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PubMed1998

[Breast cancer screening: ethical problems. The Strasbourg experiment. Deontological issues raised by breast cancer screening: quality assurance and accreditation of structures].

Cancer of the breast is so widespread that it has become a genuine problem of public health, with around one woman in twelve developing it in her lifetime. Mass breast-cancer screening campaigns began some 30 years, first in the United States and then in Sweden. Results showed a lowering of the breast-cancer-related death-rate. French doctors experienced considerable difficulties in changing over from an individually-focused organization to the kind of public healthcare service that exists in Nordic and Anglo-saxon countries. However, the first departmental-level breast-cancer screening program, launched in Strasbourg, France, in 1989 proved successful inasmuch as it obtained the involvement of the vast majority of radiologists and general practitioners. Results of the campaign were broadly in line with those obtained elsewhere in Europe. It is only possible to bring this sort of campaign into wider use through intensive groundwork and by providing suitable training for general practitioners, radiologists and gynecologists alike.

Breast Neoplasms↗
PubMed1999

Achilles foot screening project: preliminary results of patients screened by dermatologists.

OBJECTIVE: Presentation of the preliminary results from the foot screening project, 'Achilles', conducted in spring of 1997 and 1998 in several European countries. At the EADV congress, only the preliminary results of the study, i.e. patients screened by dermatologists, were presented. SUBJECT: Foot diseases, especially fungal infections (tinea pedis and onychomycosis). METHODS: A questionnaire and a mycological examination in patients visiting a dermatologist for disorders irrespective of their foot problems. RESULTS: The proportion of patients with foot diseases visiting a dermatologist was high (58%). In the total population, fungal infections were the most prevalent clinically diagnosed foot diseases (35%), especially onychomycosis (23%) and tinea pedis (22%). The prevalence of foot diseases increased with advancing age and more men as compared with women had fungal infections of the feet. The most prevalent predisposing factors were vascular disease and sports participation. In subjects with onychomycosis, the big toenail was affected most often. Twenty-three percent of the participants with clinically diagnosed tinea pedis and/or onychomycosis had infection of both the skin and the nail. The most frequently isolated pathogen was Trichophyton rubrum. Patients with onychomycosis often reported quality of life problems, especially pain and discomfort in walking. CONCLUSION: The preliminary results of this pan-European study show that epidemiological studies can give a better idea of foot diseases in dermatological patients. The results indicate a need to pay more attention to foot disease, to predict and prevent future diseases and complications. The most frequent foot diseases were fungal infections, especially onychomycosis, which affects the quality of life of the patients. More results will be available in 1999.

Adult↗
PubMed1992

[Cardiovascular risk factors in participants of screening procedures in the framework of the Frankfurter Health Days 1990--comparison with representative screenings].

During the public information programme, "Frankfurter Gesundheitstage" 1990 (Frankfurt Days for Health), organised by the Frankfurt Public Health Office, informations on healthy lifestyle and prevention of diseases were available, as well as a screening programme for cardiovascular diseases. 1,875 persons took part in that screening programme. Their total cholesterol, blood pressure and body weight were measured; they were asked about their age and body weight, activities in sports, smoking behaviour, medications, and their personal and family history for cardiovascular diseases. After accounting for sex and age, the results were compared with the representative epidemiological data of the DHP-Surveys, as well as other representative data of Germany. Body mass index was lower than expected; the heavily obese underrepresented. Mean of serum-cholesterol and blood pressure were comparable with the DHP-Survey, as well as the prevalence of hypercholesterolaemia. The prevalence of hypertension was less than expected. Smokers were underrepresented; in women aged greater than 40 years the prevalence of smoking did not differ from the representative data, and in women aged 30-50 years the prevalence of heavy smokers was much higher than expected. Our data are not representative: participation was voluntary, and it may be supposed that especially people who take care of their health and thus may exhibit less risk factors than others took part in the programme. Direct conclusions from our data on the prevalence of cardiovascular risk factors of the Frankfurt population are hence not possible. It may be speculated, however, that the extremely high lung cancer mortality of women in Frankfurt can be explained by the high prevalence of heavily smoking women.

Adult↗
PubMed2004

[Simplified malnutrition screening tool: Malnutrition Universal Screening Tool (MUST)].

MUST (Malnutrition Universal Screening Tool) is a nutritional screening tool easy to use by any trained care-giver and valid for any adult patient. It considers body mass index, weight change and acute disease effect equally and determines a malnutrition risk score. If necessary, anthropometric measures may be simpliyfied by alternative methods. MUST is reliable between different healthcare settings et promotes detection and management of malnutrition during the patient medical course.

Acute Disease↗
PubMed1992

[Mass screening for detection of infants with hearing impairment. II. Screening items and risk factors of hearing impairment].

Validity of the items included in a questionnaire for mass screening for hearing impairment of infants and the risk factors for hearing impairment of 4-month-old infants were studied. Qualitative differences in the questionnaire items were found that would be related to decisions regarding need for thorough examination or followup of a case. The combined use of the risk factors and the questionnaire for 4-month-old infants may considerably reduce the number of false positive cases. A case whose number of negative items was three or less and who had at least one risk factor at 4 months of age was shown to have a high risk of auditory impairment. The cut-off point for the followup screening questionnaires at 7- and 10-month old infants was determined to be at three or less and four or more items.

Hearing Disorders↗
PubMedDate not supplied

[Screening for cardiovascular risk factors in public screening programs: are target groups being reached?].

In 1990 the public health department of Frankfurt organised the third "Frankfurter Gesundheitstage". 1875 persons took part in the voluntary public screening programme for cardiovascular risk factors. Mean age of the persons tested was 60 years. 13% of them smoked, 16% were obese. In 19% elevated blood pressure, and in 85% hypercholesterolemia (greater than 200 mg/dl) was observed (46% greater than 250 mg/dl). Hypercholesterolemia and hypertension was not known before to 444, resp. 88 persons. "Persons at risk" for cardiovascular disease can be reached by such a screening programme.

Adult↗
PubMed1990

Mass screening for neuroblastoma in Japan. Committee of the Neuroblastoma Mass Screening Study of the Japanese Society of Pediatric Oncology.

The present status of NB mass screening in Japan, which is the first national trial in the world, is presented. This program was conducted in cooperation with infants' mothers, local health centers, screening centers and hospitals. Three hundred and thirty-seven cases detected by the program, from the start in Kyoto in 1974 to the end of 1989, are analyzed. As many cases were detected at early stages, 97% of them were expected to be cured. Several clinical, technical and programmatic problems are also discussed.

Child↗
PubMed1990

[Selective screening for hypercholesterolemia. Results from a screening model in general practice].

At present, it appears to be probable that both dietary changes and medicinal treatment can reduce the risk of development of coronary disease in middle-aged men with moderately to severely raised blood cholesterol values. Internationally, the limits for cholesterol intervention are considerably lower than in Denmark. Extensive cholesterol screening is, however, very expensive and the identified persons with high cholesterol values will frequently be found in sex and age groups where the beneficial effect of intervention is probably limited. A model for selective cholesterol screening in high risk groups in general practice is described here. In 20 general practices, all of the men aged 45-59 years belonging to the practice were invited to examination of cholesterol and blood pressure. Plasma cholesterol was measured by means of a Reflotron (results are available within three minutes) and the blood pressure and tobacco consumption were registered. After this, the patient's own general practitioner calculated with each of the persons the risk for development of myocardial infarction within the next ten years and intervention could be commenced immediately. 41% of those invited came for examination. Out of these, 29% had cholesterol values greater than or equal to 7.0 mmol/l (Danish limiting value), 44% greater than or equal to 6.5 mmol/l (limiting value in the remainder of Western Europe), and 5% greater than or equal to 9.0 mmol/l (severe hypercholesterolaemia) while only 18% had completely normal cholesterol less than 5.2 mmol/l. In every practice, two patients on an average were found with severe hypercholesterolaemia greater than or equal to 9.0 mmol/l. 28% of the participants had at least two of the three risk factors investigated. (ABSTRACT TRUNCATED AT 250 WORDS)

Denmark↗
PubMed1987

[ABACTO-SCREEN: a new system for the rapid screening of bacteriuria. Evaluation of the precision versus the traditional methods and compared with the Abbott MS-2].

ABACTO-SCREEN is an automated turbidimetric system for rapid screening of bacteriuria composed by a multichannel photometric instrument and an original disposable. In this study the system has shown good sensitivity (6.9% of false negative results on the true positives) and specificity (22.4% of false positive results on the true negatives) when on assuming 100,000 colony forming units (CFU)/ml as a threshold of positivity. Comparison with Abbott MS-2 has revealed better performances for sensitivity and comparable specificity. False negatives analysis has revealed probable influence of anaerobic bacteria in the plate counting or slowing in culture broth growth cause by antimicrobial substances in urine samples.

Bacteria↗
PubMed1988

[Screening tests in childhood. Hearing screening--a necessity?].

The incidence of hearing loss in early childhood is not exactly defined in the Federal Republic of Germany. There are only some publications on this problem giving incidental information. By analysing this sparse data we tried to determine whether in incidence of hearing loss also applies to the German region. It appears necessary that hearing loss is screened in Germany, considering that other diseases having a lower incidence are also screened.

Child↗
PubMed1987

The application of a comprehensive visual screening programme to children aged 3-5 years. Can a modified procedure be devised for visual screening by ancillary staff?

Current commercially available tests to examine visual performance in children are discussed and adapted for a visual screening programme applied to 249 children aged 3-5 years at school or playgroup premises. Correlation of refractive and ocular muscle findings with the remaining tests is evaluated. A simplified screening procedure is thereby recommended which may be undertaken by ancillary staff, without any need for sophisticated equipment. This would enable identification, for further examination, of most children whose refraction and eye coordination are outside normal limits.

Age Factors↗
PubMed1985

The thyroxine screening index in congenital hypothyroidism screening.

A modification of the RIA total thyroxine assay from a dry drop of blood has been applied in 5-day-old neonates for the screening of congenital hypothyroidism. For first classification, the thyroxine screening index was used in 13 500 newborns; it proved to be simple, rapid and economically acceptable. In borderline cases, more detailed examinations were carried out, viz. estimation by RIA of thyroid stimulating hormone, thyroxine and thyroxine-binding globulin from venous blood. The incidence of permanent and transient impairment of thyroid function is shown in a special graph.

Congenital Hypothyroidism↗
PubMed1982

[Value of neonatal screening for cystic fibrosis. Evaluation of a neonatal screening program including 34,522 neonates (author's transl)].

Screening for cystic fibrosis in 34,522 neonates was done by assaying proteolytic activity in feces samples spread on special filter paper. Infants were considered at high risk for cystic fibrosis if proteolytic activity was significantly decreased and albumin was found in all the fresh stool specimens. Cystic fibrosis was detected in eight infants, most of whom were already hospitalized for respiratory and/or digestive manifestations suggestive of the disease. Six other patients, one of whom was three-and-a-half years-old, were detected after referral by pediatricians. Two false-negative results were recorded, in infants without detectable pancreatic involvement. Given these results, the authors believe that routine neonatal screening for cystic fibrosis is unnecessary. The various etiopathogenetic mechanisms and the possibilities for investigating patients with cystic fibrosis are discussed.

Clinical Enzyme Tests↗
PubMed1982

Pitfalls in screening for neonatal hypothyroidism. Report of the New England Regional Screening Program and the New England Congenital Hypothyroidism Collaborative.

This report reviews problems encountered during the first five years of operation of the New England Regional Screening Program. Human error was responsible for either overlooked or delayed diagnosis and treatment in 14/159 infants with hypothyroidism. This group consisted of three infants who were never tested, six infants whose diagnosis was missed because of errors during the processing of the blood specimens, and five additional children in whom the diagnosis of hypothyroidism could not be made at birth because the concentrations of thyroid-stimulating hormone were not elevated. Many of the problems, most of which occurred during the first two years of the study, have been eliminated by improved communication and monitoring. This study emphasizes the potential vulnerability of all screening programs and underscores the need for physicians to continue to exercise their best clinical judgement regardless of the circumstances.

Congenital Hypothyroidism↗
PubMed1995

[Model calculations for HIV screening of blood and plasma donors with a combination of 2 screening tests: test strategies, validity, costs and effectiveness].

OBJECTIVE: The strategies for combining two screening tests for HIV infections in blood or plasma donors are formulated in biometric terms and analyzed with respect to their value, i.e. their validity, cost and effectiveness. DESIGN: Biometrical modeling using assumptions on the validity of the single tests, the conditional correlations between them, as well as on the cost of testing and the consequences of false-negative or false-positive test results. RESULTS: If the test combination is defined as positive whenever at least one of the single tests is positive, then this rule (the 'believe the positive' rule, BTP), due to its lower specificity, has extremely low positive predictive values. In case of high prevalence rates of the infection (e.g. 1:1,000), the BTP rule leads to lower total cost than single testing, unless the latter has very high sensitivity (e.g. 99%). For smaller prevalence rates (< 1:50,000), which are more typical of the selected group of blood or plasma donors, combination testing is of little value because the extra cost of detecting one additional infection (compared with single testing) may reach several 100 million DM. CONCLUSION: The cost for detecting additional cases of HIV infection by using combination instead of single testing in HIV screening is so high that this decision requires a public consensus.

AIDS Serodiagnosis↗
PubMed1994

[Study of X-ray filter and peak kilovoltage in film-screen chest radiographs in regard to detection of simulated pulmonary nodules: comparison between film-screen combination and FCR].

We compared the ability of standard film-screen chest radiographs to detect simulated pulmonary nodules. The radiographs were taken with different X-ray filters and tube voltages. Detection capability was analyzed utilizing receiver operating characteristic (ROC) curves formed from the interpretation of six readers. Nodule detection was slightly better in images obtained with a tube voltage of 135 kVp than with one of 100 kVp (not statistically significant). Approximately equal detection performance was shown by a conventional film-screen system and FCR with three X-ray filter sets: a copper filter backed by aluminium, a tungsten filter backed by yttrium and aluminium, and a lead filter backed by yttrium and aluminium. Results showed less X-ray exposure with the two latter filter sets. Unenhanced FCR images taken with approximately the same X-ray exposure as conventional radiographs showed nearly equal ability to detect the simulated nodules.

Humans↗
PubMed1995

Genetics in cancer prediction, screening, and counseling: Part I, Genetics in cancer prediction and screening.

PURPOSE/OBJECTIVES: To review molecular biology and gene technology as they relate to cancer prediction and screening. DATA SOURCES: Published professional articles, texts, and proceedings; computerized data bases. DATA SYNTHESIS: Basic principles of inheritance and mutations; a discussion of proto-oncogenes, oncogenes, and anti-oncogenes; a summary of gene-mapping techniques; and a review of genes linked to familial, breast, ovarian, and colorectal cancers. CONCLUSIONS: Most human cancers are influenced genetically but are not inherited. Discoveries about cancer genes play a major role in identifying individuals and families who are likely to develop cancer. IMPLICATIONS FOR NURSING PRACTICE: Nurses need to heighten their awareness of this science and its ramifications, which ultimately will affect recommendations for early detection and screening.

Genes, Tumor Suppressor↗