Battery Of Laboratory Tests Research Articles

Treadmill-based cycling time trial better predicts seasonal cross-country mountain bike performance than traditional parameters in laboratory tests

Specific cross-country mountain bike (MTB) laboratory tests are used to monitor training and performance of elite athletes. To better follow up long-term performance development we designed a new MTB specific treadmill-based cycling time trial. The purpose of this study was to investigate the relationship between different physiological parameters from this new test as well as from traditional laboratory tests and overall MTB performance in the following season. Thirteen male cyclists (24.1 ± 3.6 y; 175.9 ± 5.1 cm; 68.1 ± 4.0 kg; 606 ± 589 UCI points) of the Swiss National MTB Team completed three laboratory tests to exhaustion within two days. On the first day, the athletes performed two tests on an SRM cycle ergometer: 1) a long graded exercise test (LGXT) (workload increased 30 W/5 min) to determine the lactate threshold (LT1), the Dmod threshold (Bishop et al., 1998: Medicine & Science in Sports & Exercise, 30(8), 1270–1275), and peak power output (PPOLGXT); and 2) a short graded exercise test (SGXT) (workload increased 25 W/min) to determine maximal oxygen uptake (VI‡O2max) and peak power output (PPOSGXT). On the second day, the athletes performed a MTB-specific 24-min time trial (TT) with variable inclination (4 - 10°) on a motorized treadmill (3x4.5 m) using their own bikes. The athletes were instructed to ride at a self-selected maximal pace and the total distance covered in 24 min was used as the performance measure. All performance-based parameters are expressed relative to body mass. The season performance was evaluated using the International Cycling Union (UCI) points. Pearson correlation analysis was applied to determine the relationship between physiological parameters and the UCI points. The UCI points correlated significantly with TT distance, PPOLGXT and Dmod (r = 0.83, p = 0.001; r = 0.76, p = 0.003 and r = 0.67, p = 0.012). No significant correlation was observed between VI‡O2max, PPOSGXT and LT1 and the UCI points (r = 0.41, p = 0.144; r = 0.49, p = 0.077 and r = 0.51, p = 0.077). The current test battery indicates that TT distance is the best correlate of seasonal MTB performance, with TT distance explaining 68% of the observed variance in UCI points. Furthermore, high UCI rankings were also highly correlated with PPOLGXT and the related Dmod during the LGXT. In contrast VI‡O2max, traditionally regarded as an important determinant of endurance performance (Coyle et al., 1988: Journal of Applied Physiology, 64, 2622–2630), and PPOSGXT, did not show a significant correlation with UCI points in this group of athletes. In accordance with these findings, we observed that younger athletes often achieved comparable values as elite athletes in the SGXT, suggesting the performance difference (UCI points) is differentiated only by the distance completed in the treadmill-based cycling TT. It appears that graded exercise tests of a short duration do not adequately represent the duration that a given workload can be sustained. Therefore for a comprehensive MTB-specific laboratory test battery, we suggest including a MTB-specific time trial with a constant test duration to predict seasonal MTB performance.

Association of television violence exposure with executive functioning and white matter volume in young adult males

Prior research has indicated that self-reported violent media exposure is associated with poorer performance on some neuropsychological tests in adolescents. This study aimed to examine the relationship of executive functioning to violent television viewing in healthy young adult males and examine how brain structure is associated with media exposure measures. Sixty-five healthy adult males (ages 18–29) with minimal video game experience estimated their television viewing habits over the past year and, during the subsequent week, recorded television viewing time and characteristics in a daily media diary. Participants then completed a battery of neuropsychological laboratory tests quantifying executive functions and underwent a magnetic resonance imaging (MRI) scan. Aggregate measures of executive functioning were not associated with measures of overall television viewing (any content type) during the past week or year. However, the amount of television viewing of violent content only, as indicated by both past-year and daily diary measures, was associated with poorer scores on an aggregate score of inhibition, interference control and attention, with no relationship to a composite working memory score. In addition, violent television exposure, as measured with daily media diaries, was associated with reduced frontoparietal white matter volume. Future longitudinal work is necessary to resolve whether individuals with poor executive function and slower white matter growth are more drawn to violent programming, or if extensive media violence exposure modifies cognitive control mechanisms mediated primarily via prefrontal cortex. Impaired inhibitory mechanisms may be related to reported increases in aggression with higher media violence exposure.

Hypertension and its association with shift work, sleep-disordered breathing and place in the organizational hierarchy

Introduction Hypertension (HT) is a highly prevalent cardiovascular disease and a risk factor for coronary heart disease, stroke, and heart and kidney failure, among others. The obstructive sleep apnea (OSA) is a well-known causative factor of hypertension, but less known is the role of shift work systems and the place in the hierarchy of social organization. Objective: To study the risk factors associated with hypertension in a group of health workers. Materials and methods We conducted a cross-sectional study in a group of health workers, as part of an occupational health program in a public hospital in Santiago, Chile. All subjects underwent a medical evaluation, which included anthropometric parameters, blood pressure measurement, a battery of laboratory tests, and surveys of sleep by Berlin Questionnaire. According to this questionnaire went classified in Low or High Risk of OSA. According to the work schedule, the workers were classified into Daytime work, 3rd Shift, and 4th Shift; and as the plant to which they belonged within the organization in Professional, Administrative, Paramedical technician, and Auxiliary. We examined the association of hypertension with shift work, the risk of OSA, and place within the organizational hierarchy using a logistic regression model adjusted for sex, age, BMI, and smoking. Results The study group consisted of 353 workers, with an average age of 44.2 ± 12.6 years (IQ = 31.8–54.7), of which 266 (75.4%) were women, and 87 (24.6%) were men. Of the total, 87 (24.6%) had hypertension. On the other hand, as the result of the Berlin Questionnaire, 151 (42.8%) had High Risk of OSA. According to the work schedule, 194 (55%) worked in daytime, and 159 (45%) were shift workers (114 in 4th Shift, and 45 in the 3rd Shift). Of the total, 44 (12.5%) were Professionals, 78 (22.1%) Administrative, 148 (41.9%) Paramedical technicians, and 83 (23.5%) Auxiliary. According to logistic regression, the 4th Shift had an OR = 2.03 (95% CI, 0.9–4.58; p = 0.088), 3rd Shift an OR = 4.23 (95% CI, 1, 51–11.83; p = 0.006); the trend test was significant with an OR = 2.05 (95% CI, 1.23–3.41; p = 0.006). The High Risk of OSAS an OR = 4.1 (95% CI, 1.89–8.9; p 0.001). Regarding the location in the organization, the Administrative had an OR = 10.1 (95% CI, 1.76–57.88; p 0.001), Paramedical technicians OR = 5.55 (95% CI, 1.1–28.27; p = 0.039), and the Auxiliary an OR = 5, 76 (95% CI, 1.11–29.86; p = 0.037). Interactions between stratum and shift work and risk of OSA, were not significant in the multiplicative scale. The age variable reached statistical significance ( p = 0.018). The factors sex, BMI, and smoking showed no increased risk associated. Conclusion According to our results, the place within the organizational hierarchy, shift work and sleep-disordered breathing, are independent risk factors of hypertension in health workers. These results also suggest that sex, overweight and obesity, and smoking act through independent risk factors and not by themselves. Acknowledgements To health workers of Felix Bulnes Hospital.

Demenz

Dementia is a clinical syndrome characterized by progressive memory loss. Alzheimer's disease, a neurodegenerative disorder, accounts for the majority of clinical cases. The differential diagnosis comprises other neurodegenerative disease entities and vascular dementia, but also secondary and potentially reversible disturbances of cognitive function such as delirium or depression. Diagnostic work-up consists of standardized cognitive testing, neuroimaging, and a basic laboratory test battery. Pharmacological treatment of cognitive symptoms is accompanied by pharmacological and nonpharmacological treatment of psychiatric and behavioral symptoms, establishment of a supportive social network, as well as prevention and treatment of medical complications of dementia. This article summarizes current clinical knowledge on dementia and has a special interest in treatment and prophylaxis of complications in the field of internal medicine.

English

The significant incidence of atopy associated with otitis media with effusion (OME) has suggested a role of allergy in the pathogenesis of OME. Past studies implicated allergy in the pathogenesis of otitis media (OM). Otitis media is a common condition, especially in children. Most episodes of OM were associated with an upper respiratory viral infection and are short- lived and self-limiting with or without medical treatment. However, chronic OM with effusion (OME) has significant sequelae, is refractory to most medical treatments, and frequently requires surgical intervention. A large body of epidemiologic and mechanistic evidence supports a role for allergic rhinitis (AR) as a risk for OM. To establish the association of allergic rhinitis with otitis media with effusion 100 children of age group 5 to14 were taken, 50 children were suffering from otitis media(test group) & 50 were healthy(control group). These children were evaluated clinically & a battery of laboratory tests was performed in all children to establish the prevalence of allergic rhinitis in them. Out of 50 children with otitis media 12 were suffering from allergic rhinitis & out of 50 healthy children 3 were suffering from allergic rhinitis. Chi-square test was performed and the 'P0.05' value was found to be 0.0127(uncorrected) and was highly significant. These findings indicate that prevalence of allergic rhinitis is more in persons suffering from OME as compared to healthy individuals.

Persistent Hypoglycemia of Unknown Etiology in a Patient Without Diabetes

Purpose: This case report reviews the presentation, evaluation, and treatment of persistent hypoglycemia in a patient without a history of diabetes. The use of laboratory tests to differentiate between drug-induced and disease-induced hypoglycemia is reviewed. Summary: A 51-year-old female with multiple medical conditions including bipolar disorder and no history of diabetes was admitted for evaluation and treatment of hypoglycemia. Pharmacotherapy included intravenous dextrose infusions and bolus doses. A battery of tests was ordered to evaluate intrinsic and extrinsic causes. Endocrine Society guidelines for hypoglycemia exist and have recommendations for testing and strategies to rule out drug-related causes. Her insulin level was 57 IU/mL (normal range < 17). Her proinsulin level was 356.8 pmol/L (normal range <8.8). Conclusion: The guidelines recommend a battery of laboratory tests; however, the results are not rapidly available necessitating a structured follow-up process. In our patient, exposure to hypoglycemic agents and exogenous insulin can be ruled out. Autoimmune hypoglycemia or a hypoglycemic reaction to one of her home medications is very unlikely, but cannot be ruled out. An insulinoma is the most likely etiology of her hypoglycemia, but that cannot be confirmed.

Interleukin-6 and Memory Functions of Encoding and Recall in Healthy and Depressed Elderly Adults

Activation of proinflammatory cytokines is associated with depressed mood, feelings of fatigue, and changes in cognitive function. This study examined the relationships between cognitive performance and circulating cellular markers of inflammation, interleukin-6 (IL-6) and C-reactive protein (CRP), in moderately depressed and comparison healthy older adults. We conducted a cross-sectional analysis of 87 volunteers (45 nondepressed and 42 depressed) in which participants completed the Structured Clinical Diagnostic Interview and were evaluated by a geriatric psychiatrist for dementia, depression, stroke risk, and neurologic disorders. Volunteers also completed an electrocardiogram, standard battery of laboratory tests, and neuropsychological examination that assessed memory functions of Encoding and Recall, Executive Function, and Attention/Processing. Mid-morning IL-6 and CRP levels were assessed. The data analysis showed that Encoding and Recall were inversely associated with IL-6 across diagnostic groups after controlling for chronological age, Mini-Mental State Examination, body mass index, literacy level, depression severity, and sex. CRP was not associated with cognition. Depression status was associated with recall independent of IL-6 levels. In conclusion, IL-6 serum levels among elderly individuals is a significant correlate of memory performance. Women, in particular, appear sensitive to IL-6 fluctuations across diagnostic groups.

Promoting mobility after hip fracture (ProMo): study protocol and selected baseline results of a year-long randomized controlled trial among community-dwelling older people

BackgroundTo cope at their homes, community-dwelling older people surviving a hip fracture need a sufficient amount of functional ability and mobility. There is a lack of evidence on the best practices supporting recovery after hip fracture. The purpose of this article is to describe the design, intervention and demographic baseline results of a study investigating the effects of a rehabilitation program aiming to restore mobility and functional capacity among community-dwelling participants after hip fracture.Methods/DesignPopulation-based sample of over 60-year-old community-dwelling men and women operated for hip fracture (n = 81, mean age 79 years, 78% were women) participated in this study and were randomly allocated into control (Standard Care) and ProMo intervention groups on average 10 weeks post fracture and 6 weeks after discharged to home. Standard Care included written home exercise program with 5-7 exercises for lower limbs. Of all participants, 12 got a referral to physiotherapy. After discharged to home, only 50% adhered to Standard Care. None of the participants were followed-up for Standard Care or mobility recovery. ProMo-intervention included Standard Care and a year-long program including evaluation/modification of environmental hazards, guidance for safe walking, pain management, progressive home exercise program and physical activity counseling. Measurements included a comprehensive battery of laboratory tests and self-report on mobility limitation, disability, physical functional capacity and health as well as assessments for the key prerequisites for mobility, disability and functional capacity. All assessments were performed blinded at the research laboratory. No significant differences were observed between intervention and control groups in any of the demographic variables.DiscussionTen weeks post hip fracture only half of the participants were compliant to Standard Care. No follow-up for Standard Care or mobility recovery occurred. There is a need for rehabilitation and follow-up for mobility recovery after hip fracture. However, the effectiveness of the ProMo program can only be assessed at the end of the study.Trial registrationCurrent Controlled Trials ISRCTN53680197

Natural history of MELAS associated with mitochondrial DNA m.3243A>G genotype.

To describe the natural history of clinical and laboratory features associated with the m.3243A>G mitochondrial DNA point mutation. Natural history data are needed to obtain prognostic information and for clinical trial planning. We included 85 matrilineal relatives from 35 families with at least 2 visits in this prospective cohort study. Thirty-one were fully symptomatic with mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes (MELAS), and 54 were carrier relatives. Evaluations included standardized questionnaires (medical history and daily living functioning), physical examination, neuropsychological testing, and a battery of imaging and laboratory tests. We evaluated changes in clinical and laboratory features over time and survival. Outcomes are reported over a follow-up period of up to 10.6 years (mean 3.8 ± 2.2 years for patients and 5.5 ± 3.0 for carrier relatives). Neurologic examination, neuropsychological testing, and daily living scores significantly declined in all patients with MELAS, whereas no significant deterioration occurred in carrier relatives. Cerebral MRI scores declined significantly in patients with MELAS. Magnetic resonance spectroscopy estimates of lactate in the lateral ventricles increased over time, and high lactate was associated with increased mortality. Symptom onset in childhood often was associated with worse outcome. Patients with MELAS had a greater death rate than carrier relatives. Patients with MELAS carrying the m.3243A>G mutation show a measurable decline in clinical and imaging outcomes. It is hoped that these data will be helpful in anticipating the disease course and in planning clinical trials for MELAS.

Predicting psychopharmacological drug effects on actual driving performance (SDLP) from psychometric tests measuring driving-related skills

RationaleThere are various methods to examine driving ability. Comparisons between these methods and their relationship with actual on-road driving is often not determined.ObjectiveThe objective of this study was to determine whether laboratory tests measuring driving-related skills could adequately predict on-the-road driving performance during normal traffic.MethodsNinety-six healthy volunteers performed a standardized on-the-road driving test. Subjects were instructed to drive with a constant speed and steady lateral position within the right traffic lane. Standard deviation of lateral position (SDLP), i.e., the weaving of the car, was determined. The subjects also performed a psychometric test battery including the DSST, Sternberg memory scanning test, a tracking test, and a divided attention test. Difference scores from placebo for parameters of the psychometric tests and SDLP were computed and correlated with each other. A stepwise linear regression analysis determined the predictive validity of the laboratory test battery to SDLP.ResultsStepwise regression analyses revealed that the combination of five parameters, hard tracking, tracking and reaction time of the divided attention test, and reaction time and percentage of errors of the Sternberg memory scanning test, together had a predictive validity of 33.4%.ConclusionThe psychometric tests in this test battery showed insufficient predictive validity to replace the on-the-road driving test during normal traffic.

Open biopsy in patients with acute progressive neurologic decline and absence of mass lesion

Objective: Patients with acute to subacute neurologic decline undergo a battery of imaging and laboratory tests to determine a diagnosis and treatment plan. Often, after an extensive evaluation, a brain biopsy is recommended as yet another tool to assist in determining the diagnosis. The goal of this retrospective cohort analysis is to measure the sensitivity of open brain biopsy in this patient population, compare these results with the preoperative presumed diagnosis, and evaluate if the biopsy result significantly alters treatment. Methods: The authors reviewed the medical records of 135 consecutive patients who underwent open brain biopsies for acute to subacute progressive neurologic decline between January 1999 and September 2008 at a single institution. All patients with mass lesions, with HIV/AIDS, and who were younger than 20 years of age were excluded from the study. Fifty-one patients met these criteria and all preoperative tests, imaging, and treatment plans were examined and compared with postbiopsy interventions to determine the impact of the biopsy on patient outcome. Results: The sensitivity of open brain biopsy at our institution was 35%. The most common preoperative presumed diagnosis was vasculitis and the most common postoperative finding was Creutzfeldt-Jakob disease, followed by amyloid angiopathy. Postbiopsy hemorrhage was a complication in 4% of patients. Treatment plans changed as a direct result of the biopsy in 8% of patients, and in only 4% did the biopsy findings make a difference in disease course. Conclusion: In patients with progressive neurologic decline without a radiographic mass lesion or immunodeficiency, open brain biopsy often fails to provide a diagnosis and even more rarely does it significantly alter treatment.

Explicit and Implicit Memory in Late-Life Depression

Late-life depression has been associated with memory loss and is frequently assumed to be a risk factor for continued cognitive decline. This study examined cognition in patients with late-life depression with a focus on the assessment of the extent and type of memory loss among elderly depressed patients. Two-year cross-sectional study of elderly depressed (N = 112) and nondepressed (N = 138) individuals at or older than 60 years in an urban area surrounding a major medical center in southern California. Participants had little to moderate stroke risk. Volunteers were screened with the Hamilton Depression Rating Scale and the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) Axis I Disorders. Patients were diagnosed for major depression by a geriatric psychiatrist using DSM-IV criteria. Volunteers completed neuropsychological testing, a standard battery of laboratory tests, and a neurologic and psychiatric evaluation to rule out a medical burden that might contribute to depression or early dementia. Depressed patients showed deficits in attention and processing, executive function, and immediate explicit recall. Implicit learning and episodic recall of the testing procedure, semantic and phonetic fluency, and retention of newly acquired verbal material after a delay period were comparable with controls. Moderately depressed patients demonstrate a pattern of cognitive deficits suggestive of mild frontal dysfunction during recall tasks. Their retention of material over a delay period and their intact language skills indicate medial hippocampal function similar to controls. Subcortically mediated implicit memory is also at normal levels. These findings support current efforts to identify pathways of frontal and/or striatal compromise during depressive episodes.

Study of occupational stress among railway engine pilots

Background:Traffic volume and speed is going to be increased in Indian Railways successively, leading to higher stress in staff connected with train operations. The jobs of railway engine pilots come under the category of high-strain jobs, necessitating a need to conduct multicentric study to unfold the factors associated with occupational stress and organizational strategies.Materials and Methods:Present study covered 185 railway engine pilots and office clerks working in various railway zones by incidental method. Occupational Stress Index (OSI) test developed by Srivastva and Singh, questionnaire of specific stressors constructed by authors and laboratory test battery for psychological screening of high-speed train pilots were used as tools.Results:Means of OSI and all the 12 occupational stressors of railway engine pilots were found significantly higher to that of office clerks. Means of OSI and occupational stressors of goods train pilots were significantly higher in comparison to high-speed train pilots and passenger train pilots. Study revealed positive correlation of speed perception and complex reaction time tests and negative correlation of other constituent tests of laboratory test battery to OSI test. Highest subgroup of stressor observedwas role overload followed by role conflict.Conclusions:These findings provide a prima facie evidence of higher occupational stress among railway engine pilots because of identified specific stressors prevalent in their job and explore the possible intervention strategies for its reduction. Significant correlation is noticed between OSI and laboratory test results, indicating its relevant utility in preliminary psychological screening.

Open biopsy in patients with acute progressive neurologic decline and absence of mass lesion

Patients with acute to subacute neurologic decline undergo a battery of imaging and laboratory tests to determine a diagnosis and treatment plan. Often, after an extensive evaluation, a brain biopsy is recommended as yet another tool to assist in determining the diagnosis. The goal of this retrospective cohort analysis is to measure the sensitivity of open brain biopsy in this patient population, compare these results with the preoperative presumed diagnosis, and evaluate if the biopsy result significantly alters treatment. The authors reviewed the medical records of 135 consecutive patients who underwent open brain biopsies for acute to subacute progressive neurologic decline between January 1999 and September 2008 at a single institution. All patients with mass lesions, with HIV/AIDS, and who were younger than 20 years of age were excluded from the study. Fifty-one patients met these criteria and all preoperative tests, imaging, and treatment plans were examined and compared with postbiopsy interventions to determine the impact of the biopsy on patient outcome. The sensitivity of open brain biopsy at our institution was 35%. The most common preoperative presumed diagnosis was vasculitis and the most common postoperative finding was Creutzfeldt-Jakob disease, followed by amyloid angiopathy. Postbiopsy hemorrhage was a complication in 4% of patients. Treatment plans changed as a direct result of the biopsy in 8% of patients, and in only 4% did the biopsy findings make a difference in disease course. In patients with progressive neurologic decline without a radiographic mass lesion or immunodeficiency, open brain biopsy often fails to provide a diagnosis and even more rarely does it significantly alter treatment.

Safety and Pharmacokinetics of Subcutaneously Administered Rilonacept in Patients With Well‐Controlled End‐Stage Renal Disease (ESRD)

The safety and pharmacokinetics of a single dose of the IL-1 inhibitor, rilonacept (IL-1 Trap; 160 mg, subcutaneously), was studied in a group of 6 patients with well-controlled end-stage renal disease (ESRD) who were observed for a period of 42 days following dosing. The safety of rilonacept administration was ascertained by regular monitoring of patients for adverse events, by periodic determination of a battery of standard laboratory and hematology tests, and by testing for binding and neutralizing antibodies to rilonacept. Two of the 6 patients had treatment-emergent adverse events that were moderate in intensity and unrelated to administration of rilonacept. There were no deaths, serious adverse events, or withdrawals due to adverse events. No patient developed binding or neutralizing antibodies to rilonacept by the 42nd day postdosing. Mean C(max) estimated by a noncompartmental analysis was 17.2 mg/L; t(max,) 2.80 days; terminal t(1/2), 7.63 days; and AUC(0-infinity), 199.3 d.mg/L. Comparison of these results to those obtained in a population of patients with cryopyrin-associated periodic syndromes, a group of rare, inherited, autoinflammatory disorders (mean [SD] eGFR of 73.1 [13.3] mL/min/1.73m2), shows that ESRD and related hemodialysis procedures do not prolong the elimination of rilonacept, and therefore no dose adjustment should be needed relative to individuals with normal renal function.

Aerobic And Anaerobic Changes In Collegiate Male Runners Across A Cross-Country Season

The purpose of this study was to assess the physiological characteristics of trained NCAA Division III male runners across a competitive season of cross-country. Eight male distance runners (age 20.6±1.4 y) were administered a battery of aerobic and anaerobic laboratory tests at the beginning and end of an 8-10 week racing season. Aerobic testing included maximal oxygen uptake (VO2max), running economy (RE), ventilatory threshold (VT) and the onset of blood lactate accumulation (OBLA). Anaerobic testing consisted of the vertical jump (VJ) and the Wingate test. Final testing revealed anaerobic Wingate peak power significantly declined (11.8±1.1 to 10.7±1.0 W·kg-1) (P = 0.006), while no significant changes were seen in VJ or any aerobic parameters (P &gt; 0.05). These results indicate that a competitive cross-country season of training and racing diminished anaerobic peak power and failed to elicit quantifiable aerobic adaptations in previously trained collegiate distance runners.

Poster 34: Evidence-Based Practice for Early Cognitive Impairment Detection on Older Individuals with Metabolic Syndrome

Background: Alzheimer's disease (AD) is the most common form of dementia, and it has been associated to diabetes and metabolic syndrome. Due to the high prevalence of diabetes and metabolic syndrome in the older population, it is important to detect cognitive decline at early stages to allow prompt initiation of therapy and counseling of the patients and family. Objective: The objective of this study is twofold: 1) to systematically analyze the literature to investigate the clinical significance of FDG-PET in the early diagnosis of mild cognitive impairment (MCI), and 2) based on the systematic review, we examine by a case study design the patterns of hypometabolism found in 2 older female subjects with metabolic syndrome and subjective memory complaints. Systematic Review Methods: An extensive review of literature has been conducted, using PubMed as the primary search engine. A set of predefined inclusion criteria was used to determine inclusion and analysis of the papers. Systematic Review Results: A total of 6 studies were included in the review. Cognitive decline was predicted with sensitivities ranging from 38% to 93%, specificities ranging from 62.5% to 97% and accuracies from 81.8 to 90% (N=6). Case Study Methods: Two older female patients (P1& P2) were evaluated by a comprehensive battery of neurological, memory, and laboratory tests. Case Study Results: Both patients had insulin resistance and MS. The neuropsychological evaluation indicated that both patients suffer from mild MCI. Conclusions: The results of the review of literature show that due to the high values for specificity, sensitivity, and accuracy, as well as due to the consistent patterns of hypometabolism detected, FDG-PET is a good diagnostic tool and shows great promise as a clinical tool in the early detection of MCI. As for the case study, the FDG-PET scans of P1 and P2 showed different patterns of hypometabolism, suggesting the patients have two different types of MCI. Even though most of the neuropsychological tests were close to normal ranges, the PET scan was able to detect patterns of hypometabolism—and thus reduced function, consistent with the subjective memory complaints of the patients. The objective assessment performed with FDG-PET was more reliable in predicting early MCI than the neuropsychological tests, as suggested by previous studies.

Field Performance and Accelerated Weathering of High Performance Acrylic and Polyurethane Sealants for Tilt-Up Applications

Abstract To demonstrate the suitability of high performance acrylic sealants to low rise industrial construction applications, a laboratory prepared high performance acrylic sealant was compared to a commonly used, commercially available two part polyurethane sealant. The centerpiece of this comparison is an exterior exposure in El Paso, TX, in which the two sealants were professionally installed in alternating joints around the perimeter of a tilt-up warehouse. The sealants were also subjected to a battery of laboratory tests, including tensile testing, sealant specification testing, paintability, and accelerated weathering in both xenon arc and fluorescent UV devices. The 3 year El Paso exposure results, in combination with the laboratory, weathering, and application test results, demonstrate the performance advantages of the high performance acrylic sealant and highlight its inherent suitability for use in low rise industrial applications such as tilt-up warehouses.

Undetectable Prostate-Specific Antigen in the Absence of Previous Prostatectomy: Laboratory Error or True Finding?

Patient: A 51-year-old Caucasian male followed by the internal medicine clinic for many years because of multiple chronic medical conditions. Chief Complaint: Presented in November 2008 as part of a previously scheduled visit for routine follow up. History of Present Illness: Chronic longstanding hypothyroidism, type II diabetes, hypertension, obesity, dyslipidemia, trigeminal neuralgia, depression (with associated decreased energy and fatigue), and erectile dysfunction. Since the patient was now over 50 years of age, the battery of laboratory tests ordered included a prostate-specific antigen (PSA). Past Medical History: He had a motor vehicle accident in 1998 with traumatic brain injury and subsequent cerebrovascular accident following endovascular graft placement for aortic dissection. He has had chronic pain in his right leg since the accident for which he was medicated with oral hydromorphone as well as a morphine pump. Physical Examination: The patient was afebrile, with class II obesity (BMI=37.1), blood pressure of 133/62 mm Hg, and a pulse rate of 72/min. By rectal exam, a “very small” prostate with no other specific findings was encountered. The remainder of his physical exam was unremarkable. Family History: Noncontributory. Drug History: Noncontributory. Allergies: Penicillin, pentazocine, nalbuphine, butorphanol, clonidine, Lamotrigine, and nifedipine. Laboratory Findings: See Tables 1–3 . His primary care physician called the laboratory to inquire as to whether or not his screening PSA value was a laboratory error. 1. What are the current recommendations for prostate cancer screening? 2. What are the risk factors for prostate cancer? 3. What PSA value triggers evaluation for prostate cancer and what may interfere with the PSA assay? 4. What other serologic markers may help with prostate cancer detection? 5. What are the treatments for prostate cancer? 6. What are the reasons for a low PSA, and how would you evaluate the finding of an undetectable PSA? 7. How are his chronic complaints and …

Is Semen Analysis Useful to Predict the Odds that the Sperm will Meet the Egg?

Any mammalian spermatozoon that achieves successful in vivo fertilization has to perform almost perfectly in many disparate functions and overcome a series of obstacles imposed by the female reproductive tract. This implies that during formation in the testis and epididymis, the spermatozoa did not incur any morphological, metabolic, immunological or genetic abnormalities. Given that the spermatozoa are such highly differentiated cells, this means that every cellular compartment must not only be intact but must also respond appropriately to intracellular and extracellular signals. Assuming that a spermatozoon possesses this level of perfection, and is able to reach and penetrate an oocyte, it can only be regarded as 'fertile' if the DNA it carries is intact and able to sustain embryonic development. Although the proportion of inseminated spermatozoa that meet these criteria is vanishingly small, the female reproductive tract applies stringent selection criteria during sperm transport and, as a result, the probability of conception around the time of ovulation is very high. If laboratory tests of semen quality could approach the efficacy of the female reproductive tract, it would be possible to predict the odds of spermatozoa meeting the egg; however, this is not possible at present. In this article, I suggest a simple model to illustrate how a battery of laboratory tests could eventually be used to make these predictions.