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At least 991 records · Page 55Linked to original sources
PubMed1998

Practical application of the European Field Guide in screening for diabetic retinopathy by using ophthalmoscopy and 35 mm retinal slides.

The Welsh Community Diabetic Retinopathy Study was designed to assess the effectiveness of the Field Guide Book for screening for diabetic retinopathy in Europe. A community-based sample (prevalence 2%) of diabetic patients was recruited from four general practices. Standardised training and equipment were provided. All patients were invited to attend practice-based screening sessions on two occasions over 3 years (phases 1 and 2). After mydriasis, clinical ophthalmoscopy was performed by a study optometrist and general practitioners (GPs). 2 x 45 field 35 mm retinal slides were obtained according to EURODIAB protocol. Anonymised slides were assessed by GPs, diabetologists and the optometrist. All the findings were graded externally (reference standard). In phase 2 community optometrists also performed ophthalmoscopy and assessed photographs. For detecting sight threatening diabetic retinopathy using ophthalmoscopy, GPs achieved a sensitivity of 65.7%, specificity 93.8% and positive predictive value (PPV) 65.7%. Community optometrists achieved a sensitivity of 82.2% with a PPV of 50.7%; the study optometrist 79.2 and 55.9%, respectively. The use of 35 mm slides improved sensitivity for the detection of sight threatening retinopathy to 87.3, 91.1 and 97.2% for GPs, community optometrists and the study optometrist, respectively. PPV fell to 51.2% for GPs, 40.6% for community optometrists, but increased to 58.8% for the study optometrist. Diabetologists achieved a sensitivity of 88.7% and a PPV of 65.6%. It is concluded that the European field guide is an effective tool for screening for retinopathy in clinical practice.

Confidence Intervals↗
PubMed2003

Development of a PCR assay for the detection of animal tissues in ruminant feeds.

The European Community ban on use of meat and bone meal in ruminant feed, as a consequence of the spread of bovine spongiform encephalopathy in Europe, has prompted a number of investigations about the possibility of detecting animal tissues in feedstuff. In this paper, a study on vertebrate primers, designed in the 16S rRNA gene of mitochondrial DNA, is described. These primers were able to amplify fragments that contained between 234 and 265 bp. The fragments were specific for bovine, porcine, goat, sheep, horse, rabbit, chicken, trout, and European pilchard and were confirmed by sequence analysis amplicons. The primers were used in a PCR assay applied to five samples of meat and blood meals of different species and subjected to severe rendering treatments (134.4 to 141.9 degrees C and 3.03 to 4.03 bar for 24 min). The presence of vertebrate tissues was detected in all samples. The assay proved to be rapid and sensitive (detection limit 0.0625%). It can be used as a routine method to detect animal-derived ingredients in animal feedstuff.

Animal Feed↗
PubMed1994

Hepatitis B and hepatitis C virus infection among chronic alcoholic patients with liver disease in Taiwan.

The prevalence of the anti-hepatitis C virus (anti-HCV) antibody and hepatitis B surface antigen (HBsAg) among 123 alcoholic patients with liver disease from our hospital and 44 alcoholic subjects from the local community was evaluated. By radio-immunoassay HBsAg was detected in 30.1% of alcoholic patients with liver disease, compared with 11.4% of alcoholic subjects from the local community (p < 0.05). The prevalence of HBsAg was 40.7% (11/27) in patients with cirrhosis and hepatocellular carcinoma (HCC), 31.5% (17/54) in patients with cirrhosis only, and 29.4% (5/17) in patients with other liver diseases. By enzyme-linked immunosorbent assay, anti-HCV antibody was detected in 30.9% of alcoholic patients with liver disease, compared with 2.3% of alcoholic subjects from the local community (p < 0.0005). The prevalence of anti-HCV antibody was 44.4% in alcoholic patients with cirrhosis and HCC, 29.6% in alcoholic patients with cirrhosis only, and 17.6% in alcoholic patients with other liver diseases. As the degree of liver damage advanced, the prevalence of either HBsAg or anti-HCV antibody, or both, being detected in these alcoholic patients increased significantly (p < 0.05). The serum ALT level was higher among alcoholic patients who had either HBsAg or anti-HCV antibody than those having neither (151 +/- 204 vs 62 +/- 47 IU/L; p < 0.005). All three alcoholic patients with chronic hepatitis had positive HBsAg or anti-HCV antibody. Histologic findings, except cells within sinusoids, were comparable between the alcoholic patients with or without superimposed hepatitis viruses.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1995

Population awareness and control of hypertension and hypercholesterolemia. The Atherosclerosis Risk in Communities study.

BACKGROUND: A national program for hypertension detection and control was implemented in the 1970s, whereas a similar program for control of hypercholesterolemia has been implemented in recent years. We studied the levels of awareness, treatment, and control of these conditions in US population samples during a 3-year period (1987 to 1989). METHODS: The levels of awareness, treatment (by medication), and adequate control of hypertension (systolic blood pressure, > or = 140 mm Hg; diastolic blood pressure, > or = 90 mm Hg; or antihypertensive medication) and hypercholesterolemia (serum cholesterol level, > or = 6.21 mmol/L [> or = 240 mg/dL], or lipid-lowering medication) were studied among participants in the baseline examination of the Atherosclerosis Risk in Communities Study, including 15,739 individuals aged 45 to 64 years. RESULTS: Eighty-four percent of the hypertensive subjects and 42% of the hypercholesterolemic subjects were aware of their conditions. Overall, 50% of the hypertensive subjects and only 4% of the hypercholesterolemic subjects had their conditions both treated and controlled. Rates of hypertension prevalence, awareness, and control remained stable during the 3-year study period. Hypercholesterolemia prevalence decreased from 30% in 1987 to 25% in 1989; its awareness increased from 31% to 50% during the same period. Hypertensive women were more likely than hypertensive men to be aware and treated, whereas hypercholesterolemia awareness was higher in men than in women. Hypertension awareness was highest in black women, but black hypertensive subjects were less likely than whites to be treated and to have their hypertension controlled. Black hypercholesterolemic subjects were less likely to be either aware or treated. CONCLUSIONS: After the recent implementation of the National Cholesterol Education Program, the levels of awareness, treatment, and control of hypercholesterolemia are improving at a high rate, although they are still substantially lower than those for hypertension. Further improvement is necessary, particularly among certain population groups, such as blacks.

Age Distribution↗
PubMed1987

Staphylococcus aureus bacteremia. Clinical, serologic, and echocardiographic findings in patients with and without endocarditis.

Seventy-two adult patients with Staphylococcus aureus bacteremia were prospectively studied clinically, serologically, and echocardiographically. Multivariate analysis identified four parameters that significantly predicted endocarditis in staphylococcemic patients at time of initial evaluation: absence of a primary site of infection; community acquisition of infection; metastatic sequelae; and valvular vegetations detected by echocardiography. Echocardiography was most predictive of endocarditis in patients with community-acquired S aureus bacteremia from an obvious primary focus. In 11 (69%) of 16 patients with endocarditis and vegetations on two-dimensional echocardiography, this technique also revealed other important findings, including ventricular dilatation, and/or underlying valvular lesions. In 18% of patients with S aureus bacteremia without stigmata of endocarditis, echocardiography provided information that led to a diagnosis of endocarditis and a subsequent change in therapy. Our findings support the routine use of two-dimensional echocardiography in all cases of community-acquired S aureus bacteremia to identify occult endocarditis in patients without classic stigmata of disease, and to provide important prognostic data in clinically apparent endocarditis.

Adult↗
PubMed2002

Effects of T4 lysozyme release from transgenic potato roots on bacterial rhizosphere communities are negligible relative to natural factors.

Rhizosphere bacterial communities of two transgenic potato lines which produce T4 lysozyme for protection against bacterial infections were analyzed in comparison to communities of wild-type plants and transgenic controls not harboring the lysozyme gene. Rhizosphere samples were taken from young, flowering, and senescent plants at two field sites in three consecutive years. The communities were characterized in a polyphasic approach. Cultivation-dependent methods included heterotrophic plate counts, determination of species composition and diversity based on fatty acid analysis of isolates, and community level catabolic profiling. Cultivation-independent analyses were based on denaturing gradient gel electrophoresis (DGGE) of 16S rRNA gene fragments amplified from rhizosphere DNA using primers specific for Bacteria, Actinomycetales, or alpha- or beta-Proteobacteria. Several bands of the DGGE patterns were further characterized by sequence analysis. All methods revealed that environmental factors related to season, field site, or year but not to the T4 lysozyme expression of the transgenic plants influenced the rhizosphere communities. For one of the T4 lysozyme-producing cultivars, no deviation in the rhizosphere communities compared to the control lines was observed. For the other, differences were detected at some of the samplings between the rhizosphere community structure and those of one or all other cultivars which were not attributable to T4 lysozyme production but most likely to differences observed in the growth characteristics of this cultivar.

Bacteria↗
PubMed2002

Validation of the Arabic version of the WHO-ILAR COPCORD Core Questionnaire for community screening of rheumatic diseases in Kuwaitis. World Health Organization. International League Against Rheumatism. Community Oriented Program for the Control of Rheumatic Diseases.

OBJECTIVE: (1) To adapt the Community Oriented Program for the Control of Rheumatic Disease (COPCORD) Core Questionnaire (CCQ) for use as a rheumatic screening instrument among Kuwaitis, including translation, back translation, assessment of cross cultural equivalence, and reliability. (2) To determine the screening characteristics of the Arabic version of the CCQ for detecting rheumatic diseases compared to clinical examination by a rheumatologist. METHODS: Translation and assessment of cross cultural equivalence were undertaken using standard methods. Back translation was done by an Arabic-speaking rheumatologist. Interviewer agreement was assessed using a convenience sample. Sensitivity, specificity, and positive and negative predictive values were assessed first by administering the CCQ followed by full clinical examinations of a randomly selected sample of 359 Kuwaiti persons aged 15 years or older. RESULTS: (1) Cross cultural equivalence and back translation of the translated questionnaire were satisfactory. Interviewer agreement was acceptable. (2) The prevalence of rheumatic diseases based only on CCQ screening was 69% compared to 73% based on clinical examination. The sensitivity and specificity of the Arabic CCQ were 94.4% and 97%, respectively, and the positive and negative predictive values of the instrument were 98.8% and 86.4%, respectively. CONCLUSION: The Arabic version of the CCQ appears promising as a screening tool to detect rheumatic diseases in Arabic speaking communities. The findings suggest that the Arabic CCQ followed by clinical examinations in positive respondents can provide an acceptable estimate of prevalence of rheumatic diseases. We intend to use this instrument to screen for the prevalence of rheumatic diseases among Kuwaiti nationals.

Adult↗
PubMed2004

A high sensitivity amperometric biosensor using a monomolecular layer of laccase as biorecognition element.

Laccases from various sources were tested, and laccase from Rigidoporus lignosus was found to be the most active towards syringaldazine and ABTS, which are typical substrates of this class of enzymes, and towards the phenols found in olive oil mill wastewaters. This laccase was covalently immobilised by carbodiimide chemistry, on a self-assembled monolayer of 3-mercaptopropionic acid deposited on a gold surface. A flow biosensor, using the monolayer of laccase as bioelement and a glassy carbon electrode as amperometric transduction system, was developed. Although the amount of the immobilised enzyme (about 140 ng/cm2 effective surface area) was tiny, the biosensor showed a sensitivity of 3 nA/microM when 1,4-hydroquinone was used as substrate, and a half-life of 35 days. The proposed device permits detection of phenols in aqueous solutions at concentrations in the low micromolar range, i.e. below European Community limits. The biosensor was successfully used to detect phenols in wastewaters from an olive oil mill after minimal sample preparation (incubation of the aqueous sample with sodium borohydride for a few minutes) to suppress the current due to oxidised compounds present in the wastewaters.

Biosensing Techniques↗
PubMed1998

An optimal cutoff point of expired-air carbon monoxide levels for detecting current smoking: in the case of a Japanese male population whose smoking prevalence was sixty percent.

An optimal cutoff point of expired-air carbon monoxide (Ex-CO) for detecting smokers should be determined in terms of its sensitivity and specificity and the prevalence of smoking in the target population. The purpose of this study is to determine the optimal cutoff point of Ex-CO for detecting smoking males in a Japanese community whose smoking prevalence was over 50%. Among free-living residents in a rural population, "true smokers" determined by presence of cotinine in serum were 61% (n = 94). When Ex-CO at 7 ppm or over differentiated "smokers" from "non-smokers", sensitivity and specificity for detecting smokers was 0.93 and 0.95, respectively, which comprised the best Youden's index. This setting also produced the minimum percentage of misclassified cases. In conclusion, 7 ppm of Ex-CO, which is exceptionally low value relative to the western standard, appears to be the most optimal cutoff point for a survey in a population with such high smoking prevalence.

Breath Tests↗
PubMed1992

Change in presentation of breast cancer in a community hospital.

An aggressive mammographic screening program under the auspices of a community hospital resulted in a significantly earlier detection of breast cancer at presentation in 1990 as compared to 1980. It is anticipated that further followup will show a reduction in cancer mortality as a result of this earlier detection.

Adult↗
PubMed1997

Cholera in Lima, Peru, correlates with prior isolation of Vibrio cholerae from the environment.

The authors utilized a recently developed DNA probe technique to obtain quantitative data on occurrence of Vibrio cholerae in samples collected monthly from 12 environmental sites in Lima, Peru, from November 1993 through March 1995. Peak V. cholerae counts ranged from 10(2)/ml to 10(5)/ml, with the highest counts in sewage-contaminated areas and irrigation water. With our methodology, no V. cholerae cases were detected at any site during the winter months of July through October. Counts were detectable in the environment before onset of cholera in the community, with counts at "cleaner" sites upriver correlating significantly with occurrence of community disease 2 and 3 months later. In sites with heavy sewage contamination, V. cholerae could still be detected before the onset of cases in the community; however, in contrast to upriver sites, counts at these latter sites correlated most closely with the number of concurrently occurring cholera cases. These data support a model of cholera seasonality in which initial increases in number of V. cholerae in the environment (possibly triggered by temperature) are followed by onset of illness in the community, with these human cases further amplifying the organism as the epidemic cycle proceeds.

Cholera↗
PubMed2004

Metal-polymer nanocomposites for integrated microfluidic separations and surface enhanced Raman spectroscopic detection.

The widespread development of microfluidics (microfluidics) has allowed the extension of efficient separations, fluid handling, and hyphenation with many detection modes to a small, portable, highly controllable physico-chemical platform. Surface enhanced Raman spectroscopy (SERS) offers the powerful advantage of obtaining vibrational spectroscopic information about analytes in an aqueous matrix with negligible background. The mating of electrophoretic separations with vibrational spectroscopy on a microfluidic device will allow the chromatographic efficiency of capillary electrophoresis (CE) with the unequivocal analyte "fingerprinting" capability of detailed structural information. By utilizing SERS as a means of detection, this work promises to yield redress for the hindrances of electrophoretic separations, including uncertainty in analyte band identification due to changing migration times as well as compromised detection sensitivity for non-fluorescent analytes. Our work represents the first steps toward developing CE-SERS on a microfluidic platform with a region of novel metal-pliable polymer nanocomposite SERS substrate fabricated directly into the device. The device fabrication material has been extensively employed by the microfluidics community for over five years. SERS detection can be achieved in real time or after the separations, with on-column laser-induced fluorescence employed as a secondary detection mode used for confirmation of efficiencies and band locations.

Journal Article↗
PubMed1979

The prevalence and distribution of Mansonella ozzardi in coastal north Trinidad, W.I.

A day blood smear survey for Mansonella ozzardi in the north coast communities of Trinidad recorded a prevalence of 4.8% in 4,488 persons examined. Prevalence rates were highest in the four western-most communities, where the vector, Culicoides phlebotomus, is a severe nuisance problem. Prevalence rates increased with age and were higher in males than in females. Mean microfilaria densities were low in both sexes up to 50 years of age but in older males the density increased with age. Wuchereria bancrofti infections were detected in five of the ten communities surveyed.

Adolescent↗
PubMed2005

Prevalence and distribution of high-risk human papilloma virus (HPV) types in invasive squamous cell carcinoma of the cervix and in normal women in Andhra Pradesh, India.

BACKGROUND: Despite the high incidence of cervical cancer reported from India, large scale population based studies on the HPV prevalence and genotype distribution are very few from this region. In view of the clinical trials for HPV vaccine taking place in India, it is of utmost importance to understand the prevalence of HPV genotypes in various geographical regions of India. We investigated the genotype distribution of high-risk HPV types in squamous cell carcinomas and the prevalence of high-risk HPV in cervicovaginal samples in the southern state of Andhra Pradesh (AP), India. METHODS: HPV genotyping was done in cervical cancer specimens (n = 41) obtained from women attending a regional cancer hospital in Hyderabad. HPV-DNA testing was also done in cervicovaginal samples (n = 185) collected from women enrolled in the cervical cancer screening pilot study conducted in the rural community, of Medchal Mandal, twenty kilometers away from Hyderabad. RESULTS: High-risk HPV types were found in 87.8% (n = 36/41) of the squamous cell carcinomas using a PCR-based line blot assay. Among the HPV positive cancers, the overall type distribution of the major high-risk HPV types was as follows: HPV 16 (66.7%), HPV 18 (19.4%), HPV 33 (5.6%), HPV 35 (5.6%), HPV 45 (5.6%), HPV 52 (2.8%), HPV 58(2.8%), HPV 59(2.8%) and HPV 73 (2.8%). Women participating in the community screening programme provided both a self-collected vaginal swab and a clinician-collected cervical swab for HPV DNA testing. Primary screening for high risk HPV was performed using the Digene Hybrid Capture 2 (hc2) assay. All hc2 positive samples by any one method of collection were further analyzed using the Roche PCR-based line blot for genotype determination. The prevalence of high risk HPV infection in this community-based screening population was 10.3% (19/185) using the clinician-collected and 7.0% (13/185) using the self-collected samples. The overall agreement between self-collected and clinician-collected samples was 92%; however among HPV-positive specimens, the HPV agreement was only moderate (39.1%). The most frequently detected HPV types in the Medchal community are HPV 52 and 16. CONCLUSION: Our results suggest that the HPV type distribution in both cervical cancer tissues and in a general screening population from Andhra Pradesh is similar to that reported in India and other parts of the world. We also conclude that an effective vaccine targeting HPV 16 will reduce the cervical cancer burden in AP.

Adult↗
PubMed1998

Renal tract abnormalities detected in Australian preschool children.

OBJECTIVE: To quantify the incidence of abnormalities in urinalysis and blood pressure from preschool children and their predictive value in detecting renal disease within an Australian community. METHODOLOGY: Urine samples, blood pressure and height measurements and parental reports of significant medical problems were collected from a total of 9355 South Australian preschool children. Seven hundred and forty-three children with abnormal results were investigated in a nephrology outpatient clinic. A control group of 357 children with no detectable abnormality were also recalled, examined and, where appropriate, investigated. RESULTS: Nine thousand, three hundred and fifty-five children were tested. Of these, 0.81% were shown to have a clinically significant renal tract abnormality. The findings included children with urinary tract infections, vesico-ureteric reflux, glomerular disease, renal calculi, essential hypertension and a renal neoplasm. While dipstick-based methods were the most specific indicators of renal tract abnormalities, measurement of blood pressure and urinary beta2-microglobulin were also important in detecting abnormalities. Screening for glycosuria did not result in the detection of significant undiagnosed abnormalities. In the control group with no abnormality detected at testing, there was one case each of aortic coarctation, polycystic kidney disease and vesico-ureteric reflux diagnosed. CONCLUSION: Undiagnosed renal tract abnormalities are present in many Australian preschool children. Most are detectable by a thorough history, examination and urinalysis.

Blood Pressure Determination↗
PubMedDate not supplied

Tuberculosis case detection in a state prison system.

OBJECTIVE: This study was designed to describe the epidemiology of tuberculosis ((TB) among inmates in the Georgia state prison system; to evaluate the effectiveness of the TB case detection methods used; to evaluate the use of contact tracing for inmate TB cases; and to determine rates of completion of therapy. METHODS: Using a standardized form, the authors abstracted data from reports to the Centers for Disease Control and Prevention, prison hospital medical charts, and county health department records for all patients with TB treated in the Georgia Department of Corrections prison system from 1991 through 1995. RESULTS: A total of 142 cases of tuberculosis were treated in the prison during five-year period. Approximately two-thirds were detected by active case finding,either at the county jail prior to transfer to the prison system (31%) or at the prison intake evaluation (37%). Routine screening procedures at entry, following Centers for Disease Control and Prevention guidelines, had a sensitivity of 96%. Contact investigations were carried out in county jails or in the community for only 25% of cases detected at entry to prison. For those released from prison still on treatment, 38% were lost to follow-up before completion of therapy. CONCLUSIONS: The Georgia prison system is doing an effective job of TB case detection and treatment among incarcerated inmates. Closer cooperation between the prison system and local health departments is needed to improve contact tracing and completion of therapy for this high risk population. Some cases detected at entry to prison appear to have been missed in the county jails

Adult↗
PubMed2002

The chest pain center strategy for delivering community heart attack care by shifting the paradigm of heart attack care to earlier detection and treatment.

Heart attack remains the number one health problem in the United States and throughout the world. It has been that way for more than 100 years. Unless we change our course, heart attack will continue to exert its horrendous casualties, not only in the United States but also throughout the world. Our present strategy in dealing with this problem needs both leadership and a change in direction. In an effort to search "outside the box" for the solution to this problem, this symposium is a call to action that challenges us to approach the heart attack problem with a mindset bent on winning this war against heart disease, and not coexisting and accepting the problem as an inescapable fate.

Angina Pectoris↗