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At least 91 records · Page 5Linked to original sources
PubMed2003

Early detection of orthostatic hypotension by quantitative sudomotor axon reflex test (QSART) in type 2 diabetic patients.

OBJECTIVE: Orthostatic hypotension is caused by autonomic nerve dysfunction, mainly by severe sympathetic nerve dysfunction in diabetic patients. Diabetes affects the peripheral nerves in a length-dependent manner. Quantitative sudomotor axon reflex test (QSART) is one of the sensitive tests for detecting sympathetic nerve function. We examined the relation between orthostatic hypotension and QSART at the foot and hand in type 2 diabetic patients. METHODS: Thirty-eight type 2 diabetic patients (age, 48.9 +/- 11.9 years; duration of diabetes, 13.4 +/- 8.6 years) and 13 age-matched non-diabetic controls were evaluated. All subjects aged under 65 years old were recruited. All subjects underwent Schellong tests and quantitative sudomotor axon reflex tests (QSART) at the back of the hand and dorsum of the foot. RESULTS: The sweating volume at the foot dorsum, but not the back of the hand, during the first 10 minutes of QSART was significantly related to the orthostatic hypotension on the Schellong test. In patients with normal, borderline and abnormal blood pressure response to standing, 6 out of 17 (35.3%), 9 out of 12 (75.0%) and 9 out of 9 (100%) had decreased sweating volume of the foot dorsum, respectively. CONCLUSIONS: Our results suggest that orthostatic hypotension may be detected early by QSART at the dorsum of the foot in type 2 diabetic patients.

Blood Pressure↗
PubMed2006

Computed tomography screening for the early detection of lung cancer.

Although lung cancer is the leading cause of cancer-related death in the world and has an increased chance of cure if detected at an earlier stage, routine lung cancer screening is currently not recommended in the United States. Unfortunately, most patients with lung cancer present only after the onset of symptoms and have advanced disease that cannot be surgically resected. The overall 5-year survival rate for all patients with lung cancer is only 15%. When the cancer is detected at its earliest stage (pathologic stage IA), however, the 5-year survival rate is more than 70%. Although past randomized screening trials evaluating the use of standard chest radiography or sputum cytology have not resulted in lower mortality, recent studies suggest that computed tomography (CT) may have promise as a screening tool. This article summarizes experience over the past decade of using low-dose spiral CT imaging as a screening tool to detect early lung cancers in asymptomatic, high-risk individuals.

Cost-Benefit Analysis↗
PubMed2000

[Early detection of exacerbation of lung infections in patients with cystic fibrosis by means of daily spirometry].

UNLABELLED: The clinical course of cystic fibrosis is characterised by pulmonary involvement with mucus retention, chronic pulmonary infection and parenchymal inflammation. Recurrent infectious exacerbations are usually accompanied by a fall in lung volumes. This pilot study investigated whether exacerbations can be detected early by daily spirometry. Ten patients with cystic fibrosis (5 female; 5 male; mean age 24.9 years) performed daily spirometry using a portable transtelephonic spirometer (Spirophone). Infectious exacerbations were diagnosed on clinical grounds and treated without knowledge of the spirometry results. Data of 9 patients recorded over a period of 5-11 months were analysed. One patient was excluded due to non-compliance. A total of 20 infectious exacerbations occurred during the observation period. A fall of at least 20% in one or more of the following parameters was observed in 90% (18/20) of exacerbations: FVC, FEV1, PEF, and FEF25/75. A daily drop in lung volumes of 0.7% to 1.2% was recorded beginning at a median of 33 (20 to 120) days before infectious exacerbations were diagnosed. There was a 2-3% daily improvement in spirometric data under treatment with antibiotics. CONCLUSION: Daily spirometry allows early recognition of pulmonary infectious exacerbations in patients with cystic fibrosis. Daily spirometry may be used as an indicator for early antibiotic treatment.

Adolescent↗
PubMedDate not supplied

Early detection and treatment of neovascular age-related macular degeneration.

BACKGROUND: The neovascular form of age-related macular degeneration (AMD) can rapidly lead to severe loss of central vision and adversely affect the patient's quality of life. During the 1990s the only proven treatment for neovascular AMD was laser photocoagulation. Only a minority of patients are eligible to receive this treatment, however, and the treatment itself can cause acute retinal damage with immediate vision loss. Verteporfin therapy is a new treatment option involving photodynamic therapy that was recently shown to be relatively safe and effective in reducing the risk of vision loss in selected cases. METHODS: Recent literature was reviewed on management of choroidal neovascularization caused by AMD that proved beneficial in large-scale randomized clinical trials. These studies were selected through a MEDLINE search of files from 1982 to the present using the keywords "randomized clinical trials," "choroidal neovascularization," and "age-related macular degeneration," as well as through personal knowledge of recently completed trials. RESULTS AND CONCLUSIONS: Primary care physicians can effect good treatment outcomes by detecting early signs of AMD and educating patients about the necessity of prompt referral to an ophthalmologist. Immediate referral is increasingly important because, compared with laser photocoagulation, current photodynamic therapy with verteporfin is applicable to more patients. Greater patient awareness of neovascular AMD and the importance of self-testing of vision can also be communicated to patients in primary care.

Aged↗
PubMed1992

[An early detection of the recurrence of serous cystadenocarcinoma of the ovary with the tumor marker CA125 levels].

We studied whether or not, and to what extent, it was possible to predict the recurrence of serous cystadenocarcinoma of the ovary by means of the tumor marker CA125 levels, in 35 treated cases of ovarian serous cystadenocarcinoma. The relationship between the change in CA125 levels and the frequency of recurrence was examined in two groups (recurrent group and non-recurrent group). When CA125 levels over 35U/ml were defined as positive for recurrence, the true positive rate was 22/23 in the recurrent group, and 0 in the non-recurrent group. When this cut-off level was lowered to 30U/ml, and then 25U/ml, the false positive rate in the non-recurrent group was increased to 1/12 and 4/12, respectively. A three-serial increase in CA125 levels was observed at the onset of recurrent cases including two cases with CA125 levels under 35U/ml, while it was not detected in any in the non-recurrent group. Analysis of the CA125 level increase pattern with a non-linear model showed that recurrence could be detected before the CA125 level reached 100U/ml in 13/19 (68.4%) cases if the interval between CA125 measurements was one mouth, and in 17/19 (89.5%) cases if the interval was two weeks. These results suggest that possibility that recurrence can be detected early.

Adolescent↗
PubMed2006

[Early detection of atherosclerosis].

According to the guidelines, the global assessment of cardiovascular risk is based on traditional risk factors. The emergence of new cardiovascular risk factors may be helpful. However, at every level of risk factor exposure, there is a substantial variation of atherosclerosis. Thus, subclinical disease measurements, representing the end result of risk exposure may be useful for improving cardiovascular risk prediction. In comparison to the ankle-brachial index, the high resolution B-mode ultrasound is a more promising tool to detect early atherosclerosis both on carotid and femoral arterial wall in asymptomatic patients. It appears as a new approach to predict the risk of cardiovascular disease and to monitor the cardiovascular therapy.

Atherosclerosis↗
PubMed1990

[Cost-effective and early detection of oncologic pathology].

A critical analysis of prophylactic medical examination of population was conducted for detecting early oncological pathology. Methodological approaches in the practice of selecting persons with pretumorous diseases were examined. Great emphasis was put on the necessity of ascertaining the rates of accelerating functional changes as the most characteristic and accessible sign of tissue change from normal into pathological. A diagram-inset for the case histories of ambulatory patients to be included into prospective programme of prophylactic medical examination is suggested.

Adult↗
PubMed1990

Early detection of the nephrotoxic effects in the environment: a survey.

Number of potentially nephrotoxic substances is growing continuously. The objective of preventive measures taken is to find such concentrations of chemicals in the environment which do not represent any risk for renal function. Sensitive methods are thus required which are able to detect early changes in renal function which are still reversible and when changes of glomerular filtration do not appear yet. The paper points out practical problems associated with determining sensitive biochemical parameters utilized as noninvasive renal function tests both in man and experimental animals. The most recent literary reports and the authors' experience show that beta 2-microglobulin, retinol-binding protein and N-acetyl-beta-D-glucosaminidase are the most suitable indicators of tubular cells damage and albumin is the best indicator of a damage located in glomerular cells.

Animals↗
PubMedDate not supplied

[Early detection of the neurosensory component of hearing loss in patients with adhesive otitis media].

Thirty patients with adhesive otitis media and 10 otologically normal subjects were examined audiometrically in a wide frequency range according to Sagalovich. It was found that this kind of audiometry may help detect early symptoms of hearing impairment on a neurosensory basis which remain unobservable in conventional audiography. It was demonstrated that hearing threshold increments in a wide frequency range correlated with the shape of the curve of bone conductivity in conventional audiography. The hearing changes in a wide frequency range were dependent on the primary disease duration and were independent of the bone-air interval value in conventional audiography. Our investigations allow the conclusion that measurement of hearing sensitivity in a wide frequency range under the conditions of bone conductivity enlarges the capabilities of current tonal audiometry and opens up new perspectives for assessing the hearing level of patients with adhesive otitis media.

Adolescent↗
PubMed1982

[Early detection of myocardial alterations in mitral insufficiency with the angiotensin test].

Left ventricular function was assessed at rest and after increasing systemic arterial resistance by angiotensin in 40 patients with isolated mitral insufficiency. Angiotensin was administered intravenously at a dose of 0,4 micrograms/mn until the systolic blood pressure rose by at least 30 mm Hg. Left ventricular and aortic pressures, cardiac index and left ventriculography in the 30 degree right anterior oblique projection (50 frames per second) were recorded before and during angiotensin infusion. The mean rise in systolic left ventricular pressure was 40 +/- 2,8 mm Hg; the heart rate increased slightly but significantly; left ventricular and diastolic pressure rose from 12,0 +/- 1,0 to 24,0 +/- 1,2 mmHg. The systolic index (Fick's method) was significantly decreased (37 +/- 1,6 ml/m2 to 26 +/- 1,6 ml/m2) though the angiographic systolic index remained unchanged. This is explained by an increase in the regurgitant fraction (51 +/- 2,5% ao 65 +/- 3%). The end diastolic volume index was unchanged; the ejection fraction was significantly decreased. The resting hemodynamic status was only slightly disturbed in 29 patients (mean capillary pressure less than 15 mm Hg, 8,8 +/- 0,52 mmHg). The left ventricular function curves with angiotensin distinguished two groups of patients: Group A (20 patients) with left ventricular dysfunction induced by angiotensin, Group B (9 patients) who maintained the systolic index despite the increase in left ventricular end diastolic pressure. These results suggest that the angiotensin test may be useful for detecting early left ventricular dysfunction in patients with isolated mitral insufficiency and virtually normal resting hemodynamic parameters.

Angiotensin II↗
PubMed1995

Glaucoma: early detection and therapy for prevention of vision loss.

Glaucoma is the second most common cause of permanent blindness in the United States and the most common cause of blindness among blacks. It is characterized by optic atrophy and vision loss, resulting from intraocular pressure that is too high to allow normal function of the optic nerve. Examination of the optic nerve and assessment of individual risk factors aids in the identification of patients who are at risk for glaucoma. Although glaucoma is a chronic disease, ocular complications can be prevented and sight may be preserved if the disease is detected early. A combination of antiglaucoma medications, laser treatment and filtration surgery is used to maintain intraocular pressure at a level sufficient to halt progression of optic nerve injury and prevent further vision loss.

Adrenergic beta-Agonists↗
PubMedDate not supplied

Early detection of hepatocellular carcinoma associated with cirrhosis by combined assay of des-gamma-carboxy prothrombin and alpha-fetoprotein: a prospective study.

BACKGROUND/AIMS: To evaluate the usefulness of des-gamma-carboxy prothrombin (DCP) assay in a group of high risk for hepatocellular carcinoma (HCC). PATIENTS AND METHODS: Plasma DCP and serum-alpha-fetoprotein (AFP) concentrations were prospectively measured in 137 patients with liver cirrhosis (LC). RESULTS: During the mean observation period of 3.4 years, HCC developed in 35 patients (25.5%; yearly rate 7.5%), of whom 16 (45.7%) had a small tumor < or = 2 cm in diameter. Eight patients (22.9%) had significantly elevated DCP at the time of HCC detection. However, all these tumors measured > 2 cm and were multiple or diffuse type. In cases with a tumor diameter < or = 2 cm HCC was diagnosed by imaging and elevated AFP concentrations. In contrast, elevated DCP frequently leads to the detection of tumors > 2 cm or those of diffuse type, which are difficult to recognize with imaging. CONCLUSIONS: Thus, although DCP alone is not sensitive enough to detect early small liver cancers, the use of both markers and imaging in the follow-up of patients with LC might be beneficial.

Adult↗
PubMed1996

Early detection of neoplasia of the esophagus and gastroesophageal junction.

Recommendations for preventing adenocarcinoma: The standard definition of Barrett's epithelium should be the presence of intestinalized mucosa in the lower esophagus. Patients in this category should be considered for inclusion in a screening program for the detection of dysplasia or carcinoma. Those who are a poor operative risk should not be screened if the detection of an end-point such as high-grade dysplasia or intramucosal carcinoma will still not lead to resection. In some centers, however, alternative experimental methods of mucosal ablation may be available. The endpoint for screening is invasive or intramucosal carcinoma (or--in centers with a very low operative mortality--high-grade dysplasia). These should lead to consideration of surgery or, in specialized centers and as part of controlled studies, newer alternative modes of epithelial ablation. Intermediate markers, e.g., use of aneuploidy, gene markers, or their products, are at present experimental. Screening should be carried out annually or, possibly, biennially. This screening should utilize a standard protocol with an endoscope capable of obtaining large-particle biopsies. Four quadrant biopsies should be taken about every 2 cm, beginning 2 cm above the proximal limit of the gastric rugae, continuing until unequivocally in squamous mucosa, and following any tongues of glandular epithelium. Recommendations for prevention of squamous carcinoma: In high-risk populations, esophageal cytology, possibly supplemented by tests for blood in the stomach, appear most useful. Repeated screening may be necessary to detect early invasive or preinvasive (dysplastic) tumors. Although preliminary results from dietary intervention studies have yet to show a statistically significant decrease, if trends continue these will reach significance and may be the best overall method of cancer prevention. Measures to reduce smoking and drinking are to be encouraged, but their effectiveness is questionable. For patients who are positive on screening, endoscopy (possibly with Lugol's iodine) may provide the best indication of harboring underlying carcinoma or dysplasia. Endoscopic resection will play an increasing role in treatment. With the exception of tylosis, most other predisposing conditions are unlikely to be cost effective.

Adenocarcinoma↗
PubMed1991

Verification of the cause of death in the trial of early detection of breast cancer. UK Trial of Early Detection of Breast Cancer Group. Trial Co-ordinating Centre.

The limitations of case review as a means of identifying errors in death certificates among breast cancer patients in a non-randomised trial of screening are illustrated by the findings of this large study. Records of 928 out of 990 deaths were available for review but were very variable in quality. Definite errors were found in 1%, errors were suspected in a further 5% and uncertainty about the cause of death, despite review, was recorded for 27%. The overall bias in reporting breast cancer deaths was less than 1%. It was concluded that the certified underlying cause of death without review provides an adequate endpoint for evaluating breast cancer screening programmes in the UK.

Age Factors↗
PubMed1982

Basal cell carcinoma. A case of longstanding neglect and a case of early detection.

The early detection and referral of a small basal cell carcinoma of the face will prevent extensive surgical excision and repair necessary for a neglected lesion. Since these tumors occur in the older population, careful examination of the skin should be performed on patients 50 years of age and older. This cancer has been estimated to constitute 90% of all malignant lid tumors and a suspicious lesion on the lid should be considered a basal cell carcinoma until proven otherwise. The lesion has a very characteristic appearance as described in the text; however, they can present with an atypical picture. An important sign in the evaluation of a possible malignant lid tumor is the loss of eyelashes within or adjacent to the lesion, which indicates the destructive nature of the tumor to the hair follicles. Basal cell carcinomas do not metastasize to distant locations in the body but rather extend locally and can produce deep tissue invasion. Differential diagnosis can present problems to the clinician but the definitive diagnosis is dependent upon the pathologist. The treatment usually requires surgical removal with wide excisional margins; however, other forms of treatment have been attempted. Recurrences of basal cell carcinomas are not uncommon, especially following an initial recurrence and it is mandatory that these patients be re-examined at least every six months for a two year follow-up period.

Aged↗
PubMed1978

Early Childhood Development Programme--early detection.

The Early Childhood Development Programme has four main objectives. These are: 1. To foster child development in families with young children largely through personal involvement of the family in an education context. 2. To provide enrichment programmes to enrich the social, emotional and physical environment and to ensure that children with special needs have these needs met optimally. 3. To provide for the early detection of children who are more vulnerable because of the presence of a condition which may tend to limit optimal development and make the child more open to adverse influence of social or cultural pressures; that is a health assessment programme. 4. To provide a family support service for families of children with special needs to enable these families to foster and to fulfil themselves in the society in which they live. This family support service is seen as providing a structure for home centred parent/infant habilitation aimed at keeping the family in the main stream insofar as education and health are concerned.

Australia↗
PubMedDate not supplied

Early detection of ovarian cancer: preliminary results of the Yale Early Detection Program.

Eighty-four women at high risk for ovarian cancer by having first-degree relatives with epithelial ovarian cancer participated in a newly established, early ovarian cancer detection program at Yale University. Participants were to be evaluated with physical examinations and circulating tumor markers at entry and every six months thereafter. Endovaginal ultrasound and color Doppler flow studies were to be performed at three and nine months following entry into the program. In addition, women were encouraged to follow American Cancer Society guidelines for mammography. Stool was checked for occult blood. Endometrial sampling was offered to post-menopausal women. No participant has developed an ovarian cancer since entering the program. One woman has been diagnosed to have breast cancer. False-positive levels of circulating tumor markers (CA 125, 4/84 [4.8 percent]; lipid-associated sialic acid in plasma, 13/84 [15.5 percent]; NB/70K, 4/84 [4.8 percent]; and urinary gonadotropin fragment, 1/65 [1.5 percent]) were observed on entry into the program. Low resistive indices (less than 0.5) were documented in 8/91 (8.8 percent) ovaries studied by the color Doppler flow technique. One participant underwent a laparotomy based on a false-positive endovaginal ultrasound examination. Tests now being employed in community practice have a high likelihood of being associated with false-positive results. Therapeutic interventions based on isolated abnormal tumor markers or ultrasound studies obtained from women with family histories of ovarian cancer may lead to inappropriate surgery. It is necessary for cancer centers to develop expertise in ovarian cancer detection techniques to advise physicians in their geographic areas appropriately about the significance of the abnormal screening test.

Adult↗
PubMed2001

Proteomics in early detection of cancer.

Early detection is critical in cancer control and prevention. Biomarkers help in this process by providing valuable information about a the status of a cell at any given point in time. As a cell transforms from nondiseased to neoplastic, distinct changes occur that could be potentially detected through the identification of the appropriate biomarkers. Biomarker research has benefited from advances in technology such as proteomics. We discuss here ongoing research in this field, focusing on proteomic technologies. The advances in two-dimensional electrophoresis and mass spectrometry are discussed in light of their contribution to biomarker research. Chip-based techniques, such as surface-enhanced laser desorption, and ionization and emerging methods, such as tissue and antibody arrays, are also discussed. The development of bioinformatic tools that have and are being developed in parallel to proteomics is also addressed. This report brings into focus the efforts of the Early Detection Research Network at the National Cancer Institute in harnessing scientific expertise from leading institutions to identify and validate biomarkers for early detection and risk assessment.

Antibodies↗