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At least 649 records · Page 36Linked to original sources

PubMed1985

Age- and sex-specific prevalence of scoliosis and the value of school screening programs.

A prevalence study of idiopathic scoliosis was conducted among 29,195 children of a community health district in the province of Quebec. The study was designed to determine whether a permanent screening program for idiopathic scoliosis was justified. The prevalence of the condition among school children aged 8 to 15 years was 42.0 per 1,000 in the screened population, 51.9 per 1,000 among girls, and 32.0 per 1,000 among boys. The positive predictive value of the bending test is estimated as 42.8 per cent for scolioses of 5 degrees or more; it is only 6.4 per cent when curves of 15 degrees or more are considered. The average cost of finding one child with a scoliosis of 5 degrees or more is $194. Mass screening for idiopathic scoliosis does not seem to be justified in the present state of knowledge of the disease.

Adolescent↗

PubMed2003

The use of fine-needle aspiration cytology and core biopsy in the assessment of highly suspicious mammographic microcalcifications: analysis of outcome for 182 lesions detected in the setting of a population-based breast cancer screening program.

BACKGROUND: Fine-needle aspiration biopsy (FNAB) is used as the first-line diagnostic test for lesions that require morphologic assessment in the authors' breast cancer screening program. A positive cytologic diagnosis is an indication to proceed to definitive surgery. Core biopsy is used if FNAB is not diagnostic. In the context of increased use of core biopsy at other centers, the authors reviewed their experience with the cytologic assessment of highly suspicious microcalcifications. METHODS: Between January 1996 and June 2000, the dominant radiologic abnormality was classified prospectively as high-grade microcalcifications in 182 lesions. Data were recorded on patient demographics, radiologic features, and the findings of FNAB and core biopsy, if performed. The results of the screening assessment were then compared with the final histologic findings. RESULTS: Overall, 15.6% of all radiologically high-grade lesions were microcalcifications. The mean patient age was 58.76 years. The lesions had a mean size of 38.49 mm (range, 5-200 mm), and 92.31% of high-grade microcalcifications proved to be malignant. Among the cases evaluated by FNAB, a positive cytologic diagnosis of malignancy was made in 70.93% of lesions, without any false-positive diagnoses and obviating the need for diagnostic core biopsy. FNAB had a sensitivity of 77.22% and a positive predictive value (PPV) of 100%. When core biopsy was performed due to the absence of a positive cytologic diagnosis, it averted the need for open biopsy in 76% of lesions. CONCLUSIONS: Where there is access to skilled cytopathologists, FNAB can provide a highly accurate, rapid, and cost-effective means of triage of patients who would benefit most from the more expensive core biopsy.

Adult↗

PubMed1998

Progression of prostatic cancer in relation to age in patients detected by mass screening program.

With the aim of revealing the natural history of prostatic cancer, the distribution of age was examined in relation to disease progression in patients detected by mass screening programs. Between 1975 and 1996, such programs detected a total number of 132 patients with prostatic cancer. The mean ages of patients with Stage B, Stage C and Stage D disease were 71.2, 73.8 and 75.3 years, respectively. This might suggest that the difference of 3 years in mean age between Stage B and Stage C disease reflects the time interval of the progression of prostatic cancer from the early (Stage B) to the advanced (Stage C) stage. These results coincided well with the natural history of prostatic cancer, which we proposed previously based upon the "size of ranking" analysis of latent prostatic cancer and doubling time obtained from ultrasonic measurement of prostatic volume. An epidemiological study of prostatic cancer detected by mass screening would offer data of value for the elucidation of the natural history of that disease.

Aged↗

PubMedDate not supplied

A comprehensive refugee health screening program.

Nationally and internationally, there is a struggle to provide adequate health screening and assessment programs for refugees. The Department of Family Medicine at the University of Colorado Health Sciences Center in partnership with the Colorado Refugee Services Program has developed a comprehensive refugee health screening and assessment program. The program was designed to ensure access to screening and to provide better care for this vulnerable population. Key features of the program include a single point of access for all family members, full availability of appropriate interpreting services, comprehensive health assessments that include a thorough mental health screening, data collection and evaluation, and education of health care providers to deliver culturally responsive care. During the first 30 months of this program, comprehensive assessments were provided for more than 1600 refugees. Future directions include improving the efficiency of daily systems, seeking alternative sources of funding, improving follow-up and vaccination rates, expanding mental health services, and tracking health outcomes and refugees' utilization of health care services through longitudinal research.

Colorado↗

PubMed1997

The cervical cancer screening program in Mexico: problems with access and coverage.

A cross-sectional study was carried out in two geographic regions of Mexico - Oaxaca (rural area) and Mexico City (urban area) - to determine the main factors for predicting participation in Cervical Cytology Screening Programs (CCSP), in populations with high mortality due to cervical cancer. We included 4,208 women aged between 15 and 49 years, randomly selected through a national household-sample frame. Knowledge of what the Pap test is used for strongly predisposes use of CCSP in Mexico City (odds ratio [OR] = 46.1, 95 percent confidence interval [CI] = 33.1-64.1) and Oaxaca state (OR = 61.5, CI = 42.0-89.9), as well as high socioeconomic level (Mexico: OR = 2.0, CI = 1.1-7.6; Oaxaca: OR = 4.1, CI = 3.1-5.3), high education level (Mexico: OR = 3.6, CI = 1.5-8.8; Oaxaca: OR = 5.3, CI = 2.8-10.0), and access to social security (Mexico: OR = 1.7, CI = 1.4-2.2; Oaxaca: OR = 2.2, CI = 1.8-2.7). Low coverage of the CCSP is confirmed as an important problem in Mexico.

Adolescent↗

PubMed2002

Ovarian cancer in BRCA-positive women: vigilance is mandatory despite screening programs.

A young BRCA-1 positive woman turned out to have advanced stage ovarian cancer despite an ensuring check-up 4 months earlier. Much remains unknown regarding the efficacy of screening programs, when applied to individuals predisposed for an inherited malignancy. Therefore, vigilance is mandatory when dealing with women with a positive family history of mammarian and/or ovarian cancer.

Adult↗

PubMedDate not supplied

High incidence of elevated B-type natriuretic peptide levels and risk factors for heart failure in an unselected at-risk population (stage A): implications for heart failure screening programs.

Only early detection and treatment is likely to stem the current epidemic of heart failure (HF). Several common cardiovascular and metabolic conditions increase the risk of developing symptomatic HF, but its detection by a simple and reliable screening method has proved elusive. HF screening sessions were conducted in September and November 2001. Members of the community with HF risk factors (e.g., hypertension, coronary artery disease, diabetes mellitus, hyperlipidemia) were invited--all specifically without a history of HF. The screening included a history review, health history questionnaire, measurement of blood pressure and pulse, as well as a measurement of B-type natriuretic peptide (BNP) level. A total of 233 individuals attended these two sessions: 108 men and 125 women (mean age, 63 years). Of the 233 subjects screened, the majority (92%) had >or=1 risk factor with an average of 2.8 risk factors for HF. The most common risks included hyperlipidemia (112), hypertension (112), age >65 years (105), cigarette smoking (105), coronary artery disease (60), and diabetes mellitus (54). Many subjects also had symptoms consistent with HF, with most (182, 82%) recording >or=1 symptom. Blood pressure measurements revealed a mean systolic of 139 mm Hg and mean diastolic of 79 mm Hg; on the screening days, 48% and 59% of subjects demonstrated either systolic or diastolic blood pressures above normal, respectively. BNP levels ranged from 0-479 pg/mL with an average of 40 pg/mL. A total of 24 subjects (10.3%) had a BNP level >100 pg/mL, and a total of 32 subjects (13.7%) had a level >80 pg/mL. The follow-up data showed that all 24 subjects saw their physician within 6 months after the screening. By 12 months following the initial screening program, 21 of the 24 subjects with elevated BNP levels (88%) underwent further testing and 18 of the 24 (67%) had changes in their medications. BNP screening identifies subjects at high risk for developing HF. Most subjects at risk have multiple risk factors and abnormal blood pressure. Approximately 10% of this population tested with an abnormal level of BNP, higher than the Food and Drug Administration-assigned cut-point diagnostic for HF. Increased public and physician awareness and information are needed to transform screening opportunities into a strategic approach to improve health care and HF prevention.

Female↗

PubMed1975

[Organization of mass-screening for early detection of cervical cancer and its precancerous conditions. I. report: Demonstration of a computer assisted mass-screening program (Model Rostock) (author's transl)].

Gynecological mass-screening leads to a decrease of prevalence and incidence of cervical cancer and precancerous conditions. In Rostock a program for early detection of cervical cancer was developed. Organization, application of computer in this model and the expenses of a computer assisted mass-screening-program are discussed. In order to facilitate comparison between various centers, a generally accepted classification and terminology of colposcopic, cytologic and histologic findings are essential. First epidemiological results of Rostock's women are demonstrated to characterize the screened population.

Costs and Cost Analysis↗

PubMedDate not supplied

Performance characteristics of a blood cholesterol measuring instrument used in screening programs.

Four experiments were conducted to assess the precision and accuracy of the Boehringer Mannheim Diagnostics Reflotron, an instrument that is being adopted by many public health groups to conduct blood cholesterol screening programs. Our study is one of the first to evaluate and document the instrument's performance characteristics. Successive generations of reagent tabs supplied by the manufacturer were tested against a reference laboratory method standardized by the Centers for Disease Control. Three of the experiments also compared two or more Reflotrons to assess intermachine reliability. The Reflotron analyzer provided precise blood cholesterol measurements both in repeated tests and among instruments. The accuracy of the method varied across reagent lots, with an average negative bias of 21.05 milligrams per deciliter (mg per dl), decreasing steadily to a negative bias of 4.07 mg per dl. Reliability between and within analyzers was high. The data provide support for the use of the instrument in blood cholesterol screening efforts, yet signal the need for attention to quality control procedures, both by the manufacturer and operators, to ensure the validity and accuracy of the results.

Cholesterol↗

PubMed1982

A study of the recommended pass/fail criteria for impedance audiometry in a school screening program.

One hundred and nine children enrolled in kindergarten to grade 3 were studied audiologically and otologically over a three month period to examine pass/fail criteria that have been recommended for impedance audiometry in school screening programs. Results indicated that tympanogram type (flat or rounded) and puretones of 2,000 Hz (20 dB) and 4,000 Hz (25 dB) agreed most often with the ENT diagnosis of significant middle ear pathology. These pass/fail criteria also gave a reasonably acceptable over and under referral rate. A third screening is recommended one month following the first and second screenings, and if the child continues to "fail" a medical referral is suggested. There are at least two limitations of current automated impedance screening devices--pressure range, and acoustic reflex sensitivity, which will produce unnecessary failures due solely to instrumentation.

Acoustic Impedance Tests↗

PubMedDate not supplied

Follow-up of participants in a preschool hearing screening program in child care centres.

As part of its response to the Ontario Ministry of Health recommendation that communication disorders in preschool children be identified, the Hamilton-Wentworth Department of Public Health Services performed hearing screening tests on all preschool children in child care centres. Parents of children who had failed the hearing screening test were recommended to take their child to their family physician for further assessment. Out of 1,844 children tested between September 1990 and February 1991, 35 children failed the pure-tone audiometry test administered by nurses. A telephone follow-up interview determined that 26 children with screening test failures had received some medical follow-up. Eight children had a confirmed hearing problem; of these, five were newly diagnosed with a hearing problem, all resulting from fluid build-up in the middle ear. Three children were treated, with two having improved hearing. Of the two children not treated, one was reported to have improved hearing. As with other recently reported preschool hearing screening programs, this study raises doubts about the usefulness of such programs.

Audiometry, Pure-Tone↗

PubMed1995

The development of a broad-spectrum toxicology screening program in Taiwan.

Our institute serves as a centralized clinical laboratory for municipal and private hospitals in Taipei, a major international metropolis in the Asian region. Two key considerations leading to the development of our toxicology program are: a large number of foreign visitors and local residents returning from overseas trips may bring in chemicals which are less commonly seen in this region; and the lack of readily available assays for a large percentage of commonly used medicines, including prescription and over-the-counter drugs. Our toxicology screening program addresses the needs of both the Emergency Department Drug Screening and Drug of Abuse Screening. In Emergency Department Drug Screening, REMEDi HS is used as the general screening method. In Drug of Abuse Screening, the TDx is used for the initial screening of amphetamine-like substances and opiates, followed by REMEDi HS for the confirmation of positive samples. Emergency Department data collected at our institute over one year (September 1992 to August 1993) identified 57 different drugs in 713 samples. Opiates, narcotics and central stimulants accounted for 24% of the encountered drugs. Presently, there is no extensive reporting of misuse of benzodiazepines in this region. The detection of herbal ingredients like ephedrine and methylephedrine (from the Ma-Huang plant) in patient samples illustrates a large area often overlooked by western toxicology.

Amphetamine↗

PubMed2006

Parents' perceptions of an emerging community-based newborn hearing screening program: A case study.

Thirty-six parents of 106 children (34% response rate) born between March 2000 and February 2003 retrospectively completed the "Probe of Parents' Perceptions: An Early Hearing Detection and Intervention (EHDI) Outcome Measure" (PPP) assessing their participation in an emerging community-based newborn hearing screening program (NHSP) involving three hospitals in Santa Barbara County, California. The PPP, an 11-item questionnaire (in both English and Spanish versions), asks parents about their impressions of the explanations of the purpose of the screening and of the results, and the referral process. The parents were generally positive about all phases of the NHSP; nearly all parents said the program had no negative effects on their ability to bond with their babies, and they would recommend NHSPs to others. These parents' positive impressions in this case study of an emerging community/private practice-based NHSP were consistent with those from studies involving parents participating in hospital-based programs.

Adult↗

PubMed1994

Dance screen programs and development of dance clinics.

Dance movements can be stressful to the body, and the required extreme positions may place physiologic structures at risk for acute, subacute, or chronic injury. The authors designed a screening program, conducted by a team of physical therapists, orthopedists, and dance instructors, to evaluate dancers for musculoskeletal problems and to make recommendations that would improve movement compensation, strength, endurance, and mobility.

Ankle↗

PubMed1981

The centralized prenatal genetics screening program of New York City: I. Developmental phase.

The increasing demand in New York City for prenatal diagnosis of genetic disorders has necessitated the development of a large-scale, centralized prenatal genetic screening program. The objective of this program is eventually to serve 3,000 to 4,000 at-risk New York City pregnant women annually. Through the teamwork of a task force comprising representatives from the New York Scientists' Committee for Public Information (SCPI), the Medical and Health Research Association of New York City Departments of Health, and five different advisory committees, the centralized Prenatal Diagnosis Laboratory of New York City (PDL) was designed and established. While this program aims to provide high quality, centralized laboratory service for the prenatal detection of chromosome abnormalities and open neural tube defects, it also emphasizes quality-controlled services in genetic counseling, aminocentesis, ultrasound monitoring, obstetric care, and patient follow-up. Genetic counseling by PDL-employed counselors is made available to patients whenever the participating hospital lacks such service or cannot handle their patient load. In addition, PDL has launched a vigorous public health education program. A detailed guideline for the program was prepared describing the highest standards of quality for each component. The initial step was th developmental phase that included establishing the advisory committees, searching for sponsors, preparing guidelines, developing the health education program, renovating the laboratory site, purchasing and installing equipment, and recruiting of staff. The experience gained from this endeavor will be of value in the development of similar large-scale prenatal diagnosis programs.

Amniocentesis↗

PubMed1992

The California Maternal Serum alpha-Fetoprotein Screening Program: the role of ultrasonography in the detection of spina bifida.

Between January 1988 and June 1990, 161 cases of open spina bifida were identified by the California Maternal Serum alpha-Fetoprotein Screening Program. Eight percent of these cases were not diagnosed by an initial ultrasonographic evaluation. Three defects were not recognized until birth. Ultrasonography is inadequate to identify all cases of open spina bifida.

California↗

PubMed2004

The hepatitis C virus genotype and subtype frequency in hepatitis C virus RNA-positive, hepatitis C virus antibody-negative blood donors identified in the nucleic acid test screening program in Poland.

BACKGROUND: Since 2002, blood donors in Poland have been tested not only for hepatitis C virus antibodies (anti-HCV) but also for HCV RNA or HCV core antigen. This screening program identifies asymptomatic, recently infected individuals with no anti-HCV (in the "window period"). The aim of this study was to compare HCV genotype and subtype distribution in window-period (wp) donors, anti-HCV-positive donors, and chronic hepatitis C (CHC) patients. STUDY DESIGN AND METHODS: A total of 2.37 million donors were investigated for HCV RNA, and 340,000 for HCV core antigen. HCV genotypes and subtypes were investigated in 50 HCV RNA-positive, anti-HCV-negative donors; in 70 anti-HCV-positive donors; and in 170 CHC patients. Re-questioning of wp donors for probable risk factors was introduced. RESULTS: HCV RNA was detected in 50 donors of 2.71 million (1:54,200) anti-HCV-negative blood donations. Of these 50 donors, 36 percent exhibited Subtype 1b, whereas Subtypes 3a and 4c/d were identified in 40 and 14 percent, respectively. In anti-HCV-positive donors and CHC patients, the frequency of Subtype 1b was significantly higher (75.7 and 85.3%, respectively); in both groups the lower frequency of Subtypes 3a (14.3 and 10.6%, respectively) and 4c/d (4.3 and 1.2%, respectively) was found. The probable source of infection was identified in 9 wp donors. CONCLUSIONS: The frequency of wp donors is 18.5 per 1 million. The unexpected high frequency of Genotype 4 and Subtype 3a and the low frequency of Subtype 1b was observed in wp donors compared to anti-HCV-positive individuals. Additional epidemiologic questioning introduced after HCV RNA detection may help to identify infection source.

Adolescent↗

PubMedDate not supplied

Ochratoxin A occurrence in slaughter-pigs in Sweden and its use as a tool for feed screening programs.

The occurrence of ochratoxin A in pig blood can be used as a measure of ochratoxin A contamination of the feed. A method for ochratoxin A analysis in pig blood, suitable for screening programs, is presented. The relationship between ochratoxin A contents in the blood of pigs and the feed given is investigated with feeding experiments. Blood samples from pigs originating from 279 herds slaughtered in nine slaughter-houses in Sweden were analyzed for ochratoxin A. In total, 14% of the investigated pigs contained greater than or equal to 2 ng ochratoxin A per ml blood. The highest level found was 215 ng/mL. Correlations between the occurrence of ochratoxin A in the blood and parameters concerning the feed are investigated.

Abattoirs↗