Evaluation Of Early Changes Research Articles

Evaluation of Early Changes in Troponin Levels During Dental Surgery in Patients with a History of Ischemic Heart Disease

Evaluation of Early Changes in Troponin Levels During Dental Surgery in Patients with a History of Ischemic Heart Disease

Evaluation of early changes of macular function and morphology by multifocal electroretinograms in patients with nasopharyngeal carcinoma after radiotherapy.

To assess the role of multifocal electroretinograms (mfERGs) and optical coherence tomography (OCT) for detecting early changes in macular functions of patients with nasopharyngeal carcinoma (NPC) after radiotherapy. mfERGs and OCT were used to examine a NPC group (36 NPC patients after radiotherapy without clinically visible radiation retinopathy, 36 eyes) and a normal control group (25 healthy individuals, 25 eyes) with the same procedure and parameters. The two groups of mfERG were summarized by calculating ring averages, response density, N1 amplitude and P1 and N1 latencies were analysed. OCT scan thickness was summarized into ETDRS regions for comparison. Compared with controls, the NPC group had significantly decreased P1 response densities in 1-4 ring regions and N1 amplitudes in 1-3 rings (P < 0.01). P1 latencies were obviously prolonged in rings 1 (P < 0.01). In four quadrants (inferonasal, superonasal, inferotemporal and superotemporal) of the mfERG response waveforms, the NPC group had significantly decreased P1 response densities and N1 amplitudes mainly in the inferonasal and inferotemporal quadrants, showing statistically significant differences from the control group (P < 0.0125). But for the OCT results, there is no statistically significant difference between the NPC group and the control group. In NPC patients after radiotherapy, there may be changes in the mfERGs before any visible fundus lesions appeared as radiation macular oedema. Since the global OCT macular thickness analysis cannot reveal early changes, the mfERGs can objectively and quantitatively assess the earlier changes in macular function in NPC patients.

Evaluation of early changes in oral health-related quality of life amongst Nigerian patients undergoing fixed orthodontic appliance therapy

The objective of the study was to evaluate changes in the oral health-related quality of life (OHRQoL) during fixed appliance therapy. Sixty-one patients requiring fixed appliance therapy participated in the study. OHRQoL was assessed in all participants using the United Kingdom Oral Health-Related Quality of Life (OHRQoL-UK) tool and the Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ), at baseline (T0), 1 week (T1), 1 month (T2), 3 months (T3), and 6 months (T4), after appliance placement. Friedman 2-way analysis of variance (ANOVA) and Wilcoxon signed rank tests were used to compare the changes at the P<0.05 significance level. There was a significant deterioration in OHRQoL in the first week of treatment based on the OHRQoL-UK measure (P=0.01). The PIDAQ, however, showed significant improvement in OHRQoL throughout the study period (P<0.05). Fixed orthodontic appliance therapy can significantly improve the OHRQoL of individuals.

Evaluation of early changes of femoral artery elasticity in type 2 diabetes mellitus combined with microalbuminuria patients using ultrasound radio-frequency

Objective To evaluate early changes of femoral artery elasticity in type 2 diabetes mellitus (T2DM) combined with microalbuminuria (MA) patients using ultrasound radio-frequency technology, and to study the clinical significance. Methods 51 T2DM without MA patients were enrolled in Group A, and 53 T2DM with MA patients were enrolled in Group B. In order to observe the early elastic changes in the subjects, two-dimensional ultrasound was used to eliminate patients whose intima-media thickness (IMT) was >1 mm. The femoral arteries were imaged by two-dimensional ultrasonography, and then the IMT, femoral artery inner diameter (D), distensibility coefficient (DC), compliance coefficient (CC), elasticity coefficient (α and β), and pulse wave velocity (PWV) were real-time tested using quality intima-media thickness (QIMT) and quality arterial stiffness (QAS) analyzing systems. Besides, the differences and correlation analyses of these parameters between the two groups were conducted. In addition, some other parameters of sujects in both group A and B were also determined and analysed, including total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), creatinine (CREA), glycosylated hemoglobin (HbA1c), fasting blood glucose (FPG), 2h postprandial plasma glucose (2hPG) and body mass index (BMI). Results There were no significant differences in the elastic parameters of femoral arteries between the male and female subjects (P>0.05), and between left and right sides (P>0.05) within a same group. Compared with group A, group B had lower CC and DC (P 0.05). The levels of TG, HbA1c, FPG and 2hPG in group B were significantly higher than those in group A (P 0.05). Conclusions The decrease of arterial elastic function is earlier than morphological changes, that is, it may have occurred before MA in T2DM patients. The application of ultrasound radio-frequency analyzing technology has certain significance in the clinical early diagnosis and treatment. Key words: Ultrasonography; Type 2 diabetes mellitus; Microalbuminuria; Femoral artery

Repeatability of contrast sensitivity testing in patients with age-related macular degeneration, glaucoma, and cataract.

To analyze the intrasession and intersession repeatability of contrast sensitivity (CS) measurements in patients with glaucoma, cataract, or age-related macular degeneration (AMD) and healthy controls. CS measurements were performed using the OPTEC-Functional Vision Analyzer (FVA), which uses a standardized and closed (view-in) system. Measurements for patients with glaucoma, cataract, or AMD and healthy controls were repeated within 30 minutes (intrasession) and during two sessions (intersession), separated by one week to one month. Test-retest reliability and correlation were measured using the intraclass correlation coefficient (ICC) and coefficient of repeatability (COR). Ninety subjects (90 eyes) with visual acuity of 0.17 logMAR or higher in the cataract group or 0.00 logMAR in the other groups were included. During the first session, the ICC values were 0.87, 0.90, 0.76, and 0.69, and COR values were 0.24, 0.20, 0.38, and 0.25 for the control, glaucoma, cataract, and AMD groups, respectively. The reliability scores significantly improved during the second session, except in the glaucoma group. There was an acceptable floor effect and no ceiling effect at higher frequencies in the glaucoma and AMD groups. In subjects with good visual acuity, the FVA system is useful for evaluating CS and demonstrates good repeatability, as shown by ICC and COR. Because there is no ceiling effect, this system is beneficial for evaluation of early changes in CS, particularly in patients with glaucoma or AMD.

Evaluation of early changes induced by diuron in the rat urinary bladder using different processing methods for scanning electron microscopy.

Diuron [3-(3,4-dichlorophenyl)-1,1-dimethylurea] is a substituted urea herbicide carcinogenic to the rat urinary bladder at high dietary levels. The suggested non-genotoxic mode of action (MOA) of diuron encompasses cytotoxicity and necrosis followed by regenerative hyperplasia. Prenecrotic swollen cells as observed under scanning electron microscopy (SEM) have been reported as early morphological alterations, putatively related to diuron cytotoxicity. However, these changes were not observed in a previous SEM study conducted in this laboratory. This study evaluated whether these early alterations are actually due to diuron cytotoxicity or artifacts related to different processing methods used for SEM analysis. Male Wistar rats were fed ad libitum with basal diet, 7.1% sodium saccharin (NaS) or 2.500ppm diuron for seven days or 15 weeks. The urinary bladders were processed for histological and labeling indices examinations and for SEM using two different processing methods. The incidence of simple hyperplasia after 15 weeks of exposure to diuron or to NaS was significantly increased. By SEM, the incidences and severity of lesions were significantly increased in the diuron group independently of exposure time. The different SEM processing methods used allowed for visualization of swollen superficial cells after seven days of diuron exposure. Probably the absence these cells in a previous study was due to the use very few animals. Our results support the hypothesis that the swollen cell is an early key event due to diuron-induced cytotoxicity and is the result of a degenerative process involved in the non-genotoxic carcinogenic mode of action of high doses of diuron.

Fluorine-18-deoxyglucose positron emission tomography/computed tomography with Ki67 and GLUT-1 immunohistochemistry for evaluation of the radiosensitization effect of oleanolic acid on C6 rat gliomas.

The aim of this study was to investigate the radiosensitization effect of oleanolic acid (OA) in an in-vivo C6 rat glioma model using fluorine-18-deoxyglucose PET/computed tomography (18F-FDG PET/CT) and Ki67 and glucose transporter-1 (GLUT-1) immunohistochemistry(IHC) and evaluate the utility of 18F-FDG PET/CT in assessing early changes after radiotherapy. Tumor-bearing rats were divided into four groups: the control group (group A), the OA group(group B), the radiotherapy group (group C), and the OA combined with radiotherapy group (group D). 18F-FDG PET/CT images were obtained to monitor the tumor/muscle (T/M) ratio of 18F-FDG uptake before treatment,1 day after treatment, and 7 days after treatment. Tumor volume changes were also assessed, and hematoxylin and eosin staining and Ki67 and GLUT-1 IHC staining were also carried out. Before treatment, there were no obvious differences between the T/M ratios (F=0.147, P=0.931)and tumor volumes (F=0.177, P=0.911) among the four groups. At day 1 after treatment, statistical differences were observed in the T/M ratios (F=2.891, P=0.05), with decreased values in groups C and D compared with group A(tCA=2.354, tDA=2.356, P<0.05). At day 7 after treatment,the T/M values of group D were lower than those of the other three groups (tDC=2.416, P=0.03; tDA=8.133,tDB=7.656, P<0.01), and the tumor volumes of group D were significantly decreased compared with group C(t=2.351, P=0.02). There were significant differences in tumor cell densities and in the expression of Ki67 and GLUT-1 in the four groups (F=16.667, 22.082, and 39.555,P<0.001). The T/M ratio showed a significant correlation with the expression of Ki67 and GLUT-1, and our study also found a significant relationship between the expression of Ki67 and the expression of GLUT-1. OA has a radiosensitization effect on C6 rat glioma tumors in vivo, detected using 18F-FDG PET/CT and Ki67 and GLUT-1 IHC staining. 18F-FDG PET/CT is a potentially sensitive tool for the evaluation of early changes after radiotherapy.

Evaluation of early changes of cartilage biomarkers following arthroscopic meniscectomy in young Egyptian adults

BackgroundThe metabolic imbalance in the articular cartilage following meniscectomy includes an increase in cartilage degradation with an insufficient reparative or anabolic response resulting in structural, biochemical and mechanical changes that can progress from pre-clinical, to pre-radiographic, to radiographic damage of the joint. PurposeTo evaluate combinations of imaging and biochemical biomarkers for cartilage breakdown, synthesis and quantity in the early period of post-arthroscopic meniscectomy. Subjects and methodsTwenty young adults (three of them were females) who underwent unilateral arthroscopic partial meniscectomy were evaluated. The patients had a mean age of 32.5years (range, 24–39), mean BMI of 28.5kg/m2 (range, 24–34). Preoperative and six months postoperative US and MRI-based markers (cartilage thickness and volume, respectively) were quantified for medial and lateral tibio-femoral compartments for both knees. Preoperative, three and six months postoperative biochemical markers serum assays were measured; COMP and Col II (cartilage matrix breakdown) and PIICP (cartilage synthesis). These three markers were measured in an age, sex and BMI matched twenty healthy subjects for comparison. ResultsThe meniscectomized knees had significantly lower total knee cartilage volume, P<0.05 but non-significant mean thickness than the intact contralateral knees. Among the individual biochemical markers, PIICP had the highest significant diagnostic accuracy quantified as the area under the receiver-operator characteristics curve (AUC) of 0.75 (95% confidence interval: 0.509–0.912) higher than all others, P<0.05 to distinguish subjects with progressive cartilage loss from non-progressors. Diagnostically, ratio of COMP and Col II to PIICP scored AUC of 0.90 (0.69–0.98, higher than PIICP: P=0.0001). For prediction of cartilage loss, none of the individual markers could be used. ConclusionCartilage volume loss by MRI combined with changes in cartilage matrix turnover detected by molecular biomarkers may reflect the initial changes associated with cartilage degeneration that account for early OA.

The Medical Home Transformation in the Veterans Health Administration: An Evaluation of Early Changes in Primary Care Delivery

To evaluate the effect of medical home implementation on primary care delivery in the Veterans Health Administration (VHA). We link interview-based qualitative data on medical home implementation to quantitative outcomes from VHA clinical encounter data. We use a longitudinal analysis with provider fixed effects (taking advantage of variation in timing of implementation and allowing each provider to serve as a control for him or herself) to test whether patient-aligned care team (PACT) implementation was associated with changes in organizational processes and patient outcomes. Among 683 PCPs, caring for 321,295 patients, the uptake of eight of nine PACT structural changes significantly increased from July 2010 to June 2012 as did the percentage of primary care appointments occurring by telephone and hospital discharges contacted within 2 days of discharge. We found that PACT implementation was associated with significant improvements in 2-day post-hospital discharge contact, but not primary care visits occurring by telephone or within 3days of the requested date. We found no association between medical home implementation and rates of emergency department use by patients. Medical home implementation at the VHA resulted in large changes in the structure of care but few changes in patient-level outcomes. These results highlight both the complexity of studying the effect of the medical home as well as implementing this model to change primary care delivery.

Strain-blood pressure index for evaluation of early changes in elasticity of anterior tibial artery in patients with type 2 diabetes mellitus.

BackgroundThe aim of this study was to investigate the feasibility and value of strain-blood pressure index (SBPI) to assess early changes in elasticity of anterior tibial artery in patients with type 2 diabetes mellitus (T2DM).Material/MethodsEighty-one randomly selected in-patients with T2DM were divided into 2 groups – a vascular complication negative group (n=42) and a vascular complication positive group (n=39). Forty healthy volunteers were enrolled in a control group. Ultrasonographic scans using Xstrain™ technique were conducted for every patient to obtain the maximum circumferential strain (CSmax) of anterior tibial artery; patient blood pressure was also measured for calculating strain-blood pressure index (SBPI=CSmax/[(local pulse pressure)/local diastolic blood pressure] ×100%. Afterwards, SBPIs of various groups were comparatively analyzed.ResultsDifferences in SBPIs among the 3 groups were statistically significant (control group > negative group > positive group, P<0.05).ConclusionsSBPI could be used as a new indicator for the evaluation on the anterior tibial arterial elasticity of T2DM patients and it was able to reflect the early elasticity changes in anterior tibial arteries in T2DM patients with atherosclerosis.

Early changes of a novel APC-dependent thrombin generation assay during chemotherapy independently predict venous thromboembolism in cancer patients—a pilot study

Identifying cancer patients who are most at risk for venous thromboembolism (VTE) is essential to improve timely delivery of chemotherapy. Several studies have been performed to identify novel candidate biomarkers, but no agreement has yet been reached. In this light, we sought to analyze whether a dynamic evaluation of early changes of activated protein C (APC) function during chemotherapy could be predictive of a first VTE episode in cancer outpatients, thus improving risk stratification. A retrospective single-center pilot study was conducted to investigate the adequacy of a dynamic evaluation of a novel APC-dependent thrombin generation assay (HemosIL ThromboPath (ThP)) in predicting VTE in 208 ambulatory cancer patients, enrolled on the basis of tight inclusion criteria, prior to start and before the second cycle of a new chemotherapy regimen. Retrospective analysis of samples showed the occurrence of an acquired APC resistance during chemotherapy, which was predictive of VTE. Univariate Cox proportional hazards survival analysis showed that early ThP changes predicted VTE (stable vs. decreasing ThP: hazard ratio (HR) 0.21; 95% CI 0.10-0.19; p < 0.0001), which was confirmed in the multivariate model (HR 0.25; CI 0.12-0.52, p < 0.0001). Stratification of patients according to a risk assessment model showed a 0.18 HR for stable vs. decreasing ThP assay results in an intermediate risk group. We may thus conclude that early changes of ThP assay in patients on active chemotherapy enhance VTE risk stratification, helping in identifying a population of cancer patients who might benefit from thromboprophylaxis.

Ultrasound Evaluation of Early Changes in Arterial Dissection

We show magnetic resonance imaging, computed tomography-angiography, and ultrasound images of internal carotid artery dissection in a patient with acute ischemic stroke. Arterial changes occurring during the first few days were detected by serial ultrasound examinations. Neurologic and functional outcome are provided and therapeutic options discussed.

Two‐Dimensional Ultrasound Speckle Tracking Imaging in Evaluation of Early Changes in Left Ventricular Diastolic Function in Patients with Essential Hypertension

To investigate two-dimensional ultrasound speckle tracking imaging (STI) in evaluating values of early changes in left ventricular diastolic function in patients with essential hypertension (EH). Seventy-five EH patients with left ventricular normal geometry (LVN), including 38 cases with nonleft atrial enlargement (NLAE) and 37 cases with left atrial enlargement (LAE), and 50 healthy persons were enrolled as study participants. Two-dimensional images of LV apical four-chamber view, two chamber view, and LV long-axis view and short-axis view of mitral annular, papillary muscle, and apical levels were obtained to measure early diastolic E' peak value, late diastolic A' peak value, and E'/A' ratio at LV apical longitudinal strain rate (SrL) and short-axis radial strain rate (SrR), circumferential strain rate (SrC), and rotation rate (RotR) in all cardiac segments. Average values of E', A', and E'/A' at SrL in three segments on long-axis and SrR, SrC, and RotR on three short-axis levels were calculated. Untwisting rate (Untw R) and untwisting half-time (UHT) were also calculated. (1) Data on 110 of 125 patients were usable for STI analysis. (2) There were no intersegment significant differences between A' at SrL in three segments or interlevel significant differences between A' at SrR in three levels in the NLAE group and the LAE group. (3) Compared with the normal group, E' at SrL and E'/A' at SrL, SrR and SrC, and Untw R reduced in the NLAE group and the LAE group, while A' at SrL, SrR, and SrC and E' at RotR increased and UHT extended. STI may be helpful for the detection of early changes in left ventricular diastolic function in patients with EH.

Molekulare Kardiale PET jenseits der FDG-Vitalitätsdiagnostik

Molecular cardiac non F-18-FDG PET is currently based on perfusion imaging. It is of excellent diagnostic accuracy to detect coronary artery disease (CAD) and superior to perfusion SPECT. There is also evidence for its incremental prognostic value. The unique feature of PET to measure myocardial perfusion in absolute terms and in short time periods define its impact on cardiac imaging enabling both the evaluation of early changes in CAD and the accurate characterization of multivessel disease. Currently, all available PET perfusion tracers in Europe are cyclotron products. Rb-82, a generator product, is the most frequently employed perfusion tracer in the United States and cyclotrone independent. This tracer has the potential to become an alternative in Europe soon. Nowadays, PET systems are manufactured as hybrid PET-CT scanners. In oncology, hybrid imaging revealed, that the combination of functional and morphological imaging is superior to the single components. In cardiology, the integration of perfusion PET imaging with CT calcium scoring and CT anatomy of the coronary arteries represents a similar constellation. Atherosclerotic plaque evaluation by combined PET-CT technique will be one of the most promising future applications with a potential immense impact on prophylaxis, diagnosis and therapy of CAD in the future.

FDG-MicroPET and Diffusion-Weighted MR Image Evaluation of Early Changes After Radiofrequency Ablation in Implanted VX2 Tumors in Rabbits

The objective of this study was to evaluate the early changes after radiofrequency ablation (RFA) in VX2 rabbit tumors implanted into the back muscles by diffusion-weighted magnetic resonance (MR) imaging and (18)F-2-fluoro-2-deoxy-D-glucose positron emission tomography ((18)F-FDG PET). Percutaneous CT-guided RFA was conducted in seven rabbits with implanted VX2 tumors. VX2 tumors on the other side were untreated and served as the control. MR imaging was performed with a clinical 1.5-T instrument 2 days after RFA, and FDG-PET, using a high-resolution PET scanner for small animals, was obtained 3 days after the procedure. The mean apparent diffusion coefficient (ADC) values and radioactivity count of untreated and ablated tumors were calculated. Untreated VX2 tumors showed hyperintensity on T1-, T2-, and diffusion-weighted MR images, ring-enhanced on contrast-enhanced T1-weighted imaging, and ring-shaped FDG accumulation on FDG-PET. Ablated VX2 tumors showed slight hyperintensity on T1-, T2-, and diffusion-weighed images, slight enhancement on contrast-enhanced T1-weighted images, and low accumulation on FDG-PET. The ADC value of ablated VX2 tumors (1.52 +/- 0.24 x 10(-3) mm(2)/s) was significantly higher than that of untreated tumors (1.09 +/- 0.12 x 10(-3); p < 0.05). The tumor/muscle ratio of ablated tumors (0.5 +/- 0.3) was significantly lower than that of untreated tumors (11.6 +/- 3.2; p < 0.05). Histopathological examination confirmed the lack of viable tumor cells in the ablated lesions. The results indicate that both ADC value and FDG-PET are potentially useful markers for monitoring the early effects of RFA.

OP10.07: Evaluation of early changes in foetal cardiac function in TTTS before and after laser therapy using the Myocardial Performance Index

To evaluate early changes in foetal cardiac function in twin to twin transfusion syndrome (TTTS) using myocardial performance index pre and post laser therapy. Both donors and recipients of 51 monochorionic twin pregnancies complicated by TTTS were studied prospectively before and after laser therapy. The myocardial performance index (MPI) of both ventricles was calculated before ( ± 24 hours) and after laser therapy ( ± 24 hours) for the evaluation of early changes in the cardiac function. As expected before laser, the donors had a significantly lower MPI-RV and MPI-LV (myocardial performance index in the right ventricle and in the left ventricle) (0.41 vs 0.67; P < 0.000000) and (0.36 vs 0.54; P < 0.0001) respectively. After laser therapy MPI increased in both the recipient and the donor in both ventricles: MPI-RV (0.67 vs 0.49; P < 0.02) (0.41 vs 0.19; P < 0.001), MPI-LV (0.54 vs 0.16; P < 0.02) (0.36 vs 0.29; P < 0.002). Diastolic time in the mitral valve of the recipient increased significantly. MPI appears is a sensitive index to evaluate early changes in the global cardiac function.

OP10.09: Assessment of the Diastolic function in TTTS before and after Laser therapy based on ductus venosus waveform analysis

Objectives: To evaluate early changes in foetal cardiac function in twin to twin transfusion syndrome (TTTS) using myocardial performance index pre and post laser therapy. Methods: Both donors and recipients of 51 monochorionic twin pregnancies complicated by TTTS were studied prospectively before and after laser therapy. The myocardial performance index (MPI) of both ventricles was calculated before (±24 hours) and after laser therapy (±24 hours) for the evaluation of early changes in the cardiac function. Results: As expected before laser, the donors had a significantly lower MPI-RV and MPI-LV (myocardial performance index in the right ventricle and in the left ventricle) (0.41 vs 0.67; P < 0.000000) and (0.36 vs 0.54; P < 0.0001) respectively. After laser therapy MPI increased in both the recipient and the donor in both ventricles: MPI-RV (0.67 vs 0.49; P < 0.02) (0.41 vs 0.19; P < 0.001), MPILV (0.54 vs 0.16; P < 0.02) (0.36 vs 0.29; P < 0.002). Diastolic time in the mitral valve of the recipient increased significantly. Conclusions: MPI appears is a sensitive index to evaluate early changes in the global cardiac function.

Contrast echocardiographic evaluation of early changes in myocardial perfusion after recanalization therapy in anterior wall acute myocardial infarction and their relation with early contractile recovery

Temporal changes in myocardial perfusion after recanalization and their relation with functional recovery in patients with acute myocardial infarction (AMI) using intravenous myocardial contrast echocardiography (MCE) have not yet been clarified. To address this issue, 19 patients with first, uncomplicated anterior wall AMI were studied using intravenous MCE within 24 hours of recanalization and before discharge. MCE was performed using harmonic power Doppler. Each asynergic left ventricular (LV) myocardial segment was scored for myocardial perfusion (1 = complete, 0.7 = patchy but >50%, 0.3 = patchy <50%, and 0 = absent) and a regional perfusion index was calculated within the dysfunctioning myocardium. During the day-1 study (11 ± 2 hours from recanalization), the regional perfusion index was 0.4 ± 0.3 and the LV wall motion score index was 1.9 ± 0.2. During the study before discharge (7 ± 4 days from admission), all but 2 patients showed an improvement of either perfusion index (0.6 ± 0.3, p <0.0001) or wall motion score index (1.7 ± 0.4, p <0.0001). Changes in perfusion score from 24-hours to before discharge showed a significant correlation with LV segment contractile recovery at 2-month of follow-up (R 2 = 0.42, 95% confidence interval 0.33 to 0.50, p <0.0001). Thus, our data show that after recanalized AMI, there is a significant amount of microvascular obstruction that recovers in the days after, and the extent of this perfusion improvement appears to be related with early myocardial contractile recovery. Our data provide clinical evidence for a transient microvascular dysfunction after successfully recanalized AMI.

Epidemiological surveillance of human hydatidosis by means of ultrasonography: its contribution to the evaluation of control programs

Epidemiological surveillance for hydatidosis is based on initial determination and follow-up of the infestation rate in man, sheep and dogs. The use of ultrasonography (US) as a screening method has demonstrated its usefulness in detecting asymptomatic human carriers of abdominal hydatidosis. To evaluate the contribution of US to epidemiological surveillance within the framework of disease control programs, we performed 719 US studies in school children from 7 to 13 years of age, in rural areas of Rı́o Negro, Argentina, subjected to canine deparasitization during 1984/1986 and 1997/1998. In the first period, 15/268 (5.6%), while in the second, 5/451 (1.1%) carriers were detected ( P<0.0004). The average diameter of the cysts was 4.71 cm in 1984/1986 and 2.14 in 1997/1998. US as a mass screening method allows evaluation of early changes in human prevalence rates, closely related to infestation rates in sheeps and dogs, thus providing a sensitive indicator of the evaluation of control programs.

Fluorescence in situ Hybridization in the Diagnosis of Transitional Cell Carcinoma

Background: Cystoscopy is still considered to be the ‘Gold Standard’ in the diagnosis or urinary bladder cancer. However, this invasive technique is not free from subjective influences, especially in cases of superficial tumors of low malignancy. As is the case with cytological detection methods, cystoscopy suffers from a diagnostic gap in the early detection of urothelial carcinomas. Molecular genetic methods, on the other hand, are objective with regard to evaluation of early changes before any macroscopic tumor detection. Cytogenetic analyses of transitional cell carcinomas show structural changes of chromosomes 1, 3, 5, and 8 along with numerical aberrations of chromosomes 7, 8, 9, 10, and the Y chromosome. The detection of these changes in in vitro studies proved to be difficult for the need to establish tumor cell lines. Consequentially, fluorescence in situ hybridization (FISH) could be used as an alternative method to detect cytogenetic changes. Patients and Methods: Since 1995 we investigated 95 patients suffering from urinary bladder carcinoma in a prospective study. FISH was carried out on cells from spontaneous urine samples and bladder washes in parallel with conventional cytology. For chromosomes 7, 8, 9, and 12 centromere probes were used. Results: Comparing results on spontaneous urine samples and on bladder washes, the sensitivity of detecting tumor cells obtained by FISH was 27/32% (pTa), 72.6/92.8% (T1G1–2), and 73.3/86.6% (≤ pT1G3 and > pT1), respectively. In cases with papillomas and cystitis as well as in a control group, FISH yielded no false-positive results. Conclusion: Our data show that FISH is an objective, appropriate technique for diagnosis and follow-up of transitional cell carcinoma and represents a valuable complementation to the conventional cytological investigations.