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PubMed2000

Early detection and assertive community treatment of young psychotics: the Opus Study Rationale and design of the trial.

BACKGROUND: Recent research indicates that early detection of young persons suffering from psychosis and subsequent intensive intervention enhances treatment response and prognosis, but the data are only preliminary and suggestive. METHOD: We present the rationale and design of the largest study to date to evaluate two major issues in the field of secondary prevention: (1) Does education and intensified collaboration with general practice, social services etc. reduce the duration of untreated psychosis? and (2) Can modified assertive community treatment improve the course and outcome in young persons suffering from psychosis as compared to treatment in community mental health centres? The article aims additionally to put the study in context and assist in designing future studies. RESULTS: Preliminary experiences are described. The findings of the first 312 patients show that modified assertive community treatment results in patients adhering to treatment significantly better than standard treatment in community mental health centres. CONCLUSION: The surge of interest in preventively oriented detection and treatment models for untreated psychosis in young people calls for research programmes and evidence. The obstacles to this are manifold. The initial findings of the OPUS study suggest, however, that better adherence to treatment is possible.

Adolescent↗
PubMed2003

Are community surveys to detect tuberculosis in high prevalence areas useful? Results of a comparative study from Tiruvallur District, South India.

BACKGROUND: In Tiruvallur District, South India, tuberculosis cases are detected at health facilities (HF) as part of a DOTS programme, and by screening adults through community survey (CS) as part of ongoing epidemiological research. OBJECTIVE: To compare socio-demographic, clinical and bacteriological characteristics and treatment outcomes of all patients detected at HF with those of all patients detected by CS during a 12-month period. RESULTS: Of 32,663 adults surveyed, 100 had smear-positive and 116 had smear-negative tuberculosis; of 65 smear-positive patients who began treatment, 44 were cured. Compared to HF patients, CS patients were significantly more likely to be older (AOR = 1.9), male (AOR = 2.7), non-literate (AOR = 1.7), and living in poor quality housing (AOR = 2.0), and were less likely to have cough >3 weeks (AOR = 3.4) or smear-positive tuberculosis (AOR = 4.2). Of 61 new smear-positive CS patients, 40 reported chest symptoms; of these, 32 (80%) had already consulted a health-care provider, but remained undiagnosed. CONCLUSIONS: The community survey was of little value in tuberculosis case detection even in this high-prevalence setting. Patients identified by the survey were less symptomatic and less infectious, and less than half were cured. Diagnostic services should be made more accessible to the elderly, the non-literate and men.

Adult↗
PubMed2006

Survival rates for breast cancers detected in a community service screening mammogram program.

BACKGROUND: This single-institution long-term prospective study was performed in the setting of community service screening mammography to evaluate the association between the methods of breast cancer detection and survival rates. METHODS: From 1994 through 2001, data on 1237 patients with breast cancer were collected concurrent with definitive surgical treatment and entered into a comprehensive database. RESULTS: Mammography was the sole method of detection for 517 (44%) of 1179 Tis-T2 breast cancers. Fifty-seven percent of invasive cancers detectable by mammography alone were less than 1 cm in diameter. For 1049 patients with invasive cancers, the 5-year overall observed survival rates were 94% for 372 whose cancers were detectable by mammogram alone and 87% for 677 whose cancers were detectable by palpation (alone or in combination with mammography) (P = .0002). CONCLUSIONS: Most of the contribution to breast cancer mortality reduction is from the detection of small nonpalpable cancers, not from adjuvant therapy.

Breast Neoplasms↗
PubMed1995

[Diagnostic efficiency of histological and simple microbiological tests for Helicobacter pylori detection in a community hospital].

The objective of this study was to compare histology and microbiology (direct method, urease test, culture) for the detection of Helicobacter pylori in antral biopsies. Thirty-six patients, aged between 18 and 82, with a peptic ulcer (active or not), or gastritis or duodenitis were studied. Eighteen patients (50%) had a positive culture, 17 (47%) had a positive urease test, 16 (41%) had positive direct microbiology and 15 (42%) had positive histology. Correlation between histology and culture was 84%. This study confirms the good sensitivity of histology and the urease test for the detection of Helicobacter pylori. Combination of both methods could optimise detection of the organism.

Adolescent↗
PubMedDate not supplied

Community participation in case detection of leprosy in Nagpur district of Maharashtra.

Involving special community groups for new case detection is of great importance for achieving the target of elimination of leprosy. During 1998-99, thirty village level Mahila mandals (women's groups), 6950 teachers and students and 34,548 heads of families were co-opted to participate in case detection. They examined 56,113 persons including 378,959 school students and 184,940 family members. Of the examined population, 275 were suspected to be cases of leprosy by mahila mandals, 411 by teachers and students and 747 by heads of families. Subsequent examination of the suspected cases by trained medical officers and paramedical workers confirmed 203 of them to be cases of leprosy. This exercise showed that when proper attempts were made to involve the community, case detection activity became easier, besides helping to disseminate knowledge about leprosy in the community.

Adolescent↗
PubMed2005

Stable isotope probing analysis of the influence of liming on root exudate utilization by soil microorganisms.

Rhizosphere microorganisms play an important role in soil carbon flow, through turnover of root exudates, but there is little information on which organisms are actively involved or on the influence of environmental conditions on active communities. In this study, a 13CO2 pulse labelling field experiment was performed in an upland grassland soil, followed by RNA-stable isotope probing (SIP) analysis, to determine the effect of liming on the structure of the rhizosphere microbial community metabolizing root exudates. The lower limit of detection for SIP was determined in soil samples inoculated with a range of concentrations of 13C-labelled Pseudomonas fluorescens and was found to lie between 10(5) and 10(6) cells per gram of soil. The technique was capable of detecting microbial communities actively assimilating root exudates derived from recent photo-assimilate in the field. Denaturing gradient gel electrophoresis (DGGE) profiles of bacteria, archaea and fungi derived from fractions obtained from caesium trifluoroacetate (CsTFA) density gradient ultracentrifugation indicated that active communities in limed soils were more complex than those in unlimed soils and were more active in utilization of recently exuded 13C compounds. In limed soils, the majority of the community detected by standard RNA-DGGE analysis appeared to be utilizing root exudates. In unlimed soils, DGGE profiles from 12C and 13C RNA fractions differed, suggesting that a proportion of the active community was utilizing other sources of organic carbon. These differences may reflect differences in the amount of root exudation under the different conditions.

Bacteria↗
PubMed1987

The prevalence of diabetes mellitus and an assessment of methods of detection among a community of elderly Chinese in Hong Kong.

This study provides information on the prevalence of diabetes mellitus in a group of elderly Chinese subjects aged 60 and above living in the community in Hong Kong, and investigates the sensitivity of the urine sugar, random blood glucose, glycosylated haemoglobin, and fructosamine measurements compared to a glucose tolerance test in screening for diabetes mellitus in this population. Four hundred twenty-seven subjects aged 60 and above were studied. The National Diabetes Data Group Criteria were used for the diagnosis of diabetes. Those with a random blood glucose exceeding 12.5 mmol/l were considered diabetic, and all of these patients had glycosuria together with elevated total glycosylated haemoglobin and fructosamine concentrations. A diagnostic 75 g oral glucose tolerance test was performed on patients with one or more of the following abnormalities: glycosuria, random plasma blood glucose 7.8 mmol/l to 12.5 mmol/l, glycosylated haemoglobin 8.5%, and fructosamine 2.20 mmol/l. By these criteria, the prevalence of diabetes in this community was found to be 9.8%. An elevated random glucose greater than 11.1 mmol/l proved to be the only specific method of screening and glycosuria was found to be at least as good as fructosamine and HbA1. However, HbA1 is more sensitive than random glucose, glycosuria or fructosamine in detecting impaired glucose tolerance. On the basis of this study, a higher reference range for glycosylated haemoglobin for the elderly alone is also suggested (5.74-9.34%).

Aged↗
PubMed1979

Recent status of detection, treatment, and control of hypertension in the community.

The Hypertension Detection and Follow-up Program (HDFP), a national collaborative study, screened approximately 159,000 people for high blood pressure in 14 communities between 1973 and 1974. Results show that detection, treatment, and control of high blood pressure has improved considerably since the 1960s. Whereas in the past about half of all hypertensives knew they had high blood pressure, half of those detected were under treatment, and half of those under treatment had their high blood pressure under control, the corresponding percentages in the 14 HDFP communities a decade later indicate that 75% of hypertensives were detected, 72% of those were under treatment, and 70% of those under treatment had a diastolic blood pressure under 95 mm Hg. While the differences in prevalence of hypertension are between races rather than sexes (with black individuals in some age groups being about twice as likely as white individuals to have hypertension), the differences in detection and treatment rate are largely between sexes and not between races. Women are considerable more likely to be aware of their hypertension, to be under treatment for it, and to have their high blood pressure under control. Rates of control vary considerably among age-sex-race subgroups, from only 8% of white male hypertensives aged 30-39 to 67% of white female hypertensives aged 60--69. It appears that although efforts to combat this disease over the past decade have probably made considerable progress in improving the recognition and treatment of high blood pressure, there remain a large number of undetected, untreated, and uncontrolled hypertensives.

Adult↗
PubMed1989

Cancer detection and the community pharmacist.

A questionnaire was prepared to asses community pharmacists' perceptions of their abilities to recognize the common signs and symptoms of cancer and their preferred methods for obtaining further education. Of 5,539 questionnaires mailed, 1,187 were returned and analyzed. Seventy percent of the pharmacists reported that at least one patient per month sought advice about possible cancer signs and symptoms. Almost half estimated that between 1% and 25% of the patients who had sought advice for these cancer signs and symptoms had attempted to purchase a medication to treat these symptoms. The vast majority of the pharmacists perceived that they could recognize common signs and symptoms of skin, breast, and colorectal cancers. However, the majority felt they could not identify the symptomatology for six other common cancers. Essentially all pharmacists rated education in cancer symptomatology to be important. There was no consensus as to the type of provider, format, or times for this continuing education. These data suggest that pharmacists can play an important role in the early detection and prevention of cancer. The rate of interaction by pharmacists in this study translates to more than 60,000 patients counseled about cancer symptoms per 1,000 pharmacists per year. Further education of the pharmacist in cancer detection is warranted, and appraisal of the outcome of such educational interventions on patient-referral patterns and cancer-related diagnoses is imperative.

California↗
PubMed1993

Prevalence of hepatitis C viral infection in a community in Taiwan. Detection by synthetic peptide-based assay and polymerase chain reaction.

The prevalence of antibodies to hepatitis C virus (anti-HCV) in a hepatitis B virus hyperendemic region was evaluated with a second-generation enzyme immunoassay. A general population of 1500 from Northern Taiwan was tested with this immunoassay which includes synthetic peptides from the capsid and non-structural protein region as the solid-phase antigen. A total of 37 subjects out of 1500 (2.5%) were positive, with no significant difference in distribution between hepatitis B antigenemic and non-antigenemic samples. The prevalence of anti-HCV was higher in subjects with abnormal than those with normal liver function tests (8.2% vs. 1.5%). Prevalence increased with age. By polymerase chain reaction, 43% of anti-HCV-positive samples were HCV-RNA-positive. However, only 1 (0.6%) of 150 anti-HCV-negative subjects had HCV-RNA. Comparison of the results with those from a conventional recombinant C100-3-based assay showed that the capsid/non-structural region synthetic antigen system provided more accurate sensitivity and specificity. The more sensitive assay revealed a high prevalence for HCV infection of 2.5% among this general population in Taiwan.

Adult↗
PubMed2006

Fluorescent in situ hybridization (FISH) for the detection of bacterial community in activated sludge from textile factories.

Conventional methods used to study the bacterial community structure in activated sludge are not sufficient enough to determine the compositions of the bacterial populations responsible for biodegradation. Activated sludge samples from 3 textile factories were analyzed by fluorescent in situ hybridization (FISH) using rRNA probes and by phase-contrast microscopy. In Factory-I, the predominant groups were the beta-subclass of Proteobacteria and the cytophaga-flavobacterium (CF) cluster (33.3% and 31.0%) followed by gamma-subclass (17.1%), high G+C DNA (HGC) gram-positive (15.4%) and alpha-subclass (3.2%). Factory-II showed a similar pattern (32.7%, 31.8%, 17.5%, 16.4%, 1.6%) but with lower concentrations, while Factory-III showed predominant alpha- and beta-subclasses (25.2%, 25.0%) and CF cluster (24.8%) followed by the gamma-subclass (13.6%) and the HGC (11.4%) at much lower concentrations. The floc characteristic for factory-I and -II was normal, however factory-III had diffuse and atypical flocs. In conclusion, the FISH technique provided comprehensive information on the bacterial consortia of activated sludge samples. The compositions of the bacterial community and their concentrations together with the floc characteristics might be some of the reasons that affect the operational efficiencies among the 3 textile factories.

Animals↗