Analysis Of Dichotomous Variables Research Articles

Prognostic Value of Complete Resection of the High-Frequency Oscillation Area in Intracranial EEG: A Systematic Review and Meta-Analysis.

High-frequency oscillations (HFOs; ripples 80-250 Hz; fast ripples [FRs] 250-500 Hz) recorded with intracranial electrodes generated excitement and debate about their potential to localize epileptogenic foci. We performed a systematic review and meta-analysis on the prognostic value of complete resection of the HFOs-area (crHFOs-area) for epilepsy surgical outcome in intracranial EEG (iEEG) accessing multiple subgroups. We searched PubMed, Embase, and Web of Science for original research from inception to October 27, 2022. We defined favorable surgical outcome (FSO) as Engel class I, International League Against Epilepsy class 1, or seizure-free status. The prognostic value of crHFOs-area for FSO was assessed by (1) the pooled FSO proportion after crHFOs-area; (2) FSO for crHFOs-area vs without crHFOs-area; and (3) the predictive performance. We defined high combined prognostic value as FSO proportion >80% + FSO crHFOs-area >without crHFOs-area + area under the curve (AUC) >0.75 and examined this for the clinical subgroups (study design, age, diagnostic type, HFOs-identification method, HFOs-rate thresholding, and iEEG state). Temporal lobe epilepsy (TLE) was compared with extra-TLE through dichotomous variable analysis. Individual patient analysis was performed for sex, affected hemisphere, MRI findings, surgery location, and pathology. Of 1,387 studies screened, 31 studies (703 patients) met our eligibility criteria. Twenty-seven studies (602 patients) analyzed FRs and 20 studies (424 patients) ripples. Pooled FSO proportion after crHFOs-area was 81% (95% CI 76%-86%) for FRs and 82% (73%-89%) for ripples. Patients with crHFOs-area achieved more often FSO than those without crHFOs-area (FRs odds ratio [OR] 6.38, 4.03-10.09, p < 0.001; ripples 4.04, 2.32-7.04, p < 0.001). The pooled AUCs were 0.81 (0.77-0.84) for FRs and 0.76 (0.72-0.79) for ripples. Combined prognostic value was high in 10 subgroups: retrospective, children, long-term iEEG, threshold (FRs and ripples) and automated detection and interictal (FRs). FSO after complete resection of FRs-area (crFRs-area) was achieved less often in people with TLE than extra-TLE (OR 0.37, 0.15-0.89, p = 0.006). Individual patient analyses showed that crFRs-area was seen more in patients with FSO with than without MRI lesions (p = 0.02 after multiple correction). Complete resection of the brain area with HFOs is associated with good postsurgical outcome. Its prognostic value holds, especially for FRs, for various subgroups. The use of HFOs for extra-TLE patients requires further evidence.

HPB P18 Continuous drain irrigation as a risk mitigation strategy for postoperative pancreatic fistula; a meta-analysis

Abstract Background Postoperative Pancreatic Fistula (POPF) formation serves as the principle cause for the significant morbidity and mortality rates observed following pancreatectomy. Several different POPF mitigation strategies have been previously trialled, with variable success. Continuous drain irrigation as a treatment strategy for infected pancreatic necrosis has previously been described as an effective treatment strategy, however its role following pancreatectomy has yet to be determined. Methods A meta-analysis of the pre-existing literature was performed. The primary endpoint was determining whether continuous drain irrigation reduced POPF rates following pancreatectomy. Secondary endpoint evaluated its impact on post operative morbidity, mortality and length of stay. Analysis of dichotomous variables (complication rates) was calculated utilising the odds ratio (OR) with 95% confidence interval (CI) with the Mantel–Haenszel method with a random effects model. Continuous data (length of stay) was assessed using mean difference (MD) and 95% CI with the inverse variance random effects model. Data was tabulated and visualised through the creation of forest plots. Results Nine articles involving 782 patients was included in this meta-analysis. Continuous drain irrigation use was associated with a statistically significant reduction in POPF rates (OR (95% CI) 0.40 (0.19-0.82), p=0.01). Upon subgroup analysis, a significant reduction in clinically relevant POPF was also noted (OR 0.37 (0.20-0.66), p = 0.0008). A reduction in post operative complications was also observed: delayed gastric emptying (0.45 (0.24-0.84), p = 0.01) and the need for re-operation (0.33 (0.11-0.96), p = 0.04). This reduction in post operative complications rates also translated into a reduced post operative length of stay (MD -2.62 (-4.97 - -0.26), p =0.03). Conclusions Continuous drain irrigation following pancreatectomy serves as an effective risk mitigation strategy against POPF.

D-dimer to lymphocyte ratio can serve as a potential predictive and prognostic value in colorectal cancer patients with liver metastases

BackgroundThe intent of this research was to generate and investigate the D-dimer to lymphocyte ratio (DLR) capacity to forecast the risk and prognosis of colorectal cancer liver metastases (CRCLM).MethodsFrom January 2010 to December 2019, 177 clinicopathologically confirmed colorectal cancer (CRC) patients (89 in the control group and 88 in the experimental group) were identified at the Affiliated Cancer Hospital of Guangxi Medical University. Multivariate Cox regression analysis was used to screen independent predictive diagnostic and prognostic factors of liver metastasis in CRC, and receiver operating characteristic (ROC) curves and Kaplan‒Meier (K‒M) curves were established to analyze the diagnostic and predictive prognostic efficacy of the DLR in the development of CRCLM.ResultsPatients with CRCLM had higher DLR levels and D-dimer levels in their blood, with statistically significant differences (p < 0.001). DLR might be employed as a predictor for the development of CRCLM, according to ROC curve research (sensitivity 0.670, specificity 0.775, area under the curve 0.765). D-dimer, lymphocyte count CEA, CA125, and CA199 were not linked to prognosis in patients with CRCLM in Cox regression analysis of dichotomous variables. In contrast, DLR level was a possible risk factor for the prognosis of patients with CRCLM (HR = 2.108, p = 0.047), and age, T stage, and DLR level (DLR < 0.4) were connected with the prognosis of patients with CRCLM (p < 0.05).ConclusionDLR serves as a risk indicator for the development of CRCLM.

Transhepatic versus transperitoneal approach in percutaneous cholecystostomy: a meta-analysis

To determine whether the transhepatic or transperitoneal approach is the optimal percutaneous cholecystostomy approach. A systematic review and meta-analysis was undertaken in which the Medline, EMBASE, and PubMed databases were searched for studies that compared both approaches in patients undergoing percutaneous cholecystostomy. Statistical analysis of dichotomous variables was carried out using odds ratio as the summary statistic. Four studies totalling 684 patients (396 [58%] males, mean age 74 years) who had undergone percutaneous cholecystostomy via the transhepatic (n=367) and transperitoneal (n=317) approach were analysed. Although the overall risk of bleeding was low (4.1%), it was significantly higher in the transhepatic approach compared with the transperitoneal approach (6.3% versus 1.6% respectively, odds ratio=4.02 [1.56, 10.38]; p=0.004). There were no significant differences in pain, bile leak, tube-related complications, wound infection, or abscess formation between the approaches. Percutaneous cholecystostomy can be performed safely and successfully via the transhepatic and transperitoneal approaches. Although the overall rate of bleeding was significantly higher with the transhepatic approach, there were confounding factors due to technical differences between the studies. The small number of the included studies, in addition to variability of the definitions of outcomes, imposed other limitations. Further large-volume cases series and ideally a randomised trial with well-defined outcomes are required to confirm these findings.

Meta-analysis of donor–recipient gender profile in paediatric living donor liver transplantation

ObjectivePaediatric living donor liver transplantation (LDLT) has gained popularity due to limited deceased donor organ supply. Some studies report inequalities in donor and recipient gender profiles, but data are sparse....

Blackburne-Peel ratio predicts patients' outcomes after total knee arthroplasty.

Alterations in patellar height and posterior tibial slope (PTS) are frequently measured radiographic parameters associated with postoperative impairments after total knee arthroplasty (TKA). Few studies correlate the clinical outcome of TKA with the radiological indices. Both the modified Insall-Salvati ratio (mISR) and the Blackburne-Peel ratio (BPR) were hypothesised to correlate with the clinical outcome after TKA. A total of 282 computer navigated primary LCS®-TKAs, implanted in our institution from 2008 to 2012, were included. Data (ROM, FJS-12, WOMAC, and revision surgery) were collected independently and prospectively. Patellar height (mISR, BPR), joint-line position, and PTS were measured on pre- and postoperative radiographs. Bivariate and multiple regression analyses were performed. Mean mISR (1.5-1.4) and BPR (0.8-0.6) decreased from preoperatively to 1year follow-up. Mean joint-line shift in a cranial direction was 2mm after TKA implantation. Analysis of dichotomous variables (presence of PB and PPB or not) only showed significantly lower flexion in patients with PPB (p < 0.001). However, multiple regression revealed that BPR was a significant positive independent predictor for FJS-12 (p = 0.016) and flexion (p < 0.001) at 1year follow-up. Postoperative PTS (p < 0.01) and initial patella height (p < 0.001) were both predictive for BPR at follow-up, while the joint-line height was not. The BPR is a useful and reliable radiographic parameter to predict patient outcomes 1year after primary navigated TKA. Lowering the BPR should be avoided, as this may lead to significant restrictions in terms of ROM and PROMs. Level 3.

Multidimensionality evaluation of supply chain management integration

Integration is constantly reported in the literature as an essential feature of SCM. However, it is as difficult to define as to operationalize it, resulting in a lack of information on how to increase the level of integration among members. Thus, this research aims to evaluate the dimensionality of SCI, to check alignment with the features identified in the literature using multivariate statistical analysis. The methodology used was based on a questionnaire to assess the level of companies integration with suppliers of its supply chain. This instrument consisted of 21 items, with response options: yes, no or not applicable. The questions focused on evaluating the integration with suppliers, so each company consulted could answer a questionnaire for each supplier, since the intensity of relationships varies. Thus, 41 companies participated in the survey, resulting in 205 responses. Full-information item factor analysis and principal component analysis on the correlation matrix tetrachoric were used for the instrument dimensionality analysis. They are appropriate procedures for analysis of dichotomous variables. The results of this analysis enabled grouping the questionnaire items in the following underlying factors: trust, information sharing, partnership, collaboration or cooperation, and coordination. The identification of such factors such as dimensions of SCI enables greater understanding on how to raise the level of integration among the members of a supply chain.

Systematic review and meta-analysis of the influence of circumferential resection margin involvement on survival in patients with operable oesophageal cancer

The prognostic role and definition of circumferential resection margin (CRM) involvement in operable oesophageal cancer remain controversial. The College of American Pathologists (CAP) and Royal College of Pathologists (RCP) define CRM involvement as tumour found at the cut resection margin and within 1 mm of the cut margin respectively. This systematic review and meta-analysis was performed to determine the influence of CRM involvement on survival in operable oesophageal cancer. PubMed, MEDLINE and the Cochrane Library (January 1990 to June 2012) were searched for studies correlating CRM involvement with 5-year mortality. Statistical analysis of dichotomous variables was performed using the odds ratio (OR) as the summary statistic. Fourteen studies involving 2433 patients with oesophageal cancer who had undergone potentially curative oesophagectomy were analysed. Rates of CRM involvement were 15·3 per cent (173 of 1133) and 36·5 per cent (889 of 2433) according to the CAP and RCP criteria respectively. Overall 5-year mortality rates were significantly higher in patients with CRM involvement compared with CRM-negative patients according to both CAP (OR 4·02, 95 per cent confidence interval (c.i.) 2·25 to 7·20; P < 0·001) and RCP (OR 2·52, 1·96 to 3·25; P < 0·001) criteria. CRM involvement between 0·1 and 1 mm was associated with a significantly higher 5-year mortality rate than CRM-negative status (involvement more than 1 mm from CRM) (OR 2·05, 95 per cent c.i. 1·41 to 2·99; P < 0·001). CRM involvement is an important predictor of poor prognosis. CAP criteria differentiate a higher-risk group than RCP criteria, but overlook a patient group with similar poor outcomes.

PTU-174 Systematic review and meta-analysis of the influence of human epidermal growth factor receptor 2 (HER2) expression and amplification on survival in patients with oesophageal cancer

IntroductionSurvival and recurrence rates following oesophagectomy remain poor despite the use of neoadjuvant therapy. Human epidermal growth factor receptor-2 (HER2) overexpression is associated with poorer survival in patients with gastric...

The Junior Temperament and Character Inventory: Italian validation of a questionnaire for the measurement of personality from ages 6 to 16 years

The Junior Temperament and Character Inventory (JTCI) has been developed for the assessment of the personality in individuals 6 to 14 years old according to the psychobiological model of Cloninger. The aim of the present study was to evaluate the psychometric properties of an Italian version of JTCI. The sample included 459 subjects ranging in age from 6 to 15.9 years. Starting from the original parent version, an Italian version of JTCI was developed and administered to parents recruited in primary schools of Lazio and Campania. Using statistically appropriate methods for the analysis of dichotomous variables (binary coded), we analyzed the factor structure, the internal consistency, and the test-retest reliability. The architecture of the JTCI was consistent with the original hypothesis of the Cloninger model. Parent reports of each of the JTCI dimensions had good internal consistency and test-retest reliability over 3 months. Regarding the analysis of risk personality traits, significant correlations were found between several JTCI factors and Strengths and Difficulties Questionnaire scales. The JTCI is useful in research and in clinical practice to evaluate the role of temperament and character dimensions in psychopathology.

P2-01-15: RT-PCR Gene Profiling for the Prediction of Bone Metastases in Primary Breast Cancer.

Abstract Background: Patients with breast cancer frequently develop bone metastases, which are responsible for high morbidity and mortality. It is known that numerous molecules are involved in the bone metastasization process and that only cancer cells with a specific molecular profile are capable of reaching and colonizing bone tissue. The early detection of patients with a high probability of relapsing to bone could be used to select candidates for tailored therapy with bone-specific drugs such as bisphosphonates or RANK-L inhibitors. The aim of the present study was to identify a pattern of tissue markers from primary breast cancer capable of predicting bone metastatization. Material and methods: The expression of different markers was retrospectively analyzed in frozen breast cancer tissue samples from 40 patients comprising 15 cases with no evidence of disease (NEDP), 15 with bone metastases (BMP), and 10 with visceral metastases (VMP). Twelve transcripts were analyzed by Quantitative Real time PCR: trefoil factor 1(TFF1), DKK1, bone sialoprotein (IBSP), heparanase (HPSE), osteopontin (SPP1), Agr2, SPARC, CTGF, COMP, follistatin (FST), osteoprotegerin and RANK. The predictive accuracy of each marker was calculated using receiver operating characteristic (ROC) curves. Results: Analysis of marker expression in the 3 different subgroups showed twofold higher median values of COMP and HPSE in BMP with respect to either NEDP or VMP (no significant difference). Furthermore, TFF1 median value was about sevenfold higher in BMP than in the other 2 subgroups (p=0.05). The area under the curve (AUC) was 0.73 for TFF1 and 0.62 for COMP and HPSE. Considering markers as dichotomous variables, TFF1 expression in BMP reached 67% compared to 21% and 20% in NEDP and VMP, respectively. In dichotomous variable analysis, the most important result was observed for TFF1; in particular, TFF1 positivity was observed in 67% of cases in the BMP subgroup compared to only 21% and 20% in NEDP and VMP, respectively. The combination analysis of TFF1 and other markers showed that positivity to at least one of the three markers, TFF1, DKK1, or IBSP, was observed in 80% of cases for the BMP group, and in only in 21% and 20% of cases in NEDP and VMP subgroups (p=0.041). Another interesting marker was RANK: although sensitivity was fairly low (12%), specificity reached 100% in both control groups. Conclusions: Our preliminary study identified a RT-PCR gene expression pattern in primary breast cancer that could predict patients destined to bone relapse. Such patients could consequently benefit from adjuvant treatment with bone-targeted therapy. Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P2-01-15.

Dimensions of Destination Images—The Relationship Between Specific Sites and Overall Perceptions of Place: The Example of Dubai Creek and “Greater Dubai”

ABSTRACT The current research study attempted to identify to what extent the overall, generic image of a place is determined by, or related to, site specific locations within the destination. A series of answers to open-ended questions were elicited from 102 respondents in Dubai, United Arab Emirates. The data were analyzed using thematic and textual analysis using the neural network program CatPac™, a principal components analysis of dichotomous variables and Spearman rho tests of frequency ranking. The results from this study imply that two homogeneities of image are able to exist simultaneously in the visitors' minds, even though little correlation appears to exist between the images.

QUALITY OF LIFE AND THE RELATIONSHIP WITH EARLY COMPLICATIONS OF BREAST CANCER TREATMENT IN BRAZILIAN WOMEN

Background and Aims: The assessment of quality of life (QOL) in women with breast cancer before treatment allows a more comprehensive assessment these patients. Some initial complications are a major cause of morbidity in the postoperative period. The aim of this study was to evaluate the association between quality of life before treatment of breast cancer and early complications in National Cancer Institute-Brazil (INCA). Methods: Participants were women with unilateral breast cancer, requiring oncological attention in INCA between June/2009 and March/2010. To assess quality of life before treatment was used EORTC QLQ-C30 and the BR23 module. Information about early changes (axillary web syndrome, pain and subjective symptoms related to early edema in the upper limbs) were obtained by physical examination 30 days after surgery and were collected in a standardized form of the medical records. Bivariate analysis of dichotomous variables and independent variables and the odds ratio, with CI 95%, were analyzed. Results181 women were evaluate and were observed that women who reported good health overall, showed a protection of 57% for early subjective edema (OR=0.43 95% CI 0.20 -0.96). Symptoms scale of BR23 is negatively associated with pain (OR=0.11 95% CI 0.21-0.73). Patients with good functionality-C30 showed protection of 66% (OR=0.34 95% CI 0.15-0.75) for pain. Were not found statistically significant results when evaluating axillary web syndrome and does not indicate the presence of association. Conclusions: These results suggest that good quality of life is predictor to evaluated early complications in women with breast cancer in the period before starting cancer treatment.

QUALITY OF LIFE IN BRAZILIAN WOMEN WITH BREAST CANCER – ASSOCIATION WITH THE SOCIAL ENVIRONMENT

Background and Aims: The incidence of breast cancer is increasing in Brazil, constituting a major cause of morbidity and mortality with major social and epidemiological impact. The aim of this study is to evaluate the association between social support before the treatment of breast cancer and quality of life (QOL) six months after starting treatment. Methods: Eligible participants were women with no history of cancer and who were treated for breast cancer in National Cancer Institute of June/2009-March/2010. The evaluation of the social support was performed before the oncology treatment. EORTC QLQ-C30 was used to measure quality of life. Medical Outcomes Survey-Social Support Survey was used to assess social support. The bivariate analysis of dichotomous variables and odds ratio with confidence interval 95% were analyzed. Results: 195 women were evaluated and it was observed that good emotional support is a protective factor for overall health (OR=0.42 95% CI 0.23-0.79) and scale functionality (OR=0.36 95% 0, 18-0.71). The information support was associated with better global health (OR=0.41 95% CI 0.22-0.76), functionality (OR=0.35 95% CI 0.18-0.70) and symptoms scale (OR=0.38 95% CI 0.18-0.77). Women who reported good emotional support showed reduced of 70% to have general health problems after six months of treatment (95% CI 0.13-0.65). Conclusions: The results of this study suggest that a good social environment in which these women are inserted prior to treatment showed a positive association with the better quality of life six months after surgery in women with breast cancer, underscoring the importance of environmental assessment of the social in these patients.

Abstract 5167: A new panel of tissue markers for the prediction of bone metastatization from primary breast cancer

Abstract Background: It is known that numerous molecular markers associated with proliferation, invasion and adhesion processes, growth factors, chemokines and their receptors, and molecules with bone-like phenotype are involved in metastasization to bone. Only cancer cells with specific molecular profiles are capable of reaching and colonizing bone tissue. The early prediction of relapse in this site could be used to select candidates for tailored therapy with bone-specific drugs such as bisphosphonates or RANK-L inhibitors. In the present study we aimed to identify primary tumor markers capable of predicting relapse to bone. Material and methods: The expression of different markers was retrospectively analyzed in frozen breast cancer tissue samples from 40 patients comprising 15 cases with no evidence of disease (NEDP), 15 with bone metastases (BMP), and 10 with visceral metastases (VMP). Twelve transcripts were analyzed by Quantitative Real time PCR: trefoil factor 1(TFF1), DKK1, bone sialoprotein (IBSP), heparanase (HPSE), osteopontin (SPP1), Agr2, SPARC, CTGF, COMP, follistatin (FST), osteoprotegerin and RANK. The predictive accuracy of each marker was calculated using receiver operating characteristic (ROC) curves. Results: The analysis of marker expression in the 3 different subgroups showed twofold higher median values of COMP and HPSE in BMP with respect to either NEDP or VMP (no significant difference). Furthermore, TFF1 median value was about sevenfold higher in BMP than in the other 2 subgroups (p=0.05). The area under the curve (AUC) was 0.73 for TFF1 and 0.62 for COMP and HPSE. In the dichotomous variable analysis, the most important result was observed for TFF1; in particular, TFF1 positivity was observed in 67% of cases in the BMP subgroup compared to only 21% and 20 % in NEDP and VMP, respectively. The combination analysis of TFF1 and other markers showed that positivity to at least one of the three markers, TFF1, DKK1, or IBSP, was observed in 80% of cases for the BMP group, and in only in 21% and 20% of cases in NEDP and VMP subgroups, respectively (p=0.041). Conclusions: The results from this preliminary study suggest that Real-Time PCR analysis of gene expression and, in particular, the coexpression of some markers in primary breast cancer could identify patients destined to bone relapse who could benefit from adjuvant treatment with bone-specific drugs. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 5167. doi:10.1158/1538-7445.AM2011-5167

Sex and Gender Differences in Travel‐Associated Disease

No systematic studies exist on sex and gender differences across a broad range of travel-associated diseases. Travel and tropical medicine GeoSentinel clinics worldwide contributed prospective, standardized data on 58,908 patients with travel-associated illness to a central database from 1 March 1997 through 31 October 2007. We evaluated sex and gender differences in health outcomes and in demographic characteristics. Statistical significance for crude analysis of dichotomous variables was determined using chi2 tests with calculation of odds ratios (ORs) and 95% confidence intervals (CIs). The main outcome measure was proportionate morbidity of specific diagnoses in men and women. The analyses were adjusted for age, travel duration, pretravel encounter, reason for travel, and geographical region visited. We found statistically significant (P < .001) differences in morbidity by sex. Women are proportionately more likely than men to present with acute diarrhea (OR, 1.13; 95% CI, 1.09-1.38), chronic diarrhea (OR, 1.28; 95% CI, 1.19-1.37), irritable bowel syndrome (OR, 1.39; 95% CI, 1.24-1.57), upper respiratory tract infection (OR, 1.23; 95% CI, 1.14-1.33); urinary tract infection (OR, 4.01; 95% CI, 3.34-4.71), psychological stressors (OR, 1.3; 95% CI, 1.14-1.48), oral and dental conditions, or adverse reactions to medication. Women are proportionately less likely to have febrile illnesses (OR, 0.15; 95% CI, 0.10-0.21); vector-borne diseases, such as malaria (OR, 0.46; 95% CI, 0.41-0.51), leishmaniasis, or rickettsioses (OR, 0.57; 95% CI, 0.43-0.74); sexually transmitted infections (OR, 0.68; 95% CI 0.58-0.81); viral hepatitis (OR, 0.34; 95% CI, 0.21-0.54); or noninfectious problems, including cardiovascular disease, acute mountain sickness, and frostbite. Women are statistically significantly more likely to obtain pretravel advice (OR, 1.28; 95% CI, 1.23-1.32), and ill female travelers are less likely than ill male travelers to be hospitalized (OR, 0.45; 95% CI, 0.42-0.49). Men and women present with different profiles of travel-related morbidity. Preventive travel medicine and future travel medicine research need to address gender-specific intervention strategies and differential susceptibility to disease.

Influence of Patient Characteristics on Success of Ambulatory Blood Pressure Monitoring

To examine the influence of specific patient characteristics on the success of ambulatory blood pressure monitoring (ABPM). Retrospective analysis. University-affiliated family care center. Five hundred thirty patients (mean age 52.7 yrs, range 14-90 yrs) who were undergoing ABPM between January 1, 2001, and July 1, 2007. Specific patient characteristics were identified through an electronic medical record review and then examined for association with ABPM session success rate. These patient characteristics included age, sex, weight, height, body mass index (BMI), occupation, clinic blood pressure, travel distance to clinic, and presence of diabetes mellitus or renal disease. The percentage of valid readings obtained during an ABPM session was analyzed continuously (0-100%), whereas overall session success was analyzed dichotomously (0-79% or 80-100%). Univariate and multivariate regression analyses were performed to examine the influence of patient characteristics on the percentage of valid readings and the overall likelihood of achieving a successful session. In the 530 patients, the average percentage of valid readings was 90%, and a successful ABPM session (>or= 80% valid readings) was obtained in 84.7% (449 patients). A diagnosis of diabetes was found to negatively predict ABPM session success (continuous variable analysis, p=0.019; dichotomous variable analysis, odds ratio [OR] 0.45, 95% confidence interval [CI] 0.23-0.87, p=0.019), as did renal disease (continuous variable analysis, p=0.006; dichotomous variable analysis, OR 0.39, 95% CI 0.17-0.90, p=0.027) and increasing BMI (continuous variable analysis, p<0.001; dichotomous variable analysis, OR 0.78, 95% CI 0.65-0.93, p=0.005). Renal disease and BMI remained significant predictors in adjusted analyses. For most patients, ABPM was successful; however, elevated BMI and renal disease were associated with less complete ABPM session results. Adaptation and individualization of the ABPM process may be necessary to improve results in these patients.

The presence of a booster phenomenon among contacts of active pulmonary tuberculosis cases: a retrospective cohort

BackgroundAssuming a higher risk of latent tuberculosis (TB) infection in the population of Rio de Janeiro, Brazil, in October of 1998 the TB Control Program of Clementino Fraga Filho Hospital (CFFH) routinely started to recommend a two-step tuberculin skin test (TST) in contacts of pulmonary TB cases in order to distinguish a boosting reaction due to a recall of delayed hypersensitivity previously established by infection with Mycobacterium tuberculosis (M.tb) or BCG vaccination from a tuberculin conversion. The aim of this study was to assess the prevalence of boosted tuberculin skin tests among contacts of individuals with active pulmonary tuberculosis (TB).MethodsRetrospective cohort of TB contacts ≥ 12 years old who were evaluated between October 1st, 1998 and October 31st 2001. Contacts with an initial TST ≤ 4 mm were considered negative and had a second TST applied after 7–14 days. Boosting reaction was defined as a second TST ≥ 10 mm with an increase in induration ≥ 6 mm related to the first TST. All contacts with either a positive initial or repeat TST had a chest x-ray to rule out active TB disease, and initially positive contacts were offered isoniazid preventive therapy. Contacts that boosted did not receive treatment for latent TB infection and were followed for 24 months to monitor the development of TB. Statistical analysis of dichotomous variables was performed using Chi-square test. Differences were considered significant at a p < 0.05.ResultsFifty four percent (572/1060) of contacts had an initial negative TST and 79% of them (455/572) had a second TST. Boosting was identified in 6% (28/455). The mean age of contacts with a boosting reaction was 42.3 ± 21.1 and with no boosting was 28.7 ± 21.7 (p = 0.01). Fifty percent (14/28) of individuals whose test boosted met criteria for TST conversion on the second TST (increase in induration ≥ 10 mm). None of the 28 contacts whose reaction boosted developed TB disease within two years following the TST.ConclusionThe low number of contacts with boosting and the difficulty in distinguishing boosting from TST conversion in the second TST suggests that the strategy of two-step TST testing among contacts of active TB cases may not be useful. However, this conclusion must be taken with caution because of the small number of subjects followed.

Test-retest reliability of the alcohol use disorder identification test in a general population sample.

A number of different screening tests are frequently used in alcohol research, but our knowledge about the reliability of many of them is quite limited. Recently, this problem has received more attention. This article examines the test-retest reliability of one of these instruments-the Alcohol Use Disorder Identification Test (AUDIT)-in a general population sample. A general population sample (n = 457) was tested and, after approximately 1 month, was retested by using the AUDIT. Correlation between the two tests has been examined with the intraclass correlation coefficient and the kappa coefficient in analysis of dichotomous variables. Specificity and sensitivity at a number of different cutoff scores have also been analyzed by using the first test as a criterion. On the item level, the correlations ranged between 0.6 and 0.8. The overall reliability of total AUDIT scores was 0.84. When stratified by gender, age, and consumer status, the total score reliability approximated 0.80 for all the categories except low alcohol consumers (0.51). Agreement using the recommended cutoff score of 8+ was also examined. The reliability (kappa) observed in the whole sample was 0.691, which was interpreted as a substantial agreement. By this cutoff, 91% were correctly classified at retest compared with the first test. AUDIT 8+ showed higher reliability for males, young people, and moderate consumers and low reliability among low consumers. In terms of reliability, the most optimal cutoff for women turned out to be 6 or more. According to these results, the test-retest reliability of AUDIT is high. The next step might be to examine to what extent the findings apply within health-care settings, which is what the test originally was designed for.

Influence of General and Crystallized Intelligence on Vocabulary Test Performance

Summary: Vocabulary tests, part of most test batteries of general intellectual ability, measure both verbal and general ability. Newly developed techniques for confirmatory factor analysis of dichotomous variables make it possible to analyze the influence of different abilities on the performance on each item. In the testing procedure of the Computerized Swedish Enlistment test battery, eight different subtests of a new vocabulary test were given randomly to subsamples of a representative sample of 18-year-old male conscripts (N = 9001). Three central dimensions of a hierarchical model of intellectual abilities, general (G), verbal (Gc'), and spatial ability (Gv') were estimated under different assumptions of the nature of the data. In addition to an ordinary analysis of covariance matrices, assuming linearity of relations, the item variables were treated as categorical variables in the Mplus program. All eight subtests fit the hierarchical model, and the items were found to load about equally on G and Gc'. The results also indicate that if nonlinearity is not taken into account, the G loadings for the easy items are underestimated. These items, moreover, appear to be better measures of G than the difficult ones. The practical utility of the outcome for item selection and the theoretical implications for the question of the origin of verbal ability are discussed.