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PubMedDate not supplied

Lanthony 15-Hue Desaturated Test for screening of early color vision defects in uncomplicated juvenile diabetes.

PURPOSE: To identify the most appropriate test for screening of early color vision abnormalities in uncomplicated juvenile diabetes. METHODS: Enrolled in this study were 39 diabetic adolescents, characterized by optimal Early Treatment Diabetic Retinopathy Study criteria for visual acuity, transparent dioptric means and angiographically normal retinas. Color vision was examined with Standard Pseudoisochromatic Plates (Part 2, SPP2), Roth 28-Hue Test (R28), Farnsworth-Munsell 100-Hue Tests (FM100), and Lanthony 15-Hue Desaturated Test (L15). Color confusion score (CCS) and desaturation angle (DSAT) were measured on L15 only. Thirty-nine normal subjects served as a control group. Poor metabolic control was an exclusion criteria. RESULTS: CCS was significantly higher in the patients than in the controls (37.8 +/- 11.1 vs 0 +/- P < .001) and normal scores were found in only 4 diabetic patients. DSAT values were spread, not showing a well-defined axis of the defect. The results of FM100 were clinically reliable but affected by a longer execution time. R28 and SPP2 demonstrated a low sensitivity, as all patients scored normally with both tests. CONCLUSIONS: Impaired color vision is a common observation even in patients with uncomplicated juvenile diabetes. Our results indicate that L15 is the most suitable test for screening of early color vision abnormalities in these subjects.

Adolescent↗

PubMed2005

Screening for early childhood hearing loss in Nigeria.

Newborn hearing screening has been recognized as an essential component of public health care in early childhood in developed countries. However, such screening is yet to be widely embraced in the developing world. The new national health policy in Nigeria seeks, for the first time, to reduce the impact of permanent hearing loss on early childhood development through early detection and timely intervention services. The aim of this paper is to ascertain if newborn hearing screening satisfies the conventional criteria for a screening programme as an early detection strategy in this developing country. A review of the available literature shows that permanent childhood hearing loss is a significant health condition and its detection through screening with oto-acoustic emissions and/or auditory brainstem response is feasible in the target population. Amplification with hearing aids is an effective and preferred option for early intervention by parents. The risk of maternal anxiety from potential false-positives or the psychological cost of false assurance from false-negatives is unlikely to outweigh the benefit of screening. Newborn hearing screening is therefore a potential early detection strategy for permanent childhood hearing loss in Nigeria.

Child↗

PubMed2006

Trends in sudden cardiovascular death in young competitive athletes after implementation of a preparticipation screening program.

CONTEXT: A nationwide systematic preparticipation athletic screening was introduced in Italy in 1982. The impact of such a program on prevention of sudden cardiovascular death in the athlete remains to be determined. OBJECTIVE: To analyze trends in incidence rates and cardiovascular causes of sudden death in young competitive athletes in relation to preparticipation screening. DESIGN, SETTING, AND PARTICIPANTS: A population-based study of trends in sudden cardiovascular death in athletic and nonathletic populations aged 12 to 35 years in the Veneto region of Italy between 1979 and 2004. A parallel study examined trends in cardiovascular causes of disqualification from competitive sports in 42,386 athletes undergoing preparticipation screening at the Center for Sports Medicine in Padua (22,312 in the early screening period [1982-1992] and 20,074 in the late screening period [1993-2004]). MAIN OUTCOME MEASURES: Incidence trends of total cardiovascular and cause-specific sudden death in screened athletes and unscreened nonathletes of the same age range over a 26-year period. RESULTS: During the study period, 55 sudden cardiovascular deaths occurred in screened athletes (1.9 deaths/100,000 person-years) and 265 sudden deaths in unscreened nonathletes (0.79 deaths/100,000 person-years). The annual incidence of sudden cardiovascular death in athletes decreased by 89% (from 3.6/100,000 person-years in 1979-1980 to 0.4/100,000 person-years in 2003-2004; P for trend < .001), whereas the incidence of sudden death among the unscreened nonathletic population did not change significantly. The mortality decline started after mandatory screening was implemented and persisted to the late screening period. Compared with the prescreening period (1979-1981), the relative risk of sudden cardiovascular death in athletes was 0.56 in the early screening period (95% CI, 0.29-1.15; P = .04) and 0.21 in the late screening period (95% CI, 0.09-0.48; P = .001). Most of the reduced mortality was due to fewer cases of sudden death from cardiomyopathies (from 1.50/100,000 person-years in the prescreening period to 0.15/100,000 person-years in the late screening period; P for trend = .002). During the study period, 879 athletes (2.0%) were disqualified from competition due to cardiovascular causes at the Center for Sports Medicine: 455 (2.0%) in the early screening period and 424 (2.1%) in the late screening period. The proportion of athletes who were disqualified for cardiomyopathies increased from 20 (4.4%) of 455 in the early screening period to 40 (9.4%) of 424 in the late screening period (P = .005). CONCLUSIONS: The incidence of sudden cardiovascular death in young competitive athletes has substantially declined in the Veneto region of Italy since the introduction of a nationwide systematic screening. Mortality reduction was predominantly due to a lower incidence of sudden death from cardiomyopathies that paralleled the increasing identification of athletes with cardiomyopathies at preparticipation screening.

Adolescent↗

PubMed1997

Screening and early detection for prostate cancer.

Prostate cancer is the most common malignancy in men. Mortality due to prostate cancer has continued to increase over the past five decades despite all the different options of treatment at the disposal of the urologist, such as, surgery, radiotherapy, chemotherapy and biotherapy. Presently, effective therapy for prostate cancer is only possible with early diagnosis of the disease still localised within the prostate. Recent studies have demonstrated that the present screening techniques including Digital Rectal Examination (DRE), Serum Prostate Specific Antigen (PSA) concentration, Transrectal Ultrasound (TRUS) and Random Ultrasonically guided multiple prostatic biopsies can detect some potentially curable asymptomatic localised cancers. The main goal of a cancer screening test is to help reduce mortality. To date, it has been established that screening increases early detection and survival but there is no evidence that screening reduces mortality. If in future early detection and intervention is proved to provide real benefit apart from the overdiagnosis of latent non aggressive tumours, then the mortality from prostate cancer could begin to decline in the next decade. However, if our current armamenteria of therapies continue to be ineffective in treating men with prostate cancer, the current emphasis on screening and early detection will decline.

Biopsy↗

PubMed1999

Early pregnancy screening for fetal aneuploidy with serum markers and nuchal translucency.

We determined the aneuploidy detection rate achievable by early pregnancy screening with pregnancy associated plasma protein (PAPP)-A, free beta human chorionic gonadotrophin (hCG) and ultrasound nuchal translucency (NT) measurement. Women having prenatal diagnosis were scanned, and a blood sample was taken and stored. Stored samples were tested and a total of 37 were found to have Down syndrome, 8 to have Edwards syndrome and 255 were controls. Results were expressed in multiples of the gestation-specific median (MOM) value in the controls after regression and, for the serum markers, maternal weight adjustment. In Down syndrome the medians were for PAPP-A 0.63 MOM (95 per cent confidence interval (CI) 0.45-0.87); free beta-hCG 1.88 MOM (1.33-2.66); and NT 2.34 MOM (1.70-3.22). Using these parameters the expected detection rate for a 5 per cent false-positive rate for different marker combinations were: 55.3 per cent for PAPP-A and free beta-hCG; 68.4 per cent for NT alone; and 84.6 per cent for PAPP-A, free beta-hCG and NT. The median values for Edwards syndrome were: 0.17 MOM for PAPP-A; 0.18 MOM for free beta-hCG; and 2.64 MOM for NT. Early pregnancy screening with the combined measurement of maternal serum PAPP-A and free beta-hCG and fetal nuchal translucency could achieve a high Down syndrome detection rate.

Aneuploidy↗

PubMed1996

Concurrent and predictive validity of an early childhood screening test.

The purpose of this study was to validate an early childhood screening instrument concurrently with other established psychoeducational tests and predictively with a standardized measure of achievement. A battery of tests including a screener and five other established psychoeducational measures was administered to 64 children during their kindergarten year. An achievement test was administered to 33 of these children during their third grade year. The screening test scores were found to be significantly related to the results of other psychoeducational measures both concurrently and predictively. The instrument permits teachers to gather behavior samples in minutes.

Achievement↗

PubMed2001

Screening and early detection among racial and ethnic minority women.

OBJECTIVES: To highlight sociocultural factors reported to influence and strategies to promote breast and cervical cancer screening and early detection behaviors of racial and ethnic minority women. DATA SOURCES: Published articles, book chapters, and reports. CONCLUSIONS: The most successful strategies for promoting screening and early detection among racial and ethnic minority women are collaborative and include approaches that are culturally sensitive and appropriate. NURSING IMPLICATIONS: Intercultural and intracultural differences in racial and ethnic minority women challenge nurses to explore strategies that focus on the health care provider, the health care delivery system, and the individual woman within the context of the woman's culture.

Breast Neoplasms↗

PubMedDate not supplied

Early pregnancy screening for neural tube defects in Israel.

A pilot project to detect neural tube defects (NTD) of the fetus by maternal serum alpha-fetoprotein (MSAFP) screening of women in early pregnancy was initiated in Tel Aviv in 1982 at the instigation of the Israel Ministry of Health. The program was designed to be an extension of routine pregnancy care, which in this city is provided in municipal family clinics that are attended by about 50% of pregnant women before the 20th week of pregnancy. Of these women, 89% complied with the program. Women with a MSAFP level above a cutoff point of 2.4 multiples of the median (MOM) were invited for an ultrasound examination of the fetus, without having to repeat the MSAFP test, thereby reducing maternal anxiety. This deviation from the usual test system protocol did not impair sensitivity (87%), or specificity of the test on its own (95.6%), or in combination with ultrasound examination of the fetus and alpha-fetoprotein and acetylcholinesterase testing of the amniotic fluid (99.9%). The program detected 13 fetuses with an NTD; there were two false-negative results and one false-positive. The predictive value of a positive test was 93%. Its effectiveness as a preventive measure was impaired by the fact that 50% of pregnant women did not attend the family clinic before the 20th gestational week. An educational program for professionals and for the public is contemplated in order to reduce this proportion. Only 50% of normal twin pregnancies had an elevated MSAFP. A check on compliance with other screening systems during the interview for MSAFP screening led to the detection and elective abortion of two fetuses with Tay-Sachs disease. MSAFP screening in Israel is cost-effective rather than cost-beneficial.

Amniocentesis↗

PubMedDate not supplied

Hip fractures--a joint effort.

More than 350,000 hip fractures occur in the United States every year, and the number will double by 2050 as baby boomers advance in age. Hip fractures remain one of the most common injuries of the geriatric cohort, where 9 of 10 patients with a hip fracture are 65 years of age or older and have multiple medical problems. A coordinated approach to care that emphasizes early ambulation, prevention of complications, and patient/family involvement is essential. This article describes the efforts of a interdisciplinary team to develop and implement a hip fracture protocol that directs the care of patients from admission in the emergency room to a planned discharge. The ideal process of care is driven by quality measures and evidence-based practice consisting of early medical screening, early surgical intervention and ambulation, physical therapy, deep vein thrombosis prophylaxis, and appropriate discharge planning.

Academic Medical Centers↗

PubMed2006

Late miscarriage and preterm birth after treatment with clindamycin: a randomised consent design study according to Zelen.

OBJECTIVE: To screen for bacterial vaginosis (BV) and to investigate the effect of treatment with vaginal clindamycin in order to observe the effect on late miscarriage and delivery prior to 37 completed weeks (primary outcome). DESIGN: Randomised consent design for clinical trials according to Zelen. SETTING: Southeast region of Sweden. POPULATION: A total of 9025 women were screened in early pregnancy. METHODS: A total of 819 women with a Nugent score of 6 and above were considered to have BV and treated according to Zelen allocation. The incidence of late miscarriage and spontaneous (noniatrogenic) preterm birth was assessed. MAIN OUTCOME MEASURES: Late miscarriage and spontaneous preterm delivery before 37 weeks. RESULTS: Therapy with vaginal clindamycin had no significant impact on the incidence of spontaneous preterm delivery prior to 37 completed weeks; OR 0.90, 95% CI 0.40-2.02 (primary outcome variable). However, only 1 of 11 women in the treatment group versus 5 of 12 in the control group delivered prior to 33 completed weeks; OR 0.14, 95% CI 0.02-0.95. Treatment was associated with 32 days longer gestation for the 23 participants who had late miscarriage or spontaneous preterm birth (P= 0.024, Mann-Whitney U test) and significantly fewer infants had a birthweight below 2,500 g (secondary outcome). A follow up of infants born preterm 4 years postnatally indicated that extending gestational age did not increase the number of sequelae. CONCLUSIONS: Clindamycin vaginal cream therapy was associated with significantly prolonged gestation and reduced cost of neonatal care in women with BV. Early screening for BV and treatment with clindamycin saved approximately 27 euro per woman.

Abortion, Spontaneous↗

PubMed1999

Otological evaluation of newborns who failed otoacoustic emission screening.

Early identification of congenital hearing loss and early rehabilitation is extremely important. Otoacoustic emissions (OAE) are an efficient tool for hearing screening. Previous studies using click evoked otoacoustic emissions (CEOAEs) for newborn hearing screening resulted in approximately 70% pass rate, reflecting intact hearing. The aim of our study was to perform a detailed otological evaluation of newborns who failed OAE screening, using otoscopy, tympanometry and ABR. CEOAEs were recorded from 257 newborns prior to their release from the hospital. Those babies who did not pass the CEOAE were examined by DPOAE, otoscopy, tympanometry and ABR, if needed. 73% of all the newborns had CEOAE in both ears. 20% had CEOAE in only one ear. When the test was administered again three days postpartum, the CEOAE pass rate increased; 98% passed in at least one ear. Most of the newborns (84%) who failed had an obstruction of the external ear canal (collapsed ear canal or debris). There was a good correlation between the otoscopy and the tympanometry. Based on the above results, a newborn hearing screening protocol was introduced.

Deafness↗

PubMed2002

A prostate cancer primer.

Prostate cancer is the second most commonly diagnosed malignancy in men and remains the second leading cause of cancer deaths among this population. Early screening and diagnosis, advances in preventive techniques, and existing cutting-edge treatments are part of a multidimensional approach in an ongoing battle to improve the health of millions of men. This primer was designed to familiarize nurses with basic facts about prostate cancer and its management. The epidemiology of prostate cancer and its risk factors, clinical manifestations, screening and early diagnosis, treatment strategies, and implications for urologic nurses are presented.

Humans↗

PubMed1989

[Incidence of craniostenosis in data from the pediatric neurologic department with emphasis on children of gypsy origin].

The authors analyzed in material extending over twenty years from the neurological department of the regional paediatric hospital in Kosice the incidence of craniostenosis, focused on gypsy children, as compared with the number of population in the East Slovakian region of the gypsy ethnic group, and the incidence of the disease in non-gypsy children. Analysis revealed a relatively increased incidence of craniostenosis in children of gypsy origin--a total of 0.11% cases, while the incidence in children of non-gypsy parents was 0.01%. In both groups boys predominated over girls. In some non-gypsy children also developmental anomalies were detected which thus could be classified into syndromes. By early screening and early surgical operation it is possible to prevent inferior development of thus affected children as well as serious sequelae with a fatal outcome.

Adolescent↗

PubMed1988

Random blood glucose sampling as an early antenatal screening test for diabetes mellitus.

Random blood glucose was measured on 1,992 pregnant women during the initial attendance at our antenatal clinic. The visit usually took place during the first part of the second trimester. Women with a random blood glucose concentration in excess of 6.1 mmol/l within 2 hours of the last meal and 5.6 mmol/l more than 2 hours after the last meal were referred for a fasting blood glucose measurement. A 75 g oral glucose tolerance test was performed in those cases where the fasting blood glucose exceeded 4.0 mmol/l. The cut-off levels were exceeded in 22 cases, but only one of these women was found to be suffering from previously unsuspected diabetes mellitus, based on the criteria of WHO (1). Five other cases of gestational diabetes were not detected by the random blood glucose method. It is concluded that random blood glucose measurements cannot be recommended as a safe and reliable screening procedure during the early part of the second trimester.

Adult↗

PubMed2004

Screening and early detection of skin cancer.

Skin cancer is the most common type of cancer in the United States. US incidence of malignant melanoma is increasing faster than any other type of cancer. To minimize increasing morbidity and mortality rates, it is imperative that appropriate screening and early detection of skin cancer become more widespread. All physicians who see patients clinically have the potential for detecting skin cancers. The scope of skin cancer as a health-care problem is discussed. Evidence for the effectiveness and necessity of skin cancer screening and early detection is presented. Costs of screening and detection are discussed in relation to impact on treatment costs and overall costs of skin cancer burden. Current methods and recommendations for skin cancer screening and detection are reviewed, especially with regard to individuals and populations that may require more specialized or intensive screening and follow-up. Newer approaches involving instrument-assisted screening and detection of skin cancer are under intense development, and these exciting emerging technologies are reviewed.

Early Diagnosis↗

PubMed2003

Current concepts in universal newborn hearing screening and early hearing detection and intervention programs.

Newborns are routinely screened for hearing loss; screening typically occurs in the newborn nursery and newborn intensive care unit. Understanding the process and outcomes of initial hearing screening and ongoing early hearing detection and intervention programs (EHDI) are important roles of the newborn/neonatal intensive care (NICU) nurse. Infants that require NICU care are at higher risk of hearing loss and need close follow-up and repeat hearing testing throughout their first 3 years of life. Parents experience anxiety and worry related to potential hearing loss problems and need guidance, education, and information on infant hearing to ensure the best possible outcome for their infant.

Hearing Loss↗

PubMed1975

Two family studies on congenital dislocation of the hip after early orthopaedic screening Hungary.

Two family studies involving 1767 and 379 index patients in Budapest and Bekes county, respectively, were undertaken to examine the effect of early orthopaedic screening on the recurrence risk of congenital dislocation of the hip. About 14%, 2.1-2.3%,1.2-1.4%, and 4.7-6% of sibs, parents, uncles and aunts, and cousins, respectively, had congenital dislocation of the hip in these two surveys. The recurrence risks were eight-fold and four-fold higher in brothers and sisters, four times higher in parents, 2.5-fold higher in uncles and aunts, and 2.0-2.5 times higher in cousins, respectively, than in the general population. This family pattern seems to fit best with a model of polygenic-multifactorial inheritance. In earlier studies higher recurrence risks were found. These may be explained by the change of diagnosis due to early orthopaedic screening which may increase the possibility of over diagnosis and the treatment of mild cases which previously recovered spontaneously.

Adult↗

PubMedDate not supplied

Advances in sputum analysis for screening and early detection of lung cancer.

BACKGROUND: Screening for lung cancer using currently available techniques is not effective in reducing mortality from the disease. METHODS: Archived sputum specimens and clinical data linking specimens to lung cancer outcomes from prior screening programs have been reexamined to evaluate altered gene expressing, including specific oncogene activation and tumor suppressor gene deletion, as well as genomic instability and abnormal methylation. RESULTS: Several of these tests allow determination of a molecular diagnosis of cancer years before clinical presentation. CONCLUSIONS: These sputum tests provide an impetus to reconsider screening for lung cancer. Prospective trials are required to confirm test performance characteristics, and management and intervention strategies must be developed that are appropriate to the stage at which lung cancer is diagnosed.

Biomarkers, Tumor↗