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At least 163 records · Page 9Linked to original sources
PubMed2006

Time to screen for proteinuria?

UNLABELLED: Screening for proteinuria in childhood is performed in some countries but remains a controversial subject. During the last decade, a greater understanding of the importance of proteinuria for the long-term prognosis of children with renal diseases has been gained. Exciting new data also show that proteinuria is a prognostic factor for long-term cardiovascular outcome. CONCLUSION: In my opinion, there are still not strong enough reasons to support the routine screening of healthy children for proteinuria.

Cardiovascular Diseases↗
PubMed2005

Chlamydia trachomatis: time for screening?

Genital Chlamydia trachomatis infection is the leading cause of bacterial sexually transmitted disease in industrialised countries, particularly among young people. The consequences of chlamydial infection may involve urethritis, cervicitis, pelvic inflammatory disease, ectopic pregnancy, tubal factor infertility, epididymitis and prostatitis. In addition, chlamydial infection increases the risk of acquisition of human immunodeficiency virus and has been associated with cervical cancer. Although screening programmes exist in a number of countries, the continuously increasing prevalence of chlamydial infections demonstrates the necessity for health authorities to establish effective screening policies, and the importance of defining a comprehensive European screening policy is emerging.

Chlamydia Infections↗
PubMed2004

[Limited value of prenatal risk group screening for heart abnormalities. Time for a general screening?].

544 fetuses at increased risk of cardiac malformations were examined by echocardiography from gestational week 14 to 40 (median 21), during the period January 1989-March 2002. A heart defect was diagnosed in 70 fetuses. Three false positive diagnoses and eight false negative diagnoses occurred (sensitivity 89 % and specificity 99 %). Seven were terminated (three with trisomy, two with concomitant diaphragmatic hernia and two with single ventricles) and eight died in utero. 22 of 52 liveborn infants died during the neonatal period. Fetal arrhythmia was diagnosed in 30 cases of which eight died prenatally. This risk group screening identified only 3.3 % of all infants with heart defects born during the study period. The ambition to diagnose a greater proportion prenatally would require a general screening program. In order to guarantee a high quality of specialized fetal cardiology service, referrals should be centralized to only a few units in the country.

Arrhythmias, Cardiac↗
PubMedDate not supplied

Objective assessment of gastrointestinal endoscopy skills using a virtual reality simulator.

BACKGROUND: This study was carried out to validate the role of virtual reality computer simulation as a method of assessment of psychomotor skills in gastrointestinal endoscopy. We aimed to investigate whether the GI Mentor II computer system (Simbionix Ltd.) was able to differentiate between subjects with different experience with GI endoscopy. METHODS: Twenty-eight subjects were included in the study. They were divided into 3 groups according to their experience with GI endoscopy: experienced [group 1, performed > 200 endoscopic procedures, (n = 8)] residents [group 2, performed < 50 endoscopic procedures, (n = 10)] and medical students [group 3, never performed GI endoscopy, (n = 10)]. All participants received identical pretest instruction on the simulator. Assessment of endoscopic skills was performed during a simulated colonoscopy and was based on parameters measured by the computer system: time, percentage of mucosa surface examined, efficiency of screening, time with a clear view, excessive local pressure, pain, time with pain, loop formation, and total time with a loop. RESULTS: Significant differences in performance existed between surgeons in the 3 groups. Experienced surgeons demonstrated best performance parameters, followed by the residents and the medical students. Significant differences in time (Kruskal-Wallis test, P < 0.001), percentage of mucosa surface examined (P = 0.001), efficiency of screening (P = 0.001), time with a clear view (P = 0.001), pain experienced (P = 0.004), time with pain (P = 0.012), loop formation (P < 0.001), time with a loop (P < 0.001), and excessive local pressure (P = 0.001) were demonstrated. Significant differences existed between group 1 and 2 and 1 and 3 (Mann-Whitney test, P < 0.05). Differences between groups 2 and 3 did not reach statistical significance (P > 0.05). CONCLUSIONS: The VR simulator was able to differentiate between subjects with different endoscopic experience. This indicates that the GI Mentor measures skills relevant for gastrointestinal endoscopy and can be used in training programs as an assessment tool.

Computer Simulation↗
PubMed2026

Association of media use with sleep of children and adolescents: an umbrella review.

Adequate sleep is essential for child and adolescent development, driving extensive research across scientific disciplines. This umbrella review provides a comprehensive overview of existing evidence on media consumption and sleep and thereby lays the foundation for identifying key concepts and gaps. An inclusive systematic search for reviews reporting literature searches was conducted in 02/2021 and updated last in 09/2024. Methodological quality of the included reviews was assessed using AMSTAR-2. We included 84 reviews reporting on the association between media use and sleep in individuals aged 0-18 years. The field is dominated by reviews of low methodological quality, mainly including original cross-sectional studies with subjective measures in older children and adolescents. A total of 475 original articles were covered by the reviews; only 10 of them appeared in at least seven and at most nine reviews. Screen time generally had a negative impact on sleep, though evidence varied from very low to strong. Evidence for effects of conventional books on sleep remains inconclusive. High quality systematic reviews are needed to evaluate robust studies using objective measures of sleep and contemporary media use across all age groups up to adolescence and to explore the impact of non-digital media use on sleep, considering age and gender differences.

Humans↗
PubMed1994

Will early detection of breast cancer reduce the costs of treatment?

A substantial investment in resources is required to provide a population-based mammography screening program. At the same time, screening may also reduce the costs of treating breast cancer. Empirical evidence to support such cost savings, however, is limited. This paper presents a simulation of the impact on treatment costs of a population-based mammography screening program in New South Wales. A 1991 cohort of women aged 45 to 69 years is followed for the period 1991 to 2023. With two-yearly screening, the present value of the total health service costs for this cohort would be approximately $112 million. Primary treatment, at $60 million, would cost $5 million more with screening than without. Treatment for advanced stages of the disease would cost $22 million less. Overall, this analysis suggests that savings in treatment costs are relatively small in relation to the overall resource requirements of organised screening.

Aged↗
PubMed1990

[Sprengel's deformity].

The authors deal with etiology, pathological anatomy and clinical finding in inborn high-riding scapula--the so-called Sprengel deformity. What is the best treatment tactics? Is the conservative treatment more suitable than the surgical one, or vice versa? By comparing their own experience with the data in the specialized literature the authors advocate a strictly individualized approach to each affected patient. After determining the diagnosis of Sprengel deformity it is necessary to evaluate the position of the scapula and the extent of the limitation of the range of motion of the respective shoulder-girdle. At the same time it is essential to consider the ability of the child and his parents to cooperate in the period of the postoperative rehabilitation. The rehabilitation carried out properly in the postoperative period is equally important as the perfect performance of the surgery. In more severe grades of affection combined with greater functional limitation of the ipsilateral shoulder the authors recommend the surgical treatment using the Green procedure with additional subperiosteal osteotomy of the ipsilateral clavicle (morcellation). The aim of the operation consists in the reduction of the scapula with simultaneous extraperiosteal release of most muscles inserted on the scapula. At the same time the os omovertebrale, if present, is always removed. The congruency of the anterior surface of the scapula and the thoracic wallis achieved by the resection of the supraspinatus part of the scapula. The proper position of the reduced scapula is ensured both by the reinsertion of muscle insertions to new, functionally more advantageous parts and by the fixation of the interior angle of the scapula in a newly created "pocket" in m. latissimus dorsi. Immediately after operation the proper position of the scapula is ensured by wire cerclage, distally anchored to the contralateral spica cast. The authors evaluate a group of 7 patients operated on at the Orthopaedic Clinic of the Institute for Further Education of Physicians, Teaching Hospital at Bulovka in Prague in the period of 1980-1987. Ensuing from the evaluation is the fact that in all deformities of III grade according to Cavendish the results achieved were satisfactory. On the other hand, the deformities of IV grade are difficult to treat even by operation. Only in one case the result was partially successful. In the conclusion the authors recommend a timely screening of the deformity, its timely operation (up to the age of 4 years) and indication carefulness in elder children.

Child↗