Availability Of Screening Methods Research Articles

EVALUATION OF QUALITY INDICATORS OF SCREENING COLONOSCOPY PERFORMED IN A PRIVATE QUARTERNARY HOSPITAL IN BRAZIL.

Colorectal cancer is the third most common type of cancer in Brazil, despite the availability of screening methods that reduce its risk. Colonoscopy is the only screening method that also allows therapeutic procedures. The proper screening through colonoscopy is linked to the quality of the exam, which can be evaluated according to quality criteria recommended by various institutions. Among the factors, the most used is the Adenoma Detection Rate, which should be at least 25% for general population. To evaluate the quality of the screening colonoscopies performed in a quarternary private Brazilian hospital. This is a retrospective study evaluating the quality indicators of colonoscopies performed at a private center since its inauguration. Only asymptomatic patients aged over 45 years who underwent screening colonoscopy were included. The primary outcome was the Adenoma Detection Rate, and secondary outcomes included polyps detection rate and safety profile. Subanalyses evaluated the correlation of endoscopic findings with gender and age and the evolution of detection rates over the years. A total of 2,144 patients were include with a mean age of 60.54 years-old. Polyps were diagnosed in 68.6% of the procedures. Adenoma detection rate was 46.8%, with an increasing rate over the years, mainly in males. A low rate of adverse events was reported in 0.23% of the cases, with no need for surgical intervention and no deaths. This study shows that high quality screening colonoscopy is possible when performed by experienced endoscopists and trained nurses, under an adequate infrastructure.

Substance-Induced Psychosis in the Geriatric Population: Overview on Screening and Treatment

As our elderly population represents an increasing percentage of the overall population, more healthcare resources are spent treating this population. One of the overlooked issues is substance use in this population and its complications. This population is often not forthcoming with psychoactive medical issues, yet many of them came into adulthood in a time when substance use was widespread. This article will discuss the epidemiology of this population, a case of substance-induced persecutory delusion and the availability of screening methods and treatment options.

PRIMARY HYPERPARATHYROIDISM. A CLINICAL OBSERVA

Background. Primary hyperparathyroidism is an endocrine disease resulting from a primary pathology of the parathyroid gland, characterized by increased secretion of parathyroid hormone and increased blood calcium levels. Among the endocrine diseases, primary hyperparathyroidism is the third most common after diabetes mellitus and thyroid disease. Without timely diagnosis, primary hyperparathyroidism causes systemic damage to internal organs: renal impairment, nephrolithiasis, esophageal affection, cardiovascular and nervous system and affects bones. The aim of the work was to present a clinical case of a patient with primary hyperparathyroidism and to analyze the stages of its diagnosis and treatment. Material and methods. We reviewed the relevant literature and analyzed the patient’s medical records. Results and Discussion. The patient had a complicated course of primary hyperparathyroidism of bone and visceral form. Despite of the slow progression and availability of screening methods, hyperparathyroidism was detected at the stage of complications. The efficacy of the therapy has been assessed. The underlying reasons that made it difficult to diagnose PHPT at an early stage, before the development of serious complications of internal organs were investigated. Conclusions: It can be assumed that our clinical case will increase the awareness of physicians, especially therapists, about the primary manifestations of this pathology and the challenges of its detecting and avoiding diagnostic errors.

A CLINICAL CASE OF PRIMARY HYPERPARATHYROIDISM OF THE OSTEO-VISCERAL FORM

Introduction. Primary hyperparathyroidism is an endocrine disease resulting from a primary pathology of the parathyroid gland, characterized by increased secretion of parathyroid hormone and increased blood calcium levels. Among the endocrine diseases, primary hyperparathyroidism is the third most common after diabetes mellitus and thyroid disease. In Russia, according to epidemiological studies, primary hyperparathyroidism is found in 1% of the population, women suffer 2-3 times more often than men do, and the average age of diagnosis is 54-59 years. In the absence of a timely diagnosis, primary hyperparathyroidism causes systemic damage to internal organs: renal impairment, nephrolithiasis, esophageal affection, cardiovascular and nervous system involvement, and it leads to a violation of bone tissue integrity. The aim is to demonstrate a clinical case of a patient with primary hyperparathyroidism and to analyze the stages of diagnosis of the disease and treatment. Material and methods. The review of medical literature on the problem of diagnostics and treatment of primary hyperparathyroidism was performed, as well as an analysis of the patient’s medical documentation with this pathology. Results and discussion. A variant of complicated course of primary hyperparathyroidism of bone and visceral form is considered. About 15 years passed from the moment of appearance of the first symptoms of the disease to the development of complications of renal and bone system. Despite the slow development of the disease and availability of screening methods, hyperparathyroidism was detected at the stage of complications. This article provides a detailed analysis of the primary hyperparathyroidism history, as well as analyzes the possibilities of diagnosis, treatment and prevention of this pathology. The efficacy of the therapy has been assessed, and ways of correction have been outlined. The analysis of the reasons that made it difficult to diagnose this pathology at an early stage, before the development of serious complications of internal organs, has been carried out. Conclusions: It can be assumed that the presented clinical case will increase the awareness of physicians, especially therapists, about the primary manifestations of this pathology and the peculiarities of its detection and routing the patient, which will allow avoiding many diagnostic errors.

Variation in Breast Cancer Screening Recommendations by Primary Care Providers Surveyed in Wisconsin.

Cancer screening is chiefly performed by primary care providers (PCPs) who rely on organizational screening guidelines. These guidelines provide evidence-based recommendations; however, they are often without unanimity leading to divergent screening recommendations. Due to the high incidence of breast cancer, the availability of screening methods, and the presence of multiple incongruent guideline recommendations, we sought to understand breast cancer screening practices in Wisconsin to identify patterns that would allow us to improve evidence-based screening adherence. A 46-question survey on breast cancer screening beliefs and practices for average-risk women was sent to healthcare providers in Wisconsin in 2018, who provided cancer screening services to women. Providers included physicians, nurse practitioners (NPs), physician assistants (PAs), and midwives. A total of 295 people responded to the survey, for a response rate of 28.6%. Most respondents were physicians (64.1%), followed by NPs (25.7%), PAs (5.3%), and midwives (1.5%). Of physicians, most practiced family medicine (65.3%), followed by internal medicine (25.3%) and gynecology (9.4%). The United States Preventive Services Task Force (USPSTF) was reported as being "very influential" for 60.5% of providers, followed by the American Cancer Society at 46.8%. For patients 40-49years old, 75.6% of providers performed clinical breast exams and 58.5% recommended self-breast exams; these numbers increased for women 50+ years old to 78.7% and 61.2%, respectively. Mammography was more likely to be recommended annually for women aged 40-49 rather than biennially by non-physician clinicians compared to physicians (p < .001). PCPs in Wisconsin continue to overestimate the efficacy of clinical and self-breast exams as well as overuse these in clinical practice. Providers find multiple screening guidelines influential but favor the USPSTF; however, these guidelines are frequently not being followed. Further research needs to be done to investigate the lack of national guideline adherence by providers to improve compliance with evidence-based screening recommendations.

Network as biomarker

Identifying robust biomarkers for cancer phenotypes has challenged the biological and pharmacological communities for many years, more so since the availability of screening methods that reveal the expression levels of all the genes in the genome. A host of different approaches have been used to address this lack of robustness. These methods have included a spectrum of approaches from gene enrichment analysis to network inference analysis. More recently, some methods that use the network properties of genes have demonstrated an ability to provide a more robust signature. In this review, we survey different network-as-biomarker methods used to identify various biomarkers and we discuss the critical role of networks in the progress toward personalized medicine. We also discuss the ability of the network to identify misguided processes, rather than the gene itself, as the core of distinctions among phenotypes. Discussions about the importance of the molecular pathway view and about processes (rather than the gene per se) at the core of understanding cancer are not new. However, this review focuses on the set of tools available for actually measuring the pathway, or the process, when the expression levels of their components are available.

Prevalence of cervical intraepithelial neoplasia in Zaria

1. Preventing cervical cancer: Unprecedented opportunities for improving women’s health. Outlook 2007;1:23. 2. Roblyer D, Richards-Kortum R, Park SY, Adewole I, Follen M. Objective screening for cervical cancer in developing nations: Lessons from Nigeria. Gynecol Oncol 2007;107:S94-7. 3. Ayangbade O,Akinyemi A. Cervical Cytology in an urban Nigeria population. E Afr Med J 1982;66:50-6. 4. Ogun GO. Ronald Bejide cervical cancer in Nigeria, Still a Dismal story: The poor state of cervical cytology screening, factors responsible for continous high incidence of cervical cancer and hope for improvement. Washington, DC, USA: UICC World Congress; 2006. p. 8-12. Sir, Cervical cytology still remains the major method of cervical cancer prevention. The prevalence and incidence of carcinoma of the cervix is on the increase, despite the availability of screening method, which necessitated this study.

Conference report: Second conference of the Middle East and North Africa newborn screening initiative: Partnerships for sustainable newborn screening infrastructure and research opportunities

The second conference of the Middle East and North Africa newborn screening initiative: partnerships for sustainable newborn screening infrastructure and research opportunities was held in Cairo, Arab Republic of Egypt on April 12 to 14, 2008. Policy makers, health ministry representatives, health care providers, and experts from the region, Europe, Asia, and North America participated. The primary outcome was development of country plans of action to implement or expand newborn screening programs. Country representatives were grouped by current levels of national newborn screening activities based on a Needs Assessment Survey for national newborn screening programs and assisted by international technical experts. The Needs Assessment Survey provided information on the level of newborn screening in each country, strengths and barriers to implementation of newborn screening programs, and identified areas for research. Newborn screening programs require an integrated system of laboratories, health care providers, and educators, thus, the infrastructure put in place to screen for one condition should support expansion to other conditions. Congenital hypothyroidism was selected for initiating newborn screening programs because of its high prevalence, availability of screening methods, and cost-effective intervention. To this end, the conference provided technical sessions on screening and treatment of congenital hypothyroidism, performance standards, quality assurance, follow-up interventions, and patient management. In addition, presentations highlighted the value of integrating research into newborn screening programs as they are established and in evaluating outcomes. Research opportunities were identified at a postconference workshop sponsored by the US Civilian Research Development Foundation.