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PubMed2006

Evaluation of BacLite Rapid MRSA, a rapid culture based screening test for the detection of ciprofloxacin and methicillin resistant S. aureus (MRSA) from screening swabs.

BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) is a major nosocomial pathogen worldwide. The need for accurate and rapid screening methods to detect MRSA carriers has been clearly established. The performance of a novel assay, BacLite Rapid MRSA (Acolyte Biomedica, UK) for the rapid detection (5 h) and identification of hospital associated ciprofloxacin resistant strains of MRSA directly from nasal swab specimens was compared to that obtained by culture on Mannitol salt agar containing Oxacillin (MSAO) after 48 h incubation. RESULTS: A total of 1382 nasal screening swabs were tested by multiple operators. The BacLite Rapid MRSA test detected 142 out of the 157 confirmed MRSA that were detected on MSAO giving a diagnostic sensitivity of 90.4, diagnostic specificity of 95.7% and a negative predictive value of 98.7%. Of the 15 false negatives obtained by the BacLite Rapid MRSA test, seven grew small amounts (< 10 colonies of MRSA) on the MSAO culture plate and five isolates were ciprofloxacin sensitive. However there were 13 confirmed BacLite MRSA positive samples, which were negative by the direct culture method, probably due to overgrowth on the MSAO plate. There were 53 false positive results obtained by the BacLite Rapid MRSA test at 5 h and 115 cases where MRSA colonies were tentatively identified on the MSAO plate when read at 48 h, and which subsequently proved not to be MRSA. CONCLUSION: The BacLite MRSA test is easy to use and provides a similar level of sensitivity to conventional culture for the detection of nasal carriage of MRSA with the advantage that the results are obtained much more rapidly.

Anti-Bacterial Agents↗

PubMed2006

Exploring existing and deliberated community perspectives of newborn screening: informing the development of state and national policy standards in newborn screening and the use of dried blood spots.

OBJECTIVE: Since the 1960s newborn screening (NBS) for several rare and serious disorders has been in place across Australia. Testing of a simple blood spot now enables the early detection of over 30 conditions. Policies across Australian states have diverged in some aspects of NBS, especially in the retention and further use of dried blood spots collected as part of the screening and attempts are underway to bring some further national consistency. Whilst this has initiated debate amongst health professionals and policy makers there is limited empirical evidence of wider community attitudes to such issues. METHODS: This research has explored the range and depth of views held by the wider community in New South Wales through moderated small group discussions. It has also assessed the range and depth of responses where the groups are reconvened after being given further information. RESULTS: The findings suggest that there is limited community awareness of the public health importance of NBS and especially that resulting biological samples are stored. Members of the wider community presented with opportunities to consider current procedures and policies appear reassured and to have high levels of trust. However there are clearly some groups who have concerns with the storage of dried blood spot specimens and perceive that these may be abused. POLICY IMPLICATIONS AND CONCLUSION: The findings will inform health professionals and policy makers as to the perceived benefits and future challenges NBS raises for the wider community. The findings have implications for improving current communications about NBS, maintaining public confidence and the development of state and national initiatives in genetic health.

Journal Article↗

PubMed1984

Screening for chest disease in college students: policies of student health services regarding the use of routine screening chest radiographs and tuberculin skin tests.

We conducted a survey of college health services to determine their policies regarding the use of screening chest radiographs and tuberculin skin tests. Pre-enrollment chest radiographs are prescribed for all incoming students by 24 per cent of the 531 respondents and for health professions students, foreign students, and intercollegiate athletes only by an additional 20 per cent, 19 per cent, and 6 per cent, respectively. Periodic chest radiography is conducted for all students by 7 per cent of the respondents and for health professions students, foreign students, and intercollegiate athletes only by an additional 22 per cent, 16 per cent, and 8 per cent, respectively. Pre-enrollment tuberculin skin tests are prescribed for all incoming students by 52 per cent of the respondents and for health professions students, foreign students, and intercollegiate athletes only by an additional 48 per cent, 29 per cent, and 9 per cent, respectively. Periodic tuberculin skin testing is conducted for all students by 27 per cent of the respondents and for health professions students, foreign students, and intercollegiate athletes only by an additional 48 per cent, 23 per cent, and 16 per cent, respectively. We estimate from these data that 723,000 incoming students in the United States received screening chest radiographs in 1979 with estimated charges totaling between $7 million and $27 million. There may be 0.05 to 0.33 induced cases of lung cancer, leukemia, thyroid cancer, and female breast cancer over a 20-year period among this group of students exposed to ionizing radiation.

Diagnostic Tests, Routine↗

PubMed2001

Compound mixtures in Caco-2 cell permeability screens as a means to increase screening capacity.

The purpose of this investigation was a study of simultaneous permeability measurement using compound mixtures (cassette dosing) as an alternative to single compound evaluation in order to increase the capacity of screens for intestinal drug permeability. Drug transport across Caco-2 monolayers was studied, both in the apical to basolateral and the basolateral to apical direction. The apparent permeability coefficients for ten compounds displaying different intestinal transport mechanisms were determined, first as single compounds and then as components of a mixture. Seven beta-adrenoceptor antagonists and baclofen were analysed simultaneously using reversed phase HPLC with UV detection, D-glucose and mannitol were measured by scintillation counting. The results indicated that the Papp from the mixture as donor phase correlated well with that of the single compounds and merely small changes in the Papp of each compound were observed between the single compound and mixture experiments. This minor variation resulted in a change in rank-order of the poorly permeable compounds in the mixture, however, without affecting their association with the permeability class according to the biopharmaceutics classification system (BCS). It can be concluded that the use of compound mixtures is a suitable method for improving the capacity in permeability screens. Further improvement of the throughput may be expected upon automatisation of permeability measurements using robotics combined with increased selectivity using LC-MS analysis.

Adrenergic beta-Antagonists↗

PubMed2001

[Screening for violence against women. Validation and feasibility studies of a French screening tool].

OBJECTIVE: To replicate, in a Francophone community, our prior work determining the reliability and validity of the full Woman Abuse Screening Tool (WAST) and a two-item version (WAST-Short). DESIGN: Questionnaires completed by abused and nonabused women. SETTING: Two women's shelters in Francophone communities in Ontario and Quebec and participants' homes or workplaces. PARTICIPANTS: A convenience sample of 25 abused women currently residing in two women's shelters and a convenience sample of 21 women who reported they were not abused. MAIN OUTCOME MEASURES: Women's responses to French versions of the WAST, the Abuse Risk Inventory (ARI), and comfort in answering the questions were compared. Also, the reliability and validity of French versions of WAST and WAST-Short were assessed. RESULTS: Abused (n = 23) and not abused (n = 21) women were demographically similar. A strong single-factor structure that accounted for 81% of total variance in the French WAST items was identified. The French WAST was found to be highly reliable with a coefficient alpha of .95 and demonstrated construct and discriminant validity. The WAST-Short correctly classified all the nonabused women and 78.7% of the abused women. The abused women reported feeling less comfortable responding to the WAST questions than the nonabused women. CONCLUSION: The French version of the WAST demonstrated good reliability and validity and discriminated between known samples of abused and nonabused women. Even though the French WAST-Short did not perform as well as the English version, results of this study support further evaluation of the WAST for screening women in Francophone or bilingual family practice settings.

Adult↗

PubMed2002

[Benefit of screening for gastric cancer--a comparison of symptomatic and screened patients who underwent gastrectomy].

UNLABELLED: We compared the clinicopathological factors and treatment results with regard to symptoms and screening in patients who underwent gastrectomy for primary gastric cancer. PATIENTS: The subjects included 797 patients with asymptomatic gastric cancer (SCG) and 1090 patients with symptomatic cancer (SYG) who had undergone gastrectomy for gastric cancer from 1989 to 2000. RESULTS: The proportion of early gastric cancer, N0 cases, and curative cases in the SCG and SYG patients were 70% & 33%, 77% & 44%, and 98% & 80%, respectively (p = 0.000, for each). Five-year survival rates of the SCG and SYG patients were 87% and 63% (p = 0.000). CONCLUSION: Screening for gastric cancer in order to detect asymptomatic disease may contribute to patient survival.

Adult↗

PubMedDate not supplied

Fast antimicrobial screen test (FAST): improved screen test for detecting antimicrobial residues in meat tissue.

The Fast Antimicrobial Screen Test (FAST) is a simple and quick screening test developed to detect antibiotic and sulfonamide residues in food animal carcasses in slaughter establishments. This microbial inhibition test detects antimicrobials that are allowed to be used in food animals. It has the ability to detect these antimicrobials at or above the allowable limit in carcass kidney fluids in 6 h. Laboratory evaluations show that the lower limit of detection (LLD) of FAST and the Calf Antibiotic and Sulfa Test (CAST) for antibiotics tested was the same, but the LLD for sulfonamides of FAST was lower than the LLD of CAST. Compared with the Swab Test on Premises (STOP) developed in 1977, the LLD's of FAST for both antibiotics and sulfonamides were significantly better. Under field conditions, the sensitivity of FAST and CAST to antibiotic and sulfonamide residues in animal kidneys was not significantly different, but the time required by FAST was significantly lower than CAST (6 versus 18 h). Compared with the STOP, the sensitivity and the range of detection by FAST for all antimicrobials were significantly higher and the testing time was lower (18 versus 6 h).

Animals↗

PubMed1992

[Screening for dementia: validity of the Cognitive Screening Test (CST) and the Mini-Mental State Examination].

The Cognitive Screening Test (CST--short version), a Dutch orientation questionnaire, and the Mini-Mental State Examination (MMSE) were compared with respect to their ability to discriminate between mildly demented, moderately demented and non-demented patients. The difference between mildly and moderately demented patients was based on the Global Deterioration Scale score. The CST and the MMSE were administered to patients who had been referred to the Memory Clinic of the University Hospital of Maastricht. Both instruments were successful in discriminating moderately and severely demented from non-demented patients. The CST and the MMSE were also successful with respect to the classification of depressive, non-demented elderly patients. The CST did not succeed in the correct classification of mildly demented patients (50% false-negative). The results of the MMSE in this group of mildly demented patients were moderate (25% false-negative). It is concluded that the value of both screening instruments, and especially the short version of the CST is limited for clinical practice.

Aged↗

PubMed2006

[Cost-benefit analysis of population screening for abdominal aortic aneurism, based on five-year results of a randomised hospital-based screening trial].

The lethality of ruptured abdominal aortic aneurysm (AAA) is 80-95% compared to 5-6% after elective surgery. However, AAA seldom causes symptoms before rupture. From 1994 to 1998, 12,639 men aged 64-73, from Viborg County, were randomised 1:1 for an invitation to an ultrasonographic scan or for controls. There were 75% fewer emergency operations (P < 0.001), and 67% lower AAA-specific mortality in the screening group (P = 0.002). The costs were 6,221 pounds sterling (4,034-13,782) per saved living year, expected to decrease to about 1,860 pounds sterling after 10 years. Screening of Danish men, aged 65-73, is recommended.

English Abstract↗

PubMed1986

Medical screening and biological monitoring for the effects of exposure in the workplace. Screening and monitoring: tools for prevention.

The mission of the National Institute for Occupational Safety and Health (NIOSH) is the prevention of work-related diseases and injuries. Medical screening and biological monitoring are recognized as important tools of prevention; however, the number of complex and sophisticated tests available has created new problems of choice in this field. Many of these tests have no relevance to preventing work-related diseases or injuries. To provide important guidelines in this area, NIOSH has identified the ten leading work-related diseases and injuries (Table 1). Several of these medical screening and biological monitoring techniques can be applied as tools for prevention. Within this framework, achieving the goal of preventing work-related diseases and injuries can be enhanced by collecting, analyzing, and interpreting information about occupational health problems.

Accidents, Occupational↗

PubMed1979

[TSH-screening program for congenital hypothyroidism. Experiences with early thyrotropin (TSH) screening].

14,919 newborn infants were screened for congenital hypothyroidism within the last 5 years using a sensitive TSH method. 10 infants with congenital hypothyroidism were discovered thus presenting a frequency of 1:4500. Four of these infants showed abnormally high TSH levels and normal thyroxine levels. The determination of TSH in cord blood--or combined with the screening program for phenylketonuria--in eluate of dried filter paper specimens is the most sensitive test for primary hypothyroidism without false negative results and a low false positive recall rate of 0.16%. After initiation of therapy with thyroxine the TSH level falls unless therapy is delayed for longer. In the latter case TSH levels may remain elevated for several months despite therapy with thyroxine. We would suggest to start therapy with triiodothyronine for up to 14 days prior to initiation of the usual thyroxine therapy.

Congenital Hypothyroidism↗

PubMed1982

Adaptations of the Denver Developmental Screening Test: a study of preschool screening.

Developmental screening tests are only rarely used in pediatric practice, reportedly because of lack of available time. This study evaluated a shortened form of the Denver Developmental Screening Test (DDST-S) consisting of only those items immediately to the left of the child's individual are line, three in each sector or a total of 12. This DDST-S was administered to four cohorts of preschool children (aged 52 to 64 months), 1,819 children in all. Subsamples of these children returned within three months for one of several developmental (criterion) tests (McCarthy Scales of Children's Abilities, the complete DDST, or the Stanford-Binet). The DDST-S was scored by selecting the profile of passes and failures most predictive of McCarthy test results, using indices of copositivity, connegativity, underreferral, and overreferral as the basis for the decision. Utilizing this scoring system, use of the DDST-S was able to identify low scorers (those scoring less than 70) on the Stanford-Binet (sensitivity = .67, specificity = .95, predictive value = .54, underreferral = 2.5%, overreferral = 4%) as well as the complete DDST. Low scoring children could thus be identified in less than half the time required by the complete DDST. A two-stage DDST-S and DDST procedure was found to have even greater predictive value (76%; 100% if borderline cases [score of 70 to 80] are considered positive) than either form alone.

Child Development↗

PubMed1994

Screening alcohol abuse potential among Army reservists with the Short Michigan Alcoholism Screening Test.

The Short Michigan Alcoholism Screening Test was psychometrically useful in screening a sample of 560 reservists from a midwest general hospital unit. The most conservative estimate of alcohol abuse potential was 11.3%, with possibly 6.6% having symptoms of alcohol dependence. Comparisons with active duty military, Army, and civilian samples suggest that prevalence of abuse in the Reserve sample is similar to that of the combined military, but lower than that of the Army. Future research and policy choices are highlighted.

Alcoholism↗

PubMed1996

DNA-based carrier screening in primary healthcare: screening for aspartylglucosaminuria mutations in maternity health offices.

Large-scale genetic screening programs are complex enterprises in which ethical, technical, medical, and socioeconomic aspects have to be handled with professional expertise. Establishment of automated, relatively robust, and inexpensive laboratory techniques is one step of this path. Here a pilot carrier-screening program for the mutations causing aspartylglucosaminuria was carried out for pregnant women in primary care maternity health offices. Women (1975) were tested before their 12th week of pregnancy, and 31 heterozygotes were detected. The sampling was based on dried blood strips, facilitating convenient handling and inexpensive mailing to the laboratory. The mutation detection technique, solid-phase mini-sequencing simplified by the use of scintillation microplates and automated equipment, proved to be rapid, simple, inexpensive, and reliable, with a low repeat rate (2.5%). In conclusion, we found that good collaboration between the primary healthcare unit, the laboratory, and counseling experts, combined with modern laboratory technology, facilitate reliable low-cost genetic testing.

Acetylglucosamine↗

PubMed2003

The National Health Service Breast Screening Programme and British Association of Surgical Oncology audit of quality assurance in breast screening 1996-2001.

BACKGROUND: The National Health Service Breast Screening Programme (NHSBSP) is an example of a nationally coordinated quality assurance programme in which all the professional groups involved participate. METHODS: Surgeons, radiologists and pathologists defined the clinical outcome measures against which they would subsequently be audited. The NHSBSP and the Association of Breast Surgery at BASO are jointly responsible for coordinating an annual audit of all surgical activities undertaken within the NHSBSP. RESULTS: The trends for key outcome measures between 1996 and 2001 are provided. The preoperative diagnosis rate (minimum standard 70 per cent or more) improved from 63 to 87 per cent. This rise was mirrored by an increase in the use of core biopsy in preference to fine-needle cytology. The proportion of patients in whom lymph node status was recorded improved from 81 to 93 per cent. There was no significant change in the number of women treated by low case-load surgeons and waiting times for surgery increased through the study interval. CONCLUSION: The BASO-NHSBSP Breast Audit has recorded major changes in clinical practice over 5 years. A key feature has been the dissemination of good practice through feedback of the results at local and national level.

Biopsy, Needle↗

PubMed1999

Disomy 1 with terminal 1p deletion is frequent in mass-screening-negative/late-presenting neuroblastomas in young children, but not in mass-screening-positive neuroblastomas in infants.

The mass screening (MS) of neuroblastoma has been undertaken in Japan by measuring urinary catecholamine metabolites in infants at the age of 6 months. To clarify the biological characteristics of MS-positive (MS+) tumors in infants and MS-negative (MS-)/late-presenting tumors in young children, metaphase cytogenetic and/or interphase 2-color FISH analyses using terminal 1p and pericentromeric 1q probes were performed on 246 (186 MS+ and 60 MS-) patients with neuroblastomas. The 246 tumors were classified into 4 groups on the basis of the constitution of chromosome 1; 22 tumors had disomy 1 with no 1p deletion (Dis1Norm1p); 41 tumors had disomy 1 or tetrasomy 1, all with the 1p deletion (Dis1Del1p); 164 tumors had trisomy 1, pentasomy 1, or a mixed population of cells with trisomy 1 and cells with tetrasomy 1, none with 1p deletion (Tris1Norm1p); 19 tumors with the same copy numbers of chromosome 1 as the Tris1Norm1p group, had 1p deletion (Tris1Del1p). mycn amplification was absent in the Dis1Norm1p and Tris1Del1p groups, frequent in the Dis1Del1p group (24/41), and rare in the Tris1Norm1p group (3/164) (p < 0.0001). Event-free survival at 5 years was lowest [19.5%; 95% confidence interval (CI), 5.1-33.9] in the Dis1Del1p group, highest in the Tris1Norm1p (96.3%; 95% CI, 93.5-99.2) and Tris1Del1p (94.7%; 95% CI, 84.7-104.8) groups, and intermediate but varied (54.5%; 95% CI, 33.7-75.4) in the Dis1Norm1p group (p < 0.0001). Of the MS+ tumors, 90% were Tris1Norm1p or Tris1Del1p, and 55% of the MS- tumors were Dis1Del1p. The finding that the Dis1Del1p tumors were frequent in MS- but not in MS+ tumors suggests the limited efficacy of the MS program into reducing mortality from neuroblastoma.

Aneuploidy↗

PubMed1989

The use of oncofetal ferritin-bearing lymphocytes as a marker for the screening, diagnosis, and follow-up of patients with early breast malignancy screening of 3400 women.

The potential of using a blood test enumerating oncofetal ferritin-bearing lymphocytes (FBL) as a biomarker for early breast cancer was further explored. Nine hundred women attending a high-risk breast cancer clinic and 2500 normal-risk women were physically examined and their blood drawn for FBL determination using a newly developed radioimmunoassay. The FBL test results were compared to clinically or histopathologically diagnosed breast disease and to known breast cancer risk factors. A gradual increase in the mean FBL ratio was seen from normal risk disease-free women to those with in situ or early stage breast cancer. The percentage of women with positive FBL was 13.6% for the normal risk group, 19% and 25.7% for clinically and histopathologically diagnosed benign breast disease, respectively, and 100, 77.8, and 66.7% for in situ, Stage I, and Stage II breast cancer, respectively. In locally advanced disease (Stage III) the percentage of positive women was only 17.2%. It was further found that a negative FBL result in known breast cancer patients at Stage I, II of the disease was a bad prognostic marker indicating a shorter disease-free survival. The follow-up of patients after surgery by periodical clinical examination and the FBL test revealed that the positive FBL was declining after removal of the precancerous or malignant tumor and that it was highly sensitive (100%) in predicting tumor development and recurrence. Using a logistic regression analysis, an FBL-positive test indicated a significant association with risk of early breast cancer (odds ratio = 2.9; 95% confidence interval = 1.4-5.8). Being a measure of the immune response the positive FBL was associated with early breast cancer and good prognosis. Since patients with locally advanced cancer and poor prognosis were FBL negative but such patients were shown to have increased serum ferritin levels. It is suggested to use the FBL and serum ferritin assays for screening and diagnosis of breast cancer.

Antigens, Neoplasm↗

PubMed2000

Pathologic-radiologic correlations in screen-detected ductal carcinoma in situ of the breast: findings of the Singapore breast screening project.

Mammography detected 34 (25%) cases of ductal carcinoma in situ (DCIS) of the breast out of a total of 135 cancers diagnosed in 28, 231 participating women during the Singapore breast screening project. Radiologic findings in these 34 women with DCIS were calcifications only in 25 (74%); mass only in 2 (6%); and mass with calcifications in the remaining 7 (20%) cases. Calcifications were classified mammographically as powderish in 2 (6%), crushed stone-like in 16 (50%) and casting in 14 (44%) cases. Pathologic assessment revealed 11 (32%) cases with pure comedo, 16 (47%) mixed, 3 (9%) cribriform, 2 (6%) papillary, 1 (3%) micropapillary and 1 (3%) solid patterns. Histologic nuclear grade was low in 6 (18%), intermediate in 9 (26%) and high in 19 (56%). Necrosis was observed in 26 (77%) cases and absent in the rest. Pathologic-radiologic correlations yielded a significant association between the mammographic and pathologic lesional size, with the degree of agreement improved when there was histologic necrosis. A trend for radiologic crushed stone-like and casting-type calcifications to be associated with DCIS with necrosis and of higher nuclear grade was noted. Int. J. Cancer (Radiat. Oncol. Invest.) 90, 231-236 (2000).

Aged↗