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PubMed1981

A clinical screening program for topical chemotherapeutic drugs in psoriasis.

In this national, multicenter cooperative study, a standardized drug screening program was designed and evaluated to test the clinical effectiveness of 30 topically applied chemotherapeutic drugs to psoriasis. Appropriate concentrations and vehicles for topical administration were selected with regard to clinical testing consisted of a double-blind application of test agents to psoriatic plaques under occlusion daily for up to nine days. Drugs known to be topically active in psoriasis, eg, thiotepa, fluorouracil, and betamethasone valerate, were easily detected in the clinical protocol, confirming the validity of this topical drug screening program. Seven drugs produced substantial clinical improvement with evidence of clearing; nine drugs produced slight improvement; 14 drugs had no effect. No systemic toxid reactions occurred. This screen should be useful to test other potential antipsoriatic drugs and to evaluate potential animal model screens for their predictive values with the same drugs.

Adult↗

PubMed1986

Screening for Duchenne muscular dystrophy: an improved screening test for creatine kinase and its application in an infant screening program.

A kinetic bioluminescence assay with optimized reagent conditions has been developed for application as a screening test for increased creatine kinase (CK) activities in dried blood spots. This test is used for the early detection of Duchenne muscular dystrophy (DMD) in a voluntary CK screening program in West Germany. Of the 176,600 boys tested up to December 31, 1984, 48 who were less than 6 months old had certain or probable DMD (frequency 1: 3679). In 1983 and 1984, the rate of false positive results was 0.016% for a cut-off activity 300 U/liter and 0.061% for a cut-off activity 180 U/liter. Long-term counseling is offered to families of newly detected DMD patients in order to facilitate the aims of the screening program, namely, avoidance of secondary cases in affected families, early professional care for the sick child, and the early opportunity to make the appropriate decisions for a life with an handicapped child. Two types of a benign hereditary blood anomaly were also detected by CK screening (CK-BB inside erythrocytes or thrombocytes).

Age Factors↗

PubMed1987

Number and cure rate of neuroblastoma cases detected by the mass screening program in Japan: future aspects.

The annual incidence of neuroblastoma in Japan, a common malignancy of young children which has a very poor prognosis in progressive cases, was previously estimated to be 8.2 cases/million children under 15 years of age. Based on the Japanese National Census of the Population for 1982, the annual number of cases of this tumor is predicted to be 220. (Sawada et al: Med Pediatr Oncol 12:101-103, 1984). Before the mass screening program was started, one-fourth of all neuroblastoma cases were detected before the age of one by clinical symptoms and other findings. Since 1974, a neuroblastoma mass screening program for 6-month-old infants by means of a qualitative Vanilmandelic Acid (VMA) test has been in effect in Kyoto, Japan, for the prognostic improvement of neuroblastoma patients (Sawada et al: Am J Dis Child 136:710-712, 1982). A Neuroblastoma Mass Screening Study Group (NBMSSG) was organized in 1981 (Sawada et al: Lancet ii:271-272, 1984), and the mass screening program has grown to encompass eight selected areas. This group discovered 15 cases of neuroblastoma among 247,500 6-month-old infants, 1 of every 16,500, until the end of 1983, and 23 cases among 434,970, 1 of every 18,900, until the end of 1984. All cases were asymptomatic. As the incidence of infantile neuroblastoma detected by this program is projected to be 52.9-60.6 cases/million 6-month-old infants, it could be predicted that 80-91 neuroblastoma cases will be discovered annually in Japan by mass screening. The cure rate of 25 cases discovered by the mass screening and followed up over 20 months was 92% (Sawada: Lancet i:377,1986). In Japan, it should be possible to detect 135-146 cases--[symptomatic 55 = 220 X 1/4] + [80-91 cases detected by mass screening]--(61.4-66.4% of the total neuroblastoma cases) in infants under 1 year of age annually, and the cure rate of all neuroblastoma cases in Japan is expected to reach 60% or more.

Adolescent↗

PubMed1977

General health screening of four-year-olds in a Swedish country. V. A strategy for improving the effectiveness and the cost efficiency of the psychological screening program.

Data presented in a previous paper pointed to the necessity for improving the overall sensitivity of the psychological screening program. The present report indicates possibilities for such an improvement without changing the screening methods. A comparison of the primary data of the true positives, the false positives and all the negatives (non-referred) revealed the necessity of more stringent referral criteria. It is predicted that the systematic application these criteria would result in an increase in the rate of true positives form 2.8 to 4.8% of the screened population. In addition a strategy aiming at a reduction of the costs without deteriorating the effectiveness and based on a differential application of the various elements of the screening program is presented.

Child Behavior Disorders↗

PubMed1985

Screening for congenital hypothyroidism with specimen collection at two time periods: results of the Northwest Regional Screening Program.

To determine the benefit of collecting two routine specimens to test for congenital hypothyroidism, we examined the results of our newborn screening program during the last 9.5 years. The Northwest Regional Screening Program (NWRSP) performs a primary thyroxine test with thyroid-stimulating hormone determinations on the lowest 10% of dried blood filter paper specimens. An initial specimen is obtained in the newborn period, and a routine second specimen is collected at approximately 4 to 6 weeks of age in all infants born in Oregon and 25% of infants born in Idaho, Montana, Alaska, and Nevada. Between May 1975 and October 1984, 182 infants with primary hypothyroidism were detected from 811,917 infants screened, a prevalence rate of 1:4,461. The routine second specimen led to the diagnosis of 19 infants of 484,604 infants screened, a detection rate of 1:25,505. When infants detected by the second screen were compared with those detected by the first screen, they had higher thyroxine and lower thyroid-stimulating hormone concentrations on filter paper and serum specimens. When thyroid scanning was used, all but one infant detected by the second screen had some residual thyroid tissue, whereas 35% of infants detected by the first screen had thyroid aplasia. Skeletal maturation was more likely to be normal in infants detected by the second screen. These infants appear to have milder hypothyroidism due to a later age of onset or slower evolution of thyroid failure. At a cost of $31,881 per infant detected by the second screen, the NWRSP found it cost-effective to obtain a routine second specimen.

Congenital Hypothyroidism↗

PubMed1997

Know your numbers: comparing participants and nonparticipants in a university health screening program.

University faculty and staff members were offered the opportunity to participate in a worksite health screening program. Both the participants and the nonparticipants responded to a questionnaire concerning their dietary and health practices. Participants' values for total serum cholesterol, blood pressure, and percentage of body fat were measured. No significant differences between the two groups were observed for the parameters of self-reported total serum cholesterol or blood pressure, and the participants' self-reported and measured serum cholesterol values were not significantly different from those of the nonparticipants. However, the measured and self-reported percentages of body fat of participants were significantly different from reported percentages of body fat of those who did not participate. Further exploration of the motivation of participants in health screening programs is called for.

Adult↗

PubMed1984

[Problems in mass screening program for prostatic diseases].

We developed transrectal ultrasonotomography for practical use in 1967 and started a model trial mass screening program for prostatic diseases with the method in 1975. A mobile unit "Dolphin" for mass screening, in which two sets of special chair-type scanner for the method was loaded, was developed successfully in 1980. Up to March, 1983, 2394 males over the age of 55 were submitted to the primary study. Among them, 12 cases (0.5%) of prostatic cancer (PC) and 755 cases (31.5%) of benign prostatic hypertrophy (BPH) were finally detected in the secondary study. Thus the prevalence of BPH was significant and even the detection rate of PC was still remarkably higher than that in mass screening for other malignancies. The diagnostic accuracy in transrectal ultrasonotomography in PC was calculated from the results of patients visiting our out-patient clinic during 7 years until March, 1983. The sensitivity was 96.5% and the specificity was 84.6%. On the other hand, the sensitivity of digital examination in the same series was 80.7%. We concluded from this study that the efficacy of digital examination was thought to be insufficient for the screening of PC. The cost-benefit balance in our mass screening system was estimated from the above mentioned results. We needed yen 2,000,000 to find out each case of early PC in the system. In our clinic, patients with early PC paid yen 2,000,000 in average for treatments including radical surgery and were cured. On the contrary, patients with advanced PC paid yen 5,000,000 approximately yen 8,000,000 and died eventually. The minimum difference of treatment fee between early and advanced PC was yen 3,000,000, accordingly. Since the cost of detecting each early PC in mass screening was yen 2,000,000, we are contributing approximately yen 1,000,000 to the national finance on each time when we pick up one case of early PC. This doesn't include benefits from detecting BPH and from life prolongation. Thus the balance seems to be sufficiently positive. In conclusion, a mass screening program for prostatic diseases is promising because it can detect the diseases accurately by transrectal ultrasonotomography with a good cost-benefit balance. The only remaining problem is how to transfer this to national political measures.

Aged↗

PubMedDate not supplied

Effects of intervention on compliance to referral and lifestyle recommendations given at cholesterol screening programs.

To enhance compliance to physician referral as well as dietary and other lifestyle recommendations given at blood cholesterol (BC) screening programs, we randomized Pawtucket Heart Health Program SCORE (screening, counseling, referral event) participants with elevated BC levels into one of four groups: usual care group; a participant intervention group (mailed reminder letter and refrigerator magnet); a physician intervention group (mailed packet to participant's physician including letter, National Cholesterol Education Program [NCEP] guidelines, and preaddressed postcard to mail to patient); and a group that received both interventions. Beginning four months after the screening, we surveyed study subjects by phone. The participant intervention increased recall of physician referral and dietary recommendations; however, neither intervention successfully improved compliance to referral or dietary and lifestyle recommendations. Overall, 58%, 67% and 34% of subjects reported complying to physician referral, dietary recommendations, and lifestyle recommendations, respectively. Referral compliance was associated with a longer time interval between screening and survey (relative risk [RR] = 1.3, 95% confidence interval [CI[ = 1.0, 1.7), possession of medical insurance that covered physician visits (RR = 2.1, 95% CI = 0.98, 4.4), and history of hypertension (RR = 2.6, 95% CI = 1.1, 5.8). Dietary compliance was positively associated with baseline BC levels > or = 240 mg/dL (RR = 3.3, 95% CI = 1.4, 7.3) and negatively associated with increasing age; each one year increase in age corresponded to a 3% decrease in compliance (RR = 0.97, 95% CI = 0.9. 1.0).(ABSTRACT TRUNCATED AT 250 WORDS)

Arteriosclerosis↗

PubMed1980

An improved electrophoretic method for a screening program for haemoglobinopathies.

A method for a screening program for haemoglobinopathies in a starch agar gel mixed with saponin is presented. Normal and abnormal blood containing haemoglobins S, C, I, M Boston, D Punjab, beta thalassaemia major and beta thalassaemia minor, were applied, in a tray with the capacity for 100 samples. The electrophoresis was performed in 45 min using 300 V. This method offers special advantages for the examination of a large number of samples, using a small amount of whole blood and without the previous preparation of haemoglobin solution.

Electrophoresis, Agar Gel↗

PubMedDate not supplied

Familial thyroxine-binding globulin deficiency detected in a pilot screening program for congenital hypothyroidism.

During a pilot screening program for congenital hypothyroidism, performed in Italy over a three years period on 38,000 newborns, seven cases (1/5,400) of thyroxine-binding globulin (TBG) deficiency, have been detected. None of these infants was affected by any pathology or had been treated with drugs which could explain TBG deficiency as an acquired condition. Familial studies pointed out that the transmission of the defect is consistent or compatible with X-chromosome linkage.

Congenital Hypothyroidism↗

PubMed1976

A dental school hypertension screening program.

This paper has described a hypertension screening program at the Medical College of Virginia School of Dentistry. The program, which has been in operation for over two years, incorporates referral to a physician and a system of repeated follow-ups. The results indicate that the program has been successful in that 134 of a total of 141 patients with suspected hypertension have been successfully referred.

Blood Pressure↗

PubMed1997

An evaluation of educational outreach to general practitioners as part of a statewide cervical screening program.

OBJECTIVES: The purpose of this study was to determine the acceptability, effectiveness, and cost of a face-to-face educational outreach intervention in the context of a program aimed at increasing cervical screening in Victoria, Australia. METHODS: All identified general practitioners in a specified intervention area were offered a visit by a general practitioner educator. Practitioners completed a questionnaire evaluating the acceptability of the visit. Odds ratios for a woman being screened in the 3 months following the visits were determined. RESULTS: Fifty-nine general practitioners (69.4%) accepted the offer of a visit. Most found both the process and the content of the intervention to be acceptable. The intervention and nonintervention regions did not differ either before or after the intervention. In both regions, there was a statistically significant increase in number of Pap tests performed. There was no difference in the change in screening between the two regions. Costs were estimated at Au$34 per general practitioner visited. CONCLUSIONS: This strategy cannot be recommended for widespread use in a cervical screening program.

Adult↗

PubMedDate not supplied

Evaluation of referral completion after a workplace cholesterol screening program.

We designed a randomized clinical trial to examine effectiveness of a follow-up educational mailing to improve referral completion following a workplace cholesterol screening program. Of 836 employees who participated in a cholesterol screening program at Blue Cross and Blue Shield of Maryland, 313 (37%) had a total cholesterol greater than or equal to 200 mg/dL and were referred to their physician for remeasurement and evaluation. Individuals with elevated cholesterol who agreed to a telephone interview two months after screening (n = 272) were randomized to a control or intervention group. The intervention consisted of a booster mailing two weeks after screening designed to encourage further physician follow-up and to increase knowledge about cholesterol and its dietary control and about risk factors for coronary heart disease (CHD). No statistically significant differences appeared between the control and intervention groups in rate of referral completion. However, a blood cholesterol level of greater than or equal to 240 mg/dL at the time of screening was the most significant predictor of referral completion (P less than .0001). Of those randomized, the association between the number of other additional risk factors for CHD and referral completion was not statistically significant. There was, however, a trend toward reported changes in lifestyle behavior as a result of screening, particularly in diet modification.

Adult↗

PubMedDate not supplied

Factors associated with participation by Mexican migrant farmworkers in a tuberculosis screening program.

BACKGROUND: Tuberculosis is an important public health concern among migrant farmworkers in the United States; providing appropriate screening and treatment is difficult due to their highly mobile existence. PURPOSE: To analyze the relationship between variables (susceptibility, severity, barriers, benefits, cues to action, normative beliefs, subjective norm, attitude, and intention) from the Health Belief Model (HBM) and the Theory of Reasoned Action (TRA) and participation by Mexican migrant farmworkers in a tuberculosis screening program. METHOD: A convenience sample of 206 migrant farmworkers were recruited after a presentation of a tuberculosis education program and were tracked during the administration and reading of the tuberculosis skin test. Participants were interviewed in Spanish by the principal investigator using the Tuberculosis Interview Instrument (TII) developed for this study. RESULTS: Most subjects were male, aged 18-27 years, and had less than a sixth-grade education. Of the 206 subjects, 152 (73.4%) received the skin test, 149 (98%) had the skin test read, and 44 (29.5%) had positive skin tests. Based on logistic regression analysis, the model that best predicted intention included cues to action, subjective norm, susceptibility, and attitude. Participation in screening was best predicted by a model containing only two variables: intention and susceptibility. CONCLUSIONS: In this study, logistic regression analysis revealed that a more parsimonious model than the full HBM and TRA model accurately predicted both intention and behavior. The findings may be helpful in developing tuberculosis education and screening programs for Mexican migrant farmworkers.

Adolescent↗

PubMed1978

The impact of a community screening program on psychiatric hospital admissions.

A rural CMHC screening program significantly reduced admission rates to a state hospital compared with hospital-based screening. Personnel from CMHCs in three counties evaluated each potential admission to the hospital to evaluate their need for hospitalization. Hospital staff screened admissions from the remaining counties of the state. Both community and hospital screening resulted in significant reductions in admissions with community screening producing larger declines. Additional possible advantages of community screening for improved treatment outcomes, efficient utilization of community resources, and reduced costs are discussed.

Commitment of Persons with Psychiatric Disorders↗

PubMed1992

Comparison of characteristics between frequent participants and non-participants in screening program for stomach cancer.

To clarify the differences in characteristics between participants and non-participants in the screening program for stomach cancer, life-style and medical histories were compared among 20, 169 subjects who lived in an urban area (Sendai) and a rural area (Wakuya and Tajiri) in Miyagi Prefecture, Japan. All subjects were classified into three groups according to the frequency of participation in the screening program during the last 5 years; i.e., frequent participating group (FPG) for 4 or 5 times, reference group (RG) for 1-3 times and non-participating group (NPG) for 0 times. Subjects in the FPG consumed more milk and green-yellow vegetable whereas those in the NPG consumed less these foods. The age-adjusted proportions of present smokers were higher in the NPG but lower in the FPG significantly. The proportions of subjects who had parental histories of all cancers and stomach cancer and past history of gastro-duodenal ulcer were higher in the FPG and lower in the NPG. To control influences among the variables a stepwise multiple regression analysis was done, and it revealed that smoking and parental history of cancers were strong predictors to explain the frequency of participation.

Adult↗

PubMed1987

Is the tuberculosis screening program of hospital employees still required?

The American Thoracic Society and the Centers for Disease Control recommend that each hospital has a tuberculosis screening program. As the incidence of active tuberculosis in the United States has been decreasing during the last 30 yr, the necessity for continuing this screening program may be questioned. This prospective study evaluates whether screening hospital employees is still useful. In the state of Washington from January 1, 1982, through December 31, 1984, tuberculosis was diagnosed in 747 patients, of whom 387 (52%) were hospitalized. One hundred seventy-one of the hospitalized patients (44%) were sputum-smear-positive. Data were collected from each of the 114 hospitals in the state. During the 3-yr period, 50 hospitals admitted no patients known to have M. tuberculosis, 48 admitted 1 or more sputum-smear-positive patients, and 16 others admitted 1 or more smear-negative patients. The number of employees at each hospital ranged from 10 to 6,289 (539 +/- 757, mean +/- SD). Skin testing was performed on 13.7 to 100% (median, 84.2%) of employees. In the 3-yr period, 126,493 skin tests were placed by trained personnel; 501 employees were reported as being converters, but only 129 were found to be true converters. The conversion rates of employees in hospitals to which patients with smear-positive and smear-negative disease were admitted were 1.05 and 1.09 per 1,000, respectively. The conversion rate in hospitals where no patients with M. tuberculosis were admitted was 0.8 per 1,000. These conversion rates were no greater than that predicted for the general population.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1996

Feasibility of an emergency department-based, risk-targeted voluntary HIV screening program.

STUDY OBJECTIVE: To assess the feasibility and effectiveness of an emergency department-based, risk-targeted voluntary HIV screening program. METHODS: We prospectively enrolled consenting adult i.v. drug users (IDUs) not known to have HIV infection in the ED of a large inner-city hospital with a high rate of HIV infection among patients during a 10-week trial. Study patients were given confidential HIV pretest and risk-reduction counseling, with 10- to 14-day on-site ED follow-up. Follow-up included posttest counseling, reinforcement of risk-reduction practices, and a +10 incentive to cover transportation costs. HIV seropositive patients were referred to the hospital HIV clinic for further evaluation and treatment. RESULTS: Of 200 eligible IDUs, 168 (84%) consented to HIV testing. Of the 104 (62%) who returned for follow-up, 17 (16%) tested positive for HIV. Of these patients, 6 (35%) kept their initial hospital HIV clinic referral appointment, a rate consistent with the experience of the hospital HIV clinic. Of nine patients in whom CD4+ counts were performed at time of the visit, three (33%) had counts less than 200. At 3-month follow-up, 4 of 20 active IDUs (20%) had reportedly ceased drug use because of the program. The complete program costs was an estimated $16,659, $99 per enrolled patient and $521 per HIV-positive patient. CONCLUSION: An ED-based, risk-targeted HIV screening program is feasible and over time could detect a significant number of asymptomatic HIV-infected individuals, including those who should receive antiretroviral therapy and prophylaxis for Pneumocystis carinii pneumonia therapy (CD4+ count less than 200). An additional benefit of ED-based HIV screening in high-prevalence EDs is the opportunity to conduct successful risk-reduction counseling in some high-risk individuals.

AIDS Serodiagnosis↗