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Increased Surveillance (increased + surveillance)

Distribution by Scientific Domains

Medical Sciences	40%

Selected Abstracts

Liver transplantation and subsequent risk of cancer: Findings from a Canadian cohort study,

LIVER TRANSPLANTATION, Issue 11 2008
Ying Jiang
Characterization of the long-term cancer risks among liver transplant patients has been hampered by the paucity of sufficiently large cohorts. The increase over time in the number of liver transplants coupled with improved survival underscores the need to better understand associated long-term health effects. This is a cohort study whose subjects were assembled with data from the population-based Canadian Organ Replacement Registry. Analyses are based on 2034 patients who received a liver transplant between June 1983 and October 1998. Incident cases of cancer were identified through record linkage to the Canadian Cancer Registry. We compared site-specific cancer incidence rates in the cohort and the general Canadian population by using the standardized incidence ratio (SIR). Stratified analyses were performed to examine variations in risk according to age at transplantation, sex, time since transplantation, and year of transplantation. Liver transplant recipients had cancer incidence rates that were 2.5 times higher than those of the general population [95% confidence interval (CI) = 2.1, 3.0]. The highest SIR was observed for non-Hodgkin's lymphoma (SIR = 20.8, 95% CI = 14.9, 28.3), whereas a statistically significant excess was observed for colorectal cancer (SIR = 2.6, 95% CI = 1.4, 4.4). Risks were more pronounced during the first year of follow-up and among younger transplant patients. In conclusion, our findings indicate that liver transplant patients face increased risks of developing cancer with respect to the general population. Increased surveillance in this patient population, particularly in the first year following transplantation, and screening for colorectal cancer with modalities for which benefits are already well recognized should be pursued. Liver Transpl 14:1588,1597, 2008. © 2008 AASLD. [source]

Unexplained elevated maternal serum ,-HCG concentration and adverse pregnancy outcome

PRENATAL DIAGNOSIS, Issue 11 2007
Ramesh Ganapathy
Abstract Objective To investigate the association between unexplained elevated maternal serum ,-Human chorionic gonadotrophin (HCG) in the second trimester of pregnancy and adverse pregnancy outcome. Methods In a case-controlled study of 3463 women who opted for second-trimester serum screening for Down syndrome, 142 were found to have a serum ,-HCG of ,3.5 multiples of the median (MoM), 56 of whom had a serum ,-HCG of ,5.0 MoM. These women were compared with a control group of women with serum ,-HCG within the 95% confidence interval around the median. Results In the elevated ,-HCG group (,5 MoM) significantly more babies required admission to the special care baby unit (p = 0.02) and were small for gestational age (SGA) (p = 0.03). The mean birth weight was also significantly lower in the group with elevated ,-HCG. Women with a serum ,-HCG of ,5, ,6, ,7 or ,8 MoM were associated with SGA babies in 40, 44, 64 and 86% respectively. All babies born to the six women with ,-HCG of 8.75,24.1 MoM were SGA. Conclusion Increased surveillance is necessary in pregnancies where the maternal serum ,-HCG in the second trimester is inexplicably elevated to ,5 MoM. Copyright © 2007 John Wiley & Sons, Ltd. [source]

Follow-Up Recommendations for Benign Breast Biopsies

THE BREAST JOURNAL, Issue 5 2006
Susanna Shin MD
Abstract: Histologically proven benign breast disease increases a woman's relative risk for subsequent cancer development. Yet follow-up guidelines for mammogram and clinical breast examination after a benign breast biopsy are lacking. Our objective was to determine if increased surveillance is indicated following a benign breast biopsy. Following institutional review board approval, a retrospective database review was conducted of prospectively gathered patients who had a benign breast biopsy (core or excisional) for an abnormality detected on mammogram, ultrasound, or clinical breast examination. Follow-up, for all subjects, was a clinical breast examination and mammogram or ultrasound at 6 months, 1 year, and 2 years after benign breast biopsy by a breast surgeon. End points were the need for additional biopsies or cancer detection. Statistical analysis was performed using chi-squared analysis. From January 2000 to July 2003, 156 patients age 18,86 years had a benign breast biopsy. During the 2 year follow-up, 20 patients (13%) required a subsequent biopsy. No significant difference was observed in mean age, race, menarche, menopause, parity, age at first live birth, use of oral contraceptives, history of prior biopsy, or the pathology of the initial lesion between those who needed a subsequent biopsy and those who did not. Seven excisional biopsies were performed (one at 6 months, four at 1 year, and two at 2 years follow-up) for growth of the benign breast biopsy lesion, and pathology remained concordant with the original diagnosis. Thirteen biopsies were done for new findings on mammogram or ultrasound. Three of these (1.9%) yielded a cancer diagnosis (one at 6 months, one at 1 year, and one at 2 years follow-up). No new lesions were identified on follow-up by clinical breast examination alone. Increased surveillance following a benign breast biopsy is necessary because of the increased need for subsequent biopsy or risk of cancer development. This should include imaging (mammography or ultrasound) and a clinical breast examination 6 months, 1 year, and 2 years after a benign breast biopsy. [source]

MOVING VIOLATIONS: DATA PRIVACY IN PUBLIC TRANSIT

GEOGRAPHICAL REVIEW, Issue 3 2007
NANCY J. OBERMEYER
ABSTRACT. This article draws from the foundation provided by the ongoing debate about geosurveillance to frame a discussion of the use of tracking technologies in public transit. Specifically, it uses the case of public transit to illustrate the uncomfortable debate about compromises that come with increased surveillance to enhance public safety and security. The article begins with a discussion of the evolution of the debate about geosurveillance, casting the use of surveillance technologies in public transit within this framework. Next, it describes and discusses the implementation of automatic vehicle locators and closed-circuit television in public transit. The following sections focus on the risks to individual privacy that accompany implementation of these technologies, then describe an unusual effort to draw attention to the prevalence of increased surveillance in public spaces in an effort to expose the risks. The article concludes by making the case that public transit is a place where surveillance provides clear benefits but where the humans who review the surveillance data must interpret and use them responsibly to minimize the risks to individual privacy. [source]

The sonographic diagnosis of chorionicity

PRENATAL DIAGNOSIS, Issue 9 2005
A. Shetty
Abstract The differentiation between mono- and dichorionic placentation in twin pregnancies is of clinical importance because of the significant difference in perinatal morbidity and mortality between the two, and the increased surveillance indicated in monochorionic gestations. Application of ultrasonography has enabled very precise prenatal determination of chorionicity. While this is best performed in the first trimester when accuracy approaches 100%, even in the third trimester, using a composite cascade of available sonographic features, accuracy has been reported to approach 97%. While two clearly separate placentae or discordant fetal gender conform to dichorionicity, in most twin pregnancies other features need to be assessed to determine chorionicity. The presence of the ,lambda' or the ,T' sign in the presence of a single placenta, best determined in the first trimester, is the most reliable indicator of chorionicity, with measurements of the inter-twin membrane thickness and counting of the membrane layers being less reliable. In this article, we review the sonographic features that help in the accurate depiction of chorionicity. Copyright © 2005 John Wiley & Sons, Ltd. [source]