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[Vaginal cytological examination in the County of Arhus. Extent of screening in a county without a systematic screening program].
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Cervical cancer screening programs.
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Cervical cancer screening programs.
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Cervical cancer screening programs: technical cooperation in the Caribbean.
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The Massachusetts preschool vision screening program.
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Comparison of universal newborn hearing screening programs in Illinois hospitals.
UNLABELLED: SUMMARY/OBJECTIVES: In accordance with the Joint Committee on Infant Hearing's (JCIH, 2000) position statement regarding Universal Newborn Hearing Screenings (UNHS), the state of Illinois enacted legislation requiring all birthing hospitals to conduct UNHS by 31 December 2002. Currently 100% of birthing facilities in the state of Illinois perform newborn infant hearing screenings using otoacoustic emissions (OAEs) and/or automated auditory brainstem response (AABR) measures. This study is an attempt to document current practices in hospital-based UNHS programs, as reported by program personnel, in the state of Illinois. The goal is to compare these reported practices to the recommended standards and identify factors that could lead to further refinement of the process. METHODS: A modified version of the Newborn Hearing Screening Survey from the Marion Downs National Center for Infant Hearing was used to gather practice- and protocol-related data for the 2004 calendar year via the World Wide Web. Data presented here are extracted from the online survey as reported by hospital staff presumably associated with the UNHS program. RESULTS: Fifty-nine of the 140 hospitals with UNHS programs responded to the Web-based survey. Nursing staff, followed by technicians, were most commonly reported to perform initial hearing screenings in both the well-baby nursery (WBN) and the neonatal intensive care unit (NICU). Audiologists appeared to participate in re-screenings at a greater number of the facilities. Automated ABR was the most common screening tool (80%) followed by Distortion Product OAEs (32%) and Transient Evoked OAEs (5%). Eighty-six percent reported referral rates that were less than 5%, with 32% reporting a referral rate less than 1%. CONCLUSIONS: At the beginning of 2004, 99% of all infants born in Illinois were being screened for hearing loss. Personnel involvement and screening measures employed were comparable to the few reports available from other states. The audiologist's role was found to be fairly limited in screening, re-screening, or managing UNHS programs. Referral rates were consistent with national standards ( approximately 1%). Management of UNHS programs in small, rural facilities, tracking/monitoring high-risk infants, and other services provided to families emerged as areas with room for improvement.
Outcome of an optional HCV screening program for blood transfusion recipients in Ireland.
BACKGROUND: An optional (general) HCV testing program for blood and blood component recipients before the introduction of routine donor anti-HCV screening (October 1991) was launched in Ireland in 1995 to complement the targeted lookback program in progress at that time and to identify transfusion-transmitted hepatitis C. STUDY DESIGN AND METHODS: The public were informed of the opportunity to avail of screening by widespread media coverage. Screening was by an initial ELISA (Abbott 3.0, Abbott Laboratories) at the transfusion center laboratories. Reactive samples were referred to a virus reference laboratory where two additional ELISAs (Ortho 3.0, Ortho Clinical Diagnostics; and Murex 3.0, Murex) were performed. Confirmation of ELISA-positive samples was by a RIBA (RIBA 3.0, Chiron Corp.). All patients found to be anti-HCV- seropositive were tested for HCV RNA by PCR and were referred to a hepatologist. RESULTS: A total of 14,917 persons have been tested for hepatitis C in this program to date (85% women). Sixty-one people were confirmed positive for HCV by RIBA 3.0 (0.4%). Excluding persons with other risk factors (n = 15), the HCV positivity rate for blood component transfusion recipients (n = 46) was 0.3 percent. Of the 46 confirmed hepatitis C-positive blood component transfusion recipients, 32 were women (70%), 24 of whom received transfusion for obstetric or gynecologic indications (75%). Thirty-eight of 46 (83%) anti-HCV seropositive transfusion recipients tested had detectable HCV RNA by PCR. CONCLUSION: This program identified 46 transfusion recipients and 10 coagulation factor concentrate recipients, all of whom were previously unaware of their infection. The majority of HCV-positive transfusion recipients identified were women. This may reflect that women are longer living survivors of transfusion therapy or alternatively, in our experience, that Irish women perceive themselves at greater risk of hepatitis C because of the well-publicized association of this virus with recipients (women) of Irish RhIG.
Fragile X screening program in a Spanish region.
In a Spanish region with a population of one million, we screened 371 mentally retarded males, who had no previous diagnosis for fragile X [fra(X))] syndrome. Fifty-three of the 371 males were fra(X) positive. Of these 44 of 362 or 12.1% were unrelated. Family studies identified a large number of obligate carriers and women at risk for being carriers who were given genetic counseling including prenatal diagnostic information. Considering the age of the carriers and the fertility rate, 23 affected males could be born to these women. The prevention potential of this program suggests that it is highly cost-effective.
[Comparative study of tonal liminal audiometry and evoked otoacoustic emissions in school screening programs].
Early diagnosis of deafness is an important objective during the pediatric age. This study compares two different audiological techniques, otoacoustic emissions (OEA) and tonal audiometry (AUD), to be used as screening methods in school revisions programmed for 6 years olds. The correlation between techniques is very good (97% of the positives and 92% of the negatives). The OEA method is objective and faster if the environmental noise is low; if not, AUD seems to be more reliable. At this age (6 years), the otoacoustic emissions have characteristics of the adult age.
Impact of family health insurance and other environmental factors on universal hearing screen program effectiveness.
OBJECTIVE: The study objective was to evaluate the relationship among health insurance type, other demographic factors, and newborn hearing screen compliance and outcomes. STUDY DESIGN: The cohort consisted of 39,153 infants screened in Rhode Island between July 1, 1995 and June 30, 1998. Multivariate analyses were completed to evaluate relationships between health insurance type and completion of the in-hospital hearing screen and the rescreen, if indicated. RESULTS: Successful newborn screen rates ranged from 98.1% to 99.8%. Infants with traditional Medicaid insurance were more likely to not be screened (p<0.0001) and to not return for a rescreen (p<0.0001). Infants in families with managed care Medicaid had screen compliance similar to infants with commercial health insurance. Multivariate analyses revealed that Medicaid insurance, no insurance, neonatal intensive care unit status, and out-of-state address predicted no initial screen (p<0.001) and no rescreen (p<0.0001). CONCLUSION: In population-based health services, it is important that the effects of socioeconomic and demographic variables on outcomes be evaluated.
Maternal weight and ethnic adjustment within a first-trimester Down syndrome and trisomy 18 screening program.
OBJECTIVE(S): To estimate weight and ethnic group correction factors for first-trimester screening markers. METHODS: Ethnic-specific median MoM free beta hCG and pregnancy associated plasma protein A (PAPP-A) and delta nuchal translucency values were calculated for cohorts of maternal weight (20 lb each) using data from 51,206 patients undergoing first-trimester screening. False-positive rates for Down syndrome and trisomy 18 were evaluated both prior to and after weight and ethnicity adjustment. RESULTS: Free beta hCG and PAPP-A significantly decreased with increasing maternal weight while nuchal translucency increased by a clinically insignificant amount. For free beta hCG the regression formula indicated that after accounting for maternal weight MoM values were 16% higher for African Americans, 6% higher for Asians and 9% lower for Hispanics compared to Caucasians (p < 0.001, p = 0.001, p < 0.001, respectively) but there was no significant difference for Asian Indians. For PAPP-A, MoM values were 35% higher for African Americans (p < 0.001) but were not significantly different for the other ethnic groups compared to Caucasians. Down syndrome false-positive rates did not vary with maternal weight prior to (p = 0.291) or after weight adjustment of biochemistry (p = 0.054). Trisomy 18 false-positive rates varied significantly with weight both before (OR = 1.455 per 20-pound increase, p < 0.001) and after (OR = 1.066 per 20-pound increase, p = 0.01) weight adjustment of biochemistry; however, the odds ratio was greatly reduced after weight adjustment. CONCLUSION(S): The first-trimester screening markers, free beta hCG, PAPP-A and nuchal translucency vary with maternal weight and ethnicity. Adjustment of free beta hCG and PAPP-A is indicated but adjustment of nuchal translucency results may not be necessary.
Measurement of aortic diameters and detection of asymptomatic aortic aneurysms in a mass screening program using a mobile helical computed tomography unit.
In a mass chest computed tomography (CT) screening using a mobile helical CT unit, we measured the aortic diameter at three segments to confirm standard values and also attempted to detect any asymptomatic aortic aneurysms. The population screened in the present study consisted of 6971 subjects (3847 men and 3124 women, mean age 60.3 +/- 12.1 years). They underwent a plain chest CT to screen for lung cancer and tuberculosis. The diameters of the ascending and descending aorta were measured at the level of the pulmonary artery bifurcation. The abdominal aorta was measured at the level of the celiac bifurcation, and the mean values for each measurement were calculated. In addition, we attempted to determine whether any correlation exists among aortic diameter, age, and indices of body size and investigated the frequency of asymptomatic aortic aneurysms among the general population. The mean aortic diameter of all three segments was significantly larger in men than in women and increased with age. It also correlated significantly with indices of body size (P < 0.01). A total of 11 subjects (0.16%) had asymptomatic aortic aneurysms (3 ascending, 4 descending, and 4 thoracoabdominal). The aortic diameter in each individual case was greater than the mean aortic diameter +3 standard deviations in each age group. Chest CT screening for lung cancer can thus detect asymptomatic aneurysms through simultaneous aortic measurement.
Direct antimicrobial susceptibility testing of urines positive in the MS-2 urine screening program.
A study was performed using the Abbott MS-2 system, in which positive urine screening specimens were set up directly to an antimicrobial susceptibility test. These results were compared with standard techniques. The overall correlation for urines containing single pathogens was 95.4%. Results were available 5-8 hr after receipt by the laboratory.
VMA mass screening program of neuroblastoma for infants in Nagoya City, Japan.
In Nagoya City, Japan, VMA mass screening for detection of neuroblastoma has been performed since 1977. Filter paper strips wetted with urine are mailed to a central laboratory. Positive tests are followed up by more definitive testing. Of the 20,053 urine samples of 6-month-old infants tested, January 1977 to March 1983, five asymptomatic infants with neuroblastoma have been discovered. All have been treated and are alive as of January 1984.
Developing a screening program to detect sight-threatening diabetic retinopathy in South India.
OBJECTIVE: To develop a screening protocol for detection of sight-threatening diabetic retinopathy in south India. RESEARCH DESIGN AND METHODS: We performed ophthalmic examinations, including posterior segment examination, using indirect ophthalmoscopy to detect sight-threatening retinopathy in patients with diabetes in screening camps targeting a high-risk population. RESULTS: We examined 3,949 persons with diabetes in 32 screening camps over a 13-month period beginning July 2001. Most of the patients (93.6%) were aware of their diabetic status, and 84.2% of those aware of their diabetes status were on treatment. One-fifth of those screened had evidence for any retinopathy; only 6.1% of these persons had evidence of past ophthalmic treatment for retinopathy. Only one-quarter of those diagnosed with worse than mild retinopathy came for follow-up to the base hospital within 2 months. CONCLUSIONS: Screening high-risk groups for sight-threatening retinopathy using indirect ophthalmoscopy may be a useful short-term alternative for India until retinal photography becomes affordable. In addition to strategies to improve coverage, strategies for better follow-up of subjects screened also need to be evolved.
[Informative value of varying serum alpha fetoprotein levels in pregnant women based on a screening program in a Hungarian institute. What next?].
The authors evaluated the maternal serum alfa fetoprotein screening data of 3 years period. Out the neural tube defects they observed increased values at 20% of another congenital malformations. At the pregnant having abnormal serum alfa fetoprotein significantly accumulated the late-term abortion, stillbirth and preterm delivery. At the mothers of stillborns and abortions frequently noticed the different values. They direct attention to the fetal-living-danger importance, control functions of the abnormal level and after prospective data collection it may have new aspecific alarm role too. Accordingly the maternal serum alfa fetoprotein may consider like fetal blood sediment examination.
Optimization of mammographic screening programs.
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