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Results for “Mandatory Testing”

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At least 415 records · Page 23Linked to original sources
PubMed2003

Feasibility of spinal cord stimulation in angina pectoris in patients with chronic pacemaker treatment for cardiac arrhythmias.

Spinal cord stimulation (SCS) has been used since 1985 as additional symptom-relieving treatment for patients with severe angina pectoris despite optimal conventional medical and invasive treatment. SCS has antiischemic effects and is safe and effective in long-term use. Several patients with coronary artery disease also suffer from disorders that necessitate the use of a cardiac permanent pacemaker (PPM). The combination of SCS and PPM has previously been considered hazardous because of possible false inhibition of the PPM. To assess if thoracic SCS and PPM can be safely combined in patients with refractory angina pectoris, 18 patients treated with both SCS and PPM were tested. The PPM settings were temporarily modified to increase the probability of interference, while the SCS intensity (used in bipolar mode) was increased to the maximum level tolerated by the patient. Any sign of inhibition of the ventricular pacing was recorded by continuous ECG monitoring. With the aid of a questionnaire, symptoms of interference during long-term treatment were evaluated. No patient had signs of inhibition during the tests. Reprogramming of the pacemaker because of the test results was not needed in any of the patients. The long-term follow-up data revealed no serious events. This study indicates that bipolar SCS and PPM can be safely combined in patients with refractory angina pectoris. However, individual testing is mandatory to ascertain safety in each patient. A testing procedure for patients in need of SCS and PPM is suggested in this article.

Aged↗
PubMedDate not supplied

Diagnosis of recurrent deep vein thrombosis.

After a first episode of deep vein thrombosis (DVT), 30-50% of the patients will develop complaints suspect of recurrent DVT. Of these patients, only 20-30% do indeed have a recurrent episode of DVT. To identify patients with a true recurrent DVT, objective testing is mandatory in every patients. However, all the available tests have their limitations in patients with recurrent DVT. In this review, diagnostic strategies using venography, impedance plethysmography, 125I-fibrinogen leg scanning and ultrasonography in patients with recurrent DVT will be discussed. Furthermore, some epidemiologic data and pathophysiologic mechanisms concerning DVT will be considered.

Humans↗
PubMed2006

Newborn screening: complexities in universal genetic testing.

Newborn screening (NBS)--in which each newborn infant is screened for up to 50 specific metabolic disorders for early detection and intervention--is the first program of populationwide genetic testing. As a public health intervention, NBS has greatly improved the lives of thousands of affected children. New technologies and new economic and social forces pose significant ethical and clinical challenges to NBS. Two primary challenges concern (1) accommodating clinical and ethical standards to rapid technological developments in NBS and (2) preparing public health systems to respond to the medical advances and social forces driving expansion of NBS programs. We describe and analyze these challenges through consideration of 3 disorders: phenylketonuria, medium-chain acyl-CoA dehydrogenase deficiency, and cystic fibrosis.

Acyl-CoA Dehydrogenase↗
PubMed2005

Shift in the reasons why adults seek HIV testing in the United States: policy implications.

HIV testing is an important step in the continuum of HIV care. It provides the opportunity to counsel people who seek testing and links those who test positive to health services. To determine the number of adults who had ever been tested for HIV, compare the reasons they sought testing, and evaluate the policy implications of their decision, data from the 1998 and 2002 National Health Interview Surveys were analyzed. Of 31,138 adults interviewed in 1998, 9728 (31.2%) reported they had been tested for HIV, whereas 10,760 (34.7%) of the 31,044 adults interviewed in 2002 had been tested for HIV. Persons who were interviewed in 1998 and 2002 were similar with regard to sociodemographic characteristics (age, gender, ethnicity, education, and region of origin). The reasons for seeking HIV testing changed between 1998 and 2002. The proportion of adults who were tested for HIV "to find out if infected or not" declined significantly, from 33.9% in 1998 to 11.8% in 2002 (P < .05); the proportion of those who were tested because the HIV test was "part of a routine medical checkup or surgical procedure" increased from 11.4% to 24.6% (P < .05). During the same period, the proportion of adults who ever were tested for HIV because the test was required for health/life insurance, immigration, or military induction decreased slightly, from 14.9% to 14.4%. The increase in testing overall may be explained, in part, by the growing acceptance of routine HIV testing among adults in the United States. While mandatory HIV testing remains controversial, it accounted for 13% to 15% of adults who became aware of their HIV serostatus in 1998 and 2002. This contribution raises questions about its merit in the fight against HIV infection.

Adult↗
PubMed2003

Drug testing athletes to prevent substance abuse: background and pilot study results of the SATURN (Student Athlete Testing Using Random Notification) study.

PURPOSE: To assess the deterrent effect of mandatory, random drug testing among high school (HS) athletes in a controlled setting. METHODS: Two high schools, one with mandatory drug testing (DT) consent before sports participation, and a control school (C), without DT, were assessed during the 1999-2000 school year. Athletes (A) and nonathletes (NA) in each school completed confidential (A) or anonymous (NA) questionnaires developed for this study, respectively, at the beginning and end of the school year. Positive alcohol or drug tests required parent notification and mandatory counseling without team or school suspension. Thirty percent of the DT athletes were tested. Data were analyzed using the end of the school year measure, adjusted for the initial questionnaire results. Demographics of the athlete sample revealed that mean age was 15.5 years with 81.5% white, 9.6% Hispanic, 4.5% Asian, 2.6% American Indian/Native Alaskan, 1.3% African-American, and 1.3% Native Hawaiian/Pacific Islander. RESULTS: A (n = 276) and NA (n = 507) were assessed at the beginning (baseline) and at the end of the school year (A, n = 159; NA, n = 338). The past 30-day index of illicit drugs (4-fold difference) and athletic enhancing substances (3-fold difference) were lower (p < .05) among DT athletes at follow-up without difference in alcohol use. However, most drug use risk factors, including norms of use, belief in lower risk of drugs, and poorer attitudes toward the school, increased among DT athletes (p < .05). Although a reduction in the illicit drug use index was present among nonathletes at the DT school, at the end of the school year, it did not achieve statistical significance (p < .10). CONCLUSIONS: Random DT may have reduced substance use among athletes. However, worsening of risk factors and small sample size suggests caution to this drug prevention approach. A larger long-term study to confirm these findings is necessary.

Adolescent↗
PubMed2007

Mandatory pre-marital HIV testing in Nigeria: the public health and social implications.

The prevalence of HIV infection among individuals referred from faith-based organizations (FBOs) in south-eastern Nigeria for mandatory pre-marital HIV screening was determined. Of the total of 319 individuals (148 males, 171 females) screened, 25 (7.8%, 95%CI: 4.9-10.7%) were confirmed HIV-positive, comprising 13 (8.8%, 95%CI: 4.2-13.4%) males and 12 (7%, 95%CI: 3.2-10.8%) females. No significant difference was observed in the association between HIV infection and gender (chi2=0.58, df = 1, P < 0.05). The highest prevalence of HIV infection (8.9%) was recorded among individuals in the 21-30 years age category, while the least HIV infection prevalence (5.3%) was observed among persons above 40 years old. There was no significant difference in the association between HIV infection and age (chi2=0.68, df = 3, P < 0.05). Mandatory pre-marital HIV screening could generate social stigmatization and infringement of the fundamental human rights of infected individuals. Voluntary counselling and confidential HIV testing and especially pre- and post-test counselling as the basis of pre-marital HIV testing are more desirable. Guidelines for the management of test-positive individuals and non-concordant couples and the safeguarding of confidentiality should be developed. Training and capacity building for religious leaders, to appropriately manage social issues associated with HIV/AIDS as it affects their organizations, are recommended.

Adolescent↗