Mass Screening Test Research Articles

Diagnostic accuracy of a novel point-of-care test for simultaneous detection of anti-transglutaminase IgA and anti-deamidated gliadin IgG antibodies.

Point-of-care tests (POCTs) may have a role in detecting undiagnosed cases of Celiac disease (CD). We assessed the diagnostic accuracy of a novel POCT, compared with the conventional serological methods, for simultaneous anti-transglutaminase (tTG) IgA and anti-deamidated gliadin (DGP) IgG antibody detection. Furthermore, we evaluated the effect of different biological matrices (whole blood and serum) on test performance. Serum and whole blood from celiac or suspected celiac patients who underwent duodenal biopsy were assayed for the presence of anti-tTG IgA and anti-DGP IgG both with the reference standard methods (Thermo Fisher Scientific, Uppsala, Sweden) and with the POCT (PRIMA Lab SA, Balerna, Switzerland). 266 sera (101 negative and 165 positive) and 60 whole blood samples (34 positive and 26 negative) were included in the study. POCT for anti-DGP IgG showed a sensitivity of 84.3% and a specificity of 90.1%, with positive (PPV) and negative predictive values (NPV) of 91.07% and 82.73%. POCT for anti-tTG IgA showed a sensitivity of 98.31% and a specificity of 98.02%, with a PPV and NPV of 98.31% and 98.02%. Test accuracies were 86.94% and 98.17%, respectively. The agreement of the results between the two different matrices showed a strong correlation rate: 95% for anti-DGP IgG and 100% for anti-tTG IgA. The anti-tTG IgA/anti-DGP IgG-based POCT showed good diagnostic accuracy with comparable sensitivities and specificities to reference standard methods in detecting CD in symptomatic patients and could be considered as a mass screening test before referring to conventional serology.

An innovative PCR-free approach for DNA methylation measure: An application for early colorectal cancer detection by means of an organic biosensor

Colorectal cancer (CRC) is one of the most treatable cancers, but high mortality levels have been reported as a result of its asymptomatic nature in the very early stages of the disease. This justifies the importance of mass screening programs to fight colorectal cancer, and thus the interest in the development of minimally invasive, cost-effective tests. In this paper, a novel approach for the detection of CRC biomarkers in DNA stool samples is reported. The strategy is based on the detection of DNA methylation alterations as highly sensitive and selective epigenetic biomarkers by means of an organic transistor-based sensor, particularly suited for the integration in portable, low-cost and easy-to-use sensing system. A clear demonstration of the detection strategy effectiveness is provided using a standard CRC biomarker, namely SEPT9 (encoding for septin9), and further deepened using an innovative biomarker, GRIA4 (encoding for glutamate ionotropic receptor AMPA type subunit 4), in several samples coming from CRC patients. The correct detection of biomarkers, as confirmed by independent optical analysis, is demonstrated both on amplicons and unamplified genomic DNA derived from stool samples, thus making the proposed approach particularly attractive for the future development of non-invasive, PCR-free and low-cost mass screening tests.

Efficacy of antitissue transglutaminase antibodies in the diagnosis of celiac disease in children.

Objective: To determine the efficacy of antitissue transglutaminase antibodies in the diagnosis of celiac disease in children. Study Design: Observational Study. Setting: Department Peadiatric at Indus Medical College Hospital Tando Muhammad Khan. Period: July 2020 to December 2020. Material & Methods: Thirty five (35) cases were diagnosed to be suffering from celiac out of 50. The mean age at the time of diagnosis was 6.67 years with standard deviation 3.7 years and the male female ratio was 1:1.27. The data was entered, saved and analyzed in SPSS 10.00. Results: Main presenting characteristics were as; diarrhea, failure to thrive, and pain of the abdomen, malodour of stool and signs of malnutrition. Thirty five (70%) cases had elevated antitissue transglutaminase antibodies levels and 15 (30%) were negative while 32 cases had total villous atrophy on Jejunal biopsy. Conclusion: The antitissue transglutaminase antibody is cheaper and simpler and more sensitive test for mass screening.

Automated Evaluation of Conventional Clock-Drawing Test Using Deep Neural Network: Potential as a Mass Screening Tool to Detect Individuals With Cognitive Decline.

IntroductionThe Clock-Drawing Test (CDT) is a simple cognitive tool to examine multiple domains of cognition including executive function. We aimed to build a CDT-based deep neural network (DNN) model using data from a large cohort of older adults, to automatically detect cognitive decline, and explore its potential as a mass screening tool.MethodsOver 40,000 CDT images were obtained from the National Health and Aging Trends Study (NHATS) database, which collects the annual surveys of nationally representative community-dwelling older adults in the United States. A convolutional neural network was utilized in deep learning architecture to predict the cognitive status of participants based on drawn clock images.ResultsThe trained DNN model achieved balanced accuracy of 90.1 ± 0.6% in identifying those with a decline in executive function compared to those without [positive likelihood ratio (PLH) = 16.3 ± 6.8, negative likelihood ratio (NLH) = 0.14 ± 0.03], and 77.2 ± 2.7 % balanced accuracy for identifying those with probable dementia from those without (PLH = 5.1 ± 0.5, NLH = 0.37 ± 0.07).ConclusionsThis study demonstrated the feasibility of implementing conventional CDT to be automatically evaluated by DNN with a fair performance in a larger scale than ever, suggesting its potential as a mass screening test for ruling-in or ruling-out those with executive dysfunction or with probable dementia.

Coronavirus disease 2019 transmission and symptoms in young children during the severe acute respiratory syndrome coronavirus 2 Delta variant and Omicron variant outbreaks.

ObjectiveLittle is known about the transmission of coronavirus disease 2019 (COVID-19) in young children. This study aimed to clarify the risk of COVID-19 transmission among this population.MethodsBetween July 2020 and April 2022, 1660 0 to 3-year-old children underwent a nasopharyngeal swab for later reverse transcription-polymerase chain reaction testing at a mass screening test center in Japan. Their disease transmission rate and clinical symptoms were evaluated according to the predominant variant strains of that season.ResultsThe secondary transmission rate after close contact of the Delta B.1.617.2 (17.4%) and Omicron B.1.1.529 (39.2%) variants was significantly higher than that of the conventional strains (B.1.1.284 and B.1.1.214; 4.5%) during the pandemic. The increased transmissibility with the Delta and Omicron variants was independent of close contact or location. The prevalence rates of cough, fatigability, and fever were similar in young children infected by the Delta and Omicron variants.ConclusionsCOVID-19 transmission in children aged 0 to 3 years increased by 3 to 4 fold during the Delta outbreak and by 8 to 10 fold during the Omicron outbreak compared with the conventional strain outbreak. The symptoms in young children were not different between the Delta and Omicron variants.

Antigen Detection Tests for SARS-CoV-2: a systematic review and meta-analysis on real world data.

Background and aimRapid antigen detection (RAD) tests on nasopharyngeal specimens have been recently made available for SARS-CoV-2 infections, and early studies suggested their potential utilization as rapid screening and diagnostic testing. The present systematic review and meta-analysis was aimed to assess available evidence and to explore the reliability of antigenic tests in the management of the SARS-CoV-2 pandemic.Materials and MethodsWe reported our meta-analysis according to the PRISMA statement. We searched Pubmed, Embase, and pre-print archive medRxiv.og for eligible studies published up to November 5th, 2020. Raw data included true/false positive and negative tests, and the total number of tests. Sensitivity and specificity data were calculated for every study, and then pooled in a random-effects model. Heterogeneity was assessed using the I2 measure. Reporting bias was assessed by means of funnel plots and regression analysis.ResultsBased on 25 studies, we computed a pooled sensitivity of 72.8% (95%CI 62.4–81.3), a specificity of 99.4% (95%CI 99.0–99.7), with high heterogeneity and risk of reporting bias. More precisely, RAD tests exhibited higher sensitivity on samples with high viral load (i.e. <25 Cycle Threshold; 97.6%; 95%CI 94.1–99.0), compared to those with low viral load (≥25 Cycle Threshold; 43.6%; 95% 27.6-61.1).DiscussionAs the majority of collected reports were either cohort or case-control studies, deprived of preventive power analysis and often oversampling positive tests, overall performances may have been overestimated. Therefore, the massive referral to antigenic tests in place of RT-qPCR is currently questionable, and also their deployment as mass screening test may lead to intolerable share of missing diagnoses. On the other hand, RAD tests may find a significant role in primary care and in front-line settings (e.g. Emergency Departments). (www.actabiomedica.it)

Effectiveness of mRNA COVID-19 Vaccines in Japan during the Nationwide Pandemic of the Delta Variant.

The coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), remained a major global health concern in 2021. To suppress the spread of infection, mass vaccinations have been performed across countries worldwide. In Japan, vaccinations of the first and second doses for most of the nation were performed during the nationwide outbreak of the B.1.617.2 (Delta) variant with the L452R spike protein mutation, and the effectiveness of the vaccinations to suppress the spread of COVID-19 among the people in Japan remains uncertain. In this study, adults aged ≥18 years, who were in contact with patients with COVID-19 and underwent nasopharyngeal swab reverse transcription-polymerase chain reaction (RT-PCR) tests during August and September 2021 at a mass screening test center in Japan, were enrolled. In this period, more than 95% of the COVID-19 infections were reportedly caused by the Delta variant. As a result, a total of 784 adults with recent contact history, including 231 (29.5%) RT-PCR test-positive cases, were enrolled. The test positivity rate was lower in individuals who had been vaccinated twice than in unvaccinated individuals (12.5% vs. 39.0%, p < 0.0001), with the risk ratio of 0.32 (95% confidence interval 0.23-0.46). The vaccine effectiveness was the highest between 7-90 days after the second vaccine dose. In conclusion, two doses of mRNA COVID-19 vaccines effectively suppressed transmission in Japan during the nationwide pandemic of the Delta variant, estimated to have prevented 50-80% of the infection.

Views of Mothers about National Newborn Screening Tests Performed in Turkey

BackgroundNewborn screening tests can detect numerous congenital diseases that may cause disability or death and be performed first in 2006 in Turkey. Newborn screenings for Phenylketonuria and congenital hypothyroidism have increased in recent years due to the emergence of new diseases. It is essential for healthcare personnel and families to carry out these screening programs in a timely, accurate, and efficient manner. Informing families, particularly mothers, about these screening tests will help more newborn babies benefit from these tests. Therefore, this study aimed to explore mothers’ views about newborn screening programs in Turkey. Materials Methods: This descriptive and cross-sectional study included 112 volunteer mothers and was conducted at Zekai Tahir Burak Hospital, Ankara, Turkey, from December 2018 to January 2019. Results: Although mothers in Turkey were to some extent informed about the screening tests, they did not have sufficient information regarding the objective of these tests. Moreover, the majority of mothers expressed a positive opinion about the tests and stated that they would have these tests done even if they had to pay for them. Conclusion: Based on the obtained results, although mothers in turkey were not sufficiently knowledgeable about screening tests and their objectives, they expressed positive views about these tests. Therefore, it is recommended that families should be informed about newborn screening tests through mass media, educational environments (pregnancy schools), and screening test centers. Therefore, it is important to organize in-service training for midwives and nurses to raise their awareness in this regard.

Biological false positive rapid plasma reagin tests in pregnant females in North India

Background: Syphilis, a sexually transmitted disease seriously complicate pregnancy and produce harmful results in fetus. Screening of pregnant females in early pregnancy with non-treponemal tests such as RPR and VDRL is a cost effective strategy for diagnosis of syphilis. However, these tests could produce BFP reaction in pregnancy. The prevalence of which may be different in different populations and at different times. The current prevalence of the biological false positive rapid plasma regain tests in pregnant females of North India was there for assessed and being reported.Methods: A total 500 consecutive pregnant females who presented to our tertiary care center for the first time were screened for syphilis by RPR (a non-treponemal test) and Hi-Quik (a treponemal test) after obtaining their written consent.Results: Of the 500 females 21 (4.2%) were RPR positive and only one (0.2%) was Hi-Quik positive. Thus the prevalence of biological false positive rapid plasma regain tests in pregnant females of North India was 4% (20/500). In semi quantitative RPR, these tests were positive in ≤1:4 dilution and were not found to be related to any particular age, geographical distribution, literacy status, occupation or period of gestation (p value &gt;0.05) and were transient in nature.Conclusions: Our study concludes that although RPR is a good, cost effective test for mass screening of pregnant females, but it produces BFP reactions in considerable percentage (4%) in pregnant females of North India.

A discussion on implementing pooling detection tests of novel coronavirus (SARS-CoV-2) for a large population.

A pooled sample analysis strategy for novel coronavirus (severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2)) is proposed for a large population in this paper. The population to be tested is divided into divisions based on earlier observed detection rate of SARS-CoV-2 first. Samples collected are then grouped in appropriate pooled size. The number of tests per person in that population is expressed as a function of two variables: the observed detection rate and the pooled size or number of samples grouped. The minimum number of tests per person can be further shown to be a function of only one of these two variables, because these two parameters are found to be related at this minimum. A management scheme on grouping the samples is proposed in order to reduce the number of tests, to save time, which is of utmost importance in fighting an epidemic. The proposed testing scheme will be useful for supporting the government in making decisions to handle regular routine detection tests for identifying asymptomatic patients and implementing health code system in large population of millions of citizens. Another important point is to use smaller number of test kits, allowing more resources to speed up the mass screening tests, particularly in places not so rich.

Tantangan Penatalaksanaan STEMI di Pandemi Covid-19

The necessity of timely management of ST-elevation myocardial infarction (STEMI) is now disrupted by the Covid-19 pandemic. This paper discussed the challenge to manage STEMI in Indonesia due to Covid-19. It also discussed the alternative strategies for solution. Challenge can occur in term of the healthcare safety as well as STEMI patient safety. Healthcare safety potentially impaired by the problem of STEMI mimicry due to cardiovascular complication of Covid-10, inaccuracy of Covid-19 screening, lack of effective personal protection equipment for the healthcare and appropriate catheterisation laboratory to anticipate virus contamination. The safety of STEMI patient is potentially impaired due to prolonged ischemia time, and the risk of cross-infection. Solution for this challenge should include mass screening, rapid and accurate test to rule-out Covid-19, dual system of hospital units - Covid and non-Covid, and algorithm for triage patients with STEMI and Covid-19.

Tantangan Penatalaksanaan STEMI di Pandemi Covid-19

The necessity of timely management of ST-elevation myocardial infarction (STEMI) is now disrupted by the Covid-19 pandemic. This paper discussed the challenge to manage STEMI in Indonesia due to Covid-19. It also discussed the alternative strategies for solution. Challenge can occur in term of the healthcare safety as well as STEMI patient safety. Healthcare safety potentially impaired by the problem of STEMI mimicry due to cardiovascular complication of Covid-10, inaccuracy of Covid-19 screening, lack of effective personal protection equipment for the healthcare and appropriate catheterisation laboratory to anticipate virus contamination. The safety of STEMI patient is potentially impaired due to prolonged ischemia time, and the risk of cross-infection. Solution for this challenge should include mass screening, rapid and accurate test to rule-out Covid-19, dual system of hospital units - Covid and non-Covid, and algorithm for triage patients with STEMI and Covid-19.

Role of Nasopharyngeal lactate dehydrogenase as a possible economical mass screening test for the detection and segregation of SARS-CoV-2 (COVID-19) cases in India

COVID-19 pandemic is affecting almost every country in the world. Every country must test all the individuals with suspected clinical presentation of COVID-19. Unfortunately, the symptoms are mild and often the incubation period is 5–7 days. Hence, the detection of COVID-19 takes time and is costly even, many resource-constrained nations are not testing their citizens due to cost incurred. That is why we need an economical mass screening test to detect and help the health-care system to segregate cases needing their attention. Nasopharyngeal lactate dehydrogenase (LDH) is raised in viral upper respiratory infections, it can be easily tested and raised serum LDH in addition to nasopharyngeal LDH can predict stormy outcome of disease. Such prediction will help health-care system for effective resource allocation.

Development of a new mathematical tool for early colorectal cancer diagnosis and its possible use in mass screening

The aim of the study is to model a new mathematical tool effective in the diagnosis of colorectal cancer and useful as a mass screening test. This work enrolled 345 subjects from January 2011 to January 2013, in 4 Italian Surgical Departments: 97 (27,4%) out of the total were healthy controls (class 0) whereas 248 (72,6%) patients were affected by colorectal cancer. The cancer patients were divided into four classes, according to TNM staging classification: 74 (20,9%) patients stage I (class 1); 61 (17,2) patients stage II (class 2); 76 (21,5%) patients vstage III (class 3); 37 (10,5%) stage IV (class 4).Blood samples were collected after 24h from hospital admission and 17 biochemical parameters (CEA, ceruloplasmin, haptoglobin, transferrin, TPA, CA 19.9, CA 72.4, PCR, Ca 50, C4 Complement, CA 125, Alfa-1-antitrypsin, alpha-2-Macroglobulin, Ferritin, RBP, Alpha-1-Acid Glycoprotein, Complement C3) were statistically analysed together with the clinical and pathological disease staging (pre and postoperative evaluation, respectively). Evaluation and comparison were made between two groups: healthy controls and the total of affected patients.Using the collected data, it was developed a mathematical model (artificial neural network ANN) allowing the distribution of colorectal cancer and controls (apparently in good health) patients in the two groups. This led to the definition of an index (B-index) that, simply analysing the combined values of the 17 biochemical parameters, decides on the either healthy or disease status of the patient. The use of the B-index, with a neural network based on real values, allows colorectal cancer diagnosis with 80.078% accuracy, probability of false positive (FP) = 0.333, probability of false negatives (FN) = 0.102, a 0.898 sensitivity and 0.667 specificity. However, by using B-index with a neural network based on the implementation of extended reality values our analysis reaches an accuracy of 91.11% in colorectal cancer diagnosis, with probability of false positive (FP) = 0.472, probability of false negatives (FN) = 0.03%, a 0.9997 sensitivity and 0.7642 specificity. The results suggest a promising role for B-index in colorectal cancer mass screening with an easily available, low cost and non-invasive test.

Biosensor for Point-of-Care Analysis of Immunoglobulins in Urine by Metal Enhanced Fluorescence from Gold Nanoparticles.

Biosensors are easy-to-use and cost-effective devices that are emerging as an attractive tool, not only in settling diagnosis or in disease monitoring, but also in mass screening tests, a timely topic that impacts on daily life of the whole society. Nanotechnologies lend themselves to the development of highly sensitive devices whose realization has become a very interdisciplinary topic. Relying on the enhancement of the fluorescence signal detected at the surface of patterned gold nanoparticles, we report the behavior of an analytical device in detecting immunoglobulins in real urine samples that shows a limit of detection of approximately 8 μg/L and a linear range of 10-100 μg/L well below the detection limit of nephelometric method, which is the reference method for this analysis. These performances have been reached thanks to an effective surface functionalization technique and can be improved even more if superydrophobic features of the substrate we produce will be exploited. Since the analyte recognition is realized by antibodies the specificity is very high and, in fact, no interference has been detected by other compounds also present in the real urine samples. The device has been assessed on serum samples by comparing IgG concentrations values obtained by the biosensor with those provided by a nephelometer. In this step we found that our approach allows the analysis of the whole blood without any pretreatment; moreover, it is inherently extendable to the analysis of most biochemical markers in biological fluids.

Deep Learning-Based Assessment of Cognitive Impairment in Elderly Using General Blood Test

Background: Development of a mass screening test for cognitive impairment is important for preventing onset of dementia. Based on the results of previous studies that cognitive impairment may be caused by systemic disorders, we developed a method of early detection using a deep neural network (DNN) trained on blood test data from health examinations. Methods: We studied a total of 304 subjects (age 72.1± 12.8 years); the cognitive function was assessed by the Mini Mental State Examination (MMSE), while systemic disorders were evaluated by a general blood test. First, we developed trained a DL-based algorithm DNN for predicting the subject's MMSE score based on the blood test data and age of subject in the algorism group in 202 patients with systemic disorders (73.5 ± 13.1years). The accuracy of the trained DL model DNN was first evaluated by leave-one-out cross validation Leave-one-out Cross Validation (LOO CV) in the Algorism group. Next, the trained DL model DNN was validated in the test a second group including 65 patients with systemic disorders (73.6 ± 11.0 year) and 37 healthy subjects (62.0 ± 8.6 years). Results: In the Training Set's LOO CV the leave-one out cross validation, the predicted MMSE scores exhibited a significant positive correlation with ground truth (the measured) -MMSE scores (p<0.001). The trained DNN model exhibited a both high prediction sensitivity and (90%) and specificity scores of (90% ) for two-class binary classification (23/24 cut off) (normal ≥ 24, cognitive impairment ≤23). In Finally, for the Out-of-Sample Set, upon which no training was performed, Test-group, the predicted MMSE scores exhibited a significant positive correlation with the ground truth measured MMSE scores (p<0.001). The DNN model exhibited a high prediction accuracy for the two-classbinary classification, with a sensitivity of 75% and a specificity of 87%. Interpretation: The DL-based algorithm DNN predicted cognitive impairment expressed by MMSE scores with high accuracy. Going forward, The DL-based such AI-based assessment of cognitive impairment may become a mass screening test of cognitive impairment, and contribute to prevention strategies for dementia. Funding: This work was supported in part by Grant-in-Aids from the MEXT (S1411017), JSPS Grant-in-Aid for Young Scientists (B, 16K16077). Declaration of Interest: There are no competing interests in this study. Ethical Approval: The ethical committee in the hospital approved this study.

Sa1036 FOLLOW-UP COLONOSCOPY IN COLORECTAL CANCER SCREENING REMAINS EFFECTIVE AMONG ELDERLY INDIVIDUALS WHO SHOW POSITIVE FIT RESULTS

Both American College of Physicians and U.S. Preventive Services Task Force recommend for people aged 75 and over to consider stopping the screening for colorectal cancer (CRC). But in Japan, there is no guideline about the ages of CRC screening, a lot of people over 75 years are receiving fecal immunochemical test (FIT) for mass screening for CRC, and consequently, a good number of elderly people undergo a follow-up exam, colonoscopy (CS). Because CS has possible severe complications, the follow-up CS among elderly people should contribute to CRC screening no less than among younger people. We investigated the efficacy of the follow-up CS among individuals over 75 years old, by comparing the results of the follow-up CS with those among younger individuals. This retrospective study was carried out in a single center. A total of 1336 subjects (657 men; 679 women) who underwent CS based on the positive result of FIT were enrolled. After dividing them into two groups, over 75 years (group A, 589 subjects) and 75 years or less (group B, 747), the detection rate of CRC, the rate of invasive CRC, treatment methods, CRC sites, and the detection rate of any neoplasm (CRC or adenoma) were determined. χ2 test was used for statistical analysis. The detection rate of CRC showed no significant difference between group A and B (8.8%, 52 out of 589 subjects; 7.5%, 56 out of 747, respectively). However, the rate of invasive CRC was significantly higher in group A than B (69%, 36 out of 52 CRC subjects; 41%, 23 out of 56, respectively, P < 0.005). As a result, 58% in group A needed surgery, on the other hand, 34% in group B underwent surgery (P < 0.015), and the others were endoscopically treated. CRCs were more frequently detected in the right side colon in group A than B (59%, 32 out of total 54 CRC lesions; 28%, 17 out of 61, respectively, P < 0.005). There was no significant difference in the total neoplasm detection rate between group A and B (53%, 312 out of 589 subjects; 55%, 411 out of 747, respectively). Individuals over 75 years who underwent the follow-up colonoscopy showed no significant difference in the detection rates of CRC or neoplasm compared with the younger individuals. However, CRCs detected in the individuals over 75 years were more deeply invasive and were more frequently seen and predominant especially in the right side colon than the younger individuals, where CRC is thought to be more difficult in early detection without any symptoms than in the left side. Taken together, we believe that CRC screening after the age of 75, using FIT and the follow-up CS, may have some efficacy.

POSSIBLE CANINE OLFACTORY DETECTION OF BREAST CANCER

There is presented a possibility of canine otorhologic diagnosis of breast cancer based on presentation of odour material to service dogs: venous blood, urine and sweatfat secretions of female patients. The examination of odour material of ill women and control groups the sensitivity of the test was at the level of 0,94-0,98, specificity of 0,92 and 1,0 the predictive value of a positive result of 0,96-1,0 and negative 0,94-1,0, which significantly exceeded the diagnostic capabilities of mammography. On the basis of otorhologic study of sweatfat secretions there was showed high specificity of identifying patients with breast cancer among some other types of pathology including nodal mastopathy. A possibility of using olfactory capabilities of dogs when organizing mass screening tests is discussed.

Cord Blood Bisphenol A Levels and Reproductive and Thyroid Hormone Levels of Neonates: The Hokkaido Study on Environment and Children's Health.

Bisphenol A (BPA) is widely used and BPA exposure is nearly ubiquitous in developed countries. While animal studies have indicated adverse health effects of prenatal BPA exposure including reproductive dysfunction and thyroid function disruption possibly in a sex-specific manner, findings from epidemiologic studies have not been enough to prove these adverse effects. Given very limited research on human, the aim of this study was to investigate associations between cord blood BPA levels and reproductive and thyroid hormone levels of neonates and whether associations differed by neonate sex. The study population included 514 participants of the Hokkaido study recruited from 2002 to 2005 at one hospital in Sapporo, Japan. The BPA level in cord blood was determined by ID-LC/MS/MS, and the limit of quantification was 0.040 ng/ml. We measured nine types of reproductive hormone levels in cord blood, and thyroid hormone levels were obtained from neonate mass screening test data. There were 283 subjects, who had both BPA and hormone levels measurements, included for the final analyses. The geometric mean of cord blood BPA was 0.051 ng/ml. After adjustment, BPA level was negatively associated with prolactin (PRL) (β = -0.38). There was an interaction between infant sex and BPA levels on PRL; a weak negative association was found in boys (β = -0.12), whereas a weak positive association was found in girls (β = 0.14). BPA level showed weak positive association with testosterone, estradiol, and progesterone levels in boys. No association was found between BPA and thyroid hormone levels. Our findings suggested that fetal BPA levels might be associated with changes in certain reproductive hormone levels of neonates in a sex-specific manner, though further investigations are necessary.

マス・スクリーニング発見腹部神経芽腫群腫瘍に対する腹腔鏡下腫瘍摘出術の経験 : 開腹手術との比較検討

マス・スクリーニング発見腹部神経芽腫群腫瘍に対する腹腔鏡下腫瘍摘出術の経験 : 開腹手術との比較検討