Adequacy Of Surveillance Research Articles

An improved dark channel prior based defogging algorithm for video sequences

Bad climatic situations comprising of haze, dimness, and residue frequently decrease the general execution of outside cameras. Fog carries an issue to PC vision/photographs applications as it drops deceivability of the scene. The murkiness is framed because of principal marvels, which may be a constriction and air-light. Weakening diminishes the differentiation and air-light will expand the whiteness inside the scene. Cloudiness disposal systems improve the shading and correlation of the stage. To enhance the adequacy of surveillance and in-vehicle cameras underneath such conditions, a method dependent on the dull channel earlier for snappy defogging of pictures is proposed. On this work to defog an image, dark channel prior based algorithm is carried out the use of atmospheric scattering version. The proposed algorithm estimates the air light-based totally on the input image, calculating the preliminary transmission rate map, refining it and then finally restoring the fog image and it is applied for a real-time video sequence, and the video frames are defogged.

IFT05. Outcomes of Basilic Vein Transposition: Challenges in an Indian Setting

Basilic vein transposition (BVT) is performed after other native access options are exhausted. Based on the numbers that we perform and vein maturation, we would expect good patency. The objective of this study was to understand the patency of BVT in our practice and the adequacy of surveillance. This was a retrospective study. All patients who underwent BVT between January 2015 and December 2016 were included. Patients who did not attend follow-up clinic were contacted by telephone. Data regarding patient demographics, previous vascular access, dialysis status, postoperative complications and patency (primary, primary assisted and secondary patency rates) at one year and two-year intervals were collected. There were 126 BVTs performed in 125 patients. Mean age of patients was 53 years (range, 16-82 years) and 78 patients (62.4%) were male. All patients had multiple failed native arterial fistulas before BVT. Two patients were in predialysis status and the others were on dialysis using tunneled central lines. BVT was performed as single-stage procedure in all patients. Three patients (2.4%) died and one patient underwent renal transplant within the first 30 days. Only 18% of the patients attended the scheduled follow-up visits. Of 122 procedures, 115 (94.3%) resulted in a mature fistula. At the 1-year follow-up, 38 patients were lost, 19 patients were dead, and 4 patients had renal transplant. At 1 year there were 65 (52%) eligible patients for analysis, of which 8 patients had ligation of the transposed basilic vein for pseudoaneurysm/bleeding complications and the primary patency was 49.2%, primary-assisted patency 56.9%, and secondary patency was 66.1%. At 2 years an additional 10 patients died and 3 patients had renal transplant. At 2 years there were 52 eligible patients (41%) for analysis, out of which the primary patency was 38.5%, primary-assisted patency was 42.3%, and secondary patency was 59.6%. Surveillance was inadequate because patients were being dialyzed at other centers and in other cities. Dialysis technicians and nurses often failed to recognize failing fistulas. BVT can be performed safely with good maturation in majority of the patients. However, inadequate surveillance and maintenance of fistulas can result in reduced 1- year and 2-year patency rates. A patient-centered approach with communication and education of patients, dialysis technicians, nephrologists and vascular surgeons could improve the patency rates.

MP18-01 THE IMPACT OF MASSIVE TRANSFUSION PROTOCOL ON SIGNIFICANT HEMORRHAGE DURING UROLOGIC SURGERIES

INTRODUCTION AND OBJECTIVES: Adult patients with myelomeningocele (MMC) and the associated neurogenic bladder require consistent, lifelong vigilance. Preventing these complications may be possible if adequate surveillance can be implemented for these patients. Our objectives are to evaluate the adequacy of urologic surveillance in this population and to outline the prevalence and risk factors for medical complications. METHODS: We performed a retrospective cohort study using a 5% sample of Medicare administrative data from 2007 2010. We used the Paralyzed Veterans of America screening guideline to define the minimum adequacy of surveillance: serum creatinine, upper urinary tract imaging and a urologist visit within a 2 year period. Neurogenic bladder associated complications and diagnosis of MMC were collected using ICD 9 codes. Complications were graded based on their clinical implications. We completed a multivariate analysis to identify predictors of complications based on severity. We included the following variables: age, gender, race, travel distance to referral center, and geographic location of residence. RESULTS: 825 MMC patients were included in our study and were a predominantly Caucasian (85.1%) female population (61.3%) with a mean age of 51.2 þ/ 17.2 years. Most patients (61.3%) received some form of neurogenic bladder surveillance, although only 33% of the patients met the minimum acceptable criteria for adequacy. A urologist visit within two years took place for 44% of the patient population. Most complications observed in the patient sample were mild complications, which occurred in 27.6% of patients. Moderate and severe complications were observed in 17.0% and 6.6% of patients, respectively. The most common complications were acute or recurrent cystitis (16.4%), pressure ulcers (7.1%), chronic kidney disease (4.4%), and kidney infection (3.7%). Multivariate analysis showed that the risk factors for increased complications included younger patient age, male gender and better adequacy of neurogenic bladder surveillance. CONCLUSIONS: This retrospective sample of patients highlights the opportunity for improvement in surveillance in this susceptible population. The select minority of patients who received adequate observation was diagnosed with a larger number of complications. Disease ascertainment may be better in the adequately screened MMC population. This emphasizes a need for a close watch on this high risk patient population.

A Single-Center Experience Comparing Surveillance of Barrett’s Esophagus in Subjects With Liver Cirrhosis and Those Without Cirrhosis

Introduction: The epithelium of Barrett’s Esophagus (BE) could sequentially progress from metaplasia to low grade dysplasia (LGD) to high grade dysplasia (HGD) and finally Esophageal Adenocarcinoma (EAC). Our aim was to evaluate endoscopic surveillance for BE in patients with and without liver cirrhosis. Methods: We conducted a retrospective review of 1960 medical records of cirrhotic patients between 1997 and 2011 at a major urban hospital. Inclusion criteria for the case group consisted of cirrhotic patients with biopsy-proven BE. Matched controls with biopsy proved BE were identified using ICD-9, and were matched for the length of BE and the year of diagnosis. Risk factors analyzed included age, sex, body mass index, aspirin use, history of Gastroesophageal reflux disease (GERD), length of BE and proton pump inhibitor (PPI) use. Adequacy of surveillance was assessed based on the 2008 guidelines of the American College of Gastroenterology for the Diagnosis, Surveillance and Therapy of Barrett’s Esophagus. Results: In total, 23 cirrhotic patients with BE were compared with 23 matched controls. Mean age was significantly different (54.8±7.7 in cirrhotic vs. 65±11.6 in non-cirrhotic group) (p<0.001). The majority of patients were Caucasian (82.6% vs. 87%) and males (87% vs. 73.9%) in cirrhosis and non-cirrhosis groups, respectively. There was a significant difference in factors which may produce symptomatic disease with hiatal hernia was diagnosed in 8 patients (35%) in the cirrhotic group versus 16 (70%) in the non-cirrhotic group (p < 0.03). Rate of GERD was lower in the cirrhosis group with 11 patients (47.8%) versus 16 (69.6%) in the non-cirrhosis group (p=0.05). There was an equal number of patients with long and short segment BE, 13 (23%) (p >0.05). The rate of surveillance of BE in both groups was low with 15% in cirrhosis group versus 20% in the non-cirrhosis group having adequate surveillance (p< 0.56). There was no statistically significant difference in identified advanced disease between the two groups. In the cirrhosis group, there was one case of EAC that was treated with Endoscopic Mucosal Resection. Follow-up repeat endoscopy showed residual HGD. In the non-cirrhosis group, there were two patients with LGD and one patient with HGD. One case of LGD regressed to no dysplasia after treatment with PPI alone. The other two cases regressed to no dysplasia after treatment with EMR and radiofrequency ablation. Conclusion: Our study demonstrates poor surveillance of diagnosed BE in both cirrhotic and noncirrhotic patients. Those with cirrhosis were less likely to have GERD or hiatal hernia at the time of diagnosis. When surveillance resulted in diagnosis of dysplasia, early management was able to result in regression of disease.

Elimination of Endemic Measles, Rubella, and Congenital Rubella Syndrome From the Western Hemisphere

To verify the elimination of endemic measles, rubella, and congenital rubella syndrome (CRS) from the Western hemisphere, the Pan American Health Organization requested each member country to compile a national elimination report. The United States documented the elimination of endemic measles in 2000 and of endemic rubella and CRS in 2004. In December 2011, the Centers for Disease Control and Prevention convened an external expert panel to review the evidence and determine whether elimination of endemic measles, rubella, and CRS had been sustained. To review the evidence for sustained elimination of endemic measles, rubella, and CRS from the United States through 2011. Review of data for measles from 2001 to 2011 and for rubella and CRS from 2004 to 2011 covering the US resident population and international visitors, including disease epidemiology, importation status of cases, molecular epidemiology, adequacy of surveillance, and population immunity as estimated by national vaccination coverage and serologic surveys. Annual numbers of measles, rubella, and CRS cases, by importation status, outbreak size, and distribution; proportions of US population seropositive for measles and rubella; and measles-mumps-rubella vaccination coverage levels. Since 2001, US reported measles incidence has remained below 1 case per 1,000,000 population. Since 2004, rubella incidence has been below 1 case per 10,000,000 population, and CRS incidence has been below 1 case per 5,000,000 births. Eighty-eight percent of measles cases and 54% of rubella cases were internationally imported or epidemiologically or virologically linked to importation. The few cases not linked to importation were insufficient to represent endemic transmission. Molecular epidemiology indicated no endemic genotypes. The US surveillance system is adequate to detect endemic measles or rubella. Seroprevalence and vaccination coverage data indicate high levels of population immunity to measles and rubella. The external expert panel concluded that the elimination of endemic measles, rubella, and CRS from the United States was sustained through 2011. However, international importation continues, and health care providers should suspect measles or rubella in patients with febrile rash illness, especially when associated with international travel or international visitors, and should report suspected cases to the local health department.

Experts split on adequacy of surveillance since SARS

A decade ago, after the SARS epidemic killed 44 people, the ensuing federal expert panel called for a national public health agency to dramatically expand emerging infectious disease surveillance. Has that been achieved? Yes, says Dr. Frank Plummer, who served on the panel as the scientific

Evidence Used to Support the Achievement and Maintenance of Elimination of Rubella and Congenital Rubella Syndrome in the United States

On 29 October 2004, an expert panel was convened to review the status of elimination of rubella and congenital rubella syndrome (CRS) in the United States. Primarily based on 5 types of information presented--epidemiology of reported cases, molecular epidemiology, seroprevalence, vaccine coverage, and adequacy of surveillance--the panel unanimously agreed that rubella virus is no longer endemic in the United States. Since 2004, new data continue to support the conclusion that elimination has been achieved and maintained. In documenting elimination in the United States, each of the 5 types of data provided evidence for elimination and collectively provided much stronger evidence than any one type could individually. As countries document the elimination of rubella and CRS, many sources and types of data will likely be necessary. Rigorous data evaluation must be conducted to look for inconsistencies among the available data. To maintain elimination, countries should maintain high vaccine coverage, adequate surveillance, and rapid response to outbreaks.

Active screening at entry for tuberculosis among new immigrants: a systematic review and meta-analysis

Although there is no evidence that imported tuberculosis increases the incidence of the disease in host countries, the rise in migration worldwide raises concerns regarding the adequacy of surveillance and control of immigrant-associated tuberculosis in low incidence countries. Assessing the performance of screening of immigrants for tuberculosis is key to rationalizing control policies for the detection and management of immigrant-associated tuberculosis. We performed a systematic review and meta-analysis to determine the yield of active screening for tuberculosis among new immigrants at the point of entry. The yield for pulmonary tuberculosis was 3.5 cases per 1,000 screened (95% CI 2.9-4.1; I(2) = 94%); for refugees, asylum seekers and regular immigrants the estimates were 11.9 (95% CI 6.7-17.2; I(2) = 92%), 2.8 (95% CI 2.0-3.7; I(2) = 96%) and 2.7 (95% CI 2.0-3.4; I(2) = 81%), respectively. The yield estimates for immigrants from Europe, Africa and Asia were 2.4 (95% CI 1.3-3.4; I(2) = 51.5%), 6.5 (95% CI 3.2-10.0; I(2) = 62%) and 11.2 (95% CI 6.2-16.1; I(2) = 95%), respectively. These results provide useful data to inform the development of coherent policies and rational screening services for the detection of immigrant-associated tuberculosis.

Increased detection rates of Barrett's oesophagus without rise in incidence of oesophageal adenocarcinoma.

The incidence of oesophageal adenocarcinoma has quadrupled in the last 20 years. Barrett's oesophagus carries a 30- to 125-fold increased risk of developing adenocarcinoma. The purpose of this study was to evaluate the incidence and surveillance of Barrett's oesophagus, dysplasia and adenocarcinoma in Eastern Switzerland. Histological reports of 3659 patients (5190 oesophageal biopsies) from the St. Gallen Institute of Pathology were searched for evidence of Barrett's oesophagus (period 1989-1999). After retrospective classification according to findings on endoscopy and histology, the data were analysed with regard to surveillance intervals and incidence rates of Barrett's oesophagus, dysplasia and adenocarcinoma. 742 patients with Barrett's oesophagus and 100 with oesophageal adenocarcinoma were identified and followed up for a mean 1.6 (1-11) years. The average incidence of Barrett's oesophagus rose from 8.5/10(5)/yr (CI-95%: 7.4-9.7) in the first to 15.5/10(5)/yr (CI-95% 14.0-17.0) in the second 5-year period. The incidence of adenocarcinoma in our study population was 0.5% (1/97 patient years). In 207 patients (25%) with follow-up of >1 year, 9% progressed to low grade and 1% to high grade dysplasia, and 5% to adenocarcinoma. Adequacy of surveillance in BE patients rose from 54% to 87% over the study period. There is an increasing incidence of Barrett's oesophagus, which is not accompanied by an increase in oesophageal adenocarcinoma, in Eastern Switzerland. Surveillance of Barrett's oesophagus is often inadequate in spite of relevant findings such as dysplasia.

Increased detection rates of Barrett's oesophagus without rise in incidence of oesophageal adenocarcinoma.

The incidence of oesophageal adenocarcinoma has quadrupled in the last 20 years. Barrett's oesophagus carries a 30- to 125-fold increased risk of developing adenocarcinoma. The purpose of this study was to evaluate the incidence and surveillance of Barrett's oesophagus, dysplasia and adenocarcinoma in Eastern Switzerland. Histological reports of 3659 patients (5190 oesophageal biopsies) from the St. Gallen Institute of Pathology were searched for evidence of Barrett's oesophagus (period 1989-1999). After retrospective classification according to findings on endoscopy and histology, the data were analysed with regard to surveillance intervals and incidence rates of Barrett's oesophagus, dysplasia and adenocarcinoma. 742 patients with Barrett's oesophagus and 100 with oesophageal adenocarcinoma were identified and followed up for a mean 1.6 (1-11) years. The average incidence of Barrett's oesophagus rose from 8.5/10(5)/yr (CI-95%: 7.4-9.7) in the first to 15.5/10(5)/yr (CI-95% 14.0-17.0) in the second 5-year period. The incidence of adenocarcinoma in our study population was 0.5% (1/97 patient years). In 207 patients (25%) with follow-up of >1 year, 9% progressed to low grade and 1% to high grade dysplasia, and 5% to adenocarcinoma. Adequacy of surveillance in BE patients rose from 54% to 87% over the study period. There is an increasing incidence of Barrett's oesophagus, which is not accompanied by an increase in oesophageal adenocarcinoma, in Eastern Switzerland. Surveillance of Barrett's oesophagus is often inadequate in spite of relevant findings such as dysplasia.