Screening and Early Detection

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Impact of screening and early detection of impaired fasting glucose tolerance and type 2 diabetes in Canada: a Markov model simulation

Impact of screening and early detection of impaired fasting glucose tolerance and type 2 diabetes in Canada: a Markov model simulation

Methods: Using a Markov model simulation, we compare the cost-effectiveness of screening for prediabetes (IFG) and T2DM with the strategy of no screening. An initial cohort of normoglycemic, prediabetic, or undiagnosed diabetic adults with one or more T2DM risk factors was used to model the strategies mentioned over a 10-year period. Subjects without known prediabetes or diabetes are screened every 3 years and persons with prediabetes were tested for diabetes on an annual basis. The model weighs the increase in quality-adjusted life-years (QALYs) associated with early detection of prediabetes and earlier diagnosis of T2DM due to lifestyle intervention and early treatment in asymptomatic subjects.
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Multicenter study of the COPD-6 screening device: feasible for early detection of chronic obstructive pulmonary disease in primary care?

Multicenter study of the COPD-6 screening device: feasible for early detection of chronic obstructive pulmonary disease in primary care?

Methods: In primary care, individuals at high risk of COPD (ie, age $35 years, relevant exposure, and at least one respiratory symptom) and no previous diagnosis of obstructive lung disease were examined with a COPD-6 screening device. In prioritized order, the cri- teria for proceeding to confirmatory spirometry were FEV 1 /FEV 6 ,0.7, FEV 1 ,80%pred, or clinical suspicion of COPD regardless of test result (medical doctor’s [MD] decision). Based on spirometry, including bronchodilator (BD) reversibility test, individuals were clas- sified as COPD (post-BD FEV 1 /FVC ,0.70), asthma (ΔFEV 1 $0.50 L), or no obstructive lung disease.
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Progress towards early detection services for infants with hearing loss in developing countries

Progress towards early detection services for infants with hearing loss in developing countries

staff rely on the existing primary healthcare workers in educating parents on the value of the programme. Funding strategies for infant hearing screening services Most of the pilot projects were privately initiated by researchers and services were offered in public and private hospitals. For programmes implemented in public hospi- tals government funding, if available, was usually limited to providing free screening or for public awareness cam- paigns/materials (Table 2). Data from most of the middle- to-high income countries were scanty and it is most likely that public funding in many of these countries may extend to free diagnostic tests and provision of hearing aids. For instance, a 4-year pilot UNHS programme in Sin- gapore and the emerging national programmes in Chile and Oman are also publicly funded [39,46]. In Nigeria, the UNHS pilot studies at five locations have been funded through a combination of public and private sources including donation or loan of equipment by manufactur- ers. The programme in Nigeria is currently offered at no charge to parents up to the provision of hearing aids through funding support from a local non-governmental organisation. In Brazil, private hospitals may charge between US$25 and US$40 to screen a baby. The cost of screening a baby was generally not reported in most stud- ies and would normally be expected to depend on several factors like the type of equipment used, the model of screening, the level and calibre of personnel conducting the programme and other overhead expenses. In Oman, the cost of screening a baby was estimated as US$7.10. There was no evidence that any of the countries in this review had a national health insurance scheme incorpo- rating hearing screening services, which may indicate that private contributions to health expenditure were predom- inantly derived from out-of-pocket spending by individ- ual health seekers. In addition, it was difficult to establish the cost of post-screening services such as diagnostic tests and fitting of hearing aids. The costs of cochlear implants were reported to vary from US$25,000 to US$30,000 in South Africa but similar information was not readily avail- able in countries such as Brazil, Mexico, Iran, India and China where they are also currently offered.
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Thioredoxin 1 as a serum marker for breast cancer and its use in combination with CEA or CA15 3 for improving the sensitivity of breast cancer diagnoses

Thioredoxin 1 as a serum marker for breast cancer and its use in combination with CEA or CA15 3 for improving the sensitivity of breast cancer diagnoses

Carcinoembryonic antigen (CEA) was first identified in 1965 by Phil Gold and Samuel O. Freedman in human colon cancer tissue extracts [23]. CEA is a glycoprotein involved in cell adhesion [24]. It is normally produced during fetal development, but the production of CEA stops before birth. Therefore, it is not usually present in the blood of healthy adults, although levels are raised in heavy smokers. It was found that serum from individuals with colorectal carcinoma, gastric carcinoma, pancreatic carcinoma, lung carcinoma and breast carcinoma, as well as individuals with medullary thyroid carcinoma, had higher levels of CEA than healthy individuals [25-27]. Analysis of detection of CEA in breast cancer patients leads to that the CEA blood test is not reliable for diagnosing breast cancer or as a screening test for early detection of the cancer especially due to the lack of sensitivity (54.4% for all grades of the cancer from I to III, 30.3% for the grade I) (Figure 4B and Table 5). If the test is not sensitive, then it may miss cancers. Therefore, the CEA breast cancer screening tests miss a large num- ber of patients with breast cancer depicted in Figure 5B. This wrong diagnosis becomes severer in the early- phased patients (grade I) with a sensitivity of 30.3% (Table 5).
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Anti-NMDA receptor encephalitis presenting as an acute psychotic episode misdiagnosed as dissociative disorder: a case report

Anti-NMDA receptor encephalitis presenting as an acute psychotic episode misdiagnosed as dissociative disorder: a case report

Moreover, results of these ancillary tests in patients with isolated psychiatric episodes were similar to the cohort population at large. As early recognition of these epi- sodes and initiation of appropriate therapy was shown to be an important prognostic factor, the authors recom- mended that, in patients with new-onset psychosis, his- tory of encephalitis, subtle neurological symptoms, and abnormal, albeit non-specific, CSF, EEG, or MRI find- ings, prompt screening should be performed for NMDA receptor antibodies and ovarian teratomas when applic- able [9]. In the present case, although the patient was first diagnosed with dissociative disorder at a district general hospital, prompt screening for NMDA receptor antibodies, early detection and removal of the ovarian teratoma, and immunotherapy following surgery were adequately performed at our hospital after transfer.
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Screening for neonatal deafness in resource-poor countries: challenges and solutions

Screening for neonatal deafness in resource-poor countries: challenges and solutions

Abstract: Newborn or neonatal hearing screening (NHS) is offered routinely in high-income countries as an essential and mandatory intervention for the early detection of infants with per- manent congenital or early-onset hearing loss. However, NHS is rarely offered presently in the vast majority of low- and middle-income countries, which account for over 80% of the incidence and burden of permanent congenital or early-onset hearing loss worldwide. This review provides an overview of the current status of NHS programs in the most developmentally disadvantaged low-and middle-income countries with a per capita income of approximately US$6,000 or less against the backdrop of relevant recommendations for effective NHS programs. It highlights the key obstacles to the delivery and uptake of NHS services based on a review of available literature from the eligible countries. It proposes strategies for addressing these challenges and examines the crucial role of pediatricians and primary care physicians in providing leadership for the requisite multidisciplinary efforts to develop and promote effective NHS services in low- and middle-income countries.
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Can pulse oxymetry be used as a routine screening tool in early diagnosis of critical congenital heart diseases in newborns?

Can pulse oxymetry be used as a routine screening tool in early diagnosis of critical congenital heart diseases in newborns?

Authors conclude that pulse oximetry is a non-invasive, reliable, and useful screening tool for an early detection of congenital heart diseases especially cyanotic heart diseases which otherwise misses the attention of the pediatrician. In addition to prenatal ultrasonography and routine clinical examination, further screening with pulse oximetry is warranted to improve early detection of CCCD. The combination of pulse oximetry and clinical judgement is needed in many cases.

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Early screening tool for autism spectrum disorder for visual impairments

Early screening tool for autism spectrum disorder for visual impairments

The issue of screening young children for autism spectrum disorders (ASDs) received increased attention following publication of a report by the American Academy of Pediatrics (AAP) in 2007 (Dough, 2011). However, before adopting screening tests into clinical practice, certain standard criteria should be met. Screening signifies looking for disease in persons without symptoms and should not be confused with diagnosis, which involves testing to confirm disease when it is suspected. A screening test should be easy, accurate, safe, and acceptable. It should detect most cases of disease with minimal false-positive results. A treatment of proven effectiveness should be available, with convincing evidence that early detection in the asymptomatic patient leads to improved, clinically important outcomes compared with later detection, when the condition manifests and the patient is symptomatic. The benefits from detecting the condition in a few patients should also outweigh the harms that can accrue to other patients from false-positive results, unnecessary workups, adverse effects of treatments, and lost opportunities for more meaningful interventions. ASD can sometimes be detected at 18 months or younger. By age 2, a diagnosis by an experienced professional can be considered very reliable. However, many children do not receive a final diagnosis until much older (Lord et al ., 2006). Developmental screening is a short test to tell if children are learning basic skills when they should, or if they might have delays. During developmental screening the doctor might ask the parent some questions or talk and play with the child during an exam to see how she learns, speaks, behaves and moves. A delay in any of these areas could be a sign of a problem.
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Prevention of chronic kidney disease through early detection

Prevention of chronic kidney disease through early detection

The current scenario of global burden of diseases comprise of a triple burden of diseases of which non communicable diseases form a huge proportion. Among the non communicable diseases, chronic tions, accessibility and availability of treatment, especially in developing countries like India. There are a few studies done on prevalence of kidney disease and our programme targets early detection of kidney disease in the form of screening directed at different segments of the society. The screening programme consists of brief history of medical illness, followed by measurement of body mass index and blood pressure and urine examination to look for proteinuria. Our programme identified prehypertension in 38.7% of the population screened and 24.% were identified with proteinuria. Individuals who were above 45 years of age, and those with proteinuria were found to be significantly associated with abnormal serum g programme has proven to be efficient in early detection of kidney diseases in the population and has also proven to be cost effective in a country like India where
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Recent Trends in Medical Imaging Modalities and Challenges for Diagnosing Breast Cancer

Recent Trends in Medical Imaging Modalities and Challenges for Diagnosing Breast Cancer

Although Mammography still remains the gold standard for detecting breast cancer, it is still criticized for its effectiveness. There is a need for an imaging modality such that it is free from radiation risk, pain and anxiety, false alarm and non-invasive. Early detection of breast cancer thus necessitates so that treatments are more effective. Ultrasound, Breast MRI and other imaging modalities diagnosis muscle density, fluids and masses. Whereas breast thermography evaluates aberrant thermal emissions on the surface of the body due to increased blood vessel circulation and metabolic changes associated with infection. Since the temperature of cancerous tissues is generally higher than that of healthy tissues, thermograms have been considered a promising screening method for early detection of breast cancer by generating thermograms. PET- CT also plays an important role in staging breast cancer and monitoring treatment response but using ionizing radiations. These imaging modalities used in adjuncts to mammography enhance the ability to detect cancer and assess treatment planning and staging. There is a need for an imaging modality such that it is free from radiation risk, pain and anxiety, false alarm and non-invasive. Early detection of breast cancer thus necessitates so that treatments are more effective and decrease mortality rate.
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Congenital heart disease: role of RBSK in reduction of morbidity & mortality in children in Kolhapur

Congenital heart disease: role of RBSK in reduction of morbidity & mortality in children in Kolhapur

Rashtriya Bal Swasthya Karyakram (RBSK), a Screening and early intervention services programme to all the children in the community. The objective of RBSK is to improve the quality of life of children through early detection of birth defects, diseases, deficiencies, development delays and disability. The high burden of these ill health contributes significantly to child mortality, morbidity and out of pocket expenditure of the poor families. This initiative ensures covers of all expenditures of the eligible families related to child health right from birth [6] .
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Advantages, limitations, and diagnostic accuracy of photoscreeners in early detection of Amblyopia: a review

Advantages, limitations, and diagnostic accuracy of photoscreeners in early detection of Amblyopia: a review

Abstract: Amblyopia detection is important to ensure proper visual development and avoid permanent decrease of visual acuity. This condition does not produce symptoms, so it is dif- ficult to diagnose if a vision problem actually exists. However, because amblyopia treatment is limited by age, early diagnosis is of paramount relevance. Traditional vision screening (con- ducted in ,3 years) is related with difficulty in getting cooperation from a subject to conduct the eye exam, so accurate objective methods to improve amblyopia detection are necessary. Handheld devices used for photoscreening or autorefraction could offer advantages to improve amblyopia screening because they reduce exploration time to just few seconds, no subject collaboration is needed, and they provide objective information. The purpose of this review is to summarize the main functions and clinical applicability of commercially available devices for early detection of amblyopia and to describe their differences, advantages, and limitations. Although the studies reviewed are heterogeneous (due to wide differences in referral criteria, use of different risk factors, different types of samples studied, etc), these devices provide objective measures in a quick and objective way with a simple outcome report: retest, pass, or refer. However, due to major limitations, these devices are not recommended, and their use in clinical practice is limited.
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Dipstick urine analysis for detection of renal abnormalities among school children

Dipstick urine analysis for detection of renal abnormalities among school children

Early detection and prevention are important in clinical practice to help overcome the burden of the financial resources required for dialysis and transplant in kidney disease children. These facilities are not available at most centres in developing countries especially for younger children. Thus, school urinary screening program may have a long-term impact in reducing the burden of renal disease in children.

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KNOWLEDGE, ATTITUDES AND PRACTICES TOWARDS BREAST CANCER SCREENING PROGRAMS AMONG IRANIAN RURAL FEMALE POPULATIONS IN NORTH OF IRAN

KNOWLEDGE, ATTITUDES AND PRACTICES TOWARDS BREAST CANCER SCREENING PROGRAMS AMONG IRANIAN RURAL FEMALE POPULATIONS IN NORTH OF IRAN

Knowledge Related to Breast Cancer and BSE Complete awareness about risk factors, symptoms, early detection methods of breast cancer, and correct performance of BSE, was noted in 47.6%, 32.1%, 26.5%, and 25.4%, respectively, of participants. Respondent knowledge of breast cancer screening programs bordered on the unsatisfactory, as the range of correct responses varied from 12.9% to 65.1%, and knowledge of breast cancer screening programs was acceptable in 8.6%, low in 57.6%, poor in 33.8%, and unacceptable in 0.1% . Table 2 shows the percentages of participants endorsing knowledge items related to breast cancer screening programs. There were also significant differences relative to demographic participant characteristics on most knowledge items. (Data are not shown, but available from the corresponding author). Complete awareness about risk factors for breast cancer, signs and symptoms of breast cancer, early detection of breast cancer, and correct performance of BSE, was noted respectively in 47.6%, 32.1%, 26.5%, and 25.4% of rural women. Respondent knowledge of breast cancer and BSE is unsatisfactory. In rural women, knowledge of breast cancer prevention was acceptable in 0.6%, low in 47.2%, poor in 52%, and unacceptable in 0.3%. Table 2 shows the percentages of participants endorsing each breast cancer- and BSE-specific knowledge item.
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Early detection and early intervention in prison : improving outcomes and reducing prison returns

Early detection and early intervention in prison : improving outcomes and reducing prison returns

Early detection and intervention in the community has been shown to be effective in reducing psychopathology (van der Gaag et al., 2013) and improving long term outcome (Valmaggia et al., 2015), as well as reducing the long term costs of care (Jarrett et al., 2012; Valmaggia et al., 2009). Recent research demonstrated that early detection screening is feasible in a prison setting, with 5% of those screened meeting criteria for Ultra High Risk for psychosis (UHR) (Jarrett et al., 2012). In the community, the longitudinal course of the UHR is highly heterogeneous (Rutigliano et al., 2016) and UHR has been found to be associated with a with an 36% risk of transition to psychosis after three years (Fusar-Poli et al., 2012), a risk which is the highest within the first two years since initial assessment (Kempton, Bonoldi, Valmaggia, McGuire, & Fusar-Poli, 2015).
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A Survey on early stage detection of Microaneurysms

A Survey on early stage detection of Microaneurysms

Detection of retinal hemorrhages helps to progress an automatic screening system which may promptly detect sight-threatening DR and eye disease [26]. Early detection and diagnosing aids in prompt treatment.Such an automated diagnostic tools are going to be notably useful in health camps particularly in rural areas in developing countries wherever an outsized population laid low with these diseases goes unknown. Automated detection of lesions in retinal images may be a crucial step towards economical early detection, or screening, of enormous at- risk populations, especially, the detection of microaneurysms, typically the first primary symptom of diabetic retinopathy (DR), and also the detection of drusen, the hallmark of age-related degeneration area unit of primary importance. Automated detection of diabetic retinopathy (DR) is very important for permitting timely treatment, and thereby increasing accessibility to and productivity of eye care suppliers. Some of the methodologies have been described for detection of microaneurysms.
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Cancer screening in Australia: future directions in melanoma, Lynch syndrome, and liver, lung and prostate cancers

Cancer screening in Australia: future directions in melanoma, Lynch syndrome, and liver, lung and prostate cancers

While Australia now has well-established national screening programs for breast, bowel and cervical cancers, research continues into the feasibility of developing systematic screening programs for a number of other cancers. In this paper, experts in their fields provide perspectives on the current state of play and future directions for screening and surveillance for melanoma, Lynch syndrome, and liver, lung and prostate cancers in Australia. Although the evidence does not support population screening, there may be opportunities to prevent thousands of deaths through systematic approaches to the early detection of lung cancer and melanoma, testing for Lynch syndrome, and organised surveillance for hepatocellular carcinoma among individuals at high risk – guided by targeted research. The paper also looks at what impact new prostate specific antigen testing guidelines are having on screening for prostate cancer.
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A Cluster-Randomized Trial of Screening for Language Delay in Toddlers: Effects on School Performance and Language Development at Age 8

A Cluster-Randomized Trial of Screening for Language Delay in Toddlers: Effects on School Performance and Language Development at Age 8

child health center physician in the intervention group interviewed the parents who routinely visited the child health center with their child, which took ⬃ 5 minutes. The complete screening procedure embraced a screening interview at 15/18 months as well as at 24 months. The final score was obtained by adding the scores on both screenings, which ranged between 0 and 7. When chil- dren had a final score of ⱕ 2, they were referred to the general practitioner for additional assessment at a speech and hearing center to confirm language delay and, if so, to assess the underlying causes. 6 This was done by a
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Visual-spatial perception: a comparison between instruments frequently used in the primary care setting and a computerized cognitive assessment battery

Visual-spatial perception: a comparison between instruments frequently used in the primary care setting and a computerized cognitive assessment battery

The study population included patients older than 65 years referred by the primary care physician for geriatric assessment. The assessment battery included the following components: 1) Demographics, including age, gender, and education level. 2) History and examination, with emphasis on medical history and physical examination, drug therapy, laboratory and other investigations (available via the com- puterized medical record system), psychosocial assessment, and nutritional status. 3) Depression screening by Patient Health Questionnaire. 18 4) Basic Activity of Daily Living. 19,20
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Detection of architectural distortion using multilayer back
propagation neural network

Detection of architectural distortion using multilayer back propagation neural network

Mammograms taken at prescribed intervals fail to curtail the vast occurrence of breast cancers. One foremost cause is that at the initial stages where there are only minor symptoms visible in a mammogram chances are that it could be overlooked during perusal. There are many signs of breast cancer like Calcification, Masses, Bilateral Asymmetry and Architectural Distortion. Architectural Distortion may be associated with early diagnosis of breast cancer because even before there is a visible mass, cancer growth can disrupt parenchyma structure. Double reading of screening mammograms could provide higher sensitivity over single reading, but the limitation on time and trained professionals makes it a not so possible approach. Algorithms are developed to assist radiologists in detecting abnormalities in mammograms. In this paper, a system is developed to classify Architectural Distortion abnormality from normal mammogram samples. Gabor features along with Law’s Texture Energy measures derived from geometrically transformed regions of interests are used to detect architectural distortion. The method has a good potential in detecting architectural distortion in mammograms of interval cancer cases.
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