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PubMed1993

Five-year experience of human immunodeficiency virus type 1 national screening program implemented at Veterans General Hospital-Taipei.

From July 1986 through June 1990, 33,199 sera from various risk groups were collected in Veterans General Hospital-Taipei for detection of antibody against human immunodeficiency virus, type 1 (HIV-1). Sixty-five samples were proved positive by Western blot analysis. Among individual high risk groups, hemophiliacs had the highest positive rate of 20/60 (29.41%), followed by homosexual/bisexual males (41/1,264, 3.24%). The overall positive rate was 65/33,199 (0.19%). Ten cases were recognized as acquired immunodeficiency syndrome (AIDS), 1 case had AIDS-related complex (ARC) and 4 case had other apparently symptomatic infections. Among these 15 cases, 7 expired, 1 lost of follow-up and 7 surviving cases are being treated with zidovudine (AZT). Most of symptomatic HIV-1 antibody positive cases had abnormal T4/T8 ratio of 0.39 +/- 0.54 as compared with the asymptomatic HIV-1 carriers at a ratio of 0.81 +/- 0.69. The opportunistic infections included Pneumocystis carinii pneumonia (PCP) in 6 case, disseminated cytomegalovirus infection in 6 cases, herpes zoster virus infection in 3 case, candidiasis in 4 cases, syphilis in 3 cases, pulmonary tuberculosis in 2 cases, and others with cryptococcosis, salmonellosis, Mycobacterium avium-intracellulare infection, gonorrhea, Staphylococcus aureus endocarditis and bacterial sepsis, etc. The natural history of HIV-1 infection to AIDS involved acute and persistent multiple infections. Although prevalence of HIV-1 infection was low in Taiwan, nationwide surveillance of HIV-1 infection in various risk groups is still needed.

AIDS-Related Opportunistic Infections↗
PubMed1998

The National Institutes of Health Anticonvulsant Drug Development Program: screening for efficacy.

The procedures employed by the ASP provide detailed information pertaining to the anticonvulsant profile of new candidate substances. In addition, the results obtained from tolerance and liver microsomal studies furnish critical information for predicting whether tolerance and/or serious drug-drug interactions are likely to develop following long-term administration of a candidate substance. Finally, in vitro mechanism-of-action studies supply preliminary information regarding the site of action of promising new anticonvulsant drugs. It is anticipated that the testing protocol outlined above will identify safer and mechanistically novel substances to enhance significantly the quality of life of those epilepsy patients still suffering from uncontrolled seizure disorders and/or experiencing significant adverse drug effects.

Animals↗
PubMed1996

Thyroid function in very low birth weight infants: effects on neonatal hypothyroidism screening.

OBJECTIVES: To supply normative data for screening thyroxine (T4) and thyrotropin concentrations correlated with birth weight and age at screening of infants with birth weights ranging from 400 to 5500 gm, and to document the effects of screening of very low birth weight (VLBW) infants, because VLBW infants comprise 0.86% of surviving newborn infants and have very low total T4 concentrations with normal or elevated free T4 concentrations as a result of deficient protein binding of thyroid hormones. STUDY DESIGN: Both retrospective and prospective studies were used. We conducted retrospective analyses of screening of T4 and thyrotropin concentrations in 9,324 term, 18,946 low birth weight, and 3,450 VLBW infants in Massachusetts, and a prospective study of T4 and thyrotropin concentrations in 48 VLBW infants at 2 weeks of age. Forty of the infants also had hormone measurements at 4 weeks, 29 at 8 weeks of age, and 24 had analysis of cord blood samples. RESULTS: Median T4 concentrations for each weight group (in 250 gm increments) increased progressively and significantly up to 2500 gm. Of the surviving VLBW infants, 1.5% had screening T4 concentrations that were unmeasurably low (<3.9 nmol/L (0.3 microgram/dl)). The mean T4 concentration varied with age at screening, increasing from cord blood concentrations to a peak at 1 to 3 days of age and thereafter decreasing to a nadir at about 2 weeks in both low birth weight and VLBW infants. In VLBW infants the mean concentrations return to the level of 1 to 3 days by 4 to 8 weeks of age. The incidence of screening thyrotropin concentrations > or = 40 mU/L correlates inversely with weight. The incidence of early, transient hypothyroidism in VLBW infants defined by this thyrotropin concentration was eight times that in term infants. Two infants had late-onset, transient hypothyroidism at 2 and 7 weeks, respectively. CONCLUSIONS: The normative data related to birth weight and age at screening allow proper interpretation of VLBW results for primary T4 and primary thyrotropin screening programs. Screening of the concentrations of T4 and thyrotropin in VLBW increases the number of secondary measurements of T4 in a primary thyrotropin screening program and the number of secondary thyrotropin measurements in a primary T4 screening program by 6% and 9%, respectively. We recommend screening analyses for VLBW infants in the latter part of the first week of life and again at 2 and 4 to 6 weeks of age. This protocol would increase the number of screening analyses by 1.6%.

Birth Weight↗
PubMedDate not supplied

Screening for spinal deformities in Minnesota schools.

Early detection of spine deformities by school screening has proven to be an effective mechanism for early diagnosis. The forward bending test is a simple rapid method of detection and has been used in the Minnesota State screening program. Screening in Minnesota began in 2 rural communities and spread to include the whole state. Over 570,000 children have been screened to the end of the 1975/1976 school year. The prevalence rate of 4.0% of rational prominences is the same as that found in other screening programs. The findings of a large number of small curves and the nearly equal sex ratio were unexpected, but reflect the recent literature. Even though a large number of normal spines are referred for physician evaluation by the screening, the benefits are great. The curves are detected when they are small, allowing progressive deformities to be detected early, promptly braced and deterioration prevented. The need for future surgical correction is thus decreased. The routine screening in Minnesota of school children for spine deformities has proved to be an effective method for the early detection of spine deformities. The screening test is rapid and easy--"a 30-second investment for a lifetime of dividends."

Braces↗
PubMedDate not supplied

[Program of neonatal screening for phenylketonuria].

A screening program for phenylketonuria in newborn infants that is being carried out at one of the Metropolitan Health Services at Santiago, Chile for the last 17 months, using the Guthrie test, is described. During this period 15,214 blood samples have been analyzed, which represented 94.4% coverage for beneficiary newborn infants. Two cases of transient hyperphenylalaninemia, one patient with benign hyperphenylalaninemia, and one infant with classical phenylketonuria have been thus identified. In this last child nutritional management was started at 13 days of life. Screening programs for early detection of phenylketonuria in Chile seem convenient, feasible and reliable.

Chile↗
PubMed2001

Reliability of isoelectrofocusing for the detection of Hb S, Hb C, and HB D in a pioneering population-based program of newborn screening in Brazil.

Out of 128,326 newborns in the first 6-month period of a population-based screening program in Minas Gerais, Brazil, a second sample was obtained at the age of 6 months from 4,635 carriers of Hbs AS, AC, and AD which were detected by isoelectrofocusing. Discordance in results occurred in only 27 cases (0.6%): in seven there was a history of hemotransfusion; errors during pipetting or transcription of results occurred in seven cases; it was difficult to differenciate between Hbs S and D in eight patients; and the causes were not elucidated in five patients. The incidence of Hbs FS and FSC for the total population was 1:2,800 and 1:3,450, respectively. Isoelectrofocusing is a very reliable method for distinguishing AS, AC, or AD carriers from patients presenting with [corrected] variant hemoglobin and beta(+)-thalassemia combinations, and may be widely used in massive newborn screening programs.

Anemia, Sickle Cell↗
PubMed1986

A community-based program of colorectal screening in an asymptomatic population: evaluation of screening tests and compliance.

The incidence of colorectal cancer in Ashkenazi Jews is two to three times higher than in non-Ashkenazis. For a community colorectal screening program 1339 asymptomatic Ashkenazis over 40 yr old were asked to participate. Of these 1012 (75%) took Hemoccult II kits [fecal occult blood tests (FOBT)], and 614 (46%) personally returned them. Screenees were interviewed regarding family and personal medical history. Fourteen persons (2.3%) had positive tests, in whom colonoscopy revealed two with cancer (Dukes' B,C) and two with a greater than 2 cm polyp. The remaining 600 persons were invited for flexible sigmoidoscopy (FS) but only 287 (48%) appeared. The mean depth of insertion of the instrument was 50.3 cm (range 30-120), but was poorer for women. FS identified lesions in 28 (9.7%) persons: three had Dukes' A carcinomas and 25 had less than 2 cm adenomatous polyps. Significantly more women than men accepted FOBT, but among those completing FOBT, there was no difference by sex for use of FS. Middle-aged persons (50-69 yr) found screening more acceptable than young or older persons. Among screenees who agreed to undergo FS, a significantly larger fraction had a first relative with colon cancer, or a personal history of colon or female genital neoplasia, compared to those not agreeing to FS. There were no differences in screenees with relatives with noncolon cancer. Eighty-eight couples completed FOBT and were invited for FS. The decision whether or not to participate was made for both members in 81 (92%) couples. In conclusion, effective screening programs have to take into consideration compliance patterns of the target population.

Adult↗