Methods of measuring lipid peroxidation products in exhaled air condensate and their clinical significance

Cellular and humoral immunity parameters were studied in patients with keratoconus at different stages, aged 14 to 49 years. The results showed the immune homeostasis to be impaired in patients with local involvement of the cornea. At a total system's level the patients developed shifts in the relative content of T-lymphocytes and their subpopulations, dysimmunoglubulinemia with increased levels of immunoglobulins of the primary immune response in the blood serum, high levels of the C3 and C4 components with a reduction of the total hemolytic activity of the complement, increased levels of NBT-positive and phagocytic cells, and a decrease of the activity of serum lysozyme.     

Methods for studying the fibrinolysis system and its components

Comparative analysis of the methods of estimation of the state of fibrinolytic system and its components, which are used in clinical practice now is presented in the review. The advantages of the approaches, which are based on the simultaneous determination of several indices of this system were considered. It was shown promising to use these methods in ophthalmology for estimation of both common and local (in liquids and eye tissues) haemostats, as important additional diagnostic and prognostic criteria of development of some ophthalmopathologies.     

Methods for studying microvascular barrier function in ischemia-reperfusion injury

Mutants of an archaeon Halobacterium halobium, resistant to the universal inhibitor of translation, pactamycin, were isolated. Pactamycin resistance correlated with the presence of mutations in the 16 S rRNA gene of H. halobium single rRNA operon. Three types of mutations were found in pactamycin resistant cells, A694G, C795U and C796U (Escherichia coli 16 S rRNA numeration) located distantly in rRNA primary structure but probably neighboring each other in the three-dimensional structure. Pactamycin resistance mutations either overlapped (C795U) or were located in the immediate vicinity of nucleotides protected by the drug in E. coli and H. halobium 16 S rRNA indicating that corresponding rRNA sites might be directly involved in pactamycin binding. Ribosomal functions were not affected significantly either by mutation of C795 (one of the positions protected by the P-site-bound tRNA), or by mutations of A694 and C796 (which neighbor nucleotides protected by tRNA) suggesting that tRNA-dependent protections of C795 and G693 are explained by a conformational change in the ribosome induced by the P-site-bound tRNA. A novel mode of pactamycin action is proposed suggesting that pactamycin restricts structural transitions in 16 S rRNA preventing the ribosome from adopting a functional conformation induced by tRNA binding.     

Methods for defining and determining the clinical significance of treatment effects: Description, application, and alternatives.

This article summarizes and scrutinizes the growth of the development of clinically relevant and psychometrically sound approaches for determining the clinical significance of treatment effects in mental health research by tracing its evolution, by examining modifications in the method, and by discussing representative applications. Future directions for this methodology are proposed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Methods for studying course of illness with severely mentally ill adults

This study examined methods for obtaining course of illness data on adults who are severely mentally ill. A convenience sample (N = 60) was recruited within 4 programs serving different subgroups of adults with severe mental illness. Forty-three participants were able to complete follow-up interviews, using a life chart format to report on personal history in the domains of housing, employment, finances, psychiatric service utilization, health problems, use of psychotropic medication, drug and alcohol use, social relationships, and other major life events. Corresponding information was abstracted from treatment records and examined for concordance with self-reports. Results showed distinct areas of concordance, including recent (1 year) life events, psychiatric care, psychotropic medications, and use of alcohol. Areas of disagreement included legal problems, illicit drug use, and general health. With multiple data sources, it is possible to involve a range of adults with severe mental illness in research and to incorporate their knowledge into course of illness studies.     

The clinical significance of compliance

The authors deal with a particular type of working alliance, called "compliance", which may be defined as mutual agreement between patient and physician with respect to prevention and therapy. This type of compliance may be influenced by the kind of disease (e.g. low compliance in psychiatric illness), by the mode of referral (verbal or written), by the kind of hospital care (an individual appointment with one particular physician in an outpatient department makes for better compliance) and by medication (intravenous or oral administration and color and size of pills). The number of medicines prescribed is of particular importance for compliance, i.e. the greater the number of drugs prescribed per day, the more the patient tends to be unreliable in taking them. Furthermore, the time spent in the waiting room, the amount of information given to the patient and the clarity of the instructions given by the physician play an important role. Situational factors and interaction in the physician-patient relationship seem to be more relevant than specific personality traits.     

Statistical significance testing and clinical trials.

The efficacy of treatments is better expressed for clinical purposes in terms of these treatments' outcome distributions and their overlapping rather than in terms of the statistical significance of these distributions' mean differences, because clinical practice is primarily concerned with the outcome of each individual client rather than with the mean of the variety of outcomes in any group of clients. Reports of the obtained outcome distributions for the comparison groups of all competently designed and executed randomized clinical trials should be publicly available no matter what the statistical significance of the mean differences among these groups, because all of these studies' outcome distributions provide clinically useful information about the efficacy of the treatments compared. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Assay of anticardiolipin antibodies and its clinical significance

In some individuals, the presence of antibodies to negatively charged phospholipids, currently measured as the lupus anticoagulant, and anticardiolipin antibodies is associated with certain clinical features, particularly a predisposition to both arterial and venous thromboses, thrombocytopenia, and spontaneous abortion. This syndrome is seen in patients with systemic lupus erythematosus (SLE). However, methods for measuring anticardiolipin antibody, especially epitope of anticardiolipin antibody which is not considered cardiolipin itself, but rather a complex of cardiolipin and beta 2-glycoprotein I are not well defined. Although many hypotheses have been proposed to explain the relation between antiphospholipid antibodies and thrombosis, the pathogenesis of thrombosis remains unclear. In this article, some problems in assaying anticardiolipin antibody, characteristics of antiphospholipid antibodies and the clinical significance of these antibodies are reviewed and discussed.     

The meanings and measurement of clinical significance.

The previous articles in this special section (P. C. Kendall et al, see record 1999-03648-001; N. S. Jacobson et al, see record 1999-03648-002; S. L. Foster and E. J. Mash, see record 1999-03648-003; and M. M. Gladis et al, see record 1999-03648-004) make the case for the importance of evaluating the clinical significance of therapeutic change, present key measures and innovative ways in which they are applied, and more generally provide important guidelines for evaluating therapeutic change. Fundamental issues raised by the concept of clinical significance and the methods discussed in the previous articles serve as the basis of the present comments. Salient among these issues are ambiguities regarding the meaning of current measures of clinical significance, the importance of relating assessment of clinical significance to the goals of therapy, and evaluation of the construct(s) that clinical significance reflects. Research directions that are discussed include developing a typology of therapy goals, evaluating cutoff scores and thresholds for clinical significance, and attending to social as well as clinical impact of treatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mediators in polytrauma--pathophysiological significance and clinical relevance

Multiple trauma induces an inflammatory response syndrome of the whole body that is triggered by (a) hemorrhage inducing an ischemia/reperfusion (I/R) syndrome and (b) fractures or organ contusions inducing tissue-repair processes. I/R injury generates oxyradical/proteolytic metabolites and adhesion molecules, while tissue and endothelial injury directly stimulate complement, coagulation and kinin pathways. Membrane-derived phospholipase A2 and lipid mediators potentiate cellular interactions and increase microvascular permeability. The tissue-repair process mediates macrophage/monocyte and T-cell activation which releases pro- and anti-inflammatory cytokines. Mediator action follows a "three-level model", proposing that depending on the degree of traumatic injury cellular and humoral responses may spread from a cellular to an organ and then a systemic level. The systemic response can result in a severe immunological dys-homeostasis that potentially hazards the survival of the trauma patient by uncontrollable cellular dysfunction, appearing clinically as multiple organ-dysfunction syndrome. Blood-mediator concentrations often parallel the inflammatory process; initially, high levels of cytokines are followed by severe organ dysfunction. However, interpretation of these data remains difficult due to distinct beneficial or detrimental effects of mediators on the different levels of inflammation and missing prognostic threshold values, indicating a risk of adverse effects. Future studies must determine pro- and anti-inflammatory mediators directly, during the intensive care therapy, and evaluate their clinical relevance prospectively for the different levels of inflammation at local and systemic sites.     

Mechanisms and clinical significance of cell volume regulation

A wide variety of factors challenge constancy of cell volume. Alterations of cell volume activate diverse cell volume regulatory mechanisms including ion transport, osmolyte accumulation, metabolism and expression of appropriate genes. A wealth of cellular signalling pathways link cell volume to the respective regulatory mechanisms. Cell volume emerges as a pathophysiologically important parameter in several diseases including diabetes mellitus, uraemia, hepatic insufficiency and hypercatabolic states. The role of altered cell volume in disease is a challenge which requires more experimental research and clinical investigation.