Science.gov

Sample records for prospective screening study

  1. Prospective performance evaluation of selected common virtual screening tools. Case study: Cyclooxygenase (COX) 1 and 2

    PubMed Central

    Kaserer, Teresa; Temml, Veronika; Kutil, Zsofia; Vanek, Tomas; Landa, Premysl; Schuster, Daniela

    2015-01-01

    Computational methods can be applied in drug development for the identification of novel lead candidates, but also for the prediction of pharmacokinetic properties and potential adverse effects, thereby aiding to prioritize and identify the most promising compounds. In principle, several techniques are available for this purpose, however, which one is the most suitable for a specific research objective still requires further investigation. Within this study, the performance of several programs, representing common virtual screening methods, was compared in a prospective manner. First, we selected top-ranked virtual screening hits from the three methods pharmacophore modeling, shape-based modeling, and docking. For comparison, these hits were then additionally predicted by external pharmacophore- and 2D similarity-based bioactivity profiling tools. Subsequently, the biological activities of the selected hits were assessed in vitro, which allowed for evaluating and comparing the prospective performance of the applied tools. Although all methods performed well, considerable differences were observed concerning hit rates, true positive and true negative hits, and hitlist composition. Our results suggest that a rational selection of the applied method represents a powerful strategy to maximize the success of a research project, tightly linked to its aims. We employed cyclooxygenase as application example, however, the focus of this study lied on highlighting the differences in the virtual screening tool performances and not in the identification of novel COX-inhibitors. PMID:25916906

  2. Screening for Acromegaly in Patients with Carpal Tunnel Syndrome: A Prospective Study (ACROCARP).

    PubMed

    Zoicas, F; Kleindienst, A; Mayr, B; Buchfelder, M; Megele, R; Schöfl, C

    2016-07-01

    Early diagnosis of acromegaly prevents irreversible comorbidities and facilitates surgical cure. Carpal tunnel syndrome (CTS) is common in acromegaly and patients have often undergone surgery for CTS prior to the diagnosis of acromegaly. We hypothesized that screening CTS-patients for acromegaly could facilitate active case-finding. We prospectively enrolled 196 patients [135 women, 56.9 (range 23-103) years] who presented with CTS for surgery. Patients were asked about 6 symptoms suggestive of acromegaly using a questionnaire calculating a symptom score (0-6 points), and insulin-like-growth factor 1 (IGF-1) was measured. If IGF-1 was increased, IGF-1 measurement was repeated, and random growth hormone (GH) and/or an oral glucose tolerance test (OGTT) with assessment of GH-suppression were performed. The mean symptom score was 1.7±1.3 points. Three patients reported the maximal symptom score of 6 points, but none of them had an increased IGF-1. There was no correlation between the symptom score and IGF-1-SDS (standard deviation score) (r=0.026; p=0.71). Four patients had an IGF-1>2 SDS. In 2 patients acromegaly was ruled out using random GH and OGTT. One patient had normal IGF-1 and random GH at follow-up. One patient refused further diagnostics. In this prospective cohort of patients with CTS, the observed frequency of acromegaly was at most 0.51% (95% CI 0.03 to 2.83%). In this prospective study, none of the 196 patients with CTS had proven acromegaly. Thus, we see no evidence to justify general screening of patients with CTS for acromegaly. PMID:26849823

  3. Prospective study of predictors of attendance for breast screening in inner London.

    PubMed Central

    Sutton, S; Bickler, G; Sancho-Aldridge, J; Saidi, G

    1994-01-01

    OBJECTIVE--To investigate the predictors of first-round attendance for breast screening in an inner city area. DESIGN--Prospective design in which women were interviewed or completed a postal questionnaire before being sent their invitation for breast screening. Sociodemographic factors, health behaviours, and attitudes, beliefs, and intentions were used as predictors of subsequent attendance. A randomised control group was included to assess the effect of being interviewed on attendance. SETTING--Three neighbouring health districts in inner south east London. PARTICIPANTS--A total of 3291 women aged 50-64 years who were due to be called for breast screening for the first time. The analysis of predictors was based on a subsample of 1301, reflecting a response rate of 75% to interview and 36% to postal questionnaire. MAIN RESULTS--Attendance was 42% overall, and 70% in those who gave an interview or returned a questionnaire. There was little evidence for an interview effect on attendance. The main findings from the analysis of predictors are listed below. (These were necessarily based on those women who responded to interview/questionnaire and so may not be generalisable to the full sample.) (1) Sociodemographic factors: Women in rented accommodation were less likely to go for screening but other indicators of social class and education were not predictive of attendance. Age and other risk factors for breast cancer were unrelated to attendance, as was the distance between home and the screening centre. Married or single women were more likely to attend than divorced, separated, or widowed women, and black women had a higher than average attendance rate; however, neither of these relationships was found in the interview sample. (2) Health behaviours: Attenders were less likely to have had a recent breast screen, more likely to have had a cervical smear, more likely to go to the dentist for check ups, and differed from non-attenders with regard to drinking frequency

  4. Screening for Vulnerability in Older Cancer Patients: The ONCODAGE Prospective Multicenter Cohort Study

    PubMed Central

    Soubeyran, Pierre; Bellera, Carine; Goyard, Jean; Heitz, Damien; Curé, Hervé; Rousselot, Hubert; Albrand, Gilles; Servent, Véronique; Jean, Olivier Saint; van Praagh, Isabelle; Kurtz, Jean-Emmanuel; Périn, Stéphane; Verhaeghe, Jean-Luc; Terret, Catherine; Desauw, Christophe; Girre, Véronique; Mertens, Cécile; Mathoulin-Pélissier, Simone; Rainfray, Muriel

    2014-01-01

    Background Geriatric Assessment is an appropriate method for identifying older cancer patients at risk of life-threatening events during therapy. Yet, it is underused in practice, mainly because it is time- and resource-consuming. This study aims to identify the best screening tool to identify older cancer patients requiring geriatric assessment by comparing the performance of two short assessment tools the G8 and the Vulnerable Elders Survey (VES-13). Patients and Methods The diagnostic accuracy of the G8 and the (VES-13) were evaluated in a prospective cohort study of 1674 cancer patients accrued before treatment in 23 health care facilities. 1435 were eligible and evaluable. Outcome measures were multidimensional geriatric assessment (MGA), sensitivity (primary), specificity, negative and positive predictive values and likelihood ratios of the G8 and VES-13, and predictive factors of 1-year survival rate. Results Patient median age was 78.2 years (70-98) with a majority of females (69.8%), various types of cancer including 53.9% breast, and 75.8% Performance Status 0-1. Impaired MGA, G8, and VES-13 were 80.2%, 68.4%, and 60.2%, respectively. Mean time to complete G8 or VES-13 was about five minutes. Reproducibility of the two questionnaires was good. G8 appeared more sensitive (76.5% versus 68.7%, P =  0.0046) whereas VES-13 was more specific (74.3% versus 64.4%, P<0.0001). Abnormal G8 score (HR = 2.72), advanced stage (HR = 3.30), male sex (HR = 2.69) and poor Performance Status (HR = 3.28) were independent prognostic factors of 1-year survival. Conclusion With good sensitivity and independent prognostic value on 1-year survival, the G8 questionnaire is currently one of the best screening tools available to identify older cancer patients requiring geriatric assessment, and we believe it should be implemented broadly in daily practice. Continuous research efforts should be pursued to refine the selection process of older cancer patients

  5. A Prospective Study of the Incidence of Retinopathy of Prematurity in China: Evaluation of Different Screening Criteria.

    PubMed

    Li, Qiuping; Wang, Zonghua; Wang, Ruijuan; Tang, Hongyi; Chen, Haihua; Feng, Zhichun

    2016-01-01

    To investigate the incidence of Retinopathy of Prematurity (ROP) in Beijing, North China, and to evaluate the effectiveness of different ROP screening criteria, we conducted a prospective cohort study in a single-neonatal intensive care unit (NICU). A total of 2997 premature infants with birth weight (BW) ≤ 2000 g and/or gestational age (GA) ≤ 34 weeks had completed ROP screening. ROP was diagnosed in 356 (11.9%) infants. The mean GA was 30.46 ± 1.98 weeks and the mean BW was 1477.35 ± 371.29 g. Of the 59 (2.0%) infants receiving treatment, the mean GA was 29.37 ± 2.10 weeks, and the mean BW was 1240.80 ± 330.71 g. The incidence of ROP declined from 14.7% in 2009 and 11.1% in 2010 to 9.5% in 2011. The United Kingdom (UK) criteria could reduce the screening number by 40.8%, and 3 infants with type I ROP needing treatment were missed, but none in 2011. The United States (US) criteria could reduce the screening number by 66.5%, and 10 infants with type I ROP needing treatment were missed, including one in 2011. So the UK criteria may be appropriate for screening of ROP in our NICU in 2011. Future multisite epidemiologic studies are required to establish suitable ROP screening criteria in China. PMID:27382487

  6. A Prospective Study of the Incidence of Retinopathy of Prematurity in China: Evaluation of Different Screening Criteria

    PubMed Central

    Li, Qiuping; Wang, Zonghua; Wang, Ruijuan; Tang, Hongyi; Chen, Haihua

    2016-01-01

    To investigate the incidence of Retinopathy of Prematurity (ROP) in Beijing, North China, and to evaluate the effectiveness of different ROP screening criteria, we conducted a prospective cohort study in a single-neonatal intensive care unit (NICU). A total of 2997 premature infants with birth weight (BW) ≤ 2000 g and/or gestational age (GA) ≤ 34 weeks had completed ROP screening. ROP was diagnosed in 356 (11.9%) infants. The mean GA was 30.46 ± 1.98 weeks and the mean BW was 1477.35 ± 371.29 g. Of the 59 (2.0%) infants receiving treatment, the mean GA was 29.37 ± 2.10 weeks, and the mean BW was 1240.80 ± 330.71 g. The incidence of ROP declined from 14.7% in 2009 and 11.1% in 2010 to 9.5% in 2011. The United Kingdom (UK) criteria could reduce the screening number by 40.8%, and 3 infants with type I ROP needing treatment were missed, but none in 2011. The United States (US) criteria could reduce the screening number by 66.5%, and 10 infants with type I ROP needing treatment were missed, including one in 2011. So the UK criteria may be appropriate for screening of ROP in our NICU in 2011. Future multisite epidemiologic studies are required to establish suitable ROP screening criteria in China. PMID:27382487

  7. Cumulative risk of false positive test in relation to breast symptoms in mammography screening: a historical prospective cohort study.

    PubMed

    Singh, Deependra; Pitkäniemi, Janne; Malila, Nea; Anttila, Ahti

    2016-09-01

    Mammography has been found effective as the primary screening test for breast cancer. We estimated the cumulative probability of false positive screening test results with respect to symptom history reported at screen. A historical prospective cohort study was done using individual screening data from 413,611 women aged 50-69 years with 2,627,256 invitations for mammography screening between 1992 and 2012 in Finland. Symptoms (lump, retraction, and secretion) were reported at 56,805 visits, and 48,873 visits resulted in a false positive mammography result. Generalized linear models were used to estimate the probability of at least one false positive test and true positive at screening visits. The estimates were compared among women with and without symptoms history. The estimated cumulative probabilities were 18 and 6 % for false positive and true positive results, respectively. In women with a history of a lump, the cumulative probabilities of false positive test and true positive were 45 and 16 %, respectively, compared to 17 and 5 % with no reported lump. In women with a history of any given symptom, the cumulative probabilities of false positive test and true positive were 38 and 13 %, respectively. Likewise, women with a history of a 'lump and retraction' had the cumulative false positive probability of 56 %. The study showed higher cumulative risk of false positive tests and more cancers detected in women who reported symptoms compared to women who did not report symptoms at screen. The risk varies substantially, depending on symptom types and characteristics. Information on breast symptoms influences the balance of absolute benefits and harms of screening. PMID:27496148

  8. Primary cervical cancer screening with an HPV mRNA test: a prospective cohort study

    PubMed Central

    Fismen, Silje; Gutteberg, Tore Jarl; Mortensen, Elin Synnøve; Skjeldestad, Finn Egil

    2016-01-01

    Objectives To assess the performance of a 5-type human papillomavirus (HPV) messenger RNA (mRNA) test in primary screening within the framework of the Norwegian population-based screening programme. Design Nationwide register-based cohort study. Setting In 2003–2004, general practitioners and gynaecologists recruited 18 852 women for participation in a primary screening study with a 5-type HPV mRNA test. Participants After excluding women with a history of abnormal smears and with cervical intraepithelial neoplasia grade 2 (CIN2+) before or until 3 months after screening, 11 220 women aged 25–69 years were eligible for study participation. The Norwegian Cancer Registry completed follow-up of CIN2+ through 31 December 2009. Interventions Follow-up according to the algorithm for cytology outcomes in the population-based Norwegian Cervical Cancer Screening Programme. Main outcome measures We estimated cumulative incidence of CIN grade 3 or worse (CIN3+) 72 months after the 5-type HPV mRNA test. Results 3.6% of the women were HPV mRNA-positive at baseline. The overall cumulative rate of CIN3+ was 1.3% (95% CI 1.1% to 1.5%) through 72 months of follow-up, 2.3% for women aged 25–33 years (n=3277) and 0.9% for women aged 34–69 years (n=7943). Cumulative CIN3+ rates by baseline status for HPV mRNA-positive and mRNA-negative women aged 25–33 years were 22.2% (95% CI 14.5% to 29.8%) and 0.9% (95% CI 0.4% to 1.4%), respectively, and 16.6% (95% CI 10.7% to 22.5%) and 0.5% (95% CI 0.4% to 0.7%), respectively, in women aged 34–69 years. Conclusions The present cumulative incidence of CIN3+ is similar to rates reported in screening studies via HPV DNA tests. Owing to differences in biological rationale and test characteristics, there is a trade-off between sensitivity and specificity that must be balanced when decisions on HPV tests in primary screening are taken. HPV mRNA testing may be used as primary screening for women aged 25–33 years and

  9. Screening for symptomatic metal sensitivity: a prospective study of 92 patients undergoing total knee arthroplasty.

    PubMed

    Niki, Yasuo; Matsumoto, Hideo; Otani, Toshiro; Yatabe, Taku; Kondo, Makoto; Yoshimine, Fumihiro; Toyama, Yoshiaki

    2005-03-01

    Metal sensitivity (MS) reactions to implant metals represent a rare but well-documented complication following total joint arthroplasty (TJA). Although 20-25% of post-TJA patients develop MS, only a few highly susceptible patients (< 1%) exhibit symptoms. Whether surgeons should perform screening for MS is currently a matter of debate. The present study investigated the clinical importance of screening for patients predisposed to symptomatic MS, and the specific metals causing symptomatic MS following total knee arthroplasty (TKA). Between 2000 and 2002, a total of 108 primary TKAs were performed on 92 patients. Preoperatively, all patients underwent modified lymphocyte stimulation test (mLST) to Ni, Co, Cr, and Fe. Of the 92 patients, 24 (26%) displayed positive preoperative responses to at least one metal. Five patients displayed implant metal-related eczema and were all mLST-positive preoperatively, suggesting that screening for symptomatic MS is clinically useful. Two of these underwent revision TKA and thereafter, eczema healed and mLST results changed from positive to negative. All mLST-positive patients were divided into three groups: Group I, patients with eczema; Group II, patients with clear history of MS; and Group III, patients neither eczema nor history of MS. When the type of sensitive metals were compared among the three groups, a significant association between presence of Cr-sensitivity and development of eczema (P < 0.05) was identified. No significant association was observed between other metals and development of eczema or history of MS. This indicates that Cr is a potential candidate metal for causing eczema in our TKA series, and Cr-sensitivity may offer a potential predictor for symptomatic MS. The present study indicates that the surgeons should undertake routine preoperative screening for MS, particularly to Cr. PMID:15369690

  10. Alloimmunization screening after transfusion of red blood cells in a prospective study

    PubMed Central

    Alves, Vitor Mendonça; Martins, Paulo Roberto Juliano; Soares, Sheila; Araújo, Gislene; Schmidt, Luciana Cayres; Costa, Sidneia Sanches de Menezes; Langhi, Dante Mário; Moraes-Souza, Helio

    2012-01-01

    Background Several irregular red blood cell alloantibodies, produced by alloimmunization of antigens in transfusions or pregnancies, have clinical importance because they cause hemolysis in the fetus and newborn and in transfused patients. Objective a prospective analysis of patients treated by the surgical and clinical emergency services of Hospital de Clínicas of the Universidade Federal do Triângulo Mineiro (HC/UFTM), Brazil was performed to correlate alloimmunization to clinical and epidemiological data. Methods Blood samples of 143 patients with initial negative antibody screening were collected at intervals for up to 15 months after the transfusion of packed red blood cells. Samples were submitted to irregular antibody testing and, when positive, to the identification and serial titration of alloantibodies. The Fisher Exact test and Odds Ratio were employed to compare proportions. Results Fifteen (10.49%) patients produced antibodies within six months of transfusion. However, for 60% of these individuals, the titers decreased and disappeared by 15 months after transfusion. Anti-K antibodies and alloantibodies against antigens of the Rh system were the most common; the highest titer was 1:32 (anti-K). There was an evident correlation with the number of transfusions. Conclusions Given the high incidence of clinically important red blood cell alloantibodies in patients transfused in surgical and clinical emergency services, we suggest that phenotyping and pre-transfusion compatibilization for C, c, E, e (Rh system) and K (Kell system) antigens should be extended to all patients with programmed surgeries or acute clinical events that do not need emergency transfusions. PMID:23049421

  11. Prospective Screening for Blunt Cerebrovascular Injuries

    PubMed Central

    Miller, Preston R.; Fabian, Timothy C.; Croce, Martin A.; Cagiannos, Catherine; Williams, J. Scott; Vang, Meng; Qaisi, Waleed G.; Felker, Richard E.; Timmons, Shelly D.

    2002-01-01

    Objective To prospectively examine outcomes associated with an aggressive screening protocol for blunt cerebrovascular injury (BCVI), and to compare the accuracy of computed tomographic angiography (CTA) and magnetic resonance angiography (MRA) versus conventional angiography with respect to BCVI diagnosis. Summary Background Data In the past 5 years, BCVI (carotid and vertebral arteries) has been recognized with increasing frequency. Initial studies described blunt carotid injuries and their associated morbidity, while more recent reports have established the devastating potential of blunt vertebral injuries. It has been suggested that early diagnosis and anticoagulation will improve outcomes and that less-invasive diagnostic techniques than conventional angiography are desirable for screening. However, there are neither established screening criteria nor studies comparing optimal diagnostic modalities. Methods The screened population included all patients with cervical spine fractures, LeFort II or III facial fractures, Horner’s syndrome, skull base fractures involving the foramen lacerum, neck soft tissue injury, or neurological abnormalities unexplained by intracranial injuries. Patients underwent screening with four-vessel cerebral angiography. During the first half of the study, patients also underwent helical CTA. Selected patients during this same period underwent MRA. At the time of diagnosis, anticoagulant or antiplatelet therapy was instituted unless clinically contraindicated. Results of this screening protocol were compared to a previously published cohort with cerebrovascular injuries (1995–1999) from the authors’ institution. Results Two hundred sixteen patients were screened over a 2-year period (3.5% of all blunt trauma admissions). Angiography identified 24 patients with carotid artery injuries (CAI) and 43 patients with vertebral artery injuries (VAI) for an overall screening yield of 29%. While the incidence of CAI remained similar between

  12. Comparing two theories of health behavior: a prospective study of noncompletion of treatment following cervical cancer screening.

    PubMed

    Orbell, Sheina; Hagger, Martin; Brown, Val; Tidy, John

    2006-09-01

    Some women receiving abnormal cervical screening tests do not complete recommended treatment. A prospective study (N = 660) investigated the value of conceptualizing attendance at colposcopy for treatment as either (a) an active problem-solving response to a health threat, motivated by attitudes toward an abnormal result, as implied by self-regulation theory (H. Leventhal, D. Meyer, & D. Nerenz, 1980); or (b) as a behavior motivated by attitudes toward clinic attendance, as implied by the theory of planned behavior (TPB; I. Ajzen, 1985). Responses to questionnaires containing variables specified by these models were used to predict women's subsequent attendance or nonattendance for treatment over the following 15 months. Although the TPB offered superior prediction of intentions and completion of treatment, discriminant function analyses showed that consideration of both models was important in distinguishing between those who attended all their appointments as scheduled, attended after being prompted, or ceased attending. Implications for measurement and theory in health protection are discussed. PMID:17014278

  13. Validity of self-reported hysterectomy: a prospective cohort study within the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS)

    PubMed Central

    Gentry-Maharaj, Aleksandra; Taylor, Henry; Kalsi, Jatinderpal; Ryan, Andy; Burnell, Matthew; Sharma, Aarti; Apostolidou, Sophia; Campbell, Stuart; Jacobs, Ian; Menon, Usha

    2014-01-01

    Objective To evaluate the validity of self-reported hysterectomy against the gold standard of uterine visualisation using pelvic ultrasound. Design Prospective cohort study. Setting UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS) based in 13 National Health Service (NHS) Trusts in England, Wales and Northern Ireland. Participants Between April 2001 and October 2005, 48 215 postmenopausal women aged 50–74 randomised to the ultrasound screening arm of UKCTOCS underwent the first (initial) scan on the trial. Interventions At recruitment, the women completed a recruitment questionnaire (RQ) which included previous hysterectomy. The sonographer asked each woman regarding previous hysterectomy (interview format, IF) prior to the scan. At the scan, in addition to ovarian morphology, endometrial thickness (ET)/endometrial abnormality were captured if the uterus was visualised at the scan. Outcome measures Self-reported hysterectomy at RQ or IF was compared to ultrasound data on ET/endometrial abnormality (as surrogate uterine visualisation markers) on the first (initial) scan. Results Of 48 215 women, 3 had congenital uterine agenesis and 218 inconclusive results. The uterus was visualised in 39 121 women. 8871 self-reported hysterectomy at RQ, 8641 at IF and 8487 at both. The uterus was visualised in 39 123, 39 353 and 38 969 women not self-reporting hysterectomy at RQ, IF or both. Validity, sensitivity, specificity, positive predictive value and negative predictive value of using RQ alone, IF or both RQ/IF were 99.6%, 98.9%, 99.7%, 98.9% and 99.7%; 98.9%, 98.4%, 99.1%, 95.9% and 99.7%; 99.8%, 99.6%, 99.9%, 99.4% and 99.9%, respectively. Conclusions Self-reported hysterectomy is a highly accurate and valid source for studying long-term associations of hysterectomy with disease onset. Trial registration International Standard Randomised Controlled Trial Number (ISRCTN)—22488978 PMID:24589827

  14. Prospective Study of Congenital Toxoplasmosis Screening with Use of IgG Avidity and Multiplex Nested PCR Methods ▿

    PubMed Central

    Yamada, Hideto; Nishikawa, Akira; Yamamoto, Tomohiro; Mizue, Yuka; Yamada, Takashi; Morizane, Mayumi; Tairaku, Shinya; Nishihira, Jun

    2011-01-01

    Acute infection with Toxoplasma gondii during pregnancy can cause congenital toxoplasmosis. The aim of this study was to evaluate whether screening with the use of IgG avidity and multiplex nested PCR methods was effective to detect a high-risk pregnancy. In a prospective study, serum T. gondii IgG avidity was measured in consecutive 146 pregnant women testing positive for T. gondii antibody and either positive or equivocal for IgM. Multiplex nested PCR for T. gondii DNA on amniotic fluid, maternal blood, and umbilical cord blood were performed with informed consent. A total of 51 (34.9%) women presented with low IgG avidity (<30%), 15 (10.3%) presented with borderline avidity (30 to 35%), and 80 (54.8%) presented with high avidity (>35%) indices. Amniotic fluid obtained at amniocentesis or birth yielded positive PCR results in nine women with low IgG avidity indices. Of these nine women, three had congenital toxoplasmosis. None of women with high or border line IgG avidity indices had a positive PCR result in the amniotic fluid or congenital toxoplasmosis. No congenital toxoplasmosis was detected in women whose amniotic fluids yielded negative PCR results. Ingestion of raw or undercooked meat was found to be the main risk factor for acute T. gondii infection. Congenital toxoplasmosis screening with a combination of IgG avidity in the maternal blood and multiplex nested PCR in the amniotic fluid was useful for detecting a high risk pregnancy and diagnosing congenital toxoplasmosis. PMID:21543572

  15. Feasibility of nephrinuria as a screening tool for the risk of pre-eclampsia: prospective observational study

    PubMed Central

    Zhai, Tianyue; Furuta, Itsuko; Akaishi, Rina; Kawabata, Kosuke; Chiba, Kentaro; Umazume, Takeshi; Ishikawa, Satoshi; Yamada, Takahiro; Morikawa, Mamoru; Minakami, Hisanori

    2016-01-01

    Objectives To investigate the possibility of nephrinuria as a screening tool for the risk of pre-eclampsia (PE). Design Prospective observational study. Setting A single university hospital. Changes in urinary nephrin:creatinine ratio (NCR, ng/mg) and protein:creatinine ratio (PCR, mg/mg) in pregnancy were determined. Significant proteinuria in pregnancy (SPIP) was defined as PCR>0.27. PE was diagnosed in women with both SPIP and hypertension. Participants 89 pregnant women in whom neither hypertension nor SPIP was present at enrolment, providing 31, 125 and 93 random urine samples during first, second and third trimesters, respectively. Results PE developed in 14 of the 89 women. NCR increased with increasing PCR in 14 women with PE (correlation coefficient, 0.862; p<0.0001). In contrast, NCR did not change significantly despite significant increases in PCR in 75 women with normotensive pregnancies defined as neither SPIP nor hypertension, indicating that there was little increase in nephrinuria over the physiological range of proteinuria in pregnancy. Relative risk of later development of PE among asymptomatic second and third trimester women with NCR (ng/mg) >122 (95th centile value for 75 women with normotensive pregnancies) was 5.93 (95% CI 2.59 to 13.6; 60% (6/10) vs 10% (8/79)) and 13.5 (95% CI 3.31 to 55.0; 75% (6/8) vs 5.5% (2/36)), respectively, compared with women with NCR≤122 at that time. Conclusions Nephrinuria was unlikely to increase in normal pregnancy. A certain NCR cut-off may efficiently differentiate women at higher risk of PE. PMID:27486123

  16. The Belgian Diabetes in Pregnancy Study (BEDIP-N), a multi-centric prospective cohort study on screening for diabetes in pregnancy and gestational diabetes: methodology and design

    PubMed Central

    2014-01-01

    Background The International Association of Diabetes and Pregnancy Study Groups (IADPSG) recommends universal screening with a 75 g oral glucose tolerance test (OGTT) using stricter criteria for gestational diabetes (GDM). This may lead to important increases in the prevalence of GDM and associated costs, whereas the gain in health is unclear. The goal of ‘The Belgian Diabetes in Pregnancy Study’ (BEDIP-N) is to evaluate the best screening strategy for pregestational diabetes in early pregnancy and GDM in an ethnically diverse western European population. The IADPSG screening strategy will be followed, but in addition risk questionnaires and a 50 g glucose challenge test (GCT) will be performed, in order to define the most practical and most cost effective screening strategy in this population. Methods BEDIP-N is a prospective observational cohort study in 6 centers in Belgium. The aim is to enroll 2563 pregnant women in the first trimester with a singleton pregnancy, aged 18–45 years, without known diabetes and without history of bariatric surgery. Women are universally screened for overt diabetes and GDM in the first trimester with a fasting plasma glucose and for GDM between 24–28 weeks using the 50 g GCT and independently of the result of the GCT, all women will receive a 75 g OGTT using the IADPSG criteria. Diabetes and GDM will be treated according to a standardized routine care protocol. Women with GDM, will be reevaluated three months postpartum with a 75 g OGTT. At each visit blood samples are collected, anthropometric measurements are obtained and self-administered questionnaires are completed. Recruitment began in April 2014. Discussion This is the first large, prospective cohort study rigorously assessing the prevalence of diabetes in early pregnancy and comparing the impact of different screening strategies with the IADPSG criteria on the detection of GDM later in pregnancy. Trial registration ClinicalTrials.gov: NCT02036619. Registered 14

  17. Using postural reactions as a screening test to identify high-risk infants for cerebral palsy: a prospective study.

    PubMed

    Zafeiriou, D I; Tsikoulas, I G; Kremenopoulos, G M; Kontopoulos, E E

    1998-08-01

    To clarify the predictive value of the seven more commonly used postural reactions (PR) in the 1st year of life regarding the diagnosis of cerebral palsy (CP), we prospectively examined 204 high-risk infants of whom 58 developed CP, 22 had developmental retardation (DR) and 124 were normal at follow-up at 3 years of age. Abnormalities of five or more PR from the 1st month of life were correlated with spastic CP, while five or six abnormal PR were also correlated with athetoid CP. Three or less abnormal PR correlated with a normal outcome. All seven PR tested were significantly abnormal in children with spastic CP from the 1st month compared to normal children. Athetoid children demonstrated abnormalities of the Peiper-Isbert (P-I) reaction and Vojta reaction from the 1st month and of the vertical, horizontal and Collis vertical suspension from the 3rd month. Children with DR had significantly abnormal Collis horizontal and Collis vertical suspension, Vojta reaction and traction response from the 1st month and Peiper-Isbert reaction from the 3rd month. Ataxic children demonstrated significantly abnormal traction response from the 1st month, Collis horizontal reaction from the 7th month and Peiper-Isbert reaction from the 11th month. We conclude that the examination of PR is a useful quantitative and qualitative diagnostic screening tool for high-risk infants from the 1st month of life. PMID:9761000

  18. Offering fragile X syndrome carrier screening: a prospective mixed-methods observational study comparing carrier screening of pregnant and non-pregnant women in the general population

    PubMed Central

    Martyn, M; Anderson, V; Archibald, A; Carter, R; Cohen, J; Delatycki, M; Donath, S; Emery, J; Halliday, J; Hill, M; Sheffield, L; Slater, H; Tassone, F; Younie, S; Metcalfe, S

    2013-01-01

    Introduction Fragile X syndrome (FXS) is the leading cause of inherited intellectual and developmental disability. Policy development relating to carrier screening programmes for FXS requires input from large studies examining not only test uptake but also psychosocial aspects. This study will compare carrier screening in pregnant and non-pregnant populations, examining informed decision-making, psychosocial issues and health economics. Methods and Analysis Pregnant and non-pregnant women are being recruited from general practices and obstetric services. Women receive study information either in person or through clinic mail outs. Women are provided pretest counselling by a genetic counsellor and make a decision about testing in their own time. Data are being collected from two questionnaires: one completed at the time of making the decision about testing and the second 1 month later. Additional data are gathered through qualitative interviews conducted at several time points with a subset of participating women, including all women with a positive test result, and with staff from recruiting clinics. A minimum sample size of 500 women/group has been calculated to give us 88% power to detect a 10% difference in test uptake and 87% power to detect a 10% difference in informed choice between the pregnant and non-pregnant groups. Questionnaire data will be analysed using descriptive statistics and multivariate logistic regression models. Interview data will be thematically analysed. Willingness-to-pay and cost effectiveness analyses will also be performed. Recruitment started in July 2009 and data collection will be completed by December 2013. Ethics and Dissemination Ethics approval has been granted by the Universities of Melbourne and Western Australia and by recruiting clinics, where required. Results will be reported in peer-reviewed publications, conference presentations and through a website http://www.fragilexscreening.net.au. The results of this study will

  19. A Prospective Study of Socioeconomic Status, Prostate Cancer Screening and Incidence Among Men at High Risk for Prostate Cancer

    PubMed Central

    Rundle, Andrew; Neckerman, Kathryn M.; Sheehan, Daniel; Jankowski, Michelle; Kryvenko, Oleksandr N.; Tang, Deliang; Rybicki, Benjamin A.

    2012-01-01

    Purpose Higher socio-economic status (SES) men are at higher risk of prostate cancer (PCa) diagnosis, an association commonly interpreted as a function of higher rates of prostate screening among higher-SES men. However, the extent to which screening explains this association has not been well quantified. Methods Within a Detroit-area cohort of 6,692 men followed up after a benign prostate procedure, a case-control study was conducted of 494 PCa cases and controls matched on age, race, duration of follow-up, and date of initial benign finding. 2000 Census data were used in a principal component analysis to derive a single factor, labeled the Neighborhood SES Index (NSESI), representing zip code-level SES. Results Among cases, higher SES was associated with a younger age at initial biopsy: −1.48 years (95% CI, −2.32, −0.64) per unit NSESI. After adjustment for confounders and duration of follow-up, higher SES was associated with more PSA tests and DRE during follow-up; 9% (95% CI, 2, 16) and 8% (95% CI, 1, 15) more respectively, per unit NSESI. Higher SES was associated with a higher risk of PCa diagnosis during follow-up, multivariable adjusted OR = 1.26 per unit increase in NSESI (95% CI, 1.04, 1.49). Further adjustment for screening frequency somewhat reduced the association between SES and PCa risk (OR = 1.19 per unit NSESI, 95% CI, 0.98, 1.44). Conclusions Differences in screening frequency only partially explained the association between higher zip code SES and PCa risk; other health care related factors should also be considered as explanatory factors. PMID:23224323

  20. The Screening Performance of Serum 1,3-Beta-D-Glucan in Patients with Invasive Fungal Diseases: A Meta-Analysis of Prospective Cohort Studies

    PubMed Central

    Hou, Tie-Ying; Wang, Shou-Hong; Liang, Sui-Xin; Jiang, Wen-Xin; Luo, Dan-Dong; Huang, De-Hong

    2015-01-01

    The serum 1,3-beta-D-glucan (BG) assay aids in the early diagnosis of invasive fungal diseases (IFDs) and has been approved for their diagnosis. However, reports on the screening performance of BG are scarce. We performed a meta-analysis of data extracted from only prospective cohort studies to evaluate the screening performance of the BG assay in the diagnosis of IFDs. We specifically searched 4 databases (the PubMed, Web of Science, Elsevier, and Cochrane Collaboration databases) according to EORTC-MSG criteria. A total of 1068 patients in 11 studies were analyzed. Deeks’ funnel plot asymmetry test suggested a low likelihood of publication bias for the included studies (p = 0.055). The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio, and area under the summary receiver operating characteristic curve, with 95% confidence intervals, were 0.75(0.63,0.84), 0.87(0.81,0.92), 5.85(3.96,8.63), 0.30(0.20,0.45), 19.53(11.16,34.18), and 0.89(0.86,0.91), respectively. The findings of this meta-analysis suggest that the BG assay is a useful screening tool with high sensitivity and specificity for discriminating between patients with and without IFDs. In clinical practice, BG assay results should be evaluated together with clinical and microbiological findings. PMID:26146829

  1. Does perceived risk predict breast cancer screening use? Findings from a prospective cohort study of female relatives from the Ontario site of the Breast Cancer Family Registry

    PubMed Central

    Walker, Meghan J.; Mirea, Lucia; Glendon, Gord; Ritvo, Paul; Andrulis, Irene L.; Knight, Julia A.; Chiarelli, Anna M.

    2014-01-01

    Summary Objective While the relationship between perceived risk and adherence to breast cancer screening guidelines has been studied extensively, the majority of studies are cross-sectional. We prospectively examined this relationship among women with familial risk. Materials and Methods The prospective association between perceived risk and screening behaviors was examined in 913 women aged 25 to 72, with varying levels of familial breast cancer risk from the Ontario site of the Breast Cancer Family Registry. Associations between perceived lifetime breast cancer risk and subsequent use of screening mammography, clinical breast examination (CBE) and genetic testing were assessed using logistic regression. Results Overall, perceived risk did not predict subsequent use of screening mammography, CBE or genetic testing. Women at moderate/high familial risk who perceived their risk as greater than 50% were significantly less likely to have a CBE (odds ratio (OR) = 0.52, 95% confidence interval (CI): 0.30–0.91, p=0.04), and less likely to have a mammogram (OR = 0.70, 95% CI: 0.40–1.20, p=0.70) or genetic test (OR = 0.61, 95% CI: 0.34–1.10, p=0.09) compared to women who perceive their risk as 50%. In contrast, women at low familial risk who perceived their risk as greater than 50% were non-significantly more likely to have a mammogram (OR = 1.13, 95% CI: 0.59–2.16, p=0.78), CBE (OR = 1.11, 95% CI: 0.63–1.95, p=0.74) or genetic test (OR = 1.29, 95% CI: 0.50– 3.33, p=0.35) compared to women who perceive their risk as 50%. Conclusion Perceived risk did not significantly predict subsequent screening use overall, however this relationship may be moderated by level of familial risk. Results may inform risk education and management strategies among women with varying levels of familial breast cancer risk. PMID:24821458

  2. Enhanced physical health screening for people with severe mental illness in Hong Kong: results from a one-year prospective case series study

    PubMed Central

    2014-01-01

    Background People with severe mental illness have significantly poorer physical health compared to the general population; previous health screening studies conducted outside Asian countries have demonstrated the potential in addressing this issue. This case series aimed to explore the effects and utility of integrating an enhanced physical health screening programme for community dwelling patients with severe mental illness into routine clinical practice in Hong Kong. Method This study utilises a consecutive prospective case series design. The serious mental illness Health Improvement Profile (HIP) was used as a screening tool at baseline and repeated at 12 months follow-up. Results A total of 148 community-based patients with severe mental illness completed the study. At one year follow-up analysis showed a significant improvement in self-reported levels of exercise and a reduction in the numbers of patients prescribed medications for diabetes However, mean waist circumference increased at follow-up. In addition to the statistically significant results some general trends were observed, including: a lack of deterioration in most areas of cardiovascular risk; a reduction in medicines prescribed for physical health problems; and general improvements in health behaviours over the 12 month period. Conclusions The findings demonstrate that using the HIP is feasible and acceptable in Hong Kong. The results of the enhanced physical health-screening programme are promising, but require further testing using a randomised controlled trial design in order to more confidently attribute the improvements in well-being and health behaviours to the HIP. Trial registration Clinical trial registration number: ISRCTN12582470 PMID:24576042

  3. Cardiovascular screening in adolescents and young adults: a prospective study comparing the Pre-participation Physical Evaluation Monograph 4th Edition and ECG

    PubMed Central

    Fudge, Jessie; Harmon, Kimberly G; Owens, David S; Prutkin, Jordan M; Salerno, Jack C; Asif, Irfan M; Haruta, Alison; Pelto, Hank; Rao, Ashwin L; Toresdahl, Brett G; Drezner, Jonathan A

    2015-01-01

    Background This study compares the accuracy of cardiovascular screening in active adolescents and young adults using a standardised history, physical examination and resting 12-lead ECG. Methods Participants were prospectively screened using a standardised questionnaire based on the Pre-participation Physical Evaluation Monograph 4th Edition (PPE-4), physical examination and ECG interpreted using modern standards. Participants with abnormal findings had focused echocardiography and further evaluation. Primary outcomes included disorders associated with sudden cardiac arrest (SCA). Results From September 2010 to July 2011, 1339 participants underwent screening: age 13–24 (mean 16) years, 49% male, 68% Caucasian, 17% African-American and 1071 (80%) participating in organised sports. Abnormal history responses were reported on 916 (68%) questionnaires. After physician review, 495/ 916 (54%) participants with positive questionnaires were thought to have non-cardiac symptoms and/or a benign family history and did not warrant additional evaluation. Physical examination was abnormal in 124 (9.3%) participants, and 72 (5.4%) had ECG abnormalities. Echocardiograms were performed in 586 (44%) participants for abnormal history (31%), physical examination (8%) or ECG (5%). Five participants (0.4%) were identified with a disorder associated with SCA, all with ECG-detected Wolff-Parkinson-White. The false-positive rates for history, physical examination and ECG were 31.3%, 9.3% and 5%, respectively. Conclusions A standardised history and physical examination using the PPE-4 yields a high false-positive rate in a young active population with limited sensitivity to identify those at risk for SCA. ECG screening has a low false-positive rate using modern interpretation standards and improves detection of primary electrical disease at risk of SCA. PMID:24948082

  4. Screening for fetal growth restriction with universal third trimester ultrasonography in nulliparous women in the Pregnancy Outcome Prediction (POP) study: a prospective cohort study

    PubMed Central

    Sovio, Ulla; White, Ian R; Dacey, Alison; Pasupathy, Dharmintra; Smith, Gordon C S

    2015-01-01

    Summary Background Fetal growth restriction is a major determinant of adverse perinatal outcome. Screening procedures for fetal growth restriction need to identify small babies and then differentiate between those that are healthy and those that are pathologically small. We sought to determine the diagnostic effectiveness of universal ultrasonic fetal biometry in the third trimester as a screening test for small-for-gestational-age (SGA) infants, and whether the risk of morbidity associated with being small differed in the presence or absence of ultrasonic markers of fetal growth restriction. Methods The Pregnancy Outcome Prediction (POP) study was a prospective cohort study of nulliparous women with a viable singleton pregnancy at the time of the dating ultrasound scan. Women participating had clinically indicated ultrasonography in the third trimester as per routine clinical care and these results were reported as usual (selective ultrasonography). Additionally, all participants had research ultrasonography, including fetal biometry at 28 and 36 weeks' gestational age. These results were not made available to participants or treating clinicians (universal ultrasonography). We regarded SGA as a birthweight of less than the 10th percentile for gestational age and screen positive for SGA an ultrasonographic estimated fetal weight of less than the 10th percentile for gestational age. Markers of fetal growth restriction included biometric ratios, utero-placental Doppler, and fetal growth velocity. We assessed outcomes for consenting participants who attended research scans and had a livebirth at the Rosie Hospital (Cambridge, UK) after the 28 weeks' research scan. Findings Between Jan 14, 2008, and July 31, 2012, 4512 women provided written informed consent of whom 3977 (88%) were eligible for analysis. Sensitivity for detection of SGA infants was 20% (95% CI 15–24; 69 of 352 fetuses) for selective ultrasonography and 57% (51–62; 199 of 352 fetuses) for universal

  5. The Retinal Disease Screening Study: Prospective Comparison of Nonmydriatic Fundus Photography and Optical Coherence Tomography for Detection of Retinal Irregularities

    PubMed Central

    Ouyang, Yanling; Heussen, Florian M.; Keane, Pearse A.; Sadda, SriniVas R.; Walsh, Alexander C.

    2013-01-01

    Purpose. To compare the sensitivity of volume scanning with optical coherence tomography (OCT) to nonmydriatic color fundus photography (FP) for the detection of retinal irregularities in asymptomatic populations. Methods. Asymptomatic subjects without known ocular disease were recruited over a 6-month period. For each eye, two undilated 45° fundus images and four undilated volume OCT image sets covering the macula and optic nerve were obtained. Color images were evaluated for irregularities both inside and outside the area covered by OCT. OCT image sets were evaluated for internal limiting membrane irregularities, abnormal retinal thickness, hyper/hyporeflective features, and photoreceptor/retinal pigment epithelium (RPE) irregularities. Detection sensitivities were compared and false-negative cases were analyzed. Results. A total of 284 eyes (144 subjects) were included, with a mean age of 38.1 years (range 18–77). Among 253 eyes (135 subjects) with gradable images from both FP and OCTs, the detection sensitivities for OCT were higher (96.2% infield and 85.7% in full field) than for FP (19.9% infield and 43.8% in full field) for all irregularities evaluated in the study (including epiretinal irregularities, abnormal retinal thickness, intraretinal hyperreflective/hyporeflective features, and photoreceptor/RPE irregularities). Overall, the presence of definite irregularities on either fundus imaging or OCT by eye in this asymptomatic population was 42.6% (121/284), with 39.4% (112/284) of eyes having RPE irregularities such as drusen. Conclusions. For detection of a variety of retinal irregularities evaluated in the current study, volume OCT scanning was more sensitive than nonmydriatic retinal photography in our asymptomatic individuals. OCT detected clinically relevant disease features, such as subretinal fluid, that were missed by FP, and had a lower ungradable image rate. It is likely that OCT will be added to photography screening in the near future for

  6. The utility of screening for perinatal depression in the second trimester among Chinese: a three-wave prospective longitudinal study

    PubMed Central

    Wong, Daniel Fu Keung; Chan, Kin Sin

    2010-01-01

    This paper aims to study the pattern of perinatal depressive symptomatology and determine the predictive power of second trimester perinatal depressive symptoms for future perinatal periods. A population-based sample of 2,178 women completed the Edinburgh Postnatal Depression Scale (EPDS) in the second and third trimesters and at 6 weeks postpartum. Repeated measures ANOVAs were used to determine the EPDS scores across three stages. The predictive power of the second trimester EPDS score in identifying women with an elevated EPDS score in the third trimester and at 6 weeks postpartum were determined. The predictive power of the second trimester EPDS score was further assessed using stepwise logistic regression and receiver operator characteristic curves. EPDS scores differed significantly across three stages. The rates were 9.9%, 7.8%, and 8.7% for an EPDS score of >14 in the second and third trimesters and at 6 weeks postpartum, respectively. Using a cut-off of 14/15, the second trimester EPDS score accurately classified 89.6% of women in the third trimester and 87.2% of those at 6 weeks postpartum with or without perinatal depressive symptomatology. Women with a second trimester EPDS score >14 were 11.78 times more likely in the third trimester and 7.15 times more likely at 6 weeks postpartum to exhibit perinatal depressive symptomatology after adjustment of sociodemographic variables. The area under the curve for perinatal depressive symptomatology was 0.85 in the third trimester and 0.77 at 6 weeks postpartum. To identify women at high risk for postpartum depression, healthcare professionals could consider screening all pregnant women in the second trimester so that secondary preventive intervention may be implemented. PMID:20058040

  7. Neonatal clinical screening of the hip in the diagnosis of developmental dysplasia of the hip: a 15-year prospective longitudinal observational study.

    PubMed

    Mace, J; Paton, R W

    2015-02-01

    Over a 15-year prospective period, 201 infants with a clinically unstable hip at neonatal screening were subsequently reviewed in a 'one stop' clinic where they were assessed clinically and sonographically. Their mean age was 1.62 weeks (95% confidence interval (CI) 1.35 to 1.89). Clinical neonatal hip screening revealed a sensitivity of 62% (mean, 62.6 95%CI 50.9 to 74.3), specificity of 99.8% (mean, 99.8, 95% CI 99.7 to 99.8) and positive predictive value (PPV) of 24% (mean, 26.2, 95% CI 19.3 to 33.0). Static and dynamic sonography for Graf type IV dysplastic hips had a 15-year sensitivity of 77% (mean, 75.8 95% CI 66.9 to 84.6), specificity of 99.8% (mean, 99.8, 95% CI 99.8 to 99.8) and a PPV of 49% (mean, 55.1, 95% CI 41.6 to 68.5). There were 36 infants with an irreducible dislocation of the hip (0.57 per 1000 live births), including six that failed to resolve with neonatal splintage. Most clinically unstable hips referred to a specialist clinic are female and stabilise spontaneously. Most irreducible dislocations are not identified from this neonatal instability group. There may be a small subgroup of females with instability of the hip which may be at risk of progression to irreducibility despite early treatment in a Pavlik harness. A controlled study is required to assess the value of neonatal clinical screening programmes. PMID:25628293

  8. Does perceived risk predict breast cancer screening use? Findings from a prospective cohort study of female relatives from the Ontario site of the breast cancer family registry.

    PubMed

    Walker, Meghan J; Mirea, Lucia; Glendon, Gord; Ritvo, Paul; Andrulis, Irene L; Knight, Julia A; Chiarelli, Anna M

    2014-08-01

    While the relationship between perceived risk and breast cancer screening use has been studied extensively, most studies are cross-sectional. We prospectively examined this relationship among 913 women, aged 25-72 with varying levels of familial breast cancer risk from the Ontario site of the Breast Cancer Family Registry. Associations between perceived lifetime breast cancer risk and subsequent use of mammography, clinical breast examination (CBE) and genetic testing were assessed using logistic regression. Overall, perceived risk did not predict subsequent use of mammography, CBE or genetic testing. Among women at moderate/high familial risk, those reporting a perceived risk greater than 50% were significantly less likely to have a CBE (odds ratio (OR) = 0.52, 95% confidence interval (CI): 0.30-0.91, p = 0.04), and non-significantly less likely to have a mammogram (OR = 0.70, 95% CI: 0.40-1.20, p = 0.70) or genetic test (OR = 0.61, 95% CI: 0.34-1.10, p = 0.09) compared to women reporting a perceived risk of 50%. In contrast, among women at low familial risk, those reporting a perceived risk greater than 50% were non-significantly more likely to have a mammogram (OR = 1.13, 95% CI: 0.59-2.16, p = 0.78), CBE (OR = 1.11, 95% CI: 0.63-1.95, p = 0.74) or genetic test (OR = 1.29, 95% CI: 0.50-3.33, p = 0.35) compared to women reporting a perceived risk of 50%. Perceived risk did not significantly predict screening use overall, however this relationship may be moderated by level of familial risk. Results may inform risk education and management strategies for women with varying levels of familial breast cancer risk. PMID:24821458

  9. Real Time Identification of Drug-Induced Liver Injury (DILI) through Daily Screening of ALT Results: A Prospective Pilot Cohort Study

    PubMed Central

    M'Kada, Helmi; Perazzo, Hugo; Munteanu, Mona; Ngo, Yen; Ramanujam, Nittia; Fautrel, Bruno; Imbert-Bismut, Françoise; Ratziu, Vlad; Schuppe-Koistinen, Ina; Leblond, Véronique; Delattre, Jean Yves; Samson, Yves; Caen, Olivier Lyon; Bricaire, François; Khayat, David; Pierrot-Deseilligny, Charles; Herson, Serge; Amoura, Zahir; Tilleul, Patrick; Deckmyn, Olivier; Coriat, Pierre; Delpech, Vincent Nicolas; Boulogne, Philippe; Bonnefont-Rousselot, Dominique; Poynard, Thierry

    2012-01-01

    Objective Identification of drug-induced liver disease (DILI) is difficult, even among hospitalized patients. The aim of this pilot study was to assess the impact of a specific strategy for DILI screening. Design We prospectively compared the number of acute DILI cases identified in one week of a proactive strategy based on centralized elevated ALT values to those identified with a standard of care strategy for 24-week period based on referral cases to the hepatology unit. In the centralized strategy, a designated study biochemist identified patients with ALT greater than 3 times the upper limit of normal values (ULN) and notified the designated hepatologists, who then went to the patients' wards, analyzed the charts, and if necessary, interviewed the identified patients. During these two periods, patients with possible DILI were included after signing an informed consent in an ongoing European diagnostic study (SAFE-T consortium). Results During the 24-week period of the standard strategy, 12 (0.04%) patients out of a total of 28,145 were identified as having possible DILI, and 11 of these accepted to be included in the protocol. During the one-week proactive period, 7 patients out of a total of 1407 inpatients (0.498%) [odds ratio vs. standard = 12.1 (95% CI, 3.9–32.3); P<0.0001] were identified with possible DILI, and 5 were included in the protocol. Conclusion A simple strategy based on the daily analysis of cases with ALT >3 ULN by designated biochemists and hepatologists identified 12 times more acute cases of drug-induced liver disease than the standard strategy. This pilot cohort is registered on the number AP-HP P110201/1/08-03-2011 and AFSSAPS B110346-70. PMID:22905129

  10. Study protocol—investigation of the Delirium Observation Screening Scale (DOSS) for the routine detection of delirium in the care home setting: a prospective cohort study

    PubMed Central

    Teale, Elizabeth; Young, John; Siddiqi, Najma; Munyombwe, Theresa; Harrison, Jennifer; Schuurmanns, Marieke

    2016-01-01

    Introduction Delirium is a common and distressing condition associated with frailty, dementia and comorbidity. These are common in long-term care settings. Residents in care homes are therefore at particular risk of delirium. Despite this, methods to detect delirium in care homes are lacking, with existing diagnostic tools taking too long, or requiring specific training to deliver. This limits their feasibility for use for the routine detection of delirium by care home staff. Routine screening for delirium in care homes would allow timely attention to exacerbating factors to attenuate the episode, and facilitate future research into delirium in the care home environment. Methods Residents from 4 large care homes will be asked to consent (or their consultees asked to provide a declaration of agreement) to participate in the study. Care home staff will administer the 25-item Delirium Observation Screening Scale (DOSS)—a delirium screening tool based on observed behaviours—and this will be tested against the research standard Confusion Assessment Method (CAM) administered by trained research assistants performed two times per week for all participating residents. Analysis Sensitivity, specificity, positive and negative predictive values, likelihood ratios and a diagnostic OR will be calculated for the detection of delirium with the 25-item DOSS. The feasibility of routine delirium screening and the scaling properties of the 25-item DOSS will also be explored. Ethics and Dissemination For residents lacking capacity to participate, a consultee will be approached for a declaration of agreement for inclusion in the study. Results will be published in peer-reviewed journals and disseminated in written format to clinical commissioning groups, general practitioners and relevant third parties. Trial registration number ISRCTN14608554. PMID:27324706

  11. The discriminatory capability of existing scores to predict advanced colorectal neoplasia: a prospective colonoscopy study of 5,899 screening participants

    PubMed Central

    Wong, Martin C. S.; Ching, Jessica Y. L.; Ng, Simpson; Lam, Thomas Y. T.; Luk, Arthur K. C.; Wong, Sunny H.; Ng, Siew C.; Ng, Simon S. M.; Wu, Justin C. Y.; Chan, Francis K. L.; Sung, Joseph J. Y.

    2016-01-01

    We evaluated the performance of seven existing risk scoring systems in predicting advanced colorectal neoplasia in an asymptomatic Chinese cohort. We prospectively recruited 5,899 Chinese subjects aged 50–70 years in a colonoscopy screening programme(2008–2014). Scoring systems under evaluation included two scoring tools from the US; one each from Spain, Germany, and Poland; the Korean Colorectal Screening(KCS) scores; and the modified Asia Pacific Colorectal Screening(APCS) scores. The c-statistics, sensitivity, specificity, positive predictive values(PPVs), and negative predictive values(NPVs) of these systems were evaluated. The resources required were estimated based on the Number Needed to Screen(NNS) and the Number Needed to Refer for colonoscopy(NNR). Advanced neoplasia was detected in 364 (6.2%) subjects. The German system referred the least proportion of subjects (11.2%) for colonoscopy, whilst the KCS scoring system referred the highest (27.4%). The c-statistics of all systems ranged from 0.56–0.65, with sensitivities ranging from 0.04–0.44 and specificities from 0.74–0.99. The modified APCS scoring system had the highest c-statistics (0.65, 95% C.I. 0.58–0.72). The NNS (12–19) and NNR (5-10) were similar among the scoring systems. The existing scoring systems have variable capability to predict advanced neoplasia among asymptomatic Chinese subjects, and further external validation should be performed. PMID:26838178

  12. Selection of competent blastocysts for transfer by combining time-lapse monitoring and array CGH testing for patients undergoing preimplantation genetic screening: a prospective study with sibling oocytes

    PubMed Central

    2014-01-01

    Background Recent advances in time-lapse monitoring in IVF treatment have provided new morphokinetic markers for embryonic competence. However, there is still very limited information about the relationship between morphokinetic parameters, chromosomal compositions and implantation potential. Accordingly, this study aimed at investigating the effects of selecting competent blastocysts for transfer by combining time-lapse monitoring and array CGH testing on pregnancy and implantation outcomes for patients undergoing preimplantation genetic screening (PGS). Methods A total of 1163 metaphase II (MII) oocytes were retrieved from 138 PGS patients at a mean age of 36.6 ± 2.4 years. These sibling MII oocytes were then randomized into two groups after ICSI: 1) Group A, oocytes (n = 582) were cultured in the time-lapse system and 2) Group B, oocytes (n = 581) were cultured in the conventional incubator. For both groups, whole genomic amplification and array CGH testing were performed after trophectoderm biopsy on day 5. One to two euploid blastocysts within the most predictive morphokinetic parameters (Group A) or with the best morphological grade available (Group B) were selected for transfer to individual patients on day 6. Ongoing pregnancy and implantation rates were compared between the two groups. Results There were significant differences in clinical pregnancy rates between Group A and Group B (71.1% vs. 45.9%, respectively, p = 0.037). The observed implantation rate per embryo transfer significantly increased in Group A compared to Group B (66.2% vs. 42.4%, respectively, p = 0.011). Moreover, a significant increase in ongoing pregnancy rates was also observed in Group A compared to Group B (68.9% vs. 40.5%. respectively, p = 0.019). However, there was no significant difference in miscarriage rate between the time-lapse system and the conventional incubator (3.1% vs. 11.8%, respectively, p = 0.273). Conclusions This is the first prospective investigation using

  13. The Prospects Study and Desegregation.

    ERIC Educational Resources Information Center

    Puma, Michael J.

    1997-01-01

    Argues that greater caution is required when drawing conclusions from statistical results than the Armor study has done, and describes the "Prospects" study (begun in 1989), the largest longitudinal study of educational outcomes conducted in the United States. "Prospects" provides much data useful in evaluating the school desegregation situation…

  14. Health-related quality of life in adolescents with screening-detected celiac disease, before and one year after diagnosis and initiation of gluten-free diet, a prospective nested case-referent study

    PubMed Central

    2013-01-01

    Background Celiac disease (CD) is a chronic disorder in genetically predisposed individuals in which a small intestinal immune-mediated enteropathy is precipitated by dietary gluten. It can be difficult to diagnose because signs and symptoms may be absent, subtle, or not recognized as CD related and therefore not prompt testing within routine clinical practice. Thus, most people with CD are undiagnosed and a public health intervention, which involves screening the general population, is an option to find those with unrecognized CD. However, how these screening-detected individuals experience the diagnosis and treatment (gluten-free diet) is not fully understood. The aim of this study is to investigate the health-related quality of life (HRQoL) of adolescents with screening-detected CD before and one year after diagnosis and treatment. Methods A prospective nested case-referent study was done involving Swedish adolescents who had participated in a CD screening study when they were in the sixth grade and about 12 years old. Screening-detected adolescents (n = 103) and referents without CD who participated in the same screening (n = 483) answered questionnaires at the time of the screening and approximately one year after the screening-detected adolescents had received their diagnosis that included the EQ-5D instrument used to measure health status and report HRQoL. Results The HRQoL for the adolescents with screening-detected CD is similar to the referents, both before and one year after diagnosis and initiation of the gluten-free diet, except in the dimension of pain at follow-up. In the pain dimension at follow-up, fewer cases reported problems than referents (12.6% and 21.9% respectively, Adjusted OR 0.50, 95% CI 0.27-0.94). However, a sex stratified analysis revealed that the significant difference was for boys at follow-up, where fewer screening-detected boys reported problems (4.3%) compared to referent boys (18.8%) (Adjusted OR 0.17, 95% CI 0

  15. [Prospective view concerning organization of breast cancer screening in France].

    PubMed

    Baudier, F

    1998-01-01

    Development of an organized cancer screening is today an essential axis of Public Health. Successive sequences are the test, the experience and the generalization. There are three principles for this generalization: 1. transparence with a specific act coding; 2. selectivity to assure the quality at each stage of this process; 3. responsibility on both professionals and policy holder levels. A such organization can only find its reasons in: 1. a legislative text who sets a very strict frame in accordance with regulations with a specific list and therefore differed for the act itself; 2. professionals and structures approved for organized screening acts, covered at 100%. The regional level will certainly be at the center of this system. Three authorities are marked out for playing significant role: the Regional Direction of Sanitary and Social Action, the Regional Union of Sickness Insurance Funds and the Regional Union of Liberal Physicians. If those measures and this organization might improve the quality of screening acts, they would be for the major part ineffective if they don't allow to get back to women who today escape, for the major part, this prevention process. They are essentially persons aged of 55 years old and over and the most deprived public. In this prospect, the general practitioner must play an essential role in a same time to go back to those public and ease an open to a dialogue around screening. PMID:10188310

  16. A Prospective Virtual Screening Study: Enriching Hit Rates and Designing Focus Libraries To Find Inhibitors of PI3Kδ and PI3Kγ.

    PubMed

    Damm-Ganamet, Kelly L; Bembenek, Scott D; Venable, Jennifer W; Castro, Glenda G; Mangelschots, Lieve; Peeters, Daniëlle C G; Mcallister, Heather M; Edwards, James P; Disepio, Daniel; Mirzadegan, Taraneh

    2016-05-12

    Here, we report a high-throughput virtual screening (HTVS) study using phosphoinositide 3-kinase (both PI3Kγ and PI3Kδ). Our initial HTVS results of the Janssen corporate database identified small focused libraries with hit rates at 50% inhibition showing a 50-fold increase over those from a HTS (high-throughput screen). Further, applying constraints based on "chemically intuitive" hydrogen bonds and/or positional requirements resulted in a substantial improvement in the hit rates (versus no constraints) and reduced docking time. While we find that docking scoring functions are not capable of providing a reliable relative ranking of a set of compounds, a prioritization of groups of compounds (e.g., low, medium, and high) does emerge, which allows for the chemistry efforts to be quickly focused on the most viable candidates. Thus, this illustrates that it is not always necessary to have a high correlation between a computational score and the experimental data to impact the drug discovery process. PMID:27043133

  17. Comparing the DN4 tool with the IASP grading system for chronic neuropathic pain screening after breast tumor resection with and without paravertebral blocks: a prospective 6-month validation study.

    PubMed

    Abdallah, Faraj W; Morgan, Pamela J; Cil, Tulin; Escallon, Jaime M; Semple, John L; Chan, Vincent W

    2015-04-01

    Investigating protective strategies against chronic neuropathic pain (CNP) after breast cancer surgery entails using valid screening tools. The DN4 (Douleur Neuropathique en 4 questions) is 1 tool that offers important research advantages. This prospective 6-month follow-up study seeks to validate the DN4 and assess its responsiveness in screening for CNP that satisfies the International Association for the Study of Pain (IASP) definition and fulfills its grading system criteria after breast tumor resection with and without paravertebral blocks (PVBs). We randomized 66 females to standardized general anesthesia and sham subcutaneous injections, or PVB and total intravenous anesthesia. The 6-month CNP risk was assessed using the IASP grading system and the DN4 screening tools. We evaluated the DN4 sensitivity, specificity, and responsiveness in capturing the impact of PVB on the CNP risk relative to the IASP grading system. Data from 64 patients showed similar demographic characteristics in both groups. Twenty patients in both groups met the grading system CNP criteria; among these, 18 patients also met the DN4 CNP criteria. Furthermore, 15 patients in both groups did not meet the grading system CNP criteria; among these, 9 patients also did not meet the DN4 CNP criteria. Therefore, the sensitivity and specificity of the DN4 were estimated at 90% and 60%, respectively. Both screening tools suggested that PVB reduced the 6-month CNP risk. Our results suggest that the DN4 can reliably identify CNP at 6 months after breast tumor resection and detect the preincisional PVB effect on the risk of developing such pain. PMID:25719620

  18. Can injury in major junior hockey players be predicted by a pre-season functional movement screen – a prospective cohort study

    PubMed Central

    Dossa, Khaled; Cashman, Glenn; Howitt, Scott; West, Bill; Murray, Nick

    2014-01-01

    Background: The Functional Movement Screen (FMS) is a tool that is commonly used to predict the occurrence of injury. Previous studies have shown that a score of 14 or less (with a maximum possible score of 21) successfully predicted future injury occurrence in athletes. No studies have looked at the use of the FMS to predict injuries in hockey players. Objective: To see if injury in major junior hockey players can be predicted by a preseason FMS. Methods: A convenience sample of 20 hockey players was scored on the FMS prior to the start of the hockey season. Injuries and number of man-games lost for each injury were documented over the course of the season. Results: The mean FMS score was 14.7+/−2.58. Those with an FMS score of ≤14 were not more likely to sustain an injury as determined by the Fisher’s exact test (one-tailed, P = 0.32). Conclusion: This study did not support the notion that lower FMS scores predict injury in major junior hockey players. PMID:25550667

  19. Screening for carbon monoxide exposure in selected patient groups attending rural and urban emergency departments in England: a prospective observational study

    PubMed Central

    Clarke, Simon; Keshishian, Catherine; Murray, Virginia; Kafatos, George; Ruggles, Ruth; Coultrip, Elizabeth; Oetterli, Sam; Earle, Daniel; Ward, Patricia; Bush, Stephen; Porter, Crispin

    2012-01-01

    Objectives Carbon monoxide (CO) exposure does not produce a classical toxidrome and so it is thought that it may easily be missed, allowing patients to continue to be exposed to CO. The aim of this study was to determine the proportion of raised carboxyhaemoglobin (COHb) levels in a targeted population of patients presenting to four emergency departments (EDs) in England. Design A prospective observational study undertaken over a 9-month period. Setting Four EDs; one in a rural/suburban area and three serving urban populations. Participants 1758 patients presenting to the EDs with chest pain, exacerbation of chronic obstructive pulmonary disease (COPD), non-traumatic headache, seizures or flu-like symptoms. Main outcome Measures COHb levels measured using a pulse CO-oximeter or venous sample. Patients with COHb levels ≥2.5% (non-smokers) or ≥5% (smokers) completed a questionnaire assessing potential sources. Patients were defined to be positive for CO exposure if they had a positive COHb and either an identified source or no other reason for their raised level. Results Proportion of positive patients was: overall—4.3%; COPD—7.5%; headache—6.3%; flu-like—4.3%; chest pain—3.3%; seizures—2.1%. A variety of gas and solid (predominantly charcoal) fossil fuel sources were identified. Conclusions This study showed that 4.3% of patients presenting to EDs with non-specific symptoms had unexpectedly raised COHb levels 1.4% of patients had a source of CO identified. Study limitations included non-consecutive recruitment, delays in COHb measurements and a lack of ambient CO measurements, which precludes precise determination of incidence. However, this study should alert clinicians to consider CO exposure in patients presenting with non-specific symptoms, in particular headache and exacerbation of COPD, and if necessary refer patients for suitable public-health follow-up, even in the presence of low COHb readings. Further research should include standardised

  20. Digital breast tomosynthesis (3D-mammography) screening: A pictorial review of screen-detected cancers and false recalls attributed to tomosynthesis in prospective screening trials.

    PubMed

    Houssami, Nehmat; Lång, Kristina; Bernardi, Daniela; Tagliafico, Alberto; Zackrisson, Sophia; Skaane, Per

    2016-04-01

    This pictorial review highlights cancers detected only at tomosynthesis screening and screens falsely recalled in the course of breast tomosynthesis screening, illustrating both true-positive (TP) and false-positive (FP) detection attributed to tomosynthesis. Images and descriptive data were used to characterise cases of screen-detection with tomosynthesis, sourced from prospective screening trials that performed standard (2D) digital mammography (DM) and tomosynthesis (3D-mammography) in the same screening participants. Exemplar cases from four trials highlight common themes of relevance to screening practice including: the type of lesions frequently made more conspicuous or perceptible by tomosynthesis (spiculated masses, and architectural distortions); the histologic findings (both TP and FP) of tomosynthesis-only detection; and the need to extend breast work-up protocols (additional imaging including ultrasound and MRI, and tomosynthesis-guided biopsy) if tomosynthesis is adopted for primary screening. PMID:27017251

  1. Children who screen positive for autism at 2.5 years and receive early intervention: a prospective naturalistic 2-year outcome study

    PubMed Central

    Spjut Jansson, Birgitta; Miniscalco, Carmela; Westerlund, Joakim; Kantzer, Anne-Katrin; Fernell, Elisabeth; Gillberg, Christopher

    2016-01-01

    Background Previous research has stressed the importance of early identification and intervention for children with autism spectrum disorders. Methods Children who had screened positive for autism at the age of 2.5 years in a general population screening and then received a diagnosis of autism spectrum disorder were enrolled in an intervention program provided by Swedish habilitation services. The following interventions were available: a comprehensive intervention based on Applied Behavior Analysis – Intensive Learning (IL) – in two settings, which included home- and preschool-based (IL Regular) and only home-based (IL Modified) and eclectic interventions. Results There was considerable variability in terms of outcome, but intervention group status was not associated with any of the chosen outcome variables. Conclusion The main finding was that the type of intervention was not critical for outcome of adaptive or global functioning. The variability in outcome demonstrates the need for continuous assessments and evaluation of the child’s function and behavior throughout the intervention period. PMID:27621636

  2. [Methodology of Screening New Antibiotics: Present Status and Prospects].

    PubMed

    Trenin, A S

    2015-01-01

    Due to extensive distribution of pathogen resistance to available pharmaceuticals and serious problems in the treatment of various infections and tumor diseases, the necessity of new antibiotics is urgent. The basic methodological approaches to chemical synthesis of antibiotics and screening of new antibiotics among natural products, mainly among microbial secondary metabolites, are considered in the review. Since the natural compounds are very much diverse, screening of such substances gives a good opportunity to discover antibiotics of various chemical structure and mechanism of action. Such an approach followed by chemical or biological transformation, is capable of providing the health care with new effective pharmaceuticals. The review is mainly concentrated on screening of natural products and methodological problems, such as: isolation of microbial producers from the habitats, cultivation of microorganisms producing appropriate substances, isolation and chemical characterization of microbial metabolites, identification of the biological activity of the metabolites. The main attention is paid to the problems of microbial secondary metabolism and design of new models for screening biologically active compounds. The last achievements in the field of antibiotics and most perspective approaches to future investigations are discussed. The main methodological approach to isolation and cultivation of the producers remains actual and needs constant improvement. The increase of the screening efficiency can be achieved by more rapid chemical identification of antibiotics and design of new screening models based on the biological activity detection. PMID:26863741

  3. Screen Study Guides.

    ERIC Educational Resources Information Center

    Duncan, Barry

    1969-01-01

    This study guide for Arthur Lipsett's film "Very Nice, Very Nice" is in four parts. First, it describes and evaluates the film, discusses Lipsett's unusual juxtapositions, fast cutting, and fragmented speeches as indications of his satirical intent, and suggests that the only meaningful summation of the film's content is through pattern…

  4. [HbA1c is not enough in screening for impaired glucose metabolism. Glucose tolerance tests are also needed, as shown in Swedish prospective epidemiological study].

    PubMed

    Hellgren, Margareta; Daka, Bledar; Larsson, Charlotte

    2015-01-01

    An HbA1c threshold of ≥ 42 mmol/mol has been proposed to diagnose prediabetes. The sensitivity, specificity and positive predictive value of the proposed threshold for detection of individuals with prediabetes was examined in a study of 573 randomly selected individuals from Vara and Skövde. In addition, the utility of the FINDRISC questionnaire and of a fasting glucose test in combination with three short questions concerning BMI, heredity for type 2 diabetes and known hypertension was examined. Results from an oral glucose tolerance test were used as reference. The sensitivity of HbA1c and FINDRISC to detect individuals with IGT was 16 and 26 per cent respectively. Questions regarding BMI, heredity and hypertension together with a fasting glucose test yielded a sensitivity of 50%, but a lower specificity and positive predictive value. We conclude that HbA1c inefficiently detected individuals with impaired glucose tolerance and that oral glucose tolerance tests can still preferably be recommended. PMID:26418933

  5. Should prospective dental students be screened for colour vision deficits?

    PubMed

    Mushtaq, F; Baraas, R C; Al-Saud, L M; Mirghani, I; van der Zee, C; Yates, E; Keeling, A; Mon-Williams, M A; Manogue, M

    2016-09-01

    A perennial question in dental education is: what skills and aptitudes should be assessed in prospective dental students? Intellectual capacity and manual dexterity understandably rank highly, but are there minimum thresholds for visual perception that applicants need be able to demonstrate before they enter the profession? We have recently flagged this issue with regard to the thresholds of stereoscopic acuity required for a dentist when operating on teeth. In the present article, we highlight the issue of identifying a minimum acceptable level of colour vision. PMID:27608568

  6. Scaffold-Focused Virtual Screening: Prospective Application to the Discovery of TTK Inhibitors

    PubMed Central

    2013-01-01

    We describe and apply a scaffold-focused virtual screen based upon scaffold trees to the mitotic kinase TTK (MPS1). Using level 1 of the scaffold tree, we perform both 2D and 3D similarity searches between a query scaffold and a level 1 scaffold library derived from a 2 million compound library; 98 compounds from 27 unique top-ranked level 1 scaffolds are selected for biochemical screening. We show that this scaffold-focused virtual screen prospectively identifies eight confirmed active compounds that are structurally differentiated from the query compound. In comparison, 100 compounds were selected for biochemical screening using a virtual screen based upon whole molecule similarity resulting in 12 confirmed active compounds that are structurally similar to the query compound. We elucidated the binding mode for four of the eight confirmed scaffold hops to TTK by determining their protein–ligand crystal structures; each represents a ligand-efficient scaffold for inhibitor design. PMID:23672464

  7. Prospective Teachers' Perspectives on Microteaching Lesson Study

    ERIC Educational Resources Information Center

    Fernandez, Maria L.; Robinson, Matthew

    2006-01-01

    Microteaching Lesson Study [MLS] is a cooperative learning experience that we felt could challenge our prospective teachers thinking about teaching and support their connection of theory and practice during an initial course on learning to teach mathematics. We studied seventy-four prospective teachers' perspectives on MLS over four sections of…

  8. Prospective screening increases the detection of potentially curable hepatocellular carcinoma: results in 8900 high-risk patients

    PubMed Central

    Izzo, Francesco; Piccirillo, Mauro; Albino, Vittorio; Palaia, Raffaele; Belli, Andrea; Granata, Vincenza; Setola, Sergio; Fusco, Roberta; Petrillo, Antonella; Orlando, Raffaele; Tosone, Grazia; Scordino, Fabrizio; Curley, Steven A

    2013-01-01

    Objectives Historically, only 10% of patients with hepatocellular carcinoma (HCC) are diagnosed with early-stage, potentially curable disease. In this study, chronic hepatitis virus-infected patients were prospectively screened to determine: (i) the proportion of patients diagnosed with potentially curable HCC, and (ii) survival following curative therapy. Methods The study included 8900 chronic hepatitis virus-infected patients enrolled in a prospective screening programme, of whom 1335 (15.0%) were infected with hepatitis B virus (HBV), 7120 (80.0%) with hepatitis C virus (HCV), and 445 (5.0%) with both HBV and HCV. Screening was conducted every 6 months and included serum alpha-fetoprotein (AFP) measurement and ultrasonography. Curative treatments included liver transplantation, resection, radiofrequency ablation and/or ethanol injection. Results Hepatocellular carcinoma was diagnosed in 765 (8.6%) patients. Of 1602 patients with cirrhosis, 758 (47.3%) developed HCC. Curative treatment was possible in 523 (68.4%) of the 765 HCC patients. Two- and 5-year rates of overall survival in the curative treatment group were 65% and 28%, respectively, compared with 10% and 0% in the advanced disease group (P < 0.001). Conclusions Prospective screening of patients at high risk for the development of HCC increases the proportion of patients diagnosed with potentially curable disease. This may result in an increase in the number of longterm survivors. Screening strategies should focus on patients with chronic HBV or HCV infection who have progressed to cirrhosis because more than 40% of these patients will develop HCC. PMID:23607636

  9. Prospective screening for ALK: clinical features and outcome according to ALK status.

    PubMed

    Fallet, Vincent; Cadranel, Jacques; Doubre, Hélène; Toper, Cécile; Monnet, Isabelle; Chinet, Thierry; Oliviero, Gérard; Foulon, Guillaume; De Cremoux, Hubert; Vieira, Thibault; Antoine, Martine; Wislez, Marie

    2014-05-01

    The aim of this study was to analyse the clinico-pathological characteristics and outcomes of a cohort of French patients who were prospectively screened for Anaplastic Lymphoma Kinase (ALK) rearrangement. One hundred and sixteen consecutive patients screened for ALK rearrangement to be recruited into a crizotinib registration trial were included from eight French centres. ALK rearrangement was detected by fluorescence in situ hybridization. Seventeen patients (14.6%) were positive for ALK. ALK+ patients were younger (p = 0.049) and more likely to be males (p=0.032), non- or light-smokers (p = 0.048) and without underlying respiratory disease (p=0.025) compared to ALK- patients. Thyroid-transcription factor-1 expression was present in all ALK+ tumours. ALK+ tumours tended to have lymph node and brain metastases. In multivariate analyses, gender, smoking history and N stage were independently associated with ALK status. Median overall survival (OS) was not reached for ALK+ patients and was significantly longer than for ALK- patients (hazard ratio for death for ALK- patients 2.98; 95% CI [1.29-6.90], p=0.01). French ALK+ patients present a specific phenotype. ALK rearrangement should be determined to improve OS with an effective targeted therapy. PMID:24589437

  10. Early Sexual Intercourse: Prospective Associations with Adolescents Physical Activity and Screen Time

    PubMed Central

    Wijtzes, Anne; van de Bongardt, Daphne; van de Looij-Jansen, Petra; Bannink, Rienke; Raat, Hein

    2016-01-01

    Objectives To assess the prospective associations of physical activity behaviors and screen time with early sexual intercourse initiation (i.e., before 15 years) in a large sample of adolescents. Methods We used two waves of data from the Rotterdam Youth Monitor, a longitudinal study conducted in the Netherlands. The analysis sample consisted of 2,141 adolescents aged 12 to 14 years (mean age at baseline = 12.2 years, SD = 0.43). Physical activity (e.g., sports outside school), screen time (e.g., computer use), and early sexual intercourse initiation were assessed by means of self-report questionnaires. Logistic regression models were tested to assess the associations of physical activity behaviors and screen time (separately and simultaneously) with early sexual intercourse initiation, controlling for confounders (i.e., socio-demographics and substance use). Interaction effects with gender were tested to assess whether these associations differed significantly between boys and girls. Results The only physical activity behavior that was a significant predictor of early sexual intercourse initiation was sports club membership. Adolescent boys and girls who were members of a sports club) were more likely to have had early sex (OR = 2.17; 95% CI = 1.33, 3.56. Significant gender interaction effects indicated that boys who watched TV ≥2 hours/day (OR = 2.00; 95% CI = 1.08, 3.68) and girls who used the computer ≥2 hours/day (OR = 3.92; 95% CI = 1.76, 8.69) were also significantly more likely to have engaged in early sex. Conclusion These findings have implications for professionals in general pediatric healthcare, sexual health educators, policy makers, and parents, who should be aware of these possible prospective links between sports club membership, TV watching (for boys), and computer use (for girls), and early sexual intercourse initiation. However, continued research on determinants of adolescents’ early sexual initiation is needed to further contribute to

  11. Prospective screening for subtelomeric rearrangements in children with mental retardation of unknown aetiology: the Amsterdam experience

    PubMed Central

    van Karnebeek, C D M; Koevoets, C; Sluijter, S; Bijlsma, E; Smeets, D; Redeker, E; Hennekam, R; Hoovers, J

    2002-01-01

    Objective: The frequency of subtelomeric rearrangements in patients with unexplained mental retardation (MR) is uncertain, as most studies have been retrospective and case retrieval may have been biased towards cases more likely to have a chromosome anomaly. To ascertain the frequency of cytogenetic anomalies, including subtelomeric rearrangements, we prospectively screened a consecutive cohort of cases with unexplained MR in an academic tertiary centre. Methods: Inclusion criteria were: age <18 years at referral, IQ<85, no aetiological diagnosis after complete examination, which included karyotyping with high resolution banding (HRB). Results: In 266 karyotyped children, anomalies were detected in 20 (7.5%, seven numerical, 13 structural); 39 cases were analysed by FISH for specific interstitial microdeletions, and anomalies were found in nine (23%). FISH analyses for subtelomeric microdeletions were performed in 184 children (44% moderate-profound MR, 51% familial MR), and one rearrangement (0.5%) was identified in a non-familial MR female with mild MR (de novo deletion 12q24.33-qter). The number of probable polymorphisms was considerable: 2qter (n=7), Xpter (n=3), and Ypter (n=1). A significantly higher total number of malformations and minor anomalies was present in the cytogenetic anomaly group compared to the group without cytogenetic anomalies. Conclusions: The total frequency of cytogenetic anomalies in this prospective study was high (1:10), but the frequency of subtelomeric rearrangements was low. The most likely explanations are the high quality of HRB cytogenetic studies and the lack of clinical selection bias. Conventional cytogenetic analyses, combined with targeted microdeletion testing, remain the single most effective way of additional investigation in mentally retarded children, also in a tertiary centre. PMID:12161591

  12. Genetic screening of prospective parents and of workers: some scientific and social issues.

    PubMed

    Hubbard, R; Henifin, M S

    1985-01-01

    Genetic screening programs are based on assumptions and values that reflect the history of racial and social eugenics in the United States and Europe. They stigmatize individuals by shifting the focus from social, economic, and political decisions that affect the health of prospective parents, newborns, and workers to "bad genes," that is, intrapersonal factors that are given the status of "causes" of disease. Prenatal screening, at best, can help the relatively few individuals who know that their future children are at risk for a particular inherited disease or disability; it has little positive value for the average person. Workplace genetic screening has not been shown to reduce occupational disease, but it has led to employment discrimination and has drawn attention away from controlling exposures to toxic chemicals in the workplace. PMID:3158618

  13. Prostate, Lung, Colon, and Ovary Prospective Study

    Cancer.gov

    A large cohort study of etiologic determinants of cancer carried out within an NCI trial for the evaluation of screening procedures for the early detection of prostate, lung, colon, and ovarian cancer (the PLCO Trial) at 10 U.S. screening centers

  14. USR-VS: a web server for large-scale prospective virtual screening using ultrafast shape recognition techniques.

    PubMed

    Li, Hongjian; Leung, Kwong-S; Wong, Man-H; Ballester, Pedro J

    2016-07-01

    Ligand-based Virtual Screening (VS) methods aim at identifying molecules with a similar activity profile across phenotypic and macromolecular targets to that of a query molecule used as search template. VS using 3D similarity methods have the advantage of biasing this search toward active molecules with innovative chemical scaffolds, which are highly sought after in drug design to provide novel leads with improved properties over the query molecule (e.g. patentable, of lower toxicity or increased potency). Ultrafast Shape Recognition (USR) has demonstrated excellent performance in the discovery of molecules with previously-unknown phenotypic or target activity, with retrospective studies suggesting that its pharmacophoric extension (USRCAT) should obtain even better hit rates once it is used prospectively. Here we present USR-VS (http://usr.marseille.inserm.fr/), the first web server using these two validated ligand-based 3D methods for large-scale prospective VS. In about 2 s, 93.9 million 3D conformers, expanded from 23.1 million purchasable molecules, are screened and the 100 most similar molecules among them in terms of 3D shape and pharmacophoric properties are shown. USR-VS functionality also provides interactive visualization of the similarity of the query molecule against the hit molecules as well as vendor information to purchase selected hits in order to be experimentally tested. PMID:27106057

  15. USR-VS: a web server for large-scale prospective virtual screening using ultrafast shape recognition techniques

    PubMed Central

    Li, Hongjian; Leung, Kwong-S.; Wong, Man-H.; Ballester, Pedro J.

    2016-01-01

    Ligand-based Virtual Screening (VS) methods aim at identifying molecules with a similar activity profile across phenotypic and macromolecular targets to that of a query molecule used as search template. VS using 3D similarity methods have the advantage of biasing this search toward active molecules with innovative chemical scaffolds, which are highly sought after in drug design to provide novel leads with improved properties over the query molecule (e.g. patentable, of lower toxicity or increased potency). Ultrafast Shape Recognition (USR) has demonstrated excellent performance in the discovery of molecules with previously-unknown phenotypic or target activity, with retrospective studies suggesting that its pharmacophoric extension (USRCAT) should obtain even better hit rates once it is used prospectively. Here we present USR-VS (http://usr.marseille.inserm.fr/), the first web server using these two validated ligand-based 3D methods for large-scale prospective VS. In about 2 s, 93.9 million 3D conformers, expanded from 23.1 million purchasable molecules, are screened and the 100 most similar molecules among them in terms of 3D shape and pharmacophoric properties are shown. USR-VS functionality also provides interactive visualization of the similarity of the query molecule against the hit molecules as well as vendor information to purchase selected hits in order to be experimentally tested. PMID:27106057

  16. Current situation and prospects of newborn screening and treatment for Phenylketonuria in China — compared with the current situation in the United States, UK and Japan

    PubMed Central

    Mei, Lin; Song, Peipei; Kokudo, Norihiro; Xu, Lingzhong; Tang, Wei

    2013-01-01

    Summary Phenylketonuria (PKU) is a treat-able and prevent-able inborn error of metabolism which leads to severe mental retardation and neurobehavioral abnormalities. A screening program, especially for early detection, combined with a Phe-restricted therapeutic diet can help to control the process of PKU of most patients. The China government has put more emphasis on newborn screening and treatment against PKU, yet by comparing the situation of newborn screening and treatment against PKU in China and the relatively developed countries — United States, United Kingdom and Japan, the newborn screening and treatment against PKU in China is relatively weak and many deficiencies are found. More studies concerning multi-stage target blood Phe concentration criteria, a policy that requires newborn screening has to be taken, better financial support for newborn screening, publicity for newborn screening, and national guidelines for treatment of PKU may be prospects in China and may provide some support for better development of newborn screening and treatment against PKU in China. PMID:25343113

  17. [Effectiveness of screening colonoscopy in a community-based study].

    PubMed

    Hüppe, D; Hartmann, H; Felten, G; Kemen, M; Tannapfel, A; Gillessen, A; Katalinic, A

    2008-02-01

    In 2002 screening colonoscopy was introduced in Germany for the prevention of colorectal cancer (CRC) and CRC mortality. Individuals took part in a prospective study from October 2002 until September 2005 performed at a single centre for gastroenterology. Histopathological data, surgical-pathological stages and further follow-up events were recorded until 31st of December 2006. For screened individuals without symptoms, the data obtained were compared to those from age-matched patients who presented with clinical symptoms/signs and who underwent colonoscopy during the same period in time. A total of 5066 individuals underwent screening colonoscopy. In this group, colorectal cancer was detected in 46 individuals (0.9%). Endoscopic treatment was considered adequate for 21 cancers. In this group of 46 patients, 94.5% were classified into UICC stages I-II by pathological staging. In 504 screened individuals, colorectal polyps were detected (12.2%) and removed by polypectomy. Of these polyps, 16 were classified as cancer, 496 as adenomas and 1 as a carcinoid tumour. High grade dysplasia was noted in 41 polyps (8.3% of adenomas). In comparison, 4099 symptomatic patients underwent colonoscopy. In this group 100 cancers (2.4%) were detected. Advanced malignant tumours were noted in 39% of these; endoscopic treatment was feasible in 16% of the cancers. As of December 2006, cancer-related deaths were observed in 20% of symptomatic patients with CRC. Screening colonoscopy detects colorectal cancers in the early stages. Given the favourable prognosis in these stages, screening can reduce CRC-related mortality. PMID:18253898

  18. Prospective Demographic Study of Cosmetic Surgery Patients

    PubMed Central

    Schlessinger, Daniel; Schlessinger, Bernard

    2010-01-01

    Objectives: The authors sought to examine and assess cosmetic surgery patient demographics as well as age in relation to partner, in a prospective manner, analyzing data for any significant correlations. Design: The authors conducted a prospective study utilizing a survey. Setting: The study was conducted in a private, nonacademic dermatological practice. Participants: Three hundred thirty-six patients participated in this study. Results: Demographics of onabotulinumtoxinA/abobotulinumtoxinA (neurotoxins), fillers, and laser hair removal users were studied. The data show that the average private practice cosmetic surgery patient in this study is a married (67.5%), college-educated or greater (66.9%), employed (74.3%), mother (74.5%). In the fillers category, 50 percent of women were older than their partners, as opposed to 14.8 percent in 2008 Census data. Additionally, women were more educated and employed to a higher percentage than similar women in 2008 Census data. Data on motivations were statistically not significant. Conclusion: Data from this study show potential correlations with Census data norms in marital status and motherhood status categories, but not in the age in relation to partner, education, and employment level categories. Motivations of individuals undergoing cosmetic surgery will need further analysis in future studies. PMID:21103314

  19. Prospective study of definite caterpillar exposures.

    PubMed

    Balit, Corrine R; Geary, Merilyn J; Russell, Richard C; Isbister, Geoffrey K

    2003-11-01

    Exposure to caterpillars results in a variety of clinical effects depending on the species involved. The aim of this study was to describe the clinical effects from caterpillar exposures within Australia. Cases were recruited prospectively from calls to a poison information centre. Subjects were included if they had a definite exposure and they had collected the caterpillar or cocoon. The caterpillars were identified to genus and species level where possible. There were 36 included cases: two were contact exposures to caterpillar contents, one was an ingestion of a caterpillar and the remaining 33 patients had definite reactions from caterpillar or cocoon exposure. There were five families of caterpillars identified in the study: Arctiidae, Limacodidae, Anthelidae, Lymantriidae and Sphingidae, many of which occur worldwide. Clinical effects ranged from severe pain to an urticarial response depending on the species involved. There were no adverse effects following ingestion in this study. Treatment consisted primarily of removal of the caterpillar or cocoon. Other treatment measures consisted of symptomatic treatment such as ice packs and antihistamines. This is the first prospective study of caterpillar exposures within Australia and demonstrates that exposures can result in a variety of reactions depending on the family and species involved. PMID:14602121

  20. Student Awareness of the Use of Social Media Screening by Prospective Employers

    ERIC Educational Resources Information Center

    Root, Teri; McKay, Sandra

    2014-01-01

    Hiring professionals are increasingly using social media sites as screening tools. The primary purpose of this study was to determine what students thought employers considered important information when researching profiles. A survey was given to students enrolled in College of Business classes at a university in the Southeast. Students were…

  1. Chemoprevention studies within lung cancer screening programmes.

    PubMed

    Veronesi, G; Guerrieri-Gonzaga, A; Infante, M; Bonanni, B

    2015-01-01

    While aggressive tobacco control and help to stop smoking are essential weapons in the fight against lung cancer, screening with low-dose computed tomography (LDCT) in high-risk populations and chemoprevention may also contribute to reducing lung cancer deaths. Persons undergoing LDCT screening are an ideal population to be tested for agents potentially able to prevent the development of lung cancer by the regression of precancerous lesions, which are routinely monitored as part of the screening process. Peripheral subsolid nodules appear as particularly suitable targets, since many are adenocarcinoma precursors. A study on inhaled budesonide (a potential chemopreventive drug) for 1 year found that the mean size of non-solid lung nodules was significantly reduced over 5 years of follow-up, compared to inhaled placebo, in a population of high-risk individuals with indeterminate lung nodules not requiring immediate specific investigation for lung cancer and detected as part of a lung cancer screening program with LDCT. A new randomised placebo-controlled phase-II trial to test the ability of aspirin to induce the regression of non-solid and partially solid nodules detected by LDCT screening has been started. The effect of aspirin on a miRNA signature able to predict the presence of both cancer and precancerous lesions in high-risk asymptomatic individuals is also being monitored in the trial. This signature was previously shown to predict the presence of both lung cancer and non-solid lung nodules in asymptomatic individuals. PMID:26635901

  2. Abdominal Lipectomy: A Prospective Outcomes Study

    PubMed Central

    Semer, Nadine B; Ho, Wan C; Mills, Sharrie; Rajashekara, BM; Taylor, Jason R; Trung, Nguyen B; Young, Henry; Kivuls, Juris

    2008-01-01

    Context/objective: Abdominal lipectomy is performed by plastic surgeons to provide symptomatic, functional, and cosmetic relief for patients with excess abdominal tissue. However, there are few clinical outcome studies looking at the utility of this procedure: this is the first prospective oucomes study. Design: Patients who underwent abdominal lipectomy at the Bellflower Medical Center during a 12-month period (September 2004 through September 2005) were prospectively studied. Data were collected at the preoperative visit, during surgery, and at the one-week, one-month, and six-month postoperative visits. Outcome measures: Complications, both major (requiring rehospitalization or reoperation) and minor (requiring local outpatient care) were identified. To evaluate the impact on our patients' perceived health and well-being as well as body image, we administered the Short Form–36 Health Survey (SF-36) and the Multidimensional Body-Self Relations Questionnaire (MBSRQ) to participants at their preoperative and six-month postoperative visits. Results: For the 72 patients enrolled in the study, the postoperative major complication rate was 5.6% (four patients) and the minor complication rate was 27.8% (20 patients); 98.3% were happy to have had the surgery. Two components of the MBSRQ, feelings of attractiveness and body area satisfaction, showed significant improvement (p < 0.0001 for each) at six-month postoperative testing. No component of the SF-36 reached statistical significance between pre- and postoperative testing. Conclusion: Because the complication rate for cosmetic abdominoplasty in our study did not significantly differ from rates reported for other studies, and given our data on perceived patient satisfaction and improvement in outcomes, our study validates the utility of abdominal lipectomy for patients with symptomatic lower abdominal pannus. PMID:21364808

  3. Prospective study on nutrition transition in China.

    PubMed

    Zhai, Fengying; Wang, Huijun; Du, Shufa; He, Yuna; Wang, Zhihong; Ge, Keyou; Popkin, Barry M

    2009-05-01

    The aim of the prospective study reported here was to examine the effects of social and economic transformation on dietary patterns and nutritional status in China. The study began in 1989 and continued with follow-ups in 1991, 1993, 1997, 2000, and 2004. A total of 5000 subjects aged 18-45 years from 4280 households in nine provinces were included. Weighed records and three consecutive 24-h recalls were used. Over the study period, average consumption of all animal foods except milk increased, while cereal intake decreased. The proportion of animal protein and fat as a percentage of energy also increased. However, vitamin A and calcium intake did not increase and remained low. Child height and weight increased while undernutrition decreased and overweight increased. The results indicate that rapid changes in dietary pattern are associated with economic reforms in China. PMID:19453679

  4. Performance Studies on Distributed Virtual Screening

    PubMed Central

    Krüger, Jens; de la Garza, Luis; Kohlbacher, Oliver; Nagel, Wolfgang E.

    2014-01-01

    Virtual high-throughput screening (vHTS) is an invaluable method in modern drug discovery. It permits screening large datasets or databases of chemical structures for those structures binding possibly to a drug target. Virtual screening is typically performed by docking code, which often runs sequentially. Processing of huge vHTS datasets can be parallelized by chunking the data because individual docking runs are independent of each other. The goal of this work is to find an optimal splitting maximizing the speedup while considering overhead and available cores on Distributed Computing Infrastructures (DCIs). We have conducted thorough performance studies accounting not only for the runtime of the docking itself, but also for structure preparation. Performance studies were conducted via the workflow-enabled science gateway MoSGrid (Molecular Simulation Grid). As input we used benchmark datasets for protein kinases. Our performance studies show that docking workflows can be made to scale almost linearly up to 500 concurrent processes distributed even over large DCIs, thus accelerating vHTS campaigns significantly. PMID:25032219

  5. A Study of Prospective Teachers' Consumption Patterns on Special Days

    ERIC Educational Resources Information Center

    Saglam, Halil Ibrahim

    2016-01-01

    The purpose of this study was to identify prospective teachers' consumption patterns on special days. The sample was comprised of 29 prospective teachers (22 females and 7 males) who studied Primary School Teaching in the Faculty of Education at Sakarya University during the 2014-2015 Academic Year. The study was designed as a phenomenological…

  6. Study of Prospective Teachers' Conceptualization of Value Preferences

    ERIC Educational Resources Information Center

    Koruklu, Nermin; Aktamis, Hilal

    2012-01-01

    The purpose of this study was to determine whether there were any changes in the conceptualization of prospective teachers' values preferences during their university studies. The research group was composed of 208 prospective teachers who were studying at Science Education, Social Science Education and Fine Arts Education at Adnan Menderes…

  7. Ion cyclotron emission studies: Retrospects and prospects

    NASA Astrophysics Data System (ADS)

    Gorelenkov, N. N.

    2016-05-01

    Ion cyclotron emission (ICE) studies emerged in part from the papers by A.B. Mikhailovskii published in the 1970s. Among the discussed subjects were electromagnetic compressional Alfvénic cyclotron instabilities with the linear growth rate √ {n_α /n_e } driven by fusion products, -particles which draw a lot of attention to energetic particle physics. The theory of ICE excited by energetic particles was significantly advanced at the end of the 20th century motivated by first DT experiments on TFTR and subsequent JET experimental studies which we highlight. More recently ICE theory was advanced by detailed theoretical and experimental studies on spherical torus (ST) fusion devices where the instability signals previously indistinguishable in high aspect ratio tokamaks due to high toroidal magnetic field became the subjects of experiments. We discuss further prospects of ICE theory applications for future burning plasma (BP) experiments such as those to be conducted in ITER device in France, where neutron and gamma rays escaping the plasma create extremely challenging conditions fusion alpha particle diagnostics.

  8. Ion cyclotron emission studies: Retrospects and prospects

    DOE PAGESBeta

    Gorelenkov, N. N.

    2016-06-05

    Ion cyclotron emission (ICE) studies emerged in part from the papers by A.B. Mikhailovskii published in the 1970s. Among the discussed subjects were electromagnetic compressional Alfv,nic cyclotron instabilities with the linear growth rate similar ~ √(nα/ne) driven by fusion products, -particles which draw a lot of attention to energetic particle physics. The theory of ICE excited by energetic particles was significantly advanced at the end of the 20th century motivated by first DT experiments on TFTR and subsequent JET experimental studies which we highlight. Recently ICE theory was advanced by detailed theoretical and experimental studies on spherical torus (ST) fusionmore » devices where the instability signals previously indistinguishable in high aspect ratio tokamaks due to high toroidal magnetic field became the subjects of experiments. Finally, we discuss prospects of ICE theory applications for future burning plasma (BP) experiments such as those to be conducted in ITER device in France, where neutron and gamma rays escaping the plasma create extremely challenging conditions fusion alpha particle diagnostics.« less

  9. Ossiculoplasty: A Prospective Study of 80 Cases

    PubMed Central

    Chavan, Shrinivas Shripatrao; Jain, Prateek V; Vedi, Jeevan N; Rai, Dharmendra kumar; Kadri, Himayat

    2014-01-01

    Introduction: The use of ossicular graft material in ossicular chain reconstruction has significantly improved hearing results hearing after tympanoplasty and tympanomastoid surgery for chronic otitis media. Today, otologists have a wide array of tools from which to choose, but may find it difficult to know which middle ear implant works best. Materials and Methods: A prospective study of 80 patients who underwent ossiculoplasty was performed in the ear, nose, and throat (ENT) department at a tertiary health care facility from 2011 to 2013. Patients with chronic suppurative otitis media with an air-bone gap (ABG) of >25 dB with ossicular involvement were included in the study. Total ossicular replacement prosthesis (TORP), partial ossicular replacement prosthesis (PORP), and refashioned incus were used. Success was defined as ABG <25 dB on postoperative Day 90. Results: The majority patients were of middle age with moderate conductive hearing loss. Incus was the most susceptible ossicle. Overall success rate in this study was 80.0% with an average change of 15.76 dB in ABG. Conclusion: With continuing advances in our understanding of middle ear mechanics, the results of ossiculoplasty are improving and results can be very rewarding in experienced hands. Severity of preoperative ear discharge, preoperative mastoid cellularity, presence of disease, and surgical procedure proved to be significant prognostic factors. Autograft incus and PORP fared better when the malleus handle was present while TORP gave better results when the malleus handle was eroded. PMID:25009804

  10. Self-rated health is prospectively associated with uptake of screening for the early detection of colorectal cancer, not vice versa.

    PubMed

    Neter, Efrat; Stein, Nili; Rennert, Gad; Hagoel, Lea

    2016-07-01

    Self-rated health (SRH) is a consistent predictor of mortality and other health outcomes. One of the mechanisms hypothesized to explain its validity as a predictor is that SRH affects the adoption of health behaviors. The present study examined the prospective association between SRH and performance of a recommended colorectal cancer (CRC) screening test. One thousand four hundred and seventy-six men and women aged 50-74 years, eligible for CRC screening, who had undergone the test a year before were interviewed 1-2 weeks (long interview, before testing) or 2 months (short interview, after testing) following the mailing of a test kit. Test performance was ascertained using an HMO's computerized data set. Respondents in the long interview group who rated their health as 'higher than others' performed the screening test 2 months following the invitation more than those who rated their health as similar to or lower than that of others (65.4, 61.6, and 49.1%, respectively, χ=8.02, P=0.018). At the same time, these respondents perceived the risk of CRC as significantly lower than that of those who rated their health as comparable with or lower than that of others. In a multivariate logistic regression of CRC screening behavior that included demographic and perceptual variables, age, intentions, and SRH were found to be significant predictors. Among respondents in the short interview, who tested before the interview, there was no significant association between SRH and behavior. SRH prospectively predicts uptake of CRC screening better than other perceptual variables, after accounting for demographic variables. PMID:26230609

  11. Injuries in competitive boxing. A prospective study.

    PubMed

    Siewe, J; Rudat, J; Zarghooni, K; Sobottke, R; Eysel, P; Herren, C; Knöll, P; Illgner, U; Michael, J

    2015-03-01

    Boxing remains a subject of controversy and is often classified as dangerous. But the discussion is based mostly on retrospective studies. This survey was conducted as a prospective study. From October 2012 to September 2013, 44 competitive boxers were asked to report their injuries once a month. The questionnaire collected general information (training, competition) and recorded the number of bouts fought, injuries and resulting lost days. A total of 192 injuries were recorded, 133 of which resulted in interruption of training or competition. Each boxer sustained 3 injuries per year on average. The injury rate was 12.8 injuries per 1 000 h of training. Boxers fighting more than 3 bouts per year sustain more injuries (p=0.0075). The injury rate does is not a function of age (age≤19 vs. > 19a, p=0.53). Injuries to the head and the upper limbs occur most frequently. The most common injuries are soft tissue lacerations and contusions. Head injuries with neurological symptoms rarely occur (4.2%). Boxing has a high injury rate that is comparable with other contact sports, but most injuries are minor. Injury frequency is not a function of whether the boxer competes in the junior or adult category. Athletes fighting many bouts per year have a greater risk of injury. PMID:25376728

  12. A prospective study of rock climbing injuries.

    PubMed Central

    Wyatt, J P; McNaughton, G W; Grant, P T

    1996-01-01

    OBJECTIVES: To study the rate, causes, and nature of rock climbing injuries presenting to an accident and emergency (A&E) department. METHODS: Patients presenting with rock climbing injuries to an urban A&E department were studied prospectively for one year. RESULTS: 19 rock climbers presented during the year, at a rate of one per 2774 A&E attendances. Fourteen climbers were injured on outdoor cliffs and five on the local indoor climbing wall, where the safety mats were noted to be in poor condition. Eighteen climbers had been injured during falls, 17 hitting the ground. Twelve of these climbers sustained fractures, four of which were missed on initial attendance. The remaining climber sustained the characteristic A2 pulley finger injury, which was treated conservatively with a good result. CONCLUSIONS: The risks of rock climbing in Britain would be reduced if lead climbers arranged protection at earlier stages of climbs. Sports centres with climbing walls should regularly inspect and repair their safety equipment. It is important for staff in A&E departments to appreciate the large forces involved in any climbing fall, in order that significant injuries are not missed. Those treating injured climbers should also be aware of the specific injuries to which elite climbers are predisposed. Images Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 PMID:8799601

  13. Investing in Prospective Cohorts for Etiologic Study of Occupational Exposures

    PubMed Central

    Blair, A.; Hines, C.J.; Thomas, K.W.; Alavanja, M.C.R.; Beane Freeman, L.E.; Hoppin, J.A.; Kamel, F.; Lynch, C.F.; Lubin, J.H.; Silverman, D.T.; Whelan, E.; Zahm, S. H.; Sandler, D. P.

    2015-01-01

    Prospective cohorts have played a major role in understanding the contribution of diet, physical activity, medical conditions, and genes to the development of many diseases, but have not been widely used for occupational exposures. Studies in agriculture are an exception. We draw upon our experience using this design to study agricultural workers to identify conditions that might foster use of prospective cohorts to study other occupational settings. Prospective cohort studies are perceived by many as the strongest epidemiologic design. It allows updating of information on exposure and other factors, collection of biologic samples before disease diagnosis for biomarker studies, assessment of effect modification by genes, lifestyle, and other occupational exposures, and evaluation of a wide range of health outcomes. Increased use of prospective cohorts would be beneficial in identifying hazardous exposures in the workplace. Occupational epidemiologists should seek opportunities to initiate prospective cohorts to investigate high priority, occupational exposures. PMID:25603935

  14. Superwarfarin poisoning in children: a prospective study.

    PubMed

    Smolinske, S C; Scherger, D L; Kearns, P S; Wruk, K M; Kulig, K W; Rumack, B H

    1989-09-01

    This prospective study was undertaken to determine the incidence, severity, time of onset, and duration of coagulopathy in children following accidental ingestion of long-acting anticoagulant rodenticides, often called "superwarfarins." Of 110 children, who ingested superwarfarins and in whom one or more prothrombin time values were obtained, 8 had a prothrombin time ratio (patient to control) of greater than or equal to 1.2, indicative of anticoagulation. Prothrombin time values obtained 48 hours after ingestion were more likely to be prolonged (6/34, 17.6%) than values obtained 24 hours after ingestion (2/104, 1.9%) (P less than .005). The occurrence of an abnormal prothrombin time could not be predicted based on the history of amount ingested or on the presence of the characteristic green-blue product dye in or around the child's mouth. Acute toxicity was evidenced by transient abdominal pain, vomiting, and heme positive stools in 2 patients. The duration of prothrombin time prolongation could not be determined because of the few values obtained after 48 hours. To detect all possible abnormal prothrombin time values, 24- and 48-hour determinations are recommended after a child has ingested a superwarfarin. PMID:2771552

  15. Depression after CABG: a prospective study

    PubMed Central

    Nunes, Joana Kátya Veras Rodrigues Sampaio; de Figueiredo Neto, José Albuquerque; de Sousa, Rosângela Maria Lopes; Costa, Vera Lívia Xavier de Castro; Silva, Flor de Maria Araújo Mendonça; da Hora, Ana Flávia Lima Teles; da Silva, Edna Lúcia Coutinho; Reis, Lívia Mariane Castelo Branco

    2013-01-01

    Introduction Depression during or shortly after hospitalization elevated two to three times the risk of mortality or nonfatal cardiac events, significantly increasing the morbidity and mortality of these patients. Objective To assess the impact of revascularization on symptoms of depression in patients with coronary artery disease. Methods A prospective cohort study of 57 patients of both sexes undergoing coronary artery bypass grafting between June 2010 and June 2011. We used the SF-36 to assess quality of life, and the Beck Depression Inventory to detect depressive symptoms, applied preoperatively and six months. Results The prevalence of patients aged 60-69 years was 22 patients (38.60%), 39 men (68.42%), 26 described themselves as mixed race (45.61%), 16 literate (28.07 %) and 30 married (52.63%). The beck depression inventory score demonstrated increased after revascularization: 15 patients mild (26.32%) at time zero to 17 (29.82%) after. And with moderate, seven patients (12.28%) before and 10 (17.54%) after. In the categories of individuals with decreased minimum degree of 32 (56.14%) to 28 (49.12%), and severe of three (5.26%) for two (3.51%) patients. Association was observed between beck depression inventory, gender, age, lifestyle, comorbidities and quality of life. Conclusion There was a high prevalence of elevated beck depression inventory scores, lowest scores of depressive symptoms among men and association between the improvement of quality of life scores and beck depression inventory. PMID:24598954

  16. Child cyclist injuries: a prospective study.

    PubMed

    Armson, C J; Pollard, C W

    1986-02-01

    A prospective study of pedalcycle accident morbidity and mortality was carried out from February to mid-November 1983 because of the high frequency of child cyclist injuries that were occurring on the relatively flat Redcliffe Peninsula. These injuries were apparently associated with the large number of young children who use a bicycle as their main mode of transport to and from school. The schools were surveyed for the extent of bicycle use and cyclists were surveyed for the amount of protective clothing that was worn while involved in cycling. It was found that a disturbingly large number of young children made regular bicycle trips on public roads with the minimal use of safety helmets or any other form of protective clothing. Nearly 40% of on-road accidents involved children of less than 12 years of age, and over 10% of these involved children of six years of age or less. No child in our series of on-road accidents was, at the time of injury, wearing a safety helmet or any other form of protective clothing. No bicycle accidents occurred on the exclusive cycle track of approximately 1 km in length on the Peninsula. PMID:3945202

  17. Supracostal percutaneous nephrolithotomy: A prospective comparative study

    PubMed Central

    Sinha, Maneesh; Krishnappa, Pramod; Subudhi, Santosh Kumar; Krishnamoorthy, Venkatesh

    2016-01-01

    Introduction: A widely prevalent fear of thoracic complications with the supracostal approach has led to its underutilization in percutaneous nephrolithotomy (PCNL). We frequently use the supracostal approach and compared the efficacy and thoracic complications of infracostal, supra 12th, and supra 11th punctures. Materials and Methods: This was a prospective study of patients who underwent PCNL between January 2005 and December 2012. The patients were divided into three groups based on the access: infracostal, supra 12th (between the 11th and 12th ribs) and supra 11th (between the 10th and 11th ribs). Clearance rates, fall in hemoglobin levels, transfusion rates, perioperative analgesic requirements, hospital stay and thoracic complications were compared. Results: Seven hundred patients were included for analysis. There were 179 (25.5%) patients in the supra 11th group, 187 (26.7%) patients in the supra 12th group and 334 (47.8%) patients in the infracostal group. The overall clearance rate was 78% with no difference in the three groups. The postoperative analgesic requirements were significantly higher in the supracostal groups and showed a graded increase from infracostal to supra 12th to supra 11th. During the study period, only 2 patients required angioembolization (0.3%) and none required open exploration. The number of patients requiring intercostal chest drain insertion was extremely low, at 1.6% and 2.2% in the supra 12th and supra 11th groups, respectively. Conclusions: Our results confirm the feasibility of the supracostal approach including punctures above the 11th rib, albeit at the cost of an increase in thoracic complications. Staying in the line of the calyx has helped us to minimize the most dreaded complication of bleeding requiring angioembolization. PMID:26941494

  18. Screening for diabetes in lower limb amputees: a pilot study.

    PubMed

    Treweek, S P; Condie, M E; Gilmour, D G

    1998-04-01

    The Saint Vincent Declaration includes 5-year targets to improve the outcome of diabetic patients as a central tenet. Meeting these targets requires a comprehensive screening and monitoring programme to establish the current incidence of diabetic complications and show that the major goals of the declaration are being achieved. The Scottish Physiotherapy Amputee Research Group and the Scottish Vascular Audit Group jointly organized a three month prospective screening programme of 146 patients presenting for a lower limb amputation. The results suggest that a significant proportion of patients have undiagnosed diabetes. Further, only around half of the patients eligible for testing actually had a test done, highlighting the difficulties associated with establishing a national screening programme. This programme is now ongoing and particular importance is being given to improving the proportion of patients actually being tested. PMID:9621529

  19. A prospective study of adverse drug reactions in hospitalized children

    PubMed Central

    Martínez-Mir, Inocencia; García-López, Mercedes; Palop, Vicente; Ferrer, José M; Rubio, Elena; Morales-Olivas, Francisco J

    1999-01-01

    Aims There are few publications of adverse drug reactions (ADRs) among paediatric patients, though ADR incidence is usually stated to be higher during the first year of life and in male patients. We have carried out a prospective study to assess the extent, pattern and profile risk for ADRs in hospitalized patients between 1 and 24 months of age. Methods An intensive events monitoring scheme was used. A total of 512 successive admissions to two medical paediatric wards (47 beds) were analysed. The hospital records were screened daily during two periods (summer, 105 days and winter, 99 days), and adverse clinical events observed were recorded. Results A total of 282 events were detected; of these, 112 were considered to be manifestations of ADRs. The cumulative incidence was 16.6%, no differences being observed between periods. Although there were no differences between patients under and over 12 months of age, risk was found to be significantly higher among girls compared with boys (RR = 1.66, 95% CI 1.03–2.52). The gastro-intestinal system was most frequently affected. The therapeutic group most commonly implicated was anti-infective drugs and vaccines (41.5%). The ADRs were mild or moderate in over 90% of cases. A consistent relationship was noted between the number of drugs administered and the incidence of ADRs. Conclusions Hospitalized patients exhibited an ADR risk profile that included female sex and the number of drugs administered. No particular age predisposition was observed. The most commonly prescribed drugs are those most often implicated in ADRs in paediatric patients. PMID:10383547

  20. The risk-stratified osteoporosis strategy evaluation study (ROSE): a randomized prospective population-based study. Design and baseline characteristics.

    PubMed

    Rubin, Katrine Hass; Holmberg, Teresa; Rothmann, Mette Juel; Høiberg, Mikkel; Barkmann, Reinhard; Gram, Jeppe; Hermann, Anne Pernille; Bech, Mickael; Rasmussen, Ole; Glüer, Claus C; Brixen, Kim

    2015-02-01

    The risk-stratified osteoporosis strategy evaluation study (ROSE) is a randomized prospective population-based study investigating the effectiveness of a two-step screening program for osteoporosis in women. This paper reports the study design and baseline characteristics of the study population. 35,000 women aged 65-80 years were selected at random from the population in the Region of Southern Denmark and-before inclusion-randomized to either a screening group or a control group. As first step, a self-administered questionnaire regarding risk factors for osteoporosis based on FRAX(®) was issued to both groups. As second step, subjects in the screening group with a 10-year probability of major osteoporotic fractures ≥15% were offered a DXA scan. Patients diagnosed with osteoporosis from the DXA scan were advised to see their GP and discuss pharmaceutical treatment according to Danish National guidelines. The primary outcome is incident clinical fractures as evaluated through annual follow-up using the Danish National Patient Registry. The secondary outcomes are cost-effectiveness, participation rate, and patient preferences. 20,904 (60%) women participated and included in the baseline analyses (10,411 in screening and 10,949 in control group). The mean age was 71 years. As expected by randomization, the screening and control groups had similar baseline characteristics. Screening for osteoporosis is at present not evidence based according to the WHO screening criteria. The ROSE study is expected to provide knowledge of the effectiveness of a screening strategy that may be implemented in health care systems to prevent fractures. PMID:25578146

  1. Cohort profile: golestan hepatitis B cohort study- a prospective long term study in northern iran ​.

    PubMed

    Poustchi, Hossein; Katoonizadeh, Aezam; Ostovaneh, Mohammad Reza; Moossavi, Shirin; Sharafkhah, Maryam; Esmaili, Saeed; Pourshams, Akram; Mohamadkhani, Ashraf; Besharat, Sima; Merat, Shahin; Mohamadnejad, Mehdi; George, Jacob; Malekzadeh, Reza

    2014-10-01

    Hepatitis B virus (HBV) infection is the most common cause of end stage liver disease in Iran and in Golestan province. Large-scale population-based prospective cohort studies with long term follow-up are the method of choice to accurately understand the natural course of HBV infection. To date, several studies of HBV epidemiology, natural history, progression to cirrhosis and association with HCC have been reported from other countries. However, few of these are prospective and fewer still are population-based. Moreover, the underlying molecular mechanisms and immunogenetic determinants of the outcome of HBV infection especially in low and middle income countries remains largely unknown. Therefore, the hepatitis B cohort study (HBCS), nested as part of the Golestan Cohort Study (GCS), Golestan, Iran was established in 2008 with the objective to prospectively investigate the natural course of chronic hepatitis B with reference to its epidemiology, viral/host genetic interactions, clinical features and outcome in the Middle East where genotype D HBV accounts for >90% of infections. In 2008, a baseline measurement of HBV surface antigen (HBsAg) was performed on stored serum samples of all GCS participants. A sub-cohort of 3,505 individuals were found to be HBsAg positive and were enrolled in the Golestan HBCS. In 2011, all first degree relatives of HBsAg positive subjects including their children and spouses were invited for HBV serology screening and those who were positive for HBsAg were also included in the Golestan HBCS. PMID:25349681

  2. Recent trends and future prospects in computational GPCR drug discovery: from virtual screening to polypharmacology.

    PubMed

    Carrieri, Antonio; Pérez-Nueno, Violeta I; Lentini, Giovanni; Ritchie, David W

    2013-01-01

    Extending virtual screening approaches to deal with multi-target drug design and polypharmacology is an increasingly important aspect in drug design. In light of this, the concept of accessible chemical space and its exploration should be reviewed. The great advantages of re-using drugs with safe pharmacological profiles with favourable pharmacokinetic properties highlights drug repositioning as a valid alternative to rational drug design, massive drug development efforts, and high-throughput screening, especially when supported by in silico techniques. Here, we discuss some of the advantages of multi-target approaches, and we review some significant examples of their application in the last decade to that well known class of pharmaceutical targets, the G-protein coupled receptors. PMID:23651484

  3. The Early Screening Profiles: A Stability Study.

    ERIC Educational Resources Information Center

    Smith, Douglas K.; And Others

    Stability of the Early Screening Profiles (ESP), developed by P. Harrison, was examined with a sample of 23 non-handicapped preschool children (14 females and 9 males) ranging in age from 3 years 0 months to 6 years 0 months at the time of initial testing. The sample was drawn from a rural/suburban community in the midwest with a predominantly…

  4. Colorectal Cancer in the Arab World--Screening Practices and Future Prospects.

    PubMed

    Arafa, Mostafa A; Farhat, Karim

    2015-01-01

    Colorectal cancer (CRC) incidence and mortality rates have dropped 30% in the US in the last 10 years among adults ages 50 and older due to the widespread uptake of colonoscopy, yet incidences in the Arab countries have been increasing in the past ten years, albeit with lower figures when compared with developed countries. Lifestyle changes, food consumption patterns and obesity have been observed during the past years where the regular consumption of traditional foods is being replaced with more Western-style and ready-made foods. Most high income countries have implemented population based colorectal cancer screening programs, which aid in decreasing the incidence and mortality of cancer, while these are lacking in most of the Arab world countries due to many cultural and religious barriers to CRC screening as well as lack of high education or familiarity. What is needed is health education to modify risky lifestyle, and to increase motives and enhance positive attitudes towards early screening especially amongst high risk groups in addition to policy designed to encourage healthier living. PMID:26625738

  5. Investing in Prospective Cohorts for Etiologic Study of Occupational Exposures

    EPA Science Inventory

    Prospective cohorts have played a major role in understanding the role of diet, physical activity, medical conditions, and genes in the development of many diseases, but have not been widely used in the study of occupational exposures. Studies in agriculture are an exception. W...

  6. Social Capital and Health: A Review of Prospective Multilevel Studies

    PubMed Central

    Murayama, Hiroshi; Fujiwara, Yoshinori; Kawachi, Ichiro

    2012-01-01

    Background This article presents an overview of the concept of social capital, reviews prospective multilevel analytic studies of the association between social capital and health, and discusses intervention strategies that enhance social capital. Methods We conducted a systematic search of published peer-reviewed literature on the PubMed database and categorized studies according to health outcome. Results We identified 13 articles that satisfied the inclusion criteria for the review. In general, both individual social capital and area/workplace social capital had positive effects on health outcomes, regardless of study design, setting, follow-up period, or type of health outcome. Prospective studies that used a multilevel approach were mainly conducted in Western countries. Although we identified some cross-sectional multilevel studies that were conducted in Asian countries, including Japan, no prospective studies have been conducted in Asia. Conclusions Prospective evidence from multilevel analytic studies of the effect of social capital on health is very limited at present. If epidemiologic findings on the association between social capital and health are to be put to practical use, we must gather additional evidence and explore the feasibility of interventions that build social capital as a means of promoting health. PMID:22447212

  7. VISION SCREENING OF THE PRESCHOOL CHILD, REPORT OF A STUDY.

    ERIC Educational Resources Information Center

    SAVITZ, ROBERTA A.; AND OTHERS

    USING A SAMPLE OF 94 CHILDREN (31 TO 54 MONTHS OLD), THIS STUDY COMPARED EIGHT VISION SCREENING PROCEDURES FOR YOUNG CHILDREN IN THE ABILITY TO TEST FOR SEVERAL VISUAL FUNCTIONS, AND PREFERENCE AMONG THEM BY CHILDREN. THE SUBJECTS WERE ORIGINALLY TESTED USING THE EIGHT SCREENING TESTS, AND 6 MONTHS LATER 40 OF THE CHILDREN WERE RETESTED FOR…

  8. [The "Neuropsychological Screening Test (NST)": initial validation and reliability studies].

    PubMed

    Schmidgen, H; Hoell, T; Regard, M; Landis, T; Rudolf, K H; Berzewski, H; Brock, M

    1994-01-01

    Medical examinations only insufficiently measure cognitive impairment in neurological and neurosurgical patients. Due to costs an personnel shortages, adequate neuropsychological test methods are typically bypassed. Indeed, the very size and methodological problems of current tests impede their application in clinical practice. To resolve this dissatisfying state of affairs, we have developed a standardized, scored form of initial neuropsychological examination. The Neuropsychological Screening Test (NST) comprises 45 items, is easy to handle, and can be conducted in 15-20 min. The NST measures psychic performance along functional parameters such as orientation in place and time, primary and secondary language, visuospatial ability, attention, and memory skills. We have assessed the validity and reliability of the NST in a prospective study. 129 neurosurgical patients (60% malignant or benign cerebral tumors, 21% vascular malformations with and without subarachnoid hemorrhage, 6% traumatic brain injury, 3% hydrocephalus, 10% others) and 52 control subjects were included in the study. The difference in average total NST-scores was highly significant for the two groups (t = -7.84, DF = 177.93, p < .001). In addition, two chronologically separate subsamples of NCH patients (N = 81) and controls (N = 35) were tested using the Mini-Mental State (MMS). The correlation between total NST-score and MMS results was r = .49 (p < .001). Cross-tabulation was used to set a cut-off score, by means of which 80% of the neurosurgical patients were identified as true positive and 74% of the controls as true negative. A 24-hour retest confirmed the NST as reliable to .85 (p < .001).(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7887046

  9. Surface reflectance and material studies for the PROSPECT Experiment

    NASA Astrophysics Data System (ADS)

    Bowes, Alyssa; Prospect Collaboration

    2015-10-01

    The PROSPECT Experiment aims to probe the existence of sterile neutrino oscillations by measuring the energy spectrum of antineutrinos emanating from nuclear reactors in a matrix of optically separated target scintillator cells at a variety of reactor-detector baselines. By measuring the absolute spectrum we also learn about reactors and what isotopes they produce. In order to properly model and optimise PROSPECT's energy resolution and background rejection capabilities, the reflective properties of the cell surfaces must be well understood. To address this, a study of various reflective surfaces under consideration to be used in the detector was conducted at non-normal incident angles through liquid using a custom-built laser-based reflectance measurement system. This presentation will describe the apparatus, reflectance measurements, and implications for the PROSPECT optical cell performance. Future plans to incorporate measurements into existing optical simulations will also be discussed. Funding provided by Illinois Institute of Technology College of Science.

  10. Novel risk markers for gastric cancer screening: Present status and future prospects.

    PubMed

    Enomoto, Shotaro; Maekita, Takao; Ohata, Hiroshi; Yanaoka, Kimihiko; Oka, Masashi; Ichinose, Masao

    2010-12-16

    Initial identification of populations at high risk of gastric cancer (GC) is important for endoscopic screening of GC. As serum pepsinogen (PG) test-positive subjects with progression of chronic atrophic gastritis (CAG) show a high likelihood of future cancer development, this population warrants careful follow-up observation as a high-risk GC group. By combining the PG test with Helicobacter pylori (HP) antibody titers, the HP-related chronic gastritis stage can be classified, thus identifying not only a GC high-risk group but also a low-risk group. Among PG test-negative patients without CAG, those with high serum PG II levels and HP antibody titers are thought to have severe gastric mucosal inflammation and the risk of diffuse-type GC is also high. Meanwhile, in gastric mucosae obtained by endoscopic biopsy, HP infection induces aberrant DNA methylation in CpG islands in multiple gene regions and the extent of methylation clearly correlates with GC risk. By quantifying aberrant DNA methylation in suitable gene markers, we can determine the extent of the epigenetic field for cancerization. These novel concepts and risk markers will have many clinical applications in gastrointestinal endoscopy, including more efficient endoscopic GC screening and a strategic approach to metachronous multiple GCs after endoscopic treatment. PMID:21191511

  11. A Qualitative Study on the Prospective Social Studies Teachers' Role-Model Preferences

    ERIC Educational Resources Information Center

    Tonga, Deniz

    2014-01-01

    In this study is intended to investigate prospective social studies teachers' role model preferences and the reflections of these preferences to their daily lives. This study was designed as a qualitative study in the form of descriptive model. The participants consisted of 306 prospective social studies teachers enrolled in nine different…

  12. Development in Children with Achondroplasia: A Prospective Clinical Cohort Study

    ERIC Educational Resources Information Center

    Ireland, Penelope J.; Donaghey, Samantha; McGill, James; Zankl, Andreas; Ware, Robert S.; Pacey, Verity; Ault, Jenny; Savarirayan, Ravi; Sillence, David; Thompson, Elizabeth; Townshend, Sharron; Johnston, Leanne M.

    2012-01-01

    Aim: Achondroplasia is characterized by delays in the development of communication and motor skills. While previously reported developmental profiles exist across gross motor, fine motor, feeding, and communication skills, there has been no prospective study of development across multiple areas simultaneously. Method: This Australasian…

  13. Prospects of Elliptic Flow Studies at NICA/MPD

    NASA Astrophysics Data System (ADS)

    Geraksiev, Nikolay

    2016-01-01

    As a key observable, anisotropic flow presents a unique insight into heavy ion collision physics. The presented poster reveals the prospects of studying elliptic flow at the NICA/MPD facility through the UrQMD model. Here, results for the elliptic flow of simulated and reconstructed hadrons at the planned NICA energy range are presented.

  14. PROSPECTIVE PREGNANCY STUDY DESIGNS FOR ASSESSING REPRODUCTIVE AND DEVELOPMENTAL TOXICANTS

    EPA Science Inventory

    Prospective Pregnancy Study Designs for Assessing Reproductive and Developmental Toxicants
    Germaine M. Buck,1 Courtney D. Johnson,1 Joseph Stanford,2 Anne Sweeney,3 Laura Schieve,4 John Rockett,5 Sherry G. Selevan,6 Steve Schrader 7

    Abstract
    The origin of successfu...

  15. Prospective Study of the Effectiveness of Coping in Pediatric Patients

    ERIC Educational Resources Information Center

    Zehnder, Daniel; Prchal, Alice; Vollrath, Margarete; Landolt, Markus A.

    2006-01-01

    Findings about the influence of coping on psychological adjustment in children with different medical conditions are inconsistent and often based on cross-sectional data. This prospective study evaluated the effect of various coping strategies on children's post-traumatic stress symptoms and behavioral problems 1 month and 1 year after an…

  16. Students' Perception on the Prospect of Economics Education Study Program

    ERIC Educational Resources Information Center

    Meiriza, Mica Siar

    2015-01-01

    This study aims to determine the extent to which perceptions of students on the prospect of the Economics Education Program. The method used in this research is descriptive method in which the required data is obtained through questionnaire and technique of analyzing data used is percentages. Questionnaires were distributed through the Student…

  17. Prospective Nationwide Study of Aeromonas Infections in France▿

    PubMed Central

    Lamy, Brigitte; Kodjo, Angeli; Laurent, Frédéric

    2009-01-01

    We report a systematic prospective multicenter nationwide study of clinical Aeromonas infections in France. During 6 months (May to October 2006), 78 cases of aeromonosis were reviewed for risk factors and clinical, microbiological, and antimicrobial susceptibility data. They included wound infections (44%), bacteremia (26%), enteritis (19%), respiratory tract infections (6%), and miscellaneous (5%) infections. PMID:19244464

  18. Does Gender Discrimination Impact Regular Mammography Screening? Findings from the Race Differences in Screening Mammography Study

    PubMed Central

    DAILEY, AMY B.; KASL, STANISLAV V.; JONES, BETH A.

    2011-01-01

    Objective To determine if gender discrimination, conceptualized as a negative life stressor, is a deterrent to adherence to mammography screening guidelines. Methods African American and white women (1451) aged 40–79 years who obtained an index screening mammogram at one of five urban hospitals in Connecticut between October 1996 and January 1998 were enrolled in this study. This logistic regression analysis includes the 1229 women who completed telephone interviews at baseline and follow-up (average 29.4 months later) and for whom the study outcome, nonadherence to age-specific mammography screening guidelines, was determined. Gender discrimination was measured as lifetime experience in seven possible situations. Results Gender discrimination, reported by nearly 38% of the study population, was significantly associated with nonadherence to mammography guidelines in women with annual family incomes of ≥$50,000 (OR 1.99, 95% CI 1.33, 2.98) and did not differ across racial/ethnic group. Conclusions Our findings suggest that gender discrimination can adversely influence regular mammography screening in some women. With nearly half of women nonadherent to screening mammography guidelines in this study and with decreasing mammography rates nationwide, it is important to address the complexity of nonadherence across subgroups of women. Life stressors, such as experiences of gender discrimination, may have considerable consequences, potentially influencing health prevention prioritization in women. PMID:18321171

  19. Studying Native America: Problems and Prospects.

    ERIC Educational Resources Information Center

    Thornton, Russell, Ed.

    Based on a conference, this volume examines the past, present, and future of Native American studies. Native American studies seeks to understand Native Americans, America, and the world from a Native American indigenous perspective, and thereby broaden the education of both Native and non-Native Americans. Part 1 asks who Native Americans are…

  20. Lifetime socioeconomic position and mortality: prospective observational study.

    PubMed Central

    Smith, G. D.; Hart, C.; Blane, D.; Gillis, C.; Hawthorne, V.

    1997-01-01

    OBJECTIVES: To assess the influence of socioeconomic position over a lifetime on risk factors for cardiovascular disease, on morbidity, and on mortality from various causes. DESIGN: Prospective observational study with 21 years of follow up. Social class was determined as manual or non-manual at three stages of participants' lives: from the social class of their father's job, the social class of their first job, and the social class of their job at the time of screening. A cumulative social class indicator was constructed, ranging from non-manual social class at all three stages of life to manual social class at all three stages. SETTING: 27 workplaces in the west of Scotland. PARTICIPANTS: 5766 men aged 35-64 at the time of examination. MAIN OUTCOME MEASURES: Prevalence and level of risk factors for cardiovascular disease; morbidity; and mortality from broad causes of death. RESULTS: From non-manual social class locations at all three life stages to manual at all stages there were strong positive trends for blood pressure, body mass index, current cigarette smoking, angina, and bronchitis. Inverse trends were seen for height, cholesterol concentration, lung function, and being an ex-smoker. 1580 men died during follow up. Age adjusted relative death rates in comparison with the men of non-manual social class locations at all three stages of life were 1.29 (95% confidence interval 1.08 to 1.56) in men of two non-manual and one manual social class; 1.45 (1.21 to 1.73) in men of two manual and one non-manual social class; and 1.71 (1.46 to 2.01) in men of manual social class at all three stages. Mortality from cardiovascular disease showed a similar graded association with cumulative social class. Mortality from cancer was mainly raised among men of manual social class at all three stages. Adjustment for a wide range of risk factors caused little attenuation in the association of cumulative social class with mortality from all causes and from cardiovascular disease

  1. Breast Cancer Challenges and Screening in China: Lessons From Current Registry Data and Population Screening Studies

    PubMed Central

    Song, Qing-Kun; Wang, Xiao-Li; Zhou, Xin-Na; Yang, Hua-Bing; Li, Yu-Chen; Wu, Jiang-Ping

    2015-01-01

    incidence, and an early age of onset. The 2009 to 2011 BC screening program targeting women aged 35–59 years had a low detection rate that resulted in a second-generation screening program that extended the cohort size and ages screened to 35–64 years. Implications for Practice: Cancer registration has been active in China for decades; however, a national survey of registries has not been routinely reported. This study used MapInfo to describe the reported data and found asymmetric registration activities, geographic variations in breast cancer (BC) burdens, and an increasing incidence with a peak at age 50. The initial Chinese BC screening programs focused on a relatively young population of women aged 35–59 years and had a low detection rate, but 69.7% of patients had early stage BC. Older women were included in the second-generation screening programs, and an additional 6 million women were screened. Consideration of regional variations and age is necessary to optimize the efficiency and utility of BC screening in China, with the ultimate goal to reduce BC mortality. PMID:26001390

  2. Screening of Diabetic Foot in Surgical Inpatients: A Hospital-Based Study in Saudi Arabia

    PubMed Central

    Elsharawy, Mohamed A.; Hassan, Khairi; AlAwad, Naif; Kredees, Ali; Almulhim, Abdelmohsen

    2012-01-01

    Previous reports found that identification of diabetic patients at high risk of foot ulcers, and managing the risk factors early, lower extremity amputations could be prevented. The aim of this study is to determine the value of screening diabetics in estimating the risk of foot ulceration among surgical inpatients. This is a prospective study on all diabetic patients admitted to the surgical department, King Fahd Hospital of the University, Saudi Arabia, during the year 2011. Patients were screened for the presence of diabetic foot. They were classified according to the international working group on the diabetic foot into four grades [0 (lowest risk patients), 1, 2, 3 (highest risk patients)]. During the study period, 391 patients had diabetes mellitus (DM), of these 73 (19%) had active ulcer and were excluded from the study and the rest were screened. Grade 0 was in 174 (54.5%) patients, the rest were grades 1, 2, and 3. There was significant difference between low-risk groups (grades 0, 1) and high-risk groups (grades 2, 3) as regards age, smoking and duration of DM. This study indicates that prevalence of diabetic patients with risk of foot ulceration in surgical inpatients was high. Routine screening of diabetic foot is recommended specially in old patients. PMID:24293979

  3. Prospects for alpha particle studies on TFTR

    SciTech Connect

    Zweben, S.J.

    1987-05-01

    TFTR is expected to produce approximately 5 MW of alpha heating during the D/T Q approx. = 1 phase of operation in 1990. At that point the collective confinement properties and the heating effects of alpha particles become accessible for study for the first time. This paper outlines the potential performance of TFTR with respect to alpha particle production, the diagnostics which will be available for alpha particle measurements, and the physics issues which can be studied both before and during D/T operation.

  4. Problems and Prospect of Chinese Communication Study.

    ERIC Educational Resources Information Center

    Chen, Guo-Ming

    Chinese have systematically practiced communication for over two thousand years, but from the Western perspective communication education and research in Chinese societies only began to burgeon in recent decades. In addition to summarizing the Western and traditional Chinese communication study and practice, this paper identified four problems…

  5. Communication Studies in Australia: Achievements and Prospects.

    ERIC Educational Resources Information Center

    Irwin, Harry

    The introduction of communications studies in Australian higher education and problems and achievements of the past decade are discussed. Attention is directed to: the development of formal college coursework; staff training and retraining schemes to support development; academic and professional associations; journals in the field; and research,…

  6. The National Lung Screening Trial: overview and study design.

    PubMed

    Aberle, Denise R; Berg, Christine D; Black, William C; Church, Timothy R; Fagerstrom, Richard M; Galen, Barbara; Gareen, Ilana F; Gatsonis, Constantine; Goldin, Jonathan; Gohagan, John K; Hillman, Bruce; Jaffe, Carl; Kramer, Barnett S; Lynch, David; Marcus, Pamela M; Schnall, Mitchell; Sullivan, Daniel C; Sullivan, Dorothy; Zylak, Carl J

    2011-01-01

    The National Lung Screening Trial (NLST) is a randomized multicenter study comparing low-dose helical computed tomography (CT) with chest radiography in the screening of older current and former heavy smokers for early detection of lung cancer, which is the leading cause of cancer-related death in the United States. Five-year survival rates approach 70% with surgical resection of stage IA disease; however, more than 75% of individuals have incurable locally advanced or metastatic disease, the latter having a 5-year survival of less than 5%. It is plausible that treatment should be more effective and the likelihood of death decreased if asymptomatic lung cancer is detected through screening early enough in its preclinical phase. For these reasons, there is intense interest and intuitive appeal in lung cancer screening with low-dose CT. The use of survival as the determinant of screening effectiveness is, however, confounded by the well-described biases of lead time, length, and overdiagnosis. Despite previous attempts, no test has been shown to reduce lung cancer mortality, an endpoint that circumvents screening biases and provides a definitive measure of benefit when assessed in a randomized controlled trial that enables comparison of mortality rates between screened individuals and a control group that does not undergo the screening intervention of interest. The NLST is such a trial. The rationale for and design of the NLST are presented. PMID:21045183

  7. STATISTICAL PRINCIPLES FOR PROSPECTIVE STUDY PROTOCOLS:

    PubMed Central

    Langberg, Henning

    2012-01-01

    In the design of scientific studies it is essential to decide on which scientific questions one aims to answer, just as it is important to decide on the correct statistical methods to use to answer these questions. The correct use of statistical methods is crucial in all aspects of research to quantify relationships in data. Despite an increased focus on statistical content and complexity of biomedical research these topics remain difficult for most researchers. Statistical methods enable researchers to condense large spreadsheets with data into means, proportions, and difference between means, risk differences, and other quantities that convey information. One of the goals in biomedical research is to develop parsimonious models ‐ meaning as simple as possible. This approach is valid if the subsequent research report (the article) is written independent of whether the results are “statistically significant” or not. In the present paper we outline the considerations and suggestions on how to build a trial protocol, with an emphasis on having a rigorous protocol stage, always leading to a full article manuscript, independent of statistical findings. We conclude that authors, who find (rigorous) protocol writing too troublesome, will realize that they have already written the first half of the final paper if they follow these recommendations; authors simply need to change the protocols future tense into past tense. Thus, the aim of this clinical commentary is to describe and explain the statistical principles for trial protocols in terms of design, analysis, and reporting of findings. PMID:23091782

  8. Biomarker research with prospective study designs for the early detection of cancer.

    PubMed

    Pesch, B; Brüning, T; Johnen, G; Casjens, S; Bonberg, N; Taeger, D; Müller, A; Weber, D G; Behrens, T

    2014-05-01

    This article describes the principles of marker research with prospective studies along with examples for diagnostic tumor markers. A plethora of biomarkers have been claimed as useful for the early detection of cancer. However, disappointingly few biomarkers were approved for the detection of unrecognized disease, and even approved markers may lack a sound validation phase. Prospective studies aimed at the early detection of cancer are costly and long-lasting and therefore the bottleneck in marker research. They enroll a large number of clinically asymptomatic subjects and follow-up on incident cases. As invasive procedures cannot be applied to collect tissue samples from the target organ, biomarkers can only be determined in easily accessible body fluids. Marker levels increase during cancer development, with samples collected closer to the occurrence of symptoms or a clinical diagnosis being more informative than earlier samples. Only prospective designs allow the serial collection of pre-diagnostic samples. Their storage in a biobank upgrades cohort studies to serve for both, marker discovery and validation. Population-based cohort studies, which may collect a wealth of data, are commonly conducted with just one baseline investigation lacking serial samples. However, they can provide valuable information about factors that influence the marker level. Screening programs can be employed to archive serial samples but require significant efforts to collect samples and auxiliary data for marker research. Randomized controlled trials have the highest level of evidence in assessing a biomarker's benefit against usual care and present the most stringent design for the validation of promising markers as well as for the discovery of new markers. In summary, all kinds of prospective studies can benefit from a biobank as they can serve as a platform for biomarker research. This article is part of a Special Issue entitled: Biomarkers: A Proteomic Challenge. PMID:24361552

  9. Adherence to immunosuppression: a prospective diary study.

    PubMed

    Gordon, E J; Prohaska, T R; Gallant, M P; Siminoff, L A

    2007-12-01

    Immunosuppression adherence among kidney transplant recipients is essential for graft survival. However, nonadherence is common, jeopardizing graft survival. Besides skipping dosages, little is known about other forms of medication nonadherence and their underlying reasons. This study sought to examine patients' extent of medication adherence over time and reasons for nonadherence. Thirty-nine new kidney transplant recipients were asked to complete a month-long medication-taking diary that included reporting medication nonadherence such as skipped medications, medications taken early or late, taking dosages greater or less than prescribed, and the reason for each occurrence of nonadherence. Of the 20 (51%) patients who completed the diary, 11 (55%) reported at least 1 form of nonadherence. Eleven patients reported taking their immunosuppression at least 1 hour later than the prescribed time, 1 patient reported skipping medication, but no patients reported changing the dosage on their own. Immunosuppression was taken on average 1.5 hours after the prescribed time. Of those patients who took their medications late, there were on average 3.1 occasions of taking it late. The most common reasons for this behavior included health care-related issues, followed by oversleeping, being away from home, work-related barriers, and forgetting. The majority of kidney transplant recipients took medications later than prescribed during 1 month. Future research should determine the clinical impact on graft function of late administration of immunosuppression. Interventions should be designed to better assist kidney recipients with taking medications on time, especially when they are away from home. PMID:18089327

  10. [Prenatal diagnosis. Review, personal and prospective studies].

    PubMed

    Engel, E; Empson, J; DeLozier, D; McGee, B; da Costa Woodson, E; Engel-de Montmollin, M; Carter, T; Lorber, C; Cassidy, S B; Millis, J; Heller, R M; Boehm, F; Vanhooydonk, J

    1979-07-01

    instruments is particularly useful in cases where a severe fetal morphologic malformation cannot currently be identified by indirect visualization (ultrasound) or by analysis of cytogenetic or molecular markers. 6. Pathological accumulations of alpha-fetoprotein which are associated with diverse feto-placental abnormalities (particularly open malformations of the neural tube) can be detected in the amniotic fluid and/or maternal blood. In extension of this approach, it is foreseeable that conditions existing prenatally will be diagnosed in a growing number of cases from the study of fetal cells and molecules which can be isolated from the venous blood of pregnant women. This will become feasible as a result of some well-developed techniques which allow separation of fetal from maternal cells and metabolites, and also to some extremely fine analytic techniques, notably examination of the DNA itself by means of restriction enzymes. PMID:88763

  11. Improving newborn screening for cystic fibrosis using next-generation sequencing technology: a technical feasibility study

    PubMed Central

    Baker, Mei W.; Atkins, Anne E.; Cordovado, Suzanne K.; Hendrix, Miyono; Earley, Marie C.; Farrell, Philip M.

    2016-01-01

    Purpose Many regions have implemented newborn screening (NBS) for cystic fibrosis (CF) using a limited panel of cystic fibrosis transmembrane regulator (CFTR) mutations after immunoreactive trypsinogen (IRT) analysis. We sought to assess the feasibility of further improving the screening using next-generation sequencing (NGS) technology. Methods An NGS assay was used to detect 162 CFTR mutations/variants characterized by the CFTR2 project. We used 67 dried blood spots (DBSs) containing 48 distinct CFTR mutations to validate the assay. NGS assay was retrospectively performed on 165 CF screen–positive samples with one CFTR mutation. Results The NGS assay was successfully performed using DNA isolated from DBSs, and it correctly detected all CFTR mutations in the validation. Among 165 screen-positive infants with one CFTR mutation, no additional disease-causing mutation was identified in 151 samples consistent with normal sweat tests. Five infants had a CF-causing mutation that was not included in this panel, and nine with two CF-causing mutations were identified. Conclusion The NGS assay was 100% concordant with traditional methods. Retrospective analysis results indicate an IRT/NGS screening algorithm would enable high sensitivity, better specificity and positive predictive value (PPV). This study lays the foundation for prospective studies and for introducing NGS in NBS laboratories. PMID:25674778

  12. Increasing chlamydia screening tests in general practice: a modified Zelen prospective Cluster Randomised Controlled Trial evaluating a complex intervention based on the Theory of Planned Behaviour

    PubMed Central

    McNulty, Cliodna A M; Hogan, Angela H; Ricketts, Ellie J; Wallace, Louise; Oliver, Isabel; Campbell, Rona; Kalwij, Sebastian; O'Connell, Elaine; Charlett, Andre

    2014-01-01

    Objective To determine if a structured complex intervention increases opportunistic chlamydia screening testing of patients aged 15–24 years attending English general practitioner (GP) practices. Methods A prospective, Cluster Randomised Controlled Trial with a modified Zelen design involving 160 practices in South West England in 2010. The intervention was based on the Theory of Planned Behaviour (TPB). It comprised of practice-based education with up to two additional contacts to increase the importance of screening to GP staff and their confidence to offer tests through skill development (including videos). Practical resources (targets, posters, invitation cards, computer reminders, newsletters including feedback) aimed to actively influence social cognitions of staff, increasing their testing intention. Results Data from 76 intervention and 81 control practices were analysed. In intervention practices, chlamydia screening test rates were 2.43/100 15–24-year-olds registered preintervention, 4.34 during intervention and 3.46 postintervention; controls testing rates were 2.61/100 registered patients prior intervention, 3.0 during intervention and 2.82 postintervention. During the intervention period, testing in intervention practices was 1.76 times as great (CI 1.24 to 2.48) as controls; this persisted for 9 months postintervention (1.57 times as great, CI 1.27 to 2.30). Chlamydia infections detected increased in intervention practices from 2.1/1000 registered 15–24-year-olds prior intervention to 2.5 during the intervention compared with 2.0 and 2.3/1000 in controls (Estimated Rate Ratio intervention versus controls 1.4 (CI 1.01 to 1.93). Conclusions This complex intervention doubled chlamydia screening tests in fully engaged practices. The modified Zelen design gave realistic measures of practice full engagement (63%) and efficacy of this educational intervention in general practice; it should be used more often. Trial registration The trial was

  13. Problems and Limitations in Studies on Screening for Language Delay

    ERIC Educational Resources Information Center

    Eriksson, Marten; Westerlund, Monica; Miniscalco, Carmela

    2010-01-01

    This study discusses six common methodological limitations in screening for language delay (LD) as illustrated in 11 recent studies. The limitations are (1) whether the studies define a target population, (2) whether the recruitment procedure is unbiased, (3) attrition, (4) verification bias, (5) small sample size and (6) inconsistencies in choice…

  14. IronMaking Process Alternatives Screening Study

    SciTech Connect

    none,

    2000-10-01

    This study by Lockwood Greene evaluates a number ironmaking processes. The appendices provide greater detail and further exploration of the ironmaking processes, including components, relative costs, and comparisons.

  15. [From early detection to early care: intervention strategies based on prospective screening].

    PubMed

    Canal-Bedia, Ricardo; García-Primo, Patricia; Hernández-Fabián, Aránzazu; Magán-Maganto, María; Sánchez, Ana B; Posada-De la Paz, Manuel

    2015-02-25

    INTRODUCTION. The challenge of early detection can be tackled from an evolutionary perspective. Early intervention treatments have shown themselves to be effective provided that they are applied systematically as part of the strategic planning of the treatment. AIMS. The aim of this study is to provide an updated review in response to the criticism targeted towards early detection and to offer some considerations on the intervention strategy. Our research is based on a review of the early care techniques that are commonly used within the field of autism and it intends to reflect the most significant aspects that can be deduced from the experiments and studies carried out to date. CONCLUSIONS. From the findings of the review it can be concluded that early detection may be more efficient if carried out within the framework of developmental surveillance, which also offers the opportunity to provide guidance on the child's development. Early care is an effective resource for attending to the needs of children with autism. Professionals have the duty to assess the work they do on available treatments with a reflexive, judicious attitude, taking into account the values and preferences of the families. Programmes must focus on the core symptoms and apply the active ingredients of the treatment. PMID:25726819

  16. Intake of coffee and tea and risk of ovarian cancer: a prospective cohort study.

    PubMed

    Silvera, Stephanie A N; Jain, Meera; Howe, Geoffrey R; Miller, Anthony B; Rohan, Thomas E

    2007-01-01

    There is some evidence from case-control studies that coffee consumption might be positively associated with ovarian cancer risk, whereas the epidemiologic evidence regarding tea consumption and ovarian cancer is inconsistent. To date, there have been few prospective studies of these associations. Therefore, we examined ovarian cancer risk in association with both coffee and tea intake in a prospective cohort study of 49,613 Canadian women enrolled in the National Breast Screening Study (NBSS) who completed a self-administered food frequency questionnaire between 1980 and 1985. Linkages to national mortality and cancer databases yielded data on deaths and cancer incidence, with follow-up ending between 1998 and 2000. Data from the food frequency questionnaire were used to estimate daily intake of coffee and tea. Cox proportional hazards models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for the association between categories of coffee and tea intake and ovarian cancer risk. During a mean 16.4 years of follow-up, we observed 264 incident ovarian cancer cases. Tea intake was not associated with ovarian cancer risk in our study population. In contrast, a borderline positive association was observed among women who drank > 4 cups coffee/day compared to women who did not drink coffee (HR = 1.62, 95% CI = 0.95-2.75, P(trend) = 0.06). Given the pervasive use of these beverages, the associations between coffee and tea consumption and ovarian cancer risk warrant investigation in further prospective studies. PMID:17571963

  17. Prospective pregnancy study designs for assessing reproductive and developmental toxicants.

    PubMed Central

    Buck, Germaine M; Lynch, Courtney D; Stanford, Joseph B; Sweeney, Anne M; Schieve, Laura A; Rockett, John C; Selevan, Sherry G; Schrader, Steven M

    2004-01-01

    The determinants of successful human reproduction and development may act as early as periconceptionally, underscoring the need to capture exposures during these critical windows when assessing potential toxicants. To identify such toxicants, couples must be studied longitudinally prior to conception without regard to a couple's ability to ascertain a clinically recognized pregnancy. We examined the utility and feasibility of prospective pregnancy study designs by conducting a systematic review of the literature to summarize relevant information regarding the planning, implementation, and success of previously published prospective pregnancy studies. Information concerning design elements and participation was abstracted from 15 eligible studies (from a total of 20 identified studies) using a standardized form. The primary author of each study was contacted to review our summary of their work and obtain missing information. Our findings confirm the ability to recruit women/couples from diverse populations using a variety of recruitment strategies. Among the studies we reviewed, 4-97% of eligible individuals were successfully contacted, with enrollment rates ranging from 42 to 100%. Length of follow-up varied from 3 to 12 months. A high percentage of women provided urine (57-98%) and blood (86-91%) specimens and most male partners (94-100%) provided semen samples. These data support the feasibility of this design. PMID:14698935

  18. Rapid screening assay for calcium bioavailability studies

    SciTech Connect

    Luhrsen, K.R.; Hudepohl, G.R.; Smith, K.T.

    1986-03-01

    Calcium bioavailability has been studied by numerous techniques. The authors report here the use of the gamma emitting isotope of calcium (/sup 47/Ca) in a whole body retention assay system. In this system, calcium sources are administered by oral gavage and subsequent counts are determined and corrected for isotopic decay. Unlike iron and zinc retention curves, which exhibit a 2-3 day equilibration period, calcium reaches equilibration after 24 hours. Autoradiographic analysis of the femurs indicate that the newly absorbed calcium is rapidly distributed to the skeletal system. Moreover, the isotope is distributed along the entire bone. Comparisons of calcium bioavailability were made using intrinsic/extrinsic labeled milk from two species i.e. rat and goat as well as CaCO/sub 3/. In addition, extrinsic labeled cow milk was examined. In the rat, the extrinsic labeled calcium from milk was better absorbed than the intrinsic calcium. This was not the case in goat milk or the calcium carbonate which exhibited no significant differences. Chromatographic analysis of the labeled milk indicates a difference in distribution of the /sup 47/Ca. From these data, the authors recommend the use of this assay system in calcium bioavailability studies. The labeling studies and comparisons indicate caution should be used, however, in labeling techniques and species milk comparison.

  19. Ureteral stricture formation after ureteroscope treatment of impacted calculi: A prospective study

    PubMed Central

    Singam, Praveen; Ho, Christopher Chee Kong; Sridharan, Radhika; Hod, Rozita; Bahadzor, Badrulhisham; Goh, Eng Hong; Tan, Guan Hee; Zainuddin, Zulkifli

    2015-01-01

    Purpose Urinary calculi is a familiar disease. A well-known complication of endourological treatment for impacted ureteral stones is the formation of ureteral strictures, which has been reported to occur in 14.2% to 24% of cases. Materials and Methods This was a prospective study. Ureterotripsy treatment was used on patients with impacted ureteral stones. Then, after 3 months and 6 months, the condition of these patients was assessed by means of a kidney-ureter-bladder (KUB) ultrasound. If the KUB ultrasound indicated moderate to serious hydronephrosis, the patient was further assessed by means of a computed tomography intravenous urogram or retrograde pyelogram to confirm the occurrence of ureteral strictures. Results Of the 77 patients who participated in the study, 5 developed ureteral strictures. Thus, the stricture rate was 7.8%. An analysis of the intraoperative risk factors including perforation of the ureter, damage to the mucous membrane, and residual stone impacted within the ureter mucosa revealed that none of these factors contributed significantly to the formation of the ureteric strictures. The stone-related risk factors that were taken into consideration were stone size, stone impaction site, and duration of impaction. These stone factors also did not contribute significantly to the formation of the ureteral strictures. Conclusions This prospective study failed to identify any predictable factors for ureteral stricture formation. It is proposed that all patients undergo a simple postoperative KUB ultrasound screening 3 months after undergoing endoscopic treatment for impacted ureteral stones. PMID:25598938

  20. The Impact of Brief Messages on HSV-2 Screening Uptake Among Female Defendants in a Court Setting: A Randomized Controlled Trial Utilizing Prospect Theory

    PubMed Central

    ROTH, ALEXIS M.; VAN DER POL, BARBARA; FORTENBERRY, J. DENNIS; DODGE, BRIAN; REECE, MICHAEL; CERTO, DAVID; ZIMET, GREGORY D.

    2015-01-01

    Epidemiologic data demonstrate that women involved with the criminal justice system in the United States are at high risk for sexually transmitted infections, including herpes simplex virus type 2 (HSV-2). Female defendants were recruited from a misdemeanor court to assess whether brief framed messages utilizing prospect theory could encourage testing for HSV-2. Participants were randomly assigned to a message condition (gain, loss, or control), completed an interviewer-administered survey assessing factors associated with antibody test uptake/refusal and were offered free point-of-care HSV-2 serologic testing. Although individuals in the loss-frame group accepted testing at the highest rate, an overall statistical difference in HSV-2 testing behavior by group (p ≤.43) was not detected. The majority of the sample (74.6%) characterized receiving a serological test for HSV-2 as health affirming. However, this did not moderate the effect of the intervention nor was it significantly associated with test acceptance (p ≤.82). Although the effects of message framing are subtle, the findings have important theoretical implications given the participants’ characterization of HSV-2 screening as health affirming despite being a detection behavior. Implications of study results for health care providers interested in brief, low cost interventions are also explored. PMID:25494832

  1. Equestrian injuries--a one year prospective study.

    PubMed Central

    McLatchie, G. R.

    1979-01-01

    A one year prospective study of equestrian injuries was carried out in an area where horse riding is a popular pursuit. 115 persons suffered injury--eighty females and thirty-five males of whom sixty were under fifteen years of age. No fatalities were recorded and there were 0.2 injuries per 100 rides. Most injuries were minor and to the musculo-skeletal system. Visceral and cerebral injuries were not common but the former were life threatening in all cases. It is concluded that young riders should be supervised. PMID:465903

  2. Short-term prospective spirometric study of new coal miners

    SciTech Connect

    Hankinson, J.L.; Hodous, T.K.

    1982-09-01

    This study examined prospectively a small cohort (N=116) of new coal miners with questionnaires and spirometry. Data collection began just prior to underground employment and extended over a two year period at 6 month intervals to address the question or short-term adverse occupational pulmonary effects and their relationship to outward migration from the industry. A comparison of the initial (unexposed) and six month (exposed) changes in lung function over the work shift was also conducted to detect an acute effect due to dust, which might be related to chronic decline in lung function.

  3. Evaluation of the pressure ulcers risk scales with critically ill patients: a prospective cohort study 1

    PubMed Central

    Borghardt, Andressa Tomazini; do Prado, Thiago Nascimento; de Araújo, Thiago Moura; Rogenski, Noemi Marisa Brunet; Bringuente, Maria Edla de Oliveira

    2015-01-01

    AIMS: to evaluate the accuracy of the Braden and Waterlow risk assessment scales in critically ill inpatients. METHOD: this prospective cohort study, with 55 patients in intensive care units, was performed through evaluation of sociodemographic and clinical variables, through the application of the scales (Braden and Waterlow) upon admission and every 48 hours; and through the evaluation and classification of the ulcers into categories. RESULTS: the pressure ulcer incidence was 30.9%, with the Braden and Waterlow scales presenting high sensitivity (41% and 71%) and low specificity (21% and 47%) respectively in the three evaluations. The cut off scores found in the first, second and third evaluations were 12, 12 and 11 in the Braden scale, and 16, 15 and 14 in the Waterlow scale. CONCLUSION: the Braden scale was shown to be a good screening instrument, and the Waterlow scale proved to have better predictive power. PMID:25806628

  4. Thermodynamic Studies for Drug Design and Screening

    PubMed Central

    Garbett, Nichola C.; Chaires, Jonathan B.

    2012-01-01

    Introduction A key part of drug design and development is the optimization of molecular interactions between an engineered drug candidate and its binding target. Thermodynamic characterization provides information about the balance of energetic forces driving binding interactions and is essential for understanding and optimizing molecular interactions. Areas covered This review discusses the information that can be obtained from thermodynamic measurements and how this can be applied to the drug development process. Current approaches for the measurement and optimization of thermodynamic parameters are presented, specifically higher throughput and calorimetric methods. Relevant literature for this review was identified in part by bibliographic searches for the period 2004 – 2011 using the Science Citation Index and PUBMED and the keywords listed below. Expert opinion The most effective drug design and development platform comes from an integrated process utilizing all available information from structural, thermodynamic and biological studies. Continuing evolution in our understanding of the energetic basis of molecular interactions and advances in thermodynamic methods for widespread application are essential to realize the goal of thermodynamically-driven drug design. Comprehensive thermodynamic evaluation is vital early in the drug development process to speed drug development towards an optimal energetic interaction profile while retaining good pharmacological properties. Practical thermodynamic approaches, such as enthalpic optimization, thermodynamic optimization plots and the enthalpic efficiency index, have now matured to provide proven utility in design process. Improved throughput in calorimetric methods remains essential for even greater integration of thermodynamics into drug design. PMID:22458502

  5. Ironmaking Process Alternative Screening Study, Volume 1

    SciTech Connect

    Lockwood Greene, . .

    2005-01-06

    Iron in the United States is largely produced from iron ore mined in the United States or imported from Canada or South America. The iron ore is typically smelted in Blast Furnaces that use primarily iron ore, iron concentrate pellets metallurgical coke, limestone and lime as the raw materials. Under current operating scenarios, the iron produced from these Blast Furnaces is relatively inexpensive as compared to current alternative iron sources, e.g. direct iron reduction, imported pig iron, etc. The primary problem the Blast Furnace Ironmaking approach is that many of these Blast furnaces are relatively small, as compared to the newer, larger Blast Furnaces; thus are relatively costly and inefficient to operate. An additional problem is also that supplies of high-grade metallurgical grade coke are becoming increasingly in short supply and costs are also increasing. In part this is due to the short supply and costs of high-grade metallurgical coals, but also this is due to the increasing necessity for environmental controls for coke production. After year 2003 new regulations for coke product environmental requirement will likely be promulgated. It is likely that this also will either increase the cost of high-quality coke production or will reduce the available domestic U.S. supply. Therefore, iron production in the United States utilizing the current, predominant Blast Furnace process will be more costly and would likely be curtailed due to a coke shortage. Therefore, there is a significant need to develop or extend the economic viability of Alternate Ironmaking Processes to at least partially replace current and declining blast furnace iron sources and to provide incentives for new capacity expansion. The primary conclusions of this comparative Study of Alternative Ironmaking Process scenarios are: (1) The processes with the best combined economics (CAPEX and OPEX impacts in the I.R.R. calculation) can be grouped into those Fine Ore based processes with no scrap

  6. The Study of the Prevention of Anal Cancer (SPANC): design and methods of a three-year prospective cohort study

    PubMed Central

    2013-01-01

    Background The incidence of human papillomavirus (HPV)-associated anal cancer is increasing in men who have sex with men (MSM). Screening for the presumed cancer precursor, high-grade anal squamous intraepithelial lesions (HSIL) in a manner analogous to cervical cancer screening has been proposed. Uncertainty remains regarding anal HPV natural history and the role of anal cytology and high-resolution anoscopy (HRA) as screening tests. Well-designed cohort studies are required to address these issues. Methods/design The SPANC study is a prospective study of the epidemiology of low-risk and high-risk anal HPV infection and related cytological and histological abnormalities in HIV-negative and HIV-positive homosexual men aged 35 years and over. The study aims to recruit 600 men from community-based settings in Sydney, Australia. There are six study visits over three years. At the first five visits men undergo a digital ano-rectal examination (DARE), an anal “Papanicolaou” (Pap) test for HPV detection, genotyping and anal cytology, followed by HRA and directed biopsy of any visible abnormalities. The men also complete a behavioural questionnaire before each visit. Questions include a detailed history of sexual behaviour, of anal symptoms, possible anal cancer risk factors and validated quality of life and psychosocial questions. Questionnaires are also completed 2 weeks and 3 months following the provision of test results and include questions on participant experience during the procedure and post-procedure symptoms, including pain and bleeding in addition to quality of life/ psychosocial outcomes. Discussion Recruitment for the study began in September 2010 and will conclude in mid-2015, with follow up continuing to 2018. Thus far, over 350 men have been recruited from a variety of community-based settings and are broadly representative of the target screening population. The SPANC study is one of only a small number of cohort studies globally to perform HPV

  7. Micronutrient Levels and Supplement Intake in Pregnancy after Bariatric Surgery: A Prospective Cohort Study

    PubMed Central

    Devlieger, Roland; Guelinckx, Isabelle; Jans, Goele; Voets, Willy; Vanholsbeke, Caroline; Vansant, Greet

    2014-01-01

    Background Studies report frequent micronutrient deficiencies after bariatric surgery, but less is known about micronutrient levels of pregnant women after bariatric surgery. Objective To prospectively evaluate micronutrient levels and supplement intake in pregnancy following bariatric surgery. Design A multicenter prospective cohort study including women with restrictive or malabsorptive types of bariatric surgery. Nutritional deficiencies, together with supplement intake, were screened during pregnancy. Results The total population included 18 women in the restrictive and 31 in the malabsorptive group. Most micronutrients were depleted and declined significantly during pregnancy. The proportion of women with low vitamin A and B-1 levels increased to respectively 58 and 17% at delivery (P = 0.005 and 0.002). The proportion of women with vitamin D deficiency decreased from 14% at trimester 1 to 6% at delivery (P = 0.030). Mild anemia was found in respectively 22 and 40% of the women at trimester 1 and delivery. In the first trimester, most women took a multivitamin (57.1%). In the second and third trimester, the majority took additional supplements (69.4 and 73.5%). No associations were found between supplement intake and micronutrient deficiencies. Conclusion Pregnant women with bariatric surgery show frequent low micronutrient levels. Supplementation partially normalizes low levels of micronutrients. PMID:25470614

  8. Prognostic Significance of Neutrophil-to-Lymphocyte Ratio in Patients with Sepsis: A Prospective Observational Study

    PubMed Central

    Liu, Xuan; Shen, Yong; Wang, Hairong; Ge, Qinmin; Fei, Aihua; Pan, Shuming

    2016-01-01

    Background. The neutrophil-to-lymphocyte ratio (NLR) is an easily accessible biological marker that has been reported to represent disease severity. The aim of this study is to investigate the association between NLR and mortality in patients with sepsis. Methods. A total of 333 consecutive adult patients with sepsis were screened for eligibility in this prospective, observational study cohort. Severity scores and leukocyte counts were prospectively recorded upon entry to the intensive care unit (ICU). Receiver operating characteristic (ROC) curves and binary logistic regression models were used to assess the performance of NLR in predicting unfavorable outcome. Correlations between variables and disease severity were analyzed through Spearman correlation tests. Results. Median NLR levels were significantly higher in patients who died than in survivors. NLR had a modest power for predicting poor outcome as suggested by area under the curve (AUC) of 0.695 ± 0.036. Multivariate linear regression indicated that increased NLR levels were related to unfavorable outcome independently of the effect of possible confounders. Spearman correlation tests showed that there was a positive correlation between NLR levels and disease severity. Conclusions. Increased NLR levels were independently associated with unfavorable clinical prognosis in patients with sepsis. Further investigation is required to increase understanding of the pathophysiology of this relationship. PMID:27110067

  9. Bariatric support line: a prospective study of support line activity.

    PubMed

    McDougall, Kirsten; Segaran, Ella; Sufi, Pratik; Heath, Dugal I

    2010-03-01

    In this prospective study, we examine the workload of the North London Obesity Surgery Service Bariatric telephone support line (BTSL) and its effects on service provision. Over a 3-month period (June to August 2008), a prospective record was kept of all calls, who they were from, whether the patient was presurgery or postsurgery, the type of procedure planned or undertaken, the nature of the enquiry, and the time taken to answer the query. Seventy-five (72%) calls were related to patients who were postsurgery and 29 (28%) presurgery. Patients scheduled for or having undergone Roux-en-Y gastric bypass accounted for 46 (44%) calls; 24 (23%) were preprocedure and 22 (21%) postprocedure. Patients scheduled for or having undergone gastric banding accounted for 56 (54%) calls; five (0.5%) were preprocedure and 51 (49%) postprocedure. Patients undergoing sleeve gastrectomy accounted for two (<1%) calls. Both calls were postprocedure. The reason for the support line enquiry was psychological support in 15 (14%) patients, questions postsurgery in 26 (25%), general enquiries in 27 (26%), and clinical enquiries in 36 (36%). This study of the BTSL has allowed us to identify areas of need within our bariatric population and improve the service we deliver. The changes we have made should lead to a better use of the team's time, greater patient compliance, and satisfaction as well as reduced complaints and litigation. PMID:19711140

  10. Endogenous hormones and breast cancer: a prospective cohort study.

    PubMed

    Toniolo, P G; Pasternack, B S; Shore, R E; Sonnenschein, E; Koenig, K L; Rosenberg, C; Strax, P; Strax, S

    1991-05-01

    A cohort study is under way in New York City to evaluate how levels of endogenous reproductive hormones influence the risk of breast cancer. The study, in which approximately 15,000 women are being recruited, utilizes a prospective design in which volunteers are asked to provide repeated specimens of serum during the period 1985-1992. A case-control study nested within the cohort is planned by which specimens from all cases arising in the population and from a randomly selected sample of time-matched controls will be analyzed and compared. As of December 31, 1989, 13,609 volunteers had donated blood specimens, about 50% of whom had already donated more than once. Of the 187 incident breast cancer cases who are expected to arise in the cohort before the end of 1992, 77 have been detected thus far. PMID:1873553

  11. Paramedic Recognition of Sepsis in the Prehospital Setting: A Prospective Observational Study

    PubMed Central

    Travers, Andrew H.; Cain, Edward; Campbell, Samuel G.; Jensen, Jan L.; Petrie, David A.; Erdogan, Mete; Patrick, Gredi; Patrick, Ward

    2016-01-01

    Background. Patients with sepsis benefit from early diagnosis and treatment. Accurate paramedic recognition of sepsis is important to initiate care promptly for patients who arrive by Emergency Medical Services. Methods. Prospective observational study of adult patients (age ≥ 16 years) transported by paramedics to the emergency department (ED) of a Canadian tertiary hospital. Paramedic identification of sepsis was assessed using a novel prehospital sepsis screening tool developed by the study team and compared to blind, independent documentation of ED diagnoses by attending emergency physicians (EPs). Specificity, sensitivity, accuracy, positive and negative predictive value, and likelihood ratios were calculated with 95% confidence intervals. Results. Overall, 629 patients were included in the analysis. Sepsis was identified by paramedics in 170 (27.0%) patients and by EPs in 71 (11.3%) patients. Sensitivity of paramedic sepsis identification compared to EP diagnosis was 73.2% (95% CI 61.4–83.0), while specificity was 78.8% (95% CI 75.2–82.2). The accuracy of paramedic identification of sepsis was 78.2% (492/629, 52 true positive, 440 true negative). Positive and negative predictive values were 30.6% (95% CI 23.8–38.1) and 95.9% (95% CI 93.6–97.5), respectively. Conclusion. Using a novel prehospital sepsis screening tool, paramedic recognition of sepsis had greater specificity than sensitivity with reasonable accuracy. PMID:27051533

  12. Pregnancy-Onset Habitual Snoring, Gestational Hypertension, and Pre-eclampsia: Prospective Cohort Study

    PubMed Central

    O’BRIEN, Louise M.; BULLOUGH, Alexandra S.; OWUSU, Jocelynn T.; TREMBLAY, Kimberley A.; BRINCAT, Cynthia A.; CHAMES, Mark C.; KALBFLEISCH, John D.; CHERVIN, Ronald D.

    2012-01-01

    Objective This study aimed to prospectively examine the impact of chronic vs. pregnancy-onset habitual snoring on gestational hypertension, pre-eclampsia, and gestational diabetes. Study Design Third trimester pregnant women were recruited from a large, tertiary medical center, between March 2007 and December 2010 and screened for the presence and duration of habitual snoring, as a known marker for sleep-disordered breathing. Clinical diagnoses of gestational hypertension, pre-eclampsia, and gestational diabetes were obtained. Results Of 1,719 pregnant women, 34% reported snoring, with 25% reporting pregnancy-onset snoring. After adjusting for confounders pregnancy-onset, but not chronic snoring, was independently associated with gestational hypertension (odds ratio 2.36, 95%CI 1.48–3.77, p<0.001) and pre-eclampsia (odds ratio 1.59, 95%CI 1.06–2.37 p=0.024) but not gestational diabetes. Conclusion New-onset snoring during pregnancy is a strong risk factor for gestational hypertension and pre-eclampsia. In view of the significant morbidity and healthcare costs associated with hypertensive diseases of pregnancy, simple screening of pregnant women may have clinical utility. Trial registration: Clinical Trials NCT01030003 PMID:22999158

  13. [Study of screening pseudoallergenic substances of Shuanghuanglian injection].

    PubMed

    Yi, Yan; Zhang, Yu-shi; Li, Chun-ying; Zhao, Hai-yu; Xiao, Hong-bin; Li, Gui-qin; Lu, Yu-ting; Han, Jia-yin; Zhao, Yong; Wang, Hong-jie; Si, Nan; Liang, Ai-hua; Bian, Bao-lin

    2015-07-01

    In this study, chemistry, biology and pharmacology were combinated to screen pseudoallergenic substances of Shuang-huanglian injection (SHLI) so that to establish a scientific and systematic approach to screen pseudoallergenic substances of traditional Chinese medicine injections. The mouse pseudoallergic reaction models were used to screen the pseudoallergic reaction of SHLI's intermediate extract and the intermediate extract's component or ingredient. Among the three intermediates of Shuanghuanglian injection (extract of Scutellaria baicalensis, extract of Lonicera japonica, extract of Forsythia suspensa) , pseudoallergic action of Forsythia suspensa was the strongest, Forsythia suspesnsa's pseudoallergic reaction mainly associated with the composition with largerchemical polarity. Further it was found that forsythiaside A and arctiin which existed in the the composition with largerchemical polarity caused obvious pseudoallergic reactions. SHLI with removal forsythoside A with the technology of HPLC-MS displayed reduced pseudoallergic reaction and a significant improved safety. This study provided a scientific basis for SHLI process improvements and also offered idea and research foundation for screening pseudoallergenic substances injections in other TCM injections. PMID:26666017

  14. A prospective study of bilateral inguinal hernia repair.

    PubMed Central

    Serpell, J. W.; Johnson, C. D.; Jarrett, P. E.

    1990-01-01

    A prospective study of outcome after inguinal hernia repair in patients undergoing simultaneous repair of bilateral hernias (n = 31), sequential repair of bilateral hernias (n = 5), and unilateral hernia repair (n = 75) is reported. There were no differences in wound complications, post-operative respiratory complications, or other adverse effects in the three groups. Operating time was similar in the unilateral and bilateral simultaneous repairs (median 55 min), but was longer (100 min) for the combination of two sequential repairs. Hospital stay was shortest for patients undergoing unilateral repair (2 days) but was less with bilateral simultaneous repair (4 days) than after two sequential repairs (total of 6 days). There were 12 (11%) wound complications of which five (5%) were infections. There was no difference in complication rate between unilateral and bilateral hernia repair. Postoperative recovery was assessed prospectively and was recorded at 1 month. There was no difference between unilateral and bilateral simultaneous repairs in the number of days before the patient was able to climb stairs easily, drive a car or return to work. The duration of the requirement for analgesia was similar in each group. We conclude that bilateral simultaneous hernia repair can be carried out with no greater morbidity than a unilateral repair, and the return to normal activity is as rapid. Bilateral hernias should be repaired simultaneously rather than sequentially. PMID:2221764

  15. Bullying increased suicide risk: prospective study of Korean adolescents.

    PubMed

    Kim, Young Shin; Leventhal, Bennett L; Koh, Yun-Joo; Boyce, W Thomas

    2009-01-01

    This study examines the independent impact of bullying on suicide risk. Bullying was assessed by peer nomination in a prospective study of 1,655 7th and 8th grade Korean students, and suicide by youth self-report. Odds Ratios (ORs) of bullying for suicidal risks were computed, controlling for other suicide risk factors. Victim-Perpetrators and female Victims at baseline showed increased risk for persistent suicidality (OR: 2.4-9.8). Male Incident Victims exhibited increased risk for suicidal behaviors and ideations (OR = 4.4, 3.6). Female Persistent Perpetrators exhibited increased risks for suicidal behaviors; male Incident Perpetrators had increased risk for suicidal ideations (OR = 2.7, 2.3). Baseline-only male Victim-Perpetrators showed increased risk for suicidal ideations. (OR = 6.4). Bullying independently increased suicide risks. PMID:19123106

  16. Early breastfeeding experiences of adolescent mothers: a qualitative prospective study

    PubMed Central

    2012-01-01

    Background Teen mothers face many challenges to successful breastfeeding and are less likely to breastfeed than any other population group in the U.S. Few studies have investigated this population; all prior studies are cross-sectional and collect breastfeeding data retrospectively. The purpose of our qualitative prospective study was to understand the factors that contribute to the breastfeeding decisions and practices of teen mothers. Methods This prospective study took place from January through December 2009 in Greensboro, North Carolina in the U.S. We followed the cohort from pregnancy until two weeks after they ceased all breastfeeding and milk expression. We conducted semi-structured interviews at baseline and follow-up, and tracked infant feeding weekly by phone. We analyzed the data to create individual life and breastfeeding journeys and then identified themes that cut across the individual journeys. Results Four of the five teenagers breastfed at the breast for nine days: in contrast, one teen breastfed exclusively for five months. Milk expression by pumping was associated with significantly longer provision of human milk. Breastfeeding practices and cessation were closely connected with their experiences as new mothers in the context of ongoing multiple roles, complex living situations, youth and dependency, and poor knowledge of the fundamentals of breastfeeding and infant development. Breastfeeding cessation was influenced by inadequate breastfeeding skill, physically unpleasant and painful early experiences they were unprepared to manage, and inadequate health care response to real problems. Conclusions Continued breastfeeding depends on a complex interplay of multiple factors, including having made an informed choice and having the skills, support and experiences needed to sustain the belief that breastfeeding is the best choice for them and their baby given their life situation. Teenagers in the US context need to have a positive early

  17. Psychopathological factors that can influence academic achievement in early adolescence: a three-year prospective study.

    PubMed

    Voltas, Núria; Hernández-Martínez, Carmen; Aparicio, Estefania; Arija, Victoria; Canals, Josefa

    2014-01-01

    This three-phase prospective study investigated psychosocial factors predicting or associated with academic achievement. An initial sample of 1,514 school-age children was assessed with screening tools for emotional problems (Screen for Childhood Anxiety and Related Emotional Disorders; Leyton Obsessional Inventory-Child Version; Children's Depression Inventory). The following year, 562 subjects (risk group/without risk group) were re-assessed and attention deficit/hyperactivity disorder (ADHD) was assessed. Two years later, 242 subjects were followed, and their parents informed about their academic achievement. Results showed that early depression (phase 1 B = -.130, p = .001; phase 1 + phase 2 B = -.187, p < .001), persistent anxiety symptoms (phase 1 + phase 2 B = -1.721, p = .018), and ADHD were predictors of lower academic achievement (phase 1 + phase 2 B = -3.415, p = .005). However, some anxiety symptoms can improve academic achievement (Social phobia B = .216, p = .018; Generalized anxiety B = .313, p < .001). Socio-economic status (SES) was positively related to academic achievement. We can conclude that in the transition period to adolescence, school-health professionals and teachers need to consider the emotional issues of students to avoid unwanted academic outcomes. PMID:26054835

  18. Prospective study of surveillance testing for metastasis in 100 high-risk uveal melanoma patients.

    PubMed

    Piperno-Neumann, S; Servois, V; Mariani, P; Plancher, C; Lévy-Gabriel, C; Lumbroso-Le Rouic, L; Couturier, J; Asselain, B; Desjardins, L; Cassoux, N

    2015-06-01

    Despite advances in the local treatment of UM, half of patients develop metastases typically to the liver with poor survival. Microscopic complete surgical resection (R0) of liver metastases improves survival in high selected patients. Early identification of high-risk patients might allow detection of asymptomatic metastases, and increase R0 liver surgery rate. From October 2006 to December 2009, we conducted a prospective study to detect early minimal lesions with 6-monthly liver function tests (LFTs) and liver MRI in 100 high-risk patients. High risk was defined by primary tumor clinical or genomic criteria: thickness>8mm or diameter>15 mm, or extra-scleral extension, or monosomy 3 by FISH or aCGH. With a median follow-up of 49 months, the 5-year metastasis-free survival and overall survival were 47 and 33%, respectively. Of the 60 patients who became metastatic, 50 (83%) had exclusive liver metastasis. LFTs screening had no sufficient accurary, but biannual MRI showed high predictive value to detect metastasis and select patients eligible for curative surgery: 25/50 underwent laparotomy and among them, 8/25 (32%) had a R0 surgery. Median survival after metastasis was 14 months, mean survival reached 40 months in the R0 resected population. Six-monthly liver MRI screening is recommended in patients with large tumors or genomic high risk in order to detect early patient candidates to complete resection of liver metastases. PMID:25978872

  19. Increased Prevalence of Celiac Disease in Patients with Unexplained Infertility in the United States: A Prospective Study

    PubMed Central

    Lebwohl, Benjamin; Wang, Jeffrey; Lee, Susie K.; Murray, Joseph A.; Sauer, Mark V.; Green, Peter H. R.

    2011-01-01

    Celiac disease is an autoimmune disorder which can present with a variety of non-gastrointestinal manifestations. In women, it may manifest with an assortment of gynecologic or obstetric disorders. Some reports have linked female infertility with undiagnosed celiac disease. Though there are a number of studies from Europe and the Middle East, only two prior American studies have examined the prevalence of “silent” celiac disease in a female infertility population. We prospectively performed serologic screening for celiac disease in 188 infertile women (ages 25–39). While we did not demonstrate an increased prevalence of celiac disease in our overall infertile female population, we were able to detect a significantly increased prevalence (5.9%) of undiagnosed celiac disease among women presenting with unexplained infertility (n=51). Our findings suggest the importance of screening infertile female patients, particularly those with unexplained infertility, for celiac disease. PMID:21682114

  20. Palliative Care Caregivers' Grief Mediators: A Prospective Study.

    PubMed

    Coelho, Alexandra M; Delalibera, Mayra A; Barbosa, António

    2016-05-01

    The aim of the study is to identify the mediators of complicated grief in a Portuguese sample of caregivers. Grief mediators were prospectively evaluated using a list of risk factors completed by the palliative care team members, during the predeath and bereavement period. More than 6 months after the death, we applied PG-13 to diagnose prolonged grief disorder (PGD). The sample was composed of 64 family caregivers. Factors associated with PGD were insecure and dependent relationship, unresolved family crisis, and the perceived deterioration and disfigurement of the patient. The results show relational factors are relevant, but we must consider the reciprocal influence among factors, as well as their impact on specific symptoms. PMID:25601321

  1. An archival prospective study of mental health and longevity.

    PubMed

    Martin, L R; Friedman, H S; Tucker, J S; Schwartz, J E; Criqui, M H; Wingard, D L; Tomlinson-Keasey, C

    1995-09-01

    The relationship between mental health status and longevity was examined in an archival prospective cohort study (N = 1,103) derived from work begun by Lewis Terman in the 1920s. Degree of psychological maladjustment, cumulatively rated by Terman and his colleagues as of 1950, was found to be related to higher risk of all-cause mortality over a 4-decade follow-up period. The differences among causes of death were nonsignificant, but there was some indication that mental health problems were more strongly related to deaths from injury and cardiovascular disease. The overall relationship was significant for men but weaker for women. The effect was not substantially mediated by alcohol consumption, obesity, or cigarette smoking. PMID:7498108

  2. Prospective study of erythema toxicum neonatorum: epidemiology and predisposing factors.

    PubMed

    Monteagudo, Benigno; Labandeira, Javier; Cabanillas, Miguel; Acevedo, Antonio; Toribio, Jaime

    2012-01-01

    We performed a prospective study of 1,000 neonates investigated in the first 72 hours of life in the health area of Ferrol (northwest of Spain) to assess the prevalence of erythema toxicum neonatorum, the anatomical sites most frequently involved, the influence of different maternal and neonatal parameters, day of life of medical examination, and type of delivery (vaginal or Cesarean). Overall prevalence of erythema toxicum neonatorum was 16.7%. Lesions most frequently involved the trunk, buttocks, and proximal areas of limbs. A higher prevalence of this dermatosis was found in Caucasian newborns (p = 0.01) and those with higher birthweight (p < 0.05), greater gestational age (p < 0.05), vaginal delivery (p < 0.05), maternal age of <30 years (p = 0.28), and fewer than two previous pregnancies (p = 0.12). PMID:22066938

  3. Predictors of early precocious talking: a prospective population study.

    PubMed

    Skeat, Jemma; Wake, Melissa; Reilly, Sheena; Eadie, Patricia; Bretherton, Lesley; Bavin, Edith L; Ukoumunne, Obioha C

    2010-11-01

    This study examines potential predictors of 'precocious talking' (expressive language ≥90th percentile) at one and two years of age, and of 'stability' in precocious talking across both time periods, drawing on data from a prospective community cohort comprising over 1,800 children. Logistic regression was used to examine the relationship between precocious talking and the following potential predictors: gender, birth order, birth weight, non-English speaking background, socioeconomic status, maternal age, maternal mental health scores, and vocabulary and educational attainment of parents. The strongest predictors of precocity (being female and having a younger mother) warrant further exploration. Overall, however, it appears that precocity in early vocabulary development is not strongly influenced by the variables examined, which together explained just 2.6% and 1% of the variation at 1;0 and 2;0 respectively. PMID:19874641

  4. Recent results and future prospects for asteroseismic studies

    NASA Astrophysics Data System (ADS)

    Miglio, Andrea

    2015-08-01

    In the last decade the study and interpretation of global oscillations in stars has undergone a dramatic development thanks to the advent of space-based telescopes such as CoRoT and Kepler. In this contribution I will review our endeavours towards a detailed understanding of stellar structure and evolution and I will discuss the symbiosis between stellar seismology and both exoplanetary and Galactic science. I will then emphasise the wider significance of asteroseismology as a tool for testing stellar physics, with examples on how seismic predictions depend on our (often poor) knowledge of the relevant physics. Future prospects in the light of future ambitious space missions such as NASA-TESS and ESA-Plato will also be briefly presented.

  5. The pleiotropic effects of metformin: time for prospective studies.

    PubMed

    Bromage, Daniel I; Yellon, Derek M

    2015-01-01

    The global prevalence of diabetes has risen to epidemic proportions and the trend is predicted to continue. The consequent burden of cardiovascular morbidity and mortality is a major public health concern and new treatments are required to mitigate the deleterious effects of cardiovascular disease in diabetic patients. Ischaemia-reperfusion injury is well known to exacerbate the harmful effects of acute myocardial infarction and subsequent therapeutic reperfusion, and several mechanical and pharmacological approaches to mitigating this injury have been investigated. Metformin, which is cheap, relatively safe and widely used in type 2 diabetes, is one such pharmacotherapy with considerable pre-clinical evidence for cardioprotective utility beyond its glucose-lowering effect. However, despite convincing basic evidence its translation to clinical application has largely been limited to studies of cardiovascular risk. There are several barriers to prospective randomized assessment in the context of acute myocardial infarction, not least the accessibility and already widespread use of metformin among patients with type 2 diabetes at high risk of cardiovascular events. In the place of class 1 evidence, well-designed prospective cohort studies of the potential pleiotropic utility of metformin in cardiovascular disease, and particularly its benefit in ischaemia-reperfusion injury, are needed. Given the availability of metformin worldwide, this is particularly true in low- and middle-income countries where the optimal therapy for acute myocardial infarction, primary percutaneous coronary intervention, may not be available, and instead patients are managed with thrombolysis. As this is less effective, metformin as an adjunct to thrombolysis (or PPCI) could represent an effective, cheap means of cardioprotection with global relevance. PMID:26271457

  6. Vaginal breech delivery: results of a prospective registration study

    PubMed Central

    2013-01-01

    Background Most countries recommend planned cesarean section in breech deliveries, which is considered safer than vaginal delivery. As one of few countries in the western world Norway has continued to practice planned vaginal delivery in selected women. The aim of this study is to evaluate prospectively registered neonatal and maternal outcomes in term singleton breech deliveries in a Norwegian hospital during a ten years period. We aim to compare maternal and neonatal outcomes in term breech pregnancies subjected either to planned vaginal or elective cesarean section. Methods A prospective registration study including 568 women with term breech deliveries (>37 weeks) consecutively registered at Sorlandet Hospital Kristiansand between 2001 and 2011. Fetal and maternal outcomes were compared according to delivery method; planned vaginal delivery versus planned cesarean section. Results Of 568 women, elective cesarean section was planned in 279 (49%) cases and vaginal delivery was planned in 289 (51%) cases. Acute cesarean section was performed in 104 of the planned vaginal deliveries (36.3%). There were no neonatal deaths. Two cases of serious neonatal morbidity were reported in the planned vaginal group. One infant had seizures, brachial plexus injury, and cephalhematoma. The other infant had 5-minutes Apgar < 4. Twenty-nine in the planned vaginal group (10.0%) and eight in the planned cesarean section group (2.9%) (p < 0.001) were transferred to the neonatal intensive care unit. However, only one infant was admitted for ≥4 days. According to follow-up data (median six years) none of these infants had long-term sequelae. Regarding maternal morbidity, blood loss was the only variable that was significantly higher in the planned cesarean section group versus in the vaginal delivery group (p < 0.001). Conclusions Strict guidelines were followed in all cases. There were no neonatal deaths. Two infants had serious neonatal morbidity in the planned

  7. Early carotid endarterectomy after a nondisabling stroke: a prospective study.

    PubMed

    Ricco, J B; Illuminati, G; Bouin-Pineau, M H; Demarque, C; Camiade, C; Blecha, L; Neau, J P

    2000-01-01

    On the recommendation of several studies, carotid endarterectomy (CEA) should be delayed for at least 6 weeks in patients suffering an acute nondisabling stroke. Our objective was to determine if these patients could be safely operated on earlier, thus decreasing the risk of a recurrent stroke prior to surgery. This prospective study, carried out from January 1990 to December 1997, included 72 consecutive patients having a nondisabling hemispheric stroke with severe ipsilateral carotid stenosis (NASCET 70-99%). All patients underwent CEA within 15 days of stroke onset. Patients were considered to have a nondisabling hemispheric stroke if (1) symptoms of hemispheric ischemia persisted longer than 24 hr and (2) the resulting deficit caused no major impairment in their everyday activities. All patients were examined by a neurologist prior to carotid angiography and contrast CT scan. Hemorrhage seen on the initial CT scan eliminated the patient from the study. If the CT scan with contrast injection was negative, patients underwent magnetic resonance imaging. CEA was performed under general anesthesia with intraluminal shunting. All patients had a postoperative duplex scan and yearly follow-up by a neurologist and a surgeon, with a duplex scan of the carotid arteries. Mean follow-up was 53 months. Our study shows that CEA can be performed relatively safely within 15 days following an acute nondisabling stroke. The arbitrary 6-week delay for CEA may unnecessarily expose patients with high-grade stenosis to a recurrent stroke, which could be prevented by earlier surgery. PMID:10629271

  8. A study of geothermal prospects in the western United States

    NASA Technical Reports Server (NTRS)

    1975-01-01

    The commercial development potential of 13 underdeveloped geothermal prospects in the Western United States was examined, and the prospects were ranked in order of relative potential for development on the basis of investment considerations. The following were considered in the ranking: geotechnical and engineering data, energy market accessibility, administrative constraints, and environmental and socio-economic factors. The primary ranking criterion is the unit cost of energy production expected from each prospect. Secondary criteria are administrative constraints, environmental factors and the quality of the geotechnical data.

  9. Prospective Coronary Heart Disease Screening in Asymptomatic Hodgkin Lymphoma Patients Using Coronary Computed Tomography Angiography: Results and Risk Factor Analysis

    SciTech Connect

    Girinsky, Theodore; M’Kacher, Radhia; Koscielny, Serge; Elfassy, Eric; Raoux, François; Carde, Patrice; Santos, Marcos Dos; Margainaud, Jean-Pierre; Sabatier, Laure; Paul, Jean-François

    2014-05-01

    Purpose: To prospectively investigate the coronary artery status using coronary CT angiography (CCTA) in patients with Hodgkin lymphoma treated with combined modalities and mediastinal irradiation. Methods and Materials: All consecutive asymptomatic patients with Hodgkin lymphoma entered the study during follow-up, from August 2007 to May 2012. Coronary CT angiography was performed, and risk factors were recorded along with leukocyte telomere length (LTL) measurements. Results: One hundred seventy-nine patients entered the 5-year study. The median follow-up was 11.6 years (range, 2.1-40.2 years), and the median interval between treatment and the CCTA was 9.5 years (range, 0.5-40 years). Coronary artery abnormalities were demonstrated in 46 patients (26%). Coronary CT angiography abnormalities were detected in nearly 15% of the patients within the first 5 years after treatment. A significant increase (34%) occurred 10 years after treatment (P=.05). Stenoses were mostly nonostial. Severe stenoses were observed in 12 (6.7%) of the patients, entailing surgery with either angioplasty with stent placement or bypass grafting in 10 of them (5.5%). A multivariate analysis demonstrated that age at treatment, hypertension, and hypercholesterolemia, as well as radiation dose to the coronary artery origins, were prognostic factors. In the group of patients with LTL measurements, hypertension and LTL were the only independent risk factors. Conclusions: The findings suggest that CCTA can identify asymptomatic individuals at risk of acute coronary artery disease who might require either preventive or curative measures. Conventional risk factors and the radiation dose to coronary artery origins were independent prognostic factors. The prognostic value of LTL needs further investigation.

  10. Toxicology screen

    MedlinePlus

    Barbiturates - screen; Benzodiazepines - screen; Amphetamines - screen; Analgesics - screen; Antidepressants - screen; Narcotics - screen; Phenothiazines - screen; Drug abuse screen; Blood alcohol test

  11. Irregular menses predicts ovarian cancer: Prospective evidence from the Child Health and Development Studies.

    PubMed

    Cirillo, Piera M; Wang, Erica T; Cedars, Marcelle I; Chen, Lee-May; Cohn, Barbara A

    2016-09-01

    We tested the hypothesis that irregular menstruation predicts lower risk for ovarian cancer, possibly due to less frequent ovulation. We conducted a 50-year prospective study of 15,528 mothers in the Child Health and Development Studies cohort recruited from the Kaiser Foundation Health Plan from 1959 to 1966. Irregular menstruation was classified via medical record and self-report at age 26. We identified 116 cases and 84 deaths due to ovarian cancer through 2011 via linkage to the California Cancer Registry and Vital Statistics. Contrary to expectation, women with irregular menstrual cycles had a higher risk of ovarian cancer incidence and mortality over the 50-year follow-up. Associations increased with age (p <0.05). We observed a 2-fold increased incidence and mortality by age 70 (95% confidence interval [CI] = 1.1, 3.4) rising to a 3-fold increase by age 77 (95% CI = 1.5, 6.7 for incidence; 95% CI = 1.4, 5.9 for mortality). We also found a 3-fold higher risk of mortality for high-grade serous tumors (95% CI = 1.3, 7.6) that did not vary by age. This is the first prospective study to show an association between irregular menstruation and ovarian cancer-we unexpectedly found higher risk for women with irregular cycles. These women are easy to identify and many may have polycystic ovarian syndrome. Classifying high-risk phenotypes such as irregular menstruation creates opportunities to find novel early biomarkers, refine clinical screening protocols and potentially develop new risk reduction strategies. These efforts can lead to earlier detection and better survival for ovarian cancer. PMID:27082375

  12. Risk factors for seabather's eruption: a prospective cohort study.

    PubMed Central

    Kumar, S; Hlady, W G; Malecki, J M

    1997-01-01

    OBJECTIVE: A prospective cohort study was performed to identify risk factors for seabather's eruption. METHODS: Study participants were recruited at four beaches in Palm Beach County, Florida, during three weekends of May and June 1993. Participants were interviewed by telephone after 48 hours regarding medical history, beach activities, development of rashes, and use of possible preventive measures. RESULTS: Seabather's eruption, defined by the occurrence of a rash within two days of exposure to seawater, was reported by 114 (16%) of 735 respondents. The strongest predictor of seabather's eruption was a past history of the condition. Children less than 16 years of age were also at increased risk, as were surfers. Showering with one's bathing suit off was a useful protective measure. CONCLUSION: The study's findings suggest that when the seasonal risk of seabather's eruption is present, children, people with a history of seabather's eruption, and surfers are at greatest risk. During the sea lice season, seabathers can minimize their risk by showering with their bathing suits off after seabathing. Length of the time spent in water was not significantly associated with seabather's eruption. PMID:9018290

  13. Sexual Function after Partial Penectomy: A Prospectively Study From China.

    PubMed

    Yu, Cui; Hequn, Chen; Longfei, Liu; Minfeng, Chen; Zhi, Chen; Feng, Zeng; Jinbo, Chen; Lin, Qi; Xiongbing, Zu

    2016-01-01

    The Purpose of this study was to evaluate the sexual function after partial penectomy for penile carcinoma patients. Between January 2010 and May 2013, patients treated with partial penectomy at our institution were prospectively enrolled in this study. Sexual function (IIEF-15), age, body mass index, penile length in the flaccid state after partial penectomy (PL), treatment, having a partner and psychological factors (SAS scores and SDS scores) were assessed. Univariate and multivariate linear regression analyses were performed. 43 patients were included in our study. The median age was 56 years, and the median PL was 4 cm. The preoperative IIEF-15, SAS, SDS scores were significantly different from the postoperative scores. There was no statistically significant difference between the patients treated with partial penectomy and partial penectomy+ lymphadenectomy on IIEF-15 scores. Age was negatively associated with erectile function, sexual desire, and overall satisfaction; PL was positively associated with intercourse satisfaction; SAS score was negatively associated with erectile function, orgasmic function, sexual desire, and intercourse satisfaction. Our preliminary findings suggest that the sexual function after partial penectomy was significantly reduced. The sexual function was negatively affected by age and anxiety but positively affected by PL. PMID:26902397

  14. Pulmonary Complications following Percutaneous Nephrolithotomy: A Prospective Study

    PubMed Central

    Palnizky, Gili; Halachmi, Sarel; Barak, Michal

    2014-01-01

    Introduction Pulmonary complications may occur in the post-operative period and are a significant cause of morbidity and mortality in patients undergoing anesthesia and surgery. Complication rates vary according to different procedures and different types of anesthesia and may be affected by the patient condition. The purpose of this study was to examine pulmonary complications following percutaneous nephrolithotomy (PCNL) and to search for associations between the pre- and intra-operative factors and the risk of post-operative pulmonary complications (PPC). Patients and Methods This was a prospective observational study of 100 consecutive adult patients who underwent PCNL surgery. We collected data of the patient, surgery and anesthesia and analyzed it to find correlations with PPC. Results Eight (8%) patients had PPC following PCNL, 7 patients had pneumothorax and 1 had atelectasis and pleural effusion. The latter patient died at post-operative day 24 due to respiratory failure. It was found that patients who had PCNL on the right kidney were at lower risk for PPC. In addition it was found that younger patients had a higher incidence of PPC. Conclusions Based on this study the most common type of post-operative complication following PCNL is pulmonary, with pneumothorax being the main complication. PPC may result in patient mortality. The side of the operation and the patient's age might affect the risk of PPC. PMID:24917770

  15. [Psychic changes in systemic lupus erythematosus: a multidisciplinary prospective study].

    PubMed

    Miguel Filho, E C; Pereira, R M; Busatto Filho, G; Shavitt, R G; Hirsch, R; de Sá, L C; de Arruda, P C

    1990-01-01

    Despite the high prevalence of psychic symptoms in lupus patients, there are few systematic studies in this area. Through a multidisciplinary approach, the authors developed a prospective study to characterize and correlate psychopathological aspects with clinical and laboratory data concerning neural manifestations of the disease. Out of 23 patients studied, 12 showed psychic alterations, which were interpreted as primary manifestations of the disease. All of them presented organic mental syndromes (DSM-III-R) in which cognitive symptoms were the most prominent, followed by affective, catatonic and hallucinatory features. The neurologic findings (seizure, migraine and muscular atrophy), as well as the ophthalmologic alterations (hemorrhage and soft exudates) were frequent and concomitant with the psychic features. The laboratory findings were: LE cells 50%; anti-Sm: 16%; anti-U1 RNP: 50%; anti-Ro/SS-A: 50%; anti-nDNA: 58%; decreased CH50 or fractions (C3, C4): 67%; anti-P: 18%; antigangliosides IgG: 67%; antigangliosides IgM: 78%. The cerebrospinal fluid analysis showed: increased cellularity: 18%; elevated protein: 36%; antigangliosides IgG: 67%; antigangliosides IgM: 33%; immunocomplexes: 36%. In spite of the absence of an adequate control group and of the small number of patients, the multidisciplinary approach leads to a better characterization of the nervous system involvement in this disease. PMID:1965671

  16. Sexual Function after Partial Penectomy: A Prospectively Study From China

    PubMed Central

    Yu, Cui; Hequn, Chen; Longfei, Liu; Minfeng, Chen; Zhi, Chen; Feng, Zeng; Jinbo, Chen; Lin, Qi; Xiongbing, Zu

    2016-01-01

    The Purpose of this study was to evaluate the sexual function after partial penectomy for penile carcinoma patients. Between January 2010 and May 2013, patients treated with partial penectomy at our institution were prospectively enrolled in this study. Sexual function (IIEF-15), age, body mass index, penile length in the flaccid state after partial penectomy (PL), treatment, having a partner and psychological factors (SAS scores and SDS scores) were assessed. Univariate and multivariate linear regression analyses were performed. 43 patients were included in our study. The median age was 56 years, and the median PL was 4 cm. The preoperative IIEF-15, SAS, SDS scores were significantly different from the postoperative scores. There was no statistically significant difference between the patients treated with partial penectomy and partial penectomy+ lymphadenectomy on IIEF-15 scores. Age was negatively associated with erectile function, sexual desire, and overall satisfaction; PL was positively associated with intercourse satisfaction; SAS score was negatively associated with erectile function, orgasmic function, sexual desire, and intercourse satisfaction. Our preliminary findings suggest that the sexual function after partial penectomy was significantly reduced. The sexual function was negatively affected by age and anxiety but positively affected by PL. PMID:26902397

  17. Dose–Volume Modeling of Brachial Plexus-Associated Neuropathy After Radiation Therapy for Head-and-Neck Cancer: Findings From a Prospective Screening Protocol

    SciTech Connect

    Chen, Allen M.; Wang, Pin-Chieh; Daly, Megan E.; Cui, Jing; Hall, William H.; Vijayakumar, Srinivasan; Phillips, Theodore L.; Farwell, D. Gregory; Purdy, James A.

    2014-03-15

    Purpose: Data from a prospective screening protocol administered for patients previously irradiated for head-and-neck cancer was analyzed to identify dosimetric predictors of brachial plexus-associated neuropathy. Methods and Materials: Three hundred fifty-two patients who had previously completed radiation therapy for squamous cell carcinoma of the head and neck were prospectively screened from August 2007 to April 2013 using a standardized self-administered instrument for symptoms of neuropathy thought to be related to brachial plexus injury. All patients were disease-free at the time of screening. The median time from radiation therapy was 40 months (range, 6-111 months). A total of 177 patients (50%) underwent neck dissection. Two hundred twenty-one patients (63%) received concurrent chemotherapy. Results: Fifty-one patients (14%) reported brachial plexus-related neuropathic symptoms with the most common being ipsilateral pain (50%), numbness/tingling (40%), and motor weakness and/or muscle atrophy (25%). The 3- and 5-year estimates of freedom from brachial plexus-associated neuropathy were 86% and 81%, respectively. Clinical/pathological N3 disease (P<.001) and maximum radiation dose to the ipsilateral brachial plexus (P=.01) were significantly associated with neuropathic symptoms. Cox regression analysis revealed significant dose–volume effects for brachial plexus-associated neuropathy. The volume of the ipsilateral brachial plexus receiving >70 Gy (V70) predicted for symptoms, with the incidence increasing with V70 >10% (P<.001). A correlation was also observed for the volume receiving >74 Gy (V74) among patients treated without neck dissection, with a cutoff of 4% predictive of symptoms (P=.038). Conclusions: Dose–volume guidelines were developed for radiation planning that may limit brachial plexus-related neuropathies.

  18. 75 FR 9902 - Proposed Collection; Comment Request; The Agricultural Health Study: A Prospective Cohort Study...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-04

    ... Disease Among Men and Women in Agriculture (NCI) (OMB : 0925-0406). Type of Information Collection Request... Health Study: A Prospective Cohort Study of Cancer and Other Disease Among Men and Women in Agriculture.... Affected Public: Private Sector, Farms. Type of Respondents: Licensed pesticide applicators and...

  19. The Yugoslavia Prospective Study of environmental lead exposure.

    PubMed Central

    Factor-Litvak, P; Wasserman, G; Kline, J K; Graziano, J

    1999-01-01

    The Yugoslavia Prospective Study of environmental lead exposure has studied the associations between exposure to lead and pregnancy outcomes; childhood neuropsychological, behavioral, and physical development; and hematologic, renal, and cardiovascular function. The cohort comprises 577 children born to women recruited at midpregnancy in two towns in Kosovo, Yugoslavia; one town is the site of a lead smelter, refinery, and battery plant and the other is 25 miles away and relatively unexposed. A sample of these children has been followed at 6-month intervals through 7.5 years of age. Blood lead concentrations ranged from 1 to 70 microg/dl. Exposure to lead was not associated with adverse pregnancy outcomes. Exposure was associated with modest decrements in intelligence, small increases in blood pressure, higher risks of proteinuria, small increases in behavior problems, and perturbed hematopoiesis. Only at low level exposures (i.e., <16 microg/dl) were small associations with decreased height found. We discuss methodological problems that may hinder causal interpretation of these data, namely, use of blood lead concentration as an exposure measure, confounding, and town-specific associations. We conclude that while reported associations are small, collectively they lend support to the notion that lead is a toxicant with numerous adverse health effects. Images Figure 1 PMID:9872712

  20. Massage Therapy for Lyme Disease Symptoms: a Prospective Case Study

    PubMed Central

    Thomason, Meghan J.; Moyer, Christopher A.

    2012-01-01

    Introduction To study the effects of massage therapy (MT) on Lyme disease (LD) symptoms and affect. Methods A 21-year-old female college student previously diagnosed with LD was recruited for a prospective case study that incorporated alternating periods of treatment and nontreatment across 65 days. Her self-reported symptoms of pain, fatigue, and impairment of concentration were assessed by means of a daily diary with corresponding visual analog scales. Immediate effects of MT on affect were assessed by completion of the Positive and Negative Affect Scales before and after each treatment session. Results LD symptoms decreased during treatment periods and increased during nontreatment periods. Positive affect was increased at every MT session. Conclusions MT is a promising treatment for the symptoms pain, fatigue, and impaired concentration associated with LD. In addition, MT reliably increased positive affect. Massage therapists should consider using light-to-medium pressure MT for treatment of persons who present with a similar pattern of LD symptoms, and further research with this population is warranted. PMID:23429967

  1. A prospective study of radionuclide biliary scanning in acute pancreatitis.

    PubMed Central

    Neoptolemos, J. P.; Fossard, D. P.; Berry, J. M.

    1983-01-01

    Early surgery for biliary pancreatitis has resulted in a need for an accurate method of gallstone detection in acute pancreatitis. Fifty patients with acute pancreatitis were studied prospectively to assess the diagnostic value of Radionuclide Biliary Scanning (RBS) performed within 72 hours of an attack. To assess the general accuracy of RBS a further 154 patients with suspected acute cholecystitis or biliary colic were similarly studied. There were 34 patients with biliary pancreatitis and 18 (53%) had a positive scan (no gallbladder seen). There were 16 patients with non-biliary pancreatitis and 5 (31%) had a positive scan. All 51 patients with acute cholecystitis had a positive scan, as did 82% of the 51 patients with biliary colic. There were 52 patients with no biliary or pancreatic disease and none of these had a positive scan. RBS is highly accurate in confirming a diagnosis of acute cholecystitis or biliary colic. However, it cannot be relied on to differentiate between biliary and non-biliary pancreatitis and should certainly not be used as the basis for biliary surgery in these patients. PMID:6859781

  2. A prospective study of collapsing focal segmental glomerulosclerosis.

    PubMed

    Raja, Ramachandran; Nada, Ritambhra; Yadav, Ashok K; Kumar, Ashwani; Goyal, Ajay; Kumar, Vivek; Rathi, Manish; Kohli, H S; Gupta, K L; Sakhuja, Vinay; Jha, Vivekanand

    2016-07-01

    Collapsing focal segmental glomerulosclerosis (cFSGS) is characterized by rapid progression to end-stage renal disease (ESRD). We evaluated the clinicopathological spectrum of cFSGS and compared its clinical behavior to steroid and tacrolimus (TAC)-resistant noncollapsing focal segmental glomerulosclerosis (FSGS). All patients (>14 years) diagnosed with cFSGS were enrolled in the study. Staining for differentiated podocyte markers such as WT 1, PAX and KI67 were performed in all patients. The outcome and histological features of cFSGS was compared with a prospectively followed cohort of steroid and TAC-resistant noncollapsing FSGS. The study included 22 cFSGS patients and 19 cases of steroid and TAC-resistant FSGS. Complete remission, partial remission, steroid resistance, progression to ESRD and death were observed in 13.6%, 4.5%, 27.3%, 36.4% and 18.2% patients, respectively. Patients with cFSGS had higher serum creatinine and more advanced tubulointerstitial changes compared to resistant FSGS. Twenty-six percent of therapy resistant noncollapsing FSGS progressed to ESRD after two years of stopping TAC. However, there was no difference in progression to ESRD between cFSGS and therapy-resistant noncollapsing FSGS at the end of two years. Glomerular collapse in the setting of FSGS is poorly responsive to treatment and has a high rate of progression to ESRD. The long-term prognosis of cFSGS and steroid and TAC-resistant FSGS are similar. PMID:27266801

  3. Risk factors for intraoperative floppy iris syndrome: a prospective study.

    PubMed

    Chatziralli, I P; Peponis, V; Parikakis, E; Maniatea, A; Patsea, E; Mitropoulos, P

    2016-08-01

    PurposeTo evaluate risk factors for intraoperative floppy iris syndrome (IFIS) in patients undergoing phacoemulsification.MethodsParticipants in the study were 1274 consecutive patients, who underwent routine phacoemulsification cataract surgery. The following data were recorded and evaluated as possible risk factors: ophthalmological conditions, axial length of the eye, sociodemographic features, clinical data (hypertension and diabetes mellitus), medications being taken at the time of surgery, and duration of their intake. Cases were characterized intraoperatively as IFIS and non-IFIS. Univariate and multivariate logistic regression analysis were performed.ResultsIFIS was observed in 63/1274 eyes (4.9%, 95% CI: 3.9-6.7%). Current use of tamsulosin, alfuzosin, terazosin, benzodiazepines, quetiapine, and finasteride, as well as hypertension, were all independently associated with IFIS. Significant associations were noted for male sex, rivastigmine, and short axial length, which did not reach significance at the multivariate analysis. Duration of α-blockers intake was not found to be associated with IFIS.ConclusionApart from the well-established associations with α-blockers, this prospective study points to benzodiazepines, quetiapine, finasteride, and hypertension as potential risk factors for IFIS. Short axial length and rivastigmine were significantly associated with IFIS only at the univariate analysis. PMID:27367744

  4. Risk of Complications in Spine Surgery: A Prospective Study

    PubMed Central

    Reis, Rodolfo Casimiro; de Oliveira, Matheus Fernandes; Rotta, José Marcus; Botelho, Ricardo Vieira

    2015-01-01

    Purpose : Complications are the chief concern of patients and physicians when considering spine surgery. The authors seek to assess the incidence of complications in patients undergoing spine surgery and identify risk factors for their occurrence. Methods : Prospective study of patients undergoing spine surgery from 1 February 2013 to 1 February 2014. Epidemiological characteristics and complications during the surgical hospitalization were recorded and analyzed. Results : The sample comprised 95 patients (mean age, 59 years). Overall, 23% of patients were obese (BMI =30). The mean BMI was 25.9. Approximately 53% of patients had comorbidities. Complications occurred in 23% of cases; surgical site infections were the most common (9%). There were no significant differences between patients who did and did not develop complications in terms of age (60.6 vs 59.9 years, p = 0.71), sex (56% female vs 54% female, p = 0.59), BMI (26.6 vs 27.2, p = 0.40), or presence of comorbidities (52% vs 52.8%, p = 0.87). The risk of complications was higher among patients submitted to spine instrumentation than those submitted to non-instrumented surgery (33% vs 22%), p=0.8. Conclusion : Just over one-quarter of patients in the sample developed complications. In this study, age, BMI, comorbidities were not associated with increased risk of complications after spine surgery. The use of instrumentation increased the absolute risk of complications. PMID:25674185

  5. Prospective study of coroner's autopsies in Benin City, Nigeria.

    PubMed

    Aligbe, J U; Akhiwu, W O; Nwosu, S O

    2002-10-01

    A prospective study of 726 cases of coroner's autopsies carried out over a period of two years (1st January, 1996 - 31st December, 1997) was reviewed. The causes and circumstances of death are defined and classified into natural and unnatural deaths. Fifty cases (6.3%) were children while the remaining 676 cases (93.1%) were adults in a male to female ratio of 2.6 to 1. The most common indications for coroner's autopsies were sudden unnatural deaths (SUDs) accounting for 485 cases (66.8%) and also sudden unexpected natural deaths (SUNDs) (241 cases) accounting for 33.2%. In the first category, road traffic accidents accounted for 86.7% of cases with deaths involving motor vehicle drivers and their passengers (41.8%); pedestrians (37.1%); and motorcyclists and their passengers (18.6%). The commonest causes of death in all road traffic accidents were craniocerebral injuries and haemorrhagic shock. In the second category the most common causes of sudden unexpected natural death were cardiovascular diseases resulting from complications of hypertension (54.7%) occurring in apparently healthy individuals. Other causes of death were pneumonia, pulmonary tuberculosis, typhoid fever and neoplastic diseases. This study showed that in Nigeria, with an increasing acquisition of dietary and life style habits of the developed western world, there is becoming a concomitant risk of deaths from road traffic accidents and sudden unexpected natural deaths from hypertensive cardiovascular disease. PMID:12487517

  6. A prospective study on postoperative pain after cataract surgery

    PubMed Central

    Porela-Tiihonen, Susanna; Kaarniranta, Kai; Kokki, Merja; Purhonen, Sinikka; Kokki, Hannu

    2013-01-01

    Purpose To evaluate postoperative pain and early recovery in cataract patients. Patients and methods A total of 201 patients who underwent elective first eye cataract extraction surgery were enrolled, and 196 were included in the final analysis. The study design was a single-center, prospective, follow-up study in a tertiary hospital in eastern Finland. Postoperative pain was evaluated with the Brief Pain Inventory at four time points: at baseline, and at 24 hours, 1 week, and 6 weeks postsurgery. Results Postoperative pain was relatively common during the first hours after surgery, as it was reported by 67 (34%) patients. After hospital discharge, the prevalence decreased; at 24 hours, 1 week, and 6 weeks, 18 (10%), 15 (9%) and 12 (7%) patients reported having ocular pain, respectively. Most patients with eye pain reported significant pain, with a score of ≥4 on a pain scale of 0–10, but few had taken analgesics for eye pain. Those who had used analgesics rated the analgesic efficacy of paracetamol and ibuprofen as good or excellent. Other ocular irritation symptoms were common after surgery; as a new postoperative symptom, foreign-body sensation was reported by 40 patients (22%), light sensitivity by 29 (16%), burning by 15 (8%), and itching by 15 (8%). Conclusion Moderate or severe postoperative pain was relatively common after cataract surgery. Thus, all patients undergoing cataract surgery should be provided appropriate counseling on pain and pain management after surgery. PMID:23885165

  7. Newborn screening for cystic fibrosis. The Cystic Fibrosis Neonatal Screening Study Group.

    PubMed

    Farrell, P M; Mischler, E H

    1992-01-01

    Many questions remain regarding the efficacy, risks, and costs of CF neonatal screening. The major gap in knowledge that must be closed before CF neonatal screening can be recommended generally in the United States concerns the potential long-term medical benefits of initiating treatment in early infancy. It would be premature, in our opinion, to implement mass population screening of newborns for CF until the benefits and risks have been fully defined, and an adequate and logistically feasible testing system developed and/or highly effective therapy for CF lung disease becomes available. It is for this reason we designed a randomized, controlled investigation of CF neonatal screening and implemented this project in Wisconsin during 1985. The fact that 5 years of randomized screening and systematic evaluation of outcome measures have not yet revealed any pulmonary benefits underscores the importance of rigorous investigation to resolve the efficacy issue. In addition to the medical uncertainties, we believe that the ethical issues described herein need to be resolved; this concern pertains not only to the CF patient but also the heterozygote carrier. On the other hand, financial factors and uncertainty about the cost effectiveness of CF neonatal screening do not appear to be dominant issues according to our assessment of current data. Despite the reservations related to the benefit/risk relationship, we expect that the discovery of the CF gene should have a favorable impact on neonatal screening for the disease, as well as for management. PMID:1442316

  8. Creation of a CT Image Library for the Lung Screening Study of the National Lung Screening Trial.

    PubMed

    Clark, K W; Gierada, D S; Moore, S M; Maffitt, D R; Koppel, P; Phillips, S R; Prior, F W

    2007-03-01

    The CT Image Library (CTIL) of the Lung Screening Study (LSS) network of the National Lung Screening Trial (NLST) consists of up to three annual screens using CT imaging from each of 17,308 participants with a significant history of smoking but no evidence of cancer at trial enrollment (Fall 2002-Spring 2004). Screens performed at numerous medical centers associated with 10 LSS-NLST screening centers are deidentified of protected health information and delivered to the CTIL via DVD, external hard disk, or Internet/Virtual Private Network transmission. The collection will be completed in late 2006. The CTIL is of potential interest to clinical researchers and software developers of nodule detection algorithms. Its attractiveness lies in its very specific, well-defined patient population, scanned via a common CT protocol, and in its collection of evenly spaced serial screens. In this work, we describe the technical details of the CTIL collection process from screening center retrieval through library storage. PMID:16783598

  9. A Comparative Study of Problematic Internet Use and Loneliness among Turkish and Korean Prospective Teachers

    ERIC Educational Resources Information Center

    Tutgun, Aylin; Deniz, Levent; Moon, Man-Ki

    2011-01-01

    The main aim of this study is to compare the problematic internet use and its relation to loneliness among two nations' prospective teachers, Turkey and South Korea. Five hundred and ninety five prospective teachers from three universities, two from Turkey and one from South Korea participated in the study. Generalized Problematic Internet Use…

  10. A Qualitative Case Study of Prospective Chemistry Teachers' Knowledge about Instructional Strategies: Introducing Particulate Theory

    ERIC Educational Resources Information Center

    Boz, Nihat; Boz, Yezdan

    2008-01-01

    The purpose of this study was to investigate prospective chemistry teachers' knowledge about instructional strategies, one component of pedagogical content knowledge about introducing particulate theory, as well as sources of this knowledge. Twenty-two prospective chemistry teachers participated in the study. Data were collected by the means of a…

  11. The Limitations of a Prospective Study of Memories for Child Sexual Abuse

    ERIC Educational Resources Information Center

    Cheit, Ross E.

    2003-01-01

    Prospective studies have been held out as a kind of Holy Grail in research about remembering or forgetting child sexual abuse. They seem to hold the perfect answer to the verification problems that plague retrospective self-reports in the clinical literature. Prospective studies begin with verified cases of abuse. Then they require detective work…

  12. Qingdao Port Cardiovascular Health Study: a prospective cohort study

    PubMed Central

    Spatz, Erica S; Jiang, Xianyan; Lu, Jiapeng; Masoudi, Frederick A; Spertus, John A; Wang, Yongfei; Li, Xi; Downing, Nicholas S; Nasir, Khurram; Du, Xue; Li, Jing; Krumholz, Harlan M; Liu, Xiancheng; Jiang, Lixin

    2015-01-01

    Purpose In China, efforts are underway to respond to rapidly increasing rates of heart disease and stroke. Yet the epidemiology of cardiovascular disease in China may be different from that of other populations. Thus, there is a critical need for population-based studies that provide insight into the risk factors, incidence and outcomes of cardiovascular disease in China. The Qingdao Port Cardiovascular Health Study is designed to investigate the burden of cardiovascular disease and the sociodemographic, biological, environmental and clinical risk factors associated with disease onset and outcomes. Participants For this study, from 2000 through 2013, 32 404 employees aged 18 years or older were recruited from the Qingdao Port Group in China, contributing 221 923 annual health assessments. The mean age at recruitment was 43.4 (SD=12.9); 79% were male. In this ongoing study, annual health assessments, governed by extensive quality control mechanisms, include a questionnaire (capturing demographic and employment information, medical history, medication use, health behaviours and health outcomes), physical examination, ECG, and blood and urine analysis. Additional non-annual assessments include an X-ray, echocardiogram and carotid ultrasound; bio-samples will be collected for future genetic and proteomic analyses. Cardiovascular outcomes are accessed via self-report and are actively being verified with medical insurance claims; efforts are underway to adjudicate outcomes with hospital medical records. Findings to date Early findings reveal a significant increase in cardiovascular risk factors from 2000 to 2010 (hypertension: 26.4–39.4%; diabetes: 3.3–8.9%; hyperlipidaemia: 5.0–33.6%; body mass index >28 m/kg2: 14.1–18.6%). Future Plans We aim to generate novel insights about the epidemiology and outcomes of cardiovascular disease in China, with specific emphasis on the potentially unique risk factor profiles of this Chinese population. Knowledge

  13. Screening Prostate-specific Antigen Concentration and Prostate Cancer Mortality: The Korean Heart Study

    PubMed Central

    Mok, Yejin; Kimm, Heejin; Shin, Sang Yop; Jee, Sun Ha; Platz, Elizabeth A.

    2015-01-01

    OBJECTIVE To evaluate the association between serum prostate-specific antigen (PSA) concentration from a screening test and prostate cancer mortality in an Asian population. METHODS We included 118,665 men in the Korean Heart Study, a large prospective cohort study of participants who voluntarily underwent private health examinations that included PSA-based prostate cancer screening. The baseline visit occurred between January 1994 and December 2004, and follow-up was through December 2011. Deaths from prostate cancer were ascertained from the underlying cause of death from a computerized search of death certificate data from the National Statistical Office in Korea. We used the Cox proportional hazards regression to estimate the association between serum PSA and risk of prostate cancer death adjusting the baseline age, cigarette smoking status, and body mass index. RESULTS During 1,381,901 person-years of follow-up, 6036 men died of any cause, and of these, 56 men died of prostate cancer. The multivariate-adjusted hazard ratio for prostate cancer death statistically significantly increased across PSA concentrations (P trend <.0001). The hazard ratio increased 7% per 1-ng/mL increase in PSA. The association between PSA concentration and death from prostate cancer was stronger in younger than in older men and in heavier than leaner men. CONCLUSION In conclusion, an increased screening PSA level is associated with an increased risk of prostate cancer death in Korean men. Our findings may have implications for the development of targeted PSA cutpoints for biopsy recommendation. PMID:25917733

  14. Zagreb Amblyopia Preschool Screening Study: near and distance visual acuity testing increase the diagnostic accuracy of screening for amblyopia

    PubMed Central

    Bušić, Mladen; Bjeloš, Mirjana; Petrovečki, Mladen; Kuzmanović Elabjer, Biljana; Bosnar, Damir; Ramić, Senad; Miletić, Daliborka; Andrijašević, Lidija; Kondža Krstonijević, Edita; Jakovljević, Vid; Bišćan Tvrdi, Ana; Predović, Jurica; Kokot, Antonio; Bišćan, Filip; Kovačević Ljubić, Mirna; Motušić Aras, Ranka

    2016-01-01

    Aim To present and evaluate a new screening protocol for amblyopia in preschool children. Methods Zagreb Amblyopia Preschool Screening (ZAPS) study protocol performed screening for amblyopia by near and distance visual acuity (VA) testing of 15 648 children aged 48-54 months attending kindergartens in the City of Zagreb County between September 2011 and June 2014 using Lea Symbols in lines test. If VA in either eye was >0.1 logMAR, the child was re-tested, if failed at re-test, the child was referred to comprehensive eye examination at the Eye Clinic. Results 78.04% of children passed the screening test. Estimated prevalence of amblyopia was 8.08%. Testability, sensitivity, and specificity of the ZAPS study protocol were 99.19%, 100.00%, and 96.68% respectively. Conclusion The ZAPS study used the most discriminative VA test with optotypes in lines as they do not underestimate amblyopia. The estimated prevalence of amblyopia was considerably higher than reported elsewhere. To the best of our knowledge, the ZAPS study protocol reached the highest sensitivity and specificity when evaluating diagnostic accuracy of VA tests for screening. The pass level defined at ≤0.1 logMAR for 4-year-old children, using Lea Symbols in lines missed no amblyopia cases, advocating that both near and distance VA testing should be performed when screening for amblyopia. PMID:26935612

  15. Proactive Approach to Lymphedema Risk Reduction: A Prospective Study

    PubMed Central

    Fu, Mei R.; Axelrod, Deborah; Guth, Amber A.; Cartwright, Francis; Qiu, Zeyuan; Goldberg, Judith D.; Kim, June; Scagliola, Joan; Kleinman, Robin; Haber, Judith

    2014-01-01

    Background Advances in cancer treatments continue to reduce the incidence of lymphedema. Yet, many breast cancer survivors still face long-term post-operative challenges as a result of developing lymphedema. The purpose of this study was to preliminarily evaluate The-Optimal-Lymph-Flow program, a patient-centered education and behavioral program focusing on self-care strategies to enhance lymphedema risk reduction by promoting lymph flow and optimize body mass index. Methods A prospective, longitudinal, quasi-experimental design with repeated-measures was used. The study outcomes included lymph volume changes by infra-red perometer and body mass index by a bioimpedance device at pre-surgery baseline, 2-4 weeks after surgery, 6-month, and 12-month follow-up. A total of 140 patients were recruited and participated in The-Optimal-Lymph-Flow program; 134 patients completed the study with 4% attrition rate. Results Fifty-eight percent patients had axillary node dissection and 42% had sentinel lymph node biopsy. The majority (97%) of patients maintained and improved their preoperative limb volume and body mass index at the study endpoint of 12 months following cancer surgery. Cumulatively, 2 patients with sentinel lymph node biopsy and 2 patients with the axillary lymph node dissection had measurable lymphedema (>10% limb volume change). At 12-month follow-up, among the 4 patients with measurable lymphedema, 2 patients' limb volume returned to pre-operative level without compression therapy but by maintaining The-Optimal-Lymph-Flow exercises to promote daily lymph flow. Conclusions This educational and behavioral program is effective to enhance lymphedema risk reduction. The study provided initial evidence for emerging change in lymphedema care from treatment-focus to proactive risk reduction. PMID:24809302

  16. Herpes simplex virus encephalitis in Peru: a multicentre prospective study.

    PubMed

    Montano, S M; Mori, N; Nelson, C A; Ton, T G N; Celis, V; Ticona, E; Sihuincha, M; Tilley, D H; Kochel, T; Zunt, J R

    2016-06-01

    Herpes simplex virus (HSV) is one of the most commonly identified infectious aetiologies of encephalitis in North America and Europe. The epidemiology of encephalitis beyond these regions, however, is poorly defined. During 2009-2012 we enrolled 313 patients in a multicentre prospective study of encephalitis in Peru, 45 (14·4%) of whom had confirmed HSV infection. Of 38 patients with known HSV type, 84% had HSV-1 and 16% had HSV-2. Patients with HSV infection were significantly more likely to present in the summer months (44·4% vs. 20·0%, P = 0·003) and have nausea (60·0% vs. 39·8%, P = 0·01) and rash (15·6% vs. 5·3%, P = 0·01) compared to patients without HSV infection. These findings highlight differences in the epidemiology and clinical presentation of HSV encephalitis outside of the Northern Hemisphere that warrant further investigation. Furthermore, there is an urgent need for improved HSV diagnostic capacity and availability of intravenous acyclovir in Peru. PMID:26733400

  17. Socioeconomic Status, Race, and Mortality: A Prospective Cohort Study

    PubMed Central

    Cohen, Sarah S.; Williams, David R.; Munro, Heather M.; Hargreaves, Margaret K.; Blot, William J.

    2014-01-01

    Objectives. We evaluated the independent and joint effects of race, individual socioeconomic status (SES), and neighborhood SES on mortality risk. Methods. We conducted a prospective analysis involving 52 965 non-Hispanic Black and 23 592 non-Hispanic White adults taking part in the Southern Community Cohort Study. Cox proportional hazards modeling was used to determine associations of race and SES with all-cause and cause-specific mortality. Results. In our cohort, wherein Blacks and Whites had similar individual SES, Blacks were less likely than Whites to die during the follow-up period (hazard ratio [HR] = 0.78; 95% confidence interval [CI] = 0.73, 0.84). Low household income was a strong predictor of all-cause mortality among both Blacks and Whites (HR = 1.76; 95% CI = 1.45, 2.12). Being in the lowest (vs highest) category with respect to both individual and neighborhood SES was associated with a nearly 3-fold increase in all-cause mortality risk (HR = 2.76; 95% CI = 1.99, 3.84). There was no significant mortality-related interaction between individual SES and neighborhood SES among either Blacks or Whites. Conclusions. SES is a strong predictor of premature mortality, and the independent associations of individual SES and neighborhood SES with mortality risk are similar for Blacks and Whites. PMID:25322291

  18. Aetiopathology of maxillary swelling--a 3-year prospective study.

    PubMed

    Biswas, Deb; Crank, Stephen

    2007-11-01

    A wide variety of lesions and not necessarily a malignant tumour can cause maxillary swelling. Non-specificity of clinical and radiological features of these maxillary lesions makes their diagnosis difficult. Review of literature adds a little regarding the aetiopathological distribution of the various lesions causing maxillary swelling. We present our finding regarding the relative distribution of various conditions causing maxillary swelling. The awareness of the spectrum of pathology related to maxillary swelling is essential for correct diagnosis and treatment. Forty-eight patients who presented with a swelling of the maxilla to our hospital between May 1998 and April 2001 were prospectively studied regarding the clinical presentations, radiological features and histological findings. Maxillary swelling was found to be caused by malignant tumours in 54.2%, benign neoplasms in 22.9% and non-neoplastic lesions in 22.9%. Overall squamous cell carcinoma (22.9%) was the commonest lesion, tumour of vascular origin was the commonest benign neoplasm and odontogenic cyst was the commonest among the non-neoplastic lesions. PMID:17611767

  19. Postoperative Pain after Root Canal Treatment: A Prospective Cohort Study

    PubMed Central

    Gotler, M.; Bar-Gil, B.; Ashkenazi, M.

    2012-01-01

    Aim. To evaluate the incidence and severity of postendodontic treatment pain (PEP) subsequent to root canal treatment (RCT) in vital and necrotic pulps and after retreatment. Methodology. A prospective study. Participants were all patients (n = 274) who underwent RCT in teeth with vital pulp, necrotic pulp, or vital pulp that had been treated for symptomatic irreversible pulpitis or who received root canal retreatment, by one clinician, during an eight-month period. Exclusion criteria were swelling, purulence, and antibiotic use during initial treatment. A structured questionnaire accessed age, gender, tooth location, and pulpal diagnosis. Within 24 h of treatment, patients were asked to grade their pain at 6 and 18 hours posttreatment, using a 1–5 point scale. Results. RCT of teeth with vital pulp induced a significantly higher incidence and severity of PEP (63.8%; 2.46 ± 1.4, resp.) than RCT of teeth with necrotic pulp (38.5%; 1.78 ± 1.2, resp.) or of retreated teeth (48.8%; 1.89 ± 1.1, resp.). No statistical relation was found between type of pain (spontaneous or stimulated) and pulp condition. Conclusion. RCT of teeth with vital pulp induced a significantly higher incidence and intensity of PEP compared to teeth with necrotic pulp or retreated teeth. PMID:22505897

  20. Endoscopic vertical ramus osteotomy: a long-term prospective study.

    PubMed

    Papadaki, M E; Kaban, L B; Troulis, M J

    2014-03-01

    The purpose of this prospective study was to evaluate the outcomes of endoscopic vertical ramus osteotomy (EVRO) with rigid fixation for the treatment of mandibular prognathism or asymmetry. Inclusion criteria were age >15 years, adequate clinical and radiographic documentation, and minimum postoperative follow-up of 3 years. Exclusion criteria were refusal to consent, rheumatoid arthritis, steroid use, and smoking. Demographic data, pre-operative (T0), immediate postoperative (T1), and latest follow-up (T2) clinical examinations and cephalometric analysis, procedure data, complications, and length of hospital stay (LOS) were documented. Ten fulfilled the inclusion criteria. Diagnoses included mandibular hyperplasia (n = 5), stable condylar hyperplasia (n = 4), and mandibular asymmetry secondary to condylar resorption (n = 1). In total, 17 EVROs were performed. The mean operative time was 33 min per side. Mean mandibular setback was 4.7 mm. Mean LOS was 1.9 days. Latest follow-up ranged from 3 to 5 years. Skeletal stability was confirmed in nine patients. One patient exhibited recurrence of mandibular prognathism at 5 years due to late growth. No VII nerve deficits were encountered. Inferior alveolar nerve (IAN) paresthesia was noted in four patients, which resolved postoperatively. EVRO was fast and resulted in minimal blood loss, quick recovery, and skeletal stability. PMID:24246948

  1. Burn injuries in Zaria: a one year prospective study.

    PubMed

    Kalayi, G D

    1994-05-01

    Fifty three patients admitted for burn care during a 12 month period from September 1987 to August 1988 were prospectively studied. There were 36 males (60%) and 21 females (40%) with ages ranging from 3 months to 60 years. Children aged 0-4 constituted 40% but 32 (60%) were younger than 16 years. Flame burns affected 26 (49%) patients, scalds in 22 (12%), electrical burns affected four patients and chemical burn was in one. Scald was the commonest injury among children aged 0-4 (70%). Flame, affected 33% of those aged 16 and above. Clothing fire was the commonest flame injury and it was a cause of very extensive injury (mean % BSA 45). Kerosene burn, gas and clothing burns caused the most extensive injury with a mean % BSA 46, 41 and 45 respectively. The commonest complication was burn wound sepsis most frequently by a gram-negative bacilli (65.63%) of which Pseudomonas aeruginosa were that commonest organisms. Pseudomonas and Staphylococcus aureus were about same frequency. Duration of hospital stay ranged from 6 days to 300 days with a mean of 46.52 days. 8 patients absconded, two were transferred to a hospital near their home and 9 died, giving a mortality rate of 17%. Since burn injuries are largely preventable, it is important to define clearly the social, cultural and economic factors which contribute to burn causation in order to combat them effectively. PMID:7925065

  2. Metabolic Bone Disease in Viral Cirrhosis: A Prospective Study

    PubMed Central

    Goubraim, Rabia; Kabbaj, Nawal; Salihoun, Mouna; Chaoui, Zakia; Nya, M'Hamed; Amrani, Naima

    2013-01-01

    Background/Aim. Metabolic Bone disorders are well-recognized extrahepatic complications of cirrhosis. The aim was to report their prevalence and the associated factors to their development in patients with viral cirrhosis. Patients and Methods. All consecutive patients with viral cirrhosis were prospectively enrolled. Parathyroid hormone, 25-hydroxyvitamin D, liver function, and phosphocalcic tests were measured in all patients. Bone mineral density was measured at the lumbar spine and total hip by dual-energy X-ray absorptiometry. Data were analyzed using SPSS software. Results. Forty-six cirrhotic patients were included with hepatitis C (87%) and hepatitis B (13%). The Child-Pugh score was grade A in 87% of cases and grade B in 13%. Thirty-seven patients had decreased bone mineral density with osteopenia in 24 patients and osteoporosis in 13 patients. Decreased 25-hydroxyvitamin D was found in 95.6% of cases. Bone disorders were significantly more frequent in old patients with low body mass index, long duration of liver disease, and low 25-hydroxyvitamin D level. None of these factors was an independent factor associated with bone disorders. Conclusion. Our study revealed a high prevalence of metabolic bone disorders among viral cirrhotic patients. Consequently, bone mineral density assessment should be performed systematically in all cirrhotic patients.

  3. Risk Profiles for Aortic Dissection and Ruptured or Surgically Treated Aneurysms: A Prospective Cohort Study

    PubMed Central

    Landenhed, Maya; Engström, Gunnar; Gottsäter, Anders; Caulfield, Michael P.; Hedblad, Bo; Newton‐Cheh, Christopher; Melander, Olle; Smith, J. Gustav

    2015-01-01

    Background Community screening to guide preventive interventions for acute aortic disease has been recommended in high‐risk individuals. We sought to prospectively assess risk factors in the general population for aortic dissection (AD) and severe aneurysmal disease in the thoracic and abdominal aorta. Methods and Results We studied the incidence of AD and ruptured or surgically treated aneurysms in the abdominal (AAA) or thoracic aorta (TAA) in 30 412 individuals without diagnosis of aortic disease at baseline from a contemporary, prospective cohort of middle‐aged individuals, the Malmö Diet and Cancer study. During up to 20 years of follow‐up (median 16 years), the incidence rate per 100 000 patient‐years at risk was 15 (95% CI 11.7 to 18.9) for AD, 27 (95% CI 22.5 to 32.1) for AAA, and 9 (95% CI 6.8 to 12.6) for TAA. The acute and in‐hospital mortality was 39% for AD, 34% for ruptured AAA, and 41% for ruptured TAA. Hypertension was present in 86% of individuals who subsequently developed AD, was strongly associated with incident AD (hazard ratio [HR] 2.64, 95% CI 1.33 to 5.25), and conferred a population‐attributable risk of 54%. Hypertension was also a risk factor for AAA with a smaller effect. Smoking (HR 5.07, 95% CI 3.52 to 7.29) and high apolipoprotein B/A1 ratio (HR 2.48, 95% CI 1.73 to 3.54) were strongly associated with AAA and conferred a population‐attributable risk of 47% and 25%, respectively. Smoking was also a risk factor for AD and TAA with smaller effects. Conclusions This large prospective study identified distinct risk factor profiles for different aortic diseases in the general population. Hypertension accounted for more than half of the population risk for AD, and smoking for half of the population risk of AAA. PMID:25609416

  4. Vocal Cord Paralysis and its Etiologies: A Prospective Study

    PubMed Central

    Seyed Toutounchi, Seyed Javad; Eydi, Mahmood; Golzari, Samad EJ; Ghaffari, Mohammad Reza; Parvizian, Nashmil

    2014-01-01

    Introduction: Vocal cord paralysis is a common symptom of numerous diseases and it may be due to neurogenic or mechanical fixation of the cords. Paralysis of the vocal cords is just a symptom of underlying disease in some cases; so, clinical diagnosis of the underlying cause leading to paralysis of the vocal cords is important. This study evaluates the causes of vocal cord paralysis. Methods: In a prospective study, 45 patients with paralyzed vocal cord diagnosis were examined by tests such as examination of the pharynx, larynx, esophagus, thyroid, cervical, lung, and mediastinum, brain and heart by diagnostic imaging to investigate the cause vocal cord paralysis. The study was ended by diagnosing the reason of vocal cord paralysis at each stage of the examination and the clinical studies. Results: The mean duration of symptoms was 18.95±6.50 months. The reason for referral was phonation changes (97.8%) and aspiration (37.8%) in the subjects. There was bilateral paralysis in 6.82%, left paralysis in 56.82% and right in 63.36% of subjects. The type of vocal cord placement was midline in 52.8%, paramedian in 44.4% and lateral in 2.8% of the subjects. The causes of vocal cords paralysis were idiopathic paralysis (31.11%), tumors (31.11%), surgery (28.89%), trauma, brain problems, systemic disease and other causes (2.2%). Conclusion: An integrated diagnostic and treatment program is necessary for patients with vocal cord paralysis. Possibility of malignancy should be excluded before marking idiopathic reason to vocal cord paralysis. PMID:24753832

  5. Predictors of critical acute pancreatitis: a prospective cohort study.

    PubMed

    Ke, Lu; Tong, Zhi-hui; Li, Wei-qin; Wu, Congye; Li, Ning; Windsor, John A; Li, Jie-shou; Petrov, Maxim S

    2014-11-01

    Critical acute pancreatitis (CAP) has recently emerged as the most ominous severity category of acute pancreatitis (AP). As such there have been no studies specifically designed to evaluate predictors of CAP. In this study, we aimed to evaluate the accuracy of 4 parameters (Acute Physiology and Chronic Health Evaluation [APACHE] II score, C-reactive protein [CRP], D-dimer, and intra-abdominal pressure [IAP]) for predicting CAP early after hospital admission. During the study period, data on patients with AP were prospectively collected and D-dimer, CRP, and IAP levels were measured using standard methods at admission whereas the APACHE II score was calculated within 24 hours of hospital admission. The receiver-operating characteristic (ROC) curve analysis was applied and the likelihood ratios were calculated to evaluate the predictive accuracy. A total of 173 consecutive patients were included in the analysis and 47 (27%) of them developed CAP. The overall hospital mortality was 11% (19 of 173). APACHE II score ≥11 and IAP ≥13 mm Hg showed significantly better overall predictive accuracy than D-dimer and CRP (area under the ROC curve-0.94 and 0.92 vs. 0.815 and 0.667, correspondingly). The positive likelihood ratio of APACHE II score is excellent (9.9) but of IAP is moderate (4.2). The latter can be improved by adding CRP (5.8). In conclusion, of the parameters studied, APACHE II score and IAP are the best available predictors of CAP within 24 hours of hospital admission. Given that APACHE II score is rather cumbersome, the combination of IAP and CRP appears to be the most practical way to predict critical course of AP early after hospital admission. PMID:25380082

  6. Atypical antipsychotic drugs and pregnancy outcome: a prospective, cohort study.

    PubMed

    Habermann, Frank; Fritzsche, Juliane; Fuhlbrück, Frederike; Wacker, Evelin; Allignol, Arthur; Weber-Schoendorfer, Corinna; Meister, Reinhard; Schaefer, Christof

    2013-08-01

    Women of childbearing age are often affected with psychotic disorders, requiring the use of antipsychotic medication during pregnancy. In the present study, we prospectively followed the pregnancies of 561 women exposed to second-generation antipsychotic agents (SGAs; study cohort) and compared these to 284 pregnant women exposed to first-generation antipsychotic agents (FGAs; comparison cohort I) and to 1122 pregnant women using drugs known as not harmful to the unborn (comparison cohort II). Subjects were enrolled through the Institute's consultation service. Major malformation rates of SGA exposed were higher compared to comparison cohort II (adjusted odds ratio, 2.17; 95% confidence interval, 1.20-3.91), possibly reflecting a detection bias concerning atrial and ventricular septal defects. Postnatal disorders occurred significantly more often in infants prenatally exposed to SGAs (15.6%) and FGAs (21.6%) compared to 4.2% of comparison cohort II. Cumulative incidences of elective terminations of pregnancy were significantly higher in both the study cohort (17%) and comparison cohort I (21%) compared to comparison cohort II (3%), whereas the rates of spontaneous abortions did not differ. The numbers of stillbirths and neonatal deaths were within the reference range. Preterm birth and low birth weight were more common in infants exposed to FGAs. To conclude, our findings did not reveal a major teratogenic risk for SGAs, making the better studied drugs of this group a treatment option during pregnancy. Because neonates exposed to SGAs or FGAs in the last gestational week are at higher risk of postnatal disorders, delivery should be planned in clinics with neonatal intensive care units. PMID:23764684

  7. Butorphanol in labour analgesia: A prospective cohort study

    PubMed Central

    Halder, Ajay; Agarwal, Rachana

    2013-01-01

    Objective Parenteral opioids can be administered with ease at a very low cost with high efficacy as labour analgesia. However, there are insufficient data available to accept the benefits of parenteral opioids over other proven methods of labour analgesia. Butorphanol, a new synthetic opioid, has emerged as a promising agent in terms of efficacy and a better safety profile. This study investigates the effect of butorphanol as a labour analgesia to gather further evidence of its safety and efficacy to pave the way for its widespread use in low resource settings. Material and Methods One hundred low risk term consenting pregnant women were recruited to take part in a prospective cohort study. Intramuscular injections of butorphanol tartrate 1 mg (Butrum 1/2mg, Aristo, Mumbai, India) were given in the active phase of labour and repeated two hourly. Pain relief was noted on a 10-point visual pain analogue scale (VPAS). Obstetric and neonatal outcome measures were mode of delivery, duration of labour, Apgar scores at 1 and 5 minutes and Neonatal Intensive Care Unit admissions. Collected data were analysed for statistically significant pain relief between pre- and post-administration VPAS scores and also for the incidence of adverse outcomes. Results Pain started to decrease significantly within 15 minutes of administration and reached the nadir (3.08 SD0.51) at the end of two hours. The pain remained below four on the VPAS until the end of six hours and was still significantly low after eight hours. The incidence of adverse outcomes was low in the present study. Conclusion Butorphanol is an effective parenteral opioid analgesic which can be administered with reasonable safety for the mother and the neonate. The study has the drawback of lack of control and small sample size. PMID:24592110

  8. Intraclass Correlation Estimates for Cancer Screening Outcomes: Estimates and Applications in the Design of Group-Randomized Cancer Screening Studies

    PubMed Central

    Murray, David M.; Pennell, Michael L.; Rhoda, Dale; Paskett, Electra D.; Champion, Victoria L.; Crabtree, Benjamin F.; Dietrich, Allen; Dignan, Mark B.; Farmer, Melissa; Fenton, Joshua J.; Flocke, Susan; Hiatt, Robert A.; Hudson, Shawna V.; Mitchell, Michael; Monahan, Patrick; Shariff-Marco, Salma; Slone, Stacey L.; Stange, Kurt; Stewart, Susan L.; Ohman Strickland, Pamela A.

    2010-01-01

    Background Screening has become one of our best tools for early detection and prevention of cancer. The group-randomized trial is the most rigorous experimental design for evaluating multilevel interventions. However, identifying the proper sample size for a group-randomized trial requires reliable estimates of intraclass correlation (ICC) for screening outcomes, which are not available to researchers. We present crude and adjusted ICC estimates for cancer screening outcomes for various levels of aggregation (physician, clinic, and county) and provide an example of how these ICC estimates may be used in the design of a future trial. Methods Investigators working in the area of cancer screening were contacted and asked to provide crude and adjusted ICC estimates using the analysis of variance method estimator. Results Of the 29 investigators identified, estimates were obtained from 10 investigators who had relevant data. ICC estimates were calculated from 13 different studies, with more than half of the studies collecting information on colorectal screening. In the majority of cases, ICC estimates could be adjusted for age, education, and other demographic characteristics, leading to a reduction in the ICC. ICC estimates varied considerably by cancer site and level of aggregation of the groups. Conclusions Previously, only two articles had published ICCs for cancer screening outcomes. We have complied more than 130 crude and adjusted ICC estimates covering breast, cervical, colon, and prostate screening and have detailed them by level of aggregation, screening measure, and study characteristics. We have also demonstrated their use in planning a future trial and the need for the evaluation of the proposed interval estimator for binary outcomes under conditions typically seen in GRTs. PMID:20386058

  9. Repeated Nipple Fluid Aspiration: Compliance and Feasibility Results from a Prospective Multicenter Study

    PubMed Central

    de Groot, J. S.; Moelans, C. B.; Elias, S. G.; Hennink, A.; Verolme, B.; Suijkerbuijk, K. P. M.; Jager, A.; Seynaeve, C.; Bos, P.; Witkamp, A. J.; Ausems, M. G. E. M.; van Diest, P. J.; van der Wall, E.

    2015-01-01

    Background Despite intensive surveillance, a high rate of interval malignancies is still seen in women at increased breast cancer risk. Therefore, novel screening modalities aiming at early detection remain needed. The intraductal approach offers the possibility to directly sample fluid containing cells, DNA and proteins from the mammary ductal system where, in the majority of cases, breast cancer originates. Fluid from the breast can non-invasively be obtained by oxytocin-assisted vacuum aspiration, called nipple fluid aspiration (NFA). The goal of this feasibility study was to evaluate the potential of repeated NFA, which is a critical and essential step to evaluate its possible value as a breast cancer screening method. Methods In this multicenter, prospective study, we annually collected nipple fluid for up to 5 consecutive years from women at increased breast cancer risk, and performed a questionnaire-based survey regarding discomfort of the aspiration. Endpoints of the current interim analyses were the feasibility and results of 994 NFA procedures in 451 women with total follow-up of 560 person years of observation. Results In this large group of women at increased risk of breast cancer, repetitive NFA appeared to be feasible and safe. In 66.4% of aspirated breasts, nipple fluid was successfully obtained. Independent predictive factors for successful NFA were premenopausal status, spontaneous nipple discharge, smaller breast size, bilateral oophorectomy and previous use of hormone replacement therapy or anti-hormonal treatment. The procedure was well tolerated with low discomfort. Drop-out rate was 20%, which was mainly due to repeated unsuccessful aspiration attempts. Only 1.6% of women prematurely declined further participation because of side effects. Conclusions Repeated NFA in women at increased breast cancer risk is feasible and safe. Therefore, NFA is a promising method to non-invasively obtain a valuable source of potential breast cancer specific

  10. Usefulness of routine preoperative testing in a developing country: a prospective study

    PubMed Central

    Bordes, Julien; Cungi, Pierre-Julien; Savoie, Pierre-Henry; Bonnet, Stéphane; Kaiser, Eric

    2015-01-01

    Introduction The assessment of anesthetic risks is an essential component of preoperative evaluation. In developing world, preanesthesia evaluation may be challenging because patient's medical history and records are scare, and language barrier limits physical examination. Our objective was to evaluate the impact of routine preoperative testing in a low-resources setting. Methods Prospective observational study performed in a French forward surgical unit in Abidjan, Ivory Coast. 201 patients who were scheduled for non urgent surgery were screened with routine laboratory exams during preoperative evaluation. Changes in surgery were assessed (delayed or scheduled). Results Abnormal hemoglobin findings were reported in 35% of patients, abnormal WBC count in 11,1% of patients, abnormal platelets in 15,3% of patients. Positive HIV results were found in 8,3% of cases. Routine tests represented 43,6% of changes causes. Conclusion Our study showed that in a developing country, routine preoperative tests showed abnormal results up to 35% of cases, and represented 43,5% of delayed surgery causes. The rate of tests leading to management changes varied widely, from 0% to 8,3%. These results suggested that selected tests would be useful to diagnose diseases that required treatment before non urgent surgery. However, larger studies are needeed to evaluate the cost/benefit ratio and the clinical impact of such a strategy. PMID:26516395

  11. Association studies including genotype by environment interactions: prospects and limits

    PubMed Central

    2014-01-01

    Background Association mapping studies offer great promise to identify polymorphisms associated with phenotypes and for understanding the genetic basis of quantitative trait variation. To date, almost all association mapping studies based on structured plant populations examined the main effects of genetic factors on the trait but did not deal with interactions between genetic factors and environment. In this paper, we propose a methodological prospect of mixed linear models to analyze genotype by environment interaction effects using association mapping designs. First, we simulated datasets to assess the power of linear mixed models to detect interaction effects. This simulation was based on two association panels composed of 90 inbreds (pearl millet) and 277 inbreds (maize). Results Based on the simulation approach, we reported the impact of effect size, environmental variation, allele frequency, trait heritability, and sample size on the power to detect the main effects of genetic loci and diverse effect of interactions implying these loci. Interaction effects specified in the model included SNP by environment interaction, ancestry by environment interaction, SNP by ancestry interaction and three way interactions. The method was finally used on real datasets from field experiments conducted on the two considered panels. We showed two types of interactions effects contributing to genotype by environment interactions in maize: SNP by environment interaction and ancestry by environment interaction. This last interaction suggests differential response at the population level in function of the environment. Conclusions Our results suggested the suitability of mixed models for the detection of diverse interaction effects. The need of samples larger than that commonly used in current plant association studies is strongly emphasized to ensure rigorous model selection and powerful interaction assessment. The use of ancestry interaction component brought valuable

  12. Prospective evaluation of serum sarcosine and risk of prostate cancer in the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial

    PubMed Central

    Koutros, Stella; Hsing, Ann W.; Berndt, Sonja I.

    2013-01-01

    Metabolomic profiling has identified, sarcosine, a derivative of the amino acid glycine, as an important metabolite involved in the etiology or natural history of prostate cancer. We examined the association between serum sarcosine levels and risk of prostate cancer in 1122 cases (813 non-aggressive and 309 aggressive) and 1112 controls in the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial. Sarcosine was quantified using high-throughput liquid chromatography–mass spectrometry. A significantly increased risk of prostate cancer was observed with increasing levels of sarcosine (odds ratio [OR] for the highest quartile of exposure [Q4] versus the lowest quartile [Q1] = 1.30, 95% confidence interval [CI]: 1.02, 1.65; P-trend 0.03). When stratified by disease aggressiveness, we observed a stronger association for non-aggressive cases (OR for Q4 versus Q1 = 1.44, 95% CI: 1.11, 1.88; P-trend 0.006) but no association for aggressive prostate cancer (OR for Q4 versus Q1 = 1.03, 95% CI: 0.73, 1.47; P-trend 0.89). Although not statistically significant, temporal analyses showed a stronger association between sarcosine and prostate cancer for serum collected closer to diagnosis, suggesting that sarcosine may be an early biomarker of disease. Interestingly, the association between sarcosine and prostate cancer risk was stronger among men with diabetes (OR = 2.66, 95% CI: 1.04, 6.84) compared with those without reported diabetes (OR = 1.23, 95% CI: 0.95–1.59, P-interaction = 0.01). This study found that elevated levels of serum sarcosine are associated with an increased prostate cancer risk and evidence to suggest that sarcosine may be an early biomarker for this disease. PMID:23698636

  13. Prospects: The Congressionally Mandated Study of Educational Growth and Opportunity. The Interim Report.

    ERIC Educational Resources Information Center

    Puma, Michael J.; And Others

    This publication is the first interim report from the Congressionally Mandated Study of Educational Growth and Opportunity (Prospects), and describes students' characteristics and the schools they attend. Prospects is designed to evaluate the short- and long-term consequences of Chapter 1 program participation by following for 5 years large…

  14. An Exploratory Study on the Perspectives of Prospective Computer Teachers following Project-Based Learning

    ERIC Educational Resources Information Center

    Karaman, Selcuk; Celik, Suat

    2008-01-01

    This study investigates perceptions of 29 prospective teachers about a course based on Project-Based Learning (PBL) approach. The course, "Authoring Languages in PC Environment (B-320)" lasted in 14 weeks in fall semester of 2004-2005. In this course each prospective teacher carried out a project that requires designing and developing courseware…

  15. Prospective Elementary School Teachers' Views about Socioscientific Issues: A Concurrent Parallel Design Study

    ERIC Educational Resources Information Center

    Özden, Muhammet

    2015-01-01

    The purpose of this research is to examine the prospective elementary school teachers' perceptions on socioscientific issues. The research was conducted on prospective elementary school teachers studying at a university located in western Turkey. The researcher first taught the subjects of global warming and nuclear power plants from a perspective…

  16. A Prospective Cohort Study of Mineral Metabolism After Kidney Transplantation

    PubMed Central

    Wolf, Myles; Weir, Matthew R.; Kopyt, Nelson; Mannon, Roslyn B.; Von Visger, Jon; Deng, Hongjie; Yue, Susan; Vincenti, Flavio

    2016-01-01

    Background Kidney transplantation corrects or improves many complications of chronic kidney disease, but its impact on disordered mineral metabolism is incompletely understood. Methods We performed a multicenter, prospective, observational cohort study of 246 kidney transplant recipients in the United States to investigate the evolution of mineral metabolism from pretransplant through the first year after transplantation. Participants were enrolled into 2 strata defined by their pretransplant levels of parathyroid hormone (PTH), low PTH (>65 to ≤300 pg/mL; n = 112), and high PTH (>300 pg/mL; n = 134) and underwent repeated, longitudinal testing for mineral metabolites. Results The prevalence of posttransplant, persistent hyperparathyroidism (PTH >65 pg/mL) was 89.5%, 86.8%, 83.1%, and 86.2%, at months 3, 6, 9, and 12, respectively, among participants who remained untreated with cinacalcet, vitamin D sterols, or parathyroidectomy. The results did not differ across the low and high PTH strata, and rates of persistent hyperparathyroidism remained higher than 40% when defined using a higher PTH threshold greater than 130 pg/mL. Rates of hypercalcemia peaked at 48% at week 8 in the high PTH stratum and then steadily decreased through month 12. Rates of hypophosphatemia (<2.5 mg/dL) peaked at week 2 and then progressively decreased through month 12. Levels of intact fibroblast growth factor 23 decreased rapidly during the first 3 months after transplantation in both PTH strata and remained less than 40 pg/mL thereafter. Conclusions Persistent hyperparathyroidism is common after kidney transplantation. Further studies should determine if persistent hyperparathyroidism or its treatment influences long-term posttransplantation clinical outcomes. PMID:26177089

  17. Gender effect on clinical features of achalasia: a prospective study

    PubMed Central

    Mikaeli, Javad; Farrokhi, Farnoosh; Bishehsari, Faraz; Mahdavinia, Mahboobeh; Malekzadeh, Reza

    2006-01-01

    Background Achalasia is a well-characterized esophageal motor disorder but the rarity of the disease limits performing large studies on its demographic and clinical features. Methods Prospectively, 213 achalasia patients (110 men and 103 women) were enrolled in the study. The diagnosis established by clinical, radiographic, and endoscopic as well as manometry criteria. All patients underwent a pre-designed clinical evaluation before and within 6 months after the treatment. Results Solid dysphagia was the most common clinical symptom in men and women. Chest pain was the only symptom which was significantly different between two groups and was more complained by women than men (70.9% vs. 54.5% P value= 0.03). Although the occurrence of chest pain significantly reduced after treatment in both groups (P < 0.001), it was still higher among women (32% vs. 20.9% P value= 0.04). In both sexes, chest pain did not relate to the symptom duration, LES pressure and type of treatment patients received. Also no significant relation was found between chest pain and other symptoms expressed by men and women before and after treatment. Chest pain was less frequently reported by patients over 56 yrs of age in comparison to those less than 56 yrs (p < 0.05). Conclusion It seems that chest pain is the distinct symptom of achalasia which is affected by sex as well as age and does not relate to the duration of illness, LESP and the type of treatment achalasia patients receive. PMID:16579859

  18. Liquid versus gel handrub formulation: a prospective intervention study

    PubMed Central

    Traore, Ousmane; Hugonnet, Stéphane; Lübbe, Jann; Griffiths, William; Pittet, Didier

    2007-01-01

    Introduction Hand hygiene is one of the cornerstones of the prevention of health care-associated infection, but health care worker (HCW) compliance with good practices remains low. Alcohol-based handrub is the new standard for hand hygiene action worldwide and usually requires a system change for its successful introduction in routine care. Product acceptability by HCWs is a crucial step in this process. Methods We conducted a prospective intervention study to compare the impact on HCW compliance of a liquid (study phase I) versus a gel (phase II) handrub formulation of the same product during daily patient care. All staff (102 HCWs) of the medical intensive care unit participated. Compliance with hand hygiene was monitored by a single observer. Skin tolerance and product acceptability were assessed using subjective and objective scoring systems, self-report questionnaires, and biometric measurements. Logistic regression was used to estimate the association between predictors and compliance with the handrub formulation as the main explanatory variable and to adjust for potential risk factors. Results Overall compliance (phases I and II) with hand hygiene practices among nurses, physicians, nursing assistants, and other HCWs was 39.1%, 27.1%, 31.1%, and 13.9%, respectively (p = 0.027). Easy access to handrub improved compliance (35.3% versus 50.6%, p = 0.035). Nurse status, working on morning shifts, use of the gel formulation, and availability of the alcohol-based handrub in the HCW's pocket were independently associated with higher compliance. Immediate accessibility was the strongest predictor. Based on self-assessment, observer assessment, and the measurement of epidermal water content, the gel performed significantly better than the liquid formulation. Conclusion Facilitated access to an alcohol-based gel formulation leads to improved compliance with hand hygiene and better skin condition in HCWs. PMID:17477858

  19. [Soccer injuries. A prospective epidemiological and socioeconomic study].

    PubMed

    Jensen, K H; Lindblad, B E; Terkelsen, C J; Helleland, H E; Terkelsen, C J

    1993-11-01

    In one year 715 soccer injuries were registered and treated in the casualty ward of Randers City Hospital. We conducted a prospective study of these patients, using a questionnaire in order to determine the most common locations, types, mechanisms and treatments of injury. Financial costs to society and the individual were also examined. Finally, we compared the most common types of injury definition in sports medicine. According to the Abbreviated Injury Scale, A.I.S., 44% of the injuries were classified as minor, 46% as moderate injury and 9% as severe. Fractures accounted for 17% of all injuries. Sprains and contusions were the most frequent injuries, accounting for 46% and 25% respectively. Most injuries (63%) were treated in the casualty ward, whilst 20% were treated as outpatients. 7% were admitted to the hospital immediately, and a further 2% were later admitted from the outpatient clinic. A total of 88% of those hospitalized were treated as inpatients for 1-7 days, and 12% for more than two weeks. 31% of all the soccer players seen in the casualty ward were absent from work, and 12% were absent from work for more than three weeks. 8% of the injured soccer players suffered loss of income. 40% had financial losses between $0-250, 40% between $250-750, seven per cent between $750-1,250, and 14% more than $1,250. From the data presented in this study, we conclude that the injury rate among soccer players increases with age, and the severity of the injuries is greatest in the oldest age groups. Soccer injuries constitute the major part of sports injuries seen in the casualty ward.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8256352

  20. Pain assessment of the intratympanic injections: a prospective comparative study.

    PubMed

    Belhassen, Sarah; Saliba, Issam

    2012-12-01

    The objective of the study is to compare the pain level of three methods of intratympanic (IT) injections using prospective, randomized clinical study in a tertiary care center. 39 patients with Ménière's disease and 30 patients with sudden sensorineural hearing loss are included. Excluded were patients treated for a chronic pain or those who took any pain killer for the last 24 h. Each patient received one IT injection a week, for three consecutive weeks. Three methods of IT injections were compared, with the application of EMLA cream on the tympanic membrane filling the external auditory canal 60 min before the procedure, with subcutaneous injection of lidocaine 1% with 1:100,000 epinephrine in the external auditory canal, and finally with an IT injection without any previous anesthesia. The pain intensity was immediately measured at 5 min, and then 45 min after the procedure, each time using four pain rating scales (visual analogue scale, numerical rating scale, verbal rating scale and categorical rating scale). No difference in pain intensity between the three methods of IT injections was detected by the visual analogue scale and numerical rating scale (p > 0.05). 45.8% of patients preferred the IT injection without previous anesthesia. However, methylprednisolone has been associated with pain intensity greater than that of gentamicin 45 min after the injection (p < 0.05). The IT injection performed without any previous anesthesia is an interesting option since it has not been shown to be more painful than the other methods of injections, and spares the patient from disadvantages associated with the anesthesia. PMID:22203120

  1. Prospective studies of infectious mononucleosis in university students

    PubMed Central

    Grimm, Jennifer M; Schmeling, David O; Dunmire, Samantha K; Knight, Jennifer A; Mullan, Beth D; Ed, Julie A; Brundage, Richard C; Hogquist, Kristin A; Balfour, Henry H

    2016-01-01

    We performed an intensive prospective study designed to obtain as much data as possible on the incubation and early illness periods of primary Epstein–Barr virus (EBV) infection. Undergraduate students who lacked EBV antibody and oral EBV DNA (EBV-naive) were seen every 2 weeks during their freshman year. Clinical and behavioral data, oral washes and venous blood were obtained. EBV antibodies were quantified by enzyme immunoassay and viral loads by PCR. During a median 8 months of observation, 14/85 subjects experienced primary EBV infections (24 cases/100 person-years). The only significant risk factor for acquisition of EBV infection was deep kissing (P=0.02). Eleven subjects had infectious mononucleosis with a median duration of 21 days. Two subjects were hospitalized. Infections were initially identified in 12 subjects by finding EBV DNA in oral cells before onset of symptoms and in 2 subjects by symptom reporting. EBV DNA and viral capsid antigen (VCA) IgM and gp350 IgG antibodies were present in the blood before onset of illness. To provide a more robust evaluation of primary EBV infection in undergraduate university students, we combined data on risk factors and antibody responses from this and an earlier study that used the exact same clinical and laboratory methods. The observation that the only significant risk factor for acquisition of EBV infection was deep kissing was confirmed. Most importantly, higher amounts of gp350 antibody correlated significantly with a lower severity of infectious mononucleosis (P<0.0001), which strengthens the rationale for a gp350-based prophylactic EBV vaccine. PMID:27588199

  2. Prospective studies of infectious mononucleosis in university students.

    PubMed

    Grimm, Jennifer M; Schmeling, David O; Dunmire, Samantha K; Knight, Jennifer A; Mullan, Beth D; Ed, Julie A; Brundage, Richard C; Hogquist, Kristin A; Balfour, Henry H

    2016-08-01

    We performed an intensive prospective study designed to obtain as much data as possible on the incubation and early illness periods of primary Epstein-Barr virus (EBV) infection. Undergraduate students who lacked EBV antibody and oral EBV DNA (EBV-naive) were seen every 2 weeks during their freshman year. Clinical and behavioral data, oral washes and venous blood were obtained. EBV antibodies were quantified by enzyme immunoassay and viral loads by PCR. During a median 8 months of observation, 14/85 subjects experienced primary EBV infections (24 cases/100 person-years). The only significant risk factor for acquisition of EBV infection was deep kissing (P=0.02). Eleven subjects had infectious mononucleosis with a median duration of 21 days. Two subjects were hospitalized. Infections were initially identified in 12 subjects by finding EBV DNA in oral cells before onset of symptoms and in 2 subjects by symptom reporting. EBV DNA and viral capsid antigen (VCA) IgM and gp350 IgG antibodies were present in the blood before onset of illness. To provide a more robust evaluation of primary EBV infection in undergraduate university students, we combined data on risk factors and antibody responses from this and an earlier study that used the exact same clinical and laboratory methods. The observation that the only significant risk factor for acquisition of EBV infection was deep kissing was confirmed. Most importantly, higher amounts of gp350 antibody correlated significantly with a lower severity of infectious mononucleosis (P<0.0001), which strengthens the rationale for a gp350-based prophylactic EBV vaccine. PMID:27588199

  3. Clinical orofacial characteristics associated with risk of first-onset TMD: the OPPERA prospective cohort study

    PubMed Central

    Ohrbach, Richard; Bair, Eric; Fillingim, Roger B.; Gonzalez, Yoly; Gordon, Sharon M.; Lim, Pei-Feng; Ribeiro-Dasilva, Margarete; Diatchenko, Luda; Dubner, Ron; Greenspan, Joel D.; Knott, Charles; Maixner, William; Smith, Shad; Slade, Gary

    2013-01-01

    Case-control studies have documented clinical manifestations of chronic temporomandibular disorders (TMD), whereas clinical predictors of TMD development are largely unknown. We evaluated 41 clinical orofacial characteristics thought to predict first-onset TMD in a prospective cohort study of U.S. adults aged 18-44 years. During the median 2.8-year follow-up period, 2,737 people completed quarterly screening questionnaires. Those reporting symptoms were examined and 260 people were identified with first-onset TMD. Univariate and multivariate Cox regression models quantified associations between baseline clinical orofacial measures and TMD incidence. Significant predictors from baseline self-report instruments included oral parafunctions, prior facial pain and its life-impact, TMJ noises and jaw locking, and non-specific orofacial symptoms. Significant predictors from the baseline clinical examination were pain on jaw opening and pain from palpation of masticatory, neck, and body muscles. Examiner assessments of TMJ noise and tooth wear facets did not predict incidence. In multivariate analysis, non-specific orofacial symptoms, pain from jaw opening and oral parafunctions predicted TMD incidence. The results indicate that only a few orofacial examination findings influenced TMD incidence, and only to a modest degree. More pronounced influences were found for self-reported symptoms, particularly those that appeared to reflect alterations to systems beyond the masticatory tissues. PMID:24275222

  4. Performance evaluation of a new rapid urine test for chlamydia in men: prospective cohort study

    PubMed Central

    Nadala, Elpidio-Cesar; Goh, Beng T; Magbanua, Jose-Paolo; Barber, Penelope; Swain, Alison; Alexander, Sarah; Laitila, Vivian; Michel, Claude-Edouard; Mahilum-Tapay, Lourdes; Ushiro-Lumb, Ines; Ison, Catherine

    2009-01-01

    Objective To evaluate the performance of a rapid test for chlamydia with first void male urine samples as a potential tool for diagnosis and screening of chlamydial infection in men. Design Evaluation of test performance in prospective cohort study. Settings A young people’s sexual health centre (site 1) and a genitourinary medicine clinic (site 2) in the United Kingdom. Participants 1211 men aged 16-73 attending either of the two sites. Main outcome measures Sensitivity, specificity, positive predictive value, and negative predictive value of the Chlamydia Rapid Test versus polymerase chain reaction assay. Relation between the visual signal of the Chlamydia Rapid Test and organism load. Results Detection rates for Chlamydia trachomatis infection with polymerase chain reaction were 4.4% (20/454) at site 1 and 11.9% (90/757) at site 2. Compared with polymerase chain reaction assay, the resolved sensitivity, specificity, positive predictive value, and negative predictive value of the Chlamydia Rapid Test was 82.6% (90/109), 98.5% (1085/1102), 84.1% (90/107), and 98.3% (1085/1104), respectively. The organism load in first void urine samples that were positive for chlamydia ranged from 7.28×102 to 6.93×106 plasmids/ml and correlated significantly with the visual signal of the Chlamydia Rapid Test (r=0.7897, P<0.001). Conclusions The performance of the new Chlamydia Rapid Test with first void male urine samples indicates that it would be an effective diagnostic tool for chlamydial infection in men. The availability of test results within an hour allows for immediate treatment and contact tracing, potentially reducing the risks of persistent infection and onward transmission. The test could also provide a simple and reliable alternative to nucleic acid amplification assays for testing of male urine in chlamydial screening programmes in high prevalence settings. PMID:19638650

  5. Surprise Questions for Survival Prediction in Patients With Advanced Cancer: A Multicenter Prospective Cohort Study

    PubMed Central

    Hamano, Jun; Morita, Tatsuya; Inoue, Satoshi; Ikenaga, Masayuki; Matsumoto, Yoshihisa; Sekine, Ryuichi; Yamaguchi, Takashi; Hirohashi, Takeshi; Tajima, Tsukasa; Tatara, Ryohei; Watanabe, Hiroaki; Otani, Hiroyuki; Takigawa, Chizuko; Matsuda, Yoshinobu; Nagaoka, Hiroka; Mori, Masanori; Yamamoto, Naoki; Shimizu, Mie; Sasara, Takeshi

    2015-01-01

    Background. Predicting the short-term survival in cancer patients is an important issue for patients, family, and oncologists. Although the prognostic accuracy of the surprise question has value in 1-year mortality for cancer patients, the prognostic value for short-term survival has not been formally assessed. The primary aim of the present study was to assess the prognostic value of the surprise question for 7-day and 30-day survival in patients with advanced cancer. Patients and Methods. The present multicenter prospective cohort study was conducted in Japan from September 2012 through April 2014, involving 16 palliative care units, 19 hospital-based palliative care teams, and 23 home-based palliative care services. Results. We recruited 2,425 patients and included 2,361 for analysis: 912 from hospital-based palliative care teams, 895 from hospital palliative care units, and 554 from home-based palliative care services. The sensitivity, specificity, positive predictive value, and negative predictive value of the 7-day survival surprise question were 84.7% (95% confidence interval [CI], 80.7%–88.0%), 68.0% (95% CI, 67.3%–68.5%), 30.3% (95% CI, 28.9%–31.5%), and 96.4% (95% CI, 95.5%–97.2%), respectively. The sensitivity, specificity, positive predictive value, and negative predictive value for the 30-day surprise question were 95.6% (95% CI, 94.4%–96.6%), 37.0% (95% CI, 35.9%–37.9%), 57.6% (95% CI, 56.8%–58.2%), and 90.4% (95% CI, 87.7%–92.6%), respectively. Conclusion. Surprise questions are useful for screening patients for short survival. However, the high false-positive rates do not allow clinicians to provide definitive prognosis prediction. Implications for Practice: The findings of this study indicate that clinicians can screen patients for 7- or 30-day survival using surprise questions with 90% or more sensitivity. Clinicians cannot provide accurate prognosis estimation, and all patients will not always die within the defined periods. The

  6. Laparoscopic Cholecystectomy Without Prophylactic Antibiotics: A Prospective Study.

    PubMed

    Mandal, Nilay; Nandy, Mintu Mohan; Majhi, Jaganmay; Kuiri, Shibshankar; Kumar Ghosh, Pranab; Ghosh, Gautam

    2015-12-01

    Laparoscopic cholecystectomy has become the new gold standard for management of symptomatic gallstones. Prophylactic antibiotics are used in elective surgery by the majority of surgeons, and their role in biliary tract surgery has been well established for a subpopulation of high-risk patients. This consensus has been derived from multiple studies involving biliary tract surgery before and in the era of laparoscopic cholecystectomy. But the use of prophylactic antibiotics in laparoscopic cholecystectomy especially in the low-risk group is now controversial and varied among the surgeons all over the world. To study the role of prophylactic antibiotics in laparoscopic cholecystectomy in different risk groups of patients, a prospective study was conducted in the Department of Surgery of Bankura Sammilani Medical College and Hospital from January 2010 to July 2011. All patients with symptomatic gallstones who underwent elective laparoscopic cholecystectomy during this period are included in this study. One hundred and two patients with symptomatic gallstones were operated on by laparoscopic technique without receiving preoperative antibiotics and studied over a period of 1.5 years. Ages ranged from 11 to 70 years (mean age of 33 years). There were 14 males (13.72 % of the patients) and 88 females (86.27 % of the patients). There was no wound infection (class I) in 99 patients, and class II type of wound infection, i.e., surgical site infection, occurred in three patients (i.e., 2.94 %) out of a total of 102 patients. Swabs were taken for culture and sensitivity; Staphylococcus aureus was found in two patients and Streptococcus viridans in one patient. In all three patients, infection occurred at the umbilical port sites, detected on the 3rd and 4th postoperative days. Antibiotic prophylaxis is not necessary in low-risk patients with symptomatic gallstone disease undergoing elective laparoscopic cholecystectomy to prevent postoperative infection

  7. Evaluation and outcome of antenatal hydronephrosis: a prospective study.

    PubMed

    Gökaslan, Filiz; Yalçınkaya, Fatoş; Fitöz, Suat; Özçakar, Z Birsin

    2012-01-01

    Antenatal hydronephrosis (AHN), defined as dilatation of renal pelvis and/or calyces, is the most frequently detected antenatal abnormality. However, postnatal management of AHN is controversial. The purpose of this study was to describe the clinical outcomes of infants with AHN and to contribute to the definition of the postnatal evaluation of these patients. One hundred and thirty-six infants with AHN were prospectively followed up to 18 months. Patients were divided into two groups according to the degree of sonographic hydronephrosis (HN) on days 5-7: group I (n = 87, 64%) included patients who had grades 1 and 2 (64%) and group II (n = 49, 36%) included patients who had grade 3 and above HN. The grade of HN was found to be correlated with the increased risk of urologic pathologies. Frequency of vesicoureteral reflux was found to be significantly lower in patients with mild HN (6%) as compared to patients with severe AHN (29%) (p = 0.005). In addition, the risk of urinary tract infection increases with increasing grades of HN (10% vs. 29%, p = 0.006). The frequency of spontaneous resolution in patients with mild AHN (64%) was also significantly higher than in patients with severe HN (29%) (p < 0.001). The degree of AHN can be used for making decision about further diagnostic imaging and treatment. Our results strongly suggest that low-grade HN is a relatively self-limited condition and needs minimal investigation. In contrast, the outcome of more severe degrees of AHN needs clarification. PMID:22506510

  8. Critical Pertussis Illness in Children, A Multicenter Prospective Cohort Study

    PubMed Central

    Berger, John T.; Carcillo, Joseph A.; Shanley, Thomas P.; Wessel, David L.; Clark, Amy; Holubkov, Richard; Meert, Kathleen L.; Newth, Christopher J.L.; Berg, Robert A.; Heidemann, Sabrina; Harrison, Rick; Pollack, Murray; Dalton, Heidi; Harvill, Eric; Karanikas, Alexia; Liu, Teresa; Burr, Jeri S.; Doctor, Allan; Dean, J. Michael; Jenkins, Tammara L.; Nicholson, Carol E.

    2013-01-01

    Objective Pertussis persists in the United States despite high immunization rates. The present report characterizes the presentation and acute course of critical pertussis by quantifying demographic data, laboratory findings, clinical complications, and critical care therapies required among children requiring admission to the pediatric intensive care unit (PICU). Design Prospective cohort study. Setting Eight PICUs comprising the Eunice Kennedy Shriver National Institute for Child Health and Human Development Collaborative Pediatric Critical Care Research Network and 17 additional PICUs across the United States. Patients Eligible patients had laboratory confirmation of pertussis infection, were < 18 years of age, and died in the PICU or were admitted to the PICU for at least 24 hours between June 2008 and August 2011. Interventions None. Measurements and Main Results 127 patients were identified. Median age was 49 days, and 105 (83%) patients were < 3 months of age. Fifty-five (43%) required mechanical ventilation. Twelve (9.4%) died during initial hospitalization. Pulmonary hypertension was found in 16 patients (12.5%), and was present in 75% of patients who died, compared with 6% of survivors (p< 0.001). Median white blood cell count (WBC) was significantly higher in those requiring mechanical ventilation (p<0.001), those with pulmonary hypertension (p<0.001) and non-survivors (p<0.001). Age, sex and immunization status did not differ between survivors and non-survivors. Fourteen patients received leukoreduction therapy (exchange transfusion (12), leukopheresis (1) or both (1)). Survival benefit was not apparent. Conclusions Pulmonary hypertension may be associated with mortality in pertussis critical illness. Elevated WBC is associated with the need for mechanical ventilation, pulmonary hypertension, and mortality risk. Research is indicated to elucidate how pulmonary hypertension, immune responsiveness, and elevated WBC contribute to morbidity and mortality

  9. Pros and cons of a wandering mind: a prospective study

    PubMed Central

    Ottaviani, Cristina; Couyoumdjian, Alessandro

    2013-01-01

    Mind wandering (MW) has recently been associated with both adaptive (e.g., creativity enhancement) and maladaptive (e.g., mood worsening) consequences. This study aimed at investigating whether proneness to MW was prospectively associated with negative health outcomes. At time 0, 21 women, 19 men; mean age = 24.5 (4.9) underwent a 5-min baseline electrocardiogram (ECG), a 20-min laboratory tracking task with thought probes, and personality questionnaires. At time 1 (1 year follow-up), the same participants underwent a 24-h Ecological Momentary Assessment characterized by ambulatory ECG recording and electronic diaries. First, we examined if the likelihood of being a “mind wanderer” was associated with specific personality dispositions. Then, we tested if the occurrence of episodes of MW in the lab would be correlated with frequency of MW in daily life. Finally, multiple regression models were used to test if MW longitudinally acted as a risk factor for health, accounting for the effects of biobehavioral variables. Among dispositional traits, the frequency of MW episodes in daily life was inversely associated with the capacity of being mindful (i.e., aware of the present moment and non-judging). There was a positive correlation between frequency of MW in the lab and in daily life, suggesting that it is a stable disposition of the individual. When differentiated from perseverative cognition (i.e., rumination and worry), MW did not predict the presence of health risk factors 1 year later, however, a higher occurrence of episodes of MW was associated with short-term adverse consequences, such as increased 24-h heart rate (HR) on the same day and difficulty falling asleep the subsequent night. Present findings suggest that MW may be associated with short term “side effects” but argue against a long term dysfunctional view of this cognitive process. PMID:23966964

  10. [Treatment of prostate cancer using cryoablation: a prospective study].

    PubMed

    Govorov, A V; Vasil'ev, A O; Ivanov, V Iu; Kovylina, M V; Prilepskaia, E A; Pushkar', D Iu

    2014-01-01

    prostate cancer and achieve a high disease-free survival. Our prospective study was aimed to analyze our own results cryoablation of the prostate gland. PMID:25799731

  11. Allergy to complex platinum salts: A historical prospective cohort study.

    PubMed Central

    Niezborala, M; Garnier, R

    1996-01-01

    OBJECTIVE: To assess the incidence of allergy to complex platinum salts in a platinum refinery. METHODS: A historical prospective cohort study was carried out on 77 workers (67 men) who started work between 1 January 1979 and 31 December 1991 and who were not atopic on skin prick tests to three common allergens at the time of recruitment. Skin prick tests with complex platinum salts were carried out and diagnosis of allergy to complex platinum salts made by the company's doctor. Skin tests and medical examinations were carried out routinely every six months. Follow up was until 30 September 1992 or until leaving refinery work. RESULTS: 18 workers developed a positive result on skin tests and 23 developed symptoms, including all 18 subjects with positive skin tests; the probability of surviving (95% confidence interval (95% CI)) for 72 months after joining the company, with negative skin test results was 0.67 (0.51-0.79) or with no symptoms was 0.63 (0.49-0.75). The incidence of positive skin tests and symptoms was highest during the first two years of work. Symptoms occurred more frequently in September and October than during the other months of the year. The exclusion of atopic subjects did not seem to have resulted in a lower incidence of sensitisation. Smoking was a significant predictive factor for both positive skin tests (estimated relative risk 5.53) and symptoms (4.70). CONCLUSION: The findings confirm that smoking is and that atopy may not be a high risk factor for the development of allergy to complex platinum salts. The high incidence of sensitisation and the available data on the clinical course of sensitised workers show that sensitised workers must be promptly and completely removed from exposure. PMID:8664963

  12. Trigeminocardiac reflex in neurosurgical practice: An observational prospective study

    PubMed Central

    Etezadi, Farhad; Orandi, Amir Ali; Orandi, Amir Hosein; Najafi, Atabak; Amirjamshidi, Abbas; Pourfakhr, Pejman; Khajavi, Mohammad Reza; Abbassioun, Kazem

    2013-01-01

    Background: Considering wide variations regarding the incidence of trigeminocardiac reflex (TCR) during cranial neurosurgical procedures, and paucity of reliable data, we intended to design a prospective study to determine the incidence of TCR in patients undergoing standard general anesthesia for surgery of supra/infra-tentorial cranial and skull base lesions. Methods: A total of 190 consecutive patients candidate for elective surgery of supra-tentorial, infra-tentorial, and skull base lesions were enrolled. All the patients were operated in the neurosurgical operating room of a university-affiliated teaching hospital. All surgeries were performed using sufficient depth of anesthesia achieved by titration of propofol–alfentanil mixture, adjusted according to target Cerebral State Index (CSI) values (40-60). All episodes of bradycardia and hypotension indicating the occurrence of TCR during the surgery (sudden decrease of more than 20% from the previous level) were recorded. Results: Four patients, two female and two male, developed episodes of TCR during surgery (4/190; 2.1%). Three patients showed one episode of TCR just at the end of operation when the skin sutures were applied while CSI values were 70-77 and in the last case, when small tumor samples were taken from just beneath the lateral wall of the cavernous sinus TCR episode was seen while the CSI value was 51. Conclusion: TCR is a rare phenomenon during brain surgeries when patient is anesthetized using standard techniques. Keeping the adequate depth of anesthesia using CSI monitoring method may be an advisable strategy during whole period of a neurosurgical procedure. PMID:24083052

  13. PROSPECTIVE EPIDEMIOLOGICAL STUDY OF ENTERIC DISEASE TRANSMISSION ASSOCIATED WITH SPRINKLER IRRIGATION WITH WASTEWATER: AN OVERVIEW

    EPA Science Inventory

    The report deals with a prospective epidemiological morbidity and serology study, in which the quality of data could be optimally controlled on the possible association between enteric disease incidence and wastewater utilization in agricultural settlements in Israel. The study r...

  14. Comprehensive screening study of pesticide degradation via oxidation and hydrolysis.

    PubMed

    Chamberlain, Evelyn; Shi, Honglan; Wang, Tongwen; Ma, Yinfa; Fulmer, Alice; Adams, Craig

    2012-01-11

    This comprehensive study focused on the reactivity of a set of 62 pesticides via oxidization by free chlorine, monochloramine, chlorine dioxide, hydrogen peroxide, ozone, and permanganate; photodegradation with UV(254); and hydrolysis at pH 2, 7, and 12. Samples were analyzed using direct injection liquid chromatography-mass spectrometry detection or gas chromatography-electron capture detection after liquid-liquid extraction. Many pesticides were reactive via hydrolysis and/or chlorination and ozonation mechanisms under typical drinking water treatment conditions, with less reactivity exhibited on average for chlorine dioxide, monochloramine, hydrogen peroxide, and UV(254). The pyrazole and organophosphorous pesticides were most reactive in general, whereas carbamates and others were less reactive. The screening study provides guidance for the pesticide/oxidation systems that are most likely to lead to degradates in water treatment and the environment. PMID:22141915

  15. Prospective evaluation of 64 serum autoantibodies as biomarkers for early detection of colorectal cancer in a true screening setting.

    PubMed

    Chen, Hongda; Werner, Simone; Butt, Julia; Zörnig, Inka; Knebel, Phillip; Michel, Angelika; Eichmüller, Stefan B; Jäger, Dirk; Waterboer, Tim; Pawlita, Michael; Brenner, Hermann

    2016-03-29

    Novel blood-based screening tests are strongly desirable for early detection of colorectal cancer (CRC). We aimed to identify and evaluate autoantibodies against tumor-associated antigens as biomarkers for early detection of CRC. 380 clinically identified CRC patients and samples of participants with selected findings from a cohort of screening colonoscopy participants in 2005-2013 (N=6826) were included in this analysis. Sixty-four serum autoantibody markers were measured by multiplex bead-based serological assays. A two-step approach with selection of biomarkers in a training set, and validation of findings in a validation set, the latter exclusively including participants from the screening setting, was applied. Anti-MAGEA4 exhibited the highest sensitivity for detecting early stage CRC and advanced adenoma. Multi-marker combinations substantially increased sensitivity at the price of a moderate loss of specificity. Anti-TP53, anti-IMPDH2, anti-MDM2 and anti-MAGEA4 were consistently included in the best-performing 4-, 5-, and 6-marker combinations. This four-marker panel yielded a sensitivity of 26% (95% CI, 13-45%) for early stage CRC at a specificity of 90% (95% CI, 83-94%) in the validation set. Notably, it also detected 20% (95% CI, 13-29%) of advanced adenomas. Taken together, the identified biomarkers could contribute to the development of a useful multi-marker blood-based test for CRC early detection. PMID:26909861

  16. Prospects and limits of the flow cytometric seed screen – insights from Potentilla sensu lato (Potentilleae, Rosaceae)

    PubMed Central

    Dobeš, Christoph; Lückl, Andrea; Hülber, Karl; Paule, Juraj

    2013-01-01

    The flow cytometric seed screen allows for identification of reproductive modes of seed formation and inference of the ploidy of contributing gametes. However, the lack of a mathematical formalization to infer male/female genomic contributions, and the prerequisite of a binucleate female contribution to the endosperm limits its applicability. We evaluated this assumption combining a DNA-based progeny survey with a comparison of the cytology of reproductive pathways co-occurring within single individuals representing 14 Potentilleae species from six phylogenetic lineages. A numerical framework valid for sexual and pseudogamous taxa was developed, enabling quantification of female and male genomes contributing to embryo and endosperm independent of gametophyte origins, numbers of sperm involved and ploidy of parents. The inference strongly depended on accurate peak index estimation. The endosperm of Potentilleae species received a binucleate female contribution in five evolutionary lineages whereas endosperm formation remained uncertain in the Tormentillae. A modified flow cytometric seed screen protocol was developed to cope with low endosperm contents. Evolutionary conservation of a binucleate female contribution to the endosperm suggested wide applicability of flow cytometric seed screen – at least in the Potentilleae. However, alternative progeny surveys and precise embryo/endosperm ploidy estimates are required for a comprehensive understanding of the cytology of seed formation. PMID:23425259

  17. Prospective evaluation of 64 serum autoantibodies as biomarkers for early detection of colorectal cancer in a true screening setting

    PubMed Central

    Chen, Hongda; Werner, Simone; Butt, Julia; Zörnig, Inka; Knebel, Phillip; Michel, Angelika; Eichmüller, Stefan B.; Jäger, Dirk; Waterboer, Tim; Pawlita, Michael; Brenner, Hermann

    2016-01-01

    Novel blood-based screening tests are strongly desirable for early detection of colorectal cancer (CRC). We aimed to identify and evaluate autoantibodies against tumor-associated antigens as biomarkers for early detection of CRC. 380 clinically identified CRC patients and samples of participants with selected findings from a cohort of screening colonoscopy participants in 2005–2013 (N=6826) were included in this analysis. Sixty-four serum autoantibody markers were measured by multiplex bead-based serological assays. A two-step approach with selection of biomarkers in a training set, and validation of findings in a validation set, the latter exclusively including participants from the screening setting, was applied. Anti-MAGEA4 exhibited the highest sensitivity for detecting early stage CRC and advanced adenoma. Multi-marker combinations substantially increased sensitivity at the price of a moderate loss of specificity. Anti-TP53, anti-IMPDH2, anti-MDM2 and anti-MAGEA4 were consistently included in the best-performing 4-, 5-, and 6-marker combinations. This four-marker panel yielded a sensitivity of 26% (95% CI, 13–45%) for early stage CRC at a specificity of 90% (95% CI, 83–94%) in the validation set. Notably, it also detected 20% (95% CI, 13–29%) of advanced adenomas. Taken together, the identified biomarkers could contribute to the development of a useful multi-marker blood-based test for CRC early detection. PMID:26909861

  18. Radiation-induced tumors of the head and neck following childhood irradiation. Prospective studies

    SciTech Connect

    Schneider, A.B.; Shore-Freedman, E.; Ryo, U.Y.; Bekerman, C.; Favus, M.; Pinsky, S.

    1985-01-01

    Nodules were found in 1108 subjects who received childhood radiation for benign conditions of the cervical area at our institution. This is 37.5% of 2958 subjects, out of a total of 5379, for whom there is follow-up information. Of the 848 subjects who have had thyroidectomies, 297 (35.0%) had thyroid cancer. In addition to thyroid tumors, salivary, neural, and probably parathyroid tumors also occurred as a late consequence of childhood radiation. Prospective studies of the subjects indicate that thyroid nodules are continuing to occur at a constant rate. The measurement of serum thyroglobulin is helpful in identifying individuals for whom the risk of developing a nodule is increased. Follow-up of patients with nonsurgically-treated nodules indicates that some of their nodules are progressive. At the present time there is no indication that radiation-induced cancers behave differently than ones in other settings. However, some of their characteristics, especially their multicentricity and occurrence in younger individuals, indicate that continued follow-up is necessary. On the basis of the data generated by the follow-up program at our institution and programs elsewhere, recommendations for screening, treatment, and follow-up are made. The recommendations stress the importance of estimating risk based on radiation dose, previous tumors, and serum thyroglobulin, in arriving at clinical decisions for these subjects.

  19. A historical prospective cohort study of carotid artery stenosis after radiotherapy for head and neck malignancies

    SciTech Connect

    Brown, Paul D. . E-mail: brown.paul@mayo.edu; Foote, Robert L.; McLaughlin, Mark P.; Halyard, Michele Y.; Ballman, Karla V.; Collie, A. Craig; Miller, Robert C.; Flemming, Kelly D.; Hallett, John W.

    2005-12-01

    Purpose: To determine carotid artery stenosis incidence after radiotherapy for head-and-neck neoplasms. Methods and Materials: This historical prospective cohort study comprised 44 head-and-neck cancer survivors who received unilateral neck radiotherapy between 1974 and 1999. They underwent bilateral carotid duplex ultrasonography to detect carotid artery stenosis. Results: The incidence of significant carotid stenosis (8 of 44 [18%]) in the irradiated neck was higher than that in the contralateral unirradiated neck (3 of 44 [7%]), although this difference was not statistically significant (p = 0.13). The rate of significant carotid stenosis events increased as the time after radiotherapy increased. The risk of ipsilateral carotid artery stenosis was higher in patients who had undergone a neck dissection vs. those who had not. Patients with significant ipsilateral stenosis also tended to be older than those without significant stenosis. No other patient or treatment variables correlated with risk of carotid artery stenosis. Conclusions: For long-term survivors after neck dissection and irradiation, especially those who are symptomatic, ultrasonographic carotid artery screening should be considered.

  20. Pregabalin for Refractory Radicular Leg Pain due to Lumbar Spinal Stenosis: A Preliminary Prospective Study

    PubMed Central

    Orita, Sumihisa; Yamashita, Masaomi; Eguchi, Yawara; Suzuki, Miyako; Inoue, Gen; Miyagi, Masayuki; Watanabe, Tomoko; Ozawa, Tomoyuki; Kamoda, Hiroto; Ishikawa, Tetsuhiro; Aoki, Yasuchika; Ito, Toshinori; Kubota, Go; Suzuki, Munetaka; Yamauchi, Kazuyo; Hanaoka, Eiji; Sakuma, Yoshihiro; Shimbo, Jun; Oikawa, Yasuhiro; Suzuki, Takane; Takahashi, Kazuhisa; Ohtori, Seiji

    2016-01-01

    We investigated the efficacy of pregabalin (PGB) for neuropathic leg pain in lumbar spinal stenosis (LSS) patients with disturbed activities of daily living (ADL)/quality of life (QOL) in a prospective observational study. Subjects were a total of 104 LSS patients with neuropathic pain (NeP) in leg and neurological intermittent claudication (IMC) refractory to nonsteroidal anti-inflammatory drugs (NSAIDs) for at least a month. NeP was identified using screening tool, Pain DETECT questionnaire. Visual analog scale (VAS) scores and responses to the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ) were assessed before and 6 weeks after PGB treatment initiation. Changes in IMC distance and adverse events were also recorded. PGB significantly improved their VAS scores for pain and sleep quality (P < 0.001). With respect to JOABPEQ, significant improvements were observed with regard to the following dimensions: pain-related disorders (P < 0.01), lumbar spine dysfunction (P = 0.031), gait disturbance (P = 0.028), and psychological disorders (P = 0.014). The IMC distance showed an improvement tendency after PGB treatment, albeit with no significance (P = 0.063). Minor adverse events such as dizziness were observed. PGB can be effective for neuropathic leg pain refractory to NSAIDs in LSS patients, resulting in not only pain control but also improving lower back pain-related ADL/QOL scores. PMID:27445615

  1. Injuries at a Canadian National Taekwondo Championships: a prospective study

    PubMed Central

    Kazemi, Mohsen; Pieter, Willy

    2004-01-01

    Background The purpose of this prospective study was to assess the injury rates in male and female adult Canadian Taekwondo athletes relative to total number of injuries, type and body part injured. Methods Subjects (219 males, 99 females) participated in the 1997 Canadian National Taekwondo Championships in Toronto, Canada. Injuries were recorded on an injury form to documents any injury seen and treatment provided by the health care team. These data were later used for this study. The injury form describes the athlete and nature, site, severity and mechanism of the injury. Results The overall rate of injuries was 62.9/1,000 athlete-exposures (A-E). The males (79.9/1,000 A-E) sustained significantly more injuries than the females (25.3/1,000 A-E). The lower extremities were the most commonly injured body region in the men (32.0 /1,000 A-E), followed by the head and neck (18.3/1,000 A-E). Injuries to the spine (neck, upper back, low back and coccyx) were the third most often injured body region in males (13.8/1,000 A-E). All injuries to the women were sustained to the lower extremities. The most common type of injury in women was the contusion (15.2/1,000 A-E). However, men's most common type of injury was the sprain (22.8/1,000 A-E) followed by joint dysfunction (13.7/1,000A-E). Concussions were only reported in males (6.9/1,000 A-E). Compared to international counterparts, the Canadian men and women recorded lower total injury rates. However, the males incurred more cerebral concussions than their American colleagues (4.7/1,000 A-E). Conclusions Similar to what was found in previous studies, the current investigation seems to suggest that areas of particular concern for preventive measures involve the head and neck as well as the lower extremities. This is the first paper to identify spinal joint dysfunction. PMID:15279679

  2. The Substance Abuse Subtle Screening Inventory-3 and Stages of Change: A Screening Validity Study

    ERIC Educational Resources Information Center

    Laux, John M.; Piazza, Nick J.; Salyers, Kathleen; Roseman, Christopher P.

    2012-01-01

    The sensitivity of the Substance Abuse Subtle Screening Inventory-3 (SASSI-3) was examined among substance-dependent adults enrolled in a family drug court. The SASSI-3 had a high sensitivity rate with this population, even across varying levels of motivation to change. (Contains 2 tables.)

  3. Catalyst Screening and Kinetic Studies Using Microchannel Reactors

    SciTech Connect

    Cao, Chunshe; Palo, Daniel R.; Tonkovich, Annalee Y.; Wang, Yong

    2007-07-15

    A multi-parallel microchannel reactor system is described, as related to catalyst screening and discovery for heat-intensive heterogeneous catalytic reactions. Example systems are detailed, in which the rapid heat transfer of the screening device is utilized to maintain isothermal operation in multiple channels for catalyst screening as well as kinetic investigations. The advantages of the system and pertinent results are discussed, specifically for Fischer-Tropsch synthesis, methanol oxidation to formaldehyde, and methanol steam reforming.

  4. Cancer screening behaviours among South Asian immigrants in the UK, US and Canada: a scoping study.

    PubMed

    Crawford, Joanne; Ahmad, Farah; Beaton, Dorcas; Bierman, Arlene S

    2016-03-01

    South Asian (SA) immigrants settled in the United Kingdom (UK) and North America [United States (US) and Canada] have low screening rates for breast, cervical and colorectal cancers. Incidence rates of these cancers increase among SA immigrants after migration, becoming similar to rates in non-Asian native populations. However, there are disparities in cancer screening, with low cancer screening uptake in this population. We conducted a scoping study using Arksey & O'Malley's framework to examine cancer screening literature on SA immigrants residing in the UK, US and Canada. Eight electronic databases, key journals and reference lists were searched for English language studies and reports. Of 1465 identified references, 70 studies from 1994 to November 2014 were included: 63% on breast or cervical cancer screening or both; 10% examined colorectal cancer screening only; 16% explored health promotion/service provision; 8% studied breast, cervical and colorectal cancer screening; and 3% examined breast and colorectal cancer screening. A thematic analysis uncovered four dominant themes: (i) beliefs and attitudes towards cancer and screening included centrality of family, holistic healthcare, fatalism, screening as unnecessary and emotion-laden perceptions; (ii) lack of knowledge of cancer and screening related to not having heard about cancer and its causes, or lack of awareness of screening, its rationale and/or how to access services; (iii) barriers to access including individual and structural barriers; and (iv) gender differences in screening uptake and their associated factors. Findings offer insights that can be used to develop culturally sensitive interventions to minimise barriers and increase cancer screening uptake in these communities, while recognising the diversity within the SA culture. Further research is required to address the gap in colorectal cancer screening literature to more fully understand SA immigrants' perspectives, as well as research to

  5. A prospective study of faecal bile acids and colorectal cancer.

    PubMed

    Haines, A; Hill, M J; Thompson, M H; Owen, R W; Williams, R E; Meade, T W; Wilkes, H; Griffin, M

    2000-10-01

    A prospective study of 7079 people aged 45-74 recruited through general practices in South Wales, Herefordshire and Edinburgh, Scotland was undertaken to test the hypothesis that faecal bile acids are implicated in the causation of large bowel cancer. The population was recruited between 1974 and 1980 and the response rate for stool collection was 67%. Bile acid analyses were performed on those cases that presented by 1990. It was decided in advance to examine the hypothesis separately for left- and right-sided bowel cancer because of known epidemiological differences between the two sites and to exclude the cases presenting within 2 years of the stool sample from the analyses because the cancer could have been present at recruitment and might have possibly affected faecal bile acid concentrations. Each case (n = 51 left-sided and 8 right-sided) was matched with three controls by age (within 5 years), sex, place of residence and time of providing the stool sample (within 3 months). Statistical analyses using conditional logistic regression showed no significant differences between the left-sided cases and controls for any of the concentrations of individual bile acids, total bile acid concentrations, faecal neutral steroids, percentage bacterial conversion and the ratio of lithocholic acid to deoxycholic acid concentrations. There was a statistically significant (P = 0.021) association of the presence of chenodeoxycholic acid (5/8 samples) in the right-sided cases compared with the controls (3/23), odds ratio 6.26 (95% confidence interval 1.19, 32.84). A high proportion of primary bile acids has also been found in other studies of patients with a genetic predisposition to proximal bowel cancer, however this pattern may also occur in low risk groups, such as Indian vegetarians, suggesting that they may predispose to right-sided bowel cancer only in the presence of other, as yet unknown factors. If bile acids are involved in the causation of large bowel cancer, they

  6. Serum erythropoietin and outcome after ischaemic stroke: a prospective study

    PubMed Central

    Åberg, N David; Stanne, Tara M; Jood, Katarina; Schiöler, Linus; Blomstrand, Christian; Andreasson, Ulf; Blennow, Kaj; Zetterberg, Henrik; Isgaard, Jörgen; Jern, Christina; Svensson, Johan

    2016-01-01

    Objectives Erythropoietin (EPO), which is inversely associated with blood haemoglobin (Hb), exerts neuroprotective effects in experimental ischaemic stroke (IS). However, clinical treatment trials have so far been negative. Here, in patients with IS, we analysed whether serum EPO is associated with (1) initial stroke severity, (2) recovery and (3) functional outcome. Design Prospective. Controls available at baseline. Setting A Swedish hospital-initiated study with outpatient follow-up after 3 months. Participants Patients (n=600; 64% males, mean age 56 years, controls n=600) were included from the Sahlgrenska Academy Study on IS (SAHLSIS). Primary and secondary outcome measures In addition to EPO and Hb, initial stroke severity was assessed by the Scandinavian Stroke Scale (SSS) and compared with SSS after 3 months (follow-up) as a measure of recovery. Functional outcome was evaluated using the modified Rankin Scale (mRS) at follow-up. Serum EPO and SSS were divided into quintiles in the multivariate regression analyses. Results Serum EPO was 21% and 31% higher than in controls at the acute phase of IS and follow-up, respectively. In patients, acute serum EPO was 19.5% higher in severe versus mild IS. The highest acute EPO quintile adjusted for sex, age and Hb was associated with worse stroke severity quintile (OR 1.70, 95% CI 1.00 to 2.87), better stroke recovery quintile (OR 1.93, CI 1.09 to 3.41) and unfavourable mRS 3–6 (OR 2.59, CI 1.15 to 5.80). However, the fourth quintile of EPO increase (from acute to follow-up) was associated with favourable mRS 0–2 (OR 3.42, CI 1.46 to 8.03). Only the last association withstood full adjustment. Conclusions The crude associations between EPO and worse stroke severity and outcome lost significance after multivariate modelling. However, in patients in whom EPO increased, the association with favourable outcome remained after adjustment for multiple covariates. PMID:26916692

  7. Computer Simulation Study of Graphene Oxide Supercapacitors: Charge Screening Mechanism.

    PubMed

    Park, Sang-Won; DeYoung, Andrew D; Dhumal, Nilesh R; Shim, Youngseon; Kim, Hyung J; Jung, YounJoon

    2016-04-01

    Graphene oxide supercapacitors in the parallel plate configuration are studied via molecular dynamics (MD) simulations. The full range of electrode oxidation from 0 to 100% is examined by oxidizing the graphene surface with hydroxyl groups. Two different electrolytes, 1-ethyl-3-methylimidazolium tetrafluoroborate (EMI(+)BF4(-)) as an ionic liquid and its 1.3 M solution in acetonitrile as an organic electrolyte, are considered. While the area-specific capacitance tends to decrease with increasing electrode oxidation for both electrolytes, its details show interesting differences between the organic electrolyte and ionic liquid, including the extent of decrease. For detailed insight into these differences, the screening mechanisms of electrode charges by electrolytes and their variations with electrode oxidation are analyzed with special attention paid to the aspects shared by and the contrasts between the organic electrolyte and ionic liquid. PMID:26966918

  8. Morbidity of harvesting of retromolar bone grafts: a prospective study.

    PubMed

    Nkenke, Emeka; Radespiel-Tröger, Martin; Wiltfang, Jörg; Schultze-Mosgau, Stefan; Winkler, Gerhard; Neukam, Friedrich Wilhelm

    2002-10-01

    20 retromolar bone grafts were harvested in outpatients for augmentation of the implant site from January to June 2000 (10 female, 10 male, 40.9 +/- 12.8 years, minimum 17 years, maximum 66 years). The aim of the study was to assess typical complications of this procedure in a prospective manner. For the determination of the superficial sensory function of the inferior alveolar and the lingual nerve, an objective method was used. The bone grafts were harvested for single tooth reconstruction. In 14 cases a ridge augmentation and in 6 cases an endoscopically controlled crestal sinus floor elevation was performed. Preoperatively, the height of bone above the cranial aspect of the inferior alveolar nerve in the retromolar region was assessed radiologically with known markers. The maximum mouth opening was determined. The superficial sensory function of the inferior alveolar and the lingual nerve was assessed with the Pointed-Blunt Test, the Two-Point-Discrimination Test and the objective method of the 'Pain and Thermal Sensitivity' Test (PATH Test). Moreover, the pulp sensitivity of the teeth of the donor site was determined by cold vitality testing. All tests were repeated 1 week postoperatively. Intraoperatively, the width of the retromolar region was measured with a caliper. The patients rated the operative strain on a visual analogue scale. The height of bone above the inferior alveolar nerve in the retromolar region was 11.0 +/- 2.2 mm. The width of the retromolar area was 14.2 +/- 1.9 mm. Postoperatively, the maximal mouth opening changed significantly (40.8 +/- 3.5 mm preoperatively, 38.9 +/- 3.7 mm postoperatively, P = 0.006). However, the reduction was not relevant clinically. A direct injury of the inferior alveolar or lingual nerve did not occur. A sensitivity impairment could not be detected for either of the nerves by the different test methods 1 week postoperatively. The operative strain related to the donor site was significantly less than the strain

  9. Anosognosia for hemiplegia: a clinical-anatomical prospective study.

    PubMed

    Vocat, Roland; Staub, Fabienne; Stroppini, Tiziano; Vuilleumier, Patrik

    2010-12-01

    Anosognosia for hemiplegia is a common and striking disorder following stroke. Because it is typically transient and variable, it remains poorly understood and has rarely been investigated at different times in a systematic manner. Our study evaluated a prospective cohort of 58 patients with right-hemisphere stroke and significant motor deficit of the left hemibody, who were examined using a comprehensive neuropsychological battery at 3 days (hyperacute), 1 week (subacute) and 6 months (chronic) after stroke onset. Anosognosia for hemiplegia was frequent in the hyperacute phase (32%), but reduced by almost half 1 week later (18%) and only rarely seen at 6 months (5%). Anosognosia for hemiplegia was correlated with the severity of several other deficits, most notably losses in proprioception, extrapersonal spatial neglect and disorientation. While multiple regression analyses highlighted proprioceptive loss as the most determinant factor for the hyperacute period, and visuospatial neglect and disorientation as more determinant for the subacute phase, patients with both proprioceptive loss and neglect had significantly higher incidence of anosognosia for hemiplegia than those with only one deficit or no deficits (although a few double dissociations were observed). Personal neglect and frontal lobe tests showed no significant relation with anosognosia for hemiplegia, nor did psychological traits such as optimism and mood. Moreover, anosognosia for neglect and prediction of performance in non-motor tasks were unrelated to anosognosia for hemiplegia, suggesting distinct monitoring mechanisms for each of these domains. Finally, by using a voxel-based statistical mapping method to identify lesions associated with a greater severity of anosognosia, we found that damage to the insula (particularly its anterior part) and adjacent subcortical structures was determinant for anosognosia for hemiplegia in the hyperacute period, while additional lesions in the premotor cortex

  10. Alcohol consumption and fecundability: prospective Danish cohort study

    PubMed Central

    Riis, Anders H; Wise, Lauren A; Hatch, Elizabeth E; Rothman, Kenneth J; Cueto, Heidi T; Sørensen, Henrik Toft

    2016-01-01

    Objective To investigate to what extent alcohol consumption affects female fecundability. Design Prospective cohort study. Setting Denmark, 1 June 2007 to 5 January 2016. Participants 6120 female Danish residents, aged 21-45 years, in a stable relationship with a male partner, who were trying to conceive and not receiving fertility treatment. Main outcome measures Alcohol consumption was self reported as beer (330 mL bottles), red or white wine (120 mL glasses), dessert wine (50 mL glasses), and spirits (20 mL) and categorized in standard servings per week (none, 1-3, 4-7, 8-13, and ≥14). Participants contributed menstrual cycles at risk until the report of pregnancy, start of fertility treatment, loss to follow-up, or end of observation (maximum 12 menstrual cycles). A proportional probability regression model was used to estimate fecundability ratios (cycle specific probability of conception among exposed women divided by that among unexposed women). Results 4210 (69%) participants achieved a pregnancy during follow-up. Median alcohol intake was 2.0 (interquartile range 0-3.5) servings per week. Compared with no alcohol consumption, the adjusted fecundability ratios for alcohol consumption of 1-3, 4-7, 8-13, and 14 or more servings per week were 0.97 (95% confidence interval 0.91 to 1.03), 1.01 (0.93 to 1.10), 1.01 (0.87 to 1.16) and 0.82 (0.60 to 1.12), respectively. Compared with no alcohol intake, the adjusted fecundability ratios for women who consumed only wine (≥3 servings), beer (≥3 servings), or spirits (≥2 servings) were 1.05 (0.91 to1.21), 0.92 (0.65 to 1.29), and 0.85 (0.61 to 1.17), respectively. The data did not distinguish between regular and binge drinking, which may be important if large amounts of alcohol are consumed during the fertile window. Conclusion Consumption of less than 14 servings of alcohol per week seemed to have no discernible effect on fertility. No appreciable difference in fecundability was observed by level of

  11. Mortality of gasworkers—final report of a prospective study

    PubMed Central

    Doll, R.; Vessey, M. P.; Beasley, R. W. R.; Buckley, A. R.; Fear, E. C.; Fisher, R. E. W.; Gammon, E. J.; Gunn, W.; Hughes, G. O.; Lee, K.; Norman-Smith, Beatrice

    1972-01-01

    Doll, R., Vessey, M. P., Beasley, R. W. R., Buckley, A. R., Fear, E. C., Fisher, R. E. W., Gammon, E. J., Gunn, W., Hughes, G. O., Lee, K., and Norman-Smith, Beatrice (1972).Brit. J. industr. Med.,29, 394-406. Mortality of gasworkers—final report of a prospective study. The mortality experience of selected groups of gasworkers employed by four area Gas Boards and observed over a period of eight years was described by us in a report in 1965. The present paper adds a further four years' data to those previously collected for men having regular exposure in coal carbonizing plants and for men having exposure only to by-products of the gas-making process. To these we have added data relating to men employed by four additional area Gas Boards who have been observed over periods of seven to eight years. The new data provide confirmation that exposure to the products of coal carbonization can give rise to cancer of the lung and leave little doubt that the risk of bladder cancer is also increased. Two additional deaths from scrotal cancer have been observed; there is evidently still a need for vigilance if this disease is to be treated at a stage early enough to prevent death. With respect to all these cancers, work as a topman appears to be particularly hazardous. The additional data included in the present report fail to settle the question whether the risk of lung cancer is especially associated with the conditions of work in one particular type of retort house; if there are any differences, however, they are likely to be small. In our original report, a highly significant association between death from bronchitis and exposure to the coal carbonizing process was described. The more recent data for the four original Gas Boards offer only limited support to the view that bronchitis is a specific occupational hazard of gasworkers, and the data for the four additional Gas Boards provide no further support whatsoever. The explanation for these discrepancies is obscure, but

  12. A Qualitative Case Study of Prospective Chemistry Teachers' Knowledge About Instructional Strategies: Introducing Particulate Theory

    NASA Astrophysics Data System (ADS)

    Boz, Nihat; Boz, Yezdan

    2008-04-01

    The purpose of this study was to investigate prospective chemistry teachers’ knowledge about instructional strategies, one component of pedagogical content knowledge about introducing particulate theory, as well as sources of this knowledge. Twenty-two prospective chemistry teachers participated in the study. Data were collected by the means of a vignette, semistructured interviews, and lesson plans. Analysis showed that concrete objects, computer animations, and expository teaching were the preferred teaching techniques by prospective teachers. Several issues, such as general pedagogical knowledge, subject matter knowledge, and knowledge about students’ difficulties, were found to be the main factors for choosing a teaching strategy to make an introduction to particles.

  13. Bulbar dysfunction in normal pressure hydrocephalus: a prospective study.

    PubMed

    Chankaew, Ekawut; Srirabheebhat, Prajak; Manochiopinig, Sriwimon; Witthiwej, Theerapol; Benjamin, Itsara

    2016-09-01

    OBJECTIVE Normal pressure hydrocephalus (NPH) is clinically characterized by gait disturbance, cognitive impairment, and urinary incontinence, as well as enlargement of the ventricles. To the best of the authors' knowledge, there have been no previous publications regarding the correlation between bulbar dysfunction and NPH. The primary objective of this study was to compare preoperative and postoperative prevalence of bulbar dysfunction in patients with NPH. Secondary objectives included assessing the results of surgery for swallowing, speech, gait, cognition, and urination, and evaluating the correlation between bulbar dysfunction and triad symptoms. METHODS Fifty-three patients with NPH who underwent shunt placement surgery at Siriraj Hospital were included in the study. Patients were evaluated for gait, cognition, urination, swallowing, and speech before and 6 months after shunt placement. Triad symptoms were assessed using standard methods. Bulbar dysfunctions were assessed using the Swallowing Problem Questionnaire, Thai Articulation Test, Resonation Screening Test (RST), and Thai Nasality Test. The Thai Speech Assessment Program and nasometer were used for objective speech measurement. RESULTS Preoperatively, 86% (43/50) of patients had swallowing problems and 75% (37/49) had speech problems, as measured by the RST. Postoperatively, there was significant improvement in swallowing (p < 0.001), speech problems by RST (p = 0.008), and voice volume (p = 0.009), but no significant change in the nasometer test. All triad symptoms were improved. There were significant correlations between swallowing impairment and gait disturbance (r = 0.358, p = 0.009), and RST and cognitive impairment (r = -0.502, p < 0.001). CONCLUSIONS This is the first study of bulbar dysfunction in patients with NPH. The results showed that the prevalence of bulbar dysfunction is very high. The correlation between bulbar dysfunction and the classic NPH triad has been documented and published

  14. Vitamin B₁₂ status, cognitive decline and dementia: a systematic review of prospective cohort studies.

    PubMed

    O'Leary, Fiona; Allman-Farinelli, Margaret; Samman, Samir

    2012-12-14

    Poor vitamin B₁₂ status may lead to the development of cognitive decline and dementia but there is a large variation in the quality, design of and results reported from these investigations. We have undertaken a systematic review of the evidence for the association between vitamin B₁₂ status and cognitive decline in older adults. A database search of the literature to 2011 was undertaken, using keywords related to vitamin B₁₂ and cognition. All prospective cohort studies assessing the association of serum vitamin B₁₂ or biomarkers were included. Quality assessment and extraction of the data were undertaken by two researchers. The quality assessment tool assigns a positive, neutral or negative rating. Of 3772 published articles, thirty-five cohort studies (n 14 325 subjects) were identified and evaluated. No association between serum vitamin B₁₂ concentrations and cognitive decline or dementia was found. However, four studies that used newer biomarkers of vitamin B₁₂ status (methylmalonic acid and holotranscobalamin (holoTC)) showed associations between poor vitamin B₁₂ status and the increased risk of cognitive decline or dementia diagnosis. In general, the studies were of reasonable quality (twenty-one positive, ten neutral and four negative quality) but of short duration and inadequate subject numbers to determine whether an effect exists. Future studies should be of adequate duration (at least 6 years), recruit subjects from the seventh decade, choose markers of vitamin B₁₂ status with adequate specificity such as holoTC and/or methylmalonic acid and employ standardised neurocognitive assessment tools and not screening tests in order to ascertain any relationship between vitamin B₁₂ status and cognitive decline. PMID:23084026

  15. TRANSMISSION OF ENTERIC DISEASE ASSOCIATED WITH WASTEWATER IRRIGATION: A PROSPECTIVE EPIDEMIOLOGICAL STUDY

    EPA Science Inventory

    We conducted a prospective epidemiological study of possible enteric disease transmission by aerosolized pathogens from sprinkler irrigation of partially treated wastewater in 20 kibbutzim (colllective agricultural settlements) in Isreal between March 1981 and February 1982. Medi...

  16. Study protocol title: a prospective cohort study of low back pain

    PubMed Central

    2013-01-01

    Background Few prospective cohort studies of workplace low back pain (LBP) with quantified job physical exposure have been performed. There are few prospective epidemiological studies for LBP occupational risk factors and reported data generally have few adjustments for many personal and psychosocial factors. Methods/design A multi-center prospective cohort study has been incepted to quantify risk factors for LBP and potentially develop improved methods for designing and analyzing jobs. Due to the subjectivity of LBP, six measures of LBP are captured: 1) any LBP, 2) LBP ≥ 5/10 pain rating, 3) LBP with medication use, 4) LBP with healthcare provider visits, 5) LBP necessitating modified work duties and 6) LBP with lost work time. Workers have thus far been enrolled from 30 different employment settings in 4 diverse US states and performed widely varying work. At baseline, workers undergo laptop-administered questionnaires, structured interviews, and two standardized physical examinations to ascertain demographics, medical history, psychosocial factors, hobbies and physical activities, and current musculoskeletal disorders. All workers’ jobs are individually measured for physical factors and are videotaped. Workers are followed monthly for the development of low back pain. Changes in jobs necessitate re-measure and re-videotaping of job physical factors. The lifetime cumulative incidence of low back pain will also include those with a past history of low back pain. Incident cases will exclude prevalent cases at baseline. Statistical methods planned include survival analyses and logistic regression. Discussion Data analysis of a prospective cohort study of low back pain is underway and has successfully enrolled over 800 workers to date. PMID:23497211

  17. Understanding the role of embarrassment in gynaecological screening: a qualitative study from the ASPIRE cervical cancer screening project in Uganda

    PubMed Central

    Teng, Flora F; Mitchell, Sheona M; Sekikubo, Musa; Biryabarema, Christine; Byamugisha, Josaphat K; Steinberg, Malcolm; Money, Deborah M; Ogilvie, Gina S

    2014-01-01

    Objective To define embarrassment and develop an understanding of the role of embarrassment in relation to cervical cancer screening and self-collected human papillomavirus (HPV) DNA testing in Uganda. Design Cross-sectional, qualitative study using semistructured one-to-one interviews and focus groups. Participants 6 key-informant health workers and 16 local women, purposively sampled. Key informant inclusion criteria: Ugandan members of the project team. Focus group inclusion criteria: woman age 30–69 years, Luganda or Swahili speaking, living or working in the target Ugandan community. Exclusion criteria: unwillingness to sign informed consent. Setting Primary and tertiary low-resource setting in Kampala, Uganda. Results In Luganda, embarrassment relating to cervical cancer is described in two forms. ‘Community embarrassment’ describes discomfort based on how a person may be perceived by others. ‘Personal embarrassment’ relates to shyness or discomfort with her own genitalia. Community embarrassment was described in themes relating to place of study recruitment, amount of privacy in dwellings, personal relationship with health workers, handling of the vaginal swab and misunderstanding of HPV self-collection as HIV testing. Themes of personal embarrassment related to lack of knowledge, age and novelty of the self-collection swab. Overall, embarrassment was a barrier to screening at the outset and diminished over time through education and knowledge. Fatalism regarding cervical cancer diagnosis, worry about results and stigma associated with a cervical cancer diagnosis were other psychosocial barriers described. Overcoming psychosocial barriers to screening can include peer-to-peer education, drama and media campaigns. Conclusions Embarrassment and other psychosocial barriers may play a large role at the onset of a screening programme, but over time as education and knowledge increase, and the social norms around screening evolve, its role diminishes

  18. Screening studies of advanced control concepts for airbreathing engines

    NASA Technical Reports Server (NTRS)

    Ouzts, Peter J.; Lorenzo, Carl F.; Merrill, Walter C.

    1993-01-01

    The application of advanced control concepts to airbreathing engines may yield significant improvements in aircraft/engine performance and operability. Accordingly, the NASA Lewis Research Center has conducted screening studies of advanced control concepts for airbreathing engines to determine their potential impact on turbine engine performance and operability. The purpose of the studies was to identify concepts which offered high potential yet may incur high research and development risk. A target suite of proposed concepts was formulated by NASA and industry. These concepts were evaluated in a two phase study to quantify each concept's impact on desired engine characteristics. To aid in the evaluation, three target aircraft/engine combinations were considered: a military high performance fighter mission, a high speed civil transport mission, and a civil tiltrotor mission. Each of the advanced control concepts considered in the study were defined and described. The concept's potential impact on engine performance was determined. Relevant figures of merit on which to evaluate the concepts were also determined. Finally, the concepts were ranked with respect to the target aircraft/engine missions.

  19. Screening studies of advanced control concepts for airbreathing engines

    NASA Technical Reports Server (NTRS)

    Ouzts, Peter J.; Lorenzo, Carl F.; Merrill, Walter C.

    1992-01-01

    The application of advanced control concepts to airbreathing engines may yield significant improvements in aircraft/engine performance and operability. Accordingly, the NASA Lewis Research Center has conducted screening studies of advanced control concepts for airbreathing engines to determine their potential impact on turbine engine performance and operability. The purpose of the studies was to identify concepts which offered high potential yet may incur high research and development risk. A target suite of proposed concepts was formulated by NASA and industry. These concepts were evaluated in a two phase study to quantify each concept's impact on desired engine characteristics. To aid in the evaluation, three target aircraft/engine combinations were considered: a military high performance fighter mission, a high speed civil transport mission, and a civil tiltrotor mission. Each of the advanced control concepts considered in the study were defined and described. The concept's potential impact on engine performance was determined. Relevant figures of merit on which to evaluate the concepts were also determined. Finally, the concepts were ranked with respect to the target aircraft/engine missions.

  20. Early Violent Death Among Delinquent Youth: A Prospective Longitudinal Study

    PubMed Central

    Teplin, Linda A.; McClelland, Gary M.; Abram, Karen M.; Mileusnic, Darinka

    2005-01-01

    Objective Youth processed in the juvenile justice system are at great risk for early violent death. Groups at greatest risk, ie, racial/ethnic minorities, male youth, and urban youth, are overrepresented in the juvenile justice system. We compared mortality rates for delinquent youth with those for the general population, controlling for differences in gender, race/ethnicity, and age. Methods This prospective longitudinal study examined mortality rates among 1829 youth (1172 male and 657 female) enrolled in the Northwestern Juvenile Project, a study of health needs and outcomes of delinquent youth. Participants, 10 to 18 years of age, were sampled randomly from intake at the Cook County Juvenile Temporary Detention Center in Chicago, Illinois, between 1995 and 1998. The sample was stratified according to gender, race/ethnicity (African American, non-Hispanic white, Hispanic, or other), age (10–13 or ≥14 years), and legal status (processed as a juvenile or as an adult), to obtain enough participants for examination of key subgroups. The sample included 1005 African American (54.9%), 296 non-Hispanic white (16.2%), 524 Hispanic (28.17%), and 4 other-race/ethnicity (0.2%) subjects. The mean age at enrollment was 14.9 years (median age: 15 years). The refusal rate was 4.2%. As of March 31, 2004, we had monitored participants for 0.5 to 8.4 years (mean: 7.1 years; median: 7.2 years; interquartile range: 6.5–7.8 years); the aggregate exposure for all participants was 12 944 person-years. Data on deaths and causes of death were obtained from family reports or records and were then verified by the local medical examiner or the National Death Index. For comparisons of mortality rates for delinquents and the general population, all data were weighted according to the racial/ethnic, gender, and age characteristics of the detention center; these weighted standardized populations were used to calculate reported percentages and mortality ratios. We calculated mortality

  1. Systematic Review and Meta-study Synthesis of Qualitative Studies Evaluating Facilitators and Barriers to Participation in Colorectal Cancer Screening.

    PubMed

    Honein-AbouHaidar, Gladys N; Kastner, Monika; Vuong, Vincent; Perrier, Laure; Daly, Corinne; Rabeneck, Linda; Straus, Sharon; Baxter, Nancy N

    2016-06-01

    Screening reduces the incidence, morbidity, and mortality of colorectal cancer, yet participation tends to be low. We undertook a systematic review and meta-study synthesis of qualitative studies to identify facilitators and barriers to colorectal cancer screening participation. We searched major bibliographic databases for records published in all languages from inception to February 2015. Included primary studies that elicited views and perceptions towards colorectal cancer screening were appraised for relevance and quality. We used a two-stage synthesis to create an interpretation of colorectal cancer screening decisions grounded in primary studies; a thematic analysis to group themes and systematically compare studies and a meta-synthesis to generate an expanded theory of colorectal cancer screening participation. Ninety-four studies were included. The decision to participate in colorectal cancer screening depended on an individual's awareness of colorectal cancer screening. Awareness affected views of cancer, attitudes towards colorectal cancer screening modalities, and motivation for screening. Factors mediating awareness included public education to address misconceptions, primary care physician efforts to recommend screening, and the influence of friends and family. Specific barriers to participation in populations with lower participation rates included language barriers, logistical challenges to attending screening tests, and cultural beliefs. This study identifies key barriers, facilitators, and mediators to colorectal cancer screening participation. Cancer Epidemiol Biomarkers Prev; 25(6); 907-17. ©2016 AACR. PMID:27197277

  2. In Vivo RNAi-Based Screens: Studies in Model Organisms

    PubMed Central

    Yamamoto-Hino, Miki; Goto, Satoshi

    2013-01-01

    RNA interference (RNAi) is a technique widely used for gene silencing in organisms and cultured cells, and depends on sequence homology between double-stranded RNA (dsRNA) and target mRNA molecules. Numerous cell-based genome-wide screens have successfully identified novel genes involved in various biological processes, including signal transduction, cell viability/death, and cell morphology. However, cell-based screens cannot address cellular processes such as development, behavior, and immunity. Drosophila and Caenorhabditis elegans are two model organisms whose whole bodies and individual body parts have been subjected to RNAi-based genome-wide screening. Moreover, Drosophila RNAi allows the manipulation of gene function in a spatiotemporal manner when it is implemented using the Gal4/UAS system. Using this inducible RNAi technique, various large-scale screens have been performed in Drosophila, demonstrating that the method is straightforward and valuable. However, accumulated results reveal that the results of RNAi-based screens have relatively high levels of error, such as false positives and negatives. Here, we review in vivo RNAi screens in Drosophila and the methods that could be used to remove ambiguity from screening results. PMID:24705267

  3. The National Children's Study: a 21-year prospective study of 100,000 American children.

    PubMed

    Landrigan, Philip J; Trasande, Leonardo; Thorpe, Lorna E; Gwynn, Charon; Lioy, Paul J; D'Alton, Mary E; Lipkind, Heather S; Swanson, James; Wadhwa, Pathik D; Clark, Edward B; Rauh, Virginia A; Perera, Frederica P; Susser, Ezra

    2006-11-01

    Prospective, multiyear epidemiologic studies have proven to be highly effective in discovering preventable risk factors for chronic disease. Investigations such as the Framingham Heart Study have produced blueprints for disease prevention and saved millions of lives and billions of dollars. To discover preventable environmental risk factors for disease in children, the US Congress directed the National Institute of Child Health and Human Development, through the Children's Health Act of 2000, to conduct the National Children's Study. The National Children's Study is hypothesis-driven and will seek information on environmental risks and individual susceptibility factors for asthma, birth defects, dyslexia, attention-deficit/hyperactivity disorder, autism, schizophrenia, and obesity, as well as for adverse birth outcomes. It will be conducted in a nationally representative, prospective cohort of 100,000 US-born children. Children will be followed from conception to 21 years of age. Environmental exposures (chemical, physical, biological, and psychosocial) will be assessed repeatedly during pregnancy and throughout childhood in children's homes, schools, and communities. Chemical assays will be performed by the Centers for Disease Control and Prevention, and banks of biological and environmental samples will be established for future analyses. Genetic material will be collected on each mother and child and banked to permit study of gene-environment interactions. Recruitment is scheduled to begin in 2007 at 7 Vanguard Sites and will extend to 105 sites across the United States. The National Children's Study will generate multiple satellite studies that explore methodologic issues, etiologic questions, and potential interventions. It will provide training for the next generation of researchers and practitioners in environmental pediatrics and will link to planned and ongoing prospective birth cohort studies in other nations. Data from the National Children's Study will

  4. Optical Simulations and Studies with the PROSPECT-20 Detector

    NASA Astrophysics Data System (ADS)

    Stemen, Nathaniel; Prospect Collaboration

    2015-10-01

    The PROSPECT (Precision Reactor Oscillation and SPECTrum) experiment at the High Flux Isotope Reactor (HFIR) at Oak Ridge National Laboratory will make a precise measurement of the reactor antineutrino spectrum from a highly-enriched uranium nuclear reactor while also probing for short-baseline oscillations as a signature of possible sterile-neutrinos. Two liquid scintillator detectors at distances of 7-10m and 16-20m from the reactor will identify inverse beta decay events initiated by reactor antineutrinos. The near detector will be divided into optically separated segments filled with lithium loaded liquid scintillator read out by photomultiplier tubes (PMTs) on either end. Light guides will be employed to direct photons from the scintillator cells to the active PMT photo-cathodes. An optical simulation was built to optimize the performance of the detectors with respect to both light collection and detector uniformity and guide the design of the scintillator cells. We present experimental data and simulation results from the PROSPECT-20 prototype detector.

  5. Isokinetic lifting strength and occupational injury. A prospective study.

    PubMed

    Mostardi, R A; Noe, D A; Kovacik, M W; Porterfield, J A

    1992-02-01

    One hundred seventy-one nurses had their back strength evaluated on an isokinetic lifting device and filled out an epidemiologic questionnaire. They were then followed prospectively for 2 years to determine the incidence of job-related low-back injuries. The data were analyzed to determine if the injury incidence correlated with any of the strength or epidemiologic variables collected during the original evaluation. Average peak force measured during the isokinetic lift was 63.8 kg + 13.6 kg at a lift speed of 30.5 cm/sec and 59.1 kg + 14.9 kg at a lift speed of 45.7 cm/sec. Sixteen nurses reported an occurrence of job-related low-back pain or injury during the 2-year prospective period. Discriminate statistical techniques showed that none of the strength or epidemiologic variables correlated with the incidence of pain or injury or explained significant amounts of variance when the variables were regressed on strength or work calculated from the lift force/lift height data. It was concluded that in this high risk population, in which loads are heavy and lifting postures are variable, the use of low-back strength or prior history of pain or injury are poor predictors as to subsequent low-back pain or injury. PMID:1532461

  6. Protein flexibility in virtual screening: the BACE-1 case study.

    PubMed

    Cosconati, Sandro; Marinelli, Luciana; Di Leva, Francesco Saverio; La Pietra, Valeria; De Simone, Angela; Mancini, Francesca; Andrisano, Vincenza; Novellino, Ettore; Goodsell, David S; Olson, Arthur J

    2012-10-22

    Simulating protein flexibility is a major issue in the docking-based drug-design process for which a single methodological solution does not exist. In our search of new anti-Alzheimer ligands, we were faced with the challenge of including receptor plasticity in a virtual screening campaign aimed at finding new β-secretase inhibitors. To this aim, we incorporated protein flexibility in our simulations by using an ensemble of static X-ray enzyme structures to screen the National Cancer Institute database. A unified description of the protein motion was also generated by computing and combining a set of grid maps using an energy weighting scheme. Such a description was used in an energy-weighted virtual screening experiment on the same molecular database. Assessment of the enrichment factors from these two virtual screening approaches demonstrated comparable predictive powers, with the energy-weighted method being faster than the ensemble method. The in vitro evaluation demonstrated that out of the 32 tested ligands, 17 featured the predicted enzyme inhibiting property. Such an impressive success rate (53.1%) demonstrates the enhanced power of the two methodologies and suggests that energy-weighted virtual screening is a more than valid alternative to ensemble virtual screening given its reduced computational demands and comparable performance. PMID:23005250

  7. Outcome from a Prospective, Longitudinal Study of Prenatal Cocaine Use: Preschool Development at 3 Years of Age

    PubMed Central

    Behnke, Marylou; Eyler, Fonda Davis; Warner, Tamara Duckworth; Garvan, Cynthia Wilson; Hou, Wei; Wobie, Kathleen

    2011-01-01

    Objective To determine the effects of prenatal cocaine exposure on child development. Methods This prospective, longitudinal study recruited 154 pregnant cocaine users who were matched on race, parity, socioeconomic status, and perinatal risk to 154 noncocaine users. Drug use status was determined by maternal history and urine screening. At 3 years of age, the child subjects were assessed by an evaluator blinded to maternal drug use history. During a home visit at age 3, caregiver, family, and home assessments were administered. Results Structural equation modeling showed a direct effect of the amount of prenatal cocaine exposure on the adjusted birth head circumference which in turn directly affected preschool development. Conclusions We could not demonstrate a direct effect of prenatal cocaine exposure on preschool development, a result that is consistent with that of earlier work and now extending findings to age 3. However, cocaine continued to exert an indirect effect on development through its direct effect on the head circumference at birth. PMID:15827349

  8. The WISTAH hand study: A prospective cohort study of distal upper extremity musculoskeletal disorders

    PubMed Central

    2012-01-01

    Background Few prospective cohort studies of distal upper extremity musculoskeletal disorders have been performed. Past studies have provided somewhat conflicting evidence for occupational risk factors and have largely reported data without adjustments for many personal and psychosocial factors. Methods/design A multi-center prospective cohort study was incepted to quantify risk factors for distal upper extremity musculoskeletal disorders and potentially develop improved methods for analyzing jobs. Disorders to analyze included carpal tunnel syndrome, lateral epicondylalgia, medial epicondylalgia, trigger digit, deQuervain’s stenosing tenosynovitis and other tendinoses. Workers have thus far been enrolled from 17 different employment settings in 3 diverse US states and performed widely varying work. At baseline, workers undergo laptop administered questionnaires, structured interviews, two standardized physical examinations and nerve conduction studies to ascertain demographic, medical history, psychosocial factors and current musculoskeletal disorders. All workers’ jobs are individually measured for physical factors and are videotaped. Workers are followed monthly for the development of musculoskeletal disorders. Repeat nerve conduction studies are performed for those with symptoms of tingling and numbness in the prior six months. Changes in jobs necessitate re-measure and re-videotaping of job physical factors. Case definitions have been established. Point prevalence of carpal tunnel syndrome is a combination of paraesthesias in at least two median nerve-served digits plus an abnormal nerve conduction study at baseline. The lifetime cumulative incidence of carpal tunnel syndrome will also include those with a past history of carpal tunnel syndrome. Incident cases will exclude those with either a past history or prevalent cases at baseline. Statistical methods planned include survival analyses and logistic regression. Discussion A prospective cohort study of

  9. The Examining of Prospective Teachers? Views about Renewable and Non-Renewable Energy Sources: A Case Study of Turkey

    ERIC Educational Resources Information Center

    Hasiloglu, Mehmet Akif

    2014-01-01

    The aim of this study is to determine prospective teachers? views about renewable and non-renewable energy sources. To collect data, a questionnaire with 5 open-ended questions was conveyed to 463 prospective teachers selected from Agri Ibrahim Cecen University. The results showed that almost three fourths of the prospective teachers tend to…

  10. Access to the Superficial Femoral Artery in the Presence of a 'Hostile Groin': A Prospective Study

    SciTech Connect

    Marcus, Adrian J.; Lotzof, Kevin; Howard, Adam

    2007-06-15

    Purpose. Lower limb angioplasty is commonly performed via antegrade common femoral artery (CFA) puncture, followed by selective superficial femoral artery (SFA) catheterization. Arterial access can be complicated by a 'hostile groin' (scarring, obesity, or previous failed CFA puncture). We prospectively investigated color duplex ultrasound (CDU)-guided SFA access for radiological interventions. Methods. Antegrade CDU-guided CFA and SFA puncture were compared in 30 patients requiring intervention for severe leg ischemia who had hostile groins. Demographics, screen time, radiation dose, intervention, and complications were prospectively recorded. Results. Treatment in 30 patients involved 44 angioplasties (40 transluminal, 4 subintimal) and 2 diagnostic angiograms. Fifteen of these patients had CDU-guided CFA punctures; in 8 of these patients CDU-guided CFA puncture 'failed' (i.e., there was failure to pass a guidewire or catheter into the CFA or SFA), necessitating immediate direct CDU-guided SFA puncture. Overall, the mean screen time and radiation dosage, via direct CDU-guided SFA puncture in 30 patients, was 4.8 min and 464 Gy cm{sup 2} respectively. With CDU-guided CFA puncture, mean screen time (10 min), radiation dose (2023 Gy cm{sup 2}), and complications (13%) were greater when compared with the SFA puncture results overall and in the same patients at subsequent similar procedures (2.7 min, 379 Gy cm{sup 2} (p < 0.05), no complications in this subgroup). Five complications occurred: 2 each at CFA and SFA entry sites, and 1 angioplasty embolus. Conclusions. The CDU-guided SFA puncture technique was both more effective than CDU-guided CFA access in patients with scarred groins, obesity, or failed CFA punctures and safer, with reduced screen times, radiation doses, and complications.