Objective Measure Of Response Research Articles

Self-reported hay fever and panic attacks in the community

The objective of this study was to determine the relationship between self-reported hay fever and common mental disorders among adults in the general population. Data were drawn from the Midlife Development in the United States Survey, a representative household survey of the adult US population (25 to 74 years old; n = 3,032). Multivariate logistic regression analyses were used to determine the relationship between self-reported hay fever and current major depression, panic attacks, generalized anxiety disorder, and alcohol/substance use disorders. Self-reported hay fever was associated with a significantly increased odds of panic attack (odds ratio = 1.8 [1.2, 2.6]), which persisted after adjusting for differences in sociodemographic characteristics and comorbid mental disorders. Self-reported hay fever was not associated with a significantly increased likelihood of major depression, generalized anxiety disorder, or alcohol/substance use disorders. Consistent with previous findings, these data show a relationship between self-reported hay fever and increased likelihood of panic attacks among adults in the general population. The mechanism of the observed association remains unknown. Future work that examines the relationship between hay fever and panic attacks, as well as other mental disorders using both self-report and objective measurement of allergic response in prospective, longitudinal, epidemiologic data may be useful in improving our understanding of this observed link.

Development of a Standardized Methodology for Double-blind, Placebo-controlled Food Challenge Patients with Brittle Asthma and Perceived Food Intolerance

Objective To develop a standardized, double-blind, placebo-controlled, food challenge (DBPCFC) methodology for identifying food intolerance in patients with brittle asthma. Subjects/setting Patients with brittle asthma and perceived food intolerance were studied in hospital. Design Each of 3 protocols began with 5 days of dietary exclusion. Protocol 1 consisted of open food challenges in 29 patients, protocol 2 consisted of 2 daily DBPCFCs in 22 patients, and protocol 3 involved 1 daily DBPCFC in 18 patients. Total immunoglobulin E level was measured and food-specific radioallergosorbent tests and skin prick tests were conducted. A standard panel of hyperallergenic foods were masked in a soup (developed specially for this study) for every food challenge. Peak expiratory flow, forced expiratory volume, and symptoms were assessed as objective measures of response. Open food challenges at home followed each protocol. Each protocol took approximately 14 days in the hospital and 4 to 6 months at home. Results For protocols 1, 2 and 3, positive reactions were experienced by 52%, 55%, and 66% of patients, respectively. Radioallergosorbent tests and skin prick tests were shown to have 40% and 71% sensitivity, respectively, and 74% and 77% specificity for predicting a positive food challenge. Applications/conclusions The high prevalence of food intolerance in patients with brittle asthma was confirmed, as was the poor positive predictive value of skin prick tests and radioallergosorbent tests. The food challenge method developed enables standardized identification of food intolerances in patients with brittle asthma and may be useful in other groups. J Am Diet Assoc. 2000;100:1361–1367.

The value of acoustic rhinometry in assessing nasal responses to cat exposure

Background: Acoustic rhinometry (AR) uses sonar principles to map the anatomy of the nasal cavity and has been used in other studies to assess acute airway responses to allergen exposure. Objective: The purpose of this study was to evaluate the utility of AR in assessing acute airway responses to cat allergen exposure by using a well-characterized cat exposure model. Methods: Thirty subjects with a history of cat-induced rhinitis and a positive skin prick test response to cat allergen underwent an environmental cat challenge. Of these 30 subjects, 10 also had repeat challenges at lower levels of antigen to determine whether there was a dose response. Five subjects with negative skin test responses to cat were recruited as control subjects. During the 1-hour cat exposure, upper and lower respiratory symptoms were scored every 5 minutes, and spirometry and AR were obtained every 15 minutes. Results: Although 29 of 30 subjects had changes in AR measurements, no correlations were detected between upper respiratory symptom scores and any of the changes observed in AR. In comparing the baseline challenges with lower antigen level challenges, upper respiratory symptom scores differed significantly ( P = .002), whereas AR responses were nearly identical. Subjects without cat allergy did exhibit less response by AR ( P = .05 to .13), but the greatest differences remained in the upper respiratory symptoms scores ( P < .0001). Conclusion: We conclude that although AR does provide an objective measure of nasal response to allergen exposure, it has significant limitations. These are evidenced by the lack of correlation with symptoms, the inability to measure a dose response, and the changes noted even among the control subjects. (J Allergy Clin Immunol 1998;102:896-901).

Transurethral Needle Ablation of the Prostate: A Minimally Invasive Treatment for Symptomatic Benign Prostatic Hyperplasia

Transurethral needle ablation of the prostate, a relatively new minimally invasive treatment modality for patients with bladder outlet obstruction attributable to an enlarged prostate gland, has undergone extensive evaluation by numerous investigators worldwide. The results to date indicate that needle ablation is safe and effective for relieving symptoms in patients with benign prostatic hyperplasia, and the effect has been demonstrated to be durable for at least 2 years. Nevertheless, additional investigations with longer follow-up data are needed to address the important issues of extended durability (5 to 10 years) and biophysiologic mechanism of action. Comparisons between transurethral needle ablation of the prostate and transurethral resection of the prostate (TURP) have revealed that the subjective and objective measures of response are comparable, although TURP has consistently displayed a slight advantage over needle ablation for most variables analyzed, except quality of life score. The advantages of needle ablation over TURP are (1) performance in the office as an outpatient procedure, (2) no need for general or spinal anesthesia, (3) rapid recovery, (4) minimal side effects, and (5) one-time intervention. The following disadvantages exist with needle ablation: (1) it may not be indicated or effective in patients with large prostate glands (75 g or more); (2) no prostate tissue is available for histologic evaluation; and (3) no long-term efficacy or re-treatment rate data have been published. Overall, the available information indicates that transurethral needle ablation is a viable minimally invasive treatment that may be applicable in men with moderate to severe bladder outlet obstruction as a result of an enlarged prostate gland.

Endoscopic ultrasound determined maximal tumor thickness is an objective measure of tumor response to chemotherapy in esophageal cancer

Endoscopic ultrasound determined maximal tumor thickness is an objective measure of tumor response to chemotherapy in esophageal cancer

Evoked potential findings in Behçet's disease. Brain-stem auditory, visual, and somatosensory evoked potentials in 44 patients

We studied 54 patients with Behçet's disease, 41 males and 13 females, mean age 28 years. Forty-four patients had auditory brain-stem evoked potential (BAEP) recordings, 39 had pattern reversal visual evoked potentials (VEP), 27 had median nerve somatosensory evoked potential (SEP) recordings, and 25 tibial nerve SEPs. BAEPs were abnormal in 16 patients (52%) with neurological manifestations and in 4 (31%) without, because of decreased amplitude of wave V, prolonged I–III or III–V interpeak latencies, or uncertain/absent waves III and/or V. Eleven patients (40%) with neurological symptoms and 3 patients (25%) without, had abnormal VEPs. Absent potentials, decreased amplitude, with or without prolonged P100 latency, were found in 75% of the cases, the rest had prolonged P100 latency only. Median SEPs were abnormal in 8 patients (38%) with neurological manifestations. Four patients (21%) had abnormal tibial SEPs. Decreased amplitude with or without mild slowing in central conduction was the predominant SEP abnormality. SEPs were normal in all patients without neurological symptoms. In total, 84% of patients with, and 38% of patients without, neurological symptoms had abnormalities of one or more EP modality. When used cautiously, EP studies in Behçet's disease might be helpful to separate neuro-Behçet from other disorders with similar symptomatology, to disclose subclinical CNS involvement, to evaluate and monitor CNS disease activity, and to provide objective measures of treatment response.

GFP image analysis in the mouse orthotopic bladder cancer model

Precise and objective measurements of tumor response have yet to be standardized in the mouse orthotopic bladder cancer model. In this study, we used image analysis and green fluorescent protein (GFP) to objectively measure tumor size in response to chemotherapy. KU-7 human bladder cancer cells transfected with GFP were intravesically inoculated into 8-week-old female nude mice. Fourteen days after tumor cell inoculation, the mice were assigned into a control (PBS) group or a doxorubicin (conc. 1.0 mg/ml) treatment group and received a single instillation of treatment. Fourteen days after treatment, the bladders were surgically exposed and fluorescent images were captured and later analyzed using image analysis. Bladders were processed for histological examination. Tumor incidence determined by GFP expression and histology was 100 and 80%, respectively, in the doxorubicin treatment group. A 9-fold (histology) vs. 12-fold (GFP expression) difference in tumor regression measured by tumor area (P<0.05) and a 5-fold (histology) vs. 9-fold (GFP expression) difference in tumor regression measured by the percent of tumor area in the bladder (P<0.001) were observed in the doxorubicin treatment group. Our findings suggest that using image analysis provides a precise, sensitive and objective means to measure tumor growth and treatment response in the mouse orthotopic bladder cancer model in lieu of histological methods. Consequently, the number of mice required in an experiment can be reduced since tissue samples are not needed for histology, thus making tissue samples readily available for additional assays in both a labor-effective and cost-effective manner.

The clinical spectrum of ocular lymphoma.

Ocular lymphoma is an uncommon cause of chronic vitreitis or uveitis, often refractory to steroid treatment, and frequently representing another site of multifocal primary central nervous system lymphoma (PCNSL). The authors reviewed the medical and ophthalmologic records of 24 patients with ocular lymphoma; 23 had associated PCNSL: In half, the eyes were the initial site of disease; in the others central nervous system (CNS) lymphoma developed before, or concurrent with, ocular lymphoma. Most patients had bilateral ocular symptoms; slit-lamp examination revealed asymptomatic disease in four. Vitrectomy was not always diagnostic, particularly in patients who had received steroids. Ocular ultrasound, performed on seven patients, provided an objective measure of disease and treatment response. Patients received a variety of therapeutic combinations of steroids, radiation, and chemotherapy, including high-dose cytosine arabinoside. Despite therapy, eventual ocular or CNS relapse or both was common. Thirteen patients have died, 12 with known recurrent CNS disease. Ocular lymphoma frequently is associated with PCNSL: The diagnosis should be considered in patients with steroid-resistant chronic vitreitis or uveitis. Patients with PCNSL should be carefully evaluated for ocular involvement, regardless of symptoms. Treatment can contribute to prolonged remission, but eventual ocular or CNS relapse is the rule.

Quantitative electromyographic analysis of changes in muscle activity following botulinum toxin therapy for cervical dystonia.

Reports of efficacy of botulinum toxin for cervical dystonia have relied on subjective reports of improvement or various clinical rating scales. We studied 19 patients with cervical dystonia using Turns analysis to determine if quantitative EMG measures of muscle activity changed following botulinum toxin injections. Before and after botulinum toxin injections, six muscles were evaluated bilaterally. Quantitative EMG analysis of active muscles injected with botulinum toxin showed a significant decline in muscle activity after botulinum toxin (F = [1,41] 55.0; p < 0.001). Significant reductions in quantitative EMG parameters were also noted in noninjected active muscles after botulinum toxin treatment (F = [1,51] 59.15; p < 0.001). The sum of EMG activity for all active muscles was calculated for each subject and showed a significant reduction after botulinum toxin injection [MANOVA: (F = [1,5] 5.69; p < 0.05]. Quantitative EMG assessment provides an objective measure of response to botulinum toxin. Decreased muscle activity in noninjected muscles may result from toxin diffusion or reflect relaxation of muscles only secondarily involved in cervical dystonia.

P 039 Brainstem reflexes — Brainstem auditory evoked potentials and MRI in Behçet's syndrome

We studied 54 patients with Behçet's disease, 41 males and 13 females, mean age 28 years. Forty-four patients had auditory brain-stem evoked potential (BAEP) recordings, 39 had pattern reversal visual evoked potentials (VEP), 27 had median nerve somatosensory evoked potential (SEP) recordings, and 25 tibial nerve SEPs. BAEPs were abnormal in 16 patients (52%) with neurological manifestations and in 4 (31%) without, because of decreased amplitude of wave V, prolonged I–III or III–V interpeak latencies, or uncertain/absent waves III and/or V. Eleven patients (40%) with neurological symptoms and 3 patients (25%) without, had abnormal VEPs. Absent potentials, decreased amplitude, with or without prolonged P100 latency, were found in 75% of the cases, the rest had prolonged P100 latency only. Median SEPs were abnormal in 8 patients (38%) with neurological manifestations. Four patients (21%) had abnormal tibial SEPs. Decreased amplitude with or without mild slowing in central conduction was the predominant SEP abnormality. SEPs were normal in all patients without neurological symptoms. In total, 84% of patients with, and 38% of patients without, neurological symptoms had abnormalities of one or more EP modality.When used cautiously, EP studies in Behçet's disease might be helpful to separate neuro-Behçet from other disorders with similar symptomatology, to disclose subclinical CNS involvement, to evaluate and monitor CNS disease activity, and to provide objective measures of treatment response.

P 047 Magnetic resonance imaging and brainstem auditory evoked potential in neuro-Behçet's disease

We studied 54 patients with Behçet's disease, 41 males and 13 females, mean age 28 years. Forty-four patients had auditory brain-stem evoked potential (BAEP) recordings, 39 had pattern reversal visual evoked potentials (VEP), 27 had median nerve somatosensory evoked potential (SEP) recordings, and 25 tibial nerve SEPs. BAEPs were abnormal in 16 patients (52%) with neurological manifestations and in 4 (31%) without, because of decreased amplitude of wave V, prolonged I–III or III–V interpeak latencies, or uncertain/absent waves III and/or V. Eleven patients (40%) with neurological symptoms and 3 patients (25%) without, had abnormal VEPs. Absent potentials, decreased amplitude, with or without prolonged P100 latency, were found in 75% of the cases, the rest had prolonged P100 latency only. Median SEPs were abnormal in 8 patients (38%) with neurological manifestations. Four patients (21%) had abnormal tibial SEPs. Decreased amplitude with or without mild slowing in central conduction was the predominant SEP abnormality. SEPs were normal in all patients without neurological symptoms. In total, 84% of patients with, and 38% of patients without, neurological symptoms had abnormalities of one or more EP modality.When used cautiously, EP studies in Behçet's disease might be helpful to separate neuro-Behçet from other disorders with similar symptomatology, to disclose subclinical CNS involvement, to evaluate and monitor CNS disease activity, and to provide objective measures of treatment response.

Objective measurement of therapeutic response in breast cancer using tumour markers

In 65 patients with systemic breast cancer, a biochemical response index using three tumour markers in combination, carcinoembryonic antigen (CEA), carbohydrate antigen 15-3 (CA 15-3) and erythrocyte sedimentation rate (ESR), allowed objective biochemical assessment of response to endocrine therapy. Changes in these three markers at 2, 4 and 6 months showed a highly significant correlation with UICC assessed response at 6 months. At 4 months, changes in these three markers resulted in a selectivity of 93%, with a sensitivity of 92% and a specificity of 82%. Survival of groups of patients assessed biochemically or by UICC criteria for non-progression or progression showed no significant difference. The advantage of the biochemical assessment are that it is objective and reproducible. The assessment gives similar information to the UICC assessment but can be carried out earlier. Changes in the three markers appears to reflect the dynamics of change in tumour mass in response to systemic therapy in contrast to the UICC criteria which reflect structural change.

An objective biochemical assessment of therapeutic response in metastatic breast cancer: a study with external review of clinical data

A series of tumour related markers have been examined in 179 patients receiving primary endocrine therapy for metastatic breast cancer. Significant correlations between therapeutic response (UICC criteria after 6 months of treatment) and appropriate alterations in serum concentrations of carcinoembryonic antigen, ferritin, c-reactive protein, orosomucoid and the erythrocyte sedimentation rate, have been observed when changes in these markers were examined only at high serum concentrations. By combining these five markers a 'therapeutic index' of response has been devised which can be employed at an early stage of treatment in more than 90% of patients, giving an overall sensitivity/specificity of 90%/78% for therapeutic response or disease stabilisation over a 6-month period. The design of an objective measurement of response, which is easy to perform, has the potential to replace the existing, largely subjective. UICC criteria for retrospective judgement of response, and may also be used to direct systemic endocrine therapy.

Assessment of four monoclonal antibodies as serum markers in breast cancer

Four monoclonal-antibody-defined serum markers (CA15-3, HMFG1, HMFG2 and NCRC-11) were examined in five groups of subjects: controls, benign breast disease and stage I/II, stage III and metastatic breast cancer. None of the markers were significantly elevated in primary breast cancer (i.e. stage I/II or stage III) compared with controls or patients with benign breast disease. These markers therefore have no role in screening or in the diagnosis of primary breast cancer. CA15-3, HMFG2 and NCRC-11 were significantly increased in the patients with metastatic breast cancer ( P < 0.001), indicating a potential use in the diagnosis of symptomatic metastases. In patients with metastases, sequential changes in CA15-3 correlated significantly with clinical response to therapy. Thus CA15-3 is a powerful marker of response and in combination with other markers, may provide an objective measurement of response to therapy in patients with advanced breast cancer.

Honeybees can be Trained to Respond to very Small Changes in Geomagnetic Field Intensity

ABSTRACT It has been demonstrated repeatedly (Kirschvink &amp; Kirschvink, 1989; Walker et al. 1989; Walker &amp; Bitterman, 1985, 1989) that free-flying honeybees can be trained to respond to local anomalies in the geomagnetic field, but none of the training methods previously available has been sensitive enough for threshold studies. Here we report some determinations of intensity thresholds with a new and more powerful technique that permits objective measurement of response.

THEORETICAL RESEARCH SHOULD BE USEFUL AND USED*

Abstract The goal of basic research is the advancement of scientific knowledge for the sake of knowledge. The applicability of that knowledge is irrelevant (Palmer 1984). Basic research is theory-oriented. Predictions are based on theoretical conceptualizations. Empirical research is done to clarify, test and develop the theory (McGuire 1969). Or as Davidson (1977: 277) formulates it: ‘The scientist is essentially the seeker after knowledge that is systematically acquired and systematically explored. His first obligations are … towards knowledge itself. Scientists want to know why things are and how they work the way they do.’ For Hilgard and Bower (1966: 574) basic-science research is guided by the problems which the investigator sets himself without regard for the immediate applicability of the results to practical situations. Most basic research makes use of a single or a few tightly defined independent variables, simple and objective response measures as dependent variables and of rather homogeneous g...

Spongious bone density determination for staging and follow-up of patients with prostatic cancer

Quantitative computerized tomography (QCT) of vertebral bodies could reveal metastatic spread of prostatic cancer before such lesions are seen with standard examinations. Focal increase in the density of the spongious bone in face of normal bone scan and serum acid phosphatase is suggestive of metastasis, but certitude is gained only if further increase in density or structural bone changes are demonstrated on follow-up studies. QCT also may provide an objective measurement of tumor response to therapy.

Subjective and objective measures of response to alcohol among young men at risk for alcoholism.

Biological sons of alcoholic men constitute one group at high risk (HR) for the development of alcoholism. A low dose of alcohol (0.5 g/kg) was administered to HR and control subjects. Measures based on self-ratings, an observer's assessment and visuomotor performance were used to compare the HR and control subjects before and after alcohol administration. Results showed HR subjects' self-ratings of intoxication and somatic symptoms were significantly lower than those of control subjects after alcohol administration. Measures based on an observer's assessment of the two groups did not distinguish them, but one measure of visuomotor performance did. Because the HR and control subjects did not differ in self-reported alcohol consumption or blood alcohol levels acquired in this study, it appears unlikely these factors could account for the differential responses to alcohol administration in HR and control subjects.

Measurement of reinforcement in depression: A pilot study

We tested whether performance on a progressive ratio schedule of reinforcement with increasing magnitudes of monetary reward could be used as a behavioral measure of response to reinforcement during depression. Performance on the task was recorded before, during and after treatment of depression in six melancholic patients. The amount of money earned and the number of responses to obtain money during the task increased in the three subjects who improved with treatment but did not increase in three subjects who did not improve. In addition, the degree to which responses increased with increasing monetary reward became greater in two of the three subjects who improved but in none of the subjects who did not improve. Methodological liabilities (e.g., the small sample size and absence of a control group) may limit the validity of our findings. Our results do suggest performance of the task may be an objective measure of response to reinforcement that could be used in both basic and clinical research on depression.

Pattern evoked retinal response (PERR) in human: effects of spatial frequency, temporal frequency, luminance and defocus.

Spatial and temporal tuning were examined for both retinal and cortical signals using low contrast sinusoidol gratings. Maximum PERR and VECP responses occurred at the 4 Hz alternation rate and at 0.68 and 2.2 cpd, respectively. A 25% low spatial frequency attenuation (LSFA) was observed for the PERR. To test the possibility that prior inability to detect LSFA of the PERR was due to the masking of a pattern contrast response by a large amplitude local luminance response, mean luminance and optical power were varied in separate experiments. Greater relative LSFA was observed with a lower mean luminance and defocus differentially affected responses elicited by high and low spatial frequency gratings. In addition greater relative LSFA was observed when power at the second harmonic rather than amplitude was the dependent measure. We conclude that LSFA may be observed. The absence of spatial tuning in previous reports is explained by the masking of pattern contrast by local lumnance responses. Detection of LSFA in the present experiments is attributed to use of stimulus conditions which minimize local luminance responses and the use of an objective response measure with a high signal-to-noise ratio, i.e., power at the second harmonic of the stimulation frequency.