electing to participate may report healthier dietary patterns than other smokers. Screening criteria regarding baseline micronutrient status of smokers should be evaluated given that intervention effects may be dependent on overall health status.

Adolescent↗

Cross-sectional analysis of the differences between patients with systemic lupus erythematosus in England, Brazil and Sweden.

This study is a cross-sectional analysis of the differences between SLE outpatients seen in Rheumatology departments at University centres in England, Brazil and Sweden, using a standard protocol. The demographic characteristics, extent and activity of disease of 209 patients with SLE were studied; 112 patients were seen in England, 33 in Brazil and 64 in Sweden. The median age of disease onset of Brazilian and English patients was 25 years and of Swedish patients 31.5 years. Disease activity was measured by the BILAG index. In most systems Brazilian patients experienced more activity than English patients and English patients more activity than Swedish patients. Non-Caucasians experienced more active disease than Caucasians. No sex or occupational differences were observed in disease activity. English patients were the most likely to have experienced photosensitivity, oral ulcers and haematological disorders, Brazilian patients renal disorders and Swedish patients discoid rashes. Brazilian patients were the most likely to be prescribed only one drug for treatment of SLE and to be taking steroids and the highest dose of steroids, in contrast to the European patients who were often prescribed steroids and an antimalarial agent or azathioprine. The results of this cross-sectional assessment of disease activity using a standardized instrument indicate that there are real differences in the extent and degree of activity of SLE in different national groups. This reflects a combination of genetic, environmental and social influences on disease expression and has implications for treatment and monitoring of SLE patients.

Adolescent↗

Smoking, obesity, and their co-occurrence in the United States: cross sectional analysis.

OBJECTIVES: To describe the prevalence of obesity, smoking, and both health risk factors together among adults in the United States. DESIGN: Cross sectional analysis of a national health interview survey. SETTING: United States. PARTICIPANTS: 29 305 adults (aged > or = 18) in 2002. MAIN OUTCOME MEASURES: Prevalence of adults who are obese (body mass index > or = 30), who smoke, and who are obese and smoke. Prevalence was stratified by age, sex, ethnic group, education, and income. RESULTS: 23.5% of adults were obese, 22.7% smoked, and 4.7% smoked and were obese. CONCLUSIONS: Although the proportion of adults who smoke and are obese is relatively low, this subgroup is concentrated among lower socioeconomic groups.

Adult↗

Metabolic syndrome and depression: a cross-sectional analysis.

OBJECTIVE: To examine the prevalence of the metabolic syndrome in depressive outpatients and to identify its correlates in depression. METHOD: This cross-sectional analysis was performed on 121 depressive outpatients from January 2002 through January 2004 who were diagnosed at baseline with the Structured Clinical Interview for DSM-III-R. The metabolic syndrome was diagnosed at 6-year follow-up according to the modified criteria of the National Cholesterol Education Program. The severity of depressive symptoms was assessed at follow-up with the Beck Depression Inventory and the Hamilton Rating Scale for Depression, and general psychopathology was assessed with the Symptom Checklist-90. RESULTS: At 6-year follow-up, the prevalence of metabolic syndrome in the study group of depressive outpatients was 36% (N = 44). The syndrome was associated with a current diagnosis of major depression and overeating, but not with age or sex. CONCLUSION: The metabolic syndrome is highly prevalent among patients with a history of depression, especially those with current major depression. This may have implications for treatment. Furthermore, attention should be focused on the physical health of those suffering from depression.

Age Factors↗

A new, clinically-based algorithm for the diagnosis of HIV in African tuberculosis patients: cross-sectional analysis from Mzuzu, Malawi.

We aimed to create an improved, clinically-based algorithm for the diagnosis of HIV in tuberculosis (TB) patients. Cross-sectional analysis was performed on data from adult TB patients consecutively diagnosed at a Malawian district level hospital. Of 225 patients, 187 with valid HIV results were included in the study. Sixty-seven per cent were HIV seropositive. Urban address, history of skin rash and sexually transmitted diseases (STDs) and, on examination, oral candidiasis and lymphadenopathy, were associated with HIV co-infection. Using these clinical characteristics, a case definition for HIV was constructed. The Mzuzu clinical case definition was highly sensitive (86%). The area under the receiver operating characteristic (ROC) curve was 0.81, significantly larger than existing World Health Organization (WHO) clinical case definitions. The Mzuzu definition is proposed for further evaluation in settings where HIV serological testing is not readily available.

Adolescent↗

Cell-mediated immunity in pregnancy evaluated using lymphocyte transformation tests and rosette tests for T and B lymphocytes. A cross-section analysis.

In vitro tests of cellular immune response using lymphocyte transformation tests and rosette tests for T and B lymphocytes were studied in a cross-section analysis of a total of 55 patients in six groups (non-pregnant, 2-3 month pregnant, 4-5 month pregnant, 6-7 month pregnant, at parturition and 3 months after parturition). No pregnancy-related changes were found in the numbers of T, B or nil cells, nor changes in PHA, PWM or MLC responses. However, a significant reversible depression of the PPD response was found in the second half of pregnancy.

Adult↗

Cellular immunity in pregnancy: blast transformation and rosette formation of maternal T and B lymphocytes: A cross-section analysis.

In vitro tests of cellular immune responses, using lymphocyte transformation tests and rosette tests for T and B lymphocytes, were studied in a cross-section analysis of a total of fifty-five patients in six groups (non-pregnant, 2--3 months pregnant, 4--5 months pregnant, 6--7 months pregnant, at parturition and 3 months after parturition). No pregnancy-related changes were found in the numbers of T, B or null cells, nor changes in PHA, PWM or MLC responses, but a significant reversible depression of the PPD response was found in the second half of pregnancy.

Adolescent↗

Depression screening instruments made good severity measures in a cross-sectional analysis.

OBJECTIVE: Test equivalence of different survey instruments to diagnose depression and to assess its severity. Where equivalence exists, describe how to convert scores between instruments. STUDY DESIGN: Cross-sectional analysis of six convenience samples consisting of 71 members of a health plan and 107 patients of mental health specialty practices with psychiatric diagnoses were compared using the Beck Depression Inventory (BDI) and one or more of the Primary Care Screener for Affective Disorder, Prime-MD-PHQ, Inventory to Diagnose Depression, the depression subscale of the Psychiatric Diagnostic Screening Questionnaire, and the Mental Health Inventory from the SF-36. RESULTS: Correlations between the screening instruments and the BDI ranged from 0.79 to 0.95 and the sensitivity to depression and the specificity against nondepressive mental health diagnoses was equally good or better. We also describe a method for equating severity scores across instruments and labeling the screener-based severity measures with clinically meaningful descriptions comparable to those used for the BDI. CONCLUSIONS: Screener-based severity measures extensively overlap each other. Good screeners for depression can also be good severity instruments. Exploiting screeners as severity instruments can significantly reduce response burden without sacrificing performance.

Adult↗

Hepatitis C infection and B-cell non-Hodgkin's lymphoma in British Columbia: a cross-sectional analysis.

OBJECTIVES: To determine the prevalence of hepatitis C virus (HCV) infection in patients with B-cell non-Hodgkin's lymphoma (NHL) in British Columbia. DESIGN: A cross-sectional analysis. SETTING: The British Columbia Cancer Agency (BCCA), a Canadian provincial tertiary oncology referral center. SUBJECTS: Consecutive patients with B-cell NHL registered onto the BCCA lymphoma database in 1996 and part of 1997 and a control group of patients with T-cell NHL registered on the database from 1995 through 1997. Patients with HIV infection were excluded from the analysis. A second control group (n = 1085) consisted of health-care workers tested for HCV infection following a needle-stick injury. INTERVENTIONS: Stored sera from patients with B-cell NHL (n = 88) and T-cell NHL (n = 37), identified from the database, were tested for the presence of HCV infection with commercially available serologic tests. MAIN OUTCOME MEASURES: HCV seropositivity in the B-cell lymphoma group compared to the control groups (T-cell NHL and health-care workers). RESULTS: 2.3% of the B-cell NHL group, none of the T-cell NHL group and 1% of the health-care worker control group were positive for HCV infection. These results were not statistically significantly different. CONCLUSION: Patients in British Columbia with B-cell NHL do not have an increased prevalence of HCV infection. These data suggest that the lymphotrophism of HCV may differ by regional, racial and genotypic variations around the world.

Adult↗

Factors associated with poor pulmonary function: cross-sectional analysis of data from the ERCF. European Epidemiologic Registry of Cystic Fibrosis.

The European Epidemiologic Registry of Cystic Fibrosis began collecting longitudinal data on European cystic fibrosis patients in 1994. A cross-sectional analysis was performed to identify the factors associated with low values of % predicted forced expiratory volume in one second (FEV1) upon patient enrollment. Data from 7,010 patients aged > or =6 yrs were included. Clinical conditions, microbiological isolates and medications reported at enrollment or within the following 180 days were analysed for age-specific associations. Factors associated with FEV1 that were lower by >10% of pred values were: lower weight for age percentiles, haemoptysis, pneumothorax, pulmonary symptoms at presentation, Pseudomonas aeruginosa, Burkholderia cepacia, oral corticosteroids, nonsteroid anti-inflammatory drugs, dornase alfa, oxygen and assisted ventilation and, in patients >12 yrs old only, use of airway clearance techniques, inhaled bronchodilators, oral nutritional supplements, pancreatic enzymes and insulin or oral hypoglycaemics. Slightly impaired lung function (5-10%) was associated with: diabetes (> or = 18-yrs-old), gastro-oesophageal reflux, allergic bronchopulmonary aspergillosis, asthma-like symptoms, portal hypertension, Aspergillus spp. and Candida spp. Sex, Haemophilus influenzae and Staphylococcus aureus were not associated with impaired pulmonary status. Regular exercise (especially in older patients) and nasal polyposis were associated with slightly better FEV1. The results confirm those of previous studies and suggest selective prescribing in sicker patients.

Adolescent↗

Association of population and practice factors with potentially avoidable admission rates for chronic diseases in London: cross sectional analysis.

OBJECTIVES: To examine the association between underlying ill health, material deprivation and primary care supply factors and hospital admission rates for potentially avoidable admissions in primary care trusts in London. DESIGN: Cross sectional analysis at primary care trusts level using routine data from multiple sources. SETTING: All 31 primary care trusts in London with a total resident population of 7 million patients. MAIN OUTCOME MEASURES: Age-standardized hospital admission rates for asthma, diabetes, heart failure, hypertension and chronic obstructive pulmonary disease. RESULTS: Admission rates varied widely for the conditions examined across the 31 primary care trusts. In 2001, age adjusted admission rates for asthma varied from 76 to 189 per 100,000 and for diabetes from 38 to 183 per 100,000. There was a significant association between higher admission rates and measures of underlying ill health and material deprivation but not quantitative measures of primary care service provision. Provision of specialist chronic disease services in primary care for diabetes but not for asthma were significantly associated with reduced admission rates. There was no association of prescribing levels in primary care trusts with admission rates for any of the conditions examined. CONCLUSIONS: Although hospital admission for some chronic diseases is potentially avoidable and rates of hospital admission for these conditions are possible indicators of the quality of care, they should be interpreted in conjunction with measures of population composition and deprivation. Failure to do this may result in primary care trusts and general practitioners being criticized for aspects of health care utilization that are not under their direct control.

Adolescent↗