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Screening Visit (screening + visit)
Selected AbstractsAlcohol Drinking Patterns and Health Care Utilization in a Managed Care OrganizationHEALTH SERVICES RESEARCH, Issue 3 2004Gary A. Zarkin Objective. To estimate the relationship between current drinking patterns and health care utilization over the previous two years in a managed care organization (MCO) among individuals who were screened for their alcohol use. Study Design. Three primary care clinics at a large western MCO administered a short health and lifestyle questionnaire to all adult patients on their first visit to the clinic from March 1998 through December 1998. Patients who exceeded the National Institute on Alcohol Abuse and Alcoholism (NIAAA) guidelines for moderate drinking were given a more comprehensive alcohol screening using a modified version of the Alcohol Use Disorders Identification Test (AUDIT). Health care encounter data for two years preceding the screening visit were linked to the remaining individuals who responded to one or both instruments. Using both quantity,frequency and AUDIT-based drinking pattern variables, we estimated negative binomial models of the relationship between drinking patterns and days of health care use, controlling for demographic characteristics and other variables. Principal Findings. For both the quantity,frequency and AUDIT-based drinking pattern variables, current alcohol use is generally associated with less health care utilization relative to abstainers. This relationship holds even for heavier drinkers, although the differences are not always statistically significant. With some exceptions, the overall trend is that more extensive drinking patterns are associated with lower health care use. Conclusions. Based on our sample, we find little evidence that alcohol use is associated with increased health care utilization. On the contrary, we find that alcohol use is generally associated with decreased health care utilization regardless of drinking pattern. [source] Testing the efficacy of plaque removal of a prototype brush head for a powered toothbrushJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 8 2000G. I. McCracken Abstract Background/aims: The principal aim of the study was to compare the efficacy of a powered toothbrush (PTB) prototype (B) brush head in removing dental plaque to the relative efficacy of a marketed model (A). Method: A 12-week, 2-group, 2-treatment, double-blind trial of 2, two-brush heads (with the same power unit) recruited 62 volunteers (18,25 years) who were non-clinical university students. After a screening visit, 31 subjects were allocated to each of groups A and B at baseline with stratification according to gender and plaque index. After 48 h of plaque growth, subjects underwent a timed and supervised brushing episode with the allocated PTB (visit 1). Subjects then used the PTBs at home for 12 days before being recalled (visit 2) and asked again to abstain from all oral hygiene measures for 48 h. Supervised brushing was repeated (visit 3) before the subjects were dismissed for a further 10-week, unsupervised period of home use of the PTBs. The sequence of visits (2 and 3) was then repeated at visits 4 and 5. Results: The sole outcome variable was plaque which was scored at all visits using the modified Quigley & Hein Index (PI) at full mouth (FM), interproximal (IP) and smooth surfaces (S). At visits 1, 3 and 5, the PI was recorded both before and after supervised brushing. There were no significant differences in PI between the brushing groups at baseline, visit 1, visit 2 or visit 5 (2 sided t -test). At visit 3, the prototype achieved significantly lower PIs than the marketed PTB brush head for IP (and FM) surfaces, this difference was most apparent on posterior tooth surfaces. For within -group changes, PIs at visit 2 were significantly lower than those at baseline (paired t -test), an observation which may be attributable to the improved cleaning and ,novelty effect' of a PTB. The PIs at visit 5 were significantly higher than the baseline values (paired t test) and this may be accountable to an element of Hawthorne effect and/or, a fall off in compliance over the entire 12 weeks. Conclusion: We conclude that this in vivo model is appropriate for testing the efficacy of PTB prototypes but only over a 2-week period, as the inter-group differences were not maintained over the full 12 weeks of the trial. [source] Quality of Life and Cost for Patients with Premature Ventricular Contractions by Radiofrequency Catheter AblationPACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 4 2006CONG-XIN HUANG Objective: To evaluate the quality of life (QoL), health-care resource utilization, and cost for the patients with premature ventricular contractions (PVCs) by radiofrequency catheter ablation (RFCA). Methods: RFCA was performed in 58 patients with symptomatic PVCs that were refractory/easy to medication. A 24-hour ambulatory electrocardiographic monitoring, QoL, health-care resources utilization, and cost were assessed at a screening visit and 3 and 12 months after RFCA. Results: RFCA was successfully performed in 56 patients (96.6%). This resulted in a significant improvement in the QoL at 3 and 12 months after the procedure. There were no major complications related to the procedure. Nine patients (15.5%) had residual arrhythmia. Seven of them underwent repeated ablation with successful results. It also improved the QoL and reduced health-care resource utilization and cost. Conclusions: RFCA is a safe and effective treatment for PVCs, and it is a viable alternative to drugs in the presence of disabling symptoms. [source] T-Wave Variability Detects Abnormalities in Ventricular Repolarization: A Prospective Study Comparing Healthy Persons and Olympic AthletesANNALS OF NONINVASIVE ELECTROCARDIOLOGY, Issue 3 2009Lara Heinz M.D. Background: Sudden cardiac death in athletes is more common than in the general population. Routine screening procedures are performed to identify competitors at risk. A new Holter-based parameter analyzes variation of the ventricular repolarization (TVar). The aim of this study was to evaluate differences in electrocardiogram (ECG), Echo, and Holter (H) in competitive athletes compared to a healthy control group consisting of medical students (MS). Methods: A total of 40 athletes (19 females, Olympic team, Luxembourg) and 40 MS (22 females) were examined by means of a resting ECG, treadmill exercise (TE), echocardiogram (Echo), as well as H recordings during a routine screening visit. To analyze TVar, a 20-minute H recording at rest (sampling rate 1000 per second) was performed. Moreover, heart rate variability (HRV) as well as HR turbulence (HRT) was computed. Results: No differences in demographic variables were detected. Quantification of HRV detected a significant increase in the vagal component of autonomic cardiac modulation. In contrast, no differences for HRT were found. Echo parameter demonstrated a thicker septal wall without differences of the posterior wall. TVar values were normal in range, but did differ significantly between the two groups. No correlation between TVar and echo as well as Holter parameters was detected. Conclusions: TVar was able to demonstrate significant differences in terms of alterations of ventricular activation. This might indicate an early change of myocardial repolarization representing a substrate for life-threatening arrhythmia. Larger studies on the predictive value of TVar including follow-up are necessary to confirm this preliminary finding. [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] 2326: Influence of change in body position on choroidal blood flow in patients with obstructive sleep apnea syndromeACTA OPHTHALMOLOGICA, Issue 2010A ALMANJOUMI Purpose Obstructive sleep apnea syndrome (OSA) has been reported to be associated with ischemic and glaucomatous optic neuropathy (especially normal tension glaucoma). OSA per se is able to generate hypertension, atherosclerosis and autonomic dysfunction, all conditions possibly interacting with ocular vascular regulation. The aim of our study was to characterize the choroidal vascular reactivity to change in body position in OSA patients, as compared with matched healthy control subjects. Methods Eighteen newly diagnosed OSA patients were included in this prospective study. Control subjects were matched with OSA patients for body mass index (BMI), gender and age. At the screening visit, each subject underwent a general exam, cardiovascular, neurologic and ophthalmological examinations, and overnight polysomnography. The LDF instrument used in this study to measure subfoveal choroidal blood flow (ChBF), ChBVel , velocity (kHz); and volume, ChBVol (in arbitrary units, AU) Vascular choroidal reactivity was tested during the change in body position from the sitting to the supine position (10 min). Results OSA patients exhibited a similar choroidal reactivity during change in body position than controls with increased ChBVel (+15%), decreased ChBVol (-11.6%), and unchanged ChBF. IOP increased by 14.2% in the supine position whereas ocular perfusion pressure remained stable. Conclusion This prospective comparative study showed for the first time unimpaired choroidal vascular reactivity in otherwise healthy OSA patients. This suggests OSA patients, without comorbidities, has long-term adaptive mechanisms active in ocular microcirculation. [source] The transient value of classifying preschool wheeze into episodic viral wheeze and multiple trigger wheezeACTA PAEDIATRICA, Issue 1 2010A Schultz Abstract Background:, A recently proposed method for classifying preschool wheeze is to describe it as either episodic (viral) wheeze or multiple trigger wheeze. In research studies, phenotype is generally determined by retrospective questionnaire. Aim:, To determine whether recently proposed phenotypes of preschool wheeze are stable over time. Methods:, In all, 132 two to six-year-old children with doctor diagnosed asthma on maintenance inhaled corticosteroids were classified as having episodic (viral) wheeze or multiple trigger wheeze at a screening visit and then followed up at three-monthly intervals for a year. At each follow-up visit, standardized questionnaires were used to determine whether the subjects wheezed only with, or also in the absence of colds. Stability of the phenotypes was assessed at the end of the study. Results:, Phenotype as determined by retrospective parental report at the start of the study was not predictive of phenotype during the study year. Phenotypic classification remained the same in 45.9% of children and altered in 54.1% of children. Conclusion:, When children with preschool wheeze are classified into episodic (viral) wheeze or multiple trigger wheeze based on retrospective questionnaire, the classification is likely to change significantly within a 1-year period. [source] | ||||||||||