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At least 307 records · Page 17Linked to original sources
PubMed2006

Concomitant analysis of salivary tumor markers--a new diagnostic tool for oral cancer.

PURPOSE: Oral squamous cell carcinoma (OSCC) is a common human malignancy. Circulatory epithelial tumor markers were previously investigated in the serum of OSCC patients but almost never in their saliva, in spite of the fact that there is a direct contact between the saliva and the oral cancer lesion. The purpose of the current study was to examine tumor markers in the saliva of OSCC patients. EXPERIMENTAL DESIGN: We measured the concentrations of the six most studied epithelial serum circulatory tumor markers in the saliva of OSCC (tongue) patients. RESULTS: Significant increases (of 400%) in salivary concentrations of Cyfra 21-1, tissue polypeptide antigen, and CA125 were shown. Salivary concentrations of CA19-9, SCC, and carcinoembryonic antigen were increased without statistical significance. A concurrent analysis of the three significantly increased markers revealed sensitivity, specificity, and negative and positive predictive values of 71%, 75%, 71%, and 75%, respectively. CONCLUSIONS: The increase reported in salivary tumor markers may be used as a diagnostic tool, especially when a concurrent analysis for significantly increased markers is done. Salivary testing is noninvasive, making it an attractive, effective alternative to serum testing, and the possibility of developing home testing kits would further facilitate it as a diagnostic aid, enabling patients to monitor their own health at home and is important for those who live far from their treatment centers and especially for those at risk of developing OSCC.

Adult↗
PubMed1984

Home urinary glucose testing. Its impact on a Third World diabetic population.

A simple system of home urinary glucose testing was introduced at the Ga-Rankuwa Hospital diabetic clinic 2 years ago. The patients are relatively unsophisticated; 20% above 16 years of age are illiterate and only 6% are employed in professions. The overall compliance rate with home testing is 55% and those complying have mean random blood glucose levels (9,8 +/- 4,5 mmol/l) significantly lower than those of non-compliers (11,1 +/- 4,6 mmol/l). In the compliers home urine testing appears to be reliable; this is shown by a good correlation between the absence or presence of glucosuria at home and low and high random blood glucose levels at the clinic. These findings have helped us to define objectives more clearly and to select suitable patients for home blood glucose measurement.

Adult↗
PubMedDate not supplied

Alternative HIV testing methods among populations at high risk for HIV infection.

OBJECTIVE: The purpose of this study was to determine the levels of awareness and use of alternative HIV tests (home collection kit, oral mucosal transudate collection kit, and rapid tests) among people at high risk for HIV infection. METHODS: Data were collected as part of an anonymous, cross-sectional interview study--the HIV Testing Survey (HITS)--conducted in seven states from September 2000 to February 2001. Three high-risk populations were recruited: men who have sex with men, injection drug users, and high-risk heterosexuals. Respondents were asked about their awareness and use of alternative HIV tests. RESULTS: The overall awareness and use of the alternative tests was limited: 54% of respondents were aware of the home collection kit, 42% were aware of the oral mucosal transudate collection kit test, and 13% were aware of rapid tests. Among those aware of alternative tests, self-reported use of the tests was also low. The most common reasons given for not using alternative HIV tests were: preference for the standard test; concern that the results could be less accurate; and that alternative tests were not offered. CONCLUSIONS: The low levels of awareness and use of alternative HIV tests suggest that the potential for promoting testing among individuals at high risk for HIV by encouraging use of alternative HIV tests has not been fully realized. Alternative tests should be made more broadly available and should be accompanied by education about these tests for physicians and people at risk. Educational efforts should be evaluated to determine if promoting alternative HIV tests increases the numbers of people at risk for HIV who are tested.

Adult↗
PubMed2003

SMART: self-management of anticoagulation, a randomised trial [ISRCTN19313375].

BACKGROUND: Oral anticoagulation monitoring has traditionally taken place in secondary care because of the need for a laboratory blood test, the international normalised ratio (INR). The development of reliable near patient testing (NPT) systems for INR estimation has facilitated devolution of testing to primary care. Patient self-management is a logical progression from the primary care model. This study will be the first to randomise non-selected patients in primary care, to either self-management or standard care. METHOD: The study was a multi-centred randomised controlled trial with patients from 49 general practices recruited. Those suitable for inclusion were aged 18 or over, with a long term indication for oral anticoagulation, who had taken warfarin for at least six months. Patients randomised to the intervention arm attended at least two training sessions which were practice-based, 1 week apart. Each patient was assessed on their capability to undertake self management. If considered capable, they were given a near patient INR testing monitor, test strips and quality control material for home testing. Patients managed their own anticoagulation for a period of 12 months and performed their INR test every 2 weeks. Control patients continued with their pre-study care either attending hospital or practice based anticoagulant clinics. DISCUSSION: The methodology used in this trial will overcome concerns from previous trials of selection bias and relevance to the UK health service. The study will give a clearer understanding of the benefits of self-management in terms of clinical and cost effectiveness and patient preference.

Adult↗
PubMedDate not supplied

A computerized model for home glucose monitoring proficiency testing: efficacy of an innovative testing program.

PURPOSE: A newly instituted computerized system for proficiency testing of home glucose monitoring was evaluated comparing accuracy of patient determination of glucose with serum values measured in the laboratory. METHODS: Patients returning for routine blood glucose testing ordered by their care provider brought their glucose monitoring equipment to the laboratory. They performed a finger-stick glucose check in the laboratory while the laboratory phlebotomist drew blood for glucose determination; both results were computer analyzed. Patients with a 25% or less variation from the laboratory were considered proficient, while those with greater than 25% variation were defined as nonproficient. RESULTS: Over a 19-month period, 300 of the 3208 patients notified about the study completed proficiency testing at least once. Using the defined proficiency of 25% variation or less, 12% of the participants were nonproficient. Using a variation of 15% or less, 31% of patients were nonproficient. CONCLUSIONS: An annual methodology evaluation such as the one in this study should become a standard of care to identify patients for remedial classes to correct the source of error. The goal must be to meet or exceed the American Diabetes Association standard of 15% total error in home glucose monitoring.

Bias↗
PubMed1995

Hematuria home screening: repeat testing results.

To determine at what interval screening should be repeated to detect bladder cancer before it becomes muscle invasive 856 men who had 14 negative daily home tests for hematuria with a chemical reagent strip 9 months previously performed repeat tests. Of these men 50 (5.8%) had at least 1 positive test during the second 14-day screening period and 38 were evaluated, 15 of whom (39.5%) had significant urological pathological conditions, including 8 with malignancies. Bladder cancer was noted in 7 men, with no tumor invading the muscularis propria. The finding of 7 bladder cancers in 856 men (0.82%) who had a negative test 9 months previously indicates that bladder cancer has a brief preclinical duration and that testing must be repeated at least annually for screening to detect bladder cancer consistently before invasion occurs.

Adenocarcinoma↗
PubMed1988

Anergy testing in nursing home residents.

Delayed cutaneous hypersensitivity (DCH) testing is commonly used to determine exposure to Mycobacterium tuberculosis and in the evaluation of cellular-mediated immunity. Many reports indicate that anergy to ubiquitous antigens is common in the elderly. Recent studies suggest that anergy in the aged is not common when five or more antigens are used. Because it is often difficult to purchase singularly or apply a larger number of quality DCH antigens, we investigated the usefulness of the Multitest CMI in 29 nursing home residents with chronic diseases. This device simultaneously applies seven skin test antigens and a negative control. Ten young healthy subjects served as controls. DCH reactions were scored based on the sum of induration and total number of positive responses. Although elderly subjects had significantly lower scores than the young subjects, only 7% of elderly subjects were anergic. Our data indicate that the Multitest CMI is a highly effective device to test for DCH in geriatric subjects with chronic diseases. Although skin test responses in these subjects were blunted, in most residents cellular-mediated immunity remained intact.

Adult↗
PubMed2002

MDMA ('ecstasy') and other 'club drugs'. The new epidemic.

Unfortunately, perceptions that the club drugs can be safe endure. Some groups, such as the Multidisciplinary Association for Psychedelic Study, continue to lobby for the legalization of MDMA for research purposes [76]. DanceSafe is an organization that seeks to educate the "nonaddicted" user to decrease the risks [82]. The DanceSafe Web site offers tips on the safe use of MDMA, such as attention to hydration status and ambient temperature. It also offers free testing of tablets submitted by mail and sells home testing kits to determine the content of pills sold as "ecstasy." Although much remains unknown about the long-term consequences of MDMA and the club drugs, there are clearly enough short-term dangers to prompt more aggressive education and surveillance for its use. Scare tactics and exaggerations often are ignored [53], while Web sites full of anecdotal or incomplete information may lead the unaware user to increased use [113]. Organizations such as DanceSafe imply that proper education decreases addiction and that only uneducated users or addicts suffer the life-altering consequences of drug use. The fallacy in the mission of educating "nonaddicted" users is evident. Peer-based education, with a focus on both he short-term dangers and long-term consequences, may be a more effective approach [9]. Both new and established drugs of abuse continue to plague teens and young adults. Pediatric, family practice, and Med-Peds physicians, and pediatric pharmacologists need to remain vigilant about patterns and trends of drug abuse. MDMA and the other "club drugs" are not benign. Their effects target the brain, alter neurochemistry, and possibly cause irreversible structural damage. What may seem like a harmless drug in a weekend dance club has the potential for major public health problems in years to come [109]. Effective education and timely intervention may prevent these addictive drugs from becoming a way of life, a lifestyle that may have a literal "dead end."

Adolescent↗
PubMed1979

Environmental and typewriter control systems for high-level quadriplegic patients: evaluation and prescription.

A formal 44-month clinical evaluation was conducted to determine the suitability of selected electronic equipment for use in high-level quadriplegia. A total of 52 traumatic high-level quadriplegic patients (C-2 to C-5,6) participated in the testing of 13 commercial electronic assistive devices including 8 environmental control units, 1 self-contained telephone, and 4 typewriter systems. Most devices were pneumatically ("breath") controlled. Devices were tested in an occupational therapy laboratory, bedside, and homes. Testing yielded data on device reliability, suitability, and acceptance by patients.

Communication↗
PubMed1999

Nurse practitioner support for transfusion in patients with haematological disorders in hospital and at home.

We prospectively studied the effects of dedicating a nurse to manage the provision of blood product support in a hospital haematology unit and at home to 45 patients with haematological disorders requiring regular transfusion. During the study 335 home blood tests, 65 home platelet transfusions and 155 hospital transfusions were managed by the nurse who organized the whole transfusion process, made home visits for blood tests and platelet transfusions and arranged hospital visits for red cell transfusions. Two hundred clinic visits and 65 day hospital attendances were avoided. The nurse-led service resulted in a significant reduction in the waiting time from admission to transfusion and in the total length of in-patient stay. The importance of and satisfaction with different aspects of the care of the transfusion process assessed by a ranking questionnaire showed improved satisfaction scores for all aspects of care. Preference for home blood sampling instead of hospital increased from 24% before to 100% after intervention. We have shown that a dedicated transfusion nurse provides a quality service between hospital and home that is greatly appreciated by patients requiring regular transfusions.

Adult↗
PubMed1989

A look at the purchase and use of home pregnancy-test kits.

A study was conducted to obtain information regarding the purchase and use of home pregnancy-test kits. Questionnaires were distributed to 438 women entering a family-planning clinic in the fall of 1987. A total of 153 questionnaires were completed and returned, providing a response rate of 34.9%. Results indicated that nearly 40% of the respondents had used a home pregnancy-test kit at least once. Of those who had used a home pregnancy-test kit, the majority did so because of "the speed of obtaining results" or "convenience." Although nearly 87% of the pregnancy-test kits had been purchased in a pharmacy, pharmacists played only a minor role in the decision-making process concerning purchase and use. Some three-fourths of the subjects listed "information on the side of the package," "price," or "advertisements" as the most important factor in the selection of a specific brand of test kit. Only about 7% of the subjects selected "recommendation of the pharmacist" as the most important factor. The results suggest that pharmacists could be doing more to promote the appropriate use of self-testing products, specifically home pregnancy-test kits.

Female↗
PubMed1994

Assessment of fetal well-being using the nonstress test in the home setting.

OBJECTIVE: To determine the feasibility of performing nonstress tests (NSTs) in the home setting instead of the health clinic environment. METHODS: In this prospective study, ten women were tested using a Sonicaid TEAM portable monitor and a Hewlett-Packard device in the health clinic. The women were then instructed on use of the Sonicaid device and were tested once a week in the home as well as in the high-risk clinic. All tests were reviewed independently by two of the authors to assess agreement in interpreting the NST. In the health clinic setting, a nonreactive NST was followed by a nipple stimulation contraction stress test (CST); in the home, a nonreactive NST was followed by maternal voice acoustic stimulation. RESULTS: There was 100% correlation during the concurrent study. Two blinded authors agreed on all tests. During the second phase, eight of the ten subjects had NSTs that were consistently reactive in both the home and office settings. In one woman, a nonreactive NST in the clinic was followed by a negative CST. In the remaining patient, a reactive NST in the health clinic was followed 3 days later by a nonreactive NST in the home, which persisted in the provider's office. CONCLUSION: Nonstress testing in the home appears to be an accurate method of antenatal fetal health assessment that adds convenience and potential cost savings.

Feasibility Studies↗
PubMed2004

Mothers performing in-home measurement of milk intake during breastfeeding of their preterm infants: maternal reactions and feeding outcomes.

This study compares feeding outcomes and perceptions of mothers using in-home test weights and those who did not use test weights to manage breastfeeding of their preterm infants during the first month after hospital discharge. There were no significant differences in daily weight gain between the 2 groups during the study period. Maternal concerns cited in both groups were similar, namely, knowing how much milk infant is taking, infant gaining adequate weight, and infant getting enough milk. All women in the experimental group and two-thirds in the control group reported that in-home measurement of milk intake by test-weighing had been or would have been helpful. This prospective randomized study demonstrated that mothers of premature infants who performed in-home test-weighing procedures found the technique to be helpful and experienced no increased stress or lower achievement of breastfeeding goals when compared to mothers not performing test weighs.

Adult↗
PubMedDate not supplied

Quality assurance, practical management, and outcomes of point-of-care testing: laboratory perspectives, Part I.

Pathologists and nurses have only recently cooperated in point-of-care testing (POCT), after accreditation organizations recommended that the laboratories take responsibility for managing the quality of patient-care testing conducted at the bedside. Laboratories are charged with ensuring that patient-care tests generate comparable results, regardless of the location or method. Many home testing devices, when used in hospitals, physicians' office laboratories, and mobile nursing practices, have presented technical and operational issues that were not foreseen from home use. These problems arise from a number of factors: the way the devices are used, the patient population, and even differences in sample type. Thus, to be successful, management of POCT in the health-care environment requires interdisciplinary cooperation of clinical nursing staff and laboratory staff. The article identifies problems in POCT, describes some solutions, and examines how well these solutions have worked from a laboratory perspective.

Clinical Laboratory Information Systems↗
PubMed2006

A review on infection with Chlamydia trachomatis.

Infection with Chlamydia trachomatis accounts for the most common bacterial sexually transmitted infection in the UK. Men between 20 and 24 years and women between 16 and 19 years have the highest prevalence of chlamydial infection. Because the majority of women with chlamydial infection are asymptomatic, a proportion remains untreated and eventually develops pelvic inflammatory disease (PID). PID can result in ectopic pregnancy, infertility and chronic pelvic pain. Screening for chlamydial infection might reduce the incidence of complications of PID. The advent of nucleic acid amplification tests and single-dose therapy for chlamydial infection has made home testing and easy treatment possible.

Adolescent↗
PubMed2006

Genetic testing of minors for alpha1-antitrypsin deficiency.

BACKGROUND: Alpha(1)-antitrypsin deficiency (AATD) is a genetic disorder primarily affecting the lungs and liver of affected individuals, causing severe panlobular emphysema and cirrhosis. OBJECTIVE: To describe the demographics and feasibility of a home test for AATD in children and adolescents. DESIGN: Case series of parents who test their children for AATD. SETTING: Nonprofit supported program in which participants telephoned or e-mailed requests for alpha(1)-antitrypsin testing. PARTICIPANTS: All persons younger than 18 years whose parents or guardians chose to test for AATD from January 1, 2002, to October 1, 2004. INTERVENTIONS: Home-administered finger-stick blood spot test for alpha(1)-antitrypsin genotype and questionnaire. MAIN OUTCOME MEASURES: The alpha(1)-antitrypsin genotypes and questionnaire responses. RESULTS: The Alpha Coded Testing Study tested 422 children and adolescents with a confidential test for AATD. Testing was suggested by a family member in most (76.7%) of the cases and was responsible for the many carrier (PIMZ and PIMS) genotypes (51.9%) in the study. Interest in testing was equally distributed among all ages. Test confidentiality was seen as an important reason to test (64.1% with a Likert scale score of 4-5 on a 5-point scale). Parents and guardians of the minors suggested that testing benefits (mean [SD] Likert score, 3.5 [1.4] on a 5-point scale) were higher than risks (mean [SD] Likert score, 1.7 [1.2]) (P=.001). CONCLUSION: Parents value genetic testing of their children at risk for AATD when testing can be done in a confidential setting.

Adolescent↗