Predictive value of tests

This study investigated the relationship between the perception of family functioning and depressive symptomatology in individuals with eating disorders (EDs). Subjects were evaluated by diagnostic clinical interview using DSM-III-R criteria for EDs, the Schedule for Affective Disorders and Schizophrenia-Lifetime Version (SADS-L), and two self-report measures, the Beck Depression Inventory (BDI) and the Family Assessment Device (FAD). A significant association was found between self-reported depressive symptomatology and perceived poor family functioning. Subjects with bulimia nervosa (BN) reported a significantly more dysfunctional family background than subjects with anorexia nervosa (AN). In our sample, the presence of self-reported depressive symptomatology was a more powerful predictive variable for perceived family dysfunction than the diagnosis of affective disorder. Also, the diagnosis of BN was a more consistent predictor of dysfunctional family interaction than the diagnosis of affective disorder. Depressive symptoms and EDs seem to play different roles in the way in which they contribute to dysfunctional family patterns.

Vascular problems such as thrombosis and stenosis of the hepatic artery, portal vein, and hepatic vein are serious complications after living-donor liver transplant and can cause increased morbidity, graft loss, and patient death. The aim of this study was to assess the incidence, treatment, and outcome of recipient vascular complications after living-donor liver transplant in a single Egyptian center. Between November 2006 and March 2014, we performed 226 living-donor liver transplants for 225 patients at Dar Al Fouad Hospital in 6th of October City in Egypt. Review of all patients with vascular complications was performed. In 20 of 225 recipients (8.9%), there were vascular complications that occurred from day 0 to 14 (mean, 5.6 ± 3.4 d). Complications included isolated hepatic artery thrombosis in 7 patients (35%), isolated portal vein thrombosis in 6 patients (30%), isolated hepatic vein stenosis in 3 patients (15%), and isolated hepatic artery stenosis in 1 patient (5%). Combin...

OBJECTIVE: Recently, new body indices, including body adiposity (BAI), a body shape (ABSI), and body roundness (BRI) indices have been developed to estimate adiposity. The aim of this study was to compare percent fat mass (%FM) with novel indices in an elite athlete population.
METHODS: Using a cross-sectional design, %FM in 159 male and 50 female athletes using a four-component model was assessed. The %FM was compared with body mass index (BMI), BAI, ABSI, BRI, and with other %FM field methods (bioimpedance spectroscopy and skinfold prediction equation). These associations were determined using multilinear regression analysis, which resulted in predictive models of %FM in athletes. Cross-validation was performed using the prediction residual error sum of squares (PRESS) statistics method.
RESULTS: Although higher associations than other indices were observed, BRI still presented low coefficients of determination (men: R(2) = 0.36; women: R(2) = 0.25) when comparing with other field methods (R(2) range, 0.33-0.75). Using BAI as the independent variable, the R(2) was 0.07 for men and 0.14 for women. ABSI did not result in a significant association with %FM in women (R(2) = 0.05) while in men a significant association was found (R(2) = 0.22). The BMI model resulted in a R(2) = 0.20 for men and R(2) = 0.22 for women. Waist circumference and the sum of skinfolds were the anthropometric variables with the highest association with adiposity. New alternatives were presented with higher coefficients of determination (PRESS R(2) ranged from 0.47 to 0.71).
CONCLUSIONS: The newly developed body indices are limited in predicting %FM in elite athletes, particularly when compared with other commonly and readily available field methods like bioimpedance analysis or skinfold prediction models.

BACKGROUND: Clinical audit has been increasingly required for the accreditation process in every modern healthcare system. Data collection and analysis are excessively time-consuming in everyday practice. The primary aim of our study was to evaluate the ...

In assessing exocrine pancreatic insufficiency (EPI), its diverse etiologies and the heterogeneous population affected should be considered. Diagnosing this condition remains a challenge in clinical practice especially for mild-to-moderate EPI, with the support of the time-consuming breath test or the coefficient of fat absorption. The fecal elastase-1 test, less precise for the diagnosis, cannot be useful for assessing treatment efficacy. Pancreatic enzyme replacement therapy (PERT) is the mainstay of treatment, whereby enteric-coated mini-microspheres are taken with every meal, in progressive doses based on an individual's weight and clinical symptoms. The main indication for PERT is chronic pancreatitis, in patients who have clinically relevant steatorrhea, abnormal pancreatic function test or abnormal function tests associated with symptoms of malabsorption such as weight loss or meteorism. While enzyme replacement therapy is not recommended in the initial stages of acute pa...

In the management of hypertension, blood pressure (BP) monitoring and medication use are key strategies, but they are dependent on patients' motivation to practice self-care. To gauge patients' approaches to monitoring their blood pressure, as well as explore their attitudes toward, and actions relating to, high blood pressure readings, as the key components of their self-management of hypertension. This qualitative study, comprising individual telephone interviews, involved patients attending community pharmacies in Sydney (Australia). Patients' perspectives were elicited using a purpose-designed, semi-structured interview guide. The verbal responses were audio-recorded, transcribed verbatim, and thematically analysed. Three key themes arose: (1) approaches to monitoring blood pressure, (2) attitudes to variability in BP, (3) responses to high BP readings. Many patients self-regulated the frequency of monitoring based on perceived need and/or opportunity. Most were indi...

Interest in the development of functions that estimate the likelihood of an individual suffering a future cardiovascular disease (CVD) event has increased in recent times (e.g. Framingham sheets, SCORE-Systematic COronary Risk Estimation, PROCAM, etc.). However, the estimates of absolute risk may show substantial variations between different populations, because of geographical, cultural, social, behavioural and genetic differences, as well as various methodological issues related to the predictive models employed. We sought to calibrate the SCORE equations to the Greek population. We used the SCORE system that offers an estimation of total fatal CVD risk in "high" and "low" CVD risk European countries. The project pulls together a pool of datasets from 12 European countries and 2.7 million person-years of observation. A mathematical procedure to adjust the risk estimates for individual countries was applied, based on local mortality and risk factor prevalence da...

Phase angle as measured by bioelectrical impedance analysis reflects fat-free mass. Fat-free mass loss relates to worse prognosis in chronic diseases. Primary aim of this study was: to determine the association between fat-free mass at intensive care unit admission and 28-day mortality. Ten centres in nine countries participated in this multicentre prospective observational study. The inclusion criteria were age >18 years; expected length of stay >48 h; absence of pacemaker, heart defibrillator implant, pregnancy and lactation. Fat-free mass was assessed by measurement of the 50-kHz phase angle at admission. The primary endpoint was 28-day mortality. The area under the receiver operating characteristic curve (AUC) was used to assess prediction of 28-day mortality by fat-free mass at ICU admission. The variables associated with 28-day mortality were analysed by means of multivariable logistic regression. Of the 3605 patients screened, 931 were analysed: age 61 ± 16 years, male ...

Percentage of viable sperms has good potential to reflect male fertilizing potential. In the present study, an attempt was made to find out the percentage of viable sperms in normal and abnormal ejaculates and influence of reactive oxygen species in affecting the viability of sperm. Malondialdehyde (MDA) in seminal plasma of normal and abnormal ejaculates was measured by Thiobarbituric Acid method and percentage of viable sperms was assessed by Eosin-Nigrosin staining. The results revealed that the abnormal semen samples have significantly lower number of viable spermatozoa (59.06 +/- 9.63% vs. 68.33 +/- 5.46%, P < 0.05) and higher levels of MDA (2.53 +/- 0.66 vs. 1.66 +/- 0.37 nmol/ml, P < 0.05) as compared to normal. A significant negative correlation was found between seminal MDA level and sperm viability. Based on the results obtained from the present study, we suggest that viability of sperm is an authentic parameter to assess male fertility potential and it can be affect...

The aim of this study was to evaluate the use of Doppler ultrasonography to monitor vascular blood flow dynamics in defined diseases of the equine digit in a noninvasive way. Doppler sonography was used to evaluate medial digital artery blood flow in eight horses with septic pododermatitis and four horses with laminitis in comparison with 10 horses of a control group. Doppler sonographic measurement and lameness examinations were performed in lame horses before treatment (day 0) and at 3, 6, and 9 days following treatment. Before treatment, blood flow velocities, arterial diameter, and flow volume were significantly higher in the lame horses, while pulsatility indices (PIs) were significantly lower (P < 0.05). Compared with the control group, there was no significant difference of resistive indices (RI) in the septic pododermatitis group, but these indices were significantly lower in the laminitis group. No significant difference between the two lame groups was recorded. After tr...

Study of the relationship between mutagenicity and molecular structure for a data set of nitrogenous cyclic compounds is reported. A computerized SAR system (ADAPT) was utilized to classify a data set of 114 nitrogenous cyclic compounds with 19 molecular descriptors. All of the descriptors represented at least 10% of the compounds in the data sets. The average correct predictability of the data base was calculated to be 89% after evaluating 100 training/prediction subsets. The actual predictive ability of the discriminants generated by the ADAPT system was demonstrated by predicting the mutagenicity of structurally similar compounds not in the data set. Weight vectors generated in the pattern recognition programs were used to predict the bacterial mutagenicity of 10 compounds which were not included in the data set. All of the compounds were predicted correctly which was actually better than the 89% calculated by the system. This displayed the ability of the system of classify compo...