ABSTRACT
Every smoker should be offered smoking cessation treatment when they present for clinical care. The Readiness to Change-Smokers (RTC-S) questionnaire and the Heidelberg Smoking History (HSH) are brief questionnaires that divide patients into three stages. The purpose of this study was to prospectively compare the performance of each questionnaire at identifying patients who will successfully quit smoking within one year of Emergency Department (ED) discharge. Out of 1292 injured ED patients nearly half (n = 599, 46.4%) were identified as current smokers. Both questionnaires were given to all 599 subjects, and used to divide patients into three stages. At 12-months postdischarge 306 patients (51.1%) were contacted to determine smoking status. Patients were similarly classified by both tests in only 36% of cases. Concordance between tests was poor (kappa = 0.33). The RTC-S classified fewer patients as ready to quit (A = 13% vs. 22.2%). At 12 month follow-up, 55 patients (17.9%) had stopped smoking. The HSH was more successful to predict quitters. Multivariate logistic regression with respect to smoking cessation resulted in significant impact of HSH (p = 0.024).
Subject(s)
Motivation , Smoking Cessation/psychology , Smoking/psychology , Surveys and Questionnaires/standards , Wounds and Injuries/psychology , Adult , Attitude to Health , Emergency Treatment , Female , Follow-Up Studies , Health Behavior , Humans , Male , Prospective StudiesABSTRACT
In this prospective study covering 5.5 years we evaluated the diagnostic power of an artificial neural network (ANN) based on PSA, %fPSA, and clinical data in the PSA range 2-20 microg/l as prostate biopsy indicator. A total of 944 patients with prostate cancer or benign hyperplasia (BPH) were analyzed. The calculation of the individual patient's risk before prostate biopsy was performed at the 90% and 95% specificity and sensitivity levels within the PSA ranges 2-4, 4.1-10, and 10.1-20 microg/l. For the low PSA range 2-4 microg/l, we recommend a first time biopsy at an ANN specificity level of 95%. For PSA range 4.1-10 microg/l, we recommend a first time biopsy at an ANN sensitivity level of 95%. A rebiopsy at the PSA range 10.1-20 micro g/l should be performed based on a 95% sensitivity level. The use of an ANN at PSA 2-20 microg/l enhances the specificity and sensitivity of %fPSA by 9-39%. The application of an ANN based on %fPSA and clinical data improves the diagnostic performance compared to %fPSA only.
Subject(s)
Algorithms , Biopsy/methods , Diagnosis, Computer-Assisted/methods , Nerve Net , Prostate-Specific Antigen/blood , Prostatic Neoplasms/blood , Prostatic Neoplasms/pathology , Risk Assessment/methods , Adult , Aged , Aged, 80 and over , Humans , Male , Middle Aged , Prostatic Neoplasms/diagnosis , Reproducibility of Results , Sensitivity and SpecificityABSTRACT
The specificity of PSA has been enhanced by using molecular forms of PSA and free PSA (fPSA) such as percent free PSA (%fPSA), proPSA, intact PSA or BPHA and / or new serum markers. Most of these promising new serum markers like EPCA2 or ANXA3 still lack confirmation of the outstanding initial results or show only marginally enhanced specificity at high sensitivity levels. PCA3, TMPRSS2-ERG, and other analytes in urine collected after digital rectal examination with application of mild digital pressure have the potential to preferentially detect aggressive PCa and to decrease the number of unnecessary repeat biopsies. The combination of these new urinary markers with new and established serum markers seems to be most promising to further increase specificity of tPSA. Multivariate models, e. g., artificial neural networks (ANN) or logistic regression (LR) based nomograms have recently been performed by incorporating these new markers in several studies. There is generally an advantage to include the new markers and clinical data as additional parameters to PSA and %fPSA within ANN and LR models. Results of these studies and also unexpected pitfalls are discussed in this review.
Subject(s)
Biomarkers, Tumor/analysis , Prostatic Neoplasms/diagnosis , Humans , Kallikreins/analysis , Male , Multivariate Analysis , Predictive Value of Tests , Prostate-Specific Antigen/analysis , Prostatic Neoplasms/bloodABSTRACT
The stability and the mobility of full lower dentures (as determined in 185 edentulous subjects by mea-s of the tests according to Herbst) were brought in relation to the form of the endentulous alveolar process. There was a statistically significant relationship which may be used for prognostic purposes.
Subject(s)
Alveolar Process/anatomy & histology , Denture Retention , Denture, Complete, Lower/standards , Female , Humans , MaleABSTRACT
Proceeding from the role played by psychic load as a pathogenetic factor, its mechanism of action and its predominant importance in every-day life, a computerized system-analytical method was developed by which regulatory disorders may be realized under close-to-reality psychic load as possible risk factors or precursors of organically manifest illness. The method has already been introduced for routine preventive diagnostics under the heading of dynamic electrocardiography with standardized psychic load since cardiac arrhythmia, due to psychic load, has proved to be of particular relevance to preventive health care. The conditions for preventive health care and for further elucidation of psychophysiological regulation behavior have been substantially improved by its recent expansion to the level of dynamic electrocardio-respirography which additionally enables differentiated regulation-diagnostic evaluation of the respiratory system and its close interrelations with the cardiovascular system.
Subject(s)
Cardiovascular Diseases/prevention & control , Diagnosis, Computer-Assisted , Electrodiagnosis/methods , Respiratory Tract Diseases/prevention & control , Adult , Cardiovascular Diseases/diagnosis , Child , Female , Heart Function Tests , Humans , Male , Microcomputers , Middle Aged , Reproducibility of Results , Respiratory Function Tests , Respiratory Tract Diseases/diagnosisABSTRACT
Essential features of the methods and results of an automated system-analytic investigation procedure with well-defined psychic load are described. This was developed with the aim of recognizing disturbances in the psychophysiological system behaviour as premorbid stages of the most important cardiovascular diseases. Results thus obtained show a.o. that healthy subjects and patients suffering from ischemic heart disease can be classified with high reliability according to their psychophysiological system behaviour. A differentiation could be obtained as well on the basis of personality characteristics. The results support the hypothesis underlying the development of this procedure.