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PubMed2005

Coexistence of osteoporosis and cardiovascular disease risk factors in apparently healthy, untreated postmenopausal women.

This study aimed to determine whether apparently healthy, untreated postmenopausal women at risk of osteoporosis relative to nonmenopausal women are concomitantly at risk of cardiovascular disease (CVD) in terms of various aspects of lifestyle, personality, body shape and composition, and blood chemistry. Two homogeneous groups of 30 women having reached menopause for 3-5 years and 30 nonmenopausal controls, all non-estrogen users without apparent CVD risk factors, were compared in a cross-sectional design. Data related to physical activity, dietary intakes, personality type, anthropometry, and skinfold-thickness were collected. Plasma insulin-like growth factor (IGF-1) and serum lipids were measured and used as biochemical predictors of osteoporosis and CVD, respectively. Compared to nonmenopausal controls, postmenopausal women were at greater risk of bone loss given their lower plasma IGF-1, lower physical activity level, and even given their higher serum lipids, as recent literature suggests. Moreover, their dietary calcium intake fulfilled only 70% of the current recommendation, which may reduce protection against osteoporosis and CVD (particularly hypertension) as well. The two groups did not differ regarding energy intake, body weight and frame size, body mass index (BMI), waist circumference, and waist-hip ratio (WHR). However, postmenopausal subjects had more adipose tissue and differed in terms of lifestyle factors (lower dietary lipids and greater alcohol consumption). While neither group was at particular risk of CVD according to waist circumference, WHR, and serum triglycerides, postmenopausal women were at risk according to percent body adiposity and serum cholesterol. This study shows that several risk factors for osteoporosis and CVD can coexist in apparently healthy postmenopausal women after a few years of natural menopause. It emphasizes the need for a timely screening that would stress both heart and bone risk factors.

Adipose Tissue↗

PubMed2005

ImmunoCyt/uCyt+ improves the sensitivity of urine cytology in patients followed for urothelial carcinoma.

ImmunoCyt/uCyt is a fluorescent test combining three monoclonal antibodies. In this study, it has been tested as a complement to cytology in the detection of urothelial carcinoma in urine. It has been performed simultaneously with standard cytology and cystoscopy on 870 urine analyses from one hospital. In 136 cases, one or more bladder tumors were found. Overall sensitivity of cytology, ImmunoCyt/uCyt and combined analyses reached 29, 74 and 84%, respectively, and overall specificity was 98, 62 and 61%. The negative predictive value of cytology, ImmunoCyt/uCyt and both analyses was 88, 93 and 95%, respectively, and the positive predictive value was 70, 26 and 29%. The sensitivity of cytology for low malignant potential neoplasms, low- and high-grade papillary carcinomas was 6, 18 and 53%, while it reached 71, 79 and 93% when combined with ImmunoCyt/uCyt. The sensitivity of cytology for stages Ta, T1, T2 and over and Tis tumors was 12, 67, 47 and 50%, while it reached 78, 83, 79 and 100% when combined with ImmunoCyt/uCyt. In the absence of tumor on cystoscopy but with positive ImmunoCyt/uCyt, 18% of patients developed a tumor, 2-6 months later. Of the 109 cases diagnosed as suspicious for malignancy by cytology, a tumor was present in 30 cases and ImmunoCyt/uCyt was positive in 22 (73%) of them. In conclusion, ImmunoCyt/uCyt may be used to postpone cystoscopies in patients followed for bladder cancer and may help to save cytologist and pathologist screening time.

Adult↗

PubMed1992

Effects of oral donor questioning about high-risk behaviors for human immunodeficiency virus infection.

The purposes of this study were 1) to compare blood donor deferrals resulting from additional, oral questions about human immunodeficiency virus risk behaviors with deferrals resulting from currently used, written screening questions; 2) to examine differences in donor deferral resulting from use of an indirect (IQ) versus direct (DQ) additional oral question format; and 3) to evaluate written survey responses of donors and staff members to the additional questions. The IQ group (n = 3050) were asked if they understood the seven ineligible-donor risk behaviors, and the DQ group (n = 4753) were asked if they had engaged in any of these behaviors. Owing to positive answers or refusal to answer the additional questions, there was an increase in donor deferrals, over the level seen with customary screening. Only 1 percent of donors indicated they would not return if the questions were asked in the future. Embarrassment was indicated by 3 percent of the IQ group and 7 percent of the DQ group; 14 to 15 percent preferred to write their answers rather than give them orally. The staff members generally felt training was adequate (IQ = 92%, DQ = 83%) and were comfortable asking the questions (IQ = 82%, DQ = 78%). Mean screening times were 5.7 minutes before the addition of the oral questions, 7.5 minutes with IQ, and 7.6 minutes with DQ. This study confirms the value of IQ and DQ formats in identifying potentially infectious donors and suggests that the DQ format may be slightly more effective.

Attitude to Health↗

PubMed1976

[The technique and success rate of transfemoral cerebral angiography].

Amongst 434 transfemoral cerebral catheter angiograms a success rate of 98.16% was achieved. The catheters and manipulations required for successful catheterisation are described. In view of the screening time required, a comparison with needle angiography was made. It was found that catheter angiography was better in all cases in which several cerebral arteries had to be demonstrated.

Adolescent↗

PubMed1995

[Radiation exposure of radiologists during angiography: dose measurements outside the lead apron].

The aim of this study was to provide practical information to angiographers concerning radiation exposure to body parts not covered by lead aprons. Individual doses to the neck and hands of radiologists measured in micro-Sieverts were obtained during the course of 80 angiographies of various types. The number of diagnostic and interventional procedures, which might lead to exceeding permissible doses, have been calculated. Possibilities of estimating doses during angiography by means of parameters such as screening times were examined statistically. Especially with regard to the hands, estimations of the doses are insufficient (correlation r = 0.21). Radiologists who undertake much angiographic and particularly interventional work may reach exposure levels requiring protective measures in addition to lead aprons.

Angiography↗

PubMed1984

Radiation exposure in endoscopic retrograde cholangiopancreatography.

Radiation exposure was studied on the basis of x-ray screening time and spotfilms taken in 3590 patients undergoing ERCP. Factors influencing radiation exposure in diagnostic procedures were the age of the patient, target duct system and gastroenteric anastomosis, while duodenal diverticula proved to be of no significance. In endoscopic sphincterotomy average fluoroscopic time was about one minute longer. In contrast to diagnostic ERC, there was an appreciable reduction of radiation exposure in endoscopic sphincterotomy with time, reflecting the growing experience of the endoscopic team. The data presented are within the acceptable range for conventional radiological Gl-examinations.

Adolescent↗

PubMed1994

[The determination of the ovarian dosage in defecography on a digital C-arm unit].

When using defaecography as a radiological tool for diagnosing the anorectal function in female patients, the ovaries are inevitably directly exposed. With the aim of minimising the ovarian dose applied both the area-dose product and the surface dose above the ovaries were measured during investigations of female patients with a digital C-arm unit. These values were converted into ovarian doses using tissue-air ratios. From the surface dose measured with TLD-100 a mean ovarian dose of 15.6 +/- 8.6 mGy was derived. The contributions of screening and film exposures were similar. A reduction of screening time by 10 seconds or omission of 60 film exposures results in a decrease of ovarian dose by values between 0.7 and 2 mGy. Employing a greater focus-skin distance during defaecography, however, made it possible to reduce the ovarian dose by 26%.

Anal Canal↗

PubMed1991

Finger doses during interventional radiology: the value of flexible protective gloves.

Finger doses of radiologists and assistants during 19 interventional radiological procedures were measured with thermoluminescent dosimeters (TLDs), and two types of flexible protective gloves were compared with each other. There were considerable differences in doses between different sites of TLDs on fingers. The exact site of TLDs on hands/fingers should thus be reported in papers. Both gloves were also irradiated through an Alderson phantom and the attenuation values were measured. The gloves with slightly greater attenuation proved to be significantly less comfortable to use. Wearing flexible protective gloves did not lengthen screening times as compared to a previous study in the same department. Various aspects of using such gloves are discussed. The attenuation values of gloves reported by the manufacturers may not apply under all clinical circumstances.

Adult↗

PubMed1983

[Value and possibilities for the improvement of hysterosalpingography].

The diagnostic results of hysterosalpingography and laparoscopy were compared (30 patients). Agreement between the methods was found in 73%. In 17% of the women, findings seen on hysterosalpingography, could not be confirmed at laparoscopy. Conversely, in 10% of negative hysterosalpingograms, adhesions were found at laparoscopy. Possible causes for these differences are discussed. At present three different methods are used for hysterosalpingography. Compared with a metal cannula or a Foley catheter, the use of a baby's feeding tube resulted in a reduction of tubal spasm. A reduction in screening time and consequent decrease in gonadal radiation is possible without loss of diagnostic information.

Female↗

PubMed1980

[Practical experience with video recorders during screening procedures (author's transl)].

As a result of increasing standardisation and simplification of video recorders, it has proved possible to use equipment made by various firms for electronic recording. Instead of an expensive central set-up, screening procedures could be recorded either dynamically or statically on mobile recorders in every x-ray room. The procedure is largely automated. Both tape and disc recorders were used in 625 and 1249 recordings respectively. In addition to shorter screening time, there were other advantages which are described.

Technology, Radiologic↗

PubMed1994

The infant or young child with developmental delay.

The practitioner should attempt to identify the infant and young child with developmental delay as early as possible, so that appropriate services can be provided. Ongoing surveillance is required, rather than one-time screening. The practitioner should also serve as an advocate for children with developmental delay. He or she should ensure that appropriate services exist within the child's community and that they are readily accessible. This requires ongoing communication not only with the child and the family, but also with schools and community agencies.

Child↗

PubMed2003

Cervical cytology in an urban population in Lagos, Nigeria.

Eight hundred and eighty-four consecutive women had cervical smears in a clinic in Lagos, Nigeria between September 1998 and 31 August 1999. Mean age was 36.6 - 11.6 years (range 16-81 years); 93.7% were first-time screening. Three hundred and twenty-five (36.5%) smears were normal, inflammatory smears 52.7%, mild dyskaryosis 2.4%, moderate dyskaryosis 1.5%, severe dyskaryosis 0.3% and probable malignancy (malignant cells) 0.8%. Abnormal smears were higher in symptomatic cases compared with asymptomatic cases (chi2=15.3, P< 0.01); 6.1% and 2.1% of symptomatic cases had dyskaryosis and carcinoma, respectively, compared with 3.4% and 0.1% for asymptomatic cases. In postcoital bleeding 9.3% and 1.9% had dyskaryosis and carcinoma, respectively. Fifty-six of 62 cases of cervical erosion had abnormal smears. In postmenopausal bleeding 13.0% and 4.3% had dyskaryosis and carcinoma, respectively. Prevalence of abnormal cervical smears is high in women who have genital tract disease. In places with no national screening programmes every effort should be made to screen such women.

Adolescent↗

PubMed2000

Factors influencing patient radiation doses from barium enema examinations.

PURPOSE: To analyse factors behind the variation of patient doses from barium enema (BE) examinations. MATERIAL AND METHODS: The patients' (n=89) organ and effective doses (E) due to BE examinations were computed with the ODS-60 program. An average risk factor for BE examinations was derived using the BEIR V schema. The correlation of E with several independent variables was analysed. RESULTS: Median Es at five hospitals were 4.4, 6.1, 7.1, 13 and 16 mSv. The E of the female patients (median 9.2 mSv) was higher than that of the males (median 5.4 mSv) (p<0.001) due to the higher female doses to the gonads, bladder and uterus, resulting from different body structure. An average fatal risk factor of 0.02%. per one BE examination was derived. Factors controlled by the radiologist (screening time, number of exposures) explained 40% and patient-related factors explained 16% of the total variation of E. The equipment-related factors are included in the residual 44%. CONCLUSION: Due to the large contribution of the radiologists' examination technique in the value of E, an optimal examination technique is essential in reducing doses and the stochastic risk to patients.

Adult↗

PubMed2002

Solvent effects on the screening of parallel combinatorial libraries for selectors for chiral chromatography.

The correlation between the resin-swelling property and the outcome of the crucial equilibration assay used in our parallel library screening method is investigated. It is found that the incorporation of CHCl3 (an effective swelling solvent for both the polystyrene and TentaGel resins) into the equilibration solvent leads to faster equilibration and thus shorter library screening time. The outcome of the equilibration experiment is also found to depend on the chemical nature of the solid base resins. It appears that polystyrene resin, which has a relatively inert surface, provides higher enantioselectivity than the polar TentaGel resin. The importance of a thoroughly swelled resin for the direct assay of functional groups on the resin is demonstrated.

Circular Dichroism↗

PubMed1999

The Clock Drawing Test: utility for dementia detection in multiethnic elders.

BACKGROUND: Disproportionate increases in dementia morbidity in ethnic minorities challenge established screening methodologies because of language and culture barriers, varying access to health services, and a relative paucity of cross-cultural data validating their use. Simple screening techniques adapted to a range of health and social service settings would accelerate dementia detection and social and health services planning for demented minority elders. METHODS: The effectiveness of the Clock Drawing Test (CDT) for dementia detection was compared with that of the Mini-Mental State Examination (MMSE) and the Cognitive Abilities Screening Instrument (CASI) in community-dwelling elders of diverse linguistic, ethnic, and educational backgrounds. Subjects (N = 295) were tested at home in their native languages (English, n = 141; another language, n = 154). An informant-based clinical dementia history and functional severity index derived from the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) protocols were used to classify subjects as probably demented (n = 170), and probably not demented (n = 125). RESULTS: All tests were significantly affected by education (p < .001) but not by primary language (p > .05). Sensitivities and specificities for probable dementia were 82% and 92%, respectively, for the CDT; 92% and 92% for the MMSE; and 93% and 97% for the CASI for subjects completing each test. However, in poorly educated non-English speakers, the CDT detected demented subjects with higher sensitivity than the two longer instruments (sensitivity and specificity 85% and 94% for the CDT, 46% and 100% for the MMSE, and 75% and 95% for the CASI). Moreover less information was lost due to noncompletion of the CDT than the MMSE or CASI (severe dementia or refusal: CDT 8%, MMSE 12%, and CASI 16%). CONCLUSIONS: Overall, the CDT may be as effective as the MMSE or CASI as a first-level dementia screen for clinical use in multiethnic, multilingual samples of older adults. Its brevity (1-5 minutes), minimal language requirements, high acceptability, and lack of dependence on specialized testing materials are well adapted for screening of non-English-speaking elderly persons in settings where bilingual interpreters are not readily available and screening time is at a premium.

Aged↗

PubMed2006

Fluroscopy in paediatric fractures--setting a local diagnostic reference level.

BACKGROUND: The ionizing radiations (Medical Exposure) Regulation 2000 has made it mandatory to establish diagnostic reference levels (DRLs) for all typical radiological examinations. OBJECTIVES: We attempt to provide dose data for some common fluoroscopic procedures used in orthopaedic trauma that may be used as the basis for setting DRLs for paediatric patients. MATERIALS AND METHODS: The dose area product (DAP) in 865 paediatric trauma examinations was analysed. Median DAP values and screening times for each procedure type along with quartile values for each range are presented. RESULTS: In the upper limb, elbow examinations had maximum exposure with a median DAP value of 1.21 cGy cm2. Median DAP values for forearm and wrist examinations were 0.708 and 0.538 cGy cm2, respectively. In lower limb, tibia and fibula examinations had a median DAP value of 3.23 cGy cm2 followed by ankle examinations with a median DAP of 3.10 cGy cm2. The rounded third quartile DAP value for each distribution can be used as a provisional DRL for the specific procedure type.

Child↗

PubMed1988

Doses to patients from diagnostic radiology in France.

Reported here are results of a 1982 national survey in France to establish the collective effective dose equivalent associated with the main types of radiological examinations practiced annually in this country (except nuclear medicine, C.T. scans, dental radiology and mass chest screening). This report describes the methodology followed in achieving dose measurements either on an anthropomorphic phantom or directly on the patient, and it highlights the importance of the radiological procedures (number of x-ray films, fluoroscopy screening time, etc.) on the patient organ doses. The estimated collective effective dose equivalent associated with these radiological practices is 86,000 person-Sv, i.e., an individual effective dose equivalent of 1.58 mSv y-1; the genetically significant dose figure is 0.29 mSv and the collective red bone marrow dose due to 45 million x-ray exams practiced in France (1982) is 40,300 person-Sv, i.e. 0.74 mSv per inhabitant.

Adult↗

PubMed1993

What factors influence radiologists' finger doses during percutaneous drainages under fluoroscopic guidance?

Radiation exposure of radiologists' left and right hands during 44 percutaneous drainages involving fluoroscopy was measured with thermoluminescent dosimeters. Finger doses of 3.4-1,300 microGy (mean 180, median 110) were recorded. Finger exposure seemed to show a significant, positive correlation with the screening time, but not with the patients' body mass indexes or ages. The mean personal doses of the radiologists were different and, in one case, the difference between the individual radiologists' doses was statistically significant. The personal working technique may therefore partly explain the amount of radiation exposure to the fingers.

Adult↗