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Ratio 2D-4D e deficiência mental: estudo exploratório dos possíveis efeitos de um marcador putativo

Sousa, Ana Cláudia Vaz de
Fonte: Universidade de Coimbra Publicador: Universidade de Coimbra
Tipo: Dissertação de Mestrado
POR
Relevância na Pesquisa
35.91%
O quociente (ratio) entre os comprimentos, em ambas as mãos, dos dedos indicador e anelar (2D:4D) conheceu na última década um interesse invulgar por parte da comunidade científica, tendo estado na origem de um número crescente de estudos, que colectivamente o têm vindo a estabelecer como um biomarcador putativo da exposição pré-natal aos esteróides sexuais, em especial a testosterona. Partindo de tal pressuposto, o presente estudo investigou, a título exploratório, uma população (N=144) de sujeitos adultos, de ambos os sexos, institucionalizados e diagnosticados com Deficiência Mental, no sentido de averiguar, a título exploratório, possíveis relações entre tal quociente (obtido através da digitalização de ambas as mãos) e diferentes aspectos do seu diagnóstico e comportamento, tal como previamente avaliado através da segunda versão da Escala de Comportamento Adaptativo – Residencial e Comunitária (ECA-RC:2). Os dados apurados, após tratamento estatístico básico, revelaram uma média do ratio 2D:4D ligeiramente diferente entre os dois lados do corpo, com valores ligeiramente superiores à esquerda. A análise em função do género revela, ainda que na direcção oposta à esperada, o padrão de ratio 2D:4D sexualmente diferenciado...

Nitrogênio e enxofre na adubação e em folhas diagnósticas e raízes do capimbraquiária em degradação; Nitrogen and sulphur in the fertilization and in diagnostic leaves and in degrading roots of signal grass

BONFIM-SILVA, Edna Maria; MONTEIRO, Francisco Antonio
Fonte: Sociedade Brasileira de Zootecnia Publicador: Sociedade Brasileira de Zootecnia
Tipo: Artigo de Revista Científica
POR
Relevância na Pesquisa
35.86%
Objetivou-se estudar os efeitos das combinações de nitrogênio com enxofre nas concentrações de nitrogênio e enxofre e na relação de nutrientes nas folhas diagnósticas e nas raízes do capim-braquiária (Brachiaria decumbens Stapf.) em degradação antes das adubações. Foram coletados cilindros com planta + solo em uma pastagem em degradação em área de Neossolo Quartzarênico. O experimento foi conduzido em casa de vegetação no período de novembro de 2003 a março de 2004. Foram utilizadas cinco doses de nitrogênio (0; 100; 200; 300 e 400 mg/dm³) e cinco doses de enxofre (0; 10; 20; 30 e 40 mg/dm³), as quais foram combinadas em estudo de superfície de resposta, em desenho experimental composto central modificado de um fatorial 5² fracionado. Realizaram-se três cortes em intervalos de 30 dias. O valor SPAD no capimbraquiária depende da combinação de doses de nitrogênio e enxofre apenas no primeiro corte; no segundo e no terceiro corte, há apenas efeito isolado das doses de nitrogênio. A baixa relação nitrogênio:enxofre observada na ausência da aplicação do nitrogênio comprova maior deficiência de nitrogênio que de enxofre no capim-braquiária em recuperação. A aplicação de enxofre, e principalmente de nitrogênio...

Influence of urban activities on polycyclic aromatic hydrocarbons in precipitation: Distribution, sources and depositional flux in a developing metropolis, Fortaleza, Brazil

Cavalcante, Rivelino M.; Sousa, Francisco W.; Nascimento, Ronaldo F.; Silveira, Edilberto R.; Viana, Rommel B.
Fonte: ELSEVIER SCIENCE BV; AMSTERDAM Publicador: ELSEVIER SCIENCE BV; AMSTERDAM
Tipo: Artigo de Revista Científica
ENG
Relevância na Pesquisa
35.76%
We measured polycyclic aromatic hydrocarbons (PAHs) in bulk precipitation in the Fortaleza metropolitan area, Ceara, Brazil, for the first time. Because little information is available concerning PAHs in tropical climatic regions, we assessed their spatial distribution and possible sources and the influence of urban activities on the depositional fluxes of PAHs in bulk precipitation. The concentrations of individual and total PAHs (Sigma(PAHs)) in bulk precipitation ranged from undetectable to 133.9 ng.L-1 and from 202.6 to 674.8 ng.L-1, respectively. The plume of highest concentrations was most intense in a zone with heavy automobile traffic and favorable topography for the concentration of emitted pollutants. The depositional fluxes of PAHs in bulk precipitation calculated in this study (undetectable to 0.87 mu g.m(-2).month(-1)) are 4 to 27 times smaller than those reported from tourist sites and industrial and urban areas in the Northern Hemisphere. Diagnostic ratio analyses of PAH samples showed that the major source of emissions is gasoline exhaust, with a small percentage originating from diesel fuel. Contributions from coal and wood combustion were also found. Major economic activities appear to contribute to pollutant emissions. (C) 2011 Elsevier B.V. All rights reserved.; CNPq; CNPq; FUNCAP; FUNCAP

Acurária do estudo dos jatos ureterais à ultra-sonografia do Doppler Colorido no diagnóstico das hidronefroses; Diagnostic accuracy of color Doppler sonographic study of the ureteric jets in evaluation of hydronephrosis

Bessa Junior, José de
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 10/08/2007 PT
Relevância na Pesquisa
36%
Introdução e Objetivo: Hidronefrose e Obstrução são condições associadas, entretanto dilatações da via excretora podem ocorrer na ausência de obstruções clinicamente importantes. Ultra-sonografia convencional e Renograma com Diuréticos são os métodos diagnósticos complementares mais utilizados na avaliação das hidronefroses na infância. Recentes trabalhos têm demonstrado a possibilidade de observarmos os jatos ureterais com o Estudo Ultra-sonográfico com Doppler Colorido e sugerido a sua aplicação no diagnóstico diferencial das hidronefroses. O objetivo do presente trabalho foi avaliar a aplicabilidade do estudo dos jatos ureterais como método diagnóstico na identificação das hidronefroses obstrutivas e não obstrutivas na população pediátrica. Métodos: Foram estudadas 48 crianças (35 meninos e 13 meninas) com idade que variou de um mês a 14 anos (mediana de 4 anos), que se apresentaram com Hidronefroses Unilaterais, Graus III e IV, e com suspeita de obstrução da junção pieloureteral. Todos os sujeitos foram submetidos ao Estudo dos jatos ureterais e ao Renograma com Diuréticos num período de duas semanas. As unidades hidronefróticas foram consideradas obstruídas quando a Função Renal Diferencial era menor do que 40%...

Acurácia diagnóstica, análise da decisão e heurísticas relacionadas à decisão clínica intuitiva de usar antagonista de bloqueador neuromuscular; Diagnostic accuracy, decision analysis and heuristics related to the clinical intuitive decision of using antagonist of neuromuscular blocking agents

Videira, Rogerio Luiz da Rocha
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 14/12/2010 PT
Relevância na Pesquisa
35.87%
INTRODUÇÃO: A curarização residual está associada a maior risco de morte após anestesia. Erros diagnósticos após o uso de bloqueador neuromuscular (BNM) estão relacionados com prevalência de 65-88% de curarização residual pré-extubação traqueal (CRPE). Esse estudo analisou a decisão clínica intuitiva de usar antagonista de BNM antes da extubação traqueal. MÉTODOS: Após aprovação do Comitê de Ética em Pesquisa, a decisão clínica dos anestesiologistas da nossa instituição foi auditada em 150 pacientes. A participação foi voluntária e anônima. As decisões, como se fossem resultados de um teste diagnóstico, foram comparadas à aceleromiografia, com TOF < 0,9 definido como CRPE. Uma árvore de decisão foi estruturada para comparar as diferentes estratégias e uma pesquisa sequencial (Delphi), realizada entre 108 anestesiologistas, extraiu as heurísticas (regras simplificadoras) mais usadas. RESULTADOS: A prevalência de CRPE foi de 77%. A intuição clínica apresentou sensibilidade de 0,35 (0,23-0,49) e especificidade de 0,80 (0,54- 0,94) para CRPE (P= 0,0001). Em uma escala de 0-10 a utilidade esperada da intuição foi menor do que sempre antagonizar (4,1 + 4,4 vs. 8,4 + 3,0, P< 0,05). As heurísticas mais proeminentes foram O intervalo desde a última dose de BNM foi curto e O padrão respiratório está inadequado...

Dosimetria em radiologia diagnóstica digital: Uso dos indicadores de exposição de sistemas digitais como estimadores de dose absorvida; Dosimetry in digital diagnostic radiology: use of exposure index of digital systems as absorbed dose estimators

Silva, Thiago Rodrigues da
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 22/11/2012 PT
Relevância na Pesquisa
35.76%
Os sistemas de radiologia digital, entre eles os baseados em fósforos fotoestimuláveis (sistemas CR como sao conhecidos em radiologia), são cada vez mais comuns na pratica radiológica da cidade de Sao Paulo, seguindo uma tendência mundial. O uso desta tecnologia, que vem substituindo o conjunto tela-filme como sistema de detecção e produção de imagem, permite o uso de uma faixa dinâmica de detecção mais ampla e pode ser prejudicial ou benéfico do ponto de vista da dose absorvida pelo paciente, pois possibilita a obtenção de imagens para superexposições ou subexposições. Para avaliar o contraste obtido na imagem, e, ao mesmo tempo, obter uma estimativa da dose absorvida pelo paciente, todos os fabricantes de sistemas CR incluem no software de analise da imagem um indicador de exposição, que deve se relacionar com a dose absorvida pela placa de fosforo foto-estimulável (Image Plate IP). Estudos que relacionam a razão sinal ruído (SNR) e Dose de Entrada na Pele (DEP), avaliada com câmara de ionização e dosimetria TL, para radiografias de torax (frente e perfil) foram conduzidos empregando técnicas clinicas. Valores de dose (DEP e dose de saída) foram comparados com valores de níveis de cinza e de indicadores de exposição obtidos para as imagens com o CR Agfa CR30-X. Para isso foram utilizados dois simuladores: um simulador homogêneo...

SFlt-1/PlGF ratio as a prognostic marker of adverse outcomes in women with early-onset preeclampsia

De Oliveira, Leandro; Peraçoli, José Carlos; Peraçoli, Maria T.; Korkes, Henri; Zampieri, Giafranco; Moron, Antonio F.; Sass, Nelson
Fonte: Universidade Estadual Paulista Publicador: Universidade Estadual Paulista
Tipo: Artigo de Revista Científica Formato: 191-195
ENG
Relevância na Pesquisa
35.88%
Soluble fms-like tyrosine kinase 1 (sFlt-1) is an anti-angiogenic factor released in higher amounts by preeclamptic placentas and it has been implicated in the endothelial dysfunction observed in the disease. In this study we evaluated if circulating sFlt-1/PlGF ratio is useful to predict adverse outcomes in women with early-onset preeclampsia. This is a cohort study of 88 preeclamptic women with singleton pregnancies at ≤35 weeks of gestation. According to definitions used, adverse outcomes occurred in 46.5% (N = 43) of the patients. The median sFlt1/PlGF ratio (25th-75th centile) for all patients evaluated was of 42.26 (13.1-226.1). The median sFlt-1/PlGF ratio among women who had any adverse outcome (N = 43) versus no adverse outcomes (N = 45) was of 227.6 (80.3-346.1) versus 14.4 (3.35-30.0), (P < 0.0001). According to our analyses a sFlt-1/PlGF ratio cut-point of ≥85 gave a sensitivity of 74.0% and specificity of 97.0%. The positive predictive value and the negative predictive value were 96.0% and 80.0%, respectively. The median sFlt-1/PlGF ratio (25th-75th centile) for patients who delivered within <7 days was 260.0 (127.7-404.7) as compared to 14.4 (3.35-34.97) for those patients who delivered within two weeks or more (P < 0.0001). Our results suggest that sFlt-1/PlGF ratio is a promising marker for adverse outcomes in women with early-onset preeclampsia. © 2013 International Society for the Study of Hypertension in Pregnancy. Published by Elsevier B.V. All rights reserved.

Portable Diagnostic Devices for Identifying Obstructive Sleep Apnea among Commercial Motor Vehicle Drivers: Considerations and Unanswered Questions

Zhang, Chunbai; Berger, Mark; Malhotra, Atul; Kales, Stefanos N.
Fonte: Associated Professional Sleep Societies, LLC Publicador: Associated Professional Sleep Societies, LLC
Tipo: Artigo de Revista Científica
Publicado em 01/11/2012 EN
Relevância na Pesquisa
35.82%
Obstructive sleep apnea (OSA), a syndrome defined by breathing abnormalities during sleep, can lead to fatigue and excessive daytime sleepiness (EDS) with an increased risk of motor vehicle crashes. Identifying commercial motor vehicle operators with unrecognized OSA is a major public health priority. Portable monitors (PMs) are being actively marketed to trucking firms as potentially lower-cost and more accessible alternatives to the reference standard of in-laboratory polysomnography (PSG) in the diagnosis of OSA among commercial motor vehicle operators. Several factors regarding PMs remain uncertain in this unique patient population: their sensitivity and specificity; the cost-benefit ratio of the PMs versus PSG; potential barriers from human factors; and evolving technologic advancement. Human factors that alter test accuracy are a major concern among commercial drivers motivated to gain/maintain employment. Current available data using PMs as a diagnostic tool among CMV operators indicate relatively high data loss and high loss to follow-up. Loss to follow-up has also been an issue using PSG in commercial motor vehicle operators. Furthermore, PM testing and PM results interpretation protocols may have no sleep specialist oversight...

Modeling of Novel Diagnostic Strategies for Active Tuberculosis – A Systematic Review: Current Practices and Recommendations

Zwerling, Alice; White, Richard G.; Vassall, Anna; Cohen, Ted; Dowdy, David W.; Houben, Rein M. G. J.
Fonte: Public Library of Science Publicador: Public Library of Science
Tipo: Artigo de Revista Científica
EN_US
Relevância na Pesquisa
35.97%
Introduction: The field of diagnostics for active tuberculosis (TB) is rapidly developing. TB diagnostic modeling can help to inform policy makers and support complicated decisions on diagnostic strategy, with important budgetary implications. Demand for TB diagnostic modeling is likely to increase, and an evaluation of current practice is important. We aimed to systematically review all studies employing mathematical modeling to evaluate cost-effectiveness or epidemiological impact of novel diagnostic strategies for active TB. Methods: Pubmed, personal libraries and reference lists were searched to identify eligible papers. We extracted data on a wide variety of model structure, parameter choices, sensitivity analyses and study conclusions, which were discussed during a meeting of content experts. Results & Discussion From 5619 records a total of 36 papers were included in the analysis. Sixteen papers included population impact/transmission modeling, 5 were health systems models, and 24 included estimates of cost-effectiveness. Transmission and health systems models included specific structure to explore the importance of the diagnostic pathway (n = 4), key determinants of diagnostic delay (n = 5), operational context (n = 5), and the pre-diagnostic infectious period (n = 1). The majority of models implemented sensitivity analysis...

Poverty Reduction and Shared Prosperity in Tajikistan : A Diagnostic

Azevedo, Joao Pedro; Atamanov, Aziz; Rajabov, Alisher
Fonte: World Bank, Washington, DC Publicador: World Bank, Washington, DC
EN_US
Relevância na Pesquisa
35.76%
Tajikistan was one of the fastest growing countries in the Europe and Central Asia region during the last decade. The economic growth was widely shared by the population and as a result poverty (measured by the national poverty line) declined from 73 percent in 2003 to 47 percent in 2009 accompanied by falling inequality. Consumption growth of the bottom 40 percent of the population -- a measure of shared prosperity proposed by the World Bank- was positive, pointing out that the growth was shared among the less well off. This work presents a diagnostic of shared prosperity and poverty reduction in Tajikistan during 2003-2009. The paper also focuses on quantifying the main drivers of poverty reduction, shared prosperity, and intra-generational mobility (class transitions). Some of the mechanisms of poverty reduction are explored in detail. Finally, main impediments to inter-generational mobility are discussed.

The Impact of an Accountability Intervention with Diagnostic Feedback

de Hoyos, Rafael; Garcia-Moreno, Vicente A.; Patrinos, Harry Anthony
Fonte: World Bank, Washington, DC Publicador: World Bank, Washington, DC
Tipo: Trabalho em Andamento
EN_US
Relevância na Pesquisa
35.92%
In 2009, the Mexican state of Colima implemented a low-stakes accountability intervention with diagnostic feedback among 108 public primary schools with the lowest test scores in the national student assessment. A difference-in-difference and a regression discontinuity design are used to identify the effects of the intervention on learning outcomes. The two alternative strategies consistently show that the intervention increased test scores by 0.12 standard deviations only a few months after the program was launched. When students, teachers, and parents in a school know that their scores are low, and this triggers a process of self-evaluation and analysis, the process itself may lead to an improvement in learning outcomes. Information on quality, without punitive measures but within a supportive and collaborative environment, appears to be sufficient to improve learning outcomes.

Diagnostic accuracy of adenosine stress cardiovascular magnetic resonance following acute ST-segment elevation myocardial infarction post primary angioplasty

Wong, T.; Leung, M.; Das, R.; Liew, G.; Williams, K.; Dundon, B.; Molaee, P.; Teo, K.; Meredith, I.; Worthley, M.; Worthley, S.
Fonte: Marcel Dekker Inc Publicador: Marcel Dekker Inc
Tipo: Artigo de Revista Científica
Publicado em //2011 EN
Relevância na Pesquisa
35.89%
Background: Adenosine stress cardiovascular magnetic resonance (CMR) has been proven an effective tool in detection of reversible ischemia. Limited evidence is available regarding its accuracy in the setting of acute coronary syndromes, particularly in evaluating the significance of non-culprit vessel ischaemia. Adenosine stress CMR and recent advances in semi-quantitative image analysis may prove effective in this area. We sought to determine the diagnostic accuracy of semi-quantitative versus visual assessment of adenosine stress CMR in detecting ischemia in non-culprit territory vessels early after primary percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI). Methods: Patients were prospectively enrolled in a CMR imaging protocol with rest and adenosine stress perfusion, viability and cardiac functional assessment 3 days after successful primary-PCI for STEMI. Three short axis slices each divided into 6 segments on first pass adenosine perfusion were visually and semi-quantitatively analysed. Diagnostic accuracy of both methods was compared with non-culprit territory vessels utilising quantitative coronary angiography (QCA) with significant stenosis defined as ≥70%. Results: Fifty patients (age 59 ± 12 years) admitted with STEMI were evaluated. All subjects tolerated the adenosine stress CMR imaging protocol with no significant complications. The cohort consisted of 41% anterior and 59% non anterior infarctions. There were a total of 100 non-culprit territory vessels...

Impact of age, gender and indigenous status on access to diagnostic coronary angiography for patients presenting with non-ST segment elevation acute coronary syndromes in Australia

Roe, Y.; Zeitz, C.; Mittinty, N.; McDermott, R.; Chew, D.
Fonte: Blackwell Publishing Asia Publicador: Blackwell Publishing Asia
Tipo: Artigo de Revista Científica
Publicado em //2013 EN
Relevância na Pesquisa
35.82%
Using Australian guidelines for management of acute coronary syndromes, we investigated the proportion of high-risk patients enrolled in the Acute Coronary Syndromes Prospective Audit registry who received a coronary angiogram. A prospective nationwide multicentre registry involving 39 Australian hospitals was used. The study cohort were patients with high-risk clinical features without ST segment elevation (n = 1948) admitted from emergency departments between 1 November 2005 and 31 July 2007. Eighty nine per cent of patients with ST segment elevation myocardial infarction and only 53% of eligible patients with high-risk acute coronary syndromes with no ST elevation received a diagnostic angiogram. Increasing age was associated with lower rates of angiography; a high-risk patient at the age of ≥70 years was 19% less likely to receive an angiogram than one at the age of <70 years (risk ratio (RR) = 0.81 95% confidence interval (CI) 0.76, 0.76). Women were 26% less likely than men to receive an angiogram (RR = 0.74; 95% CI = 0.65, 0.83). The adjusted RR from the multivariate analysis suggests that a patient at the age of ≥70 years was 35% less likely to receive an angiogram than one at the age of <70 years (RR = 0.65, 95% CI = 0.60...

Derivation and validation of diagnostic thresholds for central blood pressure measurements based on long-term cardiovascular risks

Cheng, H.M.; Chuang, S.Y.; Sung, S.H.; Yu, W.C.; Pearson, A.; Lakatta, E.; Pan, W.H.; Chen, C.H.
Fonte: Elsevier Science Inc Publicador: Elsevier Science Inc
Tipo: Artigo de Revista Científica
Publicado em //2013 EN
Relevância na Pesquisa
35.87%
OBJECTIVES: This study sought to derive and validate outcome-driven thresholds of central blood pressure (CBP) for diagnosing hypertension. BACKGROUND: Current guidelines for managing patients with hypertension mainly rely on blood pressure (BP) measured at brachial arteries (cuff BP). However, BP measured at the central aorta (central BP [CBP]) may be a better prognostic factor for predicting future cardiovascular events than cuff BP. METHODS: In a derivation cohort (1,272 individuals and a median follow-up of 15 years), we determined diagnostic thresholds for CBP by using current guideline-endorsed cutoffs for cuff BP with a bootstrapping (resampling by drawing randomly with replacement) and an approximation method. To evaluate the discriminatory power in predicting cardiovascular outcomes, the derived thresholds were tested in a validation cohort (2,501 individuals with median follow-up of 10 years). RESULTS: The 2 analyses yielded similar diagnostic thresholds for CBP. After rounding, systolic/diastolic threshold was 110/80 mm Hg for optimal BP and 130/90 mm Hg for hypertension. Compared with optimal BP, the risk of cardiovascular mortality increased significantly in subjects with hypertension (hazard ratio: 3.08, 95% confidence interval: 1.05 to 9.05). Of the multivariate Cox proportional hazards model...

Diagnostic value of serum hCG on the outcome of pregnancy of unknown location: a systematic review and meta-analysis

van Mello, N.; Mol, F.; Opmeer, B.; Ankum, W.; Barnhart, K.; Coomarasamy, A.; Mol, B.; van der Veen, F.; Hajenius, P.
Fonte: Oxford University Press Publicador: Oxford University Press
Tipo: Artigo de Revista Científica
Publicado em //2012 EN
Relevância na Pesquisa
35.94%
BACKGROUND The term ‘pregnancy of unknown location’ (PUL) refers to cases where a pregnancy test is positive but the pregnancy cannot be visualized by transvaginal sonography (TVS). Various strategies integrating TVS and serum hCG measures are used to follow-up until the location and/or viability of the pregnancy becomes clear; however, the optimal strategy to predict the outcome of pregnancy in women with PUL is unknown. Therefore, we performed a systematic review and meta-analysis to determine the diagnostic accuracy of the various serum hCG strategies in women with PUL. METHODS We searched Medline and EMBASE for articles which were published (in any language) from 1980 to January 2012 on strategies using serum hCG in women with PUL and reporting on the final outcome of pregnancy. RESULTS From 980 selected titles, 23 articles, all cohort studies, were included. There were 10 studies on a single serum hCG cut-off level, 4 on serum hCG ratio (hCG 48 h/hCG 0 h) and 6 on logistic regression modelling. Three other strategies were reported using serum hCG, serum progesterone and/or uterine curettage findings; each of these strategies comprised a single study. Comparative diagnostic studies have not been performed on the diagnostic value of serum hCG in women with PUL. Included studies showed substantial clinical heterogeneity in the definition of the outcome...

Diagnostic services in Australia: service rates and characteristics of patients

Brennan, D.S.; Balasubramanian, M.; Spencer, A.J.
Fonte: Australian Dental Association Publicador: Australian Dental Association
Tipo: Artigo de Revista Científica
Publicado em //2015 EN
Relevância na Pesquisa
35.89%
Background: Diagnostic services are the most common area of dental service in Australia. The objective was to investigate differences in services per visit for examinations and radiographs in relation to the characteristics of patients receiving these services in terms of age and sex, aspects of visiting such as dental insurance and reasons for visit, and oral health such as number of teeth and presence of decay. Methods: A random sample of Australian dentists was surveyed in 2009-10. Data on diagnostic services and patient characteristics were collected from a service log. Results: A total of 1,148 dentists responded (response rate=67%). Models adjusted for age and gender of patients showed that rates [Rate Ratio, 95% CI] of examinations were higher for insured patients [1.13; 1.06-1.21], while rates of radiographs were higher for emergency visits [1.25; 1.11-1.48]. Patients with 20 or more teeth had higher rates for examinations [1.15; 1.01- Accepted Article This article is protected by copyright. All rights reserved. 1.32] and radiographs [1.28; 1.02-1.60]. Decayed teeth were associated with lower examination rates [0.70; 0.65-0.76] but higher rates of radiographs [1.34; 1.16-1.55]. Conclusions: The finding that number of teeth was associated with higher rates of examinations and radiographs suggests that retention of teeth could be influencing the increasing rates of diagnostic services in Australia.; DS Brennan...

Global hypothesis test to compare the likelihood ratios of multiple binary diagnostic tests with ignorable missing data

Mar??n-Jim??nez, Eugenia; Rold??n Nofuentes, Jos?? Antonio
Fonte: Institut d'Estad??stica de Catalunya (Idescat) Publicador: Institut d'Estad??stica de Catalunya (Idescat)
Tipo: Artigo de Revista Científica
ENG
Relevância na Pesquisa
35.82%
In this article, a global hypothesis test is studied to simultaneously compare the likelihood ratios of multiple binary diagnostic tests when in the presence of partial disease verification the missing data mechanism is ignorable. The hypothesis test is based on the chi-squared distribution. Simulation experiments were carried out to study the type I error and the power of the global hypothesis test when comparing the likelihood ratios of two and three diagnostic tests respectively. The results obtained were applied to the diagnosis of coronary stenosis.

Reduced platelet amyloid precursor protein ratio (APP ratio) predicts conversion from mild cognitive impairment to Alzheimer's disease

Zainaghi, Isis A.; Talib, Leda L.; Diniz, Breno S.; Gattaz, Wagner F.; Forlenza, Orestes V.
Fonte: SPRINGER WIEN; WIEN Publicador: SPRINGER WIEN; WIEN
Tipo: Artigo de Revista Científica
ENG
Relevância na Pesquisa
36%
Studies have shown that platelet APP ratio (representing the percentage of 120-130 kDa to 110 kDa isoforms of the amyloid precursor protein) is reduced in patients with mild cognitive impairment (MCI) and Alzheimer's disease (AD). In the present study, we sought to determine if baseline APP ratio predicts the conversion from MCI to AD dementia after 4 years of longitudinal assessment. Fifty-five older adults with varying degrees of cognitive impairment (34 with MCI and 21 with AD) were assessed at baseline and after 4 years. MCI patients were re-classified according to the conversion status upon follow-up: 25 individuals retained the diagnostic status of MCI and were considered as stable cases (MCI-MCI); conversely, in nine cases the diagnosis of dementia due to AD was ascertained. The APP ratio (APPr) was determined by the Western blot method in samples of platelets collected at baseline. We found a significant reduction of APPr in MCI patients who converted to dementia upon follow-up. These individuals had baseline APPr values similar to those of demented AD patients. The overall accuracy of APPr to identify subjects with MCI who will progress to AD was 0.74 +/- A 0.10, p = 0.05. The cut-off of 1.12 yielded a sensitivity of 75 % and a specificity of 75 %. Platelet APPr may be a surrogate marker of the disease process in AD...

Global hypothesis test to compare the likelihood ratios of multiple binary diagnostic tests with ignorable missing data

Marín Jimenez, Ana Eugenia; Roldán Nofuentes, José Antonio
Fonte: Universidade Autônoma de Barcelona Publicador: Universidade Autônoma de Barcelona
Tipo: Artigo de Revista Científica Formato: application/pdf
Publicado em //2014 ENG
Relevância na Pesquisa
35.82%
In this article, a global hypothesis test is studied to simultaneously compare the likelihood ratios of multiple binary diagnostic tests when in the presence of partial disease verification the missing data mechanism is ignorable. The hypothesis test is based on the chi-squared distribution. Simulation experiments were carried out to study the type I error and the power of the global hypothesis test when comparing the likelihood ratios of two and three diagnostic tests respectively. The results obtained were applied to the diagnosis of coronary stenosis.

Diagnostic accuracy of spot and timed measurements of urinary albumin concentration to determine microalbuminuria in sickle cell disease

Asnani,MR; Reid,ME
Fonte: West Indian Medical Journal Publicador: West Indian Medical Journal
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/12/2013 EN
Relevância na Pesquisa
35.97%
OBJECTIVE: Whereas measurement of albumin:creatinine ratio (ACR) in spot urine samples is indicated for determining microalbuminuria, its performance or that of urinary albumin excretion rate (UAER) in predicting microalbuminuria in sickle cell disease (SCD) is unclear. We therefore tested the diagnostic performance of these measures in spot and timed urine samples in predicting a UAER in 24-hour samples. METHODS: Thirty participants with SCD had spot, two-hour and four-hour, followed by 24-hour urine collections for ACR, urinary albumin concentration (UAC) and UAER determinations. Receiver operating characteristic (ROC) curve analyses were performed. RESULTS: The areas under the ROC curves for microalbuminuria were 0.99 (CI: 0.97, 1.00) for ACR and 0.97 (CI: 0.92, 1.00) for UAC in spot urine samples. For ACR, at the cut-point of 4.13 mg/mmol, there was 100% sensitivity and 82.6% specificity, allowing an 86.2% correct classification. At the cut-point of UAC = 20.9 mg/L, there was 100% sensitivity and 73.9% specificity, allowing a 79.3% correct classification. Corresponding areas for microalbuminuria in two-hour timed samples were 0.99 (CI: 0.95, 1.00) for ACR and 0.96 (CI: 0.89, 1.00) for UAER. For ACR, the cut-point was 4.64 mg/mmol with 83.3% sensitivity and 91.3% specificity...