A methodology study to validate a structured diagnostic method used to diagnose female sexual dysfunction and its subtypes in postmenopausal women

The currently accepted gold standard for diagnosis of female sexual dysfunction (FSD) is a nonstandardized interview by a clinician whose field of expertise is FSD. However, the limited number of experts in the field has implications for running efficient large-scale clinical trials. Therefore, we developed a structured diagnostic method (SDM) to enable diagnosis of FSD in postmenopausal women by health care professionals who are not FSD experts. Our study objectives were to evaluate both convergent validity and intrarater reliability of the SDM. The results showed that the method had good convergent validity and excellent intrarater reliability. Thus, we conclude that the SDM can reliably diagnose FSD status and FSD subtypes in postmenopausal women.     

Decreased levels of circulating lytic anti-T in the serum of patients with metastatic gastrointestinal cancer: a correlation with disease burden.

Using a cytotoxicity assay, we have shown that all of 40 normal human sera tested contained antibodies cytotoxic for neuraminidase-treated red blood cells in the presence of complement. The antibodies were shown to be specific for the T disaccharide by studies using a synthetic T antigen (formula: see text). Certain patients with metastatic gastrointestinal cancer were found to have depressed serum levels of anti-T when compared to normal controls. There was a correlation between depression of circulating anti-T and disease burden in that 83% of patients with extensive disease had lower than normal levels of cytotoxic anti-T as compared to 45% of patients with moderate disease and none with minimal disease. There was no correlation between the concentration of cytotoxic anti-T and the age of the patients, time since surgery or the type of therapy the patient was receiving. Patients with low levels of cytotoxic anti-T had normal levels of cytotoxic anti-sheep red blood cell antibody. Measurement of circulating anti-T in the serum of certain cancer patients may prove valuable in the monitoring of disease progression.     

Morbid obesity treated by gastroplasty: radionuclide gastric emptying studies

Mechanisms by which gastroplasty for morbid obesity causes weight loss are poorly understood. We studied the role of altered gastric emptying in 50 patients before surgery, 1-4 weeks after surgery, and 2-24 months after surgery using technetium-99m pentetate in water for liquid meals and a Tc-99m styrene divinylbenzene copolymer resin in oatmeal for semisolid meals. We determined the emptying half-times of the stomach before and after surgery in the proximal and distal compartments. The proximal compartment emptied promptly in the early and late postoperative periods. The distal compartment emptied liquids at rates similar to those before surgery, while the late postoperative emptying of semisolids was significantly faster. The stoma connecting the two compartments thus permits rapid transit of liquids and semisolids without delay of distal compartment emptying. No correlation was seen between the emptying half-times or changes thereof and eventual weight loss. Delayed gastric emptying is therefore not the mechanism for satiety and weight loss after gastroplasty has been performed.     

13C abundances of nutrients and the effect of variations in 13C isotopic abundances of test meals formulated for 13CO2 breath tests

Unlike 14CO2 breath tests, 13CO2 breath tests are performed in the presence of a large background of naturally occurring isotope. Because the exact abundance of 13CO2 in breath can be changed by variations in diet, a study of the 13C abundance of dietary constituents and their effects on breath 13CO2 has been undertaken. Dietary constituents have been combusted to CO2 and the relative abundance of 13C analyzed by mass spectrometry. Breath CO2 was collected and isotopically analyzed after the ingestion of several dietary constituents and test meals. The 13CO2 abundance of breath CO2 was shown to change in response to the 13C abundance of the substrate being oxidized. Conversely, a test meal that closely approximates the 13C abundance of fasting breath CO2 from North Americans was shown not to alter the 13CO2 abundance in breath. Investigation of the breath 13CO2 response to individual 13C-labeled dietary constituents demonstrated that amino acids produced the earliest 13CO2 response followed in order by medium chain triglycerides, carbohydrates, and long chain triglycerides. Because of the variation in 13C abundances in nature, the 13C abundance of any unlabeled substrate ingested during a 13CO2 breath test must be considered in order to eliminate artifacts that may reduce the sensitivity of the breath test or produce erroneous results. Methods for correcting breath tests for changes in background 13CO2 abundance are also discussed.