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At least 217 records · Page 12Linked to original sources

Low back pain: risk evaluation and preplacement screening.

As screening tests in a currently asymptomatic population, all of the available methods for predicting low back pain and disability have serious technical, ethical and legal limitations. From a technical point of view, none of the predictive tests appear to have sufficient sensitivity or specificity to justify routine usage. The most sensitive indicator (a past history of low back pain) lacks reliability and specificity. Muscle strength-testing may be predictive of future musculoskeletal injury as part of a well-designed program that considers specific job demands in relation to specific worker capabilities. Unfortunately, the conditions necessary for a well designed program--a large number of predictable high-risk jobs that have measurable specific demands that can be reproduced reliably in a testing situation--are rarely met. In the future, the use of computer-assisted multivariate models analogous to those used in the prediction of cardiovascular risk may be capable of integrating information about an individual's medical history, physical exam, physical capacity and other tests with specific job requirements to give us a more accurate prediction of the future risk of back pain and disability. If such predictive models are ever developed and verified, it would then be appropriate to examine various interventions and their effectiveness in modifying risks for the population and the individual worker. From a legal point of view, all of the techniques described hold potential for significant discrimination against legally protected groups. Making employment decisions with regard to a past history of low back pain or on the basis of an x-ray will lead to systematic age discrimination and discrimination against the handicapped. The use of muscle strength-testing will systematically discriminate against women and certain ethnic groups. The ethical implications of predictive screening for low back pain clearly depends on what is done with the information that is garnered from such tests. If the information is used only to make a safe job placement for an individual, and this placement does not affect the individual's salary or future job possibilities, then the testing program may have a net social value to the extent that it leads to true prevention of low back pain and disability. If the tests are used merely to reduce employer liability by refusing employment to those who are thought to be at "high risk," the technical, legal and ethical limitations will far outweigh any perceived benefits.

Back Pain↗

An automated 96-well-plate loader for FACScan.

Staining multiple samples for data acquisition with a flow cytometer is done in 96-well plates to save time and make large data assessment in one working day possible. However, the inability of the FACScan to take up the samples from 96-well plates is a major drawback. In order to avoid the individual transfer of samples to tubes, we have developed a system, which allows using the FACScan with 96-well plates. The machine consists of a programmable control module and a loader which moves the 96-well plate in 3 axis well by well along the sample collector. The machine is equipped with a wash buffer tank to avoid cross contamination of samples and a shaking option to avoid sedimentation of cells during acquisition. The machine can be further developed into a full automatic loader if connected to the FACS Station. In 24 hours about 7,000 samples with 10,000 cells each can be acquired.

Flow Cytometry↗

[Basic trends in the use of mathematics and computer technics in cardiology].

Five cardinal, according to the author, trends in the utilization of mathematics and computing technique in cardiology are discussed, viz. in the diagnosis, including mass-examinations of the population; in prognosing, with screening at the time of mass-examination of the population groups of persons presenting risks as to the development of atherosclerosis, myocardial infarction, hypertensive disease, etc.; in the treatment; in the organization of information-search systems; in modelling. The significance of the cited trends for theoretical and practical cardiology is shown on examples from experience of the work carried out by research bodies headed by the author.

Cardiology↗

The present status of immunodiagnosis and immunotherapy of cancer.

A number of immunodiagnostic procedures in cancer is clinically important in the sense that the tests may confirm the results of other cancer diagnostic investigations. However, each one of the tests has its own area of application. Immunodiagnostic tests are used for the detection of relapse or metastases as well as for the histological verification of the tumor. A mass screening for tumors in the population and most probably the early tumor diagnosis by immunological means is impossible due to biological variables among the tumor bearers and to technical difficulties. Immunotherapy of tumors is still at an experimental stage. Although immunization is possible to animal tumors convincing data on similar effects in the human tumor system do not exist as yet. This conclusion is based on immunization experiments with adjuvants as well as with tumor preparations, transfer factor, thymosin, or immune RNA. The fact that tumor cytotoxic and tumor cytostatic immunological mechanisms do occur even in the human tumor system is a stimulus for future approaches.

Animals↗

[The value of MRI in staging gynecologic tumors].

Traditionally gynecologic malignancies are staged by examination under anaesthesia which provides high accuracy as far as small tumors are concerned. In advanced tumors clinical staging is often inaccurate because of the difficulty to evaluate parametrial or myometrial tumor infiltration or lymphatic tumor spread. Therefore imaging modalities, such as sonography, computed tomography (CT), and magnetic resonance imaging (MRI), are required in most cases. The range of applications for MRI imaging includes staging, therapy planning, and follow-up examinations of uterine tumors and recurrent carcinoma. Based on its excellent soft tissue contrast, which allows a precise differentiation between several tissues and its direct multiplanar imaging capability, MRI is superior to sonography and CT. Only in the staging of ovarian carcinoma has the value of MRT not yet been defined, nevertheless it seems to offer diagnostic advantages over CT and sonography on account of its higher specificity. CT lose some of its value after the introduction of MRI into clinical practice. Indications for the use of CT are advanced space-occupying tumors with lymphatic spread or peritoneal implants as well as monitoring the tumor response to therapy for ovarian cancer. Sonography, as the technically simplest imaging modality, has consistently demonstrated its value as a screening method in the evaluation of benign gynecologic disease and is traditionally used for the detection of ovarian masses.

Female↗

[Obstacles and reticences in the screening of cancer of the cervix by the general practitioner].

To have a better understanding of the poor participation rate among general practitioners (GPs) in cervical cancer screening, we have conducted a survey in the department of Bas-Rhin on a small sample of GPs. This helped to explain how they perceived this technical act, the problems or barriers related to it: rate, function and status of general practitioner in the current health care system, the difficulty to combine the scientific and technical aspects of modern medicine with the need to care for the patients.

Adult↗

[Screening for hemoglobinopathies in blood donors from Caxias do Sul, Rio Grande do Sul, Brazil: prevalence in an Italian colony].

The high prevalence of beta thalassemia among Italians and their participation in the ethnic formation of Caxias do Sul, Rio Grande do Sul State, Brazil, and neighboring cities prompted us to investigate hemoglobinopathies in 608 blood donors at the Caxias do Sul Regional Blood Center. Despite the ethnic influence, abnormal hemoglobin levels were found in only 1.81% of the donors (0.16% Hb AC, 0.99% Hb AS, and 0.66% Hb AH), similar to the levels observed in a study on qualitative disorders conducted in the rural area of Rio Grande do Sul. In our setting, the most commonly used screening tests for thalassemia, combined with DNA sequencing, were unable to detect quantitative hemoglobin synthesis disorders. This may be attributable to still-unknown genetic disorders, technical limitations, or simply to miscegenation.

Adolescent↗

Uro- and angiographic findings in a "normal" population: screening of 151 symptom-free potential transplant donors for renal disease.

Potentially significant renal abnormalities were encountered in 7.3% of 151 symptom-free renal transplant donors and included renal cysts, cortical adenoma, ectopic and solitary kidney, and vascular abnormalities. Findings as they relat to donation of a kidney were important in 2.1% of patients and included solitary kidney and certain rare vascular variants rejected for technical reasons and danger of distal ureteral necrosis after transplantation.

Adolescent↗