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1.
In the study of monozygotic twins relative to disease and risk factors, particular interest focuses on the subset who are discordant for some suspected risk factor (for example, smoking), since such twins constitute a natural case-control pair. In such studies, questionnaires designed to identify the status of all twin pairs are sometimes error prone and can yield misleading estimates of the concordance-discordance ratios. Greater efforts to verify the characteristics of apparently discordant pairs than to verify those of apparently concordant pairs can result in the 'unequal ascertainment' fallacy. Using the results of a questionnaire with known error rates and the 'apparent' frequencies yielded, we present unbiased, maximum likelihood estimates of the 'true' proportions of concordant and discordant pairs. concordant and discordant pairs. We also present approximate covariances among these estimates. 相似文献
2.
Psychophysiology is just as closely related to internal medicine as it is to psychiatry. “Psychological variable” has two distinct meanings: a) an external sensory stimulus, or b) an organismic state described in psychological language. “Psychological” and “Physical” are names of two different languages. There is no such thing as a non-physical illness. Asking whether emotions cause diseases, or diseases cause emotions, leads to many difficulties and is unprofitable. It is far more useful to ask about stimulus-response relationships. There are more kinds of specificity relations in psychophysiology and psychosomatic medicine than are usually recognized, and the usual specificity statements in psychosomatic medicine are not concerned with I-R or S-R specificity. There are many problems in medicine which psychophysiology could help to solve. 相似文献
3.
A protamine sulphate (PS) pretreated solid phase coated with different amounts of dsDNA has been used to develop a sensitive, specific and reproducible anti-dsDNA ELISA. Using low concentrations of a dsDNA coat 50% of SLE sera were found to be positive and false positive reactivity due to anti-PS reactivity was found in 3/40 patients with other auto-immune diseases (OAID). In contrast, when PS was saturated with higher concentrations of dsDNA 80% of SLE sera were detected, the reproducibility of the results was better and anti-PS reactivity of OAID patients with an anti-PS reactivity disappeared. The sera of three other OAID patients contained low avidity anti-dsDNA, measured after a salt elution step in the ELISA procedure, and 2/60 patients with non-auto-immune disease exhibited a false positive anti-dsDNA reactivity since they reacted with the solid phase even in the absence of PS and dsDNA. Thus an ELISA procedure using a PS pretreated solid phase permits the sensitive, specific and reproducible measurement of anti-dsDNA antibodies only if a high concentration of dsDNA is coated on the PS and appropriate controls are performed. 相似文献
4.
Arend Mosaterd Jaap W. Deckers Arno W. Hoes Angelique Nederpel Albert Smeets David T. Linker Diederick E. Grobbee 《European journal of epidemiology》1997,13(5):491-502
Several scores based on symptoms and signs have been developed to assess the presence of heart failure. The goal of this study was to compare six heart failure scores in non-hospitalised subjects and to determine their usefulness in population based research. The scores were applied to 54 participants of a population based study. All underwent a complete medical examination, including chest X-ray, electrocardiography and Doppler echocardiography. Using all information available, a cardiologist, unaware of the results of the scores, clinically classified participants as having no, possible or definite heart failure. Sensitivity, specificity, predictive values and receiver operating characteristics were calculated, using the cardiologist's assessment as a gold standard. The cardiologist judged definite or possible heart failure to be present in 17 persons. All scores had a high sensitivity for the detection of definite heart failure, whereas the study of men born in 1913 and Walma's score had the highest sensitivity for the combination of possible and definite heart failure. Gheorgiade's and the Boston score had the highest positive predictive values. In conclusion, five of the six scores we studied are broadly similar in the detection of heart failure. The men born in 1913 score relies heavily on the assessment of dyspnea, resulting in a relatively large number of false positives. Although the scores are useful in detecting manifest heart failure, objective measurements of cardiac function appear necessary to reduce the false positive rate and accurately detect early stages of heart failure. 相似文献
5.
目的 进一步证实 P P D 实验在监测结核免疫力中的应用价值。方法 用卡介苗接种879名儿童,12 周后进行 P P D 试验并查验卡痕反应,计算评价筛选试验的指标。结果 卡痕试验的敏感度、特异度、正确指数均低,而误诊率、漏诊率均高。结论 P P D 实验是目前尚未开展人体内测定结核免疫力前唯一有效的监测结核免疫力的方法。 相似文献
6.
7.
ROC analysis of alcoholism markers – 100% specificity 总被引:1,自引:0,他引:1
Brinkmann B Köhler H Banaschak S Berg A Eikelmann B West A Heinecke A 《International journal of legal medicine》2000,113(5):293-299
A combination of 4 so-called markers of alcoholism, i. e. methanol, aceton + 2-propanol, γ-glutamyl-transferase and carbohydrate
deficient transferrin, was investigated in 341 blood samples from alcoholics and non-alcoholics. From the history of alcohol
consumption, four defined subgroups were formed: non-alcoholics divided into (A) 33 persons with no ethanol consumption during
the past year and (B) 60 persons with daily consumption less then 40 g ethanol. Alcoholics were divided into (C) 177 persons
with no ethanol at the time of admission/first blood sampling (withdrawal therapy) and (D) 71 persons with positive ethanol
levels on admission/first blood sampling. All markers showed different extents of overlap between the collectives of alcoholics
and non-alcoholics. By logistic regression, a formula was developed combining these markers with different mathematical weights.
Thus an “Alc-Index” could be calculated for each individual. The ROC curve connecting all individual values gives an ideal
form with 100% specificity and nearly 93% sensitivity. The threshold between the collectives of alcoholics and non-alcoholics
was defined by the Alc-Index value 1.7. This was associated with no false positives among the non-alcoholics while nearly
93% of the alcoholics exceeded this index. The ROC-based calculation of the Alc-Index thus seems to be the most effective
method for the diagnosis of alcoholism.
Received: 24 June 1999 / Received in revised form: 1 November 1999 相似文献
8.
目的:观察电针不同穴位后小鼠肝组织内ET-1、NO含量变化,探究电针对小鼠肝脏血管活性物的影响以及电针不同穴位效应的差异。方法:将实验动物随机均分为电针足三里组、电针曲泉组、电针非经非穴组和对照组;各电针组电针30min和对照组不电针30min后,用放射免疫法检测各组肝组织内内皮素-1(ET-1)含量,用硝酸还原酶法检测各组肝组织内一氧化氮(NO)含量;分析比较各组肝组织内ET-1、NO含量水平的差异。结果:肝组织内ET-1平均含量水平为对照组>电针非经非穴组>电针曲泉组>电针足三里组;NO平均含量水平为电针足三里组>电针曲泉组>电针非经非穴组>对照组;电针曲泉组、电针非穴组、对照组肝组织内NO平均含量与电针足三里组比较,电针非穴组、对照组肝组织内ET-1平均含量与电针足三里组比较,均具有统计学意义(P<0.05);对照组肝组织内ET-1平均含量与电针曲泉组比较具有统计学意义(P<0.05)。结论:电针作用可使正常小鼠肝组织内NO含量增高,ET-1含量降低;这一效应具有穴位特异性,即电针足三里穴产生的效应最强。 相似文献
9.
Martina Aida Angeles Federico Migliorelli Sergi Vidal-Sicart Adela Saco Jaume Ordi Cristina Ros Pere Fust Meritxell Munmany Sílvia Escura Núria Carreras Nuria Snchez-Izquierdo Jaume Pahisa Aureli Torn Pilar Paredes Marta del Pino 《Journal Of Gynecologic Oncology》2021,32(4)
ObjectiveWe aimed to evaluate the accuracy of sentinel lymph node (SLN) mapping with transvaginal ultrasound-guided myometrial injection of radiotracer (TUMIR) to detect lymph node (LN) metastases, in patients with intermediate and high-risk endometrial cancer (EC), focusing on its performance to detect paraaortic involvement.MethodsProspective study including women with preoperative intermediate or high-risk EC, according to ESMO-ESGO-ESTRO consensus, who underwent SLN mapping using the TUMIR approach. SLNs were preoperatively localized by planar and single photon emission computed tomography/computed tomography images, and intraoperatively by gamma-probe. Immediately after SLN excision, all women underwent systematic pelvic and paraaortic lymphadenectomy by laparoscopy.ResultsThe study included 102 patients. The intraoperative SLN detection rate was 79.4% (81/102). Pelvic and paraaortic drainage was observed in 92.6% (75/81) and 45.7% (37/81) women, respectively, being exclusively paraaortic in 7.4% (6/81). After systematic lymphadenectomy, LN metastases were identified in 19.6% (20/102) patients, with 45.0% (9/20) showing paraaortic involvement, which was exclusive in 15.0% (3/20). The overall sensitivity and negative predictive value (NPV) of SLNs by the TUMIR approach to detect lymphatic involvement were 87.5% and 97.0%, respectively; and 83.3% and 96.9%, for paraaortic metastases. After applying the MSKCC SLN mapping algorithm, the sensitivity and NPV were 93.8% and 98.5%, respectively.ConclusionThe TUMIR method provides valuable information of endometrial drainage in patients at higher risk of paraaortic LN involvement. The TUMIR approach showed a detection rate of paraaortic SLNs greater than 45% and a high sensitivity and NPV for paraaortic metastases in women with intermediate and high-risk EC. 相似文献
10.
目的:通过测定胸腔积液(胸水)中胆固醇(Pch)以判定胸水的性质。方法:回顾性研究148例诊断明确且为单一因素所致胸水患者的Pch、胸水乳酸脱氢酶活性(PLDH)、胸水蛋白(Pprot)、血清蛋白(Sprot)值及胸水与血清总蛋白的比值(P/Sprot),按病因分为漏出液组、结核性胸膜炎(TB)组、炎症组和恶性胸水组,比较各组Pch、PLDH、Pprot、P/Sprot值的差异,及Pch、PLDH、P/Sprot诊断胸水渗漏性的价值。结果:漏出液组Pch、PLDH、Pprot、P/Sprot低于渗出液各组相应值(P<0.001)。取Pch 1.25 mmol/L作为诊断渗、漏出液的临界值,Pch、PLDH、P/Sprot、Pch联合PLDH对胸水渗出液诊断的敏感性分别为92.1.%、71.9%、86.8%和97.4%,特异性分别为100%、100%、97%和100%,总有效率分别为93.9%、78.4%、90.5%、98.0%。结论:Pch是胸水中相对稳定的参数,其检测简单易行,对胸水渗漏性具有较高的诊断价值,可为Light标准的一个重要补充。 相似文献