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At least 235 records · Page 13Linked to original sources
PubMed2005

The use of a panel of monoclonal antibodies to enrich circulating breast cancer cells facilitates their detection.

OBJECTIVE: Metastatic relapse due to early dissemination of tumor cells is associated with poor prognosis for epithelial cancer. The molecular characterization of these single cells or cell clusters that have evaded the tumor is indispensable in order to evaluate their biological behavior and metastatic potential. In this study, we established a sensitive immunomagnetic method to isolate rare cancer cells from peripheral blood based on their expression of epithelial- or tumor-cell-specific markers. METHODS: Low numbers of cells of breast cancer cell lines - ZR-75-1, MCF-7, HBL-100 - were spiked into peripheral blood specimens of healthy volunteers. Enrichment of tumor cells was performed using either pre-coupled HEA and/or ErbB2 microbeads or a mixture of three monoclonal antibodies against HEA, ErbB2 and EGFR. RESULTS: The recovery rate of spiked tumor cells correlated with the expression of the corresponding antigens. ZR-75-1 cells high expressing all three genes could be isolated to 60-71%. MCF-7 cells, which hardly express EGFR, showed a significant better recovery by using two specific antibodies in combination (50-68%) than one pre-coupled bead alone (31-42%). HBL-100 cells little expressing HEA could not be isolated with HEA microbeads and only to 27% in combination with ErbB2 beads -in contrast the use of an antibody cocktail achieved 38%. CONCLUSION: As tumor and epithelial specific cell marker antigens are expressed differently in disseminated tumor cells, the immunomagnetic enrichment from peripheral blood is most robust and reliable when using a combination of specific antibodies compared to single antibodies.

Adult↗
PubMed1996

Abnormal nuchal findings on screening ultrasonography: aneuploidy stratification on the basis of ultrasonographic anomaly and gestational age at detection.

OBJECTIVE: Our purpose was to determine the specific likelihood of different aneuploidies by gestational age in patients with nuchal folds and simple and septated nuchal membranes. STUDY DESIGN: Retrospective database analysis was performed of 158 consecutive patients with a nuchal fold or simple or septated nuchal membrane on either abdominal or vaginal ultrasonography. RESULTS: Thirty-eight patients with nuchal folds, 65 with simple nuchal membranes, and 55 with septated nuchal membranes were evaluated. Septated nuchal membranes were associated with the highest incidence of karyotypic abnormalities (> 50%). A peak incidence of trisomy 21 (27%) was found in the early midtrimester, leveling off to 11% by the late midtrimester. The late first trimester had a high incidence of trisomy 18 (22%), occurring more frequently than 45,X. CONCLUSION: Ultrasonographic anomalies in the posterior neck are associated with aneuploidy from 21% to 58% of the patients in this selected population. Each anomaly has different risks for aneuploidy type, varying with gestational age at diagnosis.

Aneuploidy↗
PubMed2002

Recurrent aphthous stomatitis and gene polymorphisms for the inflammatory markers TNF-alpha, TNF-beta and the vitamin D receptor: no association detected.

OBJECTIVE: To investigate the possibility that minor recurrent aphthous stomatitis (MiRAS) is associated with the inheritance of specific gene polymorphisms for markers associated with macrophage driven inflammation, i.e. tumor necrosis factor-alpha (TNF-alpha), TNF-beta or the vitamin D receptor (VDR). SETTING: MiRAS is a common, painful, ulcerative condition of the mouth. Its etiology is unknown although mononuclear inflammatory cells are thought to play an important role. There is no clear genetic mode of inheritance, however, many patients report a positive family history and disease concordance is significantly higher in monozygotic than dizygotic twins, suggesting a polygenic mode of inheritance. METHODS: Ninety-five MiRAS patients and an ethnically matched control population were genotyped for TNFA-308, TNFB Ncol and VDR (intron 8 and exon 9) polymorphisms. Chi-square analysis was used to compare the allele frequencies and genotypes of cases and controls. RESULTS: No significant association was identified between inheritance of specific alleles or genotypes of the TNFA-308, TNFB Ncol and VDR (intron 8 and exon 9) polymorphisms and susceptibility to MiRAS. CONCLUSIONS: Inheritance of specific gene polymorphisms for TNF-alpha, TNF-beta or VDR does not appear to be a significant factor in determining susceptibility to MiRAS.

Adult↗
PubMedDate not supplied

Nephrocalcinosis in premature infants: variability in ultrasound detection.

OBJECTIVE: To measure variability among radiologists in the ultrasound diagnosis of nephrocalcinosis in premature infants. METHODOLOGY: In this prospective multicenter study, renal ultrasounds were performed on 54 very low birth weight infants using a 5.0- and 7.5-MHz transducer, and these ultrasounds were read independently by three radiologists. kappa coefficients were calculated to assess variability in identification of nephrocalcinosis among the radiologists. RESULTS: The kappa coefficient (+/- confidence intervals) using a 5.0-MHz transducer was 0.143 (0.108, 0.178); using the 7.5-MHz transducer, the kappa coefficient was 0.268 (0.243, 0.293). All three radiologists agreed in their identification of nephrocalcinosis on 3 of 54 ultrasounds using a 5.0-MHz transducer; a total of 6 of 54 ultrasounds obtained using a 7.5-MHz transducer were read as positive by all three radiologists. CONCLUSION: There is significant variability among radiologists in the ultrasound identification of nephrocalcinosis in premature infants; a 7.5-MHz ultrasound transducer is associated with less variability in recognizing this lesion.

Evaluation Studies as Topic↗
PubMed2002

Wound infections after cardiac surgery--a wound scoring system may improve early detection.

OBJECTIVE: This study was aimed at describing the early development of wound infections after cardiac surgery to identify markers for upcoming infections. DESIGN: We followed a cohort of 200 patients for 3 months after cardiac surgery to establish the incidence of all types of postoperative infections. Wound healing and C-reactive protein (CRP) were followed for the first 2 weeks. RESULTS: A total of 175 patients out of 200 could be followed up. Using a broad definition of wound infection a total of 30% of the patients had some kind of wound infection. The diagnosis of most infections occurred after the patients had left the cardiac surgery unit (median 12 d after surgery). Our wound scoring method shows significant differences at an early stage between infected and non-infected wounds. At the time of diagnoses CRP was elevated in patients with deep sternal infection. CONCLUSION: A long follow-up period is needed to establish the true incidence of infection. Wound scoring can give an early indication of wound infections and CRP can help in the diagnoses of deep infections.

Adult↗
PubMed2006

Medication errors and adverse drug events in an intensive care unit: direct observation approach for detection.

OBJECTIVE: To determine the incidence and preventability of medication errors and potential/actual adverse drug events. To evaluate system failures leading to error occurrence. DESIGN: Prospective, direct observation study. SETTING: Tertiary care academic medical center. PATIENTS: Patients in a medical/surgical intensive care unit. INTERVENTIONS: Observers would intervene only in the event that the medication error would cause substantial patient harm or discomfort. MEASUREMENTS AND MAIN RESULTS: The observers identified 185 incidents during a pilot period and four phases totaling 16.5 days (33 12-hr shifts). Two independent evaluators concluded that 13 of 35 (37%) actual adverse drug events were nonpreventable (i.e., not medication errors). An additional 40 of the remaining 172 medication errors were judged not to be clinically important. Of the 132 medication errors classified as clinically important, 110 (83%) led to potential adverse drug events and 22 (17%) led to actual, preventable adverse drug events. There was one error (i.e., resulting in a potential or actual, preventable adverse drug event) for every five doses of medication administered. The potential adverse drug events mostly occurred in the administration and dispensing stages of the medication use process (34% in each); all of the actual, preventable adverse drug events occurred in the prescribing (77%) and administration (23%) stages. Errors of omission accounted for the majority of potential and actual, preventable adverse drug events (23%), followed by errors due to wrong dose (20%), wrong drug (16%), wrong administration technique (15%), and drug-drug interaction (10%). CONCLUSIONS: Using a direct observation approach, we found a higher incidence of potential and actual, preventable adverse drug events and an increased ratio of potential to actual, preventable adverse drug events compared with studies that used chart reviews and solicited incident reporting. All of the potential adverse drug events and approximately two thirds of the actual adverse drug events were judged to be preventable. There was one preventable error for every five doses of medication administered; most errors were due to dose omission, wrong dose, wrong drug, wrong technique, or interactions.

Academic Medical Centers↗
PubMed1994

The sight test fee: effect on ophthalmology referrals and rate of glaucoma detection.

OBJECTIVE: To assess changes, if any, in the numbers of referrals and outcome of glaucoma referrals to the hospital eye service since the introduction of the sight test fee on 1 April 1989. DESIGN: Review of referral records and clinical notes. SETTING: Referrals to the Bristol Eye Hospital. SUBJECTS: 51,919 patients referred to the Bristol Eye Hospital between 1984 and 1992. 9438 case notes of patients referred between 1987 and 1991 were examined in detail. MAIN OUTCOME MEASURES: Numbers of referrals; rate of adult true positive glaucoma referrals. RESULTS: Referrals to the Bristol Eye Hospital were between 13.7% and 19.0% fewer than expected after the introduction of the sight test fee. True positive glaucoma referrals were reduced by the same proportion. CONCLUSIONS: The numbers of patients being identified as requiring treatment or follow up for potentially blinding glaucoma have declined by nearly one fifth since the introduction of the sight test fee. An increased prevalence of preventable blindness may result.

Adult↗
PubMed2001

Vaginal microflora associated with bacterial vaginosis in nonpregnant women: reliability of sialidase detection.

OBJECTIVE: To determine the prevalence of Gardnerella vaginalis, anaerobic bacteria and Mycoplasma hominis in vaginal specimens of women with and without bacterial vaginosis (BV) as well as to determine the sensitivity and specificity of the direct sialidase assay of vaginal fluid as a rapid test for diagnosing this syndrome. METHODS: Vaginal cultures were obtained from 109 nonpregnant women (mean age 33 +/- 7.1 years), 47 of them with clinical signs of BV (BV+) and 62 of them without BV (BV-). In addition, we determined the vaginal sialidase activity in both groups, which may serve as a feature of this syndrome. RESULTS: Anaerobic bacteria were isolated in 91% and 18% of the BV+ and BV- groups, respectively (p < 0.001). Peptostreptococcus spp., Prevotella bivia and Porphyromonas spp. were strongly associated with BV. P. bivia and Prevotella spp. represented 44% of all the anaerobes isolated in the BV+ group. All the isolated P. bivia strains presented sialidase activity. G. vaginalis and M. hominis were isolated in 76% and 42% of the BV+ and 1% and 0% of the BV- women, respectively (p < 0.001). Mobiluncus morphotypes were observed in 34% of the BV+ and 0% of BV- women. Sensitivity, specificity, positive predictive value and negative predictive value of sialidase activity were 81%, 94%, 90% and 86%, respectively. CONCLUSIONS: Our data demonstrate a strong association between G. vaginalis, M. hominis, and P. bivia and BV. Sialidase activity and Gram stain of vaginal fluid represent accurate methods for diagnosing BV.

Adult↗
PubMed2005

Unexpectedly high prevalence of alcohol use among pregnant Swedish women: failed detection by antenatal care and simple tools that improve detection.

OBJECTIVE: We examined the use of alcohol during early pregnancy in urban Swedish women, the ability of Swedish antenatal care to identify alcohol-related risk pregnancies and the utility of some potential tools for improving its performance. METHOD: Women attending regular antenatal care were randomized to regular assessment only (control, n = 156) or intensified screening (intervention, n = 147). In the intervention group, alcohol use was determined using the Timeline Followback (TLFB) interview, alcohol use habits with the Alcohol Use Disorder Inventory Test (AUDIT), and biomarkers for alcohol use were analyzed. Data were typically obtained in pregnancy week 12. RESULTS: In the intervention group as a whole, average absolute alcohol consumption during the first 6 weeks of pregnancy was low but highly variable (mean [SD] = 24.9 [50.5] g/week; 4.8 [6.0] episodes for the entire 6 week period); 22 women (15%) drank at levels exceeding 70 g/week during any 2 or more weeks and/or in a heavy episodic drinking pattern, 60 g/episode, on 2 or more episodes. The AUDIT had a moderate sensitivity (54%) to identify these subjects. Biomarkers identified subjects with somatic illness rather than high alcohol consumption. In the control group, only 4 (3%) were identified as using alcohol, indicating a probable underestimation of alcohol use by regular antenatal screening procedures (p = .0001). CONCLUSIONS: An unexpected proportion of pregnant women in urban Sweden consume alcohol at levels likely to produce adverse effects. Regular antenatal care did not identify most of these risk pregnancies. The TLFB identified pregnant women with risk use of alcohol during pregnancy who were only partly identified by analyzing prepregnancy alcohol use patterns with the AUDIT. Elevated laboratory markers likely indicated somatic illness rather than harmful drinking.

Adult↗
PubMed2003

[Postoperative hemodynamic parameter follow-up in children with severe pulmonary resistance hypertension due to ventricular septal detect].

OBJECTIVE: To study the relationship between the age at operation and prognosis in children with severe pulmonary hypertension (PH) due to ventricular septal defect (VSD). METHODS: Forty children with severe PH (increased total pulmonary circulation resistance)due to VSD were divided into two groups based on age at operation(Group I aged less than 2 years and group II more than 2 years). The hemodynamic parameter follow-up was measured by cardiac catheterization at presurgery, one week after surgery and 5-7 years postoperatively. RESULTS: The ratio of pulmonary arterial pressure and systemic arterial pressure (pp/ps),pulmonary resistance and systemic resistance (R(p)/R(s)), and pulmonary vascular resistance (PVR) and small pulmonary arterial resistance (PAR) were significantly different in two groups (P<0.01). During follow-up in the group less than 2 years, all the hemodynamic parameters were at normal level, while in the group more than 2 years, only p(p)/p(s) and R(p)/R(s) were close to normal level. The pulmonary arterial resistance was still abnormal. CONCLUSION: An early operation may be the only way to gain optimal long term result of surgery and decrease the incidence of pulmonary vascular disease in children with PH due to VSD.

Adolescent↗
PubMed2000

Gender and tuberculosis: a comparison of prevalence surveys with notification data to explore sex differences in case detection.

OBJECTIVE: To explore whether lower tuberculosis notification rates among women are due to a reduced access to health care, particularly diagnostic services, for women. METHODS: Age- and sex-specific tuberculosis prevalence rates of smear-positive tuberculosis were obtained from tuberculosis prevalence surveys reported to the WHO or published in the literature. Age- and sex-specific notification rates from the same countries in 1996 were used. RESULTS: Prevalence data and notifications from 29 surveys in 14 countries were used. Notification rates varied strongly among countries, but the female/male ratio was below 1 and decreased with increasing age in almost all. The female/male (F/M) prevalence ratios were less than 0.5 in surveys in the South-East Asia and Western Pacific Region, and approximately 1 in the African Region. CONCLUSION: In most countries the F/M sex ratio in prevalent cases was similar or lower than that in notified cases, suggesting that F/M differences in notification rates may be largely due to epidemiological differences and not to differential access to health care. However, available data are limited as the prevalence surveys in Africa were carried out many years ago, and in Asia notification rates may be distorted by a large private sector with deficiencies in notification.

Adolescent↗
PubMed2000

[Incidence of genitourinary infection caused by Chlamydia trachomatis in a STD center calculated by direct antigen detection].

OBJECTIVE: Chlamydia trachomatis is one of the most common sexually transmitted agents which causes a wide spectrum of diseases including urethritis in men and endocervicitis in women. We analyzed patients with genitourinary C. trachomatis infections evaluating risk factors and the association with other sexually transmitted infections. MATERIAL AND METHODS: We processed 1,180 specimens from 913 patients (772 women and 141 men), attended at a Sexually Transmitted Diseases (STD) Center. The diagnostic of C. trachomatis infection was made by an enzyme-linked fluorescent immunoassay, Vidas Chlamydia test (bioMérieux). RESULTS: The incidence of C. trachomatis infection was 4.8% (57 cases) and was higher in women (70.1%) than in men (29.8%). The risk groups observed were: 26 prostitute, 7 contact with prostitute or risk partner, 5 homosexual, 5 promiscuous heterosexual and 14 without risk groups. Associated with this infection we observed other: 10 bacterial vaginosis, 8 Papillomavirus infection, 3 Trichomonas vaginalis infections, 2 Neisseria gonorrhoeae infections and 2 Candidiasis. The 53.4% of these patients didn't have any symptomatology at the consult moment. CONCLUSIONS: The control of patients with risk factors is important for the diagnostic of C. trachomatis and other sexually transmitted infections, because most of them were prostitutes and asymptomatic. Within men, homosexuality, contact with prostitute or risk partner were the practices with higher risk.

Antigens, Bacterial↗
PubMed2001

Characteristics of spongiform leukoencephalopathy induced by heroin: MRI detection.

OBJECTIVE: To elucidate the imaging characteristics of spongiform leukoencephalopathy induced by heroin and the diagnostic value of MRI examination. METHODS: Eleven cases of heroin addiction were examined by MRI. The sequences included T1-weighted imaging (T1WI), T2-weighted imaging (T2WI) and fast fluid-attenuated inversion recovery pulse sequence (Flair). RESULTS: Bilateral symmetrical lesions were located in the white matter of the cerebrum and cerebellum, the internal capsule in all cases, and the callosum in 6 cases. Elliptical lesions in the mesencephalon were found in two cases. These lesions were shown as hypointense signals on T1WI and hyperintense signals on T2WI and Flair's imaging. Cerebellar white matter suffered more severely, but the dentate nuclei were not invaded. CONCLUSION: Heroin-induced spongiform leukoencephalopathy has characteristic patterns in MRI, which are very specific to this form of the disease.

Adult↗
PubMed2001

[Determination of shikimic acid in fruit of Illiciaceae plants by HPLC with diode-array detection].

OBJECTIVE: To establish the determination method of Shikimic acid. METHOD: Using HPLC method as the determination method. The separation was performed in a SiO2-NH2 column with a mobile phase of Acetonitrile-2% H3PO4 water solution (95:5); The sample wavelength was 213 nm, reference wavelength 300 nm. RESULT: The average collection was 98.5%, RSD 1.67% (n = 5). CONCLUSION: This method is suitable for the determination of Shkimic acid in herb medicines and preparation containing shikimic acid.

Chromatography, High Pressure Liquid↗
PubMed2004

[Invasive prenatal diagnosis in the Netherlands, 1991-2000: number of procedures, indications and abnormal results detected].

OBJECTIVE: To provide an overview of invasive prenatal diagnosis in the Netherlands during the period 1991-2000 and to analyse potential trends. DESIGN: Retrospective. METHOD: The annual results from all 13 Dutch centres for invasive prenatal diagnosis over the period 1991-2000 were combined and described, with particular emphasis on indications, number and type of invasive procedures, and number and type of abnormal results. RESULTS: The percentage of pregnancies in which invasive prenatal diagnostics were carried out increased from 5% in 1991 to 6% in 1996 and remained at the same level until 2000. 'Maternal age' was the main reason for prenatal testing (69.2-73.3% of procedures). However, the number of pregnant women aged 36 or over increased by 69.9%. An abnormal result was found in an average of 4.7% of procedures, rising from 3.6% in 1991 to 5.4% in 2000. In 70.8% of cases with abnormal results, the pregnancy was terminated. Important trends were the relative decrease of cordocentesis (-82%) and chorionic villi biopsy (-18%) in favour of amniocentesis (+48%), and a strong decrease in the number of amniocentesis procedures on indication of increased risk of neural tube defect. CONCLUSION: The total number of invasive prenatal diagnostic procedures remained stable. However, there was an important decrease in the percentage of pregnant women aged 36 or over who underwent invasive prenatal diagnosis without previous prenatal screening.

Adult↗
PubMedDate not supplied

Cancer in Asian American males: epidemiology, causes, prevention, and early detection.

OBJECTIVES: The objective of this paper is to discuss the epidemiology, etiology, and cultural phenomena that characterize cancers specific to Asian American males. METHODS: The author reviewed various published literature concerning the health of Asian American males. RESULTS: Data show an epidemiological dichotomy in cancer incidences between Asian American males and the general U.S. male population. First, lung and colorectal cancers are among the top three cancers for most Asian groups, similar to the situation in the White population. Second, prostate cancer is the leading, or second leading, cause of cancer for Chinese, Japanese, and Filipino males -- all groups considered, in U.S. terms, to be more established in their migration patterns. Third, liver and stomach cancer are in the top five cancers for most Asian groups, an incidence not shared by the White population. CONCLUSIONS: The most common cancers in Asian American males involve the interplay of host genetic and environmental factors, and both primary and secondary prevention strategies are necessary to decrease the morbidity and mortality rates of this uniquely diverse population.

Asian↗
PubMedDate not supplied

Cervical cancer among young Vietnamese American women: incidence, risk factors, and early detection.

OBJECTIVES: This paper has three objectives: 1) to review the problem of cervical cancer in Vietnamese American women; 2) to identify the gaps in the published literature regarding this problem in young Vietnamese American women; and 3) to gain a better understanding of their health behavior in order to address an important health concern for this population in the future. METHODS: Published literature about the health status of Vietnamese American women was reviewed. RESULTS: Little has been published about the health of Young Vietnamese American women (are 18-30), the age group at highest risk for Hepatitis B infection. Also, it is unclear why they do not have regular Pap screenings. CONCLUSIONS: A greater understanding of this population's high-risk behaviors, such as sexual and smoking behaviors, must be reached. More research is needed on the impact of acculturation and their knowledge and understanding of screening. Educational approaches targeting risky behaviors and the need for screening must be developed. Implementation of effective health education and disease prevention strategies are needed.

Asian↗
PubMed2005

A multi-resolution approach for content-based image retrieval on the Grid--application to breast cancer detection.

OBJECTIVES: Hospitals and medical centers are producing more and more data that need to be processed. Those data are confidential, heterogeneous, and limited to the geographic site where they have been produced. Unless properly anonymized, they cannot be distributed on wide area networks. METHODS: Grid technologies allow the globalization of storage and processing resources, and enable large-scale experimentations on distributed data. They constitute a promising tool to treat the different data and analyze the knowledge they contain, while offering secured access and high-performance computing capacities to the different users. Our aim is to evaluate the possibilities of grid technologies for handling medical data. RESULTS AND CONCLUSIONS: In this paper, we focus on a breast cancer diagnosis assistance tool, based on distributed and incremental knowledge construction and a content-based image retrieval system. We analyze the different scenarios of uses of such a tool. We further propose an algorithm that indexes mammographic images for content-based query purposes. This algorithm is tested on images of different resolutions in order to reduce the indexation time and we analyze its performance with experiments on the grid.

Algorithms↗