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Screening Study (screening + study)
Selected AbstractsPrenatal screening for serious congenital heart defects using nuchal translucency: a meta-analysisPRENATAL DIAGNOSIS, Issue 12 2008Nicholas J. Wald Abstract Objectives To assess the performance of nuchal translucency (NT) measurements in screening for congenital heart defects (CHD) which would benefit from prenatal detection. Methods A literature search was conducted of studies published prior to August 2007 of CHD and NT measurements in fetuses without chromosome defects. From this, data on 159 pregnancies were obtained. Fetuses with CHD that would benefit from prenatal detection were identified and their NT measurements were compared with NT measurements in 29 776 unaffected fetuses without Down syndrome from the Serum Urine and Ultrasound Screening Study (SURUSS) trial to determine the screening performance of NT measurements. Results In all 67 fetuses with CHD were identified as potentially likely to benefit from prenatal detection. Using NT measurements, the estimated detection rate (DR) for a 5% false-positive rate (FPR) was 52% (95% CI: 42,71). Conclusion Prenatal screening for CHD using NT measurements is likely to be effective, and given that NT measurement is already in place as part of prenatal screening for Down syndrome; this is an ideal time to set up demonstration projects to validate these results. Copyright © 2008 John Wiley & Sons, Ltd. [source] Sequential and contingent prenatal screening for Down syndromePRENATAL DIAGNOSIS, Issue 9 2006Nicholas J Wald Abstract Objective To compare the Integrated test in three policies for prenatal Down syndrome screening: Integrated screening for all women, sequential screening (first-trimester tests allowing early completion of screening for high-risk pregnancies), and Contingent screening (early completion of screening for high- and low-risk pregnancies). Design and Methods Estimation of detection rates (DRs) and false-positive rates (FPRs) using Monte Carlo simulation and cost effectiveness for each method. Setting and Population Down syndrome affected and unaffected pregnancies studied in the Serum Urine and Ultrasound Screening Study (SURUSS). Results and Main Outcomes Integrated screening has the best screening performance. The performance of the other two policies approached that of Integrated screening as the first-trimester test FPR decreased. If the first-trimester FPR is set to 0.5% (risk , 1 in 30) with an overall DR of 90%, sequential and contingent screening yield overall FPRs of 2.25% and 2.42%, respectively, and 66% of the affected pregnancies are detected by the first-trimester test. The Integrated test on all women yields an FPR of 2.15%. With sequential screening, 99.5% of women would proceed to an Integrated test, or 30% with contingent screening if those with first-trimester test risks of ,1 in 2000 are classified screen-negative and receive no further testing. About 20% of affected pregnancies identified in the first trimester using sequential or contingent screening would have unnecessary terminations (they would miscarry before the early second trimester). Contingent screening is the most cost-effective if there is no alphafetoprotein screening for neural tube defects, otherwise Integrated screening is more cost-effective. Conclusions Integrated screening for all women is the simplest, most effective, and the safest policy. Contingent screening is the most complex with the lowest screening performance. Making an earlier diagnosis with sequential and contingent screening has adverse consequences that are sufficient to discourage their use. Copyright © 2006 John Wiley & Sons, Ltd. [source] Screening study for potential lead compounds for natural product-based fungicides: I. Synthesis and in vitro evaluation of coumarins against Botrytis cinerea,PEST MANAGEMENT SCIENCE (FORMERLY: PESTICIDE SCIENCE), Issue 9 2004Mourad Daoubi Abstract An efficient, one-pot synthesis of angular and linear dihydropyranocoumarins, along with C-6 and C-8 prenylated coumarins is reported. These compounds, together with single- and furanocoumarins, were tested for their potential antifungal activity against the phytopathogen Botrytis cinerea Pers ex Fr. The results show that furanocoumarins may be able to control the fungus B cinerea. Copyright © 2004 Society of Chemical Industry [source] First trimester maternal serum free , human chorionic gonadotrophin and pregnancy associated plasma protein A as predictors of pregnancy complicationsBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 10 2000Charas Y. T. Ong Research Fellow (Fetal Medicine) Objective To examine the value of first trimester maternal serum free , human chorionic gonadotrophin (, hCG) and pregnancy associated plasma protein A (PAPP-A) as predictors of pregnancy complications. Design Screening study. Setting Antenatal clinics. Population Singleton pregnancies at 10,14 weeks of gestation. Methods Maternal serum free , hCG and PAPP-A were measured at 10,14 weeks of gestation in 5584 singleton pregnancies. In the 5297 (94.9%) pregnancies with complete follow up free , hCG and PAPP-A were compared between those with normal outcome and those resulting in miscarriage, spontaneous preterm delivery, pregnancy induced hypertension or fetal growth restriction and in those with pre-existing or gestational diabetes. Results Maternal serum PAPP-A increased and , hCG decreased with gestation. The multiple of median maternal serum PAPP-A was significantly lower in those pregnancies resulting in miscarriage, pregnancy induced hypertension, growth restriction and in those with pre-existing or gestational diabetes mellitus, but not in those complicated by spontaneous preterm delivery. The level was < 10th centile of the reference range in about 20% of the pregnancies that subsequently resulted in miscarriage or developed pregnancy induced hypertension or growth restriction, and in 27% of those that developed gestational diabetes. Maternal serum free , hCG was < 10th centile of the reference range in about 15% of the pregnancies that subsequently resulted in miscarriage or developed pregnancy induced hypertension or growth restriction, and in 20% of those that developed gestational diabetes. Conclusion Low maternal serum PAPP-A or , hCG at 10,14 weeks of gestation are associated with subsequent development of pregnancy complications. [source] Sesquiterpene lactone dermatitis in the young: is atopy a risk factor?CONTACT DERMATITIS, Issue 1 2008Evy Paulsen Screening for Compositae contact allergy has documented fairly high prevalence in adults, and recent studies indicate that the allergy may be more common in children than previously believed. However, detailed information on sensitization in this age group is sparse. The objective of this study was to present another 2 cases in children and review the literature. Screening with sesquiterpene lactone (SL) mix has shown prevalence of 0.5% and 1.8% in 2 studies, while screening with 2 different Compositae mixes detected 4.2% and 2.6% positives among children and adolescents. All individual case reports describe sensitization in atopic children, and the largest screening study showed a prevalence of Compositae mix sensitization that was significantly higher in children with atopic dermatitis compared with non-atopics. Compositae sensitization should be considered in children with a family or personal history of atopy, summer-related, or -exacerbated dermatitis of any kind, and a history of plant exposure. Screening with SL mix is recommended but should be supplemented with plant extracts based on exposure history. Compositae weeds, especially dandelions, seem to be important sensitizers in children. [source] Co-ocurrence of developmental delays in a screening study of 4-year-old Finnish childrenDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 7 2004Riitta Valtonen The aim of this population study was to examine the severity and prevalence of co-occurring developmental delays in 4-year-old children, the rate of overlapping problems, and sex differences. A sample of 434 children (196 males, 238 females; mean age 4 years 3 months, SD 1 month) were administered the,Lene'test: a comprehensive neuro-developmental screening test. Results suggest that co-occurrence of attention-behavioural, motor-perceptual, and language delays occurring in school-aged children could already be detected at the age of 4 years. Isolated delays were usually mild, but co-occurring difficulties were mostly moderate or severe. Overlap between developmental delays depended on the severity of the problems. It emerged that males had more severe and more often co-occurring problems than females. Co-occurrence of developmental delays as a risk factor at the early stage of development is discussed. [source] An examination of the relationship between dyslexia and offending in young people and the implications for the training systemDYSLEXIA, Issue 2 2001Jane Kirk Abstract A screening study was undertaken which involved 50 young offenders, serving sentences of various lengths, all from the largest young offenders' institution in Scotland. All 50 were screened for dyslexia and a number received a more detailed follow-up assessment. The results of the screening showed that 25 of the young offenders (50%) were dyslexic to some degree. This finding has implications for professionals, particularly in respect of follow-up assessment and support, and for politicians in relation to issues such as school experience, prison education and staff training. These issues are discussed here in relation to the background and results of the study. Copyright © 2001 John Wiley & Sons, Ltd. [source] Copper toxicity thresholds for important restoration grass species of the western United States,ENVIRONMENTAL TOXICOLOGY & CHEMISTRY, Issue 12 2002Mark W. Abstract Copper toxicity thresholds for plant species that are used in restoration activities in western North America have not been established. As a result, ecological risk assessments must rely on toxicity thresholds established for agronomic species, which usually differ from those of species used in restoration. Thus, risk assessors have the potential for classifying sites as phytotoxic to perennial, nonagronomic species and calling for intensive remediation activities that may not be necessary. The objective of this study was to provide a better estimate of Cu toxicity thresholds for five grass species that are commonly used in restoration efforts in the western United States. We used a greenhouse screening study where seedlings of introduced redtop (Agrostis gigantea Roth.), the native species slender wheatgrass (Elymus trachycaulus [Link] Gould ex Shinners var. Pryor), tufted hairgrass (Deschampsia caespitosa [L.] Beauvois), big bluegrass (Poa secunda J. Presl var. Sherman), and basin wildrye (Leymus cinereus [Scribner&Merrill] A. Löve var. Magnar) and the agricultural species common wheat (Triticum aestivum L.) were grown in sand culture and exposed to supplemental concentrations of soluble Cu of 0 (control), 50, 100, 150, 200, 250, and 300 mg/L. We determined six measures of toxicity: the 60-d mean lethal concentration (LC50), 60-d mean effective concentration (EC50)-plant, 60-d EC50-shoot, 60-d EC50-root, phytotoxicity threshold (PT50)-shoot, and the PT50-root. Results suggest that these restoration grass species generally have higher Cu tolerance than agronomic species reported in the past. Of the species tested, redtop appeared to be especially tolerant of high levels of substrate and tissue Cu. Values of EC50-plant for restoration grasses were between 283 and 710 mg Cu/L compared to 120 mg Cu/L for common wheat. Measured PT50-shoot values were between 737 and 10,792 mg Cu/ L. These reported thresholds should be more useful for risk assessors than those currently used, which are based largely on agronomic crops. [source] Screening the Hanford tanks for trapped gasENVIRONMETRICS, Issue 5-6 2002Paul Whitney Abstract The Hanford Site is home to 177 large, underground nuclear waste storage tanks. This article describes a screening study carried out in the mid 1990s that used the tank waste level measurements to assess the tanks for potential flammable gas hazards. At the time of the study, 25 of the 177 tanks were on the flammable gas watch list. The use of this monitoring data provided additional insight, resulting in operational changes on the Hanford site. The waste level measurements used in this study were made primarily to monitor the tanks for leaks and intrusions. Four measurement devices are widely used in these tanks. Three of these measure the level of the waste surface. The remaining device measures from within a well embedded in the waste, thereby monitoring the liquid level even if the liquid level is below a dry waste crust. The data from each of the four measurement devices were utilized in this investigation. The analytic method used for this screening was to look for an inverse correlation between waste level measurements and ambient atmospheric pressure. If the waste level in a tank decreases with an increase in ambient atmospheric pressure, then the compressibility may be attributed to gas trapped within the waste. In this article, this methodology is not used to estimate the volume of gas trapped in the waste. Copyright © 2002 John Wiley & Sons, Ltd. [source] Non-participation and adjustment for bias in case,control studies of periodontitisEUROPEAN JOURNAL OF ORAL SCIENCES, Issue 5 2008Rodrigo López Periodontal researchers frequently use case,control studies, but information on participation rates and the reasons for participation are often missing in the publications, thus hindering the assessment of the validity of those studies. A nested case,control study based on a well-defined population was used to (i) describe the patterns of participation; (ii) show how some associations can be biased; and (iii) illustrate how inverse probability weights can be applied to reduce bias. Differential subject participation was quantified using the ratio between participation for each level and the overall participation. Possible biased associations were illustrated using the odds ratios found for eligible and participant subjects. Finally, we used the estimated probability that an individual participates in the case,control study conditional on that individual's covariate pattern, as observed in the screening study to attempt bias reduction. Considerable differential participation was observed for selected factors, including age, annual tuitions and fees, parental income, and parental education. The strategy used for adjustment of bias resulted in some degree of bias reduction. These findings challenge the inferential validity of many studies on periodontitis. The design and conduct of these studies should aim to improve subject participation and must consider and minimize this potential source of bias. [source] Simultaneous triple organ specific autoantibody profiling in adult patients with type 1 diabetes mellitus and their first-degree relatives,INTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 3 2009S. Dagdelen Summary Aims:, We aimed to document prevalence and clinical presentations of seropositivities for glutamate decarboxylase (GAD)-antibody, celiac's disease (CD) and autoimmune thyroiditis (AIT) in adult patients with type 1 diabetes mellitus (T1DM), and their first-degree relatives. Methods:, Sixty-five patients with T1DM, 124 first-degree relatives and 65 healthy controls were screened for GAD-antibody, anti-thyroid peroxidase (ATPO), anti-thyroid stimulating hormone receptor (TSHR), anti-tissue transglutaminase and anti-gliadin antibodies in a matched case,control study. Results:, Prevalence of more than one seropositivity for CD-associated antibodies in T1DM-group is 6.0 times increased, compared with controls (p < 0.05). ATPO seropositivity is 5.3 times increased in T1DM group (p < 0.05), but TSHR antibody is comparable with controls (p > 0.05). Seropositivities for T1DM, AIT and CD are 4.3, 1.9 and 2.4 times more prevalent among first-degree relatives respectively, compared with controls (p < 0.05). Pathologically confirmed cases with CD among first-degree relatives were all identified at screening. In contrast, all of pathologically confirmed cases with CD in T1DM group, were either previously diagnosed or symptomatic at time of screening. In the group of patients with T1DM, 31% of seropositive cases for anti-ATPO were clinically latent for AIT, and 74% of ATPO (+) cases were identified at current screening study. Sixty-four per cent of ATPO (+) first-degree relatives were clinically latent for AIT, and 54% were identified at screening. Conclusion:, Type 1 diabetes mellitus, CD and AIT represent a significant overlap in an adult population with already-diagnosed T1DM and their first-degree relatives. With regard to clinical presentations, CD was less likely to be clinically silent than AIT among patients with T1DM. [source] Diagnostic value of serum prostate-specific antigen in hemodialysis patientsINTERNATIONAL JOURNAL OF UROLOGY, Issue 5 2003MASAHIRO SUMURA Abstract Background: The value of serum prostate-specific antigen (PSA) screening was examined to detect prostate cancer in men receiving hemodialysis. Methods: Forty-one male patients age 60,95 (median age, 70 years) receiving hemodialysis were investigated for PSA levels. We set the cut-off point at 4 ng/mL (the usual reference range). Digital rectal examination (DRE) and transrectal ultrasonography (TRUS) of the prostate were performed in patients whose PSA was more than 4 ng/mL and/or who expected further examination of the prostate. When prostate cancer was suspected, biopsy of the prostate was performed. In patients with prostate cancer, magnetic resonance imaging, computed tomography and bone scintigraphy were performed to diagnose the clinical stage. Results: The mean serum level of PSA was 2.10 ± 0.49 ng/mL. In this screening study, four of 41 men required further examinations for prostate cancer. Two of four refused further examinations. The other two were diagnosed with prostate cancer. The incidence of prostate cancer was at least 5% in our hemodialysis patients. One man, whose clinical stage was T2aN0M0, was treated with radical retropubic prostatectomy. Another man, whose clinical stage was T2bN0M0, was treated with luteinizing hormone-releasing hormone analogue. Conclusion: In our preliminary study, prostate cancer screening with PSA was useful for the early detection of prostate cancer in hemodialysis patients. If possible, DRE and TRUS should be performed in conjunction with PSA tests. [source] Validity of sonographic screening for the detection of abdominal cancersJOURNAL OF CLINICAL ULTRASOUND, Issue 7 2002Yoshihiro Mizuma MD Abstract Purpose This study assessed the prevalence of abdominal cancers and the validity of sonographic screening for abdominal cancers in an asymptomatic population. Methods We investigated the findings of the first sonographic screening of 16,024 residents of Osaka Prefecture. A comparison of records was carried out between the list of those screened and the Osaka Cancer Registry to identify false-negative results of our screening. Results The rate of subjects who required further testing after screening was 4.76% (762/16,024). Eleven of the 762 subjects with a positive sonographic screening study had abdominal cancers detected on further testing. Three subjects had false-negative screening results. The positive predictive value of sonographic screening was 1.4% (11/762), and the rate of screening-detected cancers was 0.069% (11/16,024). The prevalence of abdominal cancers was 0.087% (14/16,024), the sensitivity of screening sonography for the detection of abdominal cancers was 78.6% (11/14), and the specificity was 95.3% (15,259/16,010). Seven of 11 screening-detected cancers were resected curatively, and 6 of these patients are still alive. Five of these 6 cancers were renal cell carcinomas. Conclusions The sensitivity of screening sonography was relatively high and the specificity was sufficient among our asymptomatic population. The present study suggests that the target organ for sonographic screening to detect curable cancers should be the kidneys. © 2002 Wiley Periodicals, Inc. J Clin Ultrasound 30:408,415, 2002 [source] Prevalence and etiology of elevated serum alanine aminotransferase level in an adult population in TaiwanJOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 9 2007Chien-Hua Chen Abstract Background:, The prevalence and etiologies of elevated alanine aminotransferase (ALT) have geographic variations and they are rarely reported in Taiwan. Through a population-based screening study, the prevalence and etiologies of elevated ALT in an adult population of Taiwan were assessed. Methods:, A cross-sectional community study in a rural village of Taiwan was conducted in 3260 Chinese adults (age ,18 years) undergoing ultrasonography (US), blood tests, and interviews with a structured questionnaire. The diagnostic criteria of non-alcoholic fatty liver disease (NAFLD) included alcohol intake <20 g/week for women or <30 g/week for men, negative hepatitis B virus (HBV) and hepatitis C virus (HCV) infections, no known etiologies of liver disease, and US consistent with fatty liver. Results:, The prevalence of elevated ALT was 11.4% (372/3260). The probable cause of this elevation was excess alcohol consumption in 0.8%, HBV in 28.5%, HCV in 13.2%, both HBV and HCV in 2.2%, NAFLD in 33.6%, and unexplained cause in 21.8%. The etiologic distribution of elevated ALT was similar in both genders, although elevation was more common in men compared to women (17.3%vs 6.1%, P < 0.05). The prevalence of elevated ALT in NAFLD was 18.1% (125/691), and the positive predictive value was 33.6% (125/372). The development of NAFLD was related to increasing age (age between 40 years and 64 years, odds ratio [OR] 1.59, 95% confidence interval [CI]: 1.25,2.01; age , 65 years, OR 1.46, 95%CI: 1.08,1.96), fasting plasma glucose (FPG) , 126 mg/dL (OR 1.54, 95%CI: 1.11,2.14), bodymass index (BMI) , 25 kg/m2 (OR 5.01, 95%CI: 4.13,6.26), triglyceridemia , 150 mg/dL (OR 1.96, 95%CI: 1.58,2.42), and hyperuricemia (OR 1.50, 95%CI: 1.22,1.84). Elevated ALT was related to male gender, BMI , 25 kg/m2, and triglyceridemia , 150 mg/dL in subjects without known etiologies of liver disease (all P < 0.05). Conclusions:, Non-alcoholic fatty liver disease appears to be the commonest cause of elevated ALT and presumed liver injury in Taiwan. The development of NAFLD is closely associated with many metabolic disorders. Metabolic disorders are also related to elevated ALT in subjects without known etiologies of liver disease. [source] Fatty acid synthase inhibitory activity of dibenzocyclooctadiene lignans isolated from Schisandra chinensisPHYTOTHERAPY RESEARCH, Issue S2 2010MinKyun Na Abstract Inhibition of fatty acid synthase (FAS) has been proposed to be a new therapeutic target for the treatment of cancer and obesity. In our preliminary screening study on the FAS inhibitory activity, a n -hexane soluble fraction prepared from the fruit of Schisandra chinensis (Schisandraceae) was found to inhibit FAS activity at 100,,g/mL. Nine dibenzocyclooctadiene lignans were isolated from the active fraction and were evaluated for their inhibitory effect on FAS for the first time. The compounds possessing a benzoyl or tigloyl group in the dibenzocyclooctadiene skeleton entirely inhibited the FAS activity in a dose dependent manner. The findings may be partially related to the anticancer effect of the medicinal plant, suggesting a further study on the anticancer potential of dibenzocyclooctadiene derivatives. Copyright © 2010 John Wiley & Sons, Ltd. [source] A prospective study of diagnosis of Toxoplasma gondii infection after bone marrow transplantation,APMIS, Issue 5 2008BENJAMIN EDVINSSON Active infection with Toxoplasma gondii in immunocompromised transplant recipients can lead to toxoplasmosis, which may have a rapid disease course and in some cases be fatal. It is of paramount importance to diagnose toxoplasmosis at an early stage, and to initiate specific treatment to improve the outcome. Polymerase chain reaction (PCR) is today the primary diagnostic tool to diagnose toxoplasmosis in immunocompromised patients. Timely diagnosis may, however, be difficult if toxoplasmosis is at first asymptomatic. To investigate the magnitude of toxoplasmosis after bone marrow transplantation (BMT), we conducted a screening study by PCR where 21 autologous and 12 allogeneic BMT recipients were included. Peripheral blood samples were taken one week prior to BMT; thereafter, blood samples were drawn weekly for the first 6 months, and monthly up to one year after BMT. The samples were analyzed by conventional PCR and real-time PCR. T. gondii DNA was detected in peripheral blood from one patient 5 days post allogeneic BMT. There were no clinical signs of toxoplasmosis. Medical records were reviewed and showed a previously undiagnosed eye infection in another allogeneic BMT recipient. These two patients were seropositive for T. gondii. We concluded that monitoring for T. gondii DNA in peripheral blood samples using PCR might be a valuable method for identifying toxoplasma-seropositive stem cell transplant recipients. [source] Performance of colposcopy in five sub-Saharan African countriesBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 6 2009R Muwonge Objective, The performance of colposcopy provided in a screening study in five African countries was evaluated. Design, Cross-sectional study. Setting, Burkina Faso, Congo Brazzaville, Guinea Conakry, Mali and Niger. Population, Women aged 25,59 years. Methods, A total of 29 294 women participated in a cervical screening study in the five study sites, and newly trained local doctors performed colposcopy and directed biopsies as indicated. Using meta-analytical tools, four measures of colposcopy performance at different thresholds of colposcopic abnormalities were assessed. Sources of heterogeneity were also assessed. Main outcome measures, Proportions of women receiving biopsies, adequate biopsies and women diagnosed with cervical intraepithelial neoplasia (CIN). Results, Among 28 553 women with satisfactory colposcopy, 3101 had a colposcopic diagnosis of probable low-grade or worse lesions and 1128 probable high-grade or worse lesions. Overall, the measures that reached the set standards were proportion of biopsy taken at colposcopy threshold of probable high-grade or worse lesions (95%, 95% CI 90,100%) and proportion of adequate biopsy samples. The set standards were not met for the proportions of women diagnosed with CIN at different colposcopic abnormality thresholds. Detection of CIN2 or worse lesions increased with increasing colposcopic abnormality. Conclusions, The performance of colposcopy in some of the African sites studied was comparable to that previously observed in other studies. With appropriate training, monitoring, continuing practice and quality assurance, adequate standards of colposcopy can be attained in sub-Saharan Africa. [source] The value of EZH2, p27kip1, BMI-1 and MIB-1 on biopsy specimens with low-risk prostate cancer in selecting men with significant prostate cancer at prostatectomyBJU INTERNATIONAL, Issue 2 2010Tineke Wolters OBJECTIVE To assess the additional prognostic value of the molecular markers EZH2, MIB-1, p27kip1 and BMI-1 on needle biopsies from men with low-risk prostate cancer, as this disease in needle biopsies shows a heterogeneous clinical outcome, and while it is known that the expression of these tissue markers is predictive of the clinical outcome after radical prostatectomy (RP) their value in prostate biopsies is largely unknown. PATIENTS AND METHODS The study included men participating in a screening study, diagnosed with low-risk prostate cancer and subsequently treated with RP. Immunohistochemical staining for EZH2, MIB-1, p27kip1 and BMI-1 on the needle biopsies were (semi)quantitatively scored and expression levels were related to significant disease at RP. Clinical low-risk prostate cancer was defined as a prostate-specific antigen (PSA) level of ,10 ng/mL, clinical T-stage ,2, biopsy Gleason score ,6, a PSA density of <0.20 ng/mL/g and two or fewer positive cores. Significant PC at RP was defined as presence of any of extracapsular extension, Gleason pattern 4/5, or tumour volume ,0.5 mL. RESULTS In all, 86 biopsy specimens were included; there was high EZH2 expression (>1.0%) in 42% and a low p27kip expression (<90%) in 63%. Significant disease was present in 44 (51%) RP specimens. A high EZH2 (odds ratio 3.19, P = 0.043) and a low p27kip1 (4.69, P = 0.036) were independent predictors for significant prostate cancer at RP. CONCLUSIONS The determination of EZH2 and p27kip1 on diagnostic needle biopsies supports the selection of men with indolent prostate cancer at RP. Especially p27kip1 could improve the pretreatment risk assessment of patients with low-risk prostate cancer. [source] Features and preliminary results of the Dutch centre of the ERSPC (Rotterdam, the Netherlands)BJU INTERNATIONAL, Issue 2003M.J. Roobol OBJECTIVE To describe the preliminary results of the Dutch section of a large multicentre study of screening for prostate cancer, the European Randomized study of Screening for Prostate Cancer (ERSPC), initiated in the Netherlands and Belgium in 1991. MATERIALS AND METHODS After a series of five pilot studies which started in 1991, full-capacity screening started in 1994 with the use of a serum prostate-specific antigen (PSA) determination, a digital rectal examination (DRE) and transrectal ultrasonography (TRUS) as screening tests. Depending on the results and the screening protocol used, men were referred for further examination by sextant biopsies (extended with a seventh biopsy if TRUS showed abnormality). The protocols used, efficiency of the different screening tests, number of cancers detected in the pilot studies, initial screening round and preliminary results of the second screening round are described. RESULTS After the pilot studies it became clear that a study of prostate cancer screening was feasible in the Rotterdam area. The screening protocol was workable and the recruitment rate acceptable (39.5%). An inventory of the population registries of Rotterdam and surrounding municipalities, and the known recruitment rate, made it clear that a contribution of 40 000 men (aged 55,74 years) from the Dutch centre to the ERSPC was feasible. The initial screening round started in December 1993 and lasted until December 1999 (protocol 5,10). In all, 42 376 men were randomized and 1014 cancers detected (5.1%). During this screening the protocol was simplified. After evaluating the different screening tests abnormal results of the DRE and TRUS were omitted as an indication for a sextant biopsy. Only a serum PSA level of , 3.0 ng/mL is now used as the indication. The second screening round started in December 1997 and continues. To December 2002, 9920 men were screened for the second time, 4 years after their initial screening visit. To date 446 cancers have been detected (4.5%); this round will last to December 2003. Further evaluation of the screening regimen and characteristics of the cancers detected are constantly assessed within the Dutch ERSPC. Meanwhile a third screening round has also been initiated, which will last to December 2007. CONCLUSION A prostate cancer screening study of the projected magnitude is feasible in Rotterdam; the recruitment rate is acceptable and the screening tests well tolerated. The study has generated many scientific publications and will be of great value in determining whether prostate cancer screening should be part of general healthcare. [source] Discordant performance of assays for free and total prostate-specific antigen in relation to the early detection of prostate cancerBJU INTERNATIONAL, Issue 6 2001B.G. Blijenberg Objective To assess the value of applying rigid threshold values in interpreting prostate specific antigen (PSA) results, by selecting and comparing five current methods for measuring free and total PSA. Materials and methods Samples taken from an ongoing screening study for prostate cancer (total PSA by Tandem-E assay, 17,334 participants; biopsy criterion a PSA of 3.0 µg/L, 4,464 men) from men with a total PSA of 1.0,6.0 µg/L were measured for free and total PSA using the Access, Immulite, Elecsys and Prostatus analysis kits, in two patient groups, i.e. with prostate cancer or no evidence of disease. Results Both patient groups had equal means for total PSA but not for free PSA. In all, 360 samples from men with cancer and 96 from men with no evidence of disease were analysed. All methods applied to both groups deviated statistically significantly from the Tandem-E result for total PSA, except for the Access kit. There was a close correlation among all the methods (correlation coefficients of 0.89,0.97). There were very discordant results for the combination of the Tandem-E vs Prostatus (8% difference), representing 315 participants at a threshold of 3.0 µg/L. For free PSA (free/total PSA) the situation was worse, with extreme differences of 32% and 36% for both patient groups (Elecsys vs Access). Conclusions Depending on the threshold value applied as an indication for biopsy, when using the total PSA alone or combined with the free/total PSA, care is needed in interpreting patient groups because of the discordance among PSA assays. [source] Incidence and clinical characteristics of symptomatic choroidal metastasis from lung cancerACTA OPHTHALMOLOGICA, Issue 5 2008Klaus-Martin Kreusel Abstract. Purpose:, To determine the clinical characteristics of symptomatic choroidal metastasis (CM) resulting from metastatic lung cancer. Methods:, Twenty-two consecutive patients with symptomatic CM resulting from lung cancer were retrospectively reviewed for ocular findings, medical history and systemic disease. All patients underwent a complete screening for further organ metastasis by computed tomography (CT) and bone scintigraphy. Annual frequency of CM was determined and compared with the incidence predicted from ocular screening studies. Results:, In eight of 22 (36%; 95% confidence interval [CI] 17,59) patients, lung cancer had been diagnosed before occurrence of CM, with a median interval of 13 months. In 14 patients lung cancer was detected after diagnosis of CM, with a median interval of 1 month. Choroidal metastasis was unilateral, solitary and located close to or at the posterior pole in the majority of patients. Further organ metastasis with a median number of three affected organ systems was present in 19 (86%; 95% CI 65,97) patients. Median survival after diagnosis of symptomatic CM was 13 months, by contrast with 2 months in lung cancer patients with CM identified in an ocular screening study. The mean number of patients in Berlin diagnosed with symptomatic CM was 1.4 per year, which was two orders of magnitude less than predicted from screening studies. Conclusions:, Symptomatic choroidal lung cancer metastasis in the majority of patients presents as a solitary tumour before diagnosis of lung cancer in patients with multiple organ systems affected by metastatic disease. Contrary to predictions from ocular screening studies, it is a rare clinical entity. [source] Cardiac troponin-I as a screening tool for myocarditis in children hospitalized for viral infectionACTA PAEDIATRICA, Issue 2 2010M Renko Abstract Aim:, The incidence of myocarditis in children is uncertain because patients with minor symptoms can remain undiagnosed. We hypothesized that screening all children who are hospitalized for an acute infection with troponin-I (TnI) would reveal myocarditis cases and performed a prospective screening study. Methods:, Between October 2005 and July 2008, a blood sample for TnI measurement was taken every time a sample for C-reactive protein measurement was drawn. If TnI value was above the screening limit (0.06 ,g/L), electrocardiogram (ECG) and cardiac ultrasound were performed. TnI measurements were repeated until at normal level. Results:, Altogether, 1009 children were screened during the 33 months. TnI was above the screening limit (0.06 ,g/L) in six children. None of them had any signs of myocarditis in ECG or cardiac ultrasound. Five of those six children were younger than 30 days. All had a respiratory infection as a cause for hospitalization, three of which was caused by RSV. In four children, all younger than 30 days, TnI levels remained high (>0.37 ,g/L) for two months, but decreased after that to normal levels. Conclusion:, The incidence of myocarditis during viral infections is low and a routine TnI screening for asymptomatic myocarditis is not useful. [source] | ||||||||||||||||