Standardized Diagnostic Tests Research Articles

Abstract 281: Prevalence of Human papilloma virus in oral squamous cell carcinoma using Liner Array HPV genotyping kit

Abstract Background. The major risk factors for oral squamous cell carcinoma (OSCC) are cigarette smoking, alcohol consumption, and betel quid chewing. In addition, human papillomavirus (HPV) infection has been associated with some OSCC. However, the relationships of HPVs to OSCCs remain unclear because of the difficulties in interpreting studies that demonstrate various prevalence rates of HPVs. We examined the prevalence of HPV in OSCCs. For HPV detection and genotyping, a sensitive and specific PCR-based method, the Roche Linear Array HPV genotyping kit test was used for these studies. Materials and Methods. Forty-five Japanese patients with OSCC were included in the present study. Surgical resection of primary tumors and normal tissues from all patients was performed at the Hospital of Tokyo Dental College, between December 2007 and December 2010. We assessed HPV infection in OSCC patients using the Roche Liner Array HPV genotyping Test, which can detect 37 different HPV types. Results. HPV was detected in 9 OSCC patients (20%). HPV subtype 39, 42 was the most prevalent type, but other types detected included 31, 33, 45 . . . high-risk types and 3, 6, 8 . . . low-risk types. Conclusion. The Roche Liner Array HPV genotyping Test is currently used as a standardized diagnostic test for HPV detection in cervical carcinoma in Europe. Some studies have shown that the most prevalent HPV subtype was the high-risk type HPV-16, However we showed that HPV is detected multiple type involved low- and high-risk type in oral carcinoma. We suggested that multiple subtypes of HPV implicated OSCC. 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 281. doi:10.1158/1538-7445.AM2011-281

Prevalence of minimal hepatic encephalopathy in cirrhotic patients

Background. Minimal hepatic encephalopathy (MHE) has implications for health-related quality of life as well as for survival of cirrhotic patients, but a standardized diagnostic test is not available.Objective. To determine the prevalence of MHE among cirrhotic patients by using the psychometric hepatic encephalopathy score (PHES) system and the critical flicker frequency (CFF) test to diagnose MHE and to identify factors that influence the results of these tests.Material and methods. From April 2007 to March 2008, PHES and CFF tests were performed on patients with cirrhosis but no overt hepatic encephalopathy. Descriptive statistics were used to express the results and the Spearman correlation was used to evaluate CFF and PHES results according to age and education level.Results. We studied 104 patients. The prevalence of MHE was 55.8% (n = 58) based on a positive result for either the PHES or the CFF test, 32.7% (n = 34) based on positive PHES results alone, 34.6% (n = 36) based on positive CFF test results alone and 11.5% (n = 12) based on a positive result for both tests. According to PHES, the incidence of MHE was correlated with education level (r = 0.333, p = 0.001), but not with age. According to CFF, the incidence of MHE was correlated with age (r = -0.93, p = 0.049), but not with education level.Conclusion. The prevalence of MHE was similar to that previously reported. Patient literacy influences MHE diagnosis with PHES but not with CFF. CFF is a simple and feasible method that identifies patients with MHE who may benefit from treatment independently of their education level.

O6-Methylguanine-DNA Methyltransferase Gene Promoter Methylation Detection in Glioma Tumors by a Novel Fluorescence Polarization Assay

O⁶-Methylguanine-DNA methyltransferase methylation status has a very good predictive value for benefit from alkylating agent therapy. The stratified therapy assignment of patients according to the O⁶-Methylguanine-DNA methyltransferase methylation status requires a standardized diagnostic test. A novel method detecting the promoter methylation status of O⁶-Methylguanine-DNA methyltransferase in tissue samples by a fluorescence polarization assay was developed. A pair of primers was used to amplify a 266 bp fragment in the promoter region of the O⁶-Methylguanine-DNA methyltransferase gene. Two probes specific for either methylated or unmethylated DNA labeled with different fluorophores hybridized with their target amplicons, and the hybridization increased the fluorescence polarization values. The methylation status was determined by the increased fluorescence polarization values. Ninety-seven glioma tumor samples were analyzed in parallel with the new assay and the nested gel-based methylation-specific polymerase chain reaction assay. The results of the methylation status of the fluorescence polarization assay were in good concordance with the results obtained with the nested gel-based methylation-specific polymerase chain reaction assay. The sensitivity and stability of the fluorescence polarization assay have been measured. The coefficient of variation of the reproducibility for the fluorescence polarization assay was <10%. The minimum detection level established with the fluorescence polarization assay was 20 copies/μL. The fluorescence polarization assay allowed the discrimination of the O⁶-Methylguanine-DNA methyltransferase methylation status at individual CpG sites directly in the solution without the 2-step approach with nested primers.

Store-operated Ca2+ Entry in Malignant Hyperthermia-susceptible Human Skeletal Muscle

In malignant hyperthermia (MH), mutations in RyR1 underlie direct activation of the channel by volatile anesthetics, leading to muscle contracture and a life-threatening increase in core body temperature. The aim of the present study was to establish whether the associated depletion of sarcoplasmic reticulum (SR) Ca(2+) triggers sarcolemmal Ca(2+) influx via store-operated Ca(2+) entry (SOCE). Samples of vastus medialis muscle were obtained from patients undergoing assessment for MH susceptibility using the in vitro contracture test. Single fibers were mechanically skinned, and confocal microscopy was used to detect changes in [Ca(2+)] either within the resealed t-system ([Ca(2+)](t-sys)) or within the cytosol. In normal fibers, halothane (0.5 mM) failed to initiate SR Ca(2+) release or Ca(2+)(t-sys) depletion. However, in MH-susceptible (MHS) fibers, halothane induced both SR Ca(2+) release and Ca(2+)(t-sys) depletion, consistent with SOCE. In some MHS fibers, halothane-induced SR Ca(2+) release took the form of a propagated wave, which was temporally coupled to a wave of Ca(2+)(t-sys) depletion. SOCE was potently inhibited by "extracellular" application of a STIM1 antibody trapped within the t-system but not when the antibody was denatured by heating. In conclusion, (i) in human MHS muscle, SR Ca(2+) depletion induced by a level of volatile anesthetic within the clinical range is sufficient to induce SOCE, which is tightly coupled to SR Ca(2+) release; (ii) sarcolemmal STIM1 has an important role in regulating SOCE; and (iii) sustained SOCE from an effectively infinite extracellular Ca(2+) pool may contribute to the maintained rise in cytosolic [Ca(2+)] that underlies MH.

A Systematic Review and Critical Evaluation of Invasive Haemophilus influenzae Type B Disease Burden Studies in Asia From the Last Decade

In Asia, questions regarding the burden of Haemophilus influenzae type b (Hib) disease have delayed decision-making on introduction of Hib vaccine. However, over the past decade many studies have been published regarding Hib disease burden in Asia. We conducted a systematic literature review of all reports of Hib disease burden in Asia between 1998 and 2009, and critically reviewed their methods and data quality. We identified 94 studies from 28 countries in Asia presenting data on Hib disease burden. Of the 94 studies reviewed, 49 (52%) used a case definition consistent with World Health Organization standards, and 47 (50%) described laboratory methodology used. Twenty-seven surveillance studies presented data on incidence of Hib disease, with 8 (30%) accounting for missed cases, 6 (15%) accounting for cases with missed diagnostic tests, and 2 (7%) that considered prior antibiotic use. Of the 21 studies that provided incidence data for Hib meningitis, 10 (48%) used active, prospective, population-based surveillance, and found unadjusted incidence rates of Hib meningitis ranging from a low of 0.98 per 100,000 child-years in children aged less than 5 years in China to a high of 28 per 100,000 child-years in children less than 5 years in Mongolia. Of 49 studies that reported the etiology of bacterial meningitis, 30 (60%) identified Hib as the most common cause. This review highlights the importance of using rigorous methodologies, including standardized surveillance methods and appropriate laboratory diagnostic tests, when conducting studies measuring the burden of invasive bacterial diseases including those caused by Hib. When poorly conducted, studies can underestimate disease burden and lead to inappropriate decisions about vaccine introduction.

Clopidogrel Resistance

Clopidogrel resistance is an emerging clinical scenario, as antiplatelet therapy has become the cornerstone of modern cardiovascular treatment. This leads to an increase in stent thromboses and recurrent ischemic events which add to the health care costs, and increased periprocedural morbidity and mortality. Management of clopidogrel resistance is challenging as there are no standardized guidelines. The arrival of newer antiplatelet drugs and the detection of genetic polymorphisms in susceptible populations may have an impact on the management. Further trials are needed regarding the target population who should be screened for clopidogrel resistance, a standardized diagnostic test to detect clopidogrel resistance, the role of pharmacogenetics, and the need for tailored therapeutic options for a patient with clopidogrel resistance.

Detection of AmpC β-lactamases in Escherichia coli, Klebsiella spp., Salmonella spp. and Proteus mirabilis in a regional clinical microbiology laboratory

There are currently no standardized diagnostic tests available for the reliable detection of AmpC β-lactamases in Klebsiella spp., Escherichia coli, Proteus mirabilis and Salmonella spp. A study was designed to evaluate a confirmation disk test using cefotetan (CTT) and cefoxitin (FOX) with phenylboronic acid (PBA). It also investigated the most suitable screening concentrations of FOX, ceftriaxone (CRO) and ceftazidime (CAZ) for the detection of AmpC β-lactamases. A total of 126 control (consisting of 11 laboratory and 115 well-characterized clinical strains) and 29 840 non-repeat clinical isolates were included. FOX with PBA used in a confirmation test and CRO and CAZ as screening agents were found to be unreliable. FOX at ≥ 32 mg/L was the best screening agent and CTT with PBA was the best confirmation test. Of the clinical isolates 635 (2%) were found to be resistant to cefoxitin (MIC ≥ 32 ug/mL) and 332 (52%) were AmpC positive. E. coli was the most common organism with AmpC β-lactamases and was mostly present in urines from community patients. It is recommended that laboratories use FOX at 32 mg/L as a screening agent and perform a disk test with CTT and PBA to confirm the presence of an AmpC cephalosporinase in isolates of Klebsiella spp., E. coli, Salmonella spp. and P. mirabilis. This approach is convenient, practical and easy to incorporate into the workflow of a clinical laboratory. False-positive AmpC detection may occur with KPC-producing bacteria when inhibitor-based methods are used.

Treatment approach, autism severity and intervention outcomes in young children

The current study examined the relation between autism severity at baseline, type of intervention employed and outcomes in young children with autism spectrum disorder (ASD). Seventy-eight children with ASD, aged 15–35 months ( M = 25.4, SD = 4.2), received either applied behavioral analysis (ABA) or integration of several intervention approaches (Eclectic) in community center-based programs. Outcome was measured after 1 year of intervention using standardized autism diagnostic tests, and cognitive and adaptive skills evaluations. ASD diagnosis was highly stable (99%). Both intervention groups improved significantly in verbal cognitive abilities and in socialization and communication adaptive skills, but no significant difference between the intervention groups was documented. Less severe autism symptoms at baseline were associated with better progress in adaptive skills and in cognitive abilities. Within the group with less severe autism symptoms, those who received Eclectic intervention had a better outcome than those who received ABA in communication and socialization adaptive skills as reported by the parents, but not in the standardized cognitive test results. The child's baseline social abilities and deficits appear to be crucial variables for intervention outcomes and should be considered in treatment approach decision-making.

Evaluation of the false-negative rate of standardized and quantitative measurement of estrogen receptor (ER) in tissue using AQUA technology

567 Background: The discovery of an astoundingly high false negative rate for estrogen receptor (ER) testing in Canada has raised questions about the accuracy and reproducibility of ER testing. One solution would be the introduction of a standardized and reproducible diagnostic test that is easily adaptable in the clinical setting. Here, we have tested the AQUA method of quantitative immunofluorescence for the standardized and reproducible quantification of ER protein expression in tissue. Methods: Quantitative Western blotting was used in conjunction with AQUA analysis to create standard curves for assessment of absolute ER protein concentration in tissue (n = 118). We used standard scoring methods and AQUA analysis to quantify ER protein expression in a large cohort of breast cancer samples (n =669). Results: Using a series of standard curves, we determined that the range of the ER AQUA assay is between 100 pg/μg and 1500 pg/μg total protein. ER protein concentration in breast cancer samples showed an expected unimodal distribution for quantitative assessment of ER. Reproducibility studies of AQUA analysis demonstrated significant instrument-to-instrument (laboratory-to-laboratory) reproducibility for 3 instruments across the range of AQUA scores (average %CV = 1.34; R2&gt;0.99; ANOVA p = 0.67). The same cases were then read and classified by 3 pathologists using the Allred scoring system. Although their concordance is similar to that seen in the literature (Kappa = 0.81, 0.88, and 0.89), pathologist concordance rate is lower than for that observed with AQUA analysis (Kappa = 0.95, 0.96, and 0.97). Importantly, 9.0% of cases showed a change of diagnosis (positive/negative) across 3 pathologists whereas only 2.8% of cases changed classification using AQUA analysis. Additionally, misclassified cases occurred across the entire range of Allred scores, but were restricted to a narrow region defined by the cut-point for AQUA scoring. Conclusions: We have demonstrated that AQUA technology can provide for the standardized and reproducible quantification of ER with a 3 fold reduction in misclassification. This approach has the potential to decrease the problem of false negative tests for ER. [Table: see text]

La coqueluche de l’enfant à l’adulte

Neither natural nor vaccine-induced immunity to pertussis lasts for life. Before intensive vaccination of toddlers, pertussis was essentially a pediatric disease. Mortality and morbidity have fallen drastically in parts of the world where toddlers have been systematically protected with efficacious whole-cell vaccines. The infection is now more common in adults with waning specific immunity, who can go on to infect newborns too young to be vaccinated, with potentially dramatic consequences. For these reasons, the vaccine strategy was recently modified in several countries, with the introduction of vaccine boosters for children, adolescents and young adults, as well as for healthcare workers in contact with newborns. In France, vaccine boosters were introduced for adolescents in 1998 and for adults in contact with newborns in 2004, leading to a decrease in morbidity in adolescents and very young adults. It is important to inform the medical community, and the families with neonates, of these changes in vaccine strategy. Efficient surveillance and notification systems are needed in all countries. Surveillance must include the use of standardized diagnostic tests and reagents. Bacterial isolates should be thoroughly characterized at the genomic, transcriptomic and proteomic levels.

Validation of Real-Time Methylation-Specific PCR to Determine O6-Methylguanine-DNA Methyltransferase Gene Promoter Methylation in Glioma

Epigenetic silencing of the DNA repair protein O(6)-methylguanine-DNA methyltransferase (MGMT) by promoter methylation predicts successful alkylating agent therapy, such as with temozolomide, in glioblastoma patients. Stratified therapy assignment of patients in prospective clinical trials according to tumor MGMT status requires a standardized diagnostic test, suitable for high-throughput analysis of small amounts of formalin-fixed, paraffin-embedded tumor tissue. A direct, real-time methylation-specific PCR (MSP) assay was developed to determine methylation status of the MGMT gene promoter. Assay specificity was obtained by selective amplification of methylated DNA sequences of sodium bisulfite-modified DNA. The copy number of the methylated MGMT promoter, normalized to the beta-actin gene, provides a quantitative test result. We analyzed 134 clinical glioma samples, comparing the new test with the previously validated nested gel-based MSP assay, which yields a binary readout. A cut-off value for the MGMT methylation status was suggested by fitting a bimodal normal mixture model to the real-time results, supporting the hypothesis that there are two distinct populations within the test samples. Comparison of the tests showed high concordance of the results (82/91 [90%]; Cohen's kappa = 0.80; 95% confidence interval, 0.82-0.95). The direct, real-time MSP assay was highly reproducible (Pearson correlation 0.996) and showed valid test results for 93% (125/134) of samples compared with 75% (94/125) for the nested, gel-based MSP assay. This high-throughput test provides an important pharmacogenomic tool for individualized management of alkylating agent chemotherapy.

Diagnostic Testing of Introductory Geology Students

A diagnostic test for assessing the general and Earth science knowledge of entry-level college students was administered to 451 students in 2002 and 401 students in 2003 enrolled in an introductory geology course at Iowa State University. The study shows that male students, seniors, and science-technology-math majors score higher than female students, freshmen, and non-science-technology-math majors and that the differences are statistically significant. Also, students who scored higher on the diagnostic test were more likely to pass the course. The results support the feasibility of a standardized diagnostic test as a tool for geoscience instructors for curriculum planning, student advising, and curriculum assessment, similar to standardized diagnostic testing and pre-post testing used in chemistry and physics courses. Standardized national tests would enhance college geoscience education.

Alcoholism in women: is it different in onset and outcome compared to men?

Onset and course of alcohol dependence show gender related differences (telescoping effect) suggesting that women are more vulnerable to chronic alcohol consumption. This raises the question whether the differences are associated with a different treatment outcome as well. We hypothesized, that alcohol dependent women with a telescoping course show a less favourable treatment outcome compared to men. We investigated 212 alcohol dependent patients; matching 106 consecutively admitted women with 106 men drawn from a total sample of 343 male patients. The treatment program consisted of a 6 week inpatient treatment and 12 months of outpatient aftercare. We assessed milestone variables in development and course of alcoholism and carried out standardized diagnostic tests, physical and blood examinations to evaluate the course of the disease and treatment outcome. Overall, we confirm the telescoping effect, a faster progression in the course of alcoholism (developmental events and adverse consequences) in women compared to men ("telescoping effect"). However, despite the telescoping effect treatment outcome was similar in women and men. During the inpatient treatment program no alcohol relapse occurred. Throughout the 12 months outpatient treatment we found no significant differences in the survival analysis between women (283.29+/-11.26 days) and men (284.72+/-12.16 days). At the end of the 12 months both groups had an abstinence rate of approximately 50% and a drop-out rate of 33%.

Bedside neuropathy disability score compared to quantitative sensory testing for measurement of diabetic neuropathy in children, adolescents, and young adults with type 1 diabetes

Background While regular yearly screening for diabetic retinopathy and nephropathy is well established in patients with diabetes mellitus, there are no standardized diagnostic tests for diabetic peripheral neuropathy (DPN). In the present study, we compared the bedside neuropathy disability score (NDS) with quantitative sensory testing (QST) for screening for DPN in youth with type 1 diabetes mellitus. Methods One hundred sixty-six patients aged 10 to 34 years (median 21 years) were evaluated for DPN by the NDS and QST. Quantitative sensory testing was also done in 43 healthy, age-matched controls. Diabetic peripheral neuropathy grade by both methods was correlated with disease-related variables. Results On QST, the diabetic group had significantly higher mean scores for vibration ( P<.001) and warm sensation ( P<.01) than controls, and lower scores for cold sensation ( P<.05); however, there was a great degree of overlap. The NDS significantly correlated with the vibration threshold, but not with the warm and cold thresholds. The NDS significantly correlated with age at testing, diabetes duration, and long-term and current HbA 1c levels ( P<.001), and with the presence of microalbuminuria and diabetic retinopathy ( P<.001). Analysis of the QST variables yielded significant correlations of vibration and warm sensation with age at testing ( P<.001, P<.05, respectively) and of vibration with diabetes duration ( P<.001) and retinopathy ( P=.05); none of the quantitative tests correlated with glycemic control. Conclusions The stronger association of the NDS with glycemic control and other microvascular complications compared to the perception thresholds, and its shorter time of performance and lack of costly equipment, may make the NDS the preferred method for measuring DPN in this population.

Translating microarray data for diagnostic testing in childhood leukaemia

BackgroundRecent findings from microarray studies have raised the prospect of a standardized diagnostic gene expression platform to enhance accurate diagnosis and risk stratification in paediatric acute lymphoblastic leukaemia (ALL). However, the robustness as well as the format for such a diagnostic test remains to be determined. As a step towards clinical application of these findings, we have systematically analyzed a published ALL microarray data set using Robust Multi-array Analysis (RMA) and Random Forest (RF).MethodsWe examined published microarray data from 104 ALL patients specimens, that represent six different subgroups defined by cytogenetic features and immunophenotypes. Using the decision-tree based supervised learning algorithm Random Forest (RF), we determined a small set of genes for optimal subgroup distinction and subsequently validated their predictive power in an independent patient cohort.ResultsWe achieved very high overall ALL subgroup prediction accuracies of about 98%, and were able to verify the robustness of these genes in an independent panel of 68 specimens obtained from a different institution and processed in a different laboratory. Our study established that the selection of discriminating genes is strongly dependent on the analysis method. This may have profound implications for clinical use, particularly when the classifier is reduced to a small set of genes. We have demonstrated that as few as 26 genes yield accurate class prediction and importantly, almost 70% of these genes have not been previously identified as essential for class distinction of the six ALL subgroups.ConclusionOur finding supports the feasibility of qRT-PCR technology for standardized diagnostic testing in paediatric ALL and should, in conjunction with conventional cytogenetics lead to a more accurate classification of the disease. In addition, we have demonstrated that microarray findings from one study can be confirmed in an independent study, using an entirely independent patient cohort and with microarray experiments being performed by a different research team.

Méningo-encéphalite à toxocara canis : à propos d'un cas

Seroprevalence studies on human toxocariasis help to assess the burden and the morbidity associated with this zoonosis. This review searched the seroprevalence studies and case reports in six North African countries: Algeria, Egypt, Libya, Morocco, Sudan and Tunisia, since 1990. The search also included studies on the environmental factors related to the risk of transmission. Most of the published epidemiological studies were done in Egypt. Cross-sectional and case-control studies in Egypt demonstrated that toxocariasis is a significant zoonosis that could be associated with conditions like bronchial asthma allergies and certain neuropsychiatric disorders. The population at risk of this infection includes all ages, both genders, in contact with dogs, resident in rural areas with poor housing conditions. The publications from Tunisia, Morocco and Algeria are limited to case reports and retrospective analyses of cases, but the disease is probably under-diagnosed in these three countries. There are no published reports on human toxocariasis in Libya and Sudan during the period covered by the review. Animal studies confirm high infection rates of dogs with Toxocara canis in North Africa. There is also evidence of wide-spread contamination of soil and water with Toxocara spp. eggs. Moreover, the use of untreated wastewater for irrigation in parts of North Africa could be a source of contamination of agricultural products with eggs of Toxocara spp. Population-based studies on human toxocariasis are recommended, using standardized diagnostic tests. These surveys should also assess risk factors to guide preventive measures.

Patient-centered communication and diagnostic testing.

Although patient-centered communication is associated with improved health and patient trust, information about the impact of patient-centered communication on health care costs is limited. We studied the relationship between patient-centered communication and diagnostic testing expenditures. We undertook an observational cross-sectional study using covert standardized patient visits to study physician interaction style and its relationship to diagnostic testing costs. Participants were 100 primary care physicians in the Rochester, NY, area participating in a large managed care organization (MCO). Audio recordings of 2 standardized patient encounters for each physician were rated using the Measure of Patient-Centered Communication (MPCC). Standardized diagnostic testing and other expenditures, adjusted for patient demographics and case-mix, were derived from the MCO claims database. Analyses were adjusted for demographics and standardized patient detection. Compared with other physicians, those who had MPCC scores in the lowest tercile had greater standardized diagnostic testing expenditures (11.0% higher, 95% confidence interval [CI], 4.5%-17.8%) and greater total standardized expenditures (3.5% higher, 95% CI, 1.0%-6.1%). Whereas lower MPCC scores were associated with shorter visits, adjustment for visit length and standardized patient detection did not affect the relationship with expenditures. Total (testing, ambulatory and hospital care) expenditures were also greater for physicians who had lower MPCC scores, an effect primarily associated with the effect on testing expenditures. Patient-centered communication is associated with fewer diagnostic testing expenditures but also with increased visit length. Because costs and visit length may affect physicians' and health systems' willingness to endorse and practice a patient-centered approach, these results should be confirmed in future randomized trials.

Les allergènes respiratoires des horticulteurs et pépiniéristes

Horticulturists and nursery workers are in frequent contact with many plant and chemical substances that are potentially allergenic. Skin contact can lead to cutaneous manifestations and inhalation can lead to respiratory symptoms. Plant substances are probably more important as causes of contact allergies whereas chemicals can induce both cutaneous and respiratory symptoms. Published data point, however, to reservations regarding diagnosis due to the lack of standardized diagnostic tests. Here, we will consider only those substances that cause respiratory symptoms.

Male Fertility: Endocrine Stress Parameters and Coping

Introduction: The impact of psychosocial stress on infertility has not yet been entirely understood in andrology. The objective of this study is to compare endocrine stress parameter levels and coping styles in andrological patients with normal and impaired semen characteristics. Besides, the study is to verify, if sperm quality and coping styles differ between subgroups with normozoospermia and high vs. normal stress parameter levels. Patients and Methods: In a prospective study, 14 patients with impaired fertility (oligo-, crypto- and azoospermia) and 34 patients with normozoospermia underwent standardized diagnostic stress testing comprising masturbation for semen analysis, venous blood testing, the Beck Depression Inventory (BDI) and the Coping with Stress Questionnaire (SVF 120) as well as spermiogram and hormon analyses. Results: As compared to men with normal semen characteristics, men with impaired fertility showed significantly better coping with stress in the SVF 120, yielding higher scores in compensation, relaxation and diversion. Furthermore, among patients with normozoospermia higher values in the stress parameters prolactin, cortisol, FSH and neopterin (an immunological marker) were associated with subfertility, impairment of motility, hypoosmotic swelling test (HOS), penetration capacity and a significantly higher reaction control in the SVF 120. Conclusions: The results indicate a measurable relationship between high stress parameter levels and subfertility in patients with normozoospermia and quite positive coping strategies in men with impaired fertility.

Psychometric evaluation of children with suspected auditory processing disorders (APDs) using a parent-answered survey

Difficulty with auditory processing in children is of increasing interest but is the subject of some controversy in the literature. This paper describes a psychometric evaluation of differences between children with suspected auditory processing disorders (APDs) and a control group, using a parent-answered questionnaire. The questionnaire comprised 51 items associated with auditory processing as well as speech/language- and behaviour-related areas. It was found that most of the items separated significantly (p < 0.01) between the children with suspected APDs and the control group. A factor analysis identified seven components (speech understanding in demanding situations, speech/language abilities, general behavioural issues, reactions to questions and demands, discrimination of speech sounds, musical cues, loudness perception) underlying the contrasts between the two study populations. The examination might serve as a basis for the development of an APD-related questionnaire. However, the validity of such a questionnaire is questionable at present, since APD is not very well specified, and standardized diagnostic tests are lacking.