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At least 1,189 records · Page 66Linked to original sources
PubMed2004

Seroprevalence of measles, mumps and rubella antibodies in Luxembourg: results from a national cross-sectional study.

A serological prevalence survey was carried out in Luxembourg during 2000-2001 to determine the antibody status of the Luxembourg population against vaccine-preventable infections. Blood samples of children and adolescents were collected prospectively in randomly selected schools. Samples of adults were obtained through volunteer patients of the national health laboratory or of the mandatory pre-nuptial test. Measles, mumps and rubella (MMR) virus antibody concentrations were measured using commercial ELISA tests. Age-standardized prevalence of measles, mumps and rubella virus antibodies was found to be 96.58, 75.40 and 95.69% respectively. Significant age-dependence of serology was observed for all three infections, with study participants born after the introduction of the MMR vaccine experiencing a gradual decline of antibodies following vaccination in childhood. Older study participants who were more likely to have antibodies from natural infection had consistently higher titres than younger individuals. Present vaccination coverage with MMR appears to be sufficient to prevent large local outbreaks of measles and rubella, but probably not mumps.

Adolescent↗
PubMed1999

Cord blood banking in London: the first 1000 collections.

The London Cord Blood Bank was established with the aim of collecting, processing and storing 10000 unrelated stem cell donations for the significant number of children in the UK requiring transplantation, for whom a matched unrelated bone marrow donor cannot be found. Collection is performed at two hospitals by dedicated cord blood bank staff after delivery of the placenta. Mothers are interviewed regarding medical, ethnic and behavioural history by nurse counsellors and sign a detailed consent form. Donations are returned to the bank for processing. Volume reduction is undertaken by a simple, closed, semi-automated blood processing system, with excellent recovery of progenitor cells. Units are cryopreserved and stored in the vapour phase of liquid nitrogen. Blood samples from mothers and cord blood donations are tested for the UK mandatory red cell and microbiology markers for blood donors. Donations are typed for HLA-A, B and DR at medium resolution (antigen split) level using sequence-specific oligonucleotide probing and sequence-specific priming techniques. The selection of collection hospitals on the basis of ethnic mix has proven effective, with 41.5% of donations derived from non-European caucasoid donors. Bacterial contamination of collections has been dramatically reduced by implementation of improved umbilical cord decontamination protocols.

Blood Banks↗
PubMed1981

Mechanism of the actomyosin ATPase: effect of actin on the ATP hydrolysis step.

The Lymn-Taylor model for the actomyosin ATPase suggests that during each cycle of ATP hydrolysis the complex of myosin subfragment 1 (S-1) with actin must dissociate into S-1.ATP plus actin before ATP hydrolysis can occur. In the present study we tested whether such a mandatory detachment step occurs by measuring the effect of actin on the rate and magnitude of the ATP hydrolysis step (initial Pi burst) and on the steady-state ATPase rate. We find that the rate of the initial Pi burst markedly increases at high actin concentration although the Lymn-Taylor model predicts the rate should remain nearly constant or decrease. In addition, at high actin concentration, the magnitude of the initial Pi burst is much larger than is predicted by the Lymn-Taylor model. Finally, at 360 microM actin, at which more than 90% of the S-1.ATP is bound to actin, there is no inhibition of the steady-state ATPase activity although the Lymn-Taylor model predicts that 70% inhibition should occur. We conclude that the acto-S-1 complex is not dissociated by ATP during each cycle of ATP hydrolysis; in fact, the rate of the initial Pi burst appears to be even faster when S-1.ATP is bound to actin than when it is dissociated.

Actins↗
PubMed2004

Proficiency studies on the determination of paralytic shellfish poisoning toxins in shellfish.

Paralytic shellfish poisoning toxins are produced by dinoflagellates. Shellfish filtering these unicellular algae will accumulate the toxins and pose a health risk when consumed by man. In the European Union, paralytic shellfish poisoning toxins in bivalve molluscs are regulated at a maximum content of 80 microg/100 g (91/492/EEC). The current reference method in the European Union is the mouse bioassay, but alternative methods including the liquid chromatography methodology are preferred for ethical reasons. Analyses of suspected shellfish batches revealed, however, unacceptable differences in results reported by a small group of Dutch laboratories all using liquid chromatography methods with precolumn derivatization, followed by fluorescence detection. Therefore, a series of proficiency studies were undertaken among these laboratories. In the first three studies, participants were more or less allowed their own choice of method execution details. This approach yielded unsatisfactory results. A fourth study was then initiated in which a standardized method was mandatory. Two types of test material were used in the fourth study: lyophilized Cardium tuberculatum material containing saxitoxin (STX) and decarbamoyl-saxitoxin (dc-STX), and lyophilized mussel material containing dc-STX. The latter material was investigated in an interlaboratory study involving 15 participants and was considered as the reference material. Among the four laboratories, coefficients of variation (ANOVA) for C. tuberculatum material were 10% (n = 11) and 9% (n = 12) for STX and dc-STX, respectively, and for the reference material was 8% (n = 12) for dc-STX. The joint efforts showed that variability in analysis results between laboratories that all apply more or less the same method can be drastically improved if the methodology is rigorously standardized.

Chromatography, Liquid↗
PubMedDate not supplied

Cost and effectiveness of the California triple marker prenatal screening program.

PURPOSE: To report the utilization of services offered and pregnancy outcomes for a unique statewide prenatal triple marker screening program and to present a cost-benefit analysis. A state population of 32 million with considerable ethnic and age distribution and with a wide variety of delivery systems providing prenatal care was considered. The entire pregnant population who appeared for care before 20 weeks gestation, approximately one-half million per year during the years of 1995 to 1997, was included in the study. METHODS: Mandatory offering of serum testing, using alpha-fetoprotein from 1986 to 1995, and the addition of human chorionic gonadotropin and unconjugated estriol in 1995, with systematic follow-up of serum screen positives with ultrasound and amniocentesis. This study collected and analyzed the program data and reports of outcomes and collected similar information from the birth defects registry. RESULTS: Triple marker serum screening was accepted by 67.4% of the women eligible and yielded an initial positive rate of 7.3%. More than 90% of the initially screen positive pregnancies were seen at a prenatal diagnostic center. After correction of gestational age, 71.3% had amniocentesis. The overall amniocentesis rate among women screened was 2.6%. The Program's detection rate was predicted to be 85% for neural tube defects, and, based on Monte Carlo modeling, was theoretically calculated to be 62% for Down syndrome. In practice, detection rates were 75% for neural tube defects and 41% for Down syndrome due to lower than expected amniocentesis acceptance rate. Nevertheless, at a 5% discount rate, the screening program was cost beneficial at a ratio of 2.69:1. The cost per case detected was $35,365 and per case prevented was $110,741. CONCLUSION: It is possible to implement a cost-effective population-based screening in compliance with quality standards in a diverse ethnic population with a variety of health-care providers. Triple marker screening in the second trimester is a cost beneficial program even if utilization of all services is less than ideal.

Biomarkers↗
PubMed1993

A comparison of methods to predict minimal weight in high school wrestlers.

The purpose of this study was to compare the accuracy of body fat determinations and subsequent calculation of minimal weight (MW) by dual energy x-ray absorptiometry (DEXA), bioelectrical impedance (BIA), near-infrared photospectometry (NIR), and anthropometry (LOHMAN). Necessitated by mandatory state minimal weight testing, the methods were cross-validated on 95 Wisconsin high school wrestlers (mean +/- SD; age: 15.1 +/- 1.2 yr, height: 170.4 +/- 7.1 cm, weight: 63.4 +/- 9.8 kg). MW, defined as fat-free body/0.93, determined by hydrostatic weighing (HW) and residual volume via O2 dilution, served as the criterion. The validity of the four selected MW predictions were evaluated against HW by examining mean differences (MD), standard deviation differences (SDD), correlations (r), standard error of estimate (SEE), and total errors (TE). Statistically significant differences were shown between the methods and the criterion by t-tests; however, these were clinically small in Lohman (0.6 kg) and BIA (0.9 kg). TE ranged from 2.25 kg (Lohman) to 6.03 kg (NIR). The results indicated that Lohman skinfold equation provided the most accurate prediction of MW, demonstrating the highest correlation (0.972), lowest MD (0.6 kg), lowest SEE (2.12 kg), and lowest TE (2.25 kg) of the methods evaluated.

Absorptiometry, Photon↗
PubMed1992

Oxygen transport during incremental exercise load as a predictor of operative risk in lung cancer patients.

To evaluate functional parameters related to the morbidity and mortality after thoracotomy, exercise loading was applied in 31 lung cancer patients under right heart catheterization. The routine pulmonary function and predicted postoperative pulmonary function (ppo) parameters were also evaluated. Patients were grouped according to postoperative complications: no complications (group 1, n = 17), nonfatal complications (group 2, n = 10), and fatal complications (group 3, n = 4). In all the patients %VCppo was above 40 percent and in patients undergoing pneumonectomy, pulmonary artery mean pressure during the unilateral pulmonary artery occlusion test was below 25 mm Hg. FEV1 percent and MVV/BSA were statistically significant between groups 1 and 2 but were not between groups 1 and 3 or groups 2 and 3. The %FEV1 ppo was statistically significant between groups 1 and 2 and groups 1 and 3 but was not between groups 2 and 3. Thus, the routine pulmonary function and predicted postoperative lung function tests, although they are mandatory for screening patients who are at risk, did not definitely discriminate between patients experiencing nonfatal and fatal complications after thoracotomy. VO2/BSALa20, CILa20, O2D/BSALa20, and TPVRILa20 were statistically significant between groups 1 and 3 and groups 2 and 3: in all the group 3 patients, as well as three patients of group 1 and one of group 2, VO2/BSALa20 was below 350 ml/min/m2. On the other hand, O2D/BSALa20 was below 500 ml/min/m2 in all the group 3 patients, while it was above 560 ml/min/m2 in all patients in groups 1 and 2. O2D/BSALa20 was the only parameter that definitely discriminated between experiencing nonfatal and fatal complications. We conclude that in addition to the generally accepted functional guidelines, VO2/BSALa20 should be above 400 ml/min/m2 and O2D/BSALa20 should be above 500 ml/min/m2 in patients who will undergo thoracotomy.

Adult↗
PubMed1998

AIDS control and the workplace: the role of occupational health services in South Africa.

AIDS interventions typically fail to address the disjuncture between private behaviors and the social determinants of HIV infection. Data from a telephone survey of manufacturing companies and a postal survey of occupational health nurses in the Western Cape, South Africa, were used to explore the possible role of occupational health services in prevention and control of AIDS. The author found limited evidence of worker involvement in AIDS programs, particularly in companies with occupational health professionals. The management of sexually transmitted diseases was incomplete. Mandatory pre-employment testing of workers for HIV was not widespread. Respondents' opinions on priorities for AIDS prevention and control reflected a preoccupation with knowledge transfer. To ensure their effectiveness, workplace AIDS programs must improve worker participation and integrate AIDS prevention in general workplace health and safety programs. In addition, education programs must develop objectives within a critical theoretical understanding of the behavioral issues relevant to AIDS prevention, and must emphasize the empowerment of women in the workplace. In the context of the present restructuring of health services in South Africa, occupational health services, using the strategies outlined, can make a major contribution to national AIDS prevention and control.

Acquired Immunodeficiency Syndrome↗
PubMed2025

The acceptability of blood spot screening and genome sequencing in newborn screening: a systematic review examining evidence and frameworks.

BACKGROUND: Population-wide newborn blood spot screening programmes are a successful public health intervention used to detect whether the baby is at risk of certain rare conditions, with the aim of earlier diagnosis and provision of optimal care and treatment. Evaluating candidate conditions to include in newborn blood spot and genetic sequencing raises questions regarding acceptability to parents/carers. METHODS: In the context of the possible expansion of the newborn blood spot screening programme in the United Kingdom, this review aimed to systematically review research on the acceptability to parents of newborn blood spot screening and genetic sequencing. A protocol was developed prior to commencing the review and was registered on the PROSPERO database. A team of researchers carried out the review, with checking at all stages carried out by at least two individuals. We included research published after 2013 with participants who were pregnant or a recent parent of a newborn and were resident in a high-income country. We included quantitative and qualitative studies that investigated the acceptability to parents/carers of newborn blood spot screening or genetic sequencing. Quantitative studies were narratively synthesised, and theories/frameworks identified and evaluated. Qualitative studies were analysed for recurring themes, and a meta-synthesis was carried out to compare and contrast these two types of data. We quality appraised included articles using tools appropriate for their study design. RESULTS: Searches were carried out in September to November 2023 and screening identified 25 relevant research articles. Just over half were from North America, with four existing reviews and nine qualitative studies. Domains of acceptability described in the literature were: support for screening; level of anxiety, information and knowledge; consent; views of the procedure; and support after screening. The research indicated consensus support for blood spot screening, and for expanding to some other conditions, although some parental anxiety was reported. Parents/carers mostly perceived that they had received sufficient information, but the timing of this could be improved. While parents indicated interest in genomic screening, studies highlighted the need for clearer consent procedures and greater support for parents following genomic screening than for blood spot screening. Only three included studies reported using any kind of theoretical framework. DISCUSSION: Most parents/carers found newborn blood spot screening programmes to be acceptable and favoured their large-scale implementation. A minority of parents/carers expressed concerns regarding the acceptability of processes underpinning newborn blood spot screening, such as consent, the timing of receiving information and support available after testing. More research is needed regarding the acceptability of newborn genomic sequencing screening programmes, which are less established compared with newborn blood spot screening programmes. LIMITATIONS: The over-representation of studies conducted in the United States has implications for the applicability of findings to other countries where testing is not typically mandatory and health systems differ considerably. Most studies were of cross-sectional design and there was limited representation of people from lower incomes and non-white ethnicity. While the inclusion of studies only in populations of future or very recent parents provided coherence to the findings, unclear reporting of participants may have resulted in under- or overinclusion of some studies. FUNDING: This article presents independent research funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme as award number NIHR159927.

ACCEPTABILITY↗
PubMedDate not supplied

Elder abuse: the role of the orthopaedic surgeon in diagnosis and management.

Increased awareness of elder abuse has led to the recognition that mistreatment of individuals over the age of 65 years is a widespread public health problem. It is estimated that the prevalence of elder abuse is 32 cases per 1,000 persons and is increasing with the growing elderly population. Elder abuse is suspected to be a major source of morbidity and mortality, representing a high economic burden to society. The diagnosis of elder abuse is seldom straightforward due to social issues, cognitive impairment, and comorbid conditions, and requires careful correlation of historical and clinical findings. Comprehensive evaluation, including a detailed history, systematic physical examination, and appropriate laboratory and radiographic assessment, is essential. The orthopaedic surgeon consulted to evaluate an elderly individual with musculoskeletal injuries must be cognizant of the potential for elder abuse, especially when circumstances are suspect. The role of the orthopaedic surgeon is often fundamental to establishing whether musculoskeletal injuries are consistent with the stated mechanism of injury. Due to the variety of presentations, there are no fracture patterns considered pathognomonic of elder abuse. Rather, the nature and pattern of injury must be viewed in the context of the general health and psychosocial environment of the patient to determine whether abuse has occurred. Once the diagnosis of elder abuse has been made, a comprehensive, multidisciplinary long-term care plan must be formulated to ensure patient safety while respecting the autonomy of a competent individual. Physicians have an ethical and legal responsibility to protect patients from suspected abuse, and most states mandate reporting by health-care personnel.

Aged↗
PubMed1999

Sexually-transmitted diseases and assisted reproduction techniques.

As to the correlation between sexually transmitted diseases (STD) and assisted reproduction techniques (ART) we must consider that it is necessary to collate information and start screening campaigns for all sexually active individuals with the purpose of prevention and early diagnosis of STD which may cause of sterility. Before starting any kind of ART it is mandatory to perform diagnostic tests in all couples and to apply the correct therapy for any STD: treatment must always involve both partners and results must be carefully checked. All diagnostic examinations and all ART procedures should not carry the risk of transmitting any infection. When one or both of the partners are carriers of a transmissible infection (especially AIDS) it is advisable to negate ART or to start treatment, particularly for the semen, in order to reduce the level of infection and to avoid the transmission of any infection to the fetus.

Acquired Immunodeficiency Syndrome↗
PubMed2000

[Primary retroperitoneal seminoma--a rare germ cell neoplasm].

A 44-year old male presented himself with left-sided abdominal pain. On clinical examination a painless, enlarged supraclavicular lymph node on the left side and small atrophic testes were detected. Ultrasonography revealed a huge retroperitoneal mass. By biopsy of the retroperitoneal tumor the diagnosis of a seminoma was made, but neither in the orchidectomy specimen of the right side nor in the testicular biopsy of the left side a primary tumor or a scar could be identified. Thus, the diagnosis of a extragonadal primary retroperitoneal seminoma was made. The patient responded well to the combined chemotherapy consisting of cisplatin, bleomycin and etoposide. For distinction from an occult and/or burned-out seminoma testicular biopsy or surgical exploration of the testes with histology are mandatory.

Adult↗
PubMed1999

[Problems of diagnosis and treatment of cervicitis].

Infectious cervicitis is a common disease in women of reproductive age. The symptoms are not characteristic and they are often neglected by the patient and the physician. Cervicitis is a very important clinical entity, because the infection can ascend to the genital tract. The most common causes for the infectious cervicitis are Chlamydia trachomatic and Neisseria gonorrhoeae. A variety of methods for the precise diagnosis must be employed--gynecologic examination, colposcopy, pathomorphology and cytology and bacteriological examination as well. Therapeutic modalities must include coverage for both Chlamydia trachomatis and Neisseria gonorrhoeae. Bacteriological test of cure is mandatory.

Adolescent↗
PubMed2004

Child-onset growth hormone deficiency in adulthood. Transfer of patients from pediatric to adult endocrinology units.

Treatment with growth hormone (GH) in adult-onset GH deficiency (AO-GHD) reverses its many metabolic alterations, modifying body composition, bone mass, several cardiovascular risk factors, and improving quality of life. In adult patients with a previous diagnosis of child-onset GH deficiency (CO-GHD), the lack of treatment also produces similar alterations, reversed by GH treatment. In patients with multiple pituitary hormone deficiency, the lack of GH is considered definitive, but in isolated GHD, the need for re-evaluation of the deficit is mandatory. The 'gold standard' test is insulin-induced hypoglycemia, after a wash-out period, and the criterion for GH therapy should be a GH (polyclonal-RIA assay) response less than 3 ng/ml. The initial recommended GH dose is lover than in children, and the dosage must be adjusted to maintain IGF-I levels in the normal range. We propose that decisions about patient recruitment, assessment, confirmation or reevaluation, information about new perspectives, disadvantages and benefits of GH therapy, and the beginning of treatment should be made in cooperation by pediatric and adult endocrinologists, so the patient receives all information from both medical teams, before being transferred to the adult endocrinology department.

Adult↗
PubMedDate not supplied

Understanding the implications of over the counter statin sales.

Coronary heart disease (CHD) is the UK's biggest killer. While recommending that all patients can benefit from lifestyle interventions, the current guidelines focus pharmacological management on those at high risk. An over the counter (OTC) statin would enable people with moderate (10-15 per cent) CHD risk to take preventive action. Pharmacists would be able to recommend OTC simvastatin to those at moderate risk by following a simple pharmacy protocol to assess a person's risk. A regime of 10 mg simvastatin daily would have a significant impact on both the low-density lipoprotein cholesterol (LDL-C) level and the CHD risk of those at moderate risk. Cholesterol testing would not be mandatory but would be available in pharmacy to enable people to monitor their progress.

Coronary Disease↗
PubMed1991

Application of a new positioning device for isometric replacement in anterior cruciate ligament repair and reconstruction.

The functional effects of displacing the cruciate ligament attachments were studied in ten adult cadaver knees. On a systematic variation of the femoral and tibial attachment sites according to a three-dimensional raster scheme, a quantitative analysis of the absolute length and of motion-dependent changes in ligament isometry was performed. All insertion points deviating from the original anatomic landmarks did not accomplish biomechanical requirements. A femoral displacement had an increased effect on disturbing isometry compared to a tibial malposition. Although recommended by several authors, the "over-the-top" position gave the most unsatisfactory results with a maximum isometry failure of 10 mm. In cruciate ligament replacement a positioning guide with isometry testing capacity should be mandatory to ensure correct placement of bone tunnels. For this purpose a new positioning device which allows for isometry measurements before a bone channel is drilled is introduced and applied in an experimental setup.

Aged↗