Prevalence caution

There is no meaningflil correlation between laboratory corrosion tests and clinical performance, but high in vitro corrosion rates on several high nickel dental prosthetic alloys (163), together with the prevalence of allergy to nickel caused by plated jewelry, gives cause for caution. 

Additional studies of the Woburn population have been completed (MDPH 1994). The final report indicated that there was an increased prevalence in choanal atresia, a rare respiratory effect, and hypospadias/congenital chordee. A small increase in eye defects was observed, but there was no association between TCE exposure and heart defects. There was no statistically significant associations between exposure concentrations and birth defects, although analyses was limited by the small number of cases observed. Based on four cases in the Woburn population, a rate of 0.88 was observed in the exposed population, compared to rates of 0.11 and 0.13 in the Atlanta and California comparison populations, respectively. In a prospective study completed after well closure, the rate of choanal atresia was 0.88 (based on 1 case) in Woburn, 0.11 in the surrounding communities, and 0.2 and 0.13 in Atlanta and California, respectively. The study authors cautioned that their study did not rule out moderate increases in rates of the less common adverse reproductive outcomes. For these outcomes only large increases would have been detected. 

Hypersensitivity to salicylates or nonsteroidal anti-inflammatory drugs (NSAIDs). Use extreme caution in patients with history of adverse reactions to salicylates. Cross-sensitivity may exist between aspirin and other NSAIDs that inhibit prostaglandin synthesis, and aspirin, and tartrazine. Aspirin cross-sensitivity does not appear to occur with sodium salicylate, salicylamide, or choline salicylate. Aspirin hypersensitivity is more prevalent in those with asthma, nasal polyposis, chronic urticaria. 

Daytime sleepiness appears to be more prevalent with the long half-life agents. Respiratory depression and sleep apnea Observe caution. In patients with compromised respiratory function, respiratory depression and sleep apnea have occurred. 

The elemental fuels applicable to IE production are not as obvious as the hydrocarbons described above and simply have to be learned and memorized. Those most prevalent are powdered metals (aluminum, magnesium, titanium), carbon disulfide, phosphorus, sulfur, and antimony sulfide. One important side note is that, for the most part, these elemental fuels produce IE formulations that are very sensitive and often unstable. Mixtures incorporating any of them should be treated with extra caution. 

Uricosurics like probenecid, sulfinpyrasone and benzbromaron increase urate clearance and fractional excretion of filtered urate. They are used in underexcretors of urate. Uricosurics benefit patients with hyperuricemia, intact renal function and no history of nephrolithiasis. In tropical and subtropical climates where most of the Third World countries are situated, the prevalence of urolithiasis is >40%. The use of uricosurics is contraindicated in patients with a history of urolithiasis as the number and size of stones will be increased. Without an history of urolithiasis, uricosurics still should be applied with caution where the risk for dehydration is high. 

This close definition of the client and service remit was true of virtually all of the practitioners interviewed. This segmentation was not an apparently intentional outcome, but a product of a prevalent model of service delivery that in being highly individualized tends to miss the influential interplay of family relationships and roles and their effect on all family members behaviours. It is just possible that a more family-centred approach that takes into account these dynamics, and works with them as they play out between family members, could achieve some alleviation of the near intolerable stresses that families seem to experience. This kind of family systems therapeutic work is not common. It is difficult, resource-intensive work and undoubtedly requires very skilful management given the emotional tenor of such intervention. As many of these practitioners described, intervention with families, even in the limited terms of enlisting help for their client, invited great caution. 

Children with pervasive developmental disorders are also at higher risk for developing TS. In a recent survey of 447 pupils from nine schools for children and adolescents with autism, 19 children were found to have definite TS, yielding a prevalence rate of 4.3% (Baron-Cohen et ah, 1999). However, caution is warranted, as complex motor tics can be difficult to distinguish from motor stereotypies, and differentiation among these behaviors may be especially problematic among retarded individuals with limited verbal skills. 

TCDD levels of >10 ppt and initial levels of >110 ppt). However, the authors caution that this relationship is based on a limited amount of data. No relationships between paternal 2,3,7,8-TCDD exposure (based on serum 2,3,7,8-TCDD levels) and the prevalence of other birth defects were observed. 

The use of an immunoprecipitation method has been reported for detecting Hu, Ri, and Yo antibodies [165, 166], This method is highly specific and sensitive, as it can detect low levels of antibodies not demonstrated by immunohistochemistry or immunoblotting, and is useful in prevalence studies. However, low levels of antibodies are often not correlated with clinical disease and must be regarded with caution in patients without neurological symptoms. For instance, 25% of patients with SCLC have low levels of Hu antibodies [167]. There are also case reports of individuals with cancer and high antibody levels without PNS, even after prolonged observation [166, 168],... 

The use of HRT is generally cautioned in liver disease because of concern over its potential to provoke or worsen cholestasis. This is based on early experience with oral contraceptive pills that contained higher doses of the less degradable synthetic oestrogen ethinylestradiol. However, several studies have demonstrated the safety and efficacy of HRT in patients with chronic liver disease, in particular those with PBC and viral hepatitis. HRT may be particularly beneficial in patients with PBC owing to the high prevalence of osteoporosis in this population. 

The collection of possible causes, consequences, prevalences, and correlations of various brain disabilities in this chapter reminds us that we need to be cautious about labels and numbers. Of particular importance is the necessity for caution about correlations, and a caveat is appropriate here, a caveat also appropriate for other parts of this book. 

CAUTION. Phenytoin. (anticonvulsant) and phenobarbital (long-acting barbiturate) can induce hepatic microsomal enzymes and thereby retard the half-life significantly and, therefore, ultimately interfering with the prevalent efficacy of the drug . 

If compared to 1993 estimates, the current TGP data suggest that there is an overall increase of 31.7% in goiter prevalence throughout the world. The prevalence increased in the WHO regions of Africa, the Eastern Mediterranean, Europe and Southeast Asia, but decreased in the Americas and the Western Pacific (Figure 48.1). However, these data must be interpreted with much caution, as TGP does not reflect recent changes in iodine intake. Furthermore, the majority of the available TGP data in the time span of 1993—2003 were collected before 1998 — a time when many programs of iodine deficiency control had not yet been implemented (WHO et ai, 1993). 

Unfortunately, ideal crossfinks are rare, and in most cases, the relative density of the two bands is nonoptimal and additional irrelevant bands are present. Such bands may indicate, for example, formation of covalent homodimers or higher order homooligomers from the mutated and possibly misfolded chemokines or receptors, or formation of covalent receptor che-mokine complexes of noncanonical stoichiometry, all of which can be deduced from Western blotting staining against the receptor and the chemokine. The prevalence of such bands indicates that the artificially introduced cysteine residue pair interferes with proper folding of the individual proteins or with their interactions, and warrants caution in appfication of the crosslink in modeling procedures. 

When vitamin D status has been evaluated in subjects with allergic rhinitis, the prevalence of deficiency was greater (Arshi et al. 2012). One caution is that both allergic rhinitis and vitamin D deficiency are prevalent conditions, and the association may be fortuitous. 

A third, less obvious limitation of sampling methods is that, due to the heavy computational burden involved, simpler interatomic potential models are more prevalent in Monte Carlo and molecular dynamics simulations. For example, polarizability may be an important factor in some polymer crystals. Nevertheless, a model such as the shell model is difficult and time-consuming to implement in Monte Carlo or molecular dynamics simulations and is rarely used. United atom models are quite popular in simulations of amorphous phases due to the reduction in computational requirements for a simulation of a given size. However, united atom models must be used with caution in crystal phase simulations, as the neglect of structural detail in the model may be sufficient to alter completely the symmetry of the crystal phase itself. United atom polyethylene, for example, exhibits a hexagonal unit cell over all temperatures, rather than the experimentally observed orthorhombic unit cell [58,63] such a change of structure could be reflected in the dynamical properties as well. 

Published results are sparse (4,6,13,155,166-169) and need to be interpreted with caution as some studies antedate the reclassification of the IIPs, and there is likely to be major bias in the selection of patients for SLB. However, an NSIP pattern appears to be less prevalent than in other CTDs (Table 2). Recent data indicate that UIP (Fig. 3A,B) may be more frequent than NSIP (4,13,166,168). In the largest series of 28 biopsy-proven cases, UIP and NSIP were the primary pattern in 62.1% and 37.9%, respectively (4). To examine selection bias, clinical and HRCT features were compared between biopsied and non-biopsied patients with RA-ELD. No significant difference was found and more than 80% of the non-biopsied group had typical HRCT features of UIP (4) in keeping with an earlier report (13). 

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