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Results for “MASS SCREENING TECHNICS”

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PubMed2001

[Study of methicillin-resistant Staphylococcus aureus colonization among intermediate-care facility patients].

PURPOSE: Prevalence of methicillin-resistant Staphylococcus aureus is high in the Poitiers teaching hospital, particularly in the intermediate care facilities. We performed a survey of methicillin-resistant Staphylococcus aureus colonization in the intermediate care facilities and 265 patients were included. METHODS: Nasal, cutaneous and wound swab cultures were done at the time of admission and at the time of the patients' departure. A decolonization procedure of methicillin-resistant Staphylococcus aureus carriers was performed using nasal application of fusidic acid and different soaps for the skin. At entry, 17.7% of patients were methicillin-resistant Staphylococcus aureus carriers (of at least one location). At departure, 30.4% were methicillin-resistant Staphylococcus aureus carriers. Among methicillin-resistant Staphylococcus aureus non-carriers at entry, 24.3% became methicillin-resistant Staphylococcus aureus carriers. RESULTS: The principal risk factor of carriage was the initial presence of a wound (RR = 3.6). The incidence rate of methicillin-resistant Staphylococcus aureus infection among the 265 patients included was 3%. CONCLUSION: The systematic screening of patients at the time of admission is expensive and isolation technically hard to manage in the intermediate care facilities. The risk factor we found in this study allow us to propose a 'light' screening limited to patients with wounds.

Aged↗

PubMed2000

Colonoscopy.

Colonoscopy and polypectomy are the most effective tools available to prevent colorectal cancer. The technical performance of colonoscopy can be improved by methods that make polyp detection easier and more reliable, facilitate cecal intubation, and reduce recurrence and complication rates after polypectomy. The state-of-the-art and possible future trends in patient preparation, indications, screening and surveillance intervals, sedation issues, and virtual colonoscopy are reviewed in this article.

Cecum↗

PubMed2001

[Measurement of HER-2/neu in breast cancer: which methodologic approach?].

HER-2/neu (c-erbB2) is overexpressed or amplified in 15%-35% of breast cancers. HER-2 testing has become of paramount importance as it represents a key therapeutic, prognostic and predictive parameter. HER-2 is associated with ER/PgR negativity, high histologic grade, high proliferative index, and increased number of metastatic lymph nodes. In N+ patients, HER-2 represents a negative prognostic factor. HER-2 also represents a predictive factor. In fact, HER-2+ patients appear to be resistant to the CMF regimen and comparatively more sensitive to anthracyclins such as Herceptin. HER-2 testing is currently performed utilizing two main methods: gene amplification is usually determined by fluorescence in situ hybridization (FISH), whereas protein overexpression is determined by immunohistochemistry (IHC). The comparison between FISH and IHC assays demonstrates a considerably high degree of concordance (around 90%). When dealing with cases scored as 3+ (according to the FDA licensed scoring method), such a concordance approaches 100%. In consideration of greater technical simplicity as well as of cost-effectiveness, IHC represents the ideal screening method for HER-2 testing. FISH analysis remains valid for HER-2 evaluation in those cases in which IHC fails to provide unequivocal data.

Breast Neoplasms↗

PubMed2003

Protein micro- and macroarrays: digitizing the proteome.

The early applications of microarrays and detection technologies have been centered on DNA-based applications. The application of array technologies to proteomics is now occurring at a rapid rate. Numerous researchers have begun to develop technologies for the creation of microarrays of protein-based screening tools. The stability of antibody molecules when bound to surfaces has made antibody arrays a starting point for proteomic microarray technology. To minimize disadvantages due to size and availability, some researchers have instead opted for antibody fragments, antibody mimics or phage display technology to create libraries for protein chips. Even further removed from antibodies are libraries of aptamers, which are single-stranded oligonucleotides that express high affinity for protein molecules. A variation on the theme of protein chips arrayed with antibody mimics or other protein capture ligand is that of affinity MS where the protein chips are directly placed in a mass spectrometer for detection. Other approaches include the creation of intact protein microarrays directly on glass slides or chips. Although many of the proteins may likely be denatured, successful screening has been demonstrated. The investigation of protein-protein interactions has formed the basis of a technique called yeast two-hybrid. In this method, yeast "bait" proteins can be probed with other yeast "prey" proteins fused to DNA binding domains. Although the current interpretation of protein arrays emphasizes microarray grids of proteins or ligands on glass slides or chips, 2-D gels are technically macroarrays of authentic proteins. In an innovative departure from the traditional concept of protein chips, some researchers are implementing microfluidic printing of arrayed chemistries on individual protein spots blotted onto membranes. Other researchers are using in-jet printing technology to create protein microarrays on chips. The rapid growth of proteomics and the active climate for new technology is driving a new generation of companies and academic efforts that are developing novel protein microarray techniques for the future.

Protein Array Analysis↗

PubMed2005

Administrative issues related to infectious disease research in the age of bioterrorism.

The recent unprecedented growth in infectious disease research funding and infrastructure has resulted in part from an outgrowth of concern about newly emerging and re-emerging diseases and the progressive development of antibiotic-resistant pathogens. However, the most compelling impetus is the suspected and demonstrated capability and will of unknown individuals, groups, or states to use biological agents and/or toxins as weapons. Although the actual number of known victims and fatalities from bioterrorism in the United States has been miniscule compared with many other daily hazards, biological agents have the potential to cause human mass casualties, severely damage segments of our economy or agricultural infrastructure, poison or compromise our food or water supply, and, perhaps most damaging, disrupt our society physically and psychologically. The significant institutional commitment necessary to participate in infectious disease research is described, with a focus on programs that involve research with pathogens thought to have potential for use by bioterrorists. Administrative considerations are described, and include obtaining necessary research funding to offset high operating costs; complying with "select agent" regulations, security screening of employees; building or renovating a biocontainment facility; finding skilled professional and technical manpower; providing adequate physical security in a threat environment; conducting targeted training; overcoming potential internal and external dissent; developing and/or providing sufficient occupational health and safety programs; achieving and maintaining compliance standards in a fluid regulatory environment; mitigating potentially hazardous working conditions; understanding personal and institutional liability; and reassuring and dealing with a concerned, skeptical, or even hostile public.

Animals↗

PubMed1986

Noninvasive bone mineral assessment.

With increased public awareness of the hazards--and possible prevention--of osteoporotic fractures, the demand for bone mineral measurement procedures has also increased. The early methods for assessing bone mass noninvasively were based on radiography; recently, radioisotope and computed tomography techniques have been developed to overcome the technical limitations of plain radiographs. The available technologies can be distinguished by their ability to measure either the vertebrae or limbs, areas of the body with markedly different bone physiology. Now, the selection of a bone mineral assessment modality for a particular individual depends upon the importance the physician places on the need to measure the potential fracture site directly. In those instances in which the examination of the forearm provides sufficient information, such as in screening the elderly, single photon absorptiometry is likely to be chosen. Where a more direct measurement of vertebral or femoral bone mineral content is required, such as for diagnosis of disease or monitoring therapy, either dual photon absorptiometry or quantitative computed tomography will be the final choice, depending on which is ultimately proven the better predictor of hip and spinal fractures.

Bone and Bones↗

PubMed1994

Screening for carcinoma of the prostate: a GP based study.

OBJECTIVE: To examine the feasibility and acceptability of screening for cancer of the prostate by digital rectal examination (DRE), prostate specific antigen (PSA) determination and subsequent transrectal ultrasound (TRUS) in selected patients in a single general practice in Hertfordshire. SUBJECTS AND METHODS: A total of 568 of 856 men aged 55 to 70 accepted an invitation for a health check which included screening for prostate cancer. Of these, 80 individuals with either a raised PSA level or an abnormal DRE underwent TRUS. In 29 individuals biopsies were taken, 11 of which confirmed the presence of adenocarcinoma of the prostate giving an overall detected prevalence of 2%. Of the 11 tumours identified by screening, two were T1M0, four were T2M0, two were T3M0 and three were T3M1. RESULTS: To assess the acceptability of the screening exercise a postal questionnaire was sent to all 568 participants: 83% replied and 69% reported no concern. Of the 67 individuals who had undergone TRUS, 69% reported discomfort. A total of 448 (95%) of respondents declared that they would be prepared to undergo the screening exercise again. CONCLUSION: Screening for prostate cancer would seem to be technically feasible and generally acceptable. However, there is a considerable false positive rate in the PSA range 4 ng/ml to 10 ng/ml, particularly among men with clinical evidence of benign prostatic hyperplasia. To establish the true benefit of screening a large-scale prospective controlled study will be necessary.

Adenocarcinoma↗

PubMed1996

A program to increase breast and cervical cancer screening for Cambodian women in a midwestern community.

OBJECTIVE: To determine local screening rates for breast and cervical cancer screening among Cambodian women older than 50 years of age who had used the health-care system, to compare these rates with those for non-Cambodian women, to identify barriers to screening among Cambodians, and to implement community screening. MATERIAL AND METHODS: From review of medical records, cancer screening rates for 1 year among Cambodians (N = 57) were compared with rates for a matched non-Cambodian sample (N = 57). Southeast Asian focus groups identified barriers to screening as a basis for intervention. The intervention included community informational programs in the Cambodian language, group screening appointments, provision of transportation, use of female physicians and interpreters, and an informal clinic setting. Cancer screening rates were compared before and after the intervention. RESULTS: Initial screening rates for Cambodians were significantly lower than for the non-Cambodians. Expressed barriers included lack of knowledge about cancer, shyness at physical examination, lack of transportation, fear of a large, technical medical center, and individual appointments. After the intervention, community screening rates were almost 5 times higher than at baseline. CONCLUSION: The intervention was successful in overcoming organizational, economic, and cultural barriers to cancer screening among older Cambodian women in this setting.

Aged↗

PubMed1998

Cervical screening: management of patients referred for colposcopy with smear abnormalities less severe than dyskaryosis.

The cervical smear and biopsy results were reviewed for 141 patients who were referred for colposcopy with either a technically unsuitable smear or with cervical smear abnormalities less severe than dyskaryosis. The number of referrals due to minor smear abnormalities more than doubled from 8.6% to 22.3% of the total colposcopy referrals over the 4 year period studied. The minor smear abnormalities were only associated with cervical intraepithelial neoplasia (CIN) in patients aged < 50 years. In 19 (13.5%) of the 141 patients high-grade lesions (CIN II or CIN III) were diagnosed. There were no cases of invasive cancer. Furthermore, the increased number of patients being referred for colposcopy with minor cervical smear abnormalities highlights the increasing pressures on colposcopy services, with prolonged waiting times for all patients.

Adult↗

PubMed2006

Characterizing the reproducibility of a protein profiling method for the analysis of mouse bronchoalveolar lavage fluid.

The detection of biomarkers in biological fluids has been advanced by the introduction of mass spectrometry screening methods such as matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOFMS), which enables the detection of the presence and the molecular mass of proteins in unfractionated mixtures. The generation of reproducible mass spectra over the course of an experiment is vital in obtaining data in which differences in protein profiles between diseased and healthy states can be assessed correctly. We have developed a protocol to automate the collection of protein profiling data from a large number of samples using MALDI-TOFMS, and we used these samples to characterize the technical reproducibility of the method. This protocol has been used for the analysis of proteins found in bronchoalveolar lavage fluid samples from mice with the ultimate goal of enabling the discovery of differential expression patterns predictive of the development of chronic obstructive pulmonary disease. Samples were purified using magnetic bead-based technology and analyzed on an AnchorChip target plate. Our results demonstrate that the number of peaks detected reproducibly decreases significantly as sample size increases, which motivates the need for technical replicates to be explicitly included in the analysis of MALDI-TOF-based protein profiling studies.

Acrolein↗

PubMed1997

[Mass screening programs for breast cancer in France. Comparative evaluation].

OBJECTIVE: The purpose of this work was to comparatively assess the results of mass screening programs for breast cancer implemented in six French departments in 1986, within the scope of the National Fund for Health Prevention, Education and Information of the National Health Insurance Office of Salaried Workers. MATERIAL AND METHODS: The data collected by the screening centres were analyzed by ten assessment teams that were independent from the program promotion staff, all using the same evaluation form. A complementary population study performed in eight French districts then, allowed assessing the frequency of self-referred screening (mammography performed out of program). RESULTS: The rate of participation in screening programs, in relation to the invited population, ranged from 21 to 48%, according to the district (36% in average). This low participation was probably related to the extent of self-referred screening. In fact, 19 to 40% of women, according to the district, had previously had a screening mammographic coverage: rate was around 68% in women aged 50 to 69 years. Positive findings with mammography ranged from 4.5 to 15.8% (10.1% in average), while intervention rates ranged from 0.7 to 1.6% and detection rates from 3.8 to 6.2%. The ratio between benign tumors and cancers ranged from 0.7 to 2.1 according to the district. In order to enlighten the judgement on French results, we propose a comparison with the international standards in force. CONCLUSION: The various experiences with breast cancer screening in France show that this screening is technically feasible on the basis of existing medical structures. However, some criteria are still below the expected values, especially if compared with international standards. This result is probably accounted for by the high rate self-referred screening before age 40 in France. In these conditions, the question is whether extending breast cancer screening programs in France is an appropriate course of action.

Breast Neoplasms↗

PubMed2006

Routine pelvic examination for asymptomatic women--Exploring the evidence.

BACKGROUND: A routine pelvic examination is often performed as part of a 'well woman' check, in combination with a Pap test, sexually transmitted infection screening, or before commencing the contraceptive pill or hormone therapy. This check is also done at the woman's request, on the understanding that it may screen for ovarian cancer and other pathology. OBJECTIVE: This article reviews the evidence regarding the use of routine pelvic examination in asymptomatic women as a screening test, and if the examination is performed, what information should be imparted to the patient to obtain informed consent. DISCUSSION: Review of the literature indicates that the use of routine pelvic examination as screening for ovarian malignancy (with or without serum CA-125 and ultrasound) cannot be justified due to the low prevalence of the disease and low sensitivity and specificity of the examination. Pelvic examinations may be performed at the time of routine Pap tests to aid in technical issues with the Pap test itself, but are not recommended for screening purposes. There is no evidence to support pelvic examination of asymptomatic women taking hormone therapy or attending for a sexual health check. The performance of pelvic examination at the woman's request must be preceded by thorough gynaecological, medical and family history and after obtaining informed consent from the patient.

Adult↗

PubMedDate not supplied

[Technical quality control of chest x-rays for the health surveillance of workers exposed to the risk of pneumoconiosis: proposal for a qualitative screening method].

BACKGROUND: The necessity of a qualitative screening has arisen from the fact that good technical quality is of fundamental importance for evaluating initial pneumoconiosis, for reducing inter- and intra-reader variability, for effective secondary prevention and for forensic medicine purposes. OBJECTIVES: The authors report experience in use of a method to evaluate the quality of chest radiographs performed in health surveillance programs for workers at risk for development of pneumoconiosis. METHODS: 747 postero-anterior chest radiographs concerning employees of 21 ceramic factories in the Province of Viterbo were examined. A standardized pattern was created for this evaluation. The pattern considers the main factors that can influence the quality of chest radiographs and assigns points for each of them. That factors are: 1) reproduced image of the lung's vascular structure, chiefly in the peripheral portions; 2) reproduced image of heart border, aorta, diaphragm; 3) deep inspiration; 4) symmetric image of the chest; 5) position of the scapulae; 6) visualization of the costal-phrenic angles; 7) technical impairments. RESULTS: The application of the method revealed that half of the chest radiographs examined had poor image quality for a suitable reading, in conformity with the ILO 1980 guidelines. The critical points are poor visualization of the lung's vascular structure due to overexposure or underexposure, technical impairments, non-correct scapulae position. CONCLUSIONS: The authors believe that the suggested method can be a useful instrument for self-testing the quality of chest radiographs performed in radiology centers and for the National Health Service to test the quality of chest radiographs performed in health surveillance programs.

Adult↗

PubMed2006

Methodology for reorganization of the cervical cancer program in Chile.

BACKGROUND: Early cancer detection methods need to be accompanied by effective public health implementation strategies in order to successfully reduce national mortality. A cervical cancer screening program was run in Chile from 1965 to 1985 which had almost no impact on cervical cancer mortality. The problem faced was how to change the entrenched practices of physicians and other professionals who had been running a multi-component program for 2 decades, with no increase in financial resources. METHODS: Expanding intervention cycles were defined for different population groups, focusing initially on females health workers and finally on the general at-risk population. The expanding cycles move from the simplest intervention, involving health service staff, to the more complex intervention, involving changing the behavior of the general public. At each cycle level the overall problem was assessed and a preliminary plan developed by a team of local experts. This was followed by involvement of the responsible public health care system managers using a workshop, problem solving in the field, a workshop presenting results and learning, and the start of a new cycle. RESULTS: In the Santiago Metropolitan Region this methodology resulted in cycles of 3-8 months duration. Clear improvements in technical and managerial skills of the staff and overall program management were observed. Pap smear screening in the Santiago Metropolitan Region rose from 43% to 66% in 2 years and the national age-adjusted cervical cancer mortality rate fell by about half over 20 years. CONCLUSIONS: Problem solving in expanding cycles produced an effective National Cervical Cancer Screening Program. This methodology can also be applied to other public health problems.

Adult↗

PubMedDate not supplied

Screening for lysosomal storage disorders--a clinical perspective.

The availability of therapies for lysosomal storage diseases (LSDs) and clear documentation from animal studies that optimal therapy depends on early diagnosis have set the scene for newborn screening for LSDs. The combined incidence of this group of conditions is approximately 1 in 7000, well within the feasible range for newborn screening programmes. The availability of multiplex technology has facilitated the technical aspects of initial screening. The scientific challenge is to predict disease severity early enough to influence choice of therapy. LSD screening is discussed from the point of view of the scientists, the families affected by these conditions, the community and clinicians.

Bioethical Issues↗

PubMed2003

[Multidetector CT and MRI of malignant liver tumors].

This chapter summarizes technical aspects of multidetector row helical CT and MR imaging of malignant liver tumors. Respective role of these examinations is shown in relation to the type of the tumors (hepatocellular carcinoma or liver metastases) and to the indications of imaging: diagnosis or pretreatment staging.

Aftercare↗

PubMedDate not supplied

[79 cases of invasive cancer of the cervix uteri in the Department of Oncology in Antananarivo. Can diagnostic delays be improved?].

The frequency of invasive cervical carcinoma in Western countries is currently decreasing. The development of methods of early diagnosis has improved the prognosis of the disease. In Madagascar, like in other African countries, invasive cervical carcinoma is the first genital cancer affecting women. The diagnosis comes late. Actions can be taken to improve the prognosis through early diagnosis of invasive cervical carcinoma. Our purpose was to analyze the main causes leading to these delays in diagnosis and to evaluate possibilities for improvement. This study was retrospective, consecutive and open wide not random, dealing with 79 cases of invasive cervical carcinoma, all confirmed by a histological examination, picked from the Department of Oncology at Antananarivo within a period of 24 months from the 1st of January 1990 through the 1st of January 1992. The Department of Oncology at Antananarivo is the only anti-cancer center available on the island. The position for an oncologist was occupied form 1984 to 1988 by a French doctor under the Technical Cooperation Agreement with France. Since then, no oncologist has been practicing in Madagascar. We evaluated the different reasons that could explain the delays in diagnosis and suggested possible actions to remedy the problem. We selected medical, human and technical, as well as geographical and social criteria for evaluation. Diagnosis was delayed too much (on average, about 8.48 +/- 7.12 months), possibly due to the above mentioned criteria.(ABSTRACT TRUNCATED AT 250 WORDS)

Cancer Care Facilities↗

PubMed1981

Photographic screening for strabismus and high refractive errors of children aged 1-4 years.

UNLABELLED: 182 children (age 1-4 years) were photographed by health sisters at the annual screening at the children's health care center as described by Kaakinen (1979). The photographs were examined by an ophthalmologist to diagnose squint and/or refractive error cases based on the typical changes in the corneal and fundus reflexes. The cases found in this way were controlled clinically. RESULTS: 7 pathological cases were detected: 2 esotropias, 1 microesotropia, 2 hyperopias of both eyes, 2 anisocorias. False positive were 6 cases, from which 4 were false positive microstrabismus suspects and 2 cases with asymmetrical fundus reflexes, which were normal. 14 cases failed (9 (4.9%) looked to the side, and 5 (2.7%) were technical failures). For the reliability of the method, a random sample of 20 children, who had normal corneal and fundus reflexes were examined clinically. No anisometropia of over 0.5 diopters appeared among these 20 control cases, and the highest hyperopic and astigmatic errors that appeared were +1.75 diopters. All the astigmatic cases were combined with a slight myopia of -0.5- -1.0 diopters in each case. No higher myopias occurred in this group, and all these 20 children had straight eyes with the cover test at near fixation.

Child, Preschool↗