screening

筛选
  • 文章类型: Journal Article
    目的:这项研究评估了2019年至2021年美国(US)血糖检测的变化。
    方法:我们对2019-2021年全国健康访谈调查进行了连续横断面分析,包括18岁以上未报告诊断为糖尿病的成年人。我们估计了12个月内血糖检测的患病率以及2019年至2021年之间检测患病率的差异。
    结果:研究样本包括2019-2021年的82,594名没有糖尿病的受访者,平均年龄在46.4至46.8岁之间。总的来说,血糖检测的患病率从64.2%显著下降(95%置信区间[CI]63.3%,65.1%)2019年至60.0%(95%CI59.1%,60.9%),2021年。在符合美国预防服务工作组2015年筛查建议的成年人中,患病率从73.4%下降(95%CI72.2%,74.6%)至69.5%(95%CI68.3%,70.6%)。尽管在大多数组中观察到测试减少,下降的程度因亚组而异。
    结论:在COVID-19大流行期间,美国的血糖检测降低。这可能会延迟糖尿病前期和糖尿病的诊断和治疗,强调在大流行期间继续获得糖尿病筛查的重要性。
    OBJECTIVE: This study assessed changes in testing for blood glucose in the United States (US) from 2019 to 2021.
    METHODS: We conducted a serial cross-sectional analysis of the 2019-2021 National Health Interview Survey by including adults aged ≥ 18 years without reported diagnosed diabetes. We estimated the prevalence of testing for blood glucose within 12 months and the difference in the testing prevalence between 2019 and 2021.
    RESULTS: The study sample included 82,594 respondents without diabetes in 2019--2021, with a mean age between 46.4 and 46.8 years. Overall, the prevalence of testing for blood glucose decreased significantly from 64.2 % (95 % confidence interval [CI] 63.3 %, 65.1 %) in 2019 to 60.0 % (95 % CI 59.1 %, 60.9 %) in 2021. Among adults who met the United States Preventive Services Task Force\'s 2015 screening recommendation, the prevalence decreased from 73.4 % (95 % CI 72.2 %, 74.6 %) to 69.5 % (95 % CI 68.3 %, 70.6 %). Although decreases in testing were observed in most groups, the extent of the decline differed by subgroups.
    CONCLUSIONS: Testing for blood glucose decreased in the US during the COVID-19 pandemic. This may have delayed diagnosis and treatment of prediabetes and diabetes, underscoring the importance of continued access to diabetes screening during pandemics.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    尿路致病性大肠杆菌,尿路感染最常见的原因,形成生物膜增强其抗生素抗性。评价化合物对尿路致病性大肠杆菌UMN026菌株生物膜形成的影响,本研究针对384孔微孔板优化了使用刃天青素,然后进行结晶紫染色的高通量组合试验.优化的测定参数包括,例如,刃天青和结晶紫的浓度,和读数的孵化时间。对于测定验证,质量参数Z'因子,变异系数,信噪比,并计算信号到背景。微孔板均匀性,信号变异性,边缘阱效应,和折移也进行了评估。最后,使用已知的抗菌化合物进行筛选以评估测定性能。发现的最佳条件是使用12μg/mL白天青150分钟和0.023%结晶紫。该测定法能够检测在亚抑制浓度下对UMN026菌株显示抗生物膜活性的化合物,在代谢活性和/或生物量方面。
    Uropathogenic Escherichia coli, the most common cause for urinary tract infections, forms biofilm enhancing its antibiotic resistance. To assess the effects of compounds on biofilm formation of uropathogenic Escherichia coli UMN026 strain, a high-throughput combination assay using resazurin followed by crystal violet staining was optimized for 384-well microplate. Optimized assay parameters included, for example, resazurin and crystal violet concentrations, and incubation time for readouts. For the assay validation, quality parameters Z\' factor, coefficient of variation, signal-to-noise, and signal-to-background were calculated. Microplate uniformity, signal variability, edge well effects, and fold shift were also assessed. Finally, a screening with known antibacterial compounds was conducted to evaluate the assay performance. The best conditions found were achieved by using 12 µg/mL resazurin for 150 min and 0.023% crystal violet. This assay was able to detect compounds displaying antibiofilm activity against UMN026 strain at sub-inhibitory concentrations, in terms of metabolic activity and/or biomass.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    肝内胆管癌(iCCA)是第二常见的恶性原发性肝癌。iCCA可能在潜在的慢性肝病上发展,其发病率与肥胖和代谢性疾病的流行有关。相比之下,肝门部胆管癌(pCCA)可能伴随着胆道慢性炎症性疾病的病史。CCA的初始管理通常很复杂,需要多学科的专业知识。法国肝脏研究协会希望组织指南,以便总结关于iCCA和pCCA几个关键点的最佳证据。这些指南是根据文献中现有的证据水平制定的,并对每项建议进行了分析,由专家小组讨论和投票。他们描述了CCA的流行病学以及从诊断到治疗如何管理iCCA或pCCA患者。还强调了个性化医学和靶向疗法的使用的最新发展。
    Intrahepatic cholangiocarcinoma (iCCA) is the second most common malignant primary liver cancer. iCCA may develop on an underlying chronic liver disease and its incidence is growing in relation with the epidemics of obesity and metabolic diseases. In contrast, perihilar cholangiocarcinoma (pCCA) may follow a history of chronic inflammatory diseases of the biliary tract. The initial management of CCAs is often complex and requires multidisciplinary expertise. The French Association for the Study of the Liver wished to organize guidelines in order to summarize the best evidence available about several key points in iCCA and pCCA. These guidelines have been elaborated based on the level of evidence available in the literature and each recommendation has been analysed, discussed and voted by the panel of experts. They describe the epidemiology of CCA as well as how patients with iCCA or pCCA should be managed from diagnosis to treatment. The most recent developments of personalized medicine and use of targeted therapies are also highlighted.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    背景:这项研究的目的是确定荷兰助产士的态度,在荷兰,妇科医生和全科医生(GP)致力于参与产前宫颈癌筛查(CCS)。
    方法:2021年,荷兰助产士,妇科医生,并向全科医生提供了一份评估感知可行性的数字问卷,好处,产前CCS的危害。
    结果:共发送了6943份问卷,应答率为18%(N=1260)。在所有受访者中,78%的人认为通过产科护理提供者进行产前CCS是可行的。大多数受访者(85%)同意亲自提供CCS可以增加参加的动机。大多数助产士(93%)认为,如果由产科服务提供者进行宫颈取样,妇女会感到负担较少,而不是GP。
    结论:结果表明,大多数荷兰助产士认为引入产前CCS是可行的,妇科医生,和GP。考虑的好处包括提高参加的动机和减少与测试相关的障碍。
    BACKGROUND: The aim of this study was to determine attitude of Dutch midwifes, gynecologists and general practitioners (GPs) towards involvement in antenatal cervical cancer screening (CCS) in the Netherlands.
    METHODS: In 2021, Dutch midwives, gynecologists, and GPs were offered a single digital questionnaire assessing perceived feasibility, benefits, and harms of antenatal CCS.
    RESULTS: A total of 6943 Questionnaires were send and response rate was 18% (N = 1260). Of all respondents, 78% considered antenatal CCS via obstetric care providers feasible. Most respondents (85%) agreed that offering CCS in person can increase motivation to attend. Most midwives (93%) considered that women would feel less encumbered if cervical sampling would be performed by obstetric care providers, rather than by GPs.
    CONCLUSIONS: Results indicate that introduction of antenatal CCS is considered feasible by a majority of Dutch midwifes, gynecologists, and GPs. Considered benefits include improved motivation to attend and reduced test related barriers.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    The S3 Guideline on the Treatment of Language Development Disorders: Summary of Recommendations Abstract: The German S3 Guidelines on the Treatment of Developmental Speech and Language Disorders (AWMF: No. 049-015) were published on the AWMF homepage at the end of 2022. The German Society for Phoniatrics and Paedaudiologie coordinated the work and developed the guideline text together with linguists and speech and language therapists. Many scientific medical societies consented to the respective recommendations. For the first time in the German-speaking area, the guideline group reviewed international research results on the treatment of various speech and language disorders and formulated evidence- or consensus-based recommendations for clinical care. The present article summarizes these recommendations and evaluates the guidelines from the perspective of child and adolescent psychiatry and psychotherapy.
    Zusammenfassung: Die S3-Leitlinie zur Therapie von Sprachentwicklungsstörungen (AWMF: Nr. 049-015), die Ende 2022 auf der Homepage der AWMF veröffentlich wurde, ist unter Federführung der Deutschen Gesellschaft für Phoniatrie und Pädaudiologie in Kooperation mit zahlreichen Sprachwissenschaftler_innen und Sprachtherapeut_innen entwickelt und von zahlreichen wissenschaftlichen medizinischen Fachgesellschaften konsentiert worden. Die Leitliniengruppe hat erstmalig für den deutschen Sprachraum versucht, die internationale Studienlage zur Therapie unterschiedlicher Sprach- und Sprechstörungen aufzuarbeiten und darauf basierend Evidenz- oder auch Konsensus-basierte Empfehlungen für die klinische Versorgung zu formulieren. In dem vorliegenden Artikel werden diese Empfehlungen zusammenfassend dargestellt, und es wird eine Wertung der Leitlinie aus Kinder- und Jugendpsychiatrischer Sicht vorgenommen.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    目的:确定射血分数(EF)保留的发生心力衰竭(HF)风险较高的受试者适用于更密集的预防计划仍然具有挑战性。我们将表型应用于DAVID-Berg种群,包括患有临床前HF的受试者,旨在完善HF风险分层。
    方法:DAVID-Berg研究前瞻性纳入596例无症状门诊患者,EF>40%合并高血压,糖尿病或已知的心血管疾病。在这个队列中,我们对591名患者进行了无监督聚类分析,包括临床,实验室,心电图和超声心动图参数。我们测试了每个集群与HF/死亡的复合结果之间的关联。
    结果:中位年龄为70岁,55.5%为男性,中位EF为61.0%。现象映射提供了三个不同的集群。第3组中的受试者年龄最大,房颤患病率最高,最低估计肾小球滤过率(eGFR),最高的N末端脑钠肽前体(NT-proBNP)和最大的左心房。在5.7年的中位随访期间,13.4%的受试者经历HF/死亡事件(N=79)。与集群1和集群2相比,集群3的预后最差(对数秩检验:集群3与1P<0.001;第3组vs.2P=0.008)。第3组的HF/死亡风险比第1组的高2.5倍[校正风险比(HR)=2.46,95%置信区间(CI)1.24-4.90]。
    结论:基于表型,肾功能较低且舒张功能较差的老年患者可能是临床前HF的一个亚组,EF>40%,值得更多努力预防临床HF.
    OBJECTIVE: The identification of subjects at higher risk for incident heart failure (HF) with preserved ejection fraction (EF) suitable for more intensive preventive programmes remains challenging. We applied phenomapping to the DAVID-Berg population, comprising subjects with preclinical HF, aiming to refine HF risk stratification.
    METHODS: The DAVID-Berg study prospectively enrolled 596 asymptomatic outpatients with EF > 40% with hypertension, diabetes mellitus or known cardiovascular disease. In this cohort, we performed an unsupervised cluster analysis on 591 patients, including clinical, laboratory, electrocardiographic and echocardiographic parameters. We tested the association between each cluster and a composite outcome of HF/death.
    RESULTS: The median age was 70 years, 55.5% were males and the median EF was 61.0%. Phenomapping provided three different clusters. Subjects in Cluster 3 were the oldest and had the highest prevalence of atrial fibrillation, the lowest estimated glomerular filtration rate (eGFR), the highest N-terminal pro-brain natriuretic peptide (NT-proBNP) and the largest left atrium. During a median follow-up of 5.7 years, 13.4% of subjects experienced HF/death events (N = 79). Compared with Clusters 1 and 2, Cluster 3 had the worst prognosis (log-rank test: Cluster 3 vs. 1 P < 0.001; Cluster 3 vs. 2 P = 0.008). Cluster 3 was associated with a risk of HF/death 2.5 times higher than Cluster 1 [adjusted hazard ratio (HR) = 2.46, 95% confidence interval (CI) 1.24-4.90].
    CONCLUSIONS: Based on phenomapping, older patients with lower kidney function and worse diastolic function might represent a subset of preclinical HF with EF > 40% who deserve more efforts to prevent clinical HF.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    结核病仍然是一个重大的全球卫生挑战。结核病影响全世界数百万人。结核病的早期发现在结核病的治疗管理中起着重要作用。本系统综述将分析几个已发表的关于早期发现结核病的研究结果。本系统综述强调了他们的方法和局限性,以及他们对我们理解这一紧迫问题的贡献。早期发现结核病可以通过结核病筛查接触者来实现。家庭接触者的全面健康教育可作为早期发现。内部深度学习模型可用于结核病自动检测的X射线。干扰素γ释放试验,常规被动和主动病例检测,便携式X射线和核酸扩增检测,和高度敏感的酶联免疫吸附试验在提高结核病检测中起着关键作用。
    Tuberculosis remains a significant global health challenge. Tuberculosis affects millions of individuals worldwide. Early detection of tuberculosis plays a relevant role in the management of treatment of tuberculosis. This systematic review will analyze the findings of several published studies on the topic of the early detection of tuberculosis. This systematic review highlights their methodologies and limitations as well as their contributions to our understanding of this pressing issue. Early detection of tuberculosis can be achieved through tuberculosis screening for contacts. Comprehensive health education for household contacts can be used as early detection. The in-house deep learning models can be used in the X-ray used for automatic detection of tuberculosis. Interferon gamma release assay, routine passive and active case detection, portable X-ray and nucleic acid amplification testing, and highly sensitive enzyme-linked immunosorbent assay tests play critical roles in improving tuberculosis detection.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    背景:COVID-19大流行对全球医疗保健系统和除直接受病毒影响的个体以外的个体都有负面缺陷。文献中已经报道了癌症治疗和诊断的延迟。我们假设在我们中心对肺癌患者有类似的影响。
    方法:我们回顾性分析了2018年至2022年转诊到我们中心的新诊断肺癌患者的数据。我们考虑了从多学科肿瘤委员会的病例介绍或从治疗医师到治疗开始的治疗指征(手术,全身治疗和放疗)来定义诊断和治疗的延迟。
    结果:从2018年至2022年,1020例新诊断的肺癌患者被转诊到我们中心,每年的中位数为206例(范围:200-208)。2020-2022年IV期病例显著高于2018-2019年(57%与46%,p=0,001)。在2018年至2022年之间进行了228次手术切除,在2018年1月至2020年2月进行了100次手术切除,在2020年3月至2022年12月进行了128次手术切除。大流行开始后,从我们的肿瘤委员会到切除的中位时间也明显长于以前(22天vs.15,5天,p=0,013)。没有观察到全身治疗的施用和放射的开始的显著延迟。
    结论:在大流行期间,肺癌患者的疾病分期较高,但没有临床相关的治疗延迟.在后covid时代的背景下,新的诊断策略对于促进肺癌的早期诊断是必要的。尽管大流行,对于有可疑症状的患者,及时进入医疗机构对早期诊断至关重要。
    BACKGROUND: The COVID-19 pandemic has had negative drawbacks on the healthcare system worldwide and on individuals other than those directly affected by the virus. Delays in cancer therapy and diagnosis have been reported in the literature. We hypothesized similar effects on patients with lung cancer at our center.
    METHODS: We retrospectively analyzed data of patients referred to our center with newly diagnosed lung cancer from 2018 to 2022. We considered distribution of UICC Stages and time from case presentation in our multidisciplinary tumor board or from therapeutic indication from treating physician to therapy initiation (surgery, systemic therapies and radiation) to define delays in diagnosis and treatment.
    RESULTS: 1020 patients with newly diagnosed lung cancer were referred to our center from 2018 to 2022, with a median of 206 cases yearly (range: 200-208). Cases with Stage IV in 2020-2022 were significantly higher than in 2018-2019 (57% vs. 46%, p = 0,001). 228 operative resections took place between 2018 and 2022, 100 from January 2018 to February 2020 and 128 from March 2020 to December 2022. Median time from presentation in our tumor board to resection was also significantly longer after the beginning of the pandemic than before (22 days vs. 15,5 days, p = 0,013). No significant delays were observed for administration of systemic treatment and initiation of radiation.
    CONCLUSIONS: During the pandemic higher disease stages were reported for patients with lung cancer, yet there were no clinically relevant delays in treatment. In the context of the post-covid era new diagnostic strategies are necessary to facilitate early diagnosis of lung cancer. Despite the pandemic, for patients with suspicious symptoms prompt access to healthcare facilities is essential for early diagnosis.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    背景:2011年7月,爱尔兰的新生儿血斑筛查计划中增加了囊性纤维化(CF)。爱尔兰比较结果研究(ICOS)是一项历史队列研究,旨在比较临床检测和筛查检测的CF儿童之间的结果。在这里,我们提供了经济分析的结果,比较了2008年中期至2016年中期出生的儿童在CF跨膜电导调节因子前2年的直接医疗保健成本。
    方法:医疗资源使用信息来自爱尔兰囊性纤维化注册中心(CFRI),医疗记录和家长问卷。入院,急诊部门的访问,门诊预约,包括抗生素和维持药物治疗.费用是使用卫生服务执行官Casemix估算的,爱尔兰药品处方集和医院药房数据,使用中央统计局的消费者价格指数数据对通货膨胀进行了调整。使用负二项回归,用研究中的时间作为偏移。
    结果:总体参与率为93%。排除胎粪肠梗阻后,来自139名患者的数据,随访至2岁,可用。72例(51.8%)来自临床诊断队列。在最终模型中(n=105),临床诊断的儿童每年的费用增加2.62倍(p<0.0001),当针对混杂因素进行调整时,包括纯合ΔF508或G511D突变,社会人口统计学因素以及诊断与首次CFRI相互作用之间的时间。
    结论:很少有研究使用常规护理数据评估新生儿筛查CF的经济方面。这些结果表明,新生儿筛查的好处扩展到国家承担的直接医疗费用。
    BACKGROUND: In July 2011, Cystic Fibrosis (CF) was added to the Newborn Bloodspot Screening Programme in Ireland. The Irish Comparative Outcomes Study (ICOS) is a historical cohort study established to compare outcomes between clinically-detected and screen-detected children with CF. Here we present the results of economic analysis comparing direct healthcare costs in the first 2 years of life of children born between mid-2008 and mid-2016, in the pre-CF transmembrane conductance regulator modulator era.
    METHODS: Healthcare resource use information was obtained from Cystic Fibrosis Registry of Ireland (CFRI), medical records and parental questionnaire. Hospital admissions, emergency department visits, outpatient appointments, antibiotics and maintenance medications were included. Costs were estimated using the Health Service Executive Casemix, Irish Medicines Formulary and hospital pharmacy data, adjusted for inflation using Consumer Price Index data from the Central Statistics Office. A Negative Binomial regression was used, with time in the study as an offset.
    RESULTS: Overall participation was 93 %. After exclusion of those with meconium ileus, data from 139 patients, with follow-up to 2 years of age, were available. 72 (51.8 %) were from the clinically diagnosed cohort. In the final model (n=105), clinically diagnosed children had 2.62-fold higher costs per annum (p<0.0001), when adjusted for confounders, including homozygous ΔF508 or G511D mutation, socio-demographic factors and time between diagnosis and first CFRI interaction.
    CONCLUSIONS: There are few studies evaluating economic aspects of newborn screening for CF using routine care data. These results imply that the benefits of newborn screening extend to direct healthcare costs borne by the State.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    背景:骨质疏松症是一个普遍关注的问题,特别是在老龄化人群中,导致骨折风险增加,包括与髋关节和膝关节置换术相关的手术。骨质疏松症筛查,尤其是双X射线吸收法(DXA)扫描,对于早期发现和管理至关重要。
    目的:本研究旨在评估65岁及以上在单一健康网络中接受选择性全髋关节置换术(THA)或全膝关节置换术(TKA)的患者对骨质疏松症筛查指南的依从性。还探讨了影响筛查依从性的因素。
    方法:对2019年1月至2023年1月期间接受选择性THA或TKA的2,160例患者进行了回顾性图表回顾。人口统计数据,骨质疏松症筛查状态,并对假体周围骨折的发生情况进行分析。统计分析包括描述性统计和卡方检验。
    结果:只有24.1%的合格患者在手术前接受了DXA扫描。女性比男性更有可能接受筛查,种族也与筛查状态相关.共发现45例假体周围骨折,骨质疏松状态之间没有显著的相关性,DXA筛查,和骨折的发生。
    结论:在所研究的健康网络中,接受选择性全关节置换术的老年患者对骨质疏松症筛查指南的依从性仍然很低。尽管在这项研究中,筛查和骨折发生之间缺乏相关性,强调高危患者筛查和潜在优化的重要性.需要进一步的研究来评估与选择性老年全关节患者骨健康筛查和管理中不同护理途径相关的结果。
    BACKGROUND: Osteoporosis is a prevalent concern, particularly among aging populations, leading to increased risk of fractures, including those related to hip and knee arthroplasty procedures. Screening for osteoporosis, especially with dual X-ray absorptiometry (DXA) scans, is crucial for early detection and management.
    OBJECTIVE: This study aimed to assess adherence to osteoporosis screening guidelines among patients aged 65 and older undergoing elective total hip arthroplasty (THA) or total knee arthroplasty (TKA) within a single health network. Factors influencing screening adherence were also explored.
    METHODS: A retrospective chart review of 2,160 patients undergoing elective THA or TKA between January 2019 and January 2023 was conducted. Demographic data, osteoporosis screening status, and occurrence of periprosthetic fractures were analyzed. Statistical analysis included descriptive statistics and chi-square tests.
    RESULTS: Only 24.1 % of eligible patients underwent a DXA scan prior to surgery. Females were more likely to undergo screening than males, and race was also associated with screening status. A total of 45 periprosthetic fractures were identified, with no significant correlation between osteoporosis status, DXA screening, and fracture occurrence.
    CONCLUSIONS: Adherence to osteoporosis screening guidelines among geriatric patients undergoing elective total joint arthroplasty remains low within the studied health network. Despite the lack of correlation between screening and fracture occurrence in this study, the importance of screening and potential optimization in high-risk patients is emphasized. Further research is needed to assess outcomes associated with different care pathways in bone health screening and management for elective geriatric total joint patients.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

公众号