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At least 847 records · Page 47Linked to original sources
PubMed1989

Visual field screening and the development of a new screening program.

The diagnosis of chronic open-angle glaucoma requires diligent and careful screening. Intraocular pressure measures and disc evaluations, when used in isolation, give unacceptably high numbers of false positives and false negatives, while full visual field analysis, as conducted with kinetic or full threshold static perimetry, takes too long for routine use. Screening of the visual field may offer a viable alternative. The effect of changing certain parameters of a visual field screening test are evaluated. These include the location of the stimuli, the number of stimuli and their suprathreshold increment. The results of an optimized visual field screening test are then evaluated with respect to the theoretical predictions. The results indicate that high levels of sensitivity and specificity can be achieved with visual field screening tests which are short enough to be included as part of the routine optometric examination.

Glaucoma, Open-Angle↗
PubMed1994

Neonatal group B streptococcal sepsis during 2 years of a universal screening program.

OBJECTIVE: To assess the feasibility and efficacy of a protocol for universal screening for group B streptococci combined with selective intrapartum prophylaxis at a teaching hospital. METHODS: This is a descriptive study of experience with a standardized protocol in which patients were screened at 26-28 weeks with a rectal and genital culture placed directly in selective media. As risk factors, we used clinical chorioamnionitis, preterm birth, and rupture of the membranes greater than 12 hours. Participants were all women receiving prenatal care at our hospital. Major outcomes were compliance and neonatal sepsis due to group B streptococci. RESULTS: The prevalence of rectal and genital group B streptococci was 18.5% of 3721 screened women. Of culture-positive women, 35% developed risk factors (9% chorioamnionitis, 13% preterm birth, and 13% membrane rupture greater than 12 hours at term). With strict application of criteria, the compliance rate in administering indicated prophylaxis was 80.3%. Of women receiving prophylaxis, 42% had the first dose for 4 hours or less before delivery. There were five cases of group B streptococcal neonatal sepsis, resulting from either protocol violations, protocol failures, or both. Compared to the historic rate of group B streptococcal sepsis of 1.5 per 1000 births at our hospital, the rate in these 2 years was 1.0 per 1000 (1.6 per 1000 in the first year and 0.5 per 1000 in the second). CONCLUSIONS: It is feasible to conduct such a protocol, but compliance is only moderately good because the algorithm is complex. The protocol is not foolproof in preventing neonatal group B streptococcal sepsis, as there are protocol failures and violations.

Adult↗
PubMed1993

Structural characterization of abnormal hemoglobins from dried blood specimens in a neonatal screening program.

Blood specimens dried on filter paper are now widely used for neonatal screening of hemoglobinopathies. These samples are perfectly suited for electrophoresis studies and HPLC analysis. They may also be used for DNA analysis. The structural characterization of a hemoglobin variant is also possible using protein chemistry methods. After elution of the hemoglobin from the paper, the different components are fractionated by a microscale preparative isoelectric focusing. The structural modification of the abnormal hemoglobin is then determined through a series of techniques including chain separation, aminoethylation, trypsin digestion, analysis of the peptides and determination of their aminoacid composition. The efficiency of this strategy is demonstrated by the study of an alpha-chain variant (Hb Hasharon) and three beta-chain variants (Hb S, Hb D Punjab, Hb E). Unambiguous identification of the structural abnormality was obtained with samples stored for up to 18 months and with abnormal fractions amounting to only approximately 10% of the total lysate.

Chromatography, High Pressure Liquid↗
PubMed1999

A comprehensive breast and cervical cancer screening program for medically underserved women in Connecticut.

A comprehensive breast and cervical cancer early detection program supported by federal and state funds and administered by the Connecticut Department of Public Health, is actively recruiting and screening older, uninsured, low income women at contracted health-care facilities throughout the state. The program provides diagnostic testing, treatment referral, outreach, and educational activities. During the first 27 months of the program, 5,509 women were enrolled and screened. Women were recruited primarily through media sources and physician/nurse referrals. The majority of women served were non-Hispanic white, between ages 40 to 59, with annual incomes of less than $10,000, and a high school education or less. Some 62% of enrolled women either never had a mammogram or did not have a repeat mammogram within the time-frames recommended by ACS. Recruitment efforts continue to enroll medically underserved women for breast and cervical cancer screening services. Future efforts will focus on rescreening in order to achieve the program's overall mission of detecting breast and cervical cancers at earlier stages.

Adult↗
PubMed1996

Implementation of a breast and cervical cancer screening program in a public hospital emergency department. Cancer Control Center of Harlem.

STUDY OBJECTIVE: To assess the feasibility and yields of screening for breast and cervical cancer in an urban public hospital emergency department. METHODS: Women who presented to the ED of a large, urban public hospital during the study period with nonurgent conditions were eligible for a Papanicolaou test (Pap smear) and a clinical breast examination (CBE) if they were 18 years of age or older and for a mammogram if they were 40 years of age or older, provided they had not had the screening examination within the past year. The Pap smear and CBE were performed by a nurse, and mammography was scheduled for a later date. Women with gynecologic complaints were excluded. RESULTS: On the basis of screening history, medical status, and age, 1,850 (32%) of the 5,830 women seen in the ER during the 23-month study period were eligible for both mammography and CBE, and 2,361 (41%) were eligible for Pap smears. Of these women, 116 (6%) completed mammography and CBE, and 644 (27%) received Pap smears. Among screened women, 10 (9%) and 20 (3%), respectively, had results that were suspicious or positive for breast or cervical cancer. Follow-up rates were low: 20% for breast screening and 50% for Pap smears. Among those receiving follow-up, 1 woman was found to have breast cancer and 8 were found to have cervical neoplasia. CONCLUSION: ED cancer screening was feasible and yielded a high rate of cancer detection. Program efficiency was hampered by low volume and high numbers of patients lost to follow-up after abnormal screening results. Greater integration into the acute care setting and more intensive recruitment and follow-up strategies are needed to maximize the potential yield and cost effectiveness of such programs.

Adolescent↗
PubMed1998

Patient participation in colon cancer screening programs.

BACKGROUND: The objectives of this study were to survey compliance and identify factors that influence continued participation with periodic colon cancer screening guidelines once patients are seen for their first screening. METHODS: The study group consisted of 95 patients who had initial fecal occult blood tests (FOBT) and flexible sigmoidoscopy (FS) in 1991 as part of a gastroenterologist-directed, aggressively managed colon cancer screening registry. Regular notices are sent to patients and their primary care provider for annual FOBT and FS at 3- to 5-year intervals. RESULTS: Of 70 (74%) reviewed, 2 had died and 3 were having colonoscopic surveillance. Thirty-two of the 65 (49%) contacted eligible study subjects were no longer participating. Reasons stated were as follows: unaware that screening was due (14), too busy (6), unpleasant experience (3), and change to insurance provider that did not cover screening (9 [commercial-3, managed care-1, Medicare-5]). CONCLUSIONS: Despite aggressive program management, 44% of nonparticipators reported that they were unaware that screening was due. Sixteen percent of those who did not continue to participate had graduated to Medicare, which did not cover screening costs. Factors that influence continued participation need to be considered in the design of public education and marketing promotions.

Attitude to Health↗
PubMed2006

Quality of life among postmenopausal Ecuadorian women participating in a metabolic syndrome screening program.

BACKGROUND: Quality of life decreases after the menopause as it has been assessed by several designed tools. Despite this, few studies have reported correlations between quality of life and the metabolic syndrome and its determinants. OBJECTIVE: Evaluate quality of life and determine factors related to its impairment among postmenopausal Ecuadorian women. METHODS: Postmenopausal women that participated in a metabolic syndrome screening and educational program at the Institute of Biomedicine of the Universidad Católica of Guayaquil, Ecuador were interviewed using the Menopause-Specific Quality of Life Questionnaire (MENQOL). Mean domain scores as well as factors associated to higher scores within each of the domains of the questionnaire (vasomotor, psycho-social, physical and sexual) were determined. RESULTS: Three hundred twenty-five postmenopausal women (n=325) were surveyed. Mean age of participants was 55.9+/-8.1 years (median: 54 years). Women presented metabolic syndrome, hypertension, hyperglycemia, hypertriglyceridemia and abdominal obesity in 41.5%, 38.8%, 16.6%, 56.9% and 54.2% respectively. Mean scores obtained for each domain were: vasomotor: 3.5+/-2.5 (median 3); psycho-social: 3.7+/-1.5 (median 3.6); physical: 3.8+/-1.2 (median 3.8); sexual: 4.9+/-2.3 (median 5.3). More than 50% of women had scores above the median for each domain of the questionnaire. Logistic regression determined that vasomotor score decreased with age. Abdominal obesity increased the risk of having vasomotor, psycho-social and physical scores above the median. Hypertension and hyperglycemia increased the risk for higher scores within the psycho-social and sexual domain respectively. CONCLUSION: In this postmenopausal Ecuadorian population, impairment of quality of life was found to be associated to age and related conditions such as abdominal obesity, hypertension and hyperglycemia.

Adult↗
PubMedDate not supplied

Improving preschool vision screening programs.

Early detection of amblyopia is important, but many preschool-aged children do not receive vision screening. Factors that account for missed opportunities in detecting vision problems in early childhood include the difficulty of evaluating vision in an uncooperative child or in an infant and toddler. Methods need to be found to improve the low rate of preschool vision screening. In Missouri, a study has begun on preschool vision screening to find the most cost-effective method.

Amblyopia↗
PubMed2000

[Are screening programs in Barrett esophagus meaningful?].

This review analyses whether the assumption is justified that endoscopic screening in patients with Barrett's syndrome facilitates early recognition of cancer and leads to prolongation of life. It is shown that no reliable data exist that would support the latter conclusion. Although there is scant information that some patients may benefit from close surveillance, it appears unlikely that an all too ambitious surveillance program will either be cost effective or acceptable for patients and/or endoscopy centers.

Adenocarcinoma↗